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Boston Medical Library

8 THE FENWAY

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fik

tf HE

A MONTHLY MAGAZINE OF

HOMCEOPATHIC MEDICINE,

PUBLISHED AT THE

UiNlVERSlTY OF MICHIGAN.

EDITOKS. T. P. WILSON, PHIL PORTER, M. D.,

MANAGING EDITOR. GYNECOLOGICAL EDITOR.

H. C. ALLEN, M. D.,

BUSINESS MANAGER.

VOL. XIV.

ANN AKBOR, MICIL:

ADVANt^E PUBLISHING t'OMPANY,

1884.

CONTRIBUTORS TO VOL. XIV.

Page

ALLEN. H. C 168, 386. 486, 467

ANDBBSO^{. J. C 818

Baer, O. P 219,675

Blatchlev, O. P 488

Bradley, Benjamin A 658

Bbioham. G. N.: 801

Beoderice. H. M 547

Brown, J. F„ 822

Bdrchfield, S. E 270

Burnett, J. C.« 405

Camp, a. A 571

Carroll, C. W 446

Church, (^ab. A 679

Clausen, Daniel W 92

Tleveland, C. L 41

Day, F. R 530

Dever 1 385

Dickenson, D. M ..547,

DISBRO, J. W 187i

DOWLING, J. W ....-..'..'OOd ^

Eaton, C. W 342

Eaton. M. M 122

Edgar, J. F 291

Eggleston, E. R 431. 470-

Ehrmann, Benjamin 654

Ellis, E. R 553

Ely, J. W 209

Fackler, J. M 420

Fahnestock, C. S 198

FoexER, W. D 895

Geppert, J.P 244

Gilbert, C. B 271, 316. 888

Gregg, R. R, 40, 228, 283, 488. 618, 664

Guernsey, W. J 827, 570

Guernsey, H. M 334, 659

Haggart. D 680

Hall, Lucy, M 285

Hazard, T. L 381

Helminth, Wm. Tod 499, 429

Hill, W. D 204

HOLMANN, E. E. 157

Hoyt, C 44, 78, 178

Hupp, U. C 518

Hunt, B. 8 191

Hunt, M. P 198

Johnson, R. B.. 267

Kent, J. T.„.248, 249, 252, 878 476. 569, 601

Page

KUNKBL. Dr 247, 421, 635

Lee, E. J 584

LiLl^NTHAL, 8 324, 451. 460

LiPPE. AD 867. 425. 539, 662

Lowe, J N 74, 394. 449

Macfarlan, Malcolm 210

Mahoney, Edward 656

Mo88,0. B „.. 294

McDermott, G. C 273

McNeil, A — 86, 93, 243, 864, 421, 435, 598

Mills, M. M 131

JVflLLSPAUGH, C. F., 148

MoRDEN, Ralph 387

Morrow, D. B 482

Morton, T 498

Ormb, F. H.. 448

Patchen, G. H 411

Phillips. W. A 142, 183

J>olhemub, W. p. 215

Porter, Phil., 38. 150, 213, 281, 353, 409 r 496. 545, 620. 673

Richards, L. B , 661

Ring, H 156

t BERTS. John B 491 ckwell, j. w 612 rabacher M 299

Ryall.»T 76, 489

Sanders. J. C 87

Sherwood, H. A 152

Sturois, J. J 154

Sturevant. L. P 329

Swan, Samuel. „..„ 461

Talcott, S. H. 595

Taylor, Tmos 895, 526

TRICH.J. C 825

Tbites, W. B 371

Wakler, W. W 82

Walton, C. E 176

Webster, J. K 140

Weboter, w 178

Wheeler, A. R lOl

Wilson, C. G 266

Wilson. T. P.. 57, 113, 114, 169. 170, 228

229, 408, 427, 523, 525, 582, 579, 609, 635, 636

Wood, J. B „.. 567

YOUNQHUSBAND, L 63?

INDEX TO VOL. XIV.

Acid Salicylic as a dressing for lacer- ated wounds 138

Aconite in cbronlc conditions 316

Acate suppuratlTe inflammation of

middle ear ^ 142. 183

Advice, some good 408

Alcohol and lungdisease 498

Alcohol as a remedy ^ 377

Alcoholism, chronic ^ 148

Allopathic poverty 364

Allopathic similarity „ 41

American institute »4. 168, 886

Amen - 49

Amenorrhoea, manganese 106

Ambrosia proving 157

Anatomy, Bureau of (Ohio State So- ciety) 188

Antiseptic medication 98

Antiseptic surgery, the present sta- tus of. 429

Appeal, a ringing 406

Appetite, Natural. 370

Are we humbugged 113

Arnica and Veratrum alb 391

Arsenicum and Baptisia compared... 431

Artifldal respiration 276

Attenuation «.. „.. 92

Anto*kleptomania ^. 822

Bacteria and Fibrin, cultivation of... 664

Bacteria abd tubercles 40

Bacteria vs. Pibrine 530

Belladonna in tobacco poisoning 481

Blair, Dr. O. A., Ih Memoriam. 87

Book notices 50. 107. 165. 221. 277. 896.

461.520.575. 687 626

Boracic acid in chronic otorrhoea..... 152

Capsicum notes » 884

Cardialgia cured by Thi^a 247

Cheesy pneumonia, or chronic phth- isis pulmonum ^.. 801

Chicago homoeopathic college 45

Colchicum 156

Correspondence, a senior »...„ 885

Correspondence - 678

Cyanosis ^ « ,. 325

Croup, membranous and diphther> iao, successful treatment of. 567

Deadly well water 446

DearpeUet „ 525

Detroit health offices report 50

Decrease of the blind, English census 486 Dlabetis mellltus, simple diagnosis

of.....„ „ „.. 514

Diarrhoea chrenic, Arsenicum »... 598

Dose, the „ 570

Double ovariotomy ^ „ 150

Dropsy cured by Kali carb. translated 86 Drug proving « .«...., 689

Dynamics 57

Eclampsia puerperal 154

Eczema capitis. Hepar, Graphites 270

^zema cured by Ant. cnid 248

Bpiphegus virginiana.a proving 887

Surgical. Errors ^ „^ 491

Experts, scientiflc «... ....^ 114

Festina lente 827

Fribinc and Bacteria 96, 488. 526, 618

Pibrine, Science of ^ 228, 288

Fistula, anal 299

Force, the vital „„ 339, 579

Forms of disease, persistence of. 886

Gonorrhoea, Abortive, treatment of... 281

Gas (sewer) and bad plumbing 592

Germ theory of disease, what Is? 487

Giflbrd's home gymnasium 48

Ghonorhoea. Thuja 11 421, 585

Gynecological case 496

Gynecological instruments : 546

Gynecology, bureau of. 189

Headache. Kali bich « 881

H Imuth. WUUam Tod, biographic sketch of. « 515

Homoeopathic department, Univer- sity of Iowa 542

Homoeopathic department, Univer- sity of Michigan 682-636

Homoeopathic Medical Society of Ohio, proceedings of. 119

Ohio State Sociktt.

Clinical medicine 181

Gynecology 189

Insanity „ 140

Obstetiics 122

Ophthalmology and otology 142

Surgery 189

Theory and practice 116

Homoeopathic Medical Society of

Pennsylvania. 254, 308

Homoeopathy and allopathy 610

How do you treat hard chancre....... 871

How I became a surgeon, a poem.... 499

How to Live Long 688

Hydrophobia 685

Inebriety in women ; its causes and

'results 235

Inflammation „ 318

Inflammation of the middle ear..l42. 183 Indianainstitute, presidents address 198

Insane, care of. ...244 595

Insanity, the study of mental diseases 140

Is it not a lact ~ 219

Intestine removed. Loop of. ^.^. 210

Institute. American 4,168. 386

Int. fever, incipient sderosis 378

INDEX TO VOLUME XIV.

Interesting syoeoological CMe 496

IntuBsiuoeptlon, a case of 612

J. Marion Sims, obituary ....-^ 409

Jurispnideuoe. an interesting case.. 448

Kaiibich, dropsy cured by 86

Law, is the law defective »m 101

Leftvvary, multilocular cyst of. 218

Laparohysterotomy 88

Lungs, foreign bodies in....-^ 82

Man's mioroscopic enemies. 609

Malposition of foetus. 888

Massachusetts Homcsopathic Hospi- tal «« - 652

Mastitis and mammary bandages..... 853

Materia medica. our 571

Medical matters in Michigan, new

laws 98

Medication, antiseptic.*.!.!...!. 93

Medicine, the practice of, as a busi- ness 842

Menorrhagia. Hamamelis, Nux y 561

Michigan Homceopathic Society .pro- ceedings of. « ^, 116, 640

Motion, active and pawive 170

Motion and rest. 169

Motion, the therapeutic value of. 411

Multilocular cyst of left ovary 213

Murex-Sepia 601

Nephralgia-lachesis. 74

Nose bleed S67

Nursing babies - 291

Orme, F. H.. M. D 638

Ovariotomy, double.. 140, 213

Ovariolomy, recovery 6T6

Ovary, strangulated 485

Paracentesis, intra-vaglnal 176

Pathological prescribing, a science

falsely so-called 584

Peculiar cases, three 248

Pelvic celluliils 178

Physicians and Surgeons of Michi- gan, College of. 358, 667

Pneumonia, or chronic phthisis pul

monum 301

Popular Science Monthly and Dr.

Bayard 225. 2^6

Practical notes, iodium, Croton, tig

S. L 460

Pregnancy, nervous.. 420

Principles of medicine. 523, 685

Procidentia. 423

Progress and reflect « .^. 424

Puerperal eclampsia 154

Rectum, ulceration of. 204

Remedif 8, dry or in solntion 449

Respiration, artificial 276

REVIEW'S—

Gelsemium sem. vir — 50

Materia Medica and therapeutics 51 The microscope and its revela- tions 51

Diseases of the ovaries 52

X compend of visceral anatomy 107 A compend of materia medica... 107 Indicazioni special! intermit-

teute 107

HomcBopathy in its relation to

gynaecology.. 108

Practical lessons In gyneecology 108

Miner's case record 165

Medical essays..- ^ 221

PAOC.

A dictionary of medicine........... 277

American Homoeopathic Phar- macopoeia 277

Hand-book of electro-therapeu- tics 277

Students' manual of chemistry... 277

Diseases of the eye 278

Nature of malaria. 896

Therapeutic hand-book of U.S. P. 396 Physician's special rate checks.. 396

Physician's erasable tablet 396

Manual of general technology.. 396

For Mothers and Daughters 397

Uterine therapeutics 397

King's dictionary of Boston.. 4^2

Harvard and its surroundings.... 462 Address of Medicochirur^cal

Society....«.« .«. 462

St Nicholas. 463

A digest of Materia Medica 463

Lectures on fevers 520

Popular Sciifnoe Monthly 521

Transactions of American Insti- tute. «.. 521

North American Review 622

Leonard^ office day-book 575

Aconite from a physiological

basis 575

Transactions of Medico-chirur-

gical Society.. 626

Annals bf British Homoeopathic

Society 626

American drugs and medicines.. 627

Cough and expectoration 627

Bacteria and germ theory 627

A trcaUse on syphilis in chil- dren 628

Uterine displacements 628

Materia Medica of differential

potoncy 629

Rheumatism 380

Rhus radicans. 271

Ringing Appeal 405

Sanitary measures of villages and

country homes 329

Sanitary needs 547

Sanitary science, dynamics of.... .481. 470

Scientinc experts 114

Sclerosis Incipient ; 878

Severe bum.. 187

Seweraffe .. 427

Sewer gas and bad plumbing 592

Sims, Dr. J. Marlon 409

Slxe of drain and soil pipe 90

Sleep 267

Spina bifida, 446

Strabismus 278

Straws (medical) 557

Student's plea 617

Sub-cellulitls 676

Suppurative inflammation of mid- dle ear. 183

Surgical case, fracture of skull 191

Surgical cases, wounds 518

Surgical errors 491

Telephone interview Dr Jahr. 620

Therapeutic use of hot water 614

The village doctor 891

Tonsilitls. acute and chronic 193

Totality and individuality 476

Trained nurse as a teacher 863

Trichinosis, abnormal cells in 582

Tubercle only a lesion of scrofula.... 294 Ulceration and perforation intestines and apendix venniformia 558

INDEX TO VOLUME XlV.

PMtE.

Uterine orgaDS, abnonnai growths in 172

Vaccination, failure of..., 616

Why Contagious Diseases attack only once « 686

Ybbifications.

Abrotanum, rhewnatism^ 881

Aconite in chronic conditions.... 316

Actea. chorea. ^ „. 215

Alcohol and lung diseases. 498

Alumina, incipient sclerosis 879

Ambrosia art., whooping cough.. 157

Am., deseased eye 661

Antimonium c, eczema 428

Antimonium t, foreign bodies

in lungs.. 82

Apis, pemphiffus 484

Arnica, cardiaigia 894

Arnica, contusion 490

Arnica, rheumatism 880

Arsenicum, asthma. 209

Arsenicum and Baptisia com- pared... .., 46L

Arsenicum, chronic diarrhoea.... 598 Arsenicum, intermittent fever... 80

Bell., headache 661

Belladonna, tobacco poisoning... 481

Borax, infants 44

Bromine, diphthwia...... „ 660

Cactus, Epistaxis „.. 868

Calcarea carb., chronic phthisis 801

Calc, despondency 655

Calcarea carb, heart disease 324

Calcarea carb., pel via cellulitis.. 248

Calcarea carb.. phthisis 488

Cantharides, spasms 662

Capsicum, intermittent fever 80

Capsicum notes, 834

Cedron, Puerperal Eclampsia..... 154

Cinchona, haemoptysis 250

Colchicum 166

Croton tig., bronchial catarrh..... 460

Cuprum, paralysis 421

Eryngium a., incontinence......... 569

Eupatorium perf., intermittent

lever 78, 469

Qraphites. eczema 248. 270

Hamamelis, monorrhagia 561

Hepar, cough. 489

Hepar, eczema 270

Ignatla, spasms chorea... 215

MOE.

lodum, insanity 460

Ipecacuanha, intermittent fever 81

Ipecac, sick headache ..». 654

Kali bich., headache 881

Kali carb., drop**y.. 86

Lachesis, diphtheria 266

Lachesls, nephralgia 74

Lachesis. rheumatinn 74

Lilium tig., prolapsus.. 480

Lobelia, asthma 65^

Lycopodium, diphtheria 266

Lyoopodium, typhoid 487

Mercurius cor., epistaxis 867

Murex pur 477

Natrum mur., int fever 76, 488

Natrum mur , procidentia.... ..„.. 423

Nat mur., psoricmiasm 656

Nux v., intermittent fever 78

Nux v., cold and hemorrhoid.. „. 654

Nux v.,mei.orrhagia. 561

Nux v.. typhus „ 660

Oxalic ac. heart disease 3*24

Phosphorus, chorea. 476

Plumbum, cardiaigia » 422

Psorinum, constipation... 654

Pulsatilla, intermittent fever 79

Pulsatilla, malposition of fastus.. 388

Rhus tox., intermittent fever 878

Rhus t.. paralysis. 271

Rhus t. rheumatism 488

Sambucus. intermittent fever 324

Sepia, inf>anity 217

Sepia and Placebo 658

Sepia, procidentia 428

Silloea, tumor 479

Stramonium, puerperal 216

Sulphur, chronic pnthisis 301

Svphilinum. pityriasis 482

Tarantula, dropsy 252

Thi:^a. cardiaigia......... 247

Thuja, gonorrhoea opthalmia,

asthma 588

Thuia. intermittent fever 79

Thuja, neuralgia „ 484

Thuia, sycosis 476

Variolinum, small-pox 482

Yeratum alb., dyspepsia 394

Vital force... - 579

What is the germ theory of disease... 487

Woman shut out 1

World moves 467

T. p. WII.SON, HI. Dm

Editor.

H. G. AI^IiEN, Id. D.,

Business Manager.

Vol. XIV.

Ann Arbor, July, 1883.

No. 1.

All subscriptions and business communications should be addressed to MEDICAL ADVANCE PUBLISHING Co.. Ann Arbor, Mich. Subscription, 92.00 per annum.

Women Shut Out. — By special request we publish the statement of the Chicago Homoeopathic College in defense of its action in excluding women from its halls. It will doubtless be read by many with great interest. It does not bear upon its face the marks of an official document, but the reader may be assured that it is genuine. We are not particularly concerned in the fate of the Chicago Hom- oeopathic College. If it should see fit to commit suicide, we should lament the act as might thousands of others. We are concerned, however, in the result of its influence while it lives, and it seems to us that this collegiate bull is capable of an infinite amount of mischief. That it will hurt its projectors we can e^-sily believe ; and that it will hurt the cause of the medical education of women is quite probable. The attempt at disclaiming all feelings of antagonism toward women practitioners, and the asser-

2

2 EDITORIAL.

tion that this act does not touch either the question of co- education in general, or of medical co-education in partic- ular, is an elegant piece of satire. It is much like kicking a man down the back stairs and then asserting that this act has no bearing on his character. No amount of taffy bestowed upon th^ lady alumni of that college will relieve them, or their successors, of the damning odium which this decree fastens upon them. And if, as a result of this act, this college should largely increase the number of its matriculates, that result would seem only to magnify the monstrous wrong committed by it against an unoffending class. When this college obtained an important franchise in the Cook Co. Hospital, it was heralded to the world as a great gain for the school. It now appears that in order to hold that most valuable franchise, it is necessary for the college to close its doors against a certain class of students. A man to save his life will suffer the loss of a part of his body ; why may not an educational institution suffer ampu- tation rather than die ? Yes, but the man and the corpora- tion are both forever mutilated. It is indeed not a back ward step, for a man likely to die, to give up an arm or leg, but it would be questionable progress for a healthy man to submit to the loss of any of Us members. And what sort of a higher education is that, which so generously lifts up the boys and leaves the girls to climl) up as best they may? Is it anything to boast of, that in this country an educa- tional institution is tied up to the necessity of bestowing its benefits only upon a favored dass ? Is it democratic ? Is it honorable or just to deny knowledge to a human be- ing because that being does not happen to be a man ? And let us ask, is the Illinois Medical Association, to whom this college owes a " loyalty and fraternal feeling," and whose reciprocity it is so anxious to maintain, is that association composed of men only? And if not, is the association concerned in the welfare of only its male members ?

Let us suppose that, under its new and valuable advan- tages, in being connected with the Cook Co. Hospital, the

EDITORIAL. 3

tables were tipped against the male members of its class ; would the college hasten to shut out the boys? The col- lege very properly, no doubt, lays much of the blame against the students of the other colleges who attend the clinics of the hospital. These students do not want the women there. Granted, Is the college quite sure that these same allopathic students want the homoeopathic boys to attend those clinics? Are these allopathic stu- dents to be allowed the control of that great public hos- pital ? Is their blind and bigoted injustice to be made the law for the citizens of Chicago, who have erected and who maintain this magnificent institution ? If they don't want the women there, the women are to be shut out. By the same rule, if they don't want the other members of the homoeopathic college, then these also should go. If the Chicago Homoeopathic College is worthy its name and' ends, it is capable of protecting all its students anywhere in the enjoyments of these rights. The people of Chicago are not all barbarians, neither are they the abject tools of allopathic students or professors. They may be appealed to with absolute safety, and they, in their sovereign capac- ity, will defend the right. The proposition to succumb to this pressure lacks the simple, yet god like element of courage. If it is inevitable and not resisted, it should be deplored, and not boasted of as a " step forward." We shall watch with interest the efiect this declaration shall have upon the profession. It looks like a perilous under- taking to abandon a principle of justice in order to court favor with the enemy. We cannot believe the faculty of the Chicago Homoeopathic College are a unit in taking this retrogressive course. There are, it is to be hoped, men on the staff of that school who would be willing to stand by their guns. Let us hear from them. The -St. Louis Hom. College has followed suit and barred its doors to women, but it may as well be noticed that the Univer- sity of Michigan hangs out the latch string to all comers.

THE AMERICAN INSTITUTE.

THE AMERICAN INSITITUTE OF HOMCEOPATHY.

THE FORTIETH ANNIVERSARY AND THIRTY-SIXTH SESSION.

Niagara Falls, June 19, 20, 21, 22, 1883.

The American Institute of Homoeopathy opened its thirty-sixth session in the spacious parlors of the Interna- tional Hotel yesterday morning. The carpet had been covered with ducking, a platform raised in the north side, and the room well supplied with chairs, making a very commodious and pleasant assembly room.

On one side of the platform and fronting one of the large mirrors was a magnificent floral piece, the gift of Dr. and Mrs. Hoxie of Buffalo to the society. The piece rep- resented an arch standing on a broad base surmounted by a lyre. The base was three feet by two feet four inches, on which were the words " Am. Inst. Hom." in front of the arch, while in the opposite was the date "1883." Over the front of the arch in blue immortelles was the word " Greeting " and in the rear were the letters " S. S. C," being the motto of the society. The institute has a mem- bership of over 900.

Promptly at 10 o'clock the institute was called to order by President Bushrod W. James, M. D., of Philadelphia, and opened with prayer by Rev. Geo. F. Rosenmuller,rec- tor of St. Peter's church.

The President then delivered his annual address as follows :

Ladies and Gentlemen ^ Member a of the American Institute of Homoeopathy : A grateful heart swells with emotion at this hour, and reciprocates in its feelings the highest honor that the largest and oldest national organization of our school of medicine can confer, as this feeble tongue utters its words of unmeasured thankfulness to you, its membership.

It is now my duty in addressing you to follow the standing resolutions of the society adopted in 1878, viz : ** He shall deliver an address at the opening of each session on the progress of

THIRTY-SIXTH SESSION. 5

homoeopathy during the year past and make such suggestions as he may deem necessary for the institute to take action during the session/'

I must therefore forego all comment upon the glorious work that our system has accomplished in the way of medioal reform — since Hahnemann issued his **Organon of Rational Medicine'' in 1810 up to the time of the last session of this body — and not even allude to the wonderful spread of our literature, the in- crease in the number of our colleges, and societies, or the long list of Elemosynary institutions that have been constantly com- ing under the control of members of our branch of the medical profession, nor am I to refer to the vast amount of good and noble work that this society has done in the distant past — your bureau of organization, registration and statistics will shortly give you a summary of these matters — the intervening year alone then will engage our attention for a few moments.

In otfering these remarks it has been deemed proper to con- sider these three questions :

First. What have we to unfold in the annual budget, and what to suggest ?

Second. What is our present status before the world and what our prospective future as a school of progress ?*•

Third. What is our duty to-day in the light of passing events ?

As a sign of the progress of the year in the literature of our school there has been issued independent of the quarterly, montlily and weekly medical journals a total of thirty publi- cations, two English and twenty-nine American — seventeen of the latter being western and twelve eastern.

There have lately been introduced three new homoeopathic periodicals, one in India, one in Uraguay, one in this country.

Quite a number of new remedies have been considered and under constant proving during the year, while some of the older ones have been undergoing reproving, others are in the hands of investigators who have their provers at work, and, as you know, it is an arduous task to sum up, collect and verify the symptoms that have been experienced during the proving and which have to be accurately noted down ; some of these provlngs and reme- dies, therefore, will not be received for one or more years to come, and likewise with the researches of our microscopists and our pharmaceutical observers.

I look to the west and the east and the south, and I find the capacities of our hospitals and colleges increasing. The stand-

6 THE AMERICAN INSTITUTE.

ard of education is being annually elevated, the Jist of matricu- • lates and graduates lengthened ; there is a greater tendency to clinical teaching in all of our institutions, a greater number of old school asylums and other such strongholds yielding to ap- pointments of homoeopathic practitioners, and more than ever have we been complimented in various other ways by legislative enactments, appointments upon state and local boards of health, and even by preferments in political elections in various parts of the country.

women's medical societies.

A most noteworthy event is the initiative taken in the for- mation of women's medical societies. The Chicago Homoeo- pathic Medical society, of which Dr. Caroline E. Manning is president, holds monthly meetings, and has identified itself with the movement favoring the co-education of the male and female students in our medical schools. It likewise disproves of methods looking towards the exclusive education of women, and recommends to all its members the necessity of influencing their students toward such colleges as are permanently and dis- tinctly open to both men and women.

The plan, as far as I can discover, seems to have worked sat- isfactorily in Boston and Chicago [and the University of Michi- gan] although in some cities the exclusive plan seems to be fav- ored by the majority. In New York a college for the medical education of women exclusively are in successful operation. In Philadelphia an effort is being made to found a woman's homoeo- pathic hospital, a movement which should certainlymeet with suc- cess, and to which our generous laity should give their strong sup- port. Ithas been thought best to adopt the separate system i n this instance,the flourishing condition of an old school medical college, which follows this plan in the same city being a guarantee for its success.

I remember the day when female physicians knocked ardently and persistently at the doors of this institute without success ; and although the knocking of scores of men was con- stantly being heard and answered, the timid signaling of the medical sisterhood was smothered, and a 4^af ear was turned thereto. When the doors were annually opened they were still kept far in the background and pushed away, though within hearing of the clatter and jollity of their successful male rivals. To-day I have the privilege and good fortune of greet-

THIBTY'SIXTH SESSION. 7

ing our lady members by the score ; and tbe good work of equal rights to all is bearing rich and ripe fruits for the present and the future.

OUR FUTURE.

The future of Homoeopathy may then be easily pre- dicted. All great reforms go onwards, not backwards, and most of them require long, persevering effort, and consume years and decades and centuries before they become inevitable in their re- sults. The religious reformations in the past have been worked out slowly but surely. The history of the political and social re- form shows that they generally take a lifetime before their suc- cessful culmination is gained. And so it is with genuine medi- cal reformation, which began with Hahnemann's issuance of' the ** Organ on," and is now progressing favorably even with the most bitter animosity prevailing against it. It is quietly battling on against 6ld beliefs that along the advancing eras of time have for three thousand or more years been attaching then^- selves to the laity like barnacles to a mighty ship. Now the owners have decided upon harboring the ship, and have wisely begun to cleanse her hull. A generation or two more may yet be needed to completely finish the work and fit it for better speed and a better voyage upoii the sea of time. And then when reform will have become universal the banner name of homcBopathy will be folded with the ensign ; the law of cure will be written on the minds of all throughout the medical world. The icebergs of Jealousy, hatred, malice, slander and misrepresentations will also slowly have melted away. Battle grounds will be oblitera- ted. The battles with the lancet are already quite unknown to the younger portion of the present medical offspring ; the tor- rents of the crimson streams have long since ceased to flow. The instrument maker who would risk the manufacture of a case full of lancets would be regarded by these young practition- ers a fit subject for an insane asylum.

The Senna and Manna craze is over, and the victims and vic- tors are beneath the sod. The ** bilious " mania is Waning, and the innumerable tons of mercury of more recent days are no longer sweeping down so many human millions. The multi- ple prescriptions, with a group of remedies like great columns for addition or multiplication, are gradually fading away and simpler modes are following with single remedies ; while palat- able sugar-coated granules, parvules and pilules are now the rage

8 THE AMERICAN INTSITUTE.

in old-school medical fashions. And remedies scientifically proved long ago upon the healthy by many pro vers of the hom- oeopathic school are fast finding their way into the ** regular " 'drug stores, and are continuously prescribed by the ** regular '' physicians, whom they most gladly delight to honor and obey.

Crab-like in its details, the old-school is moving backward. It will reach, ere long, common-sense ethics— the single remedy, comminuted doses and non-frequency of repetition— long before it will reach the practical law of cure, which it is destined in the end, to arrive at and acknowledge.

We aim at reform, beginning at the opposite standpoint, in prescribing, the law of cure — aimilia similibua curan(ur—be\ng first and always accepted ; then the other points in our medical reform may be supplemented as rules, the single remedy, the n on- frequency of repetition while a case is with certainty im- proving, the minimum dose of real medicine, and the like, which Hahnemann hinted at, such as this :

'* The characteristics of the case must be similar to the char- acteristics of the drug, taking the totality of the symptoms.''

Or this : ** In chronic cases which progress from the periph- ery, external or less essential parts of the body, towards the in- ternal or more central and vital parts give by preference reme- dies that are opposite to this direction in producing their proved effects upon the body." Or another still : '* Symptoms recently developed are the first to yield; old symptoms disap- pear last.'' Tills gives the last appearing symptoms the claim of decision in selecting the remedy. The revered Hering, that most scrupulous and accurate observer, added still another rule, as follows : ** Every affection going from one side of the body to the other is more effectually overcome by such medicines as will cause or produce a similar affection, but in the opposite direc- tion." Others may be formulated in the future as the system of homoeopathic treatment continues to develop. They should be looked upon with calmness ; and no censorious or vindictive spirit should arise in discussing any one or all of them.

THE EXTREMISTS.

Much wandering and fanciful thinking and wild enthusi- astic writing have of recent years been freely and unwisely in- dulged in by both ends of the line of dose. Are they likely to continue? I am inclined to think not. We are hardly likely to have such extremists in the school in the next generation;

THIR TY'SIXTH SESSION, 9

time sifts from all new and old things the unseemly growths, the rank tares and weeds that are bold in their alluring shape, and wild appearance in the literary grain field ; and these they wither in the sunbeams of truth. So will it be With these gaudy thoughts, these weird mental wanderings, these tinsel words of theoretic reasoning, and all this gay cerebral worls, col- ored with many hues of fancy^s thought, with its crusty and curt verbal pungency, will fade away and be forgotten. Fear them not. Harmless are they as the babbling mountain brook • that serves to charm the traveller, while the crystal glacier which gives support and existence to the gurgling stream, remains solid, beautiful and strong in the sunlight, immovable through years and ages. And so the grand system of medicine now known as horaseopathy will endure and will ever shine gloriously illuminated through its beamd of truth. It will be effulgent with future beneficence when the rushing torrents of over-enthusiastic thought have evanesced, the angular rocks, the projections, the pebbles and the sands that caused the mur- murs and brooklet-like babblings .may remain ; but the dark currents that rushed over them will be gone and forgotten.

A committee composed of Drs. J. P. Dake of Nash- ville, 1. T. Talbot of Boston, and J. S. Mitchell of Chicago, was appointed to consider the recommendations contained in the address.

Under the head of reports that of the Publishing Com- mittee was accepted. Reading of the treasurer's report was deferred by request. The chair appointed as an auditing com- mittee D. S. Smith of Chicago, F. H. Orme of Atlanta, and P. G. Valentine of St. Louis. The Necrologist, Dr. H. D. • Paine of New York, reported the death since the last re- port of twelve members, the ^oldest sixty-eight and the youngest forty-two years of age.

The report of the Bureau of Organization, Registra- tion and Statistics was read by the chairman, Dr. I. T. Tal- bot. It gave the number of State societies at 27, of which 21 held charters, and with a membership of 2,180; 107 local societies, composed of 2,660 members ; 30 general hospitals erected at a cost of nearly $2,000,000 ; 47 dispen- saries, 21 of which report 60,628 patients ; 19 medical jour-

10 THE AMERICAN INSTITUTE.

nals, and 11 colleges, with 6,000 alumni. There are T,400 homcBopaths in the United States, no less than 3,000 of which are not members of any reporting society. A letter from Dr. Charles Mohr of Philadelphia, accompanying the report on dispensaries, was read. The statistics on this subject are very incomplete, fully one-half of the institu- tions not having reported.

The report was referred to the Committee on Publica- tion, and Dr. Talbot was reappointed chairman of the Bureau. There being some unoccupied time before din- ner, the 01 der of verbal reports from delegates, which* had been set down for the afternoon, was called for. Under the head of State societies the following medical gentle- men presented reports from their various sections : P. G. Valentine, of St. Louis, editor of the Clinical Review^ Henry E. Spalding, Mass. ; D. S. Smith, Chicago ; Henry E. Stone, New Haven; H. E. Beebe, Sidney, O.5 H. C. Allen, of the Medical Advance^ Ann Arbor, Mich.; J. A. Compton, Indianapolis ; Milton S. Briry, Bath, Me. ; Pemberton Dudley, of the Hahnemannian Monthly^ Phil- adelphia ; I. T. Talbot, Boston ; T. P. Wilson, Dean of the Homoeopathic College of the University of Michigan, Ann Arbor, and an honorary member of the Kansas soci- ety. Under the head of local societies, hospitals, clubs^ and asylums, reports were presented : Egbert Guernsey, New York Medical TimeSj spoke of Ward's Island Asy- lum ; William Todd Helmuth, of the New York Hahne- mann Hospital ; J. S. Mitchell, Chicago, of the Cook Co. Hospital ; S. P. Hedges, Chicago, of the State Penitenti- ary at Joliet ; T. F. Allen, of the New York Ophthalmic 'Hospital ; T. P. Wilson and E. C. Franklin, of Ann Ar- bor; E. B. Holt, of the Lowell (Mass.) Hahnemann Soci- ety ; D. H. Beckwith and N. Schneider, Cleveland, of the Huron street Hospital, Cleveland ; W.L. Jackson, Hughes Medical Club, Boston ; D. S. Smith, Hahnemann Society, Chicago ; J. H. McCollum, Pittsburgh Hospital and Dis- pensary ; David S. Foss, Newburyport, Mass., of the Es-

THIRTY'SIXTS SESSION. 11

sex County Medical Society; 0. G. Higbee, St. Paul, Minn. ; K A. Phillips, of the Massachusetts Society of Surgery and Gynaecology, Boston ; and P. Dudley, of the Children's Hospital of Philadelphia,

At the conclusion of the reports, Dr. Wright, of Buf- falo, stated what arrangements had been made for sight- seeing, and an adjournment was taken until 3 o'clock.

AFTERNOON SESSION.

When the members came together after dinner, the worfe of the " Bureau of Materia Medica and Provings " was at once taken up. The special topic for discussion was " A Model for a Condensed Materia Medica." This Bureau is composed of the most eminent authorities on the subject in the school. The majority of the members have published works or dissertations on Materia Medica. They were instructed at the last meeting to suggest an ideal Materia Medica, and to this end had prepared ex- haustive papers, synopses of which were read by the Chairman.

The members — corresponding and regular — who con- tributed to niake up the report were : J. P. Drake, chair- man, Nashville, Tenn. ; Conrad Wesselhoeft, Boston, Mass. ; John W. Hayward, M. D., Liverpool, England ; Tomasso Cigliano, Naples, Italy ; Lewis Sherman, Milwaukee,Wis. ; E. A. Fanington, Philadelphia, Pa. ; H. R. Amdt, Grand Rapids, Mich. ; A. C. Cowperthwaite, Iowa City, Iowa ; Wm. Owens, Cincinnati, Ohio ; A. W. Woodward, M. D., Chicago, 111.

Dr. J. P. Jousset, of Paris, France, was unable to re- spond, as he is writing a large work. T. F. Allen, M. D., of New York City, the author of the Standard Encyclo- I)edia of Materia Medica (in twelve volumes) which bears his name, read his own contribution, and presented printed copies of a pamphlet of some twenty-five pages as a sample of the revision which he is making of his work. Asa S. Couch, of Fredonia, N. Y. ; A. W. Wood-

12 THE AMERICAN ITSTITUTE.

ward, of Chicago ; H. 0. Allen, Ann Arbor ; Wm. Owens, Cincinnati ; S. Lilienthal, New York, and N. W. Butler, of Montclair, N. J., discussed the report. It was referred to the Publication Committee, and Dr. Dake was re- appointed chairman of the Bureau.

The Bureau of Pharmacology had assigned no subject for discussion, and the chairman. Dr. H. W. Taylor, of Terre Haute, Ind , was not present. Dr. C. Wesselhoeft, of Boston, one of the Bureau, was called on, and spoke for some time on the necessity for improved methods in the compounding of drugs, and of a new theory as to the solubility of glass. A free discussion followed, partici- pated in by Drs. Dake of Nashville, Peck of Providence, Smith of Cleveland, Allen of Ann Arbor, Waters of Terre Haute, Hall of Toronto, Duncan of Chicago, Cowl of New York, and Owens of Cincinnati.-

Dr. Pemberton Dudley, of the Committee on Medical Literature, read a paper severely scathing certain medical works and journals, and suggesting as a remedy for un- grammatical, loosely-constructed and superficial literary efforts the boycotting of all such by the profession.

EVENING SESSION.

A series of interesting papers were offered at the evening session by the Bureau of Clinical Medicine — J. Sidney Mitchell, M. D., of Chicago, chairman — on '' Mal- arial Fevers."

Prof. J. W. Dowling, of New York City, discussed the causes relating to place, and instanced many new facts and theories.

Dr. J. W. Dake, of Nashville, read an able paper, tak- ing the ground that new settlers and those whose systems were unused to the poison, would be attacked sooner and more violently.

E. A. Farrington, of Philadelphia, gave a compre- hensive resum6 of the remote effect of malaria on the system.

THIBTY SIXTH SESSION. 13

Chairman J. Sidney Mitchell discussed the relation of malaria to consumption and pneumonia, and gave his opinion that there was no specific effect due to malaria in causing those diseases.

Dr. H. C. Allen, of Ann Arbor, gave an exhaustive review of the treatment of intermittents.

L. A. Falligant, of Savannah, Qa., took the ground that quinine in crude doses was often necessary, especially in congestive fevers.

Anna Warren, M. D., of Emporia, Kan., gave some original observations upon the effect of malaria upon women, stating that it sometimes caused uterine and blad- der troubles.

Dr. S. Lilienthal, of New York City, detailed instances of diseases of the nervous system resulting from malaria. . R. B. Johnson, of Ravenna, 0., gave a concise account' of the treatment of remittent fever.

An animated discussion followed, and the day's work was gracefully wound up with a musicale.

INTEBNATIONAL ASSOCIATION,

The International Hahnemannian Association is the official title of a body which has for three years past been holding its sessions in connection with those of the Amer- ican Institute. The Association grew out of a desire on the part of some of the older members of the Institute for greater freedom in setting forth their views as to what Homoeopathy is, or rather what it should be. They think that there has been a departure in some quarters from the principles as Hahnemann held and taught them. The Association comprises some sixty gentlemen, prominent among whom is Dr. Gregg, of this city. About twenty of the members held a meeting in parlor 11 of the Interna- tional. The President, Dr. C. Pearson, made an address, and the Association adjourned until Wednesday.

The second day's meeting of the fortieth anniversary and thirty-sixth session of the American Institute of

14 THE AMERICAN INSTITUTE.

HomcBopathy was characterized by the same unflagging interest and unruffled good-fellowship which gave such a signal impetus to the initial meeting on Tuesday. The convention has a tremendous appetite for hard work, and grinds away at a pace really astonishing to those experi- enced in the ways of deliberative bodies. Two of the subjects assigned for yesterday's discussion would hardly be regarded as wildly fascinating by any one other than an enthusiastic scientist. The special report by the emin- ent microscopist and chemist, Prof. J. Edwards Smith, of Cleveland, was the most noteworthy feature of the day's work. His eflFort, which was brought in under the head of " Remarks and Suggestions concerning certain Homoe- opathic Preparations," was in fact a tremendous exposure of alleged frauds practiced by some pharmacists upon the medical profession and the general public. Prof. Smith has done yeoman's service for the year past, and was au- thorized to continue the good work. A large number of delegates arrived on yesterday's trains.

MORNINe SESSION.

Promptly at 9:30 I^resident James brought down the gavel, catching most of the doctors napping, and causing a hasty scurrying through the corridors. Business had begun. Dr. Henry D. Paine, of New York, was announced as Necrologist for the coming year, and Dr. J. H. McClel- land, of Pittsburg, Pa., as chairman of the Bureau of Medical Education. The former is a reappointment.

Treasurer E. M. Kellogg, of New York City, read his annual report. The receipts were given at $3,938.50 ; dis- bursements, $3,927.19, including a deficiency of $928.09 from last year. The balance in the treasury is $11.35, so the Institute may felicitate itself on being on the weather side of the situation.

Dr. T. M. Strong, of the^ Committee on Foreign Cor- respondence, reported that during the year a large num- ber of letters of inquiry had been addressed to prominent

THIRTY SIXTH SESSION. 16

physicians of the school in Europe, South America, India, Mexico, etc. The answers.received showed an advancing prosperity in England, South America, and Portugal, oflScial opposition in Eussia and Sweden, and the cause at a standstill in Switzerland and Belgium. Italy is hopeful, and from Austria and Germany but little has been heard. The report was referred to the Committee on JPublication. Later in the session Dr. Strong was reappointed chairman of the committee.

The President announced that he had received letters from Dr. A. Claude, of Paris, France ; Dr. A. Gerstel, of Vienna, Austria ; Dr. T. Cigliano, of Naples, Italy ; Dr. Alfred C. Pope, of London, England ; Dr. Eichard Hughes, of Brighton, England; Dr. J. W. Hayward, of Liverpool, England, and other foreign member^, besides handfuls of letters and telegrams from members all over this country, expressing regrets at not being able to be present, and ex- tending congratulations and expressing good wishes for the success of the session.

The work of the Bureau of Obstetrics was taken up. The chairman. Dr. M. M. Walker, of Germantown, Pa., led off in the discussion, the special subject being " Com- plications of Gestation." Papers on various complicated points were read by the following doctors : Geo. B. Peck, Providence, E. I. ; E. M. Foster, Chicago, 111. ; L. C. Gros- venor, Chicago, 111. ; Louis N. Danforth, New York ; C. Van Artsdalen, Ashbourne, Pa. ; C. G. Higbee, St. Paul, Minn. ; J. C Sanders, Cleveland, O.

The papers were all intensely technical, but excited keen interest among the medical gentlemen. In the" vig- orous debate and fire of inquiries and answers which they provoked the following gentlemen took part : L. C. Gros- venor, Chicago ; B. F. Dake, Pittsburg ; John E. Gilman, Chicago ; M. S. Briry, Bath, Me. ; A. A. Whipple, Quincy, 111.; J. C. Morgan, Philadelphia; E. Ludlam, Chicago; and M. M. Walker, Germantown.

16 THE AMERICAN INSTITUTE.

The Bureau of Microscopy and Histology announced itself as ready to report. The treatise on the " Solubility of Glass," by Dr. Conrad Wesselhoeft, of Boston, which had been prepared under the direction of this bureau, was read on Tuesday afternoon to fill up a gap. The Doctor, how- ever, had prepared, and, on request, read, a notable con- tribution on '' Bacteria," from the pen of the distinguished savant. Dr. Albert Haupt, of Chemnitz, Saxony. The dissertation dealt rather roughly with Dr. Gregg's theory of fibrillae. There was a marked diversity of sentiment on the intrinsic originality of the papers, some members characterizing it as elementary, and thought time wasted in listening to its reading, while^ other delegates declared it to be of great pith and moment, and urged the reader to give it in full.

Two members of the Bureau had been assigned for " Remarks and Suggestions Concerning Certain Homoeo- pathic Preparations." Chairman J. Edwards Smith, of Cleaveland, read the contribution from Dr. W. A. Ed- monds, of St. Louis, and then submitted a report of his own year's research in this fascinating field. Dr. Smith is an enthusiast in chemical investigation, and apparently possesses to the full that belief in his work which conquers the world. The Doctor read extracts from his report of seventy- three pages, the reading calling forth frequent re- quests for details on interesting points. The interest aroused was so great that on the expiration of Prof. Smith's allotted time it was unanimously resolved that he be allowed to go on, and the session was extended to that end. ' His humorous exposure of the adulterations prac- ticed by certain pharmacists in compounding sugar of milk brought out shouts of laughter and prolonged ap- plause. The Doctor gave a list of pharmacists and the results of many analyses. Despite their hearty apprecia- tion of the ludicrous side of the subject, the doctors pres- ent evidently regarded the matter as a very serious one

THIRTY-SIXTH SESSION. 17

indeed, and astonishment was, after all, the predominant feeling.

A paper by a non-member of the Institute — Prof. M. B. Wood, of Cleveland— -on the same subject, was allowed to go to the Publication Committee as part of the report.

When Prof. Smith left the platform, Dr. T. P. Wilson, of Ann Arbor, stepped forward and in eloquent words paid a glowing tribute to Profs. Smith and Wood, and offered to head a subscription list, that their work of inves- tigating homoeopathic preparations might be continued this year. He concluded by moving that the Institute lose no time in electing Prof. Wood as an honorary associate member. In an instant a dozen members were on their feet struggling for the honor of seconding the motion. It was carried with a thunder of ayes. Then the contribu- tions to the investigation fund begati to pour in. Prof. Smith was directed to continue his labors.

It was decided that the discussioa.on Bacteria be re- opened. Dr. Wesselhoeft resumed the reading of, and at the same time enlarged upon, Prof. Haupt's treatise. When he closed. Dr. R. R. Gregg, of Buffalo, was given five minutes in which to defend some of his theories which had been assailed by the paper. The Institute did not relax its grip on these infinitesimal parasites until the wild clang of the dinner gong echoed through the hall.

AFTERNOON SESSION.— SECOND DAY.

The session convened very promptly — all too promptly for most of the members. At 3 sharp came the report of the Bureau of Ophthalmology, Otology, and Laryngology — or, translated into workaday English, of diseases of the eye, ear, and throat. Dr. J. A. Campbell, of St. LoUis, wa9 at the head of this Bureau.

An animated and practical address on abscesses of the eye, and improved methods of treatment therefor, was made by Dr. George S. Norton, of New York, answering 3

18 THE AMERICAN INSTITUTE.

the inquiry, " Can Glaucoma be Cured without Opera- tion?"

Dr. D. J. McGuire treated " The Relation of the Dis- eases of the Choroid and Optic Nerves to Diseases of the Sexual Organs."

The Chairman read a two-minutes synopsis of an arti- cle on " Iritis," by Dr. G. C. McDermott, of Cincinnati.

The paper of Dr. C. B. Currier, of San Francisco, on " Nasal Polypi," went to the Committee on Publication without being read.

A paper which possessed great practical worth was that of Dr. F. Park Lewis, of this city, on " Direct Causes of Deaf-Mutism." The statistics presented are of interest to all. The paper of Dr. Lewis gives in brief the results of a careful examination of the clinical histories of 144 deaf-mutes, noting at the same time the present condition of the auditory apparatus, with a view of determining as far as might be the direct cause of the loss of hearing. The wider study of the influence of certain occult causes, and more especially dyscrasia and parental consanguinity, were reserved for future consideration.

"Attention is called to the rather peculiar fact that the external aural canal of many of the children was occluded by inspisated cerumen — a fact probably accounted for by the unusual immobility of the jaws. In speaking the ar- ticulation of the condyle of the maxillary in glenoid fossa gives rise to a slight movement in the external canal, loos- ening the wax, and allowing it to drop out and be brushed away. In the mutes, however, this motion does not occur, and the wax accumulates in masses. As they are already deaf the added obstruction causes no further annoyance than a sense of weight, which they^cannot understand, and the ear canal may become completely occluded and they be quite unconscious of the fact."

Dr. C. H. Vilas, of Chicago, who stands in the front rank of American oculists, oflFered his contribution under

THIRTY-SIXTH SESSION. 19

the head of " Abuses of the Politzer Method of Infla- tion."

The Chairman spoke of " Spots before the Eyes."

The Bureau's report was amplified and discussed by Drs. Norton, Lewis, McGuire, Couch of Fredonia, Lilien- thal, of New York, Vilas and Ludlam of Chicago, Camp- bell of St. Louis, and Morgan of Philadelphia. This closed the discussion.

Dr. D. J. McGuire was appointed Chairman of the Bu- reau for the coming year, with power to select his associ- ates.

Next in order was the presentation of synopses of the papers of the Bureau of Gynaecology — which for the ad- mirers of '' English as she is spoke," may be interi^reted as the surgery of the diseases of women. The Chairman of the Bureau is the genial Vice-President of the Institute, Dr. O. S. Runnells of Indianapolis. The following papers were read by title and referred : " Observations on Diagno- sis in Uterine Diseases," by Dr. H. Minton of Brooklyn, editor Homceopathic Journal of Obstetrics / " Subinvolu- tion of the Uterus," by Dr. R. C. Allen of Philadelphia. The treatise on '' Coccyodynia and the Operations for the Removal of the Coccyx," by Dr. S. S. Lungren of Toledo, was next read — too technical to make a synopsis of any ac- tual use. The Contribution on " Dysmenorrhoea," offered by a Philadelphia practitioner — Dr. W. H. Bigler was quite clear and succinct despite its title.

The essay of Dr. S. P. Hedges of Chicago, on " Re- sults in Dilation of Cervix Uteri with Metallic Dilators" proved briefer and more interesting than the name would seem to promise.

The Chairman's statement of the general subject, "Pelvic Cellulitis," was one of the most powerful and timely of the session — timely in the manly way in which it laid bare and denounced some of the most crying evils. It was far more than a mere surgical analysis of the sub- ject matter.

20 THE AMERICAN INTSITUTE,

" Dysmenorrhoea" was next discussed by Drs. R. N. Foster, of Chicago, L. A. Phillips of Boston, J. C. Morgan of Philadelphia, A. S. Couch of Fredonia, S. P. Hedges of Chicago, J. D. Buck of Cincinnati, O. S. Runnells of In- dianapolis. Dr. S. S. Lungren of Toledo will have charge of the Bureau for the next year.

The President announced the receipt of a very inter- esting communication from Shoshee Bhooseen Mookerjee of Calcutta, India, announcing the establishment of a school of homoeopathy in that city. The Ihstitute at this point took a recess until eight o'clock.

IN THE EVENING.

The programme for the evening meeting included the report of the Bureau of Surgery, the reunion of the " Sen- iors," and the musicale and promenade concert with which the toils of the day were closed. As usual the business session came to order promptly at the appointed hour, and the programme prepared by the Chairman — as below — was gone through with :

General Subjects— Antiseptic Surgery— Definition and His- toric Mention — J. H. McClelland, M. D., Cliairman.

Tlie Principles of Antisepsis— L. H. Wlllard, M. D.

The Antiseptic Method Described— J. E. James, M. D.

The Antiseptic Method as Modified in Germany— C. M. Thomas, M. D.

Distinctive Qualities of Various Antiseptic Agents— W. L. Jackson, M. D.

The Best Ligatures and Best Method of Application— M. O. Terry, M. D.

The Value and Best Means of Drainage — N. Schneider, M.D.

Toxoemic Results of Following Antiseptic Treatment — I. T. Talbot, M. D.

Experience with Iodoform vs. Carbolic Acid— H. J. Os- trom, M. D.

The Antiseptic Method in Abscesses, Ulcers, and Morbid Growths— G. A. Hall, M. D.

The Antiseptic Method in Wounds and Compound Frac- tured—D. W. Hartshorn, M. D.

THIRTY-SIXTH SESSION. 21

The Nou- Antiseptic Treatment in Wounds— E. C. Frank- lin, M.D.

The Present Status of Antiseptic Surgery— W. Tod Hel- muth, M. D.

Friacture of the Cranium— W. D. Foster, Kansas City, Mo.

The question of " septics or antiseptics" is a live one, and one tliat will not down. In every homoeopathic gath- ering issue is joined upon it, and the the end is not yet. Last evening's contributions to the literature of the con- troversy were great ones. Notable indeed was the argu- ment of William Tod Helrduth of New York on the side of antiseptics. Prof. Helmuth is acknowledged by sur- geons of his school to be the greatest of them all, the more enthusiastic of them asserting his claim to be considered America's greatest living surgical operator.

The papers ended, a truce was called, and the heat of the conflict was soon forgotten in the cordial fraternizing which followed the adjournment.

Then came the time of the " Seniors." It may be ex- plained that this order, class, whatever it is, was estab- lished some ten years ago among members of the Institute of twenty-five years standing, of whom there are about 100 at present. Last night the feast was kept by twenty- three of the medical veterans, including Dr. Gregg of Buffalo. The rites ancj ceremonies of the craft have never yet seen the light, so nothing need be said of the manner in which the gentlemen initiated last evening earned their spurs. The memories of the seven "Seniors" who had during the last year " passed from labor to refreshment " were commemorated in a special service.

STILL ANOTHER H0M(E0PATHIC SOCIETY.

To-morrow will witness the inauguration of a conven- tion of homoeopathic specialists. The seventh annual ses- sion of the American Homoeopathic Ophthalmological and Otological Society will be held in the parlors of the Inter- national Hotel, beginning at 9 o'clock. The society has

22 THE AMERICAN INSTITUTE.

about fifty active members, together with a corps of for- eign correspondents. A large attendance is expected. The programme as arranged is as follows :

Opening Address by the President— C. H. Vilas, M. D. Report of the Secretary, Treasurer, and Board of Censors. Presentation and discussion of tlie following papers—

OPHTHALMOLOGY.

Retinitis Albumenuria — Cases, James A. Campbell, M. D. Detachment of Retina Associated with Albummuria, Alfred Wanstall, M. B. Removal of Foreign Bodies from the Interior of the Eye-ball, W. A. Phillips, M. D. Choroidal Tumors, C. H. Vilas, M. D. Extracts from Ca^je Books— (I) Catarrhal Disten- sion of Frontal Sinus; (2) Partial Opacity of Lens, E. H. Lin- nell, M. D. A Peculiar Case, Charles Deady, M. D Spongy Iritis, J. H. Buffbm, M. D. The Use of lee in Ophthalmic Dis- ease, George S. Norton, M. D. Field of Vision, John L. Moffat, M.D. Remarks on the Diagnosis of Cataract. C. H. Vilas, M.D. Essential Phthisis Bulbi (Cared), Charles Deady, M. D. The Value of Absorbent Cotton In Ophthalmologlcal and Otologlcal Practice, E. W. Beebe, M. D. Clinical Cases, D. J. McGulre, M. D. Retinosoopy, F. Park Lewis, M. D.

Subject for Special Dvicuasion. The Value of Remedies in Asthenopia.

OTOLOGY.

Boracic Acid in Otitis Med. Sup. phr., J. F. Brown, M. D. Apoplexy of Tympanum, W. H. Winslow, M. D. Auditory Vertigo, E. H. Linnell, M. D. A New Instrument for the Re- moval of Foreign Bodies from the Auditory Canal, L. D. Couch, M. D.

Subject for Special Discussion.

Treatment of Chronic Non -Suppurative Inflammation of Middle Ear.

Other papers of interest will doubtless be read. Physicians, whether members of the Society or not, If Interested in the study of diseases of the eye and ear, are cordially invited to be present at the meeting.

Dr. F. Park Lewis, of Buffalo, is Secretary of the So- ciety.

THIBTY'SIXTH SESSION. 28

OTHER SOCIETIES IN SESSION.

The American Institute of Homoeopathy, now in ses- sion at the International Hotel, Niagara Falls, is nearing the end of its programme, and to day will see an adjourn- ment. The place for the next meeting has been fixed as Deer Park, Md. — a new summer resort situated high up on the Alleghenies about midway between Washington and Baltimore.

Nineteen additional names of members of the Insti- tute had been recorded at the registration bureau up to last evening.

Before the regular session was called some of the en- thusiasts on Gynaecology held a meeting for the special discussion of papers presented Wednesday morning. The debate was participated in by Drs. R. Ludlum of Chicago, J. P. Mills of Chicago, T. L. Brown of Binghampton, Cornelius Ormes of Jamestown, M. H. Waters of Terre Haute, Philip J. Porter of Detroit, William J. Hawkes of Chicago, O. G. Ross of Ravere, Mass., Maurice J. Chase of Galesburg, 111., and L. A. Phillips of Boston. The special topic for consideration was Dysmenorrhoea. , When the gynaecologists had retired a small number of delegates inaugurated a general business session. Pres- ident James in the chair. Dr. D. S. Smith of Chicago, Chairman of the Auditing Committee, reported that the Treasurer's account had been examined and found correct. An abstract of the Institute's financial standing was pub- lished in yesterday's Express. Dr. L. H. Willard of Alle- gheny City was then called to the chair. The report of the special committee on President's Address was pre- sented by Dr. J. P. Dake, chairman.

A debate resulted on some of the resolutions which the committee had prepared respecting the recommenda- tions contained in the address. The resolution which called forth the principal opposition was that making the Provisional Secretary a salaried officer, placing him out of

24 THE AMERICAN ITSTITUTE,

the control of the GeneralSecretary,and making him respon- sible for certain portions of the work of the Secretary's de- dartment. It was carried. The recommendations as finally approved by the .meeting were : (1) That the Executive Committee be requested to report a suitable plan for es- tablishing a depositary for the archives. (2) That the same committee report on the feasibility of publishing the papers and transactions in four bi-monthly numbers. (3) That no member be placed on more than one bureau in the same year.

The resolution offered by Dr. I. T. Talbot of Boston, to re-establish the Intercollegiate Committee, to be com- posed of delegates from each American homoeopathic col- lege, was carried.

Dr. Pemberton Dudley read a communication from Dr. Charles Mohr of Philadelphia, the chairman of a spec- ial committee appointed to supervise the preparation of the article '' Homoeopathy " in Stoddart's forthcoming edi- tion of the Encyclopaedia Brittannica. The article will not be completed for some months to come. The bureau of surgery was granted the privilege of continuing the de- bate begun last evening in " Antiseptics." The subject was ably handled by an array of surgeons from all parts, of the country. There was by no means a unanimous sen- timent animating the earnest debaters. Dr. James H. McClelland of Pittsburg, led off with a brief enquiry into the history of the method and a criticism upon the terms employed by many. The principles were presented in a brief paper by Dr. L. H. Willard, taking strong ground in favor of the theory that putrefaction is due to germs or particles which float in the air, and the whole object of the specific measures is to destroy and exclude these. The details of the method were set forth concisely by Dr. J. E. James of Philadelphia.

A i)aper by Dr. C. M. Thomas of Philadelphia, dis- cussed the method as practiced in (lermany. The use of iodoform was particularly dwelt upon, and the great sue-

THIRTY SIXTH SESSION. 25

cess of famous Germans was made known. Germany is a great centre for extreme antiseptic methods. The special qualities of antiseptic agents was discussed by Dr. W. L. Jackson of Boston, who presented the results of prolonged original researches. Dr. M. O. Terry of Utica, told of the ligatures best adapted to secure the ends in view, and Dr. N. Schneider of Cleveland, discussed the value of drain- age, and suggested the probability that perfect drainage was the most important element in the whole system.

The poisonous effects experienced and to be feared from the use of antiseptic agents were thoroughly dis- cussed by Dr. I. T. Talbot of Boston, who concluded final- ly that the careful use of well-known antiseptics was not to be feared. The virtues of iodoform were written of by Dr. H. I. Ostrom of New York, who was of the opinion that the special field for this drug was in bone diseases.

Dr. George A. Hall of Chicago, gave an account of this method in the treatment of abscesses, ulcers, and morbid growths, claiming excellent results. Dr. Harts- horn of Cincinnati, also advocated this method in the treatment of compound fractures. On the other hand, Dr. E. C. Franklin of Ann Arbor University, took strong * grounds against this method, arguing that the claims so extravagantly set forth were chimerical. A comparison of the results obtained by Dr. C. E. Walton of Ohio, howev- er, showed amazingly in favor of the system, especially as practiced in Germany.

The closing paper by Dr. Wm. Tod Helmuth of New York, was a guarded endorsement of the system. This valuable paper was warmly received and represented the present status of the method. He expressed a strong doubt as to the eflSciency of living germs in the produc- tion of putrefaction.

In the discussion that followed a strong feeling was manifested in favor of thorough antiseptic measures in all important surgical operations, especially when the joints and large cavities of the body are opened.

26 THE AMERICAN INSTITUTE.

Dr. F. R. McManus, the aged chairman of the Board of Censors, and who by the way has held the position for the forty years of the Institute's existence, turned in the daily lot of applications for membership.

MORNING SESSION.

The first regular bureau of the morning meeting — Paedology (diseases of children)— was called on. Dr. F. H. Orme of Atlanta, Ga., is the head of the Bureau and opened the discussion. Brief synopses were presented of the papers entitled : " Affections of the stomach and bowels from irritating substances swallowed or improper food, reflected upon the nervous system," by Dr. B. F. Dake, Pittsburgh, Pa., and "Tubercular meningitis and alimentary disturbances connected therewith," by Dr. S. P. Hedges, Chicago. Other papers synopsized by the chair- man were : " Atmospheric influences affecting the nervous and alimentary systems," by Dr. A. H. Carville of Somer- ville, Mass. The chairman closed the reading with a gen- eral resume of the special subject. " Relationship of cere- bral disturbances to disorders of the alimentary canal." The debate was led by Drs. D. H. Beckwith, Cleveland : T. C. Duncan, Chicago ; and Pemberton Dudley, Phila- delphia.

SPECIAL BUSINESS.

The hour of noon having arrived, the discussion of papers was closed, and the special order of business ap- pointed for Thursday at 12 m. was taken up. This was the election of officers for 1884 and the selection of a place and time for the next meeting. The great mass of doctors who had been lobbying and wire-pulling in the corridors now poured in, filling the room to overflowing. It was quickly decided to leave the question of time of the next meeting with the Executive Committee.

The representatives of the different sections then came to the front. These special pleaders hastily swal- lowed the voice- clearing troche, and with a get-it-or-die

THIRTY-SIXTH SESSION. 27

look let loose their seductive pleas. As one after another of the glowing letters were read, and as each strain of im- passioned rhetoric was lost in the echoes, derisive laughs and incredulous remarks were heard from the opposition. The number of places named and the determination dis- played by the rival claimants made the struggle an excit- ing one. The fight narrowed down to Old Point Comfort, Va. ; Savannah, Ga. ; Deer Park, Md. ; Nantasket Beach, Mass. ; and Lake Minnetonka, Minn., with Deer Park ap- parently leading. Each place was voted upon separately in the order named. The friends of Deer Park won an easy victory. It was not finally settled without calling out considerable dissatisfaction-r-some of the doctors frankly speaking out in meeting — but these were in a hopeless minority.

The result obtained was the fruit of some very fine work got in by the Baltimore & Ohio railroad company — who control Deer Park. The company had thrown their prospectuses broadcast throughout the convention from the opening day.

Then came the tug of war — the election of oflScers. The '' Express " reporter did not learn whether Greek met Greek, but certain it is that West met East. The greatest interest of course centered in the choice of President. The nominations were notable ones, and every gentleman named would have done honor to the position.

The following were presented in the order named (President James being barred out of the contest by the Institute's rule against re-election to the presidency) : O. S. Runnells, Indianapolis; J. 0. Sanders, Cleveland; George A. Hall, Chicago.

The first ballot stood — ^Runnells, 49 ; Sanders, 50 ; Hall, 37.

As a plurality of sixty-nine was necessary to a choice, a second ballot was ordered. Dr. Hall withdrew from the field. It stood — Runnels, 59 ; Sanders, 69.

The election of Prof. J. C. Sanders was made unanimous.

28 THE AMERICAN INSTITUTE.

The President-elect was called for, and stepping to the front, he briefly expressed his gratitude.

For Vice-President the nominees were — Drs. A. I. Saw- yer, Monroe, Mich, ; A. R Wright, Buffalo, N. Y. ; Tim- othy F. Allen, New York.

Drs. Wright and Sawyer withdrew in favor of Dr. Allen, and the latter was declared the choice of the con- vention.

General-Secretary J. 0. Burgher of Pittsburgh ; Pro- visional-Secretary T. M. Strong of New York; and Treas- urer E. M. Kellogg of New York were unanimously re- elected. Some of these gentlemen have efliciently filled their respective positions from time to which the memory of homoeopath runneth not to the contrary.

The Board of Censors was filled as follows without dissent : F. R. McManus, Baltimore ; A. R. Wright, Buf- falo ; F. H. Orme, Atlanta, Ga. ; R. B. Rush, Salem, O. ; D. S. Smith, Chicago.

Chairmen of Bureau were appointed : Surgery — Dr. George A. Hall, Chicago ; Paedology — Dr. C. H. Lawton, Wilmington, Del.

The morning session had already stretched out to two o'clock, but no adjournment was had — the President an- nouncing that the state of the work marked out' would not permit an intermission for the rest of the day, if bu- reau discufsion was continued then. The remaining bu- reau of the day — Anatomy, Physiology, and Pathology — then reported, after which Chairman William Owens of Cincinnati, summarized the arguments in a well written paper. Prof. Owen's subject was the " Nerves of Organic Life." The paper commenced by explaining that he used the term " nerves of organic life " instead of sympathetic, etc., because it was more appropriate, being common to all life. He proceeded to quote Strieker, Owen and Tuck- ett to show that a differential relation between the primi- tive structure from which the vegetable and animal or- ganizations were developed could not be shown. That all

THIRTY-SIXTH SESSION. 29

were derived from the primitive cell and were subject to the same physiological law. That no organism could live a day without innervation and the performance of certain functions, such as nutrition, circulation, respiration, secre- tion, and reproduction.

He quoted a number of authorities to show that in vegetable and the lower order of animals where no nerv- ous apparatus could be discovered by the highest powers of the microscope. All of the evidences of nerve pres- ence were clearly demonstrated by the application of nerve, poisons and anesthetics, which effected them in a manner precisely similar to that of higher animals and man. The paper then discussed the comparative anatomy of the nerves of organic life, and showed that there is a similar- ity of structure as well as of function in these nerves, and the only difference between the lower order of animals and the higher, including man, consists of the location of the main nervous cords. They were found within the body a'nd along the belly of the animal, while in the higher orders, including man, they were found inside lying on either side of the spinal column.

The convention was then declared adjourned until the morning.

The members thus secured their first holiday of the session. The remainder of the afternoon was spent in visiting the attractions in the vicinity of the falls, and in renewing old acquaintanceships.

THE BANQUET.

The annual banquet of the Institute was held in the handsomely-decorated diiiing-hall of the International. A large number sat down. The music was furnished by the 74th Regiment Band of Buffalo. •

Dr. T. P. Wilson of Ann Arbor was toast-master. The following were the formal toasts and responses :

To the memory of Samuel Hahnemann— all ages shall bless it. A libation.

30 THE AMERICAN INSTITUTE.

To the memory of the many noble dead, whose lives and labors are onr richest legacies. Response by Dr. Geo. B. Peck of Rhode Island.

The American Institute of Homoeopathy — past, present, and future. Response by Bushrod W. James, M. D., Philadelphia.

The Physician— wise, conservative, progressive. Response by J. C. Sanders, M. D., Cleveland, O.

The Surgeon— cautious, fearless, and successful. Response by William Tod Helmuth, M. D., New York.

The College Professor— The only man in the world who is in every sense a ** doctor." Response by Ruben Ludlam, M. D.,of • Chicago.

The New Code vs. The Old— Will ancient bottles hold new wine? Response by J. W. Dowling, M. D., New York.

The Homoeopathic School of Medicine— anchored, drifting, sailing. Response by J. H. McClelland, M. D., Pittsburg.

The Pulpit^ the Press, and the School— the trinity of human civilization. Response by the Rev. Mr. Rosenmuller in behalf of the Pulpit ; President Monroe of De Veaux College in behalf of the School ; Peter Porter, Esq., in behalf of the Press.

The Ladies.

On man, She tried her 'prentice han'. And then she made the lassies, O.

Response by P. G. Valentine, M. D., of St. Louis. Niagara. Response by the Rev. John W. Brown, D. D., of Buffalo.

IN HOMEOPATHIC DOSES.

The President-elect of the institute, Dr. J. 0. Sanders, is a resident of Cleveland, Ohio, where he has an elegant home at No. 308 Prospect Street. He is about fifty years of age, of distinguished presence, and is said to be very highly cultivated. He is a graduate of the Western Re- serve University of the class of 1847, and also of Yale College of the class of '54. Dr. Sanders has been in active practice for thirty years, and his yearly income is reported to be about $40,000. Of course he must necessarily have to deal with important cases. His connection with the Cleveland Homoeopathic College dates back twenty-three

THIRTY-SIXTH SESSION. 31

years, for twenty of which he has filled the Chair of Ob- stetrics.

The report of Dr. J. Edwards Smith of Cleveland, of the special committee appointed to analyze certain hom- oeopathic preparations, read on Wednesday, has been already referred to in these pages. To-day we print some of the results of the Doctor's analyses of samples of sugar of milk obtained from pharmacists in various sections of the United States. What the American Institute thought of the report may be seen in the fact that a fund of over $300 was almost instantly raised to enable Dr. Smith to con- tinue his work.

The following table shows the amount of ash in mill- • egrammes obtained from ten grammes of sugar of milk from the several dealers named :

Halsey Bros., Chicago 1.18

Gray & Co., Boston 4.30

H. C. Gaylord, Cleveland 6.00

Boericke ATafel, Philadelphia 2.00

WorthiDgton, CiDciunati 3.40

L. H. Witte, Cleveland 1.40

Smith, Cincinnati 2.10

l«uyties,St. Louis 3.60

JEppa, London, Eng 2.07

Smith. New Yorlc 1.60

Duncan Bros., Chicago 2.20

Munson & Co 2.60

Gross & Delridge 5.30

Hurlburt, New York 17.00

These showings given above are the most favorable that have been obtained from the several analyses. A Philadelphia pharmacy published a patented analysis recently, which purported on the one hand to represent their milk as " absolutely pure," while on the other hand the analysis obtained ash enough to try half a dozen sub- siduary analyses.

Sugar of milk plays a very large part in Homoeopathic pharmacy, triturations being made with this vehicle, its

32 THE AMERICAN INSTITUTE.

chenlical formula being 012 H24 012. Hence it follows that a pure sample of sugar of milk should give no ash after incineration at full red heat.

OPTHALMOLOGISTS AND OTOLGGISTS.

Three other conventions, all of Homoeopaths, were held at the International yesterday.

The seventh annual session of the American Homoeo- pathic Ophthalmological and Otological Society met in parlor 10 of. the International at 10 o'clock yesterday morning. The attendance was very fair. Dr. 0. H. Vilas of Ohicago presided and Dr. F. Park Lewis of this city was at his post as secretary. After a brief introductory address by the President, in which the work of the Asso-* ciation was reviewed, the Secretary's annual report was read and accepted. The Treasurer's report, which was re- ferred to the Auditing Oommittee, showed a very gratify- ing condition financially. The programme as printed in yesterday's Express was fully carried out, the papers of absent members being read by title and referred to the Committee on Publication. Tlie following essays in ad- dition to those mentioned in the programme were read.

A remarkable case of tumor orbitae. 0. H. liebold^M. D., New York.

A peculiar case of congenital cataract. A. B. Norton, M. D., New York.

On the value of Hydrastis can. as an antiseptic and cur- ative agent in catarrhal and purulent comjunctivitis. M.O. Terry, M. D., Utica, N. Y.

Allium cepa. Dr. C. H. Liebold, New York.

Anomalous cases : 1, keratitis bullosa ; 2, anophihae- miis. Dr. F. Park Lewis of Buffalo. 1, serous accumula- tion in middle ear ; 2 otitis traumatica interna. Henry C. Houghton, M. D., New York.

An interesting paper by Dr. James A. Campbell of the St. Louis Homoeopathic Coileii^ illustrated the inti-

THIBTY'SIXTB SESSION. 88

mate connection between certain degenerate retinal changes and diseases of the kidney.

Dr E. H. Linnell of Norwich, Conn., read a paper on extracts trom his case book.

An interesting paper by Dr. Charles Deady of New York, resident surgeon in the New York Opthalmic Hos- pital, demonstrated the value of medicine in apparent nearsightedness. The case cited by the Doctor was a pe- culiar one in several respects.

A paper by Prof. George S. Norton of New York on the value of ice in certain diseases of the eye was of ex- ceptional value and called forth a general interchange of views.

Dr. D. J. McGuire of Detroit read a valuable essay on some clinical cases.

A paper by Dr. C. H. Liebold on Allium cepa was read by the secretary.

Dr. F. Park Lewis reported two curious cases. One that of a child bom without eyes, and the other that of a peculiar inflammation of the^eyeball.

Dr. Linnell presented his essay on ^' Auditory Ver- tigo.''

The subject for special discussion, " The Value of Remedies in Asthenopia," was taken up and debated by Drs. Wilson, Campbell, and Norton.

Dr. Houghton treated the special subject under Otol- ogy—" Treatment of Chronic non-Suppurative Inflamma- tion of the Middle Ear."

' The appointment of a date for the next meeting was referred to the Executive Committee.

The election of officers resulted as follows :

President— F. Park Lewis, M. D., Buff'alo, N. Y.

Vice-President — James A. Campbell, M. D., St. Louis.

Secretary and Treasurer — Charles Deady, M. D., New York.

Censors — D. J. McGuire, M. D., Detroit; Wm. P. Fowler, M. D., Rochester; Henry C. Houghton, M. D., New York. 3

34 THE AMERICAN INSTITUTE,

The Society then adjourned to meet in connection with the American Institute at Deer Park, Md.

THE HAHNEMANNIAN MEN.

The International Hahnemannian Association have been holding some very interesting meetings in one of the parlors of the International Hotel.

The reports of the bureaus of Clinical Medicine and Surgery have been most valuable additions to homoeo- pathic literature.

The Bureau of Surgery's report was directed especi- ally to plans for dispensing with the use of knives in many operations. It was decided to hold all future sessions at the same place as the American Institute of Homoeopathy, but three days in advance of the meetings of that body.

Officers were elected as follows :

President — Dr. George F. Foote, Stamford, Conn.

Vice-President — Dr. R. R. Gregg, Buffalo.

Treasurer — Dr. Edward Cranch, Erie Pa.

Secretary — ^Dr. J. B. G. Custis, Washington, D. C.

Foreign Corresponding Secretary — ^Dr. E. W. Berridge, London, Eng.

Board of Censors — Drs. C. 'Pearson, Washington; Benjamin Ehrman, Cincinnati; S. Swan, New York ; C. H. Lawton, Wilmington, Del. ; T. F. Smith, New York.

The President appointed the following heads of bureaus for 1884: Materia Medica and Provings: Dr. Edward G. Rushmore, Plainfield, N. J. ; Obstetrics : Dr. J. R. Haynes, Indianapolis ; Clinical Medicine : Dr. J. A. Biegler, Rochester ; Surgery : Dr. C. H. Lawton, Wilming- ton, Del.

JOURNALISTS MEET.

A meeting of gentlemen connected with the different homoeopathic journals represented at the convention was held at 8 o'clock last evening to consider the "club" question. It has been freely charged that some of the medical journals were cutting rates by taking club sub-

THIRTY SIXTH SESSION. 36

scriptions at greatly reduced rates. It was resolved to form a permanent organization to regulate this and other trade questions. Dr. S. Lilienthal of New York was elected President, and Mr. A. L. Chatterton of New York, Secretary.

The following journals were represented : The various homaeopathic publications were generally represented by members of their editorial staff. Among others. The Medical Advance^ Ann Arbor, Mich., by Dr. H. 0. Allen ; the Clinical Review of St. Louis, by Dr. P. G. Valentine ; the Investigator of Chicago, by Dr. T. C. Duncan ; the Hahnemannian Monthly of Philadelphia, by Dr. T. 0. Duncan ; the New York Medical Titnes^ by Dr. Egbert Guernsey ; the Homasopathic Leader of New York, by Dr. Walter Y. Cowl ; the Honueopathic Journal of Obstetrics of New York, by Dr. H. Minton ; the Med- ical Counselor of Grand Rapids, Mich., by Dr. H. R Arndt ; the American Homaeopath of New York, and the Homceopathic Physician of Philadelphia by Mr. A. L. Chatterton of the A. L. Chatterton Publishing Company.

CLOSING SESSION.

The Fortieth Anniversary and Thirty-sixth Session of the American Institute of Homoeopathy, begun so auspic- iously at Niagara Falls on Tuesday last, closed yesterday. The meeting has been a notable one in several respects. The attendance has been as large as any previous session, and somewhat more representative in character. The In- stitute leaves a good name behind it for hard work and harmonious action. Of the convention's work, viewed in the light of scientific usefulness you have already read.

At the general business session, called at half-past nine o'clock yesterday jnorning by President James, the attendance was very light, many members being home- ward-bound, and others in the throes of packing up. Dr. Dake, of Nashville, oflFered the following important pre- amble and resolutions :

36 THE AMERICAN INT81TUTE.

Wherbas, It has been demonstrated in the report of Dr. J. Edwards Smith at this session of the Institute that the amount of impurity existing in Sugar of Milic may be detected by the simple process of incineration, and that a ten-gramme sample of ordinary purity ought not to give an amount of ash exceeding one and one-half milli-grammes.

Besolved, That samples of sac. lac., ten grammes of which yield residaura exceeding one and one- half milli-grammes in weight, shall be considered unfit for homooepathic use.

Besolved, That manufacturers of Sugar of Milk be re- quested to state on each package offered for sale the amount of ash in grammes produced from incineration of ten grammes of said sugar.

Dr. Smith's work has borne fruit, for the resolutions were adopted unanimously.

The Board of Censors presented th^ir final report for 1883.

The report was adopted, and the names were placed on the membership list. Forty-seven new members in all have been admitted at this session.

Dr. A. C. Cowperthwaite of Iowa City, Iowa, was re- appointed as Chairman of the Railroad Committee.

Mrs. Dr. E. G. Cook of Chicago presented her resigna- tion as a member of the Institute. Accepted. •

The Bureau of Psychological Medicine was to have presented papers at this session, and to have discussed ^' Sleep, and the Means for Most Safely and Surely Induc- ing it in Cases of Mental Disturbances." The Chairman was absent, however, and the papers in hand were read by title and referred to the Committee on Publication. These were : " Diseases of the Omentum as a Cause of Hppo- chondriasis," Seldon H. Talcott, Chairman; "Hallucina- tions in Physical Insanity," S. Lilienthal, New York ; " A Case of Acute Mania," J. M. Kershaw, St Louis ; " Oxy- gen in the Prevention and Cure of Nervous Diseases," T. L. Brown, Binghamton.

The Institute referred all the papers prepared under the direction of the Bureau of Sanitary Science to the

THIRTY-SIXTH SESSION. 37

Committee on Publication. The articles covered a very wide field, in fact, some of those present thought rather too wide a field to be discussed in detail. The papers re- ceived were : " Hygiene in Traveling," T. P. Wilson, Ann Arbor ; " Hygiene of Food in Cooking," T. S. Verdi,Wash- ington ; " Hygiene of Manufacturing," George M. Ockford, Vincennes, Ind.; "Hygiene of Schools," Bushrod W. James, Philadelphia.

The chairman of the Bureau, Dr. D. H. Beckwith, Cleveland, stated that he had attended the meeting of the American Public Health Association for 1883, and also the " State Medicine " of the American Medical Associa- tion at Cleveland, this month, and that the reports of his Bureau compared favorably with any on similar subjects offered at either of these meetings.

Dr. J. P. Dake, of Nashville, offered a resolution in- structing the Committee of Arrangements, when negoti- ating for future meetings pf the Institute, to arrange with hotel proprietors that no other meetings be allowed to convene while the Institute is in session. The resolution was laid on the table.

Dr. T. P. Wilson, of Ann Arbor, offered a resolution calculated to restrain hasty legislation by providing that a certain specified notice should be given in advance ot the offering of any resolution materially affecting the pol- icy of the Institute. It was debated, and referred to the Bureau of Organization, Registration, and Statistics.

The memorial service in honor of deceased members was announced.

Dr. George W. Peck, of Providence, R. I., read a well written eulogy of the late Dr. Ira Barrows, of Providence, who had died during the year past.

Dr. Pemberton Dudley, of Philadelphia, said a few words regarding his long-time friend, the late Dr. Robert J. McClatchey, of that city. Dr. McClatchey was a veter- an member of the Institute, and for many years the Gen-

38 LAPARO-HYSTEROTOMY.

eral Secretary. Some practical life lessons were drawn from his record.

Resolutions of thanks were voted to the hotel propri- etor, local committee of arrangements, and the press.

President James then declared the convention ad- journed, to meet at Deer Park, Md., in 1884.

Ed. Note.— We are indebted to the Buffalo Express for the above full and correct report of the proceedings of the Insti- tute.

LAPARO-HYSTEROTOMY.

SUCCESSFUL REMOVAL OF A LARGE FIBROID.

BY DR. PHIL PORTER.

The triumphs of ovariotomy in the hands of a few homoeopthic surgeons have naturally emboldened others to attempt the removal not only of uterine fibroids that have baffled the skill of therapeutics, but also the uterus itself, when it has undergone fibroid or cancerous degen- eration, and yet there are no operations, the indications of which ought to be more clear than laparotomy and laparo- hysterotomy for the removal of fibroid tumors. If we consult the percentage ot mortality as published by the old-school operators we are at once convinced that the dan- gers to be encountered, both during and following the op- eration, are the greatest within the range of pelvic sur- gery.

During the last two years I have successfully removed three large uterine fibroids, once including the entire ute- rus, which was duly reported to the profession and I now have the honor to report my third case.

Miss Jessie S — , set. 15, had been menstruating one year, scrofulous diathesis. Sent bv Dr. L. Younghusband of this city. First noticed a hard lump in the left iliac re-

PHIL. POETER. 89

gion about one year ago but as it did not pain or distress her she did not call her mother's attention to it. .

Three months ago she commenced having what her at- tending physician called hystero-epileptic attacks and she then comolained of the growth in her abdomen, which was examined by several physicians. The patient came under my care in April and after a thorough trial of sev- eral remedies and as the tumor increased rapidly in size, I determined to operate.

Preparing the patient in the usual manner for lapar- otomy, I opened the abdomen and found a large fibroid tumor attached by a broad pedicle to the left side of the fundus of the uterus. The adhesions were abundant and very troublesome. The tranverse and descending colon were attached three to four inches to the upper portion of the tumor which necessitated some careful dissecting and time. Before dividing any extensive adhesion I was care- ful to clamp, thus avoiding any great amount of hemor- rhage. After freeing the tumor from all its attachments except the pedicle, where it was connected with the ute- rus and left broad ligament, including the Fallopian tube and ovary and so closely identified with the tumor that it was impossible to separate them. I ligated the pedicle in five different sections and then crushed the entire pedicle above the ligatures with one of Billroths large clamps and severed the mass with scissors and removed the tumor and all the uterine attachments on the left side. I examined the stump carefully and bathed it with warm water and Calendula. While cleaning the abdominal cavity I found another tumor about the size of a cocoanut in the omen- tum, Which, after ligating all vessels, I removed. It proved under the microscope to be encephaloid in character. When all bleeding points had been secured, the entire cav- ity was treated to a bath of warm water and Calendula. The incision was then washed with equal parts of calen- dula and Hyperium, and silk worm sutures used to close the abdomen.

40 BACTERIA AND TUBERCLES.

The operation lasted one bour and fifteen minutes.

All the antiseptic precautions were employed except the spray.

The patient's temperature never rose above 99° and after the first day the pulse was not over lOG.

Nothing but Hypericum was administered in the 6x but on the third day the patient complained of naueea and Ars 12 x one dose, was given which controlled the trouble.

The patient has not had one bad symptom since the day ot the operation and is convalescing nicely.

The sutures were removed on the eighth day as union was perfect. No drainage tube was used.

BACTERIA AND TOBERCLES.

BY R. R. GRBOG, BUPPALO, MAY 12.

Will you allow me to prick one of the bacteria bub- bles that is now sailing so gaily over the world ? You know that Prof. Koch of Berlin asserts that tubercles are caused by bacilli and by them only. Very well : what are bacilli ? They are one of the sub- divisions of bacteria, and Prof. Koch says they are vegetable parasites, or vege- table germs, and all scientists agree with him as to their vegetable nature.

What next are tubercles ? Tubercles are wholly ani- mal structures, and tubercle cells are purely animal cells* Well, Prof. Koch's claim then involves this flat contradic- tion of all nature, namely: That a purely vegetable germ, the bacillus, will produce a purely animal structure, the tubercle. And one of the strangest anomalies in all sci- entific controversy has arisen over the discussion of the subject, to wit : That Prof. Tyndall, after fighting Bastian for years, upon the latter's " de novo origin of life," and on his doctrine of transmutation in the lowest forms of

R. R. QEEQG. 41

animal and vegetable life, now turns around against his own teachings of a life time, and says yes to Prof. Koch's claim, a vegetable germ will produce a purely animal structure.

How Bastian must dance for joy at this evidence of Tyndall's contradiction of himself, and endorsing his (Bas- tian's) position. They might just as well tell us violets furnish the germs of aligators.

ALLOPATHIC SIMILARITY.

BY CHARLES Jj, CliETBLAND, A. B., V.4 D., CLKVlSIiAND, OHIO.

Apropos to the <5lever criticism of Dr. Cathell's " Phy- sician Himself," written for the May issue of the Advancb by Dr. Camp of Minneapolis, I present a few i)oints fur- nished for the benefit of homoeopathy by Dr. Robert Bar- tholow, Professor of Materia Medica in Jefferson College. It is an illustration of knot tieing very similar to that into which Dr. Cathell has so admirably placed himself to the amusement of all of us ; and thanks are undoubtedly due to Dr. Camp for his interesting criticism. As another ex- ample of strange incongruity, let us take up Bartholow's " Materia Medica and Theai)eutics," edition of 1881 :

Chapter on the Mineral acids, p. 83, we find the fol- lowing sentence, " It is true of all the mineral acids that their long continued use diminishes the production of acid gastric juice, and in this way after a time they cause the very trouble for the relief of which they were originally administered." And a little further on, p. 84, " To pre- vent the excessive formation of acid, whether due to the action of the gastric glands, or to adnormal fermentation of the starchy, saccharine, and fatty elements of the food, mineral acids are used with decided advantage, but they must be anministered before meals. For this purpose,

42 ALLOPATHIC SIMILARITY.

hydrochloric or phosphoric acid is to be preferred. The excessive production of acid is manifested by acid eructa- tiona^pyrosis^ heaHJmrn^ and ulcerative stoniatitisP What better indications for a remedy prescribed homoeopathi- cally according to our best authorities ? Speaking of Bel- ladonna, p. 311, Dr. Bartholow says, "The remarkable similarity in the symptoms of atropinism and of scarlatina has led to the use, by homoeopathic practitioners, of Bella- donna and prophylactic against this disease. The points of resemblance are so superficial, and the differences so wide, that no more striking instance could be adduced of the uncertainty in the application of the homoeopathic dogma, even admitting its truth." By this unique method of reasoning, this " striking instance," the homoeopathic dogma is shown to be false 1 Look at those two sentences. It is stated that there is a " remarkable similarity in the symptoms of atropinism and of scarlatina," and in the next breath this "remarkable similarity" is "so superficial," and " the differences" are " so wide," that there is really no similarity, is the legitimate conclusion. Truly the text books of allopathy are complex and confusing. It is not to be wondered at that the physicians of that school make compound prescriptions.

Note again on p. 129 : " Arsenic is one of the numer- ous remedies proposed for the treatment of epidemic chol- era. It is a curious circumstance, first demonstrated by Virchow, that some cases of acute arsenical poisoning are not distinguishable by their symptomatology or morbid anatomy from cases of epidemic cholera." This fact may seem a "curious circumstance" to some allopaths, and some of them may, perhaps, believe that Virchow " first demonstrated" said fact ; it don't seem " curious" to us, neither are we so ignorant of medical history as to believe that Virchow " first demonstrated" it. It is not necessary to multiply instances of this kind. The case is clear ; the argument conclusive. Sit down in the evening, after a hard day's work, and amuse yourself, in healthy, mental

CHARLES L. CLEVELAND. • 43

recreation, by picking out neat and concise statements of " similia" in almost any allopathic work on Materia Med- ica. I will venture to say that in twenty minutes any one can discern fifty or more examples like the above ; there is certainly that number in Dr. Bartholow^s work. But let us look once more, and now we come to a still stranger portent : p. 445, the subject under consideration is Aco- nite. We find, " The monopoly of homoeopathic practi- tioners of the use of Aconite has aroused a prejudice against it, which has discouraged its employment. Aconite is, however, an antagonist to to the fever process ; it is not applicable in accordance with the so-called laws of simil- ars. It is used by these quacks because it is a powerful agent which will produce manifest effects in small doses, that may easily be disguised."' This is certainly remarka- ble. Dr. B. says Aconite is " an antagonist to the fever process" but " not applicable in accordance with the so- called law of similars." These are mere statements. No proofs are furnished. It is stated that the effects of Aco- nite " may easily be disguised ;" and there it is left. This is too vague for us ; it may do for allopaths. There is a fog which we would wish dispelled. Look at the knot, and at the same time note the "remarkable similarity" be- tween Drs. Cathell and Bartholow.

Dr. Oathell, in his " Physician Himself," would make a first-class '' quack" out of the follower of his advice, and Dr. Bartholow, in his "Materia Medica and Therapeutics," distinctly states the homoeopathic law, gives indications for remedies and for prescribing under that law, and then calls the homoeopaths " quacks." These instances of "sim- ilarity," remarkable indeed, rather incline one to the be- lief that some gentlemen of the " old school" are as much governed by the law of similars in their logic as are the homoeopaths in their practice of medicine. Think of the many medical colleges in which Dr. Bartholow's " Materia Medica" is used as a text-book, and hence the number of " quacks" turned loose upon the public every year from

44 • BOBAX: A VERIFICATION.

said colleges! "PiHure it, think of it!" Verily, there are strange men and straage things in " regular" medi- cine!

<■>

BORAX: A VERIFICATION.

BT a HeTT, M. D., CHILIOOTHAk O.

The mother came to me for medicine for her baby, two months old, and gave the following history of the case. The child would waken up very much frightened, and she thought would have spasms if some one were not at hand to take her np at once, and so they were afraid to have the child sleep without some one near to watch her. The rustling of a paper or dress, or the slamming of a door, would cause the child to start and scream and seem badly frightened. When laying her down the child would start and throw up her hands as though afraid of falling, and some nfghts they could not put her down at all — would have to hold the child all night in their arms. The baby seemed pretty well, only that she was so extremely nervous. Appetite pretty good, and bowels regular. The mother had, each time after nursing the child, wet the nipples with Borax and whisky, and neglected to wash it off before the child would again nurse. The nurse had told her to do so to keep her nipples from cracking, and she had followed instructions implicitly ever since the child was bom ; supposed it was all right ; " did not think the Borax would do any harm." In order to keep the baby from getting sore mouth, she had, in addition, fre- quently given borax and sugar in solution.

I forbade the use of Borax in any way, assuring her it was the entire cause of her child's illness. She followed my directions, and in a few days all nervousness had dis- appeared and she was perfectly well. I think she ob- tained a very good proving of Borax, without intending to add anything to the science of therapeutics!

THE CHICAGO HOMCEOFATFIC COLLEGE. 45 THE CHICAGO HOMCEOPATHIC COLLEGE.

ITS RELATION TO CO-EDUCATIOW.

READ BEFORE THE IIJ.IK01S STATE XBDICAX. A8K>GXA.TIOir, AIT1> PCTB&ISHBD BY RBQinEST OF THE FACULTY, MAY 18, 1883.

The Chicago Homoeopathic Medical College having by the unanimous vote of its faculty decided not to matricu- late women as students in the future, it has been thought proper that the reasons for such action should be clearly stated before the State Society, not only to forestall criti- cism and misrepresentation, but as an exhibition of loyalty and fraternal feeling, which the college has ever been proud to feel have been reciprocal, between the two med- ical bodies.

It should be stated clearly and emphatically in the first place, that there is not, and haa not been, the slight- est feeling of antagonism in the minds of the faculty of this college toward women practitioners of medicine in general ; nor is the college less proud of the women, than it is of the men among \i% alumni. The college has. no feeling of regret, nor dissatisfaction, aa it looks over the entire list of its graduates.

Nor has the question of co-education in general or as related specifically to medicine, entered as a factor in de- ciding its future policy in the exclusion of women from its benefits.

The college believes fully in the aptitude of women for the study and practice of the medical art ; and it is fully cognizant of the fact, that already many noble wom- en, some of them its own graduates, have achieved an enviable reputation for the prompt and skillful relief of human suffering.

In taking this action it was careful to protect the women it has graduated, in all their rights and privileges, and it will always be glad to welcome them back to their old home regardless of sex.

46 THE CHICAGO HOMCEOPATHIC COLLEGE.

The reasons which impelled the college to take this step were wholly local and. special in their nature, and scarcely touch the general question of co-education at all. Let me state these reasons as briefly as I can.

First, then, the location of the college is such that for the proper utilization of the clinical advantages open to it, its students are compelled to come into contact with from five hundred to seven hundred students of other col- leges whose students are exclusively males.

It should be understood that grouped around the great Cook'County Hospital are the two leading allopathic col- leges of the west, and the amphitheatre of the hospital, where all the clinics are held, are open to their students as well as to ours. When clinics are held here by the professors of these colleges no discrimination is made nor can be made in the selection of clinical material out of respect to the women who come alone from our college ; and the five hundred to seven hundred students from these colleges cannot, or at least do not, understand that our women students are not there more out of curiosity than otherwise.

Hence our women students are placed in an embar- rassing position, which would not be the case if the hos- pital were under our exclusive control ; and yet the clinics which are held here daily are so attractive and advan- tageous that the students are drawn to them until nearly every seat in the vast amphitheatre is filled.

More than this, it has been found that a by no means inconsiderable number of the women who make up the gynaecological clinic in our own college building, where our private clinics are held, strenuously object to a local examination before a mixed class, thus curtailing to an important extent the advantages to be derived by the male members of the class, who have always been in the ma- jority.

When the Chicago Homoeopathic Medical College was founded, its projectors (incorporators) believed that it had

ITS RELATION TO CO-ED UCA TION. 47

a mission to fulfill, and its motto was " A higher medical education."

For seven years past it has labored honestly and faith- fully to fulfill this mission and secure to its students and graduates the best practical education aflbrded by any medical college in the country. For this reason two years ago it erected the present magnificent college building directly opposite the Cook County Hospital, in order to supplement its large dispensary clinics with the larger ones of this immense hospital ; and it has now found after two years of trial that its male students cannot derive all of the benefits they ought to do, so long as the two sexes are commingled. Finally, at the time this action was taken there was not a single homoeopathic college in the west in which the two sexes were not admitted on an equality, and as a consequence of this, many western stu- dents passed by our western colleges and went east where they could find no better facilities for learning, nor better teaching, but where they could pursue their studies un- trammeled and unembarrassed by the presence of the op- posite sex.

It seemed best, therefore, that there should be at least one western homoeopathic medical college confining its course of instruction to the male sex solely, and it felt that in taking the action it did, it was doing no wrong nor injustice to the women who would naturally knock at its doors, by refusing them admission, since there are numer- ous other colleges willing and glad to receive them.

These, then, are briefly the reasons actuating the fac- ulty of this college in refusing in the future to matriculate other than male students.

We believe that the step is a wise one ; that it is not a step backward, but a step forward ; and we believe that time will demonstrate its wisdom.

The college is still determined to do all and every- thing in its power to advance the status of medical educa- tion and to improve the character and acquirements of its

48 GIFFO BJyS HOME Q YMNASl UM.

graduates from year to year. To this end it seeks rather than fears just criticism, but it is solicitous to retain and add to, rather than alienate, that large body of the west- em profession which it is proud to call its friends.

GIFFORD'S HOME QYAINASIUM.

Niagara Falls, N. Y., June 21, 1883.

The essential of systematic and healthful exercise consists in frequent changes in the position of the body, bringing into action at each change a different set of mus- cles, thereby strengthening and symmetrically develop- ing every part of the body. Thus exercise may become an exhilorating pleasure, instead of a tiresome and ex- hausting labor. By using light weights at first and fre- quently changing movements^ the weights and amount of exercise can be gradually increased without fatigue.

We, the Committee on Sanitary Science and Hygiene of the American Institute of Homoeopathy, have made a thorough investigation of the Home Gymnasium, or Health Exercising Apparatus, invented and manufactured by the Gifford Brothers, of New York city. We cheerful- ly give it our hearty endorsement. It supplies a want long felt, and brings within the reach of every one the means of acquiring a thorough physical education.

It wiU, if properly and intelligently used prove a val- uable adjunct in the treatment of many diseases, and of great benefit to the over-taxed brain-workers in our own profession.

[Signed.]

D. H. Bbckwith, M. D., Charrman, Cleveland, Ohio.

T. P. Wilson, M. D., Professor of Principles and Piactice, University of Michigan, Ann Arbor.

A. R. Wright, M. D., BuflFalo, N. Y.

BusHBon W. Jaaiss, M. D-, Philadelphia, Penn.

FEUILLETON. 49

FEUILLETON.

New Jersey Ahead.—Od July Ist the new law prohibiting the sale of tobacco in any form to persons under 16 years of age, went into effect.

The Philadelphia Abortionist Hathaway has been found guilty, and sentenced to seven years imprisonment, and to pay a fine of $500 and costs of prosecution.

Ohio Fungi.— In a continuation of his paper on the mj'col- ogic flora of the Miami valley, Mr. A. P. Morgan gives a descrip- tion of the Hyporhodii, Dermini, Pratelli, and Corprinarii of the region mentioned, including sixty-five species.— (.yc/enfe.)

Is it a Fact? At the meeting of the Western Academy at Madison, Wisconsin, Dr. R. Ludlam, of Chicago, stated as a clinical fact, that he had never seen a patient who had leucorrbcea during pregnancy troubled with morning sickness. Let us hear from some of our specialists.-

At the recent meeting of the American Medical Associa- tion, a member reported the successful removal of three inches of intestine, '* as the first case of the kind recorded in surgical literature." The Dr. is not well read in surgical literature. lu July, 1869, the late Dr. G. D. Beebe, of Chicago, successfully re. moved 58 iuches of intestine, with complete recovery.

Injurious Alg^.— In a paper on some Algte of Minnesota supposed to be poisonous, Prof. J. C. Arthur gives an account of a species of Rivularia infesting the water of ponds at Waterville, Minnesota, and supposed to be the cause of death or injury to cattle. He also describes the condition of Lake Phalen, near St. Paul, in which he found several species of NostochacesB. (/Sci- ence.)

Amen !— We take it that there is too universal a belief in the homoeopathic law, too general a use of it in the practice of homoeopathic physicians, too sure a knowledge that the only way to propagate a truth distasteful to its opponents is by fighting with a banner, too honest a faith that, when homoeopathy has been fully developed and simplified, an ordinary man will seldom need to go to any other resource, for us just now to forsake the name which is compelliug the world to listen to the truths of scientific therapeutics. Not, we think, till this war is over, will the homoeopathist be ready to give up that by which he is known, and for which the world respects him. — \_IIomoeopathic Leader,^ 5

60 V >BOOK NOTICl

The readers of Health Officer Wight's annual report will be astounded to learn of the prevalence of entero colitis in this com- munity^ twenty lives having succumbed to that disease. Seven people during the year died of hempilegia and two of insolatio. Necrencephalus carried off twelve, senectus claimed fifty-one, and ambusta eight. One died of contusio, one of explosioi four- teen from submersio, ten from vulnera, five from suspendium, and one, unfortunately, from icterus fulminis. The learne<l doc- tor puts down ihe cause of death of twenty-four as unknown, which is probably an oversight on his part He undoubtedly meant to say incognita. — (Detroit Daiiy,)

What's in a Name ?— It is only a short time since one of our medical journals dropped its distinctive name and became known as the New York Medical Times, At the recent session of the American Institute one of its editors gave notice that at the next meeting he would move to have the word Horruxopathy erased from the name of the Institute, making the name simply the American Institute of Medical Science. While the Institute is being re-named, we commend the following name given by the Medical Becord to the American Medical Association : ** A shift- ing,purpose]e88, illy-organized monster, with a floating member- ship of undifferentiated medical protoplasm.'' None but the most fastidious ought to find fault with such a name.

BOOK NOTICES.

OELSEMIUM SEMPERVIRENS. A Monograph by the Hughes Medical Club, of MasBachusetU. 1883. OtlR Clapp & Bon, Boston.

This little work is the product of a very enterprising club of Massachusetts doctors, who have in this way set about the com- mencement of a revision of the Materia Medica. With perhaps no ambition to cover a very wide field, they have set a worthy example in this their maiden efibrt, and with special pleasure we look over its well filled pages, finding in them much that is worthy of remembrance. The plan of the work, adopted after Dr. Hughes, of London, may be open to criticism, and doubtless is, but the lesult of placing before the student a clear compre- hension of the action of the drug is obtained perhaps quite as well in this manner as in any other. Gelsemium is a drug of

BOOK NOTICES. 51

rare power and well w<Trthy the labors of the Hus:hes Club, and the monograph is thrice worthy a place in every physician's library.

MATERIA MEDICA AND THERAPEUTICS: INORGANIC SUBSTAN- CES, Vols. I. and II. By Chas D. F. Phillips, M. D. Wm. Wood & Co., New York.

These volumes have been edited and adapted to the U. 8. PharmacopcEia by Lawrence Johnson, M. D. They are there- fore well adapted to the uses of allopathic students, and in many respects they are the best work extant of the Old School which treats of tliis subject. One can see at a glance wliat remarkable improvements are being made in understanding the nature of drugs by the later writers of the Allopathic School. It is also interesting to trace in all parts of Dr. Phillips's writings the fact that is always freely exhibited but never acknowledged, of a large amount of knowledge obtained from the Homoeopathic School. And a careful comparison of the toxicological effects with the therapeutic uses will show with what extraordinary frequency the remedies are given according to the Law of Simi- lars. These volumes are parts of Wood's Library of Standard Medical Authors for 1882.

THE MICROSCOPE AND ITS REVELATIONS. By Wm. B. Carpkntbk, M. D., etc., etc. Sixth Edition. Illustrated by Twenty-six Plates and Five Hundred Wood Engravings. Vols. I. and II. William Wood and Co., New York.

We have here the April and May volumes of Wood's Li- brary of Standard Medical Authors for 1883. For a physician to be without a microscope is for him to be largely out of the world. What a man may chance to see with his unaided eyes is after all but a small part of the universe. To say nothing of the knowledge gained, curiosity alone might impell us all to employ the aid of the microscope, but to the physician it is an instrument almost indispensable to his daily work. Thanks to this work of Dr. Carpenter the study is largely reduced to verifi- cations. While there is no end of original study remaining, as there always will be, yet the amateur will find the work in almost every department well laid out, and he can, by carefully consult- ing his drawings, verify his work and make sure of its reliabil- ity. The author's observations are brought down with scrupu- lous care to 1881, and the student and practitioner will find the whole subject thoroughly up to date.

52 EDITOR'S TABLE.

The closing words of the preface w% apprehend are to the point : ** To such as feel inclined to take up the use of the micro- scope as a means of healthful and improving occupation for their unemplcyed hours, the author would otfer this word of en- couragement : that notwithstanding the number of recruits con- tinually being added to the vast army of microscopists, and the rapid extension of its conquests, the inexhaustibility of Nature is constantly becoming more and more apparent; so that no apprehensions need arise that the microscopist^s researches can ever be brought to a standpoint for want of an object.^'

DISEASES f)P THE OVARIES. By Lawson Tait, F. R. C. 8. Fourth Edition, Re-wrltt6Q and Enlarged. Win. Wood & CJo., New York.

This volume was brought out by the author as the Hastings Essay in 1873. It at once took rank as the leading text- book upon this most interesting subject. Less than a year ago the writer added to it the fruits of his subsequent experience so as to include the latest observations and conclusions — his contempo- raries' as well as his own. With unusual simplicity he says in his preface : ** I have found reason to change my opinion upon some points." And yet Dr. Tait shows an English tenacity in holding to his own views. This book is thoroughly readable, and though not large, is comprehensive enough to meet the requirements of study into the intricacies of ovarian diseases. Besides, the writer has added a full bibliography to each chap- ter, which gives the reader a most excellent opportunity to con- sult if he desire contemporaneous literature. Our readers may safely add this volume to their growing libraries.

EDITOR'S TABLE.

Married.— Dr. A. L. Shepherd of Glendale, Ohio, and Miss Florence Richardson. Qreetings to the happy pair.

Dr. J. Heber Smith has removed his residence from Melrose, to 279 Dartmouth st., Boston,* opposite the Hotel Vendome, and Dr. Samuel A. Kimball of Bath, Me., succeeds him at Melrose.

We regret to learn that Dr. M. M. Eaton of Cincinnati, O., is still confined to his room. Is sufiering from rheumatic sciatica and h&s been unable to attend to his practice for the past two months.

EDITOR'S TABLE, 63

For Sale.— a good paying practice in a town of 3,500 in- habitants with new office, practice worth in good pay $3,500 per year. Good reasons for selling. Address W. P. Bennett, M. D., Crestline, O.

BEiiMA, Dallas County, Alabama, population about ten thousand, wants a Homoeopathic physician. First class opening for an enterprising man. For particulars write Dr. John H. Henry, Montgomery.

The Homceopathic Pellet is a new journalistic cadidate to be issued at Austin, Texas, by C. E. Fisher, M D. It prom- ised to be '* chatty, spicy, readable and controversial," all for $2 a year. We hope it may succeed in ^Aing and not have " to cut bait or go ashore."

Medical Students are now considering what medical col- lege they shall attend the coming year. Let them not forgetthe splendid opportunities offered by the Homoeopathic Department of the University of Michigan. The motto of this school is a

HiaHER EDUCATION FOR MEN AND WOMEN.

Practice for 8ALE.--Desirable, medium, growing practice on sea shore near New York. Sell furniture, horse, phaeton, medicines, etc , or practice alone, introduce successor, established

ten years, price nominal, possession Sept. 1st. Doctor B ,

lock box B— , Woodsburgh, Long Island. N. B. No postals an- swered.

College op Physicians and Surgeons op Buffalo.— An injunction has recently been issued forbidding this college to issue certificates or diplomas to its graduating class. Like the U. S. Medical and Surgical College of New York, the legality of its incorporation is disputed and is now before the courts for a legal discussion.

Pluck.— The Associated Press dispatch recently said that, an American physician had been forbidden to practice in Trip- oli, because he did not possess a Turkish degree. The American Minister, General Wallace, had him visit Constantinople, pass the examination, take the diploma, and return to Tripoli. He then demanded an apology from the Porte for the treatment to which the physician had been subjected, as hundreds of native doctors are permitted to practice without diplomas.

HoMCEOPATHY STILL DYING.— Several mouths ago the Re- gents of the State University of Nebraska established a Medical Department, O. S. i. e., Old School. As soon as announced to the public our men took it up, and below we give the result

64 EDITOR'S TABLE,

which gives us three Professors: C. L. Hart, (Hahnemann, Philadelphia), Omaha, Chair Materia Medica; B. F. Righter, (Hahnemann, Chicago), Lincoln, Obstetrics and Diseases of Children ; B. 8. Paine, (Hahnemann, Philadelphia), Lincoln, Theory and Practice.

American Public Health Association.— -It "has been decided to hold the next session of this body in Detroit, com- mencing November 13th. It is to be hoped that our readers will bear the date in mind, and by no means fail to be present. Whatever a few narrow minded persons may seelt to do, the As- sociation is open to all comers, and will be kept open if we do our duty. Questions of public health should call forth our best endeavors. Let there be a big meeting and especially let Mich- igan show her appreciation of the honor and benefits bestowed upon her by this national gathering.

The Calcutta School of Homceopathy.— Established on the 15th of February, 1883. This school has been established to meet a great want felt among the medical as well as the gen- eral public. Its object is to disseminate the Principles and Prac- tice of Homoeopathic Therapeutics. The Homoeopathic treat- ment is now recognized as that of the mont advanced and ration- al mode of Therapeutics. For the present, the following courses of lectures will be delivered : ** Principles and Practice of Med- icine," by M. M. Bose, Esq., M. D., L. R. C. P., (Edin), Ac, on every Thursday at 4:30 p. M. ** Materia Medica and Therapeu- tics," by P. C. Mojumdar, Esq., L. M. S., on evejy Monday, at 4;30 p. M. ** Principles of General Anatomy and Physiology," by B. L. Bose, Esq., L. M. S., on every Wednesday, at 4:30 p.m. L. Salzer, Esq., M. D., will also lecture once a week. For further particulars, apply to Shoshee Bhoosun Mookerjee.

Messrs. Palliser <& Co., of Bridgeport, Conneticut, the well-known Architects and Publisiiers of Standard works on architecture, have lately issued a sheet containing plans and specifications of a very tasteful modern eight-room cottage with tower, and also with the necessary modifications for building it without the tower, and with but six rooms if desired In its most costly form, the outlay is estimated at $3,000 ; without the tower it has been built for $2,500 ; and if only six rooms are in- cluded, the cost may be reduced to $1,700 or $2,000. Details are given of mantels, stairs, dooiB and casings, cornices, etc. The same firm issues specifications in blank adapted for frame or brick buildings of any cost ; also forms of building contract, and sev-

EDITOR^S TABLE. 65

era! booke on modern inexpensive, artistic cottage plans which are of great practical value and convenience to everyone inter- ested. Many of our practitioners who contemplate building,and who have not access to local architects, would find it advantag- eous to consult the above.

University of Michigan Commencement Exercises. —Commencement week of the University always notably full of events, was nevermore so than the present year. The annual crowd of visitors did not fall of their presence or enjoyment. We lack space for notice of each day's full and interesting pro- gram. Rev. Dr. Murray of Andover gave a remarkably fine address on Commencement Day. The Class of the Homoeopathic Department gave an entertainment to their friends on Wednes- day afternoon. Profs. Allen and Wilson made brief addresses and Dr. Phil Porter of Detroit, followed with a brief speech and the exercises closed with an appropriate poem by Dr. Will P. Polhemus. The following were graduated in the Homoeopathic Department : Elmer J. Bissell, New York ; Charles H. Black- burn, Louisiana ; Emma E. Bower, Michigan ; Wm. D. Cooper, Michigan ; Theodore L. Hazzard, New. York ; Susan M. Hicks, Indiana; Jacob O. Hoffman, Pennsylvania; Julian B. Hubbell, New York ; Myron L. Huntington, Wisconsin ; Harry C. Kas- selmann, Michigan; Anna L. Laub, Iowa; Harry Mc Lufkin, M. D., Illinois; Jas. T. Martin, B. S., Washington Territory; Jay S. Meade, Michigan ; Wm. B. Page, Missouri; Morton C. Reeves, Indiana; Carrie G. Watres, Pennsylvania.

** The Popular Science Monthly '^ for July is a strong number in its variety of instructive reading, and contains sev- eral striking articles. The first one, *• The Railroad Problem in the United States,** is an admirable statement of the various urgent and difficult questions that have been created by this uew and colossal interest of our civilization. But the most brilliant paper in the number, and as practical as entertaining, is that of Dr. Oswald on ** Dyspepsia " in his series on ** The Remedies of Nature." It presents the hygienic treatment of this protean and life embittering disease with great vividness and force. In fact, he shows that Nature is the only doctor that can deal effectually with derangements of digestion and the dis- orders of its organs. Many a dyspeptic wretch would get new experience of life by adopting the treatment here laid down. Dr. Emily Blackwell has a very radical and able article on ** The Industrial Position of Women,*' in which she advocates

66 EDITOR'S TABLE.

the freest competition in ali outside vocations, and maintains that the liberation and independence of woman are to come by removing all domestic labor from the home to the sphere of out- side business orgauization. The editor of the *' Monthly '' makes a lively reply to Dr. Blackwell's main positions. Hux- leys article on ** Unwritten History " is one of the finest of this incomparable scientific essayist. Vadous other contributions make the number a peculiarly attractive one. New York : D. Appleton A; Company. Fifty cents per number, $5 per year. The following from a Cleveland daily is rather hard on the American Medical (Allopathic) Association : ** A great deal of time is being wasted just now by the scores of physicians as- sembled in the city. One seldom hears them read a paper half of which is not devoted to glittering and senseless generalities. If the average doctor, like the average live journalist of to-day, would immediately get at the heart of his subject, this medical convention might adjourn a day sooner than it will do. While the doctors are taking such elaborate pains with their papers it would be well if they would u?e their endeavors to have the same rule of leisurely painstaking apply to the medical colleges. The hate which characterizes the medical schools is some- thing appauling to the. public. Hundreds of young doc- tors are turned loose on the public, who, granting that they complied with the rules of their college, have probably devoted but three years to study, including two terms of lectures of twenty weeks each. Even this rule" is made flexible in many instances. The superabundance of rival medical colleges makes it necessary that one shall ofiTer special inducements over an- other, and experience has taught the conductors of schools that the school that turn out doctors with the least outlay of time and money will be the best patronized. The professors, so- called, in these institutions are not salaried men, paid for de- voting their best energies to their colleges, but ambitious doc- tors, who seek places on the faculties on account of the prestige it gives them to be called ** Sawbones, A. M., B. 8., M. D., pro- fessor of therapeutics, the practice of medicine and diseases of the intellect in the college of doctors — made- to-order-on-short- notice. ^' The time has come when national legislation is de- manded in the premises. The country demands doctors, but it can't afford to submit itself to the manipulations of a lot of ready made doctors. The learned medical gentlemen who com- pose the regular profession so-called, talk a great deal about quacks and empirics, but they ought to turn their attention to the licensed quacks which the doctor manufactories are turning out"

T. P. mmiiSON, n. ik,

Editob.

Business Manages.

Vol. XIV.

Ann Arbor, August, 1883.

No. 2.

All sabscriptions and basiness commnnications should be addressed to MEDICAL ADVANCE PUBLISHINQ Co.. Ann Arbor, Mich. Snbsoription, 92.00 per annum.

Dynamics. — A gentleman well known to the profes- sion, who has long been a regular subscriber, a careful reader and an uncompromising enemy of the Medical Ad- vance, who also has entertained opinions not at all com- plimentary to the editor of this journal, made to us a proposition at the American Institute meeting, worthy of some thought. The gentleman referred to is a vigorous fighter of high dilutions. He hates " dynamics" as the devil hates holy water ; and he has spent years in studying how the homoeopathic school might be rid of these pestife- rous attenuationists. His recent failure to place hi6 State society upon the record against what he is pleased to call high dilutionism, and his utter inability to rid the Ameri- can Institute of these dreadful " Hahnemannians," have brought him to a more agreeable state of mind. He now proposes to treat with, rather than make further at-

2

58 EDITORIAL.

tempt to annihilate,. his ancient enemy. This is creditable to his heart as well as his brain. His proposition, as we understand it, is, to draw a line so as to separate the atten- uations into two classes. The line of separation, he claims, should be definitely placed at the twelfth centesimal. That attenuation and all below it, should be, or may be, called "Homoeopathy;'- and all attenuations above the twelfth, should be labeled "dynamic." This point, we suppose, is chosen because the microscope or the spectro- scope or chemistry, or all three together, stop at about this point, in giving evidence of the drug presence. When asked if one might with his consent use preparations above the twelfth he readily consented, but demanded, that all cures reported by such attenuations, should be marked " dynamic." Also, we understood him to say, they might be called " psychological." We are certain that he gave the largest liberty in the choice and use of attenuations, and declared, that he had no war to make upon high dilu- tionists, if they would draw the line of distinction at the twelfth centesimal. This was so foreign to our former un- derstanding of the gentleman's position, that it took us quite by surprise. And as he is a representative man among the so-called low dilutionists, it might be well to treat with him, and, if possible, put an end to this inter- necine warfare. For our part, we are willing to grant Dr. Paine even more than he asks. All drugs seem to act dy- namically. The kinetic power of a drug is all there is about it, that gives it any value ; and so we have no objec- tion to labeling every cure as dynamic. The heart of Ho- moeopathy lies in its law of cure. But similia is no expla^ nation of the mode of cure. It is a law, by which, under any given case, we select the proper drug. When the proper drug is chosen, the question of attenuations, fre- quency of giving and the philosophy of the cure, are left to the judgment and skill and taste of the prescriber. When by the symptoms of the patient, arsenic is indicated, we are morally and scientifically bound to give arsenic.

MICHIGAN 8TA TE SOCIETY. 59

There is no law, hiwever, compelling us to give any par- ticular quantity or attenuation of arsenic. Similia says, Give the drug indicated. Each individual determines the dose for himself. Now, for our part, we are willing to ac- cept all that the microscope, chemistry, or the spectroscope can possibly reveal. If thay have nothing to tell us be- yond the twelfth centesimal, then let us draw a line th'ere. Up to that point we ^.re giving ponderable doses of drugs, and beyond that point, we have no evidence such as the microscope or spectroscope reveal, of the drug presence. But as we understand Homoeopathy, as expressed in the law similia, it can h-ive no reference to the line drawn. It does not dictate or suggest the particular preparation to be used. On both sides of the line, however, we find dynam- ics, and only dynamics. Every purely psychological effect is as dynamic as any phenomenon can possibly be. Can we not then have a lasting truce declared, between the contestants who war so vigorously and injudiciously over attenuations. There can be no possible objection to grant- ing Dr. Paine what he desires, so far as labeling the higher attenuations are concerned, and we do but extend his de- mand by giving the same designation to all attenuations. On this basis, then, let us have peace, and go forward with our work and learn what more we can from experiment, observation and clinical experience.

PROCEEDINGS OF THE FOURTEENTH ANNUAL SESSION OF THE HOMCEOPATHIC MEDI- CAL SOCIETY OF THE STATE OF MICHIGAN.

HELD AT LANSING, MAY 15tH AND 16tH, 1883.

First Day. — The Society was called to order at 9:30 A. M. by the President, Prof. E. C. Franklin, M. D., of Ann Arbor.

60 MICHIGAN STA TE SOCIETY.

Before proceeding to the order of business, Dr. Frank- lin stated that his name had been used extensively throughout the State, and entirely without his authority, by a Detroit firm of medical men. The use of his name and position in the circulars widely circulated by them having seriously annoyed the profession and having cast upon it suspicion of countenancing a species of advertis- ing not in accord with generally accepted views of profes- sional propriety, he desired to state that he personally was not responsible for the use of his name in said circular ; that he had, for some time past, refused to give his ser- vices to said firm, and wished to express sincere regret that he had inadvertently been the means of annoying his colleagues in this state. Upon motion of Dr. Sawyer, this explanation was accepted, and referred to the Secre- tary.

The chair then appointed the following standing com- mittee,— Auditing Committee: Drs. H. M. Warren, of Jonesville; H. Whitworth, of Grand Rapids; A. R. Wheeler, of St, Louis.

Dr. I. N. Eldridge, of Flint, in behalf of the Board of Censors, reported favorably upon applications for member- ship of Drs. James C. Wood, Byron C. Elm, S. A. John- son, J. M. Griffin, D. M. McLachlan, J. H. Brucker, M. N. Avery, M. J. Slocum. On motion, the applicants were elected to membership.

Dr. Long moved the adoption of the order of business presented by the Secretary. Gamed.

The Treasurer, Dr. G. A. Robertson, made his report, which, on motion of Dr. Allen, was received and referred to the Auditing Committee.

Dr. J. G. Gilchrist as a delegate from the College of Physicians and Surgeons, of Detroit, stated that the society he represented had met regularly every week during the year, had done an excellent work for its members in stim- ulating research and study, and in cultivating pleasant personal relations among its members.

FO URTEENTH SESSION. 61

Dr. H. R. Amdt, of Grand Rapids, reported that, in 1882, he had represented this society at the meeting of the Western Academy, held at Kansas City, Mo. After speaking of the excellent work done by the Academy, he stated that he had reasons for knowing that the Academy would probably accept an invitation to hold its next an- nual meeting, (1884), in this State.

Report of the Bureau of Pathology. — In the absence of Dr. Jones, Dr. Arndt, as acting chairman, called upon Dr. Gilchrist, who read a paper on " Spinal Traumatism." Dr. Gilchrist said :

The most important oondition in spinal traumatism is con- cvMicm^ whicli is defined as a ioss of conduction in the spinal nerves, terminating in various forms of paralysis, an essential feature being that there must be no organic lesion ; an actual structural lesion places the case in another category. Thus when a watch falls to the ground, and the glass is broken, no injury may result ; if the glass is not broken the movement stops. The causes of concussion being Jarring or shaking injuries, the pro- gress of symptoms is insidious and deceptive. The necessity for accurate deferential diagnosis was shown, and the chief points were stated to be as follows : In cases with organic lesion there is immediate disability. Concussions of the spine occasion by per- sesthesia with nervous irritation. Pressure on the nerves by effusion, or contusion of ligaments, gives minor hypersesthesia, viz., the band like constriction around the trunk. Complete painless paralysis shows lesion of posterior columns. Motor paralysis shows deep injury. Extreme painftdness shows men- ingeal lesion ; subsidence of pain, with no improvement in the motor paralysis, shows extension to the gray matter. Hemip- legia may proceed from uni-lateral injuries to the cord, from the decussation of the fibres of the pillars.

At the conclusion of this paper. Dr. Sawyer moved a vote of thanks to Dr. G. for his able paper.

DISCUSSION.

Dr. H. C. Allen : I am opposed to giving a vote of thanks to a member of this society who has simply done his duty. If to one, why not to another, or to all ?

Dr. Sawyer : I am sorry that Dr. Allen has raised tliis question. If we have failed in anything it is in manifesting ap-

62 MICHIGAN 8TA TE SOCIETY.

preciatioQ of work well done. And, therefore, I think an ex- pression of appreciation Is due to Dr. Gilchrist for the able paper he has read. I have considerable trouble with these spinal diffi- culties, and have been puzzled on account of some of the symp- toms I have found present. But I have received light from the paper just read.

Br. Gilchrist: I think myself, a member should not be thanked for doing his duty.

Dr. Allen : I move that the paper be received and referred to the committee. I wish Dr. Sawyer to know that I appreci- ate that paper. Still, while I feel myself unable to criticise it, I would have liked it a little more full in some respectp. For in- stance, we have one remedy (Hypericum) peculiarly adapted to the ranjre of diseases spoken of in the paper; and this remedy was not given in the paper.

Dr. Sawyer : About five years ago I had under my charge the case of a young lady who had fallen and hurt her spine. In a short time she was taken to her bed, and soon became unable to move. She was, I think, confined to the bed for five months, and during that time never set iier foot on the floor. During all this time she could not tolerate heat in the room, nor the covers to touch her. She was covered by hoops being stretched over the bed, and the covers were placed upon these. She could not endure talking or moving in the room. I tried various remedies without success. Finally I fell upon Agaricus. The result was very gratifying to me. She recovered and is now a mis^onary in China.

Dr. Long: I had a case that I think is in point. A boy, while coasting had run against a tree, and when I saw him he was unconscious and unable to swallow. I gave him Arnica. I told them I considered it a serious case, and could not tell how it would terminate. An allopathic physician had been called in. He considered the case very serious, almost hopeless, and thought inflammation would surely set in. In a month's time they took him to Washington. He was somewhat lame, but there had de- veloped no inflammation.

Dr. Arndt: While I have had no very extensive special experience in the treatment of spinal difficulties, it has been my good fortune after all to have had a good deal to do with cases of spinal diseases. It has seemed to me that a large majority of cases that have been brought to me have been occasioned by slipping and falling backward, inflicting a blow upon the spine,

FO UBTEENTH SESSION. 63

the results not showing themselves for a long time. A lady was stepping into a carriage, fell and struck her back against the curb stone. It wss not tintil months after this that she experi- enced any difficulty. The late Dr. Hempel was totally blind for four years before his death ; no satisfactory reason could be given for his blindness. For three years before his death he was help- less from general paralysis. The facts in the case were, that, some years before these grave symptoms showed themselves, he had fallen, and struck upon his spine ; about the fourjth day after this, he had suffered a very slight stroke of paralysis, but this had passed away hardly noticed. He did not think any- thing about it until about a month before his death ; then, he re- called the accident. The slight injury received resulted in ex- tensive necrosis of the sacrum, as shown after death.

Dr. McGuire : There is a good deal to be said upon such a subject as this. Cases frequently occur where there seems to have been no accident to cause them. Injuries are often pro- duced from remote causes. They occur in our young people. Very often, I have no doubt, they result from indiscretions,run- ning up and down stairs, etc. First they complain of cerebral pains ; we are apt to neglect these. It is only a headache, and we let it go on from year to year, and bye and bye there is trou- ble with the eyes, and on examination we find some form of optic nerve trouble, as optic nerve atrophy^ perhaps already so far advanced that relief is impossible.

Afternoon Session. — ^The society met at 2 p. m., Presi- dent Franklin in the chair. The following were appointed the committee to nominate chairmen of bureaus : Drs. O. R Long, Phil. Porter, H. 0. Allen.

The Board of Censors reported favorably upon the applications of Drs. D. A. McLachlan and Geo. E. Ehle, both of whom were duly elected.

The Auditing Committee then reported that they had duly examined the accounts of the Secretary and Treas- urer, and found them correct. On motion, the report was accepted.

Board of Censors for 1884 -'Drs. I. N. Eldridge, A. R. Wheeler, C. J. Covey, G. A. Bagley, R. C. Olin, J. H. Rey- nolds.

64 MICHIGAN STA TE SOCIETY.

Judiciary Committee for 188i. — ^Drs. I. N. Eldridge, O. R. Long, D. J. McGuire, A. I. Sawyer, W. J. Mills.

Dr. B. F. Bailey, of Lansing, being present, then de- livered a brief address of welcome to the society. Dr. Bailey said : " In making this address of welcome, you all know that you are welcome. When a man pays his own money for entertainment, he certainly is, and should be, welcome."

After a brief response from the President, in behalf of the society, the society proceeded to the regular business.

Bureau of Surgery. — Dr. O. R Long, chairman, offered an apology for an unsatisfactory report, explaining the in- completeness of his bureau work by his unfitness for liter- ary work by reason of fatal sickness in his own family. Prof. Franklin, having called the Vice-President, Dr. A. B. Avery, of Farmington, to the chair, read a paper on " Spinal Curvatures,'^ and Dr. J. Q. Gilchrist presented a paper on " Operations for Tumors.'' The papers were dis- cussed by Drs. Long, Gilchrist, Arndt, Porter, House, and M. N. Avery.

DISCUSSION.

Dr. Arndt. : I desire to ask a question of Dr. Gilchrist : Suppose a patient sufferiDg from a tumor, say, of the breast, comes to a medical man ; the physician discovers no urgent symptoms calling for an operation, the patient possessing the best of general health ; would the doctor carry out the advice given in his paper, and operate immediately? A lady came to me under such circumstances ; the tumor is one of the breast, and has caused no pain ; the only pain of which the patient complains is in the shoulder ; it seems neuralgic; certainly, the patient has always sufTered keenly from neuralgia. Under the the action of Conium the tumor has grown smaller, and it is now, in size, quite insignificant Other physicians have care- fully examined the tumor and acknowledged that it has de- creased in size. There is no enlargement of axillary glands. What would Dr. Gilchrist do in the case?

Dr. Long : I would like to ask Dr. Gilchrist if the pain in the tumor is not an evidence that it is malignant ?

FO VBTEENTH SESSION. 65

Dr. Gilchrist: In case it is a fact that the patient is doing well, that is enough. I do not deny the propriety also of using internal remedies. If you can determine that you have a be- nign tumor to treat, it is well not to hurry, but if you have found that the tumor is malignant, I think the longer you delay the worse. Now, up to the time the skin is non-adherent, the tu- mor may be considered benign. That is the stage when tumors should be removed. I think we all agree upon that. Is it be* nign or is it malignant? All hinges upon this.

Dr. Arndt : The patient called my attention to a feeling of pain on the shoulder joint. She has become convinced that not not only is the tumor better, but the *^ feel," as she calls it, is better.

Dr. Porter : One important fact, in relation to carcinoma of the mammary that has been overlooked, or, at least, not men- tioned by Dr. Qllchrist in his paper, when arriving at a conclu- sion, as to the malignancy of a tumor of the breast is, the en- largement of one or more of the axillary glands. When you do have this condition accompanying a tumor of the breast, it is usually safe to look with suspicion upon the growth and treat it accordingly. Again, tumors of the breast are oftentimes benign in character and due, sympathetically, to uterine diseases, but can be distinguished from the true cancer, ordinarily, by the changes that take place in the breast during menstruation to en- title the flow to that name, and sufficient in quantity to soil two napkins a day. for two days. The peculiarity of this case gives both Lawson Tait and those who disagree with him something to think of. Lawson Talt believes that ovulation and menstru- ation are independent of each other. That the menstrual flow is controlled or associated with a periodical congestion of the Fal- lopian tubes, and a host of writers, on the other hand, are as as- siduously trying to demonstrate that menstruation is absolutely under the control of the ovaries. Lawson Tait claims to have seen an ovisac on the point of rupturing some days after men- struation bad ceased. Now, with my case, with both the ovaries removed, as well as the Fallopian tubes and uterus, who will ex- plain where the menstrual fluid comes from ? or what causes it? The fluid is similar in character to her past menstrual flow, she says she sees no diflTerenoe. The tumor proved to be, on ex- amination, what Holmes called a withering scirrhus.

Dr. House : I would like to ask if recurrence of the pain is not an indication of malignant growth ? I had the case of a girl

66 MICHIGAN STA TE SOCIETY.

nineteen years of age. A year ago I was in New York, and the little girl came home with me after having had an operation for tumor performed upon her. In a short time a tumor began to form on the opposite side. The mother consulted me as to whether she should have a second operation. I gave the child Coniuni. The tumor has gone, there has been no appearance as if it would return. I have no experience in the treatment of tu- mors and do not profess to be able to diagnosticate closely in such cases. I did not consider this tumor to be a malignant growth.

Dr. Porter : Last fall, in September, I diagnosed a fibroid tumor in a lady thirty-four year years of age. She had a great many of those characteristic pains, yet I was in doubt until I had opened the patient. In regard to the removal of the tumor, in this case I had to remove the entire uterus and ovaries. The patient presented herself to me a month ago, and I found a tu- mor of the stomach. I do not know whether she will submit to an operation or not. She has now enjoyed good health for nine months. She has menstruated. The question now comes up where the menstruation comes from.

Dr. Long : I would like to hear something more about this menstruation. Does the nervous system take no cognizance of the fact that the doctor has removed ovaries and uterus?

Upon motion, Dr. Porter was requested to prepare for publication, a report in full of the ease referred to.

DR. porter's report.

It is often very difficult to arrive at a proper diagnosis re- garding fibroid tumors as to their malignancy before an opera- tion. It is almost imp6ssible to state whether a tumor is benign or not. Last fall, in September, I examined a case and pro- nounced the tumor a fibroid growth of the uterus, as it had be- haved like a benign tumor and presented none of the character- istic symptoms of a sarconea. As the patient demanded an operational felt justified in doing all I could to relieve her of her suffering. I assured her I would, in all probability, be com- pelled to remove the uterus with the tumor, not suspecting I had a carcinoma to deal with. On opening the patient I found, to my surprise, I had a soft encephaloma of the uterus. I removed the entire uterus including all its attachments, except the neck, which I reserved for a stump, and covered it with peritoneum, I had taken from the interior wall of the uterus. The tumor was very soft and would give way at the slightest force. This

FO UBTEENTH SESSION. 67

lady is now at this date, doing house work. One interesting feature of the sequel of the operation is the fact, that the patient after the fourth month commenced menstruating. Not exactly as before the operation, yet with sufficient regularity.

Discussion on H^. Franklin's paper.

Dr. Avery, of Niles : I would like to ask how long it will do for patients to wear casts ?

Dr. Franklin : Two or three weeks, if the Jacket is put on well. I take off the cast during the night, and the patients take a bath if they desire. Put the Jacket on patients standing up. Just as I am now (raising himself up) ; it holds the patient up as crutches would. There is a great deal to be learned on this subject of spinal curvatures. Surgery, I believe, is yet in its in- fancy. By the use of homoeopathy we shall get rid of a large measure of the difficulties connected with surgery. It will not be twenty years before surgery will be robbed of many of its ter- rors of a few years ago. There are not more than one-half the operations now, that there were twenty years ago. I believe it is ascribable to the benefits of homoeopathy.

Dr. Gilchrist : In treatment for spinal curvatures we are under necessity to carefully consider causes. We are apt to get into a rut, and I would emphasize caution.

Dr. Franklin : If a patient comes to you with spinal cur- vature, and you can relieve by lifting upy you are going to cure that patient.

Dr. Avery : I have a case of spinal curvature of nine years standing. I applied the spinal cast, and she wore the vest one or two months. Before that, she was unat>le to stand upon her feet, but in a short time could stand. I applied the cast, and after removing it in due time, kept her quiet. After leaving it off for two months, I again applied it, and let it remain three months. Now, dare I continue this treatment ?

Dr. Franklin : Yes sir, you can continue it. You must un- derstand that disease can only be cured by going back to the causes. After you kept her under the cast three months it ceases to do any good. It has retained the body in that position; now take it off and replace it I would go on and treat that case in this manner and I am sure you will greatly help, if not cure it. You can^t take away all the deformity, that is impos- sibly. You can't build up that lost vetebral disk ; but you can greatly relieve.

68 MICHIGAN STA TE SOCIETY.

On motion, these papers were referred to the Publish- ing Committee.

Upon motion, the Bureau of Surgery was then de- clared closed, and its papers referred to the Publishing Committee. Dr. O. R. Long moved that the consideration of the Northern Asylum be made a special order for four o'clock. Carried.

Bureau of Mental and Nervovs Diseases. — Papers were read by Dr. Warren, of Jonesville, on " Chorea " and by Dr. M. Rorabacher, of Battle Creek, on " Epil- epsy." After discussion they were referred to the Pub- lishing Committee, and the bureau declared closed.

Dr. Bailey, of Lansing, then introduced the Hon. JSIr. Robertson, who addressed the society in reference to the Northern Insane Asylum bill, then pending action in the House, expressing the hope that, for the sake of justice, the bill would become a law.

On motion of Dr. Arndt, the President expressed the thanks of the society to Representative Robertson and to those gentlemen in the legislature who have labored to secure the passage of the bill.

At 5 o'clock p. M., Dr. A. B. Avery took the chair, and Dr. E. C. Franklin delivered his annual address.

Dr. Arndt moved that the address be referred to a committee of three. Carried.

The chair appointed Drs. Arndt, Eldridge, and Long.

The society adjourned until 8 o'clock p. m.

Evening Session.— ^wr^t^ of Pmdology.—Tyt. Rey- nolds, of Grand Haven, chairman, read a paper on " In- fantile Colic," also a paper on " Infantile Convulsions." Discussed by Drs. Long, H. C. Allen, Reynolds, and Porter. Dr. Clark, of Three Rivers, read a paper on " Diseases of the Foetus," which was discussed by Drs. A. A. Allen, H. C. Allen, and Dr. Warren. On motion, bur- eau was declared closed.

FO URTEENTH SESSION. 69

On motion Dr. Gilchrist was unanimouly chosen to address the legislature on the Northern Insane Asylum.

Dr. Rorabacher, Chairman Bureau of Mental and Nervous Diseases, presented a paper on " Epilepsy," by Dr. L. D. Vanhom, which, on motion, was referred to the Committee on Publication.

Bureau of Obstetrics and Chynodcology* — Dr. Phil. Porter, of Detroit, Chairman, announced several papers by title.

Dr. Whitworth, of Grand Rapids, then read a paper on " Meddlesome Midwifery."

Dr. Reynolds: Dr. Whitworth says nothing about sup porting the perineum. Does he not think it necessary ?

Dr. Whitworth : That I think, is not an open qu^tion. There are cases, no doubt, in which it is necessary and in which the physician would be culpable who neglected it.

Dr. A. B. Avery : The reader referred to bandaging, and said he would not bandage unless the patient desired it. Is not the physician best able to judge of that? In ninety-nine cases out of a hundred, the patient will take his advice. I have had good success in obstetrics. I have advised my patients to get along without bandages ; and generally I have found that they did do better without them. And there is another point. I have found by experience that, when the head has entered the super- ior straits, introducing the finger will induce more frequent pains. Is that meddlesome ? And does it increase the amount of pain ?

Dr. Qrant : I would like to ask Dr. Avery if he ever knew of any bad results from the use of the bandage ?

Dr. Avery : How could I ? I have never used one.

Dr. Grant : Did you ever hear of any ?

Dr. Avery : I think not. But the bandage might get out of order. It may also generate heat.

Dr. Mosely : Manipulations of that kind would tend to reg- ulate the pain.

Dr. A. A. Allen : In cases of that kind I think that any- thing which tends to open the uterus is allowable. The first case that I attended I put on the bandage.

Dr. Whitworth : I do not wish to go on record as allowing the patient to dictate whether the bandage should be put on or not. I usually advise not to use it.

70 MICHIGAN STA TE SOCIETY.

Dr. Gilchrist : I do not profess any special knowledge of obstetrics, and that is one reason I wish to speak. Wlien a wo- man has been in the habit of using a bandage, we may do dam- age if we don't use it. But there are no iron-clad rules. From preference I would never use it.

Dr. Avery : I have been expecting to hear from Dr. Porter in regard to this one point. [ would like to ask him or Dr. Morley, whether or not the use of the abdominal bandage would not have a tendency to induce general congestion of Uie pelvic organs ?

Dr. Porter: In reply to Dr. Avery I would say, that it would consume fifteen or twenty minutes time of the society to give a definite or explanatory answer to his question. I will say, however, that when the abdominal parieties are very much re- laxed and flabby, after confinement, I do not see how a bandage put on with moderate force can do any harm, but I do know it affords the greatest comfort to the patient. Do not understand me as advocating bandaging women after delivery, for there is no greater source of disease producing cause than the bandage as ordinarily put on. The bandage has not the slightest influence in giving a woman ** good form'' as is claimed.

Dr. Porter reported a paper from Dr. Wood, of Mon- roe, on " Acute Endometritis," and read the last pages. Commenting, he said : 1 would simply say that I think it a mere farce to mix Glycerine and Calendula. I think it simply a waste of time.

Dr. Porter then read a paper on " Ovarian Dysmenor- rhea."

Dr. Reynolds : I thought I followed the reading of the pa- per pretty closely, yet I have one question to ask Dr. Porter. Do I understand rightly that his paper related exclusively to Ova- rian Dysmenorrhea?

Dr. Porter : I went outside of that, yet the whole paper re- lated to that subject.

Dr. Gilchrist : There ought to be some remarks on this pa- per ; if not in criticism, certainly in commendation. Certainly it is an able paper, and does credit to Dr. Porter.

Dr. Allen : I was very much pleased, indeed, with the pa- per. It was not only well written, but well read.

FO UBTEENTH SESSION. 71

The convention then adjourned to meet at 8 o'clock Wednesday morning.

Wednesday Morning Session,— The society was called to order by the President at 8:30 a. m.

President Franklin spoke in reference to the misun- derstanding in regard to those members whose dues they considered paid, some of whom held receipts ; and advised that something be done by which this could be settled. :

Dr. Gilchrist, supported by Dr. Olin, then oflfered the following resolution, which was adopted : - :

Whereas, There is conlinual dispute between thjelhr^s- urer and members of the society with reference to the individual accounts of the members ; and,

Whereas, Inaccuracies in the accounts extending over a period of time antedating the administration of th^ present Treasurer; therefore

Resolvedy Ist, That the Auditing Committee be instructed to correct the financial accounts of the society, and to- settle all matters of dispute between members and the former Treasurer.

Resolved^ 2d, That all members, regardless of their stand- ing as to dues, be entitled to the privileges of membership for the remainder of this session.

The resolution was passed,

A member desired that the society should examine a clinical case, and the matter was referred to a committee consisting of Drs. Olin, Gilchrist and Warren.

On motion of Dr. Gilchrist, the Bureau of Hygiene and Climatology was stricken out of the list of Bureaus.

Dr. Eldridge presented the name of Dr. Palmer Co- vill, a graduate of the Western Homoeopathic College, 185Y, for membership. '

On motion of Dr. Allen, Prof. J. C. Sanders, M. D., of Cleveland College, was made an honorary member of the society. •

Dr. Covey moved that Dr. C. A. Jeflfries be made an honorary member of the society, and the motion prevailed.

72 MICHIGAN STA TE SOCIETY.

Bureau of Materia Medica. — Dr. Arndt, chairman, reported papers by Dr. Whitworth, Dr. H. C. Allen, and himself.

Dr. Allen said : I am very much pleased with Dr. Whit- worth's '* apology." He has given us a very good paper. He says that our chemistry is the chemistry of the other school, and that is true. We must always remember that we have been compelled to take our pathology from their text-books. The teachings of the two schools in Materia Medica differ diametri- cally. It is impossible to build up an ideal Materia Medica. We shall never get this in our school. We differ in our modes of thought, aud we do not all treat our patients alike. But as we do not commit Worcester's or Webster's lexicon to memory, so we do not get our Encyclopsadia by heart. And we very often treat diseases instead of patients.

The convention then listened to a paper by Dr. H. C. Allen, " The Study of Materia Medica."

Dr. Gilchrist : We live in an age of compensation, where it is impossible for one man to master all departments. So I think the doctor's point was not very well taken, that every practi- tioner should master all the great mass of matter in the Materia Medica.

Dr. W. M. Bailey : I came here to learn ; and I must say that in the last paper I have gotten pay for coming down here. We cannot master all things, of every department ; but I got hints from that paper that are very valuable to me. I do not wish to criticise the paper at all.

Dr. Phil Porter : The subject has now reached a very inter- esting point, and, although not so well versed in the matter of drug proving as those who live with, exist on, and will in all probability die, believing in the honesty of these pro vers. I still take a deep interest in this much abused subject. Were these provings carried to the extent, that we had, as a result, some pathological changes or tissue changes, we could, with some degree of confidence, trust our patients with remedies that were supposed to have some affinity for the diseased condition we are called upon to treat. But you give a prover the 80th of any drug and tell him or her to give you symptoms as they are presented, and I will venture the remark, that you will be sup- plied with enough to fill a book in a week's time, especially if the prover is at all susceptible. According to our well-known

FO URTEENTH SESSION. 73

belief, that diseased organs or tissues are much more susceptible to the action of remedies, than the well or healthy, on what ground can we expect to obtain any reliable symptoms from the 30th, when taken by a prover ? It seems to me that the gentle- men who are so willing to accept the symptoms of these enthu- siasts as provers, should not overlook this fact. Again, it is a recognized fact that the symptoms of a prover are influenced by the quantity and repetition of the remedy being proved. Thus, two droi>s of the strong tinctures will produce a certain train of symptoms, if repeated in two hours, more symptoms variously manifested, will be added to those already obtained, now, if thirty drops are taken, you will have still another group of symptoms and so on until you have tissue change, in this way something tangible would be presented to the profession, I firmly believe, all drugs when being proved, should be carried to that point, when definite toxicological efiects are produced. * * * Now, Mr. President and gentlemen, don't understand me as trying to throw ridicule or distrust iipou homoeopathy, for it is, when stripped of this absurd sophistical connection, one of the grandest gifts of God to man— a boon— I wish all mankind could have, but it is this everlasting load of chaff we are con- stantly obliged to carry with us that is such a curse to the school. You look about and see who are the progressive men of our school, who have made places for the name of homoeopathy in every State in tiie Union, m^de places for it in many of the public institutions of this country, has all this been accomplished by these theorists ? No, sir ; but by men who are willing first to cure their patients, then work out the similium of the prov- ing of the 30th afterwards. I believe as sincerely in the law of similars as any one, but in the provings of our Materia Medica I do no not. * * * I only desire to say that I have learned one important fact while I wats in Europe, that the homoeopathic practitioners of this country have done more to make Hahne- mann's name celebrated, than his German associates ever did. I have very little confidence in the provings of the German fol- lowers of Hahnemann. That reminds me, Mr. Chairman, that I have in my possession a vial of Borax 30, that was given me by Mr. Schwabe of Leipsic, who assured me on his honor (and you know a dutchman never lies'* that it was from one of Hah- nemann's own private pocket case, I saw it taken from a case anyway, and yet, with this in my care, I do not feel any nearer Hahnemann than do my less unfortunate brothers who are 3

74 LA CHESTS IN NEPHRALOIA.

without it. Schwabe said the label is Id Hahnemann's own hand writing. ♦ * * i knew I would kick a hornets nest when I refused to accept all that has been written under the banner of homoeopathy, especially the provings. You must accept all or nothing, is the verdict Well, as I said before, this is a field or branch of medicine I do not like and I know little about— this ought to excuse my remarks, but I do say that if twelve men are taken who do not know each other or any thing about medi- cine, to prove remedies and the work is carried out until toxico- logical eflTects are produced, and then the symptoms compared,! should have some confidence that we were approaching some- thing that could be utilized. But you let -any one of these doc- tors about me take a remedy and go to work noting symptoms and it would keep type setters busy to keep up.

The President announced the following gentlemen to constitute the Bureau of Ophthalmology and Otology, viz.: Drs. D. J. McGuire, T. P. Wilson, and H. Gilbert.

LACHESIS IN NEPHRALGIA.

BY J. N. IX)WS, MILFOBD, N. J.

Case 1.— Miss A. H., aet. 20. Disease, Renal Calculi of the triple phosphates.

On the night of June 9th she was suddenly seized with very agonizing pain in the right renal region, result- ing in very severe Colica Renalis. The pains were parox- ysmal and spasmodic, attended with emesis and cysto- spasmos ; and seemed to extend from the right kidney, and ureter to the bladder.

We first saw her in the following morning. She then stated that she had had sensations as if a worm was crawl- ing within the bladder. Guided by this marked charac- teristic, and the known action of Belladonna in relation to spasm of the ureters caused by the passage of Renal •Calculi, we prescribed it in the 30th. Anticipating a prob- able renewal of an aggravation of her symptoms, we or-

J. N. LOWE. 75

dered that she should be placed in a warm sitz bath — if again visited with severe pain — and that, when in bed, hot water fomentations should be kept continuously applied to the seat of pain. Very early in the morning of the 10th a call came again, stating that she was no better, but rather worse ; and that we must see her as soon as possible. Her sufferings since one o'clock of the previous night had been intense, at times driving her to cries and screams. We found her with diminished pain, but affected with al- most constant nausea and vomiting (reflex as to cause) with scanty ejectment of watery mucus with slight traces of bile. We gave Ipecac, 3c., without relief. Next, Canna- bis., 20c., partial relief of stranguary, vomiting, no change. Canthasis, 20c. Nil. Opium, 3x. These were not alternated, but tested single, until we were satisfied of their ineffic- iency. We were pretty well "out at sea," now — into something of a fog — and had given our personal observa- tion to the case for about ten hours ; and had settled down to the conclusion that we should " fight it out" on the line of the true Similim'um, if it took all summer. The voyage thus far had been conducted without chart and compass. Still we abode in the ship. " Unless you abide in the ship (the truth) ye cannot be saved."

At this extremity — the fog began to disperse — and the vis conservatrix asserted its prerogative, by signals, which led us at once to a true selection. The signals given were a sick feeling from stomach to throat with a sense of nau- sea and choking in the throat. She could bear nothing to touch her throat externally ; and, strange as it may ap- pear, whenever she changed her position she felt some- thing rolling in the bladder. Lachesis 1000 c. (Boericke) given dry, immediately after every renewal of the vomit- ing. After three or four doses of this remedy in the Im. had been used, all of 'her troublesome symptoms abated, and several small calculi were passed from the bladder.

Never before in the conduct of a case have we met with these salient characteristics of Bell, and Lach., viz.,

76 NA TR UM MUB, IN INTERMITTENT FE VER.

of a worm as to the former, and a ball as to the latter, (t. e,) in the history of one sickness, in one patient.

A word more : The indication of Lachesis was at the last undeniably simple, plain. It afforded an opportunity not only to test the truth of the provings (verified) of the ophidia, but to satisfy my desire in the demonstration of the truth, or falsity, of the assertion (at least in one well- defined instance) viz.: that there can be no remedial in- fluence imparted by a dynamized remedy above the 10c. or lie. potency ; and not the shadow of an effect from the decillionth. We had the 6c. of Lach. in one case — and in- tended to use it should the 1000th fail. But it didn't — and now, *^'' what can we do about it ?" Comment is unneces- sary.

NATRUM MUR. IN INTERMITTENT FEVER.

BY T. BYALL., M . D., SALEM, NE^.

Miss , aet. 23 years. Has been a sufferer with inter- mittent fever since she was a little girl, or as long ago as she can remember. Twelve years ago abscesses were found in the right hip, which would last about two weeks, sometimes discharging through the uterus, when she would get better and continue to be better for three or four months, when another paroxysm of chill-fever and sweat would intervene, ending in abscesses. The right lower limb was two inches shorter than the left. The limb was bent upon itself an- teriorly at the knee, so that when the patient walked she she apparently hopped on and off the shorter limb to keep the knee-joint from extending too far backward as it in. clined to, several inches. Sore eyes ; one cheek red ; very sad; yellow spots on forehead; urine dark, like coffee, and uncontrolable,; great longing for salt. Gave Natrum muriaticum 30th and 1000th, three doses of the 30th every

T, BYALL. 11

two hours, followed by two doses of the 1000th every two hours, then Placebo. I thought that the medicine aggra- vated the case. In two days' time patient was feeling so well that she went out into the yard, and in about two weeks went to assist in taking care of a sick woman. Sub- sequently complained of toothache, which indicated ul- ceration about the root. For which I gave Hep. 100,000th, with relief in a few hours. The patient stated that ab- scesses and always formed after the paroxysm of chill, fever and sweat, previous to this time. Patient stated that an enlargement had formed, the size of a hickory-nut, in the hip when I gave the Natrum. I did not look at the hip, but I believed the statement of the patient. No ab- scess formed this time.

Case 3. — Mr. , aet. about 30 years; married.

About two' years ago, while living on the shore of the ocean, was attacked with intermittent fever, which was suppressed by taking large doses of quinine. I am sorry to say that a professed homoeopathist had also given him large doses of quinine. An allopathist we would expect would give his panacea, but not a professed follower of Hahnemann. The patient had a very severe frontal head- ache during the paroxysm ; blisters on the lips ; very sad and impatient. One powder of Natrum muriaticum 1,000th greatly ameliorated the paroxysm the next day, and a few doses taken three or four days apart, of the same potency, prevented a return of the trouble for a year, probably longer, as I lost sight of the patient.

Case 4. — Little girl, aet. six years. Father came for the medicine ; stated that last fall his daughter had the " chills," which were apparently cured by giving quinine ; had the paroxysms for two or three weeks every two days. Sometimes they would commence at 7 a. m. and sometimes 10 A. M. Very severe frontal headache attended the par- oxysm. Sore lips. Natrum, 30th. Three dose? to be given every three hours. Father reported that the next day she had a slight chill, but not any fever. Placebo was then

78 CLINICAL CASES.

given, resulting in a cure. I do not justifymyself in giv- ing four or five doses of the indicated remedy, each dose every three or four hours, as a routine practice, but when patients have taken a good deal of medicine the results are more satisfactory.

CLINICAL CASES.

INTERMITTENT FEVER.

BY C. MOYT, 31. D., CHILJCOTHB, OHIO.

Case 1. — J. H. A., aet. 42 years. Had been suffering with chills for more than a month, and had not been in good health for some time previous to being 'attacked by the chills. He has a chill every other day, at about 2 p. m. Feels badly for a couple of hours before the chill comes on. Is sleepy and feels very tired, with a great deal of aching in back and legs for some time before the chill comes on. The chills run up and down his back, and liis hands and feet are very cold. He has no thirst during any stage of the paroxysm. Has some dryness of the mouth, but no desire to drink. Complains very much of dizzi- ness, especially when lying in bed. Bowels are usually regular, although inclined to looseness during the parox- ysm. During the fever has severe pain in the top of the head and down the back of his neck. The sweating stage is almost entirely wanting. Gave Pulsatilla 3x every three hours during apyrexia, and it cured him entirely.

Case 2. — Walter E., aet. 10 years. Had been having chills for about one year, only excepting when under the influence of quinine. It would check them only to return again in a few days. Finally his father came to me and desired to have me cure him of the chills, as he was tired of trying to do so with quinine. I succeeded in getting a very brief history of his case, as follows : The boy had a

a HOYT. 79

chill every other day, from nine to eleven o'clock a. m. He was very thirsty before and during the chill, and always vomited after drinking. Complained of his knees being so cold. Wanted to sleep during the fever. Sweat- ing stage well marked. I gave him Eup. perf, 30x, to be repeated once in two hours. In two or three days after I gave the medicine, as I was going down the street, the boy's father hailed me from the opposite side of the street, and I waited until he came, as I thought, to tell me the boy was no better; but, instead of- that, he looked very happy, and said the boy had missed his chill.

Case 3. — John F., set. 35; railroad engineer. Is hav- ing a chill every other morning, at three a. m. Has a se- vere shaking chill, and says he is cold all over. The chill last an hour or more, followed by high fever and then per- spiration, which is very profuse. Is not thirsty during any stage of the paroxysm, and complains very little of pain anywhere. The sweating troubles him more than any- thing else, as it is so profuse and makes him feel so weak. I gave him Pulsatilla and various other remedies, the names of which I have now forgotten, but without their having the least eflFect upon the chills, and we were both beginning to get discouraged. I had treated this patient for gonorrhoea a few weeks previous to this attack of chills, and thinking, possibly, that it might account for my failure to cure, I again studied his case with that fact in view. Finding that Thvja occ, met the symptoms of his case better than anything else, I gave it to him in the cc. potency, and he has not had another chill from that time, now several weeks ago. I think this case was undoubt- edly in some way complicated by the gonorrhoeal virus, al- though he showed no signs of the original trouble.

Case 4. — J. H. M., set. 37 years. Has been suffering from ague for nearly a year, and now looks very sallow and bad, as old ague patients usually do. Has repeatedly had the chills broken by quinine, only to return again as soon as the effects of it passed oflf. He says he has taken

80 CLINICAL CASES,

eight or ten dollars' worth of quinine during the time he has been suflFering from the chills. This patient was also addicts to the use of morphine. He has now had two chills, the first one coming on at eight p. m. and the last one at 11:30 a. m. The chills are every second day. The last chill was very severe and lasted about three hours, and was followed by a moderate degree of fever, while the sweating stage was almost entirely absent. He suffered from nausea nearly all the time during the chill and fever, and vomited once during the fever. Was sleepy during the chill, and wanted very heavy covers over him. Com- plained of pain in the forehead and eye-balls. During the chill his hands and arms were very cold and looked blue clear to his elbows. Is very low-spirited and despondent all the time, and has no ambition to do any work or busi- ness of any kind. Bowels are very much constipated al- ways. Does not sleep well, especially towards morning. I gave him Nux, Vom, 3x trit., a powder every three hours during apyrexia, which cured him entirely.

Case 5. — S. B. S., a3t. 50 years. Has a chill every other day at 2 p. m. Is very thirsty before and during the chill, and usually vomits several times. Complains prin- cipally of coldness in the back, between the shoulder blades, and says it feels so good to have something real hot next to his back. The chill is followed by high fever, which is accompanied by very severe pain in the head. Sweating stages well marked and last quite a long time. His bowels are loose and he has four or five stools each day, of scalding, burning character. Gave him Capsicum 30x, and he had no more chills.

Case 6. — Miss F., set. 32 years; school teacher. Has chill every other day at 1 a. m. Hot and cold, all at the same time. Is very thirsty and wants a swallow of water almost constantly, with vomiting after drinking snveral times. Is very restless and full of anguish during the par- oxysm. The bowels are inclined to looseness. Sweats very freely as the fever leaves. She wanted to try homoeo-

a HOYT. 81

pathic treatment, but was almost afraid to do so, for fear it would not cure her quickly enough. I gave her Arstn- icum 30x every two hours, and she did not have another chill.

I find Ipecac a grand remedy in chills, especially where nausea and vomiting are prominent symptoms. Many times parties from the country send for the same medicine to " break" the chills, and it is impossible to get a clear his- tory of the case. In such cases I nearly always send Ipe- cac, and tell them to report again if that does not cure. In a large number of cases it will prove to be the right remedy and will cure the case promptly. It is certainly much wiser to pursue this course than it would be to send qui- nine, as some do for lack of positive indications, as the Ipecac can do no harm and will cure many more cases than quinine. I think Ipecac is one of our most frequently in- dicated remedies in chills. I have failed to keep a record of many of my cases, or I would report some cases cured by this remedy.

I rarely find a case of chills that can be cured by Cin- chona in Homoeopathic doses, and I verj/ seldom give it for ague. I do find it the remedy for many cases that are undoubtedly of malarial origin. Such patients complain of headache of an undefined character, but especially marked about the occiput and back of the neck. The pains change localities often, and the patient can hardly tell what part of their head hurts the worst. They look sallow and complain of feeling tired all the time, and any little exertion causes them to perspire. They complain of pain in both sides, in the region of the liver and spleen. Also of inability to eat on account of feeling so full all the time, or after eating a very little ; and they belch a great deal after eating. They are chilly much of the time, and they desire to keep near the fire. The bowels are not very costive, but still do riot move with their accustomed ease

82 FOBEIQN BOD Y IN L UNOS.

and promptness. Such cases as these are promptly cured by Cinchona, and which if allowed to go on would doubt- less soon result in genuine shakes."

FOREIGN BODY IN LUNGS.

BY DB. W. W. WALKERi MUIB. MICH.

I was called last winter to see John R. aet. 40. Suffer- ing with pneumonia. Right side, second stage : dullness over circumscribed spot at about bifurcation of right bron- chus, cough bloody, expectoration great dyspnoea. This man. called me in place of an old school doctor who he said gave him nothing but Quinine and stimulants. He had suffered more or less at different periods for the last nineteen or twenty years with a heavy burning feeling and after every attack of cold a considerable pain in this region. Alter prescribing several remedies as the case advanced, I placed him on Ant. Tart, and while taking this, and during a severe fit of coughing, he expectorated what to all appearances appeared to be a solid tubercle. Quite a quantity of fresh blood followed but finally ceased. He preserved the cyst until my next visit, and on cutting down through it I found embeded in its center a complete coffee-bean, slightly softened but in a complete state of preservation.

The man remembered well that while cooking coffee on the field during the war, a battery opened fire upon them a shell bursting among the camp kettles scattering things generally on the instant he felt something pass down the wind pipe as he expresses it. I suppose the shock of the exploding shell produced a sharp sudden in- spiration at the instant the coft'ee bean passed through the glottis, it produced a great deal of pain and severe cough at the time, but subsided to some extent with an occasional trouble after great exertion or taking cold as I have stated.

CORRESPONDENCE FROM LINCOLN, NEB. 83

This foreign substance had passed as far into the tube as its caliber would admit, and had become encysted and was only removed by a sloughing process induced by a severe pneumonia nineteen or twenty years after its lodg- ment.

The case recovered speedily after this, with the ex- ception of some dullness over this region. He is fleshy and well, and of course better than he has been for twenty years.

CORRESPONDENCE FROM LINCOLN, NEBRASKA.

STATE HOMCEOPATHIC MEDICAL SOCIETY MEETING.

Our goodly city of Lincoln has been the focus of all eyes during the present week ; for by chance, or intention, there were three conventions in session at the same time, the Nebraska State Medical Society, the State Homoeo- pathic Society, and the State Dental Society. Lincoln may not be very much subject to epidemics, but for a short time at least has suffered from an endemic attack of doc- tors. The courtesies of the city were extended to all visi- tors alike ; the Commercial and Arlington were the prin- cipal points of attraction. The Homoeopathists held a public meeting Wednesday evening. A large and appre- ciative audience was present to listen to the address of President Dinsmoor, of Omaha, and Prof. Duncan, of Chi- cago, the author of two widely known and valued medical books, and editor of the United States Medical Investiga- tar^ one of the leading medical journals of the day. Prof. Duncan is a genial, wide-awake, appreciative gentleman, and our society considered itself fortunate in securing his presence with them.

Prof. Duncan delivered the address. Topic : " Ho- moeopathy." Its scope was both retrospective and pro- phetic. He entered quite fully into the results of '' the

84 CORRESPONDENCE FROM LINCOLN, NEB,

reform," as he termed it, upon the practice of medicine in all the other schools, and to the modifying influence of homoeopathy he attributed, in large measure, the deca- dence of the old time " heroic" treatment.

The business sessions of the society were held in the parlors of the Arlington. Forty-one physicians were in attendance, thirty-eight being present at the opening of the first session.

Papers of more than ordinary merit were read ; the discussions were spirited, but not in the least acrimonious. The topics for discussion covered a wild field of scientific knowledge and experience, and were full of practical sug- gestions. The papers and discussions alike, were charac- terized by broadness and catholicity of sentiment ; in fact, narrow guage found no representatives among that intelli- gent body of men.

Three ladies were present, wearing the title of M.D.'s, ready with experience, suggestion, and repartee, viz.: Drs. Starr, of Beatrice ; Sabine, of Lincoln ; and Burroughs, of Omaha.

Thursday evening came the banquet, given by our resident physician to their guests ; and it was a right royal feast to which they were invited. Palate, ear, eye and mind alike were the recipients ; flowers of rhetoric vied with the natural flowers, and wit mingled with the per- fume of the roses.

The meeting was in every respect a complete success, the utmost harmony prevailed throughout. Perhaps the most important action of the society related to a homoeo- pathic medical department in the State University. The following physicians were nominated to the regents as members of that faculty: Dr. B. L. Paine, Lincoln, Pro- fessor of Theory and Practice; Dr. C. L. Hart, Omaha, Professor of Materia Medica and Therapeutics ; Dr. F. B. Right^r, Professor of Obstetrics and Diseases of Women and Children. The following gentlemen were also recom-

STA TE SOCIETY MEETING. 85

mended as a Board of Censors: Dr. C. M. Dinsmoor, Oma- ha, chairman ; Dr. G. H. Parsell, Omaha ; Dr. R. Carscad- den, York ; Dr. H. B. Lashlee, Grand Island ; Dr. A. R VanSickle, Hastings ; Dr. A. L. Macomber, Norfolk. The election of officers for the coming year was the next busi- ness. Dn Oarscadden being elected president, (and right here let me speak of one, of whom not only Omaha, but our entire State, has reason to be justly proud, I refer to Dr. C. M. Dinsmoor, the retiring presi- dent of our society). Dr. Dinsmoor is a man of broad and liberal views, a thorough scholar, both in literature and medicine, of sound judgment and alive to the interests of his profession. Every citizen, and especially physician, would profit by reading his address, made at a public meet- ing of the society. It is due almost entirely to his efforts that our society is in its present prosperous condition, and and it is very much to be regretted that he had to decline, on account of professional duties, the nomination to the Board of Regents for a professorship in our University Medical School, for no one in our society would fill the po- sitien better than he. We are glad, however, that he was nominated to the Regent to be made Chairman of the Board of Censors, as this will place him where he can do the college great service.

Dr. G. H. Simmons, the retiring Secretary, is a young man of excellent qualifications for his profession, and made a most energetic Secretary. He leaves for Europe soon, to pursue his medical studies in one of the great universi- ties there. We wish him a safe voyage, success in his pur- suits, and will express the hope that he will return to Ne- braska.

Drs. Carscadden, our new President, and G. E. Brown, our new Secretary, are both excellent men, and we hope and expect much from their capability and energy in building up the interests of the society. It was decided to hold the annual meeting in Omaha next May.

Medicus.

86 DROPSY CURED BY KALI CARBONICUM, DROPSY CURED BY KALI CARBONICUM.

FROM THE ALLGEMEINER ZEITUNG.

TRANSLATED BY A. MC NEIL, M. D.

Another enemy against which we are tolerably pow- erless, and against which we are sometimes necessitated to employ the infusion of digitatalis, is dropsical swellings as a result of heart disease. A recent case has, however, taught me that our medicinal treasure has a remedy which can accomplish something. It relates to a six year old rachitic boy in whom occurred in consequence of a light and transient rheumatism of the joints, a failure of the valves and hypertrophy of the heart. After I had used a number of what appeared to be suitable medicine in both high and low dilutions and triturations, I was under the necessity on account of the increasing oedema which be- gan in the forehead and the ascites to try digitali. I prescribed Digitalin 3d trit, as much as rested on the point •of a small knife, three times a day. The heart became quieter and the oedema disappeared except in the fore- head. But as usual the improvement was only temporary. As soon as the medicine was discontinued eight or ten days the swelling again increased. Finally it entirely ceased to benefit and the oedema spread over the entire surface of the body, but particularly in the scrotum and the collection of water in the abdominal cavity increased rapidly and consequently the dyspnoea also. Under these desperate circumstances I resolved as no other palliatives promised benefit, to try a homoeopathic remedy, (better late than never) but it is strange a homoeopathic physician had not thought of that before. On comparing the case and the drugs I chose Kali carb. It had the heart symp- toms, the oppression and the dropsy, of the skin and ab- dominal cavity. I prescribed at first the 6th, but changed to the 30th as soon as its beneficial effects ceased. At first

f7

IN MEMORIAM—DR, A, O. BLAIR, 7S^

every four hours a dose, afterwards three times a day, then every three on four days. After using it about eight days, an increased flow of urine was observable, which kept increasing so that at fii'st the oedema of the scrotum then that of the other parts of the body and at length the ascites gradually decreased. Now, after about four months use of the remedy continued at increasing intervals, all the dropsical symptoms and at last the obstinate oedema of the forehead have entirely disappeared. The deathly paleness, in fact transparency of the boy, has given place to a healthy color of the face. His almost intolerable obstinancy and his resort of appetite have gone, he has again begun to grow and his movements are more ener- getic. The urine both in quantity and quality is normal. The heart trouble is of course unchanged, yet its move- ments are less stormy and are regular, I will rejoice if my colleagues will try this remedy in a similar calamity and have as favorable result.

[Any of those who doubt that drugs above the tenth potency have any Curative effect, will confer a favor on me if they will state their reasons in the Advance why in this case the patient got well without the agency of Kali carb. 30. — Translator.]

IN MEMORIAN— DR. A. O. BLAIR.

BY J. C. SANDERS, M. D,, PROFBSSOR OF OBSTETRICS CLEVELAND HOMOBO- PATHIC COLLEGE.

We honor the dead most, not by monumuents of granite and marble, nor by busts and tablets of silver and bronze, but by the memories of the heart. I desire to link to the memory pf the great Samuel Hahnemann the memory of the good Alonzo P. Blair, whom death "has laid him down in his last sleep," at the mature age of seventy-six years. A Massachusetts man by birth, an Ohio man by early

88 IN MEMORIAM—DR. A. O. BLAIR,

adoption, he embodied all the sterling qualities of Puri- tanic stock and the stir and thrift and aspiration of the Empire of the West. He was a man about the average height, but large bodied, broad shouldered, large chested, with a finely proportioned large head, broad forehead, dark hair, somewhat unusually prominent eyebrows, and deep gray eyes. His manner was plain, his movements slow and measured, though this was largely perforce of a chronic infirmity of respiration, having been asthmatic for all his latter life. His voice was low, his speech delib- erate, his conversation modestly unobtrusive. His learning was by no means broad and general, but within its range was thorough and assured. He had great largeness of heart towards the young, was ever ready to render aid by counsel an sympathy, time and skill, to the struggling and needy, to the humble and lowly, in health and in sickness. He was full of afiection and had a heart of tenderness. He was especially fond of children, he exalted home and motherhood, ever crowning them with his smile and bless- ing. Of his own home relations we are not permitted to speak ; too sacred are they for the public eye and ear, they lie treasured unapproachable within the hearts of his family home. But of all his other relations in life, more or less public in character and wherein we best knew him, it is our right and privilege to speak. A whole decade he was a professor in the Homoeopathic college of Cleveland, and it was in the rich harvest time of his life, occupying the chairs in succession of Materia Medica and of Theory and Practice, and the latter half of this decade the presi- dental chair.

He was an earnest worshiper at the shrine of Hahne- mann; an uncomproming expounder of the great truths that Hahnemann formulated and gave to the world. As a a teacher he was plain and simple, yet profound ; as pro- fessor he taught no mongrel, ambiguous things, but the pure, simple truth of homoeopathy ; and fortunate indeed were they who, in successive classes, were his pupils and

J. a SANDERS. 89

listeners ; and it is fortunate, too, for the college that his successors in these respective chairs were each his cher- ished pupils and wear spotless the ermine of his mantle. As one of only four yet connected with the college who were his associate teachers I can sx>eak only to emphasize the kind and fatherly spirit unexceptionably manifested towards his fellow professors in all the relations in which his life and character, socially or officially, touched the members of the faculty. As president his administration was characterized by careful deliberation and wisdom, and has left its stamp indelibly upon the history of the college. Besides all this he was a representative practit- ioner of medicine, of the Hahnemann baptism. He prac- ticed what he taught ; he was loyal to his teachings ; he believed in, and implicitly trusted the homoeopathic law of cure. He was, however, profounder as a symptomatol- ogist, than a pathologist though by no means lacking in the latter. As a practitioner he was eminently successful, and his fame in this is second to no man's. His judgments were never hasty, but rather careful deductions from well considered premises. The key-note symptom, the single remedy, and a potency of high range were his ideals.

This deliberateness, simplicity, and accuracy, together with his personal qualities, made him dearly beloved and honored by all who employed him. At the bedside of suffering he was gentle and tender, full of cheer and sym- pathy; in the household of sorrow he was judiciously calm, and knew when silence and the unbidden tear were more potent than words and sounds to appease a wounded heart. To lose a worthy and honorable family physician is a loss over which any household may rightly grieve and mourn. How he" sh ii es their confidence and trust in times of hope, and in times of anxiety and despair ; how his coming is watched with eagerness and his going with concern ; how his ministry of skill sends thrills of delight throughout the home and his disability to save, turns joy into mourning ; how his smile renews and his gathering 4

90 SIZE OF DRAIN AND SOIL PIPES.

brow breaks hope. Yes, in the family and household he is the one above all othei's, " whom all eyes follow with one consent." The decease of Dr. Blair has robbed thou- sands of households of their beloved family physician. Fathers, mothers, children will ever remember him grate- fully and reverently, for his name is embalmed in the litany of their loves and their homes.

As professor and president, as physician and friend, we, his survivors in college and out, deplore his death, though recognizing the Biblical truth, that there is a time to be bom so there is a time to die, but we deplore him, not without profound gratitude, that his Master's call came not until we had caught something of his generous and pure spirit, something of the rich gamerings of mature and chastened experiences, until his life had come to a ripe, " full age, like as a shock of corn cometh in his

SIZE OF DRAIN AND SOIL PIPES.

In Great Britain 6-inch soil pipes were formerly com- mon to receive the wastes from four or five water-closets. At present 5-inch and 4^-inch are the usual sizes, even for a single water-closet. Hellyer claims that the soil pipes should be no larger than the outlet of the water closet, and sarcastically says, it is not wanted for a coal shute or dust shaft, but to be well flushed at every using. For pri- vate houses where care would be shown in using fixtures, he thought a S^-inch lead soil pipe ample for a tier of three water-closets, and a 4^-inch pipe for twelve closets ; the smaller pipe kept cleaner than one of larger size. Whether IMr. Hellyer would favor an iron soil pipe of like size is not lo be taken for granted, as he always assumes that lead is smoother and can be kept cleaner than cast iron. Hellyer refers to the architects and others who want good strong

SIZE OF DRAIN AND SOIL PIPES, 91

plumbing — using the best material but requiring very large soil pipes and drains. These are as common here as in Great Britain, and we have frequently come upon their work — 10-inch wrought iron drains, with hubs as large as a barrel.

Colonel Waring'^s vigorous advocacy of small drains has converted most persons to admit their advantage. His experiments at Saratoga showed that the drainage of a large hotel, containing 2,000 occupants, could be carried ofi' in a 6-inch pipe. For an ordinary city dwelling a 4-inch drain is ample, even including the rainfall, while for a large house or a French flat a 6-inch pipe will suffice. The common objection to small drains is that they may get choked with articles thrown into them by careless servants — as scrubbing brushes, towels, broken glasses, crockery', spoons, forks, etc., all of which have been found in them . but a 4-inch drain will carrj^ off any artrcle which can pass through a water-closet or sink-trap, and hence it is quite large enough to meet that objection, so long as it is laid with a proper pitch, no angles, and is well finished. The growing use of modem water-closets which discharge sev- eral gallons of water each time they are used, is an addi- tional aid to keeping house-drains clean and clear from obstructions. Small drains are more likely to be self- cleaning than large ones. A stream of sewage that fills the former completely will only cover the bottom of the latter, and, having less velocity, will exert less force upon the sediments and coatings of filth which forms within all waste-pipes. Grease always fills up a large pipe sooner than a small one. We have a 5-inch drain taken from a very large house in Brooklyn, in which the water line shows plainly exactly along the centre of the pipe. A pipe two-thirds as large would have served just as well. Colonel Waring now advocates reducing soil pipes to 3- inches, but this change is yet to be demonstrated by expe- rience.

02 ON A TTEN UA TION.

ON ATTENUATION.

BY DANIEL W. CLAUSBK, M. D, M. I., H. A , AUBURN, N. Y.

The power of attenuation is as marvelous as its phil- osophy is inexplicable ; its truth is as evident and grand to the faithful and observing prescriber as it is obscure and foolish to the careless and unobserving materialist. While, in point of doctrine, it is distinct from the law of similars, it is a glorious luminary by which the truth of that law is more clearly revealed.

A drug exhibited in an unattenuated form, is like the ' light of a lamp surrounded by a dense fog : the light is there ; but, its glorious spread and illumination are pre- vented and veiled by the material mist, unlike the light in atmosphere clear and transparent, where it can spread it luminous rays and penetrate into every dark and obscure comer, as the attenuated drug penetrates into every obscure corner of the living organism.

Dr. Samuel Swan, of New York, has, in a recent letter to me, drawn a beautiful comparison between attenuations and the imaginary circles around a cone. The apex or X)oint of the cone represents the mother tincture ; and as we progress toward the base, we may imagine so many circles (circular bands) of gradually increasing diameters, corresponding to the gradually increasing potencies in the scale of dilution. He thus argues, that as the imaginary circles nearer the base of the cone cover a large area of surface, so the higher potencies (which these represent) cover a large field of action in the living organism.

I have only one suggestion to oiTer Dr. Swan, in re- gard to this beautiful elucidation, and that is, — that he must also imagine the cone to have no hose ; because, a base would represent a limit to the process of dilution ; and, certainly, there is no limit ; for even the D. M. M. is by no means the height to which attenuation might be carried. The possibility of attenuation being without

ANTISEPTIC MEDIC A TION. 93

limitation is also beautifully illustrated by the gradually and continuously increasing divergence of the conical figure. Convergence comes to a terminating point, diverg- erne opens into wide expanse and boundless space, and spreads and spreads to iniinity. And who is he that would pretend to measure that immeasurable space in which all visible orbs and starry worlds form but a dot ?

Note.— No figure of course goes on all fours. Both Dr. Clausen's figure of light and Dr. Swan's cone have a danger- ously small origin. We would be loth to accept either of them as satisfactory in their analogy. They are suggestive, but far from conclusive. We give them for what ever they may be thought worth. It would be easy to criticise Dr. Clausen's state- ments on several points. That we leave to the reader. — [£d.]

ANTISEPTIC MEDICATION.

BY A. MC NEIL, M. D., JRFFERSONVILLB, IND.

On page 485 of the last volume of the Advance is an article with the above caption by Dr. L. Younghusband ol Detroit. It is well for the partizans of the germ theory to talk about truth, observation, etc., etc. The writer of the above article mentions a large part of all the diseases which afllict mankind and says ^'they are undoubtedly caused by contagion " and that it is conveyed by germs, which are micro organisms or bacteria. The advocates of this theory have taken for instance some of the pseudo-membrane from the throat of a diphtheritic patient, and an examination with the microscope have found that there are innumerable numbers of bacteria, therein ; they then put some of these bacteria along with the exudation into a wound of a dog or other animal, and in a short time diphtheritic membranes and other symptoms of the disease arise. Then they shout Eureka ! Bacteria are the cause of diphtheria. Now that looks

94 ANTISEPTIC MEDICATION.

very plausible at first sight. But let us investigate Inore carefully. Was there anything conveyed be- sides bacteria, and what was it? Why the contagious products of the disease. Now let us separate the bacteria from the putrid membranes and place the bacteria in the wound of one dog and the membranes in that of another one, and see what is the result. Now I appeal to every fair minded observer if that is not the fair and only fair way of seeing what causes the disease. Traube and Gscheilel found the warm blooded animals bear the injection of considerable numbers of bacteria without any serious in- jury. Arterial blood from a pup, taken carefully so as to exclude the entrance of bacteria from the atmosphere, into whose veins twenty-four or forty eight hours pre- viously, one and a half centigrammes of fluid containing bacteria had been injected, did not putrify for months. Schles fttr vaterlandisches Kultur 1870.

Kusner employed, in order to obtain a filtrate free from bacteria, a glass funnel in which there were two lay- ers of filtering paper, the neck of the funnel was densly packed with boiled cotton ; through this he passed ichor of different kinds (Pyaemic pus, Puerperal and Peritoneal secretions), containing bacteria in considerable numbers. Microscopic examination as well as cultivation, showed that there was in the filtered fluid no trace of bacteria, notwithstanding, the injection of this liquid free from bac- tena, always had the same eflect as th'^t containing the parasites, viz., death in a short time. Dissection revealed the same condition in both cases, viz., ichorous infiltration of the cellular tissues. In the blood and large abdominal glands there was no bacteria in either case. Med. Cent^ BlatU Band VI, Seit 32.

No comment is necessary.

Hiller separated the bacteria by different methods from the fluids containing them, and found that in every case the injection of the parasites alone was innoxious. The next day after the operation, fungi were found in the

A. MC NEIL. 95

blood, but never afterwards. Skin wounds of dogs, wet with liquid containing the micrococci and covered with gutta-percha paper healed without secreting pus. Sub- cutaneous injections of the liquid did not cause the puru- lent process. He even made in himself subcutaneous in- jections of liquid containing bacteria, to the amount of a grain, without any local or constitutional injury. Healthy wounds secreting laudable pus covered with isolated mosses of bacteria continued to heal as before. But the filtered fluid free from bacteria, or the unfiltered putred liquids, when so applied, soon produced the well-known local and general affects of septicaemia, when applied to recent wounds, but on old granulating ones no harm was done. Hiller asserts emphatically, also, that these washed bacteria multiplied in cultivation. Allg. Med. Central Zeitung^ No. 1, 1874, and Chirurgical Central JSlatt^ Band I, Seit 33.

This covers the whole ground and until they are over- thrown by repeated and authenticated experiments, all ar- guments in favor of the germ theory are, voxprceierea nihil.

Billroth, the greatest living surgeon, experimented at great length on this subject in many diseases, and the re- sult may be summed up. He found that, they (bacteria), exist in the pus of wounds only when it has reached a condition of decomposition. Contain inflammations (ery- sipelas, phlegmos, or diphtheria), must occur in order that the parasites may multiply hixuriantly,(Untersuchung tlber die Vegetations forman der Cocco-bacteria.)

The whole argument of these champions may be com- pared to that of a man seeing a mass of putrifying flesh in summer, which is alive with maggots, and jumps at the conclusion that they are the cause, when the truth is they could not exist till putrification began, and they are a wise provision of nature to lessen it by eating up the putrify- ing matter.

But, let us acknowledge in order to carry the argu- ment further, that bacteria are the cause of various diseases,

96 GOOD BYE BACTERIA.

and that if the bacteria be destroyed that the disease will end. Turn to the 398th page of the present volume of the Advance and see the carefully conducted experiments therein detailed, made by Lewis Sherman, M. D. I have not time to enumerate those experiments, but I ask all the readers of the Advance to turn back to the January No. and read the article carefully. I will only mention a fair specimen. He says : " One part, in twenty or a saturated solution of Carbolic acid, did not at first appear to kill any of the infusion. On the fourth day they were still present in great numbers and retained some activity. They would turn round and round, move against the current of the fluid and occasionally run against a globule of undissolved Carbolic acid, without receiving any apparent injury." In order to make the fluids of the body equal to this solution in which some of the bacteria lived thirteen days, would require a dose of five pounds of Carbolic or Phenic acid which is sufficient to kill 1,250 men. Was there ever such absurdity ?

The true and only reason why some men professing to be homoeopaths buy a syringe and a set of Declat's prepar- ations, is that it is so much easier than it is to learn the Materia Medica and carefully obtain the totality of the symptoms and give the indicated remedy. But there is no other way to cure the sick, cito tuto et jucundo.

GOOD BYE BACTERIA.

Editors Medical Advance :

I write this time simply to extend my compliments and sympathies to the Bacterists of the world ; and to in- form them that their bantling, the bacteria, or germ the- ory of disease, has fallen mortally wounded.

I now have the microscopic proof of everything that I ever claimed for the organizing and disorganizing forms

R. B. OREOG. 97

of fibrin, and of far more than I ever claimed. The proof of the shallovmess of the claims of the bacterists to any science iA their theory, will make the matter almost too ludicrous to demand further serious consideration; but error dies hard, and the more absurd it is the harder it dies, when it once gets possession of the human mind ; so the battle must no doubt be fought out to the end.

In view of professional duties, it will probable require two or three months for me to get the time to prepare a paper explaining. all; but I hope to have it ready in that time. From specimens I already have I could give micro- photographs far surpassing in both beauty and numbers any and all that the bacterists have ever produced.

And hear I wish an earnest word with earnest, think- ing men in our ranks. I am fighting a great battle on this subject for our school, and for a acientiHc pathology ; and such men as indicated have no right to any longer leave me to fight this battle alone. I am willing to work to the utmost of my endurance, until the field is won ; but I can- not well afford to pay all the expenses besides, of the large number of micro-photographs, etc., that may be required to illustrate all phases of the subject.

And this leads me to further say, that if any of our journals want illustrations, and will pay the first cost of producing them, I will endeavor to furnish them in any numter they may want, with explanations that will make the matter clear and satisfactory, I think, to all. The va- riety and beauty of illustrations that can be given of or- ganizing and organized, and also of disorganizing and dis- organized fibrin, down to its ultimate or primary granules, are almost without limit.

In conclusion, I believe I have not as yet shown my- self possessed of any selfishness in the development of this subject, any more than may be inseparable from sus- taining one's views with what vigor he may, after an ex- haustive and exhausting investigation of the subject. My sole desire has been to see the truth prevail, and to do all

98 MEDICAL MA TTERS IN MICHIGAN.

in my power to forward that desirable consummation.

When the climax comes I think it will be seen that I have

worked to a purpose.

Yours truly,

R. R. GREGG, M. D. Buffalo, N. Y., August 1, 1883.

MEDICAL MATTERS IN MICHIGAN.

LAWS ENACTED BY THE LAST LEGISLATURE.

AN ACT TO PROMOTE THE PUBLIC HEALTH.

Section 1. The People of the State of Michigan enacts That from and after this act shall take effect,, it shall not be lawful for any person to practice medicine or surgery, or any branch thereof (except dentistry), in this State, without having the qualifications required in the provisions of this act, and without having first registered in the office of the county clerk as provided in this act.

Sec. 2. The necessary qualifications to practice medi- cine in this State shall be :

Firsts That every person who shall have actually practiced medicine continuously for at least five years in this State, and who is practicing when this act thall take effect, shall be deemed qualified to practice medicine in this State, after having registered in the office of the county clerk as provided by this act ;

Second^ Every graduate of any legally authorized medical college in this State, or in any one of the United States, or in any other country, shall be deemed qualified to practice medicine and surgery in all its departments, after having registered as provided in this act : Provided^ That the provisions of this act shall not be construed so as to prohibit any student or under-graduate from prac- ticing under the instruction of any person legally qualified to practice medicine and surgery under and by the pro-

AN ACT TO PBOMOTE THE PUBLIC HEALTH. 99

visions of this act : Provided^ That every person quali- fied to practice medicine and surgery under the provisions of this act, shall, within three months after this act shall take effect, file with the county clerk of the county where- in he has been engaged in practice, or in which he intends to practice, a statement sworn to before any officer au- thorized to administer oaths in said county, setting forth, first, if he is actually engaged in practice in said county, the length of time he has been engaged in such continu- ous practice, and if a graduate of any medical college, the name of the same and where located, when he graduated, and the length of time he attended the same, also the school of medicine to which he belongs. And if he is a student or undergraduate, the length of time he has been engaged in the study of medicine, and where, and if he has attended a medical college the name of the same, and where located, and the length of time so attended and when, also the name and residence of the physician under whose instruction he is practicing or intends to practice. It shall be the duty of the county clerk of each county in this State to record in a book to be provided by the county, the affidavit (or sworn statement) of every physician prac- ticing in said county. For recording each statement the county clerk clerk shall receive fifty cents, to be paid by the person filing the same.

Sec. 3. It shall be the duty of the supervisor, at the time of making the annual assessment in each year, to make out a list of all the physicians and each student prac- ticing under the instruction of a preceptor residing within his township, village, ward, or city, with the name, age, sex, and color of each and the length of time each has been engaged in practice, and if a graduate of a regularly established and reputable college, the name of the college, and the date of graduation. Such list shall be returned by the supervisor to the township, village, or city clerk, and by tbe clerk recorded in the book in which are kept the records of the local board of health.

100 AN ACT.

Sec. 4. No person who practices medicine, surgery, or midwifery, in any of their branches (except dentistry), shall be able in any of the courts of this State, to collect pay for professional services rendered subsequent to the time that this act shall take effect, unless he was, at the time such professional services were rendered, duly quali- fied and registered as a medical practitioner according to the several provisions of this act.

Sec 5. The supervisor, township, villiage or city clerk is hereby authorized to administer the oaths required by this act.

Sec. 6. Whoever advertises or holds himself out to the public as authorized to practice medicine or surgery in this State, when in fact he is not so authorized under the provisions of this act, shall be deemed guilty of a mis- demeanor, and on conviction thereof, shall be liable to a fine of not less than five dollars nor more than fifty dollars for each offense.

Sec. 7. It shall be the duty of the supervisor and health officer of the local board of health in each town- ship, village, ward, or city, to enforce this act.

Approved June 6, 1883.

AN ACT

TO AUTHORIZE THE BOARD OP CONTROL OP THE INSAXE ASYLUM

AT TRAVERSE CITY TO PLACE THE SAME UNDER CHARGE

OP THE HOM(EOPATHIC SCHOOL OP MEDICINE.

Section 1. The People of the State of Michigan enacts That the board of control of the northern asylum for the insane is hereby authorized to place the medical administration -of the same under the supervision and con- trol of a reputable physician and surgeon of the homoeo- pathic school of medicine.

Approved June 8, 1883.

IS THE LA W DEFECTIVE f 101

IS THE LAW DEFECTIVE?

Mr. Editor:

While we hail any advance in the line of " promoting the public health," we think the law as it now stands, contains many serious defects which we hope the next legislature will not fail to remedy. We believe a law has been as loudly called for by the people as by the doctors, hence we consider it proper to call the attention of the readers of your journal to the defects in the one passed by the legislature. While a large number of the states around us have passed stringent regulations concerning the prac- tice of medicine, Michigan has been " free for all " and as a consequenc.e has within her borders many of those who could not pass muster in our sister states, together with the indigenous " species."

The provision that " every person who has practiced continuously for at least five years," etc., " shall be deemed qualified," is an absurdity. The school teacher who wishes a position has to pass a rigid examination before he can secure an appointment. To enter the legal profession the candidate must be examined before he can become a mem- ber of the bar. Any man or woman, however, no matter whether he can read or write, if he has " continuously practiced five years " is the peer before the law of the educated practitioner. It has been urged that the people are competent to judge. A little observation will satisfy you that such is not the case. The man who is not allowed to practice in our courts or direct the studies of children is allowed and often does take into his hands the lives of the little ones, and after they are placed in the grave the poor mother is consoled by the statement that it was God's will. It was murder.

We need not go far to find evidence of the truth of our statement A man who calls himself " doctor " — God save the mark — stated to a gentleman of our town within the past ten days that he had a specific for diphtheria ;

102 IS THE LA W DEFECTIVE f

when asked concerning it, he informed the gentleman that it was toad oil. The recipe was as follows : " Four large toads to be killed, and then placed in a bottle in the sun ; the oil which exuded to be applied to the throat." He warranted it to cure in four days. The statement may ex- cite your disgust or ridicule, but remember if he has "prac- ticed five years continuously " he is " qualified to practice medicine in this state." This practitioner is undoubtedly an alumnus of the college that graduated a man practic- ing in Jackson county, who being called to a case of en- largement of the heart, gravely informed the patient that her " heart strings 1 " had become stretched which allowed the organ greater sway than it normally had. He would, however, give her an astringent to draw them in position. Another practitioner of this county has informed a patient that she has lizards in her stomach. He is certain they are there for he " can hear them splash 1 " It is useless to say, these men are not patronized ; they are, and gain a comfortable living by their practice. We are creditably informed that a well-known man in this county, has al- ready secured a license to practice " having actively prac- ticed five years" and who registered as belonging to the electic school. Webster does not give the word, hence we conclude it is original with the Dr. (?) who has probably started a new school. Possibly he was driving at eclectic. We have noticed these men never " do surgery." No. They may listen for the heart on the right side of the chest ; speak of the liver as on the left side of the body, but they not knowing whether the femurs are " in the limbs, loins, or larynx," feet a little "shaky " about cut- ting.

If " five years continuous practice " qualifies one, why has our state imposed tens of thousands of dollars in taxes to support the teaching of medicine at our university. After passing an examination in the English branches, to enter the university the student is required to attend lec- tures and demonstrations three years, to spend months

I& THE LA W DEFECTIVE f 103

in the dissecting rooms familiarizing himself with the structure of the human body ; months in the chemical and microscopical laboratories. At the close of this course he has to pass examinations not only before the faculty, but finally before a Board of Censors who have had no part in the teaching and who are appointed by the regents. The query will arise to the young man about to enter the uni- versity— " What will it profit me in the race ? The toad- oil man has as many privileges as 1 1 " The public exercise too little care. They are running after the worm lozenger vender, cancer curers, magnetizers, natural bone-setters, and consult a medical man to evade the stigma of a coro- ners inquest. In these times merit is voted a slow coach and modesty a humbug.

A recent writer pointedly remarks: " Mythologists tell us that Minerva threw aside the flute when she found it puffed her cheeks. If in this age men cast away the flute, it is to use a more potent instrument of puffing: the hloioinff of their own horn." The applicability of the above to this class is patent to every one. How applicable to these aspirants are the lines of Lessing :

Tompkins forsakes his last and awl

For literary squabbles — Turns doctor next, but bis trade

Remains the same, he cobbles.

Second^ "Every graduate of any legally authorized medical college in this state or in any one of the United States shall be deemed qualified to practice," etc. Notice, no distinction is made in regard to colleges. It is notor- ious that a large number of colleges that are " legally au- thorized " are frauds. Yet the alumnus of such an insti- tution is the peer before the law of a graduate of Harvard or the College of Physicians and Surgeons, of N. Y., or even our own University, or others where the curriculum 8 extensive and examinations rigid.

104 CORRESPONDENCE.

" Buchanan men " can find here a congenial home and nothing to hinder their " flourishing like a green bay tree." Graduates in Canada cannot settle among us al- though it is well known that a higher standard is required than in any of the states. If the great Brown Sequard or any other European surgeon or physician, should attempt to practice in Michigan, he could be fined fifty dollars for his audacity, while the "toad-oil doctor," with the "electic" for associate, can hammer into sick humanity the laws of health and the cure of disease at two dollars a visit,"med- icine extra." For fear that>«very one should not be accom- odated, it is " provided that the provisions of this act shall not be construed so as to prohibit any student or under- graduate from practicing with and under the instruction of any person legally qualified " etc. Mr. Editof , who cannot practice ? I am glad to be informed that measures are already being taken by physicians throughout the state, to have parties prosecuted who secure licenses with- out having any true claim to them.

Now that the ball has opened, and the doctors seem determined to push the matter, we say God speed and may their efforts not cease till pretenders in this profession are unmasked. x. y. z.

St. Louis, Mich.

CORRESPONDENCE.

BY a. N. BBIGHAK, M. D., GRAND BAPIDS, MICH.

Editor Advance:

The investigations as to honest work in our pharma- cies, and by men who prepare the medicines we use, begun by members of the American Institute seems to me very timely. If we are being imposed upon by any party whomsoever, let him be exposed and btanded. The question of potency or dilution is of much more import-

O. N. BRIOHAM. 105

ance than many believe. I have succeeded with an ad- vanced dilution when a cruder article failed me. Others have had similar experience. But, if we cannot know whether we are using the third dilution or the tenth, what then? Indeed, we are quite at sea.

No remedy which I have ever used has given me more satisfaction than Sulphur. And a potency I obtained from the elder Guernsey, called the 100m. worked cures in cer- tain chronic cases which utterly astonished me. But, if the label had no significance, I know nothing of the dilu- tion. I suppose it came from Fincke. Possibly the way Dr. Fincke prepared his potencies may introduce an unre- liable factor so that the strength is not uniform in an ounce of the same dilution. We want honest work and reliable remedies, and this move proves not to have been made any too soon. I have often reported cases from high dilutions, and they were honest reports. But, if my remedy was not as I supposed, I know not what was the dilution. Let the matter be thoroughly examined.

And yet I believe we must have high dilutions if we are to succeed in many cases in our most obstinate forms of diseases. I have not reached this conclusion upon speculative grounds or any predilections that way. For years I opposed the use of all advanced potencies. Ex- perience alone set me right on the question. To what ex- tent I have been imposed upon, I do not pretend to say, but I do know there is a difference in different dilutions of the same remedy. What failed in the lower dilu- tions has been entirely successful in the higher. I could not have been always cheated if I have been at other times.

[That is all right Brother Brigham, but what we want just now is ten dollars from every man who like you is in sympathy with the American Institute work. Send it to the editor of this journal who is authorized to collect and it will be duly reported, and the money employed in the purification of our pharmaceu- tioal work.] 5

106 FEUILLETON.

FEUILLETON.

The following is the proportion of doctors to the population in the countries named, as given by the Siglo-Medico :

France 2 91 per 10.0000

Germany 3.21 ♦• *♦

Austria 3.41 ** *•

England 6

Hungary 6.10 per 10.000

Italy 6.10 **

SwltKerland 7.06 ** "

United States 16.24 "

It has been discovered that the best disinfectant for sewer gases is the washings from gas works. This serves a double pur pose, that of annulling the poisonous effect of the sewer gas, and at the same time enabling persons having defective traps to de- tect it by the strong, pungent odor arising therefrom, while sewer gas alone, almost odorless, permeates the building, carry- ing sickness and death with it. The washings from water gas works, at least, will not clog or obstruct even the smallest of sewers, while their presence, as above stated, might save valua- ble life. — Water Gas Journal.

Helferich reports a case in which, as a result of the re- moval of fibrosarcoma from the arm of a woman aged 36, the whole upper half of the biceps, with the exception of a thin strand at its outer part, was extirpated. Into the cavity which was left he promptly introduced a large fragment of the biceps from the leg of a dog. The cut sources were carefully brought together with sutures, as little injury as possible being done to the parts. The transplanted muscle was much more voluminous than the original portion, and was long after the operation dis- tinctly perceptible to the touch. Electric experiments instituted about three months after the operation showed that the biceps reacted perfectly nacural to both kinds of current. The high point of stimulation situated at the place of section of the mus- culo-cutaneous nerve was, however, absent. The movements at the elbow-joint were almost normal.

Manqanrse for Amenorrhcea. — The permanganate of Potash is highly recommended by Dr. Binger of London, Eng., (allopath) for ammorrhoea in young girls who have *' missed'' on account of taking cold or getting wet. He cites a great many cases where the menstrual functions had been re-established af- ter an absence of months. He gives it in pill form, of three grains each. He says : '* In several instances patients complain of its producing a heavy, persistent pain over the upper part of the sternum,'' as 'Mf something had stuck there and would not

BOOK NOTICES. 107

f^ down/' He farther states, that this pain was not due to the drug being given in the form of a pill, for the same complaint was made when the same dose was given in solution. Here is a chance for some of our Homoeopathic ** key note*' gentlemen. The peculiar symptoms given is due, no doubt, to the effect of the manganese, not the potash in the salt, for 'tis a well-known fact, that raanganate of soda and the binoxide of manganese are equally regarded by the allopaths as efficacious in the treatment of amenorrhoea.

BOOK NOTICES.

A COMPEND OF VISCERAL ANATOMY. By Samuel O. L. Potter, M. A.. M. D. P. BlakiRton Son & Co., Philadelphia.

This is an admirable pocltet rembrancer for both student and practitioner. The illustrations are familiar and much in- crease its value.

A QUIZ— Compel© on Materia Medlca and Therapeutics. By 8. O. L. Pot- TER, M. A., M. D., A. A. Surgeon U. S. A. P. Black Iston Son & Co., Philadelphia.

From the stand point of the dominant school of practice, this compend is a pocltet companion of great value to the stu- dent and busy practitioner. It is well and tersely arranged, and enables the salient points of a drug to be seen at a glance. We regret that the author's study of Hahnemann and Dunham did not convince him of the absurdity of the substitution of drugs. But, like Bartholow and Ringer, he may learn this in time for the second edition.

INDICAZIONI SPECIALI DI VENTICINQUE RIMEDJ NELLA PEBBRE INTERMITTENTE. Per 111 Dott T. P. Wilson, etc Versloue dall' Iqglese del Dott. G. Pomplll, Rome, 1882.

We owe the distinguished translator an apology for fail- ing to notice this work before. The " Twenty Five Remedies in Intermittent Fever " is graced in its new Italian dress by an interesting preface by the translator, which shows that **the. homoeopathic idea '* is well understood by our Italian confrer. The disjointed and unscientific methods that disgrace some por- tions of our American homoeopathic literature in regard to the treatment of Intermittent Fever do not find favor with Doctor Pompili. He believes that Homoeopathy is the true healer as much with fever and ague as with other diseases. We commend

108 BOOK NOTICES.

the doctor's views and appreciate the honor his translation has done to our little book.

HOMCEOPATHY IN ITS RELATION TO DISEASES OF FEMALES OR GYNECOLOGY, pp 66. By Thos. Skinner. M. D., London. Hom- ceopathlc Publishing Co., No. 2 Finsbury Circus.

This little work when it first appeared several years ago at- tracted very considerable attention. It appears that the inter- est has not died out, and the author has put it into more sub- stantial form and placed a second edition before the profession. Dr. Skinner is a vigorous thinker and writer. He does nothing by halves. When he left the Allopathic camp and became a Homoeopath it was not only with zeal that he did it, but with unusual intelligence. He grasped the philosophy of Hahnemann fully and followed it logically. In the midst of a large gynsB- cological practice he threw away everything but the things needed for a correct diagnosis, and then relied implicity upon the indicated remedy. This is not modern gynfiecology, but it is Homoeopathy applied to diseases of women. The reader will do well to study this little book and to profit by its teachings. Many will think it too full of faith', but no one can Justly charge it with heresy.

PRACTICAL LESSONS IN GYNAECOLOGY. By Hbywood Smith. A. M., M. D., Oxon, 4&C., (&c.

** A little old man named McCaw, Oh, he was well read up In law ; With a very wise look He'd take down a great book, And, turning Its leaves say "pshaw I "

The Englishman takes pride in his reputation for bluntness or abruptness of address, in other words, he prefers to cut short everything he can, and is amused at his brother American who loves to indulge in a little spread eagle language, which often attracts and entertains the reader. When I met the author of the above work in London, in 1881, he remarked that he was then completing a work on gynaecology, which should l>e thor- oughly practical. In turning over the leaves I can fully concur with the author, it is practical in more senses than one ; it is more than an abridged dictionary. If a practitioner of this country should dare to oflfer to the profession a work similar in character and make up, a petition would be presented to congress paying for the author's banishment to the Fiji Islands. How

BOOK NOTICES. 109

the medical profession of Great Britian can accept ttie work witliout a strong protest, is beyond the comprehension of the average American practitioner. The only acknowledgement the writer makes in the preface is, to Br. Thomas' work on diseases of women whose aid was relied upon for the *' systematic order of the matter.'' Under the head of '* diseases of the uterus (un- impregnated) " the author disposes of the '* definition/' causes, symptoms, signs, diagnosis, prognosis, of catarrh of the uterus in eight lines^ that is indeed ** boiling it down " with a vengance. Ttie treatment consists ** rest, tonics (?), Iron, Quinine, Zinc, £rgot, intra-uterine injections of Carbolic acid and Glycerine or Iodine." In metritis he advises ** rest, leeches to the cervix uteri, Opium in full doses and mild diet." For endocervicitis '* laxatives, tonics (?) (whatever that may mean) injections of warm water with Opium, applications of Nitrate of Silver, Iodine, (Do they not know that the force of this remedy is spent upon the first tissue it comes in contact with ? It is not absorbed beyond the surface, and is about as useless in gynaecological prac- tice as Nitrate of Silver.) Carbolic acid, another remedy that will soon be cast aside. Tannin, Acetate of Lead, Chromic acid. Nitrate of Mercury, Nitric acid, acutal cautery^ scarification," **The three best methods of treatment are: 1st, by Potassa Caustica; 2d, the actual cautery *^ 3d, excision." Menorrhagia: '*CoId applications to vulva and thighs, cold drinks, Galic acid. Ergot, Opium ; intra-uterine injections of Carbolic acid and Glycerine, Iodine, persulphate of Iron." This is simply a sample of the remainder of the work, and of course speaks for itself. Every time a medical work of any special note or char- acter is published in this country, it is at once severely reviewed and criticised by the English journals until the author wonders why he did not subscribe himself in large capitals an Asa, They review with a vengance that is startling, our gynsecological efforts. The reviewers always perceive that every portion of the text that is valuable, was stolen from some one or other writer of that country on the subject, and the plates were pirated from a valuable English work, and then what a scathing would the un- fortunate compiler of pirated medical literature and art get. Then we have an other set of publishers of English medical lit- erature, and to curry favor with our transatlantic brothers accept withan.ecto^, that is truly humiliating any medical writings published on that side of the water. I give the following, taken from a republisher of English works who referred to a review of

no EDITOR'S TABLE.

one of our standard gyneecological works : ** With the character of this criticism as affecting the profession of this country, or whether our reviewer would not materially have changed his tone and temper had he been better acquainted with the status of the writer, we, as publishers, have of course nothing to do. Our business is to furnish a reprint only,'' including downright abuse too, I suppose. Oh, Holy Keeper of the departed spirits of our forefathers in medicine in this country, cannot you, in your omnipotent power, bring forth from their sanctums of rest, those will rise up in their dignity and wisdom to defend your offsprings from these assaults of unjust criticism ? Shall we submit calmly to ridicule and sarcasm ? No ! The answer comes back in thundering tones, ** establish for yourselves on a scien- tific basis a proper recognition of medical literature and colleges, that will demand the respect and honor of the world.'' To be compelled to return the criticism of an English work on gynce- coiogy is indeed a sad condition of affairs. To think that any one in the practice of this branch of medicine would present to the profession such a useless book, is a mystery. It shows a degree of retrogression in practice tliat is simply appalling. We supposed that our brother Englishmen would at least keep peace with our American works, especially as they have had an op- portunity to study Thomas, Emmet. Dr. Smith, aside from his crude manner of treating his cases, has not what Hewitt, Barnes, Wright or Tait can boast of, interesting study of the pathological conditions of diseases. He also believes, evidently, that brevity is the soul of wit, as whole chapters are completed with half a page. We beg the privilege of suggesting to Dr. Prptheroe Smith, who was made the victim of the author's dedications, that, in the future, he look well to the editions that are likely to follow. It is extremely painful to witness the Old School alias Allopaths, alias regulars, alias scientific medicine, alias code or no code, going back, fifty years in their therapeutical treatment of diseases peculiar to women. Phil.. Porteb.

EDITOR'S TABLE.

Dr. a. R. Wheeler, U. of M., is located at St. Louis, Mich. Dr. Wm. D. Cooper, U. of M., '83, has settled at Wayne, Mich.

EDITOR'S TABLE. Ill

Dr. J. A. Cross has removed to North Branch, Lapeer Co., Mich.

Br. Morton C Reeves, U. of M., commences practice in Clinton, Mich.

Dr. a. Stanley Dolan (U. of M.) has located in Dans- viUe, Mich.

Prof. E. C. Franklin* has resigned his position in the University of Michigan and removed to St. Louis, his former home.

The Homoeopathic Hospital of the University is undergoing extensive repairs, and will be ready for patients the last week in September.

The Ann Arbor School of Music is an institution worthy of special mention. It oflTers rare inducements to students seelting a musical education. Send for a circular to Prof. C. B Cady.

Oliver Wendell Holmes says that bad air, bad whisky and irregular habits keep the doctors alive. He must be mistaken. Thote very things have killed several doctors, we know.

A New Brunswick doctor was asked, at the Falls, why he didn't ask the Institute to meet in his city. He replied : " O, you doctors will go to my town soon enough." He lives in Hal- ifax.

The Medical Era is a new Homoeopathic Journal of Chicago, published by Gross <& Delbridge, and edited by Dr. James E. Gross. We like its appearance very much and hope it may suc- ceed.

The many friends of Dr. Thos. S. Hoyne, of Chicago, will feel a deep sympathy with him in the death of his honored father, Hon. Thomas Hoyne, who was killed in a recent railroad disaster.

Next month we shall publish the list of donors to the In- vestigation Fund of the Microscopical Bureau of the American Institute. Now is the time to send in your ten dollars. Fifty more subscribers are wanted.

The announcements for '83 of all the Homoeopathic Colleges are on our table save that of the Homoeopathic Department of the University of Michigan. This delay m issuing the annual catalogue of this school is unavoidable. Our readers may, how- ever^ rely upon the school being open as usual and in running order October 1st.

112 EDITOB'S TABLE.

The Homoeopathic Department of the University of Michi- gan has added a new and important motto to its banner : Fob

THE HIGHER MEDICAL EDUCATION OF MEN AND WOMEN. Other

schools may have a diflferent experience, but the University of Michigan is able to demonstrate the perfect success of the co- education of the sexes.

The Medical Era marvels that when Dr. Egbert Guernsey, in the American Institute gave notice that he would introduce a resolution striking the word Homoeopathy from the name of the Institute no one entered a protest or made any remarks. Does »not the Era also marvel that Dr. Guernsey failed to introduce his promised resolution ? The idea was so absurd it could not be seriously opposed. The doctor did the wisest thing : He took the fifst train for New York.

Prop. E. C. Franklin has retired from his post as Surgeon in the Homoeopathic Department of the University of Michigan. The doctor has made a splendid record both in general surgery and spinal curvature practice. In his hospital work he has shown remarkable success, while as a teacher he has done a large amount of valuable work. The doctor returns to his former home in St. Louis with the best wishes of his late confreres and the highest regards of his many Michigan friends.

The Medical Counselor, Aug. Ist : ** The faculty of the Ho- moeopathic College of the University of Michigan is undergoing the regular annual reorganization. Prof. E. C. Franklin sent in his resignation as Professor of Surgery and has left Michigan for his former home. Dr. A. C. Cowperthwaite, of Iowa, has been appointed to the chair of Gynecology, but refu'ies to accept. This leaves the Professor of Theory and Practice sole professor of the field." And also it leaves the editor of the Medical Counselor still out in the cold. Hinc illae lachrymos,

Havanah, N. Y., July 19th, 18SS.

Dear Doctor : Will you give notice in your Journal of the meeting of the Homoeopathic Medical Society of the State of New York, at Ithaca, September 11th and 12th. The Ithaca Ho- tel will entertain at $2.00 per day. The Delaware, Lackawanna & Western B. R. will sell return tickets at Ithaca for one-third the usual rate. This road connects with N. Y. & Buffalo. The Utica, Ithaca & Elmira will carry from Utica & Elmira for the fare one way. The steamboat on Cayuga Lake will carry from Cayuga Bridge, on the N. Y. C. & H. H. R. R. and return for |1. All of the above tickets sold on the certificate of the Secretary, A. P. Hollett.

Fallows' Eyf o»Flioi-FMt@3

Contains THE ESSENTIAL ELEMENTS to the Animal Organizations — Potasli and Lime;

Tlic OXTDIZINO AGENTS— Iron and Manfifanese;

Tlie TONICS— Quinine and Stryclinine;

And tlie YITAUZING CONSTITUENT— Pbopphorns. Combined in the form cf a Syrup, with slight alkaline reaction.

IT DIFFERS IN EFFECT FROM ALL OTHERS, bein? pleas- ant to taste, acceptable to the stomach, and harmless under prolonged nse.

IT HAS SUSTAINED A HIGH REPUTATION In America ind England for efficiency in tlie treatment of Pulmonary Tuberculosis, Chronic Bronchitis, and other affections of the respiratory organs, and is employed also in yarioos nervous and debilitating diseases witii success.

ITS CURATIYE PROSPERITIES are largely attributed to StIraulHnt, Tonic, and Nutritive qualities, whereby the various organic fur.ctions are recruited.

IN CASES where innervating constitutional treatment is applied, and tonic treatment is desirable, this preparation will be found to act with safety and satisfaction.

ITS ACTION IS PROMPT, stimulating the appetite, and the digestion, it promotes assimilation, and enters directly into the circu- lation with the food products.

THE PRESCRIBED DOSE produces a feeling of buoyancy, removing depression or melacnoly, and hence is of great value in the treatment of meotal and nervoas affeotloos.

From its exerting a double tonic effect and inflencing a healthy flow of the secretions, Its use Is indicated in a wide range of diseases.

Eacli Bottle of Fellof 's Hypoptiosiiliites contains 128 Doses. Prepared Ij JAMES I. FELLOWS, Chenust,

48 VESEY ST., NEW YORK.

CireiUar* and Samplea Sent Free to Physieiana on Applteatlon.

t^SPECIAL K ^HYSICIANS.-One large bottle containing 15 oz. (which usually si Uh . • $1.50) will be sent upon receipt of Fifty cents with the application, t.r« will be applied to the prepayment of expre^sage, and will affo* an opportunity for a tliorough lest in Clironic cases of debility and nervousness. £xpress charges prepaid ii|»on all samples- For sale by all druggists.

The New England Medical Gazette.

A 32-patfo Journal, exclnstvc of ndveriiseraents. Full of original articles by able writer^ editorials on ciirrcut events in tbo homoDopatbic world, condensed reports of cases in practice, reports of medical societies and institutions, correspondence, book reviews, abstracts of important articU>A in •ther jonmuls, items, extracts, and personals. The Qazbttb offetB nK>re for the money than any other homceopatliic journal in the country.

Vol. XVIII. oommenoee Jam 1, 1888.

One Dollar per Year. Sample Copies sent free on application.

Bend your Subscriptions to the Publishers,

OiIS CLAPP & SON, Na 3 Beacon Si, Boston. 307 Westminster St, Providence, B.L

SUPPOSITORIES

MANUFACTUBED BY

OTIS CLAPP & SON, BOSTON.

We desire to call attention to the foci that our Suppositories are made with the use of the Oil of Theobroma as a vehicle, this being unduubiedly the best material for tliis purpose. It is not prone to become rancid, and has more exactly the requisite degree of oonslatCTicy and fusibility than any other substance or combination that can be used.

RECl'AL. UTERINE. URETHRAL. Descriptive List fbrnishod on application. Prtoe* p«r doaen Sffc | Prioe, per i^roas •SJtO

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The publishers would respectfully call the attention of nhyslcians to their new Visrmto LnT AKD Pbescription Rsoobd, which they offer as possessing many features especially desirable in a Poctcet Record.

While it gives an opportunity to keep a full record of Visits, Prescriptions, and Oliarges, ito fize is smaller and more compact than any other list offered to the Uoraceopathic profession.

The paper, tjrpography, and binding are superior in quality, beine bound in flexible tncK bfliding ana gilt edges, with pocket and pencil, presenting a Record both rich and elegant in appearance.

Tlie List is made " Perpetual." and of two sizes, for 30 and 60 patients a week. Price : for 88 potieDts, $1.25 ; for 60 paUenU, $1.50.

Sample pages of Record of daily engagements and prescriptions sent to any address on Amplication to the publishers,

OTIS OIj-AJ>I» Sz so3sr,

£ B«*coa Street, Boston. 807 Westminster Street, Providence, B. I.

12

2 X OR HIGHER.

4 Ounces in a Package, - 30 cents. 4 Ounces in a Bottle, - 35 cents. 4 Ounces free by mail, - 40 cents.

ONLY A FEW EXCEPTIONS.

The cost for power to run my Trlturatore is only about two cents per day for euch machine. T use better Sugar of Milk than any pharmacy in the U. S In one table on pajre 31, cur- rent Yolume of the Advancb, the figures 1.18 should read 4.18, to correspond with the report as delivered.

Thi'» is the only Triturator where each mortar is properly covered to effectually secure it against the contanimation from neighboring machines.

Tliis is the only Triturator not having any frictional parts above the mortar.

Ttiis is the only pharmacy where one hour {s alloted to every 100 grains of the first decimHl trituration.

The first decimal trituration of this oharmacy was found upon exnminalioii (see N, 7. Medical Times, Sept., 1882) to have aU the epores broken, while that of a Philadelphia pharmacy (see Hahne' mannnian Monthly^ July, 1682) was found to have only ten per cent, broken.

L. H, WITTE,

CkTdla&d Eomosopaihic PlLarmaey I

350 SUPERIOR ST., (CITY HALL BLOCK),

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Medicines, Books, Sugar of Milk,

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30 Tear's Ptrsorul Experience in the Preparation and Bale of Medicine.

13

We publish below, for the benefit of our sub^ scribers, the names of specialists in the different departments of Medicine and Surgery, residing in various parts of the United States.

A. M. WOODRUFF, M. D.»

Special Attention Given to Diseases of the Lungs.

On Otimaiie SubjecU,

As affecting Invalids, shall be happy to answer correspondents. Enclose stamp for reply to

Las 'Vesas Hot Sprinffs, - - - Ne^w IMexioo.

P. G. Talentine, A.M., M.V.,	DB« PHIL. PORTER,
throat and lung diseases.	SURGICAL
	DISEASES OF WOMEN.
ConsalUtlon by letter or in person.	Office and Private Hospital,
1308 Chontesu Ave , ST. LOUIS, MO.	79 Lafayette Ave., - DETROIT, MICH.
T. P. WILSON, M. D.,	8. M. FOWLER, M. D ,
E"3rs j^isTX) jsijl:r	Del«and« Fla.
80 Sontb IHTlMlon,	Diseases Of ttieTbroat and Loup
ANN ARBOR, . MICHIGAN.	A SPECIALTY.
J.W.HAINR^M.D.,	MAT HOWELL, M.D., DISEASES OF WOMEN AND CHILDREN.
SUR6E0M,	4J9 W. Eielith St.. Office Hours. CINCINNATI, O. 10 to 1, 5 to 7.
161 W. Seventh St., CINCINNATI.	Patients from abroad can be acccom- modated with board in the house.
G. C. McDermott, M. D.,	J. W. D0WUX6, M.D.,
EYE AND EAR SURGEON	313 Madison Avenue, NEW YORK.
118 West Seventh StroeC,	SPECIALTY :
CINCINNATI.	DISEASES OF THE HEART,
Office HouQi :9 A.M. to laM.; 4 to p.m.	Lungs and Tbroat.
W. J. HAWKES, M. D.,	G. A. HALL, M. D.,
ROOMS : H and 2S Central Music HaU Block.	Consulting and Operating Surgeon.
CTaUC^fi^CKD.	oFFicB :
	231. T^-SLBJi^e:^ .^T7"E.,
HOURS from i to \. Rheumatism and Diseases of tlie Heart and Kidneys a Specialty. '	CniCAGO. HOURS, from 9 to 11 a.m., &7 to 8 p.m.

14

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FORMULA OF HYDROLEINE :

Each doie of two tecupoonfuU^ equal to lao dropi^ ccntains:

Pare Cod Liver Oil, 80 m (drops.) I Soda, ... 1-8 trrains. iJiBtilled Water, 85 m. Boric Add, - .- 1-4 '*

Soluble Pancreatln, 6 frains. | i.yocboUc Acid, • 1 20 -*

DOSB— Two teaspoonfals alone ; or mixed wiili twice the qaantity or soft water, to be taken twice daily with mealt*.

The principles upon which this discovery is based have been described in a Trea- tise on '^THBD OBSTION AND ASSIMILATIOM OF PaTB IN THB HUMAN BODT,^' by H. 0,

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HTDROLBINB id readily tolerated by the most delicate stomach?, even when the pure Oil or the most carefully prepared Emulsions are rejected. The Oil is so treated with pancreatin soda, boric and 1 yocholic acids, that the process of dlfestion is partly effected befoie the organs of the patient are called upon to act upon it. Consequently It is readily assimilated. It will nourish and induce increase in weight in those caties where oils or fats, not so treated, are difficult or im ossible to digest. In Consump- TioN AND Othxb Wabtino Di-^BAsrs, the most prominent symptom is emaciation, of which the first is the starvation of the fatty tissues ot the body, including the brain and nerves. This tendency to emaciation and loss of weight is arrested by the regu- lar use of HY .>R' )LBINB, which may be discontinued when the usual average weight has been permanently regained.

The permanence and perfection of the emulsion, and the extreme solubility of the HYDRATED OIL, solely prepared and sold by us under the name of HTDKOLBINB is shown by its retaining its cream-like condition as long as tne purest Cod-Liver Oil will retain Its sweetness. Unlike the preparations mentioned, or simple Cod-Uver 0il| it produces no unpleasant eructation or sense of nausea, and should be taken In such very much smaller doses, according to the directions, as will Insnre its complete assim- ilation; this, at the same time, renders its use economical in the hlghtest degree.

To brain-workers of all clisses, Hydrated Oil is invaluable, supplying, as it does, the true brain food.

Economical in use— certain in result. Tonic— Digestive and Highly Nutritive.

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16

Natural Uterine Supporter

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i.t li.«ks •-^•r IdttAza. plflic«d. IdAfox* t3a.« a>g»<fl1ci1

BTerjr Indication of Uterine Displacenient* is met by tbis combi- natiou; iTolap^UM. Aateven»tuu, Hetrovemion aud Flexloos are oveicome by thl8 inslrument, when othen) fail. This is proven by tbe fact that since ItM introduction to tbe Profession it lias come Into more general nse than all other insirumeniM combined.

Union of External and Internal Support.— The abdomen is held up by the broad niorucco leather belt with concave front and elastic straps to buckle around tiie hips The Uterine Support is a cup and stem made of higlily polished hard rubber, very light and durable, snaped to fit the neck ot the womb, with openings for the secretions to pass out, as shown by the cuts. Cups are made with expended lips, to correct flexions and versions of the womb

Adaptability to Varying: Position* of tlie Body*— The cup and stem are Biisp^Muled iroin the belt by two soft elastic Rubber lubes. which are fas- tened to the irout of the belt by simple loops, pass down and through the stem of the cup and up to the bacK of the belt. These soft rubber tubes be- ing elastic, adapt themselves to all the varying positions of the body, and perform the service of the ligamei^ts of the womb.

Self Adjusting.— One of the many reasons which recommend this Sup- porter lo the Ptiy^lolan is that it is self-adjust ing. The Physician after ap- plying it need have no feai that he will be called in haste to remove or read- Ju-t it (as Is often the case with rings and various pessaries held in position by pressure against the vaginal wall), as the patient can remove It at will, aud replace it without assUtance. It can be worn at all times, will not in- terfere with nature's necessities, will not corrode, and is lighter than metal. It will answer for all cases oi Anteversion, Retroversion, or any Flexion of the womb, and is used by the leading Physicians with unfailing success, even in the most dldlcult r

ODE KKDUCKD PEICRS ARK. TO PHTSICIANS, $6.00; TO PiTIINTS, $10.00.

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VAUTJOJ^.—We call partleuUr altentiou oi Physicians to the fact, that anucra- paloa^ parties are manuiaccuriiitf a worthless imitation of this Supporter, and some dlebonent dealers, for the sake of gain, are trying to sell them, knowing tbev are de- ceiving both physician an * patient. Pereons receiving a Supporter will find. If it is Senaine, the directions pasted in the cover of the box. with the bead-line *' DR. L. ►. McIN'OSH's NATuK.aL UTERINE SUPPmTBR," a cut on the rlitht, showing the Supporter sud on the left lu application ; also the Facsimile Signature of DH. I/. L>. MoINTOSti. Bach pad of the abdominal belt is stamped in gilt let. era, DR. McINiO^R'S NATUKAL UTERINE 8UPPOKTER CO., CHICAGO, ILL. iwush box also contains our pampMot on " Displacements of the Womt),^^ and an extra pair of Rubber Tubes. JRiaan advantage to order direct prwn «*, as we exchange cnpe at any time without extra charge, and are able to fit any case that requires uter- ine support. The inveutur, DR. L. D. McINl 03H, is connected with the main office, and gives his personal attehtion to orders

DR. Mcintosh natural uterine supporter co.,

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Our valuable pamphlet, "tiome Practical Facts auout Displacements of the Womb,'' will be sent you free on application.

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The advantaices oflTered in this Instltatlon Areeo'tal if not superior to any iu thecoantnr for the gaocessrul treatment of the fullowlne diseases, vis.: All forms of Nervous, and Chronic diseases, Rheumatism NeuralKia, Paralysis, Epllepj«y, Dyspepsia, Nervons.Exhaustion.diseaseHOf women Heart disease and the Opium habit. Our treatment conslxts more esplcally in t»^e use of the most perfect EIjEOTRO-Tn*'RITI %Ii BATH, in connection with appropriate Medical and tjurgical treatment and sicillful nursing. Open the entire year for the reception and treatment of patients. Post-office, Tele- graph and Telephone connection In the house. For Circulars giving full particulars, reference, t^^rms, etc . etc.. Rddress. PR. GlMjABP^Oa? UraBhlngton St., Sandnaky, O.

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Also received the spec- ial endorsement of the Committee on Sanitary Science and Hy<i:ieiie of the American Institute of Homoeopathy, at Niagara Falls, N. Y.» on June 2l8t, 1883.

Has a large ana increasing; circulation among the inte]li>rent and thinking members of the Homoeopathic profession; hence advertisers desirous of good returns will lind this journal tlie best means of reaching the masses.

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ADVANCE PUBLISHING CO., Ann Arbon 18

T. P. DriI.80N« HI. D.,

Editor. .

H. €. AIjIjEN, IK. Dm

Business Manager.

Vol. XIV. Aifs Arbor, September, 1883.

No. 8.

All snbscriptions and basiness oommanioations shonld be addressed to MEDICAI. ADVANCE PUBLISHING Co.. Ann Arbor. Mioh. Snbsoription. 92.00 per annum.

Are We Humbugged ? — The natural tendency of the human mind is to settle down on finalities. Most men de- sire to anchor somewhere, and feel that they are fastened to something. To be mentally afloat and drifting, is looked upon as criminal. This surely is needless, since so many havens of security are ofi*ered us. Not to enter the domain of philosophy or religion, we can easily find in medicine this same tendency most strongly marked. Doubtless there is some virtue in all this, but in the vast msgority of cases it is only a covert for laziness and cow- ardice. Many Tfnen are too indolent to think for them- selves, and many more lack the courage to do so. In this way they attempt to escape individual responsibility. In

114 EDITORIAL.

the palmy days of the lancet, tens of thousands of patients were hurried to their graves by being bled, and the physi- cian, so called, who knew he was tilling his patients, ex- cused himself on the ground that he was following the rule. Mercury, too, has slain its multitude, and the doc- tor who employed it was conscious of the wrong, but the crime was not in him, but in the system. This was con- venient for the indolent man and plausible for the coward. But there is after all but very little difference between the past and the present. The same classes of men are still in the medical profession, and they worship finalities as devotedly as did their fathers. They have systems which have metes and bounds, and over the line they do not and dare not go. These men are generally very " scientific.-' They are the loyal and liberal patrons of science. With them, science is some fixed and invariable standard, and by that standard they can at once measure and accept, or condemn. Neophytes are generally greatly charmed by the pretensions of these " scientific gents." They capture the young students in medicine, for the boys " want to know, you know," and here is the only chance. An aged wise man shakes his head, and that is not encouraging. When these blatant pretenders mount the rostrum, the world is all eyes and ears. At this moment, such is the real state of afi*airs in medical science. Everybody knows that doctors humbug the people, but everybody does not know how thoroughly doctors humbug oi^e another. And so it is, '^ fleas have fleas to bite 'em."

Scientific Experts have decided many important questions. In our courts of justice and upon expert tes- timony, men have been condemned not only to years of prison life but to death. In our penitentiaries are not a few prisoners serving life sentences ; and many men have gone to the gallows almost solely on the testimony of sci- entific experts. This is a startling fact, and allowed in an

EDITORIAL. 115

intelligent government, principally, because it is the fash- son. It is, however, dawning on the public mind, that ex- perts are not infallible. Popular confidence in their tes- timony is being badly shaken. It is easy to decide a ques- tion if only one expert is allowed to testify. Neither judge nor jury can gainsay his evidence. But when two or more experts assay the same work, it appears that they do not always agree. They mutually vitiate each others testimony. The public has recently been greatly shocked by the discovery of expensive adulterations of lard. The market was found stocked with thousand of tierces of so- called lard, which contained foreign substances, chiefly tallow and cotton-seed oil. The discovery of this alleged fraud, has caused heavy commercial failures ; moreover it has struck a serious blow at commercial integrity. It was thought that chemistry could and would easily settle the question. Chemistry and the microscope were both con- fidently invoked. Lard and tallow were substances so well known, that their presence or absence could easily be detected. A series of test cases was therefore made up and the aid of science invoked, through specially selected experts. The result is laughable if nothing more. The experts failed. With all their knowledge of chemistry and microscopy, they could not tell the pure from the adulterated. Of course they each made a learned report, and decided as to the samples given them, but it proved they were very wide of the mark. So at precent, in this department, expert testimony is in a state of collapse. Now, as a matter of fact, much of our so-called medical science, is resting on this sort of foundation. Scientific experts are in possession of the field, and they are trying to decide vital questions for us ; and, as the fashion goes, we are guilty of heresy if we do not bow down humbly to their decisions. Against all this we venture to protest. The sham of pretended scientists are cheating us. We want true science, but we shall never get it by jumping iit hasty and ill-considored conclusions.

116 MICHIGAN ST A TE SOCIETY.

PROCEEDINGS OF THE FOURTEENTH ANNUAL SESSION OF THE HOMCEOPATHIO MEDI- CAL SOCIETY OF THE STATE OF MICHIGAN.

HELD AT LANSING MAY 15tH AND 16tH, 1883.

i CONCLUDED.]

Bureau of Ophthalmology and Otology. — ^Dr. Mc- Guire, chairman, reported a paper from Dr. J. F. Brown, of Jackson, on " Eye Clinics," and one from Prof. T. P Wilson, M. D., of Ann Arbor, on "The Relation of the Specialist and the General Practitioner to the Diseases of the Eye."

Dr. McGuire then read a paper entitled " Some Re- marks on the Clinical History of Diseases of the Optic Nerve, as met in Young Subjects." Discussed by Drs. J. G. Gilchrist and H, C. Allen.

On motion, the papers reported by Dr. McGuire were referred to the Publication Committee.

The President announced the Bureau of Pathology for the ensuing year, viz.: H. R. Amdt, chairman ; R. C. Olin, Detroit ; H. M. Warren, Jonesville.

Bureau of Theory and Practice^ O. R. Long, chair- man ; Wm. Bailey, and A. B. Grant.

Moved by Dr. Morley to go into Committee of the Whole.

On motion of Dr. Bailey, this motion was laid upon the table.

On motion, the papers from the Bureau of Theory and Practice was referred to the Publication Committee.

Dr. Eldridge presented the name of C. K Covey, M.D., of Grand Ledge, and, on motion, he was elected to mem- bership in the Society.

The convention then adjourned till 1:30 p. M.

FO URTEENTH SESSION, 117

Wednesday Afternoon Session. — The Society was called to order by President Franklin at 1:40 p. m.

Dr. Eldridge presented the names' of J. 0. Wheelock, M. D., of Bancroft, and R. Simmons, M. D., who were were elected to membership.

Dr. Amdt, for the Committee on President's Address, made a report, which, on motion of Dr. Porter, was adopted.

Dr. Eldridge, necrologist, reported that so far as he knew there had been no death during the year.

The Secretary oflFered a resolution that the General Secretary be instructed to enter the names of gentlemen present who have been elected to membership, in his own writing, which was carried.

Dr. Gilchrist oflfered a resolution of thanks for the use of the Council rooms, and Pioneer room. Adopted.

election of delegates.

To American Institute of Homceopathy—J>Ts, Borabacher,C. J. Covey, Wm. Bailey, Johnson, Olin, Simmons, L. M. Jones, and Hyde.

To Western Academy of Homoeopathy — Drs. Arndt, Rora- bacher, and Eldridge.

To the New York State Sodety^Bn. R. B. House, H C Allen.

To Ohio State Society— Dr9. Porter and Gilchrist.

The President was requested to appoint delegates to Indiana, Illinois, Wisconsin and Minnesota, and appointed the following :

To Indiana State Society— 1>t%, VanHorn and Warren. To Illinois Society— Drs. Wm. Bailey and B. Defendorf. To Wiscormn Society^Dn, Reynolds and Whitehead. To Minnesota Society^Brs. Botsford and Grant.

Dr. Porter presented a German work to the Society, and moved that it be translated and printed in the trans- actions.

The motion prevailed, and Dr. Arndt was requested to complete the translation.

118 MICHIGAN STA TE SOCIETY.

The Treasurer, Dr. Robertson, presented a final report, which was accepted.

Dr. House moved that the Treasurer be instructed to erase the names of all delinquents, in accordance with the provisions of the Constitution and By-Laws. Adopted.

Dr. Porter moved that Drs. Eldridge, Covey, Sawyer, and Pomeroy be placed on the honorary list, and relieved from further financial obligation. Adopted.

Dr. Eldridge respectfully declined the honors offered him, if such action would debar him from the privileges of the Society, as he had decided objections to being laid upouNthe shelf.

Dr. Bailey then moved that all honorary members of the Society shall have all rights and privileges accorded to regular members. Adopted.

Dr. H. C. Allen moved that all members of this So- ciety who have been members for twenty years, and have paid all dues, be relieved from further financial obliga- tions. Adopted.

Dr. Gilchrist moved that the Treasurer notify mem- bers in arrears for dues to the amount of $6.00 and over, that they will be proceeded against for collection of the same. Adopted.

Dr. Allen requested universal consent to have the name of Dr. F. Woodruff placed on the honorary list. And Dr. Porter moved a resolution to that efiect. Adopted.

ELECTION OF OFFICERS.

The Convention then proceeded to the election of offi- cers for the ensuing year, with the following result :

President— J>T. R. B. House, of Tecumseh. Ut Vice-President—Br. Phil. Porter, of Detroit. 2d Vice-Preaident—Bt. A. A. Allen, of St. Johns. Secretary— Br. J. G. Gilchrist, of Detroit. Corresponding Secretary— It, T. Van Horn, of Homer. Treasurer— Br, G. A. Robertson, of Battle Creek. Dr. Gilchrist moved that the Treasurer be authorized to pay the janitor $2.00. Adopted.

OHIO STATE SOCIETY. 119

Dr. A. B. Avery read tfie following paper :

Gentlemen,— In view of the action of this Society con- doning the confessed outrages perpetrated upon the profession by your President, E. C. Franklin, and feeling it a duty to the first graduating class of our University department as their president, and to the profession at iarge as first vice-president, I protest against this action, and against the refusal of this Soci- ety to infiict the proper penalty prescribed by the constitution and by-laws, and for your quasi endorsement of said E. C. Franklin f by your refusal to do anything as a society in the matter.

Therefore, there is but one honorable course for me to pur- sue ; and in doing this I feel that no one could have more just grounds for severing professional ties.

Gentlemen, I hereby tender my resignation as a member of your Society. A. B. Aveby.

For the above reasons, I hereby Join in tendering my resig- nation to your Society. Charles G. Mobley.

Lansing, Mich., May 16, 18S8.

The Convention then adjourned.

PROCEEDINGS OF THE NINETEENTH SESSION OF THE HOMCEOPATHIC MEDICAL SOCI- ETY OF THE STATE OF OHIO.

held at the board op trade rooms, city hall building,

COLUMBUS, OHIO, MAY 8tH AND 9tH, 1883.

Columbus, O., Tuesday, May 8, 1883.— The Society was called to order by the President, C. C. White, M. D., of Columbus, at 10:30 a. m. The Treasurer's report being called for, the Treasurer, J. C. Sanders, M. D., moved it be deferred until the second day of the proceedings.

The Secretary, H. E. Beebe, M. D., then made his re- port.

Reports from other Societies being in order, H. C. Allen, M. D., Professor of Materia Medica in the Homoeo- pathic College, University of Michigan, said :

120 OHIO STA TE SOCIETY.

I have DO written report to present. We have a hospital in connection with our University, which was opened in 1880. We have clinics in connection with the college, and l>oth are in a prosperous condition. When the hospital was opened it was readily filled, and has remained so ever since. Our hospital and dispensary work are very satisfactory, and our clinics well at- tended. We try to take care of every patient who enters. Now I have to say that I am very glad to be here, to make a report of our hospital at the University. There has been a good deal of bitterness between the two schools,which is gradually subsiding. Occasionally a patient comes ttora the other hospital, 'and gets cured. But we do not operate upon every case that comes into the hospital. We try to avoid having any funefals, though we have had, I believe, one this year. We are holding our own nicely, and gaining all the time. Our friends of the other school have fought us stubbornly, but, we prefer to let them do the fighting. It does not pay.

Dr. Connell, being the only member of the Board of Censors present, was requested to act as chairman, and Drs. L. Barnes and J. R. Flowers were added to the Board.

Dr. Sanders gave a report from the Cleveland College.

Dr. Allen : I do not know that we can have a better place than this to air some of our college matters. I am very much pleased with this report. I do not know but up in ou' school we have raised the standard too high. Our college course has been lengthened to three years of nine months each. Why I say I do not know but we have elevated our standard too high, is, that some students do not like to face the music. If any fail to pass the freshmau or junior examinations instead of coming back again they go elsewhere, and that is the last we see of them until they get their degree, or we see their names in some other college annouucement, after one course of lectures, as full-fiedged M. D.'s! Now, what I would like to propose is that, like this college, we all raise our standard of scholarship. Our students say they can go down to Cnicago,— and I don't speak of Chicago to make any invidious comparisons, — that they can go down to Chicago and get Just as clean parchments. Just as good litho* graphs, with less study, and in shorter time.

Dr. Barnes : I don't know that I am one who ought to say anything agaiost the standard, fjr I have put three boys into

NINETEENTH SESSION. 121

the medical profession. The more I learn in the world, the more I am convinced that it takes a great while to learn a little. You may take any branch of study, and it will take at least three years for any man to become proficient in it. And yet we take a young man who has never been trained to study, and we make a doctor-of him in two or three years, with two courses of lec- tures of six to nine months each. Now there is certainly some- thing wrong in this. Yet I have no doubt that our Homoeo- pathic colleges have done the best they could. Now, not only must we have better students, but we must hd^vQ better prof ea- 9orB, I go in for a regular reform. I am getting pretty old. I suppose I have been in the practice as long as any man in Ohio. I should remodel some of these colleges if I had charge of them, but I have not. If a student should apply for admission into a senior class, I would take him in, and graduate him if he were competent, wherever or however long he may have studied, but I would make the standard very high. Now, some of you younger men may take these things and lay them to heart if you please ; and if you don't please, do it any way I

Dr. Cleveland : It may not be out of place for one of the youngest members, who has Just Joined you this moruing, to ex- press an opinion on this subject. It may, perhaps, be in the power of some of us who are coming on, to reach for the degree of B. A. before the degree of M . D.

Dr. Sanders: I recognize the correctness of all that Dr. Barnes has said. And in addition I would say that the Cleve- land college hospital has been moving right directly toward this higher plane indicated by Dr. Barnes. Preliminary examina- tion was first instituted by this college, and we design that the examination shall be made more and more rigid from year to year. Many come to us who are graduates of High Schools, or who hold the degrees of B.A., etc This examination applies only to those who hold no such certificates. But over forty per cent of our matriculates were graduates of High 3cho<fls, or held the degree of B. A. or M. A. Our standard is not yet as high as de- sirable, but we are moving as rapidly as possible ; and we hope to make it so high that no man will be admitted who does not hold the degree of B. A. or M. A. However there is a curious fiact that should make, us cautious. And it is this : that some- times those students who have possessed only a moderate schol- arship are the ones who most frequently come out at the top. You can't always tell. Possibly we are in danger of making the

122 OHIO STATE SOCIETY.

standard so high as to exclude some of the finest minds. I could mention several who had hard work to get through, and who to- day are at the very top of the profession. Such facts should make us careful as to the standard of general education abso- lutely demanded of our matriculates.

Report on Legislation was made by Dr. J. R. Flowers, and were adopted.

Afternoon Session. — At 2:15 the convention reassem- bled, and listened to the able address of President White.

The following gentlemen were appointed a committee on the President's address, viz.: Drs. Wm. Webster, J. R. Flowers, and J. M. Miller.

Bureau of Materia Medioa. — Dr. Ralph Morden, of Groveport, read a paper on " A Proving of Epifagus."

DISOUSSION OF DB. MORDENTS PAPBB.

Dr. Pulford : Epifagus has a very delicate waxy appear- ance. It grows twenty or thirty inches high under the shadow of the beech tree I have had very little experience with the drug. I think it would be a little more commendable in this paper of Dr. Morden 's if he had told us whether it was 9ick headache, or gastric headache, that he cured with Epifagus.

Dr. Allen : I hope Dr. Morden does not put this forward as t^ proving. It seems to me that it is singularly Wanting as a proving. There are hundreds of remedies that we use to cure sick headache. I think the Doctor should have given us, from his notes, the character of the pain, how long it lasted, etc.

Dr. Morden : I will Just say that my experience with the drug is very limited. The pain was of the character of a pressing pain in the temples.

Bureau of Obstetrics. — ^Dr. J. C. Sanders read a paper on " The Liquor Amnii." (See June issue).

A telegram from the Indiana State Homoeopathic Medical Society, now in session, was received and read by the Secretary, the same being in answer to one sent by this convention.

Dr. M. M. Eaton, chairman of this Bureau, read a pa- per on " How to Make Labor Rapid and Safe : "

NINETEENTH SESSION. 123

This subject, though often discussed, never loses its interest to the obstetrical practitioner. During the past ten years it has engrossed more attention than previous to that time, and the profession has been eager to secure more rapid delivery than was the custom twenty -five years since. This desire to hasten delivery has caused many accidents, especially to the mother, notably cervi- cal and perineal lacerations. The reason of this is to be . found in the giving of Secale Oomutum tx) the lying-in woman, before there was full dilatation of the os uteri, or suitable relaxation of the vagina, thus resulting in more rapid delivery ; but the practice is not to be com- mended, because of the injury to the mother, very fre- quently following in such cases. The use of the forceps under circumstances similar to those mentioned is equally objectionable, and should never be practiced or approved.

Disapproving, therefore, of the careless use of Ergot or the forceps to cause rapid delivery, we still believe there is a possibility of making most labors not only rapid and easy, but safe also to both mother and child. This belief is founded upon a reasonably large obstetrical prac- tice, and upon the experience of many other physicians.

My own cases of labor in the past ten years have averaged less than three hours' detention, the longest de- tention having been but thirteen homrs, which was a first labor in a woman thirty-four years of age, whose husband was very large, and the wife below medium size. Two other cases in first labor, nearly the age mentioned, both having large husbands, were terminated in nine and ten hours respectively. Fortunately during this time I have had but one case of monstrosity, which was in consulta- tion. This I delivered at once, by turning. The attend- ing physician. Dr. Coan, had been in attendance on the case for three days previously. Oases of monstrosity in the child, or deformity of the mother, are not considered in this paper, more than to remark that they may un- avoidably delay delivery in the hands of any one. But we

124 OHIO ST A TE SOCIETY.

intend to discuss the ordinary case of natural labor which may terminate without material assistance if time enough be allowed and no account is taken of the mother's pro- tracted suffering.

The evils resulting from this practice are not alone the suffering of the mother, but there is danger to both mother and child in tedious labor. Danger to the mother in the exhaustion produced, in the danger of sloughing of the soft parts from long-continued pressure of the child in the pelvis, causing vesico or recto- vaginal fistula, and in any event tending to cause the development of puer- I)eral peritonitis. There is danger to the child in tedious labor from the long-continued pressure causing debility or strangulation, asphyxia, etc., from the interruption of the circulation in the cord. These considerations, in con- nection with the loss of time to the physician and the great anxiety of friends, cause me to be in favor of rapid delivery as a rule, when it can be accomplished with safety to both mother and child. How to accomplish this we will now consider.

First see to it, if possible, that the mother takes ex- ercise in moderation ijp to the time of delivery, and give her a 3 gr. powder of the 3x trit. of Pulsatilla three times a day for six weeks before the expected labor. See that her bowels are kept regular, by diet, enemas, or suitable remedies. Do not allow labor to come on before the com- pletion of the full period of gestation, if it is possible to prevent it. Disregard of this injunction in my opinion causes many protracted deliveries and much loss of life. We lay it down as a rule that no labor should be encour- aged unless the cervix uteri has disappeared and the os is felt as a simple opening in a membrane, so to speak. The tissue of the uteinis should not be felt thicker than paste- board or heavy cloth in any case at the completion of full term. When the cervil uteri is felt a half inch long, stop the pains if they are present, even though there be dilata- tion sufficient to readily admit the index finger, or even

NINETEENTH SESSION. 126

the ends of two fingers. Unless we do this, the case will be protracted, if not dangerous. Attention to this prin- ciple of practice we wish to emphasize, as we think more attention should be given this matter than has ever been given to it by writers or practitioners ; and to its neglect more than one-half of the tedious labors may be attrib- uted. When called to a case supposed to be in labor, we first make an examination to determine whether or not the cervix has disappeared. If it has not, we take meas- ures to arrest the pains, even if they are quite regular, and there is present considerable dilatation of the cervix. This we usually accomplish vrith Secale 3x dilution, or with Bell. 3x if there is a flushed face present in the patient. If these remedies fail to arrest the pains, we give Oamph. 3x ; and if this is not sufficient, we give ^ gr. pill of Morph. Sulph., and repeat it in an hour if the pains etill continue. These false pains, coming on before the com- pletion of term, often mislead the physician when he fails to note the condition of the cervix uteri, and he states that labor has commenced, and goes about attending to the case, has the nurse sent for, etc., etc. After an hour or two the pains grow less frequent, or stop entirely in some instances, when he feels called upon to make his words good by trying to excite pains by giving warm teas, irritating the cervix uteri with the finger, and, as soon as some pain occurs, giving Secale cor. flu. ext. in half-tea- spoonful doses, till the uterus is excited into violent con- traction. Still the OS dilates but slowly, and time wears away, little progress is made, the patient becomes ex- hausted, stimulants are given, and often more Ergot also, and still no delivery takes place; the friends become alarmed, the doctor gets nervous, another is called in con- sultation, and the forceps decided upon owing to the ex- haustion of the patient and the little progress made, though by this time a considerable dilatation of the os has been accomplished. AU this goes to make up a bad case. The forceps are not easily applied owing to the lack

126 OHIO STA TE SOCIETY.

of full dilatation of the os and vagina, and delivery with them when finally adjusted is slow and difficult, very fre- quently causing laceration, and in too many cases results in loss of life to both mother and child.

This is a dark picture, but one only too often seen ; all of which is attributable to the mistake made at first, in supposing the labor pains genuine, and the full term of gestation accomplished.

I hope I have made myself well understood in regard to the necessity for preventing premature delivery, in con- nection with which I might mention as an important con- sideration that in these cases the child is less strong, even if able to live, the soft parts of the mother are more un- yielding, and consequently more liable to laceration, than at the completion of full term.

We will now consider normal labor at full term, and how we may make it rapid and easy. First, keep the pa- tient warm in bed most of the time, bee to it that the bowels have been freely evacuated recen^^ly, and that the urine is frequently voided ; be careful that the membranes are not ruptured till nearly complete dilatation of the os is accomplished ; and if they are accidentally ruptured, distend the os with two fingers during each pain, to take the place of the bag of waters which usually will distend the OS when the membranes are not ruptured. Apply a little diluted Bell, ointment to the cervix uteri, if there is any rigidity of its margin ; let the patient inhale a little chloroform every ten minutes during dilatation of the os, not to cause insensibility, but simply to relax the system. This accomplishes what was once secured by venesection and emetics. Occasionally Tart. Em. 3x may be given to advantage, if the patient or friends object to chloroform. When full dilatation is secured, and the vagina is relaxed, rupture the membranes and let the labor progress, which it usually does rapidly. I then encourage the patient to use voluntary expulsive efforts till the head of the child begins to press upon the perineum ; then I give chloro-

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form to cause almost a loss of consciousness, till the pa- tient have three or four pains, which will usually termin- ate the labor. In case the child is not rapidly delivered I allow the chloroform discontinued for a time, and I hold the child back at each pain for a half hour or so, to allow of relaxation of the vagina, then again give the chloro- form and allow the head to progress, simply supporting the perineum gently with the palm of the hand and press- ing the head gently toward the pubis. As soon as the head of the child is delivered, wipe it with a soft cloth and remove any mucus from its mouth which may be there, then insert a finger by the side of the child's neck, hook it under an arm, and use a little traction in the axis of the outlet of the vagina — i. e., forwards. This usually terminates the labor at once. When the child is delivered we wipe its face and chest dry, and see that the cord is not around its neck. It is well to notice this as soon as the head is delivered ; but in some cases, when we dis- cover this, we cannot slip the cord over the head on ac- count of its being too short, and can only remove it after the child is delivered. As soon as the child is delivered and wiped dry, the chloroform is discontinued. The cord is cut if the child cries lustily ; if not, wait, bathe its face and chest in cool water, or use artificial respiration if need be. Never, if possible, cut the cord till the child breathes freely and cries ; then tie the cord tightly and firmly with strong cord about an inch from the child's body, and cut it two inches from where it is tied. Now pass the hand over the mother's abdomen and ascertain if the uterus is contracting, and aid its contraction if it is not, by the fric- tion of the extended palm. As soon as we find the uterus contracting, we assist the delivery of the placenta by gently pressing it backwards and downwards into the hol- low of the sacrum, with two fingers passed into the ante- rior of the vagina, thus speedily delivering the placenta, and using care not to tear off a part of the membranes to be left in the uterus to cause after-pains.

128 OHIO STA TE SOCIETY.

Regarding the use of the forceps, to hasten delivery, I must say a few words. In cases where we have full dilatation of the os, and a complete relaxation of the va- gina, and the labors are retarded from the large size of the head of the child in comparison with the mother's pelvis, the shortness of the funis, or the inefficiency of the pains, and two doses of 20 drops of the flu. ext. of Ergot fail to cause progress to be made in two or three hours, or where the head becomes impacted and does not progress for this length of time, I much prefer to apply the forceps and deliver. In such cases we think this the safer prac- tice, rather than to wait ten or twelve hours with no prog- ress in the case. We usually give some chloroform before applying the forceps, and do not often ask for advice be- fore using them, though in the case of a young physician I would advise asking for a consultation in such cases, if one can readily be obtained. After the delivery of the child, in any case, and the removal of the placenta, we apply a bandage gently about the mother's abdomen. This we direct the nurse to tighten from day to day, al- ways seeing that it is tighter in its lower portion than above.

These, I believe, constitute the main points I have practiced, to secure rapid and safe delivery, and I hope the discussion which may follow will bring out the experi- ence of many others upon this important subject.

Dr. Eaton said, after reading his paper : These views are simply my own, as they have come to me in my practice. This subject, though often discussed, can never lo9e its interest to the obstetric practitioner. The profession have been eager to hasten delivery. Before sitting down a word in regard to success. In using the forceps I have not caused laceration but in one in- stance.

DISCUSSION.

Dr. Connell : I am a little surprised at some things in that paper. I am surprised that one of our own school should come before this Society and advocate the use of chloroform in our practice. I take decided exceptions to this. I do not think it is

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in accordance with the principles of our practice to use chloro- form. And I am satisfied from my own observation that the giving of chloroform cannot help, but be an injury in a majority of cases. If it must be done in any case, It is the greatest exception ; it is not to be done very often. And I would be very careful in employing a physician in my own family, or for a friend, that was in the habit of using chloroform. You get relaxation, but It is general relaxation, and that is what you do not want. It becomes an agency that you cannot control. And I am satis- fied that many a patient's life has been lost because we have been in a hurry. The friends get anxious, and they say, ** Doctor, can't you do something for Annie or Jane?" And the doctor goes to work and gives his ansesthetlcs ; and the patient, I be- lieve, often dies as the result. A word, also, as to bandages. £very physician fears prolapsus uteri. You place the patient upon her back, to apply the bandage, and what can you do ? I don't care how skillful you are, you are going to do an injury. I say, if you are going to have a good delivery, and a strong female after delivery, give up the use of aneesthetics and band- aging.

A Member : I would like to ask the doctor if he bases his views on his experience ?

Dr. Ck>nnell : I have used anaesthetics but a few times. Once, in a case of version. I have watched other practitioners by my side, and I 'can say that the cases which have been disastrous have been the cases which were given chloroform or ansesthet- ics. I could call instances. One of our prominent physicians a short time ago lost his wife. He had given her an ansesthetic. I do not say it killed her, but he said to me, *' I wish I had not done it."

Dr. Mills : I have given ansesthetics, and I have not had the least difficulty or any bad results. This does not prove auses- thetics to be so objectionable.

A Member : Neither does it prove a good delivery to be the result of ansBsthetics.

Dr. Warren : I would like to say a word in regard to false pains. I have always endeavored to impress upon the patients that these are false pains ; that they are not real pains. I have tried that plan with success. I had one case where a lady had over-lifted, and she thought labor had commenced. By impress- ing upon her mind that labor had not commenced, that these were fttlse pains, she was immediately relieved and went to full term. 3

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As to the use of chloroform, I believe that it is an old saying that he who knows but one religion does not know any religion. And I think this is applicable to * those who do not use chloro- form. They should not sq freely condemn those who do. I have used chloroform in labor with marked relief to the patient. Never saw any bad effects from its use, and believe the danger of hemorrhage from its use is very greatly over-estimated. We frequently see bad cases of hemorrhage where it has not been used at all. Look for shreds or pieces of placenta left in the uterus before blaming the chloroform. I would rather have statistics given to show its bad efTects ; they are more convinc- ing than assertions.

Dr. Eggleston : I do not use chloroform except in certain cases. Where it is indicated, I use it. Use it carefully, and it is safe. ^

Dr. Morrill : I never yet gave a woman chloroform, and my success is as good as my neighbors'. I also find it is best to cut the cord about an inch long. It is my practice to give Pulsatilla.

Dr. Allen : I think the doctor ought to have put in the word ** n^t " in the title of his paper — ** How not to Make Labor Bapid and Safe." I have the same habit that Dr. Morrill has, of giving Pulsatilla or some other remedy. Surely Dr. Eaton does not mean to give Pulsatilla 3x three times a day for six weeks before parturition I Why, he might produce an abortion. I would have been very glad to have a few remedies given in the paper for " rigid os," because if we understand our Materia Medica well we do not need chloroform. I have never given chloroform in my life during labor. I have never givea mor- phia. I have never ruptured the wiAters. As a rule we have too much business on our hands to be good obstetricians. A young practitioner told me that he used the forceps in about one-half his cases. Now he is furnishing cases for the gynecologist. He is leaving many a ruptured os behind him.

Dr. Eaton : I want to say a wocd as to chloroform being such a dangerous thing. I have never lost a single case from the use of chloroform. There was only one case where there was post- partem hemorrhage. I don't think that chloroform produced it.

A Member : Must a physician give c?Uoroform and do some- thing, so that he can collect his money ?

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Dr. Eaton : No^ air. But I hold that It is a physician's prov- ince to save pain as well as life. Those who object to the use of anaesthetics will tell you it is very common to sit 24 or 80 hours with the patient in labor. Now if that is right, then go on. But I tell you those patients die, and die undelivered. I will tell you how it is. Some doctors have a way of sliding out of bad cases. Some one will say, ** I don't know but we had bet- ter call somebody else.'' Audthe doctor replies, '* Well, I have no objections." So they call another physician, and then this man can say he has never lost a single case ! These points I think I have made clear, viz. : Do all you can to hasten labor with safety. Rapidly and safely.

Bureau of Clinical Medicine, — Dr. R. N. Warren, chairman of this Bureau, reported a paper from S. D. Waters, M. D., entitled '' Bright's Disease vs. The Kid- neys."

On motion the paper was received.

The following paper was read by M. M. Mills, M.D., of Attica, on "Ague:"

I present the following cases, hoping they may be the means of inducing some of our members to abandon the routine and unscientific method of prescribing for every case of " Ague" or Intermittent Fever the universal Allo- pathic remedy. Quinine. Believing that every remedy has its key-note, and that every case its corresponding characteristic symptom, and can therefore be very easily prescribed for on the grand law of Similia Simililms Gu- rantur^ I consequently give only the key-note symptoms in some of the cases, it being the only ones obtained.

Case 1.— Geo. H , aet 45 ; dark, fleshy ; miller by

trade ; sent for me Aug. 22, 1877, during second paroxysm, which came on at same hour as on the 20th. Severe chill and high fever with delirium. Sweat long continued. Apyrexia clear. Head feels large as "bushel basket." Gave Quinine 3x trit. powder every three hours for two days, which was all that was needed until the present spring.

, Cask 2. — March 5th, 1883, saw him again during sweat of second paroxysm, and learned that it came on two

132 OHIO STA TE SOCIETY.

hours ealier than preceding one of the 3d, and In both he was very thirsty only during chill. Ign. 12th prevented another.

Case 3. — Isaac S , 8et. 48 ; dark, large, lean ; car- penter. Had the third every other day. '' Chill Fever" May 30, 1878, when I saw him. Chill very severe, irregu- lar in time, accompanied by thirst for large draughts. No thirst at other stages. During chill small of back felt hot, and cold during fever. Ign. 2x, five drops every four hours permanently cured him.

Case 4. — Flora H , aet. 22 ; light, tall, and slender ;

teacher. Has taken Quinine and broken fever three times this spring, only to have a return in a short time. June 20th, 1878, found her in bed with burning fever, not- withstanding she was Heavily and closely covered. The least movement or removal of covering caused her to chill. After paroxysm she is so weak she can hardly walk. Nux. 2x, in water, every two hours cured after a light chill on the 22d.

Case 5. — Geo. C , aet. 33; tall, dark; farmer.

Called on me August 1st, 1878, his " well day." Being only able to ride to town since his " shake" yesterday. Describe paroxysms as every other day, not at same hour. Chill without thirst ; slight shaking, lasting half an hour. Heart with thirst and headache, and desire to be covered up in bed, as it made him cold to move or be uncovered. Nux. vom. 12th every three hours cured without another " shake."

Case 6. — Ad. W , set. 35 ; light ; red whiskers and

hair ; sallow and weak ; a farmer. Came to me on his well day, Sept. 23, 1878. Has been sick all summer with every other day "Ague." Has taken Quinine in large doses from two Homoeopathists and three AUopathists, breaking up the paroxysms for a short time at first, but now it has no effect. Present symptoms, hard chill and fever; no sweat; fever lasting until next chill in light form ; therefore is not well any day. No appetite ; dull

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headache all the time. Very weak ; hardly able to sit up all of his well day. Gave Polyp, off. 2x five drops every four hours, and in ten days he was at work on the farm and has had no return to this date.

Case 7. — Edna F , eet. 8 ; light, slender and ner- vous. At 7 A. M., April 21st, 1880, had violent chill. Pa- rents sent word that she was in spasms. Found her semi- conscious, with great thirst; complained of tickling in ears. Gave Sac. lac. until I could see her again at noon, when I found her with temp. 102 and increasing, thirsty, and tickling in ears. Hydroa covering lips. Nat. mur. 30th cured.

Case 8. — Carrie N , eet. 21; brunette; small (wt.

80 lbs.) and nervous. A teacher of music. Has had Chill Fever and sweat every other night for a week. Chill with desire to get nearer the stove and warm ;. no thirst. Heat with thirst ; oppression of chest and extreme tenderness of lower bowels ; cannot have the bedclothes touch her. The least pressure on throat causes cough. Sweat relieves all. Lach. 30th every four hours cured, and she has had no return now for three months.

Dr. Warren then read a paper on " Salicylic Acid as a Primary Dressing for Lacerated and Incised Wounds :"

Much has been written during the last decade on the subject of micro-organisms and the relation they bear to the human system. Posterity in writing a history of the science of medicine will doubtless call this the " Germ AgeP

The object of this paper will not be to discuss the truth or falsity of the germ theory ; but as a prelude to what I have to say on the primary treatment of wounds I shall call your attention briefly to that part of the germ theory that relates to the suppurative process. A host of careful, conscientious and untiring workers are in the field in search of these microscopic bodies, to ascertain, if pos- sible, their origin, their habits, their place of abode, and

134 OHIO STATE SOCIETY.

the relation they sustain to the human organism in health and disease. Are they organized or unorganized bodies ? Do they belong to the animal or vegetable kingdom ? Are they the cause or the result of disease ? These and many other questions concerning them are yet in doubt in the minds of many observers. Some contending that they are nothing more than fibrin threads and fat crystals ; but the fact that they are capable of independent locomotion and multiply by fission is evidence to my mind that they are organized bodies. They probably belong to the vegetable kingdom, a species of fungi or algee. Eminent patholo- gists are still in doubt in regard to the relation these bod- ies sustain to the suppurative process. Wiggart was in- clined to regard micro-organisms hot merely a cause, but the sole cause of acute suppuration ; but this idea has been dissipated by later and more trustworthy experiments.

Billroth concluded after much experience that bacte- ria were the result and not the cause of certain changes in the secretions and tissues during the suppurative process. It is said, however, that of late he has materially modified some of his conclusions. Conheim thinks that suppura- tion not due to bacteria is extremely rare. Bel field says, practically we may regard acute suppuration as proof of the access of external irritant matter organized or unor- ganized. Pasteur, Lister, Koch, and many other patholo- gists of note, attribute suppuration in a majority of cases to the puterfactive fermentation set up in animal fluid by the development in it of organisms carried into it as germs floating through the atmosphere, and not spontaneously developed in it by any change taking place in the tissues or fluids of the part independently of such impregnation. It necessarily follows that if this " germ theory," as ap- plied to suppuration, be correct, suppuration in open wounds can in a large proportion of cases be avoided by preventing the entrance of germs into the wound, or by destroying their vitality by some antiseptic agent. Nature is an excellent teacher, and »n apt scholar can learn much

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by observing closely her methods : witness the blood clot, nature's hsemostatic, which forms and covers the wound with crust or scab, excluding all foreign material that would be noxious to the healing process. Thus many wounds, entrusted to her care, either in man or the lower animals heal promptly.

Assuming the " germ theory" as regards open wounds to be correct, and taking a suggestion from nature as my guide, I at once entirely occlude the wound with an agent fulfilling the indications, viz.: prevening the access of irri- tant matter, either inorganized or if organized, rendering it inert. This agent is dry Salicylic Acid, it being nearly insoluble in blood and serum, it unites with them, forming a crust which protects mechanically as well as antiseptic- ally. Salicylic Acid unquestionably holds a place in the front rank of antizymotic agents and is a powerful remedy to prevent puterfactive changes. Some of the advantages of this mode of treatment are :

1st, The wound unites without suppuration, conse- quently without loss of tissue.

2d, Time is saved to the patient as the process of healing is shorter than when suppuration takes place.

3d, A great saving of labor to the physician and nurses, because of infrequent dressings.

4th, The Acid being a feeble poison and very insoluble there is no danger of accidents from absorption.

5th, The odor is not so disgusting and unpleasant as some other remedies now in use.

6th, It is Very inexpensive as compared with some other methods.

When to use this remedy as a dressing :

1st, The rule is, to use it in all lacerated, incised and operating wounds that can be closed or nearly closed.

2d, Do not use it in wounds when there is a great loss of tissue or the surrounding soft parts so badly injured as to destroy their vitality.

136 OHIO STA TE SOCIETY.

3d, In this paper the Acid is recommended as a pri- mary dressing, as I have had no experience in its use after the wound has become infected.

My first experienoe in the use of this agent as a dress- ing was in " scalp wounds," and the result being excellent I was led to its use in incised and lacerated wounds in other parts of the body ; thus far the results have been extremely satisfactory. I can cheerfully recommend it for further trial.

How to use it: Cleanse the wound of all foreign ma- terial, check hemorrhage if troublesome, coaptate the edges, using silver wire sutures when necessary, and over all apply the dry Acid, pressing it down and making it compact, absolutely occluding the entire wound.

Unless there is evidence of putrefaction or suppura- tion do not disturb the wound for a number of days. Let infrequent dressing be the rule. Do not bandage heavily over the wound after applying the acid, just enough to keep everything in its place. My rule is, keep the injured part cool and dry. Warmth and moisture favor suppura- tion, according to my experience.

Case 1. — Gillie H., aet. 10, was attacked by a savage and ferocious dog and severely bitten about the head and face ; the scalp being sadly lacerated in a great number of places. After cleaning and coaptating the parts as best I could, the wounds were immediately occluded with dry Salicylic Acid. The result was almost immediate relief of pain. There was no suppuration, and no change of dressing was needed. No work for the attendants. Wounds all healed in a few days.

Case 2. — ^J. S„while under the influence of poor whisky, had his head and face fearfully lacerated with beer glasses. On presenting himself for treatment I doubt if his own mother would have recognized him, so terribly were his head and face disfigured, flesh hanging in pieces about his forehead, eyebrows cut loose and turned downward over his eyes, upper lip cut entirely through and through. It

NINETEENTH SESSION. 137

was a long and tedious task to get him in shape again — a stitch here and a stitch there until all was completed — then all was occluded with the dry Acid. The result was excellent, all the wounds healing without suppuration — possibly a few drops formed where some of the stitches were inserted as that frequently occurs when the stitches are silk.

In conclusion, 1 would say I have used Calendula, wa- tery solution, also Carbolic Acid in water, and iu oil, as applications to open wounds, but feel confident that dry Salicyle Acid has given me the best results when used as a primary dressing.

Dr. Eaton : Dr. Warren has shown us much that will com- mand the respect of all practitioners. I must say that Salicylic Acid is superior to anything with which I am acquainted.

Dr. Webster : I have made use of it for three or four years. Ji* is excellent.

Dr. Allen : How does it differ fh>m Calendula ?

Dr. Warren : I think that it acts mechanically, as well as antiseptically. Calendula has always been used in water. This can be used with very little trouble— applied dry to the wound.

Bureau of Pcedology. — ^No report. Dr. Sanders offered the following :

Eesolvedj That any member of this Society, who shall have maintained a membership in good and regular standing for a pe- riod of twenty years, shall be placed on the roll of honorary membership, and shall thenceforth be exempt from further financial obligations to the Society.

Dr. Sanders : It seems to me, Mr. President, that a mem- ber who has thus served out a period of twenty years, should be exempt from further financial obligation.

Dr. Conn ell said : This is a motion to let our old war- horses go free. They are the men who have the money, while we young men have to bear the burden. Certainly they are bet- ter prepared than our young men to pay their dues. I am lure the old men can afibrd to back up the young men. I do not think the Society will be benefited by such action. I think it will tend to lessen the obligation on the part of the older men.

The President : This Society has been organized since '64.

188 OHIO 8TA TE SOCIETY.

Dr. Eaton : We have in our city (Cincinnati) some of these old members whom we delight to honor. The purpose of this resolution is to show them honor. If the gentleman who has opposed the motion had been here twenty years, he would be willing to accept the honor.

Dr. Webster : I am one of the oldest members of this Soci- ety. It would be very humiliating to us to be laid upon the shelf. I think we can pay our dues. If we do pass this resolu- tion we have got to change our constitution. I am opposed to it myself.

The resolution prevailed.

On motion of Dr. Connell, Drs. Pulte and Benjamin Ehrman were placed on the honorary list.

Wednesday's Session. — ^The Society was called order at 9:15 a. m., by Dr. 0. E. Walton, of Hamilton, first Vice- President

* Credentials and reports were presented from North- eastern Ohio Homoeopathic Medical Society, and from the physicians of the Ohio Hospital for Women and Chil- dren.

Dr. Flowers presented the report of the Necrologist, ond read an obituary of Dr. McMahon, of Marion, O.

Bureau of Anatomy^ Physiology and Pathology, — ^Dr. W. O. Miller, acting as chairman, announced a paper by Dr. C. W. Carroll, on '^ Spina Bifida."

Dr. Randers : I am not very familiar with this subject, but am very niuch interested in it The paper is very commenda- ble, is ^ery praiseworthy. I think there could have been added to it, vt-ry properly, the consideration of some malformations.

Dr. Walton : I was recently called to an interesting case. The breech presentation had terminated in delivery as far as the head, when all progress ceased ; the vagina was occupied by a large fluctuating mass upon which the struggling uterus exer- cised its fruitless eflbrts. After patient endeavors the forceps were introduced, and careful manipulation resulted in the delivery of an enormous hydrocephalic head. The child also presented the unusual accompaniment of a Spina Bifida. Whethei the fact that the mother of the child, and of the child referred to in my

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paper, resided within a few yards of the Hamilton Reservoir, or whether the long- con tinned and ahimated discussion of the wa- ter works question had any relation with the production of these water-logged youngsters, I will leave too older and wiser heads to determine. v

Bureau of Surgery. — ^Dr. Walton said : " I am sorry to say that so far as I know I am the only member of that Bureau present." He then presented, Iby title, a paper by M. P. Hunt, M. D., and proceeded to read his own,' on '* Intravaginal Paracentesis."

The papers were received by the Society.

Bureau of OynoBcology. — The Secretary said he had no papers from this bureau.

Dr. Wm. Webster read a paper on "Abnormal Growths in Connection with Uterine Organs."

Dr. Walton : Mr. President, I would like to ask by the shade of Hahnemann what the doctor means by uterine tonics f

Dr. Webster : After this lady had this removed. I gave her Aconite 8x for two or three days to prevent inflammation ; then followed with Nux. vom. 8x; then Bryonia 6x. I consider these among the best uterine tonics. I will state that I am in the habit of giving one remedy at a time, then watch the effect.

Dr. Walton : I will ask the doctor if it would not have been a good plan to not give any medicine at all, and watch the case. I have often not given anything, and think it a good plan.

Dr. Allen : I would like to ask Dr. Webster a question. You gave us three or four remedies as uterine tonics. I would like to ask if you have any remedies in the Materia Medica that are not uterine tonics?

A paper was read by C. Hoyt, M. D., of Oxford, on " Pelvic Cellulitis," and it was received and referred.

Dr. Sanders : I was very much pleased with this paper. It is evidently a very scholarly production. This is a subject of very great interest. Bometimes a case has run its career undiag- nosed, or sometimes as Inflammation of the womb. While the paper is a very interesting one, I would have liked it better if he had indicated what particular drugs he used. I have really but one criticism, and that is in regard to the use of camphorated oiL Camphor is a drug that is incompatable with many of our

140 OHIO STA TE SOCIETY.

remedies. I do not think anything will be gained by its use, but on the contrary, will interfere with the indicated drug, which may be used tropically in these oases.

Dr. Allen : I think that point is very well taken by Dr. Sanders. We cannot or ought not to apply camphor while treat- ing our patients with internal remedied. We do not pay nearly enough attention to the relationship of remedies. We will give one, and then another, and another without a proper under- standing of their action. For a number of years Dr. Hering paid great attention to this relative action of remedies. One remedy may be the direct antagonist of another. Another thing I would like to add is, Aloe, for instance, is not a good remedy with which to commence the treatment of a chronic case. It resembles Lycopodium in this respect. Sometimes an acute at- tack of diarrhoea will be cured by it. But Aloe like Lycopodium, is not a good remedy to commence a chronic case with. But, I repeat, as a rule we do not pay enough attention to the relation of one drug to another. If we would pay more attention to this we should have better success, infinitely better.

Bureau of Insanity..— 'Dr. Gilbert, chairman, reported a paper by J. K. Webster, M. D., of Dayton, on '• The Study of Mental Diseases," and, on motion, it was read by Dr. Qeppert :

The National Association for the Protection of the In- sane has issued a circular, addressed to the various Medi- cal Colleges of the country,' asking that the didactic and clinical teachings of insanity be introduced^

Now, all are aware that the study of mental and ner- vous diseases are receiving too little attention from the profession. About a dozen of Old School colleges have lectures on mental diseases, and I believe our school has in proportion a larger percentage. Yet, each college ought to have a course of lectures on mental diseases and clinical instruction in the same when possible. How few young physicians have seen, professionally speaking, a case of insanity, and when confronted with his first case how incompetent he feels to treat it. He has heard no lectures on the subject, consequently has no notes to which he can refer, and as to books pertaining to the mat-

NINETEENTH SESSION. 141

ter, it is doubtful whether his small library contains a line pertaining to the case in hand. Who does he blame? Who should he blame ? Other subjects which he has not heard mentioned, he can read up. But in regard to this one he finds the literature exceedingly meager. The same may be said of physicians of riper years. How few are competent to treat successfully nervous diseases, espec- ially mental diseases. We as a school claim, and I think justly, to be in the advance. Let us then not falter here.

Until the present decade little was known, and the fraternity seemed to care less, concerning this branch of practice. And even now with the general practitioner, the first thing to be done is to send the patient to the asy- lum. The question arises is it always proper to send the patient to this resort at once. Well, yes, when we know so little about treating his affictions. We claim and be- lieve that so far as Homoeopathic treatment has been tested in mental diseases its superiority has been as fully demonstrated as in the treatment of other diseases. And let us and our students be fully prepared to take charge of and intelligently treat all such cases as may come un- der our care.

The time is coming, and we trust is not far distant, when Ohio will have her Homoeopathic Asylums, and let us be prepared for the work. True, this is a specialty. But where are our specialists ? When the time referred to arrives who will we recommend ? The men of experience are too busy and could not accept. The young men are not prepared. The Old School have men who have held subordinate positions in such institutions, and when a new man is needed all that is necessary is promotion. We cannot do this at present.

We have not advanced these ideas in any spirit of criticism toward the teaching in our colleges, for we be- lieve they are equal in this branch to the Old School. But let us be ahead in this as we are in many others. Clinical teaching with the present facilities would hardly be prac-

142 OHIO 8TA TE SOCIETY.

tdcable, but let us have more didactic instruction now and clinical when we can. Now that our Old School brethren consider us insane, let us be able to treat insanity.

Dr. Cleveland : This subject is one undoubtedly greatly ne- glected. As we get reports from Europe we fiud that insanity is on the increase. And our medical colleges are greatly deficient in instruction relating to these diseases. I myself have had some experience in regard to mental diseases. Two years ago while studying in the college in New York, I felt a peculiar sen- sation while listening to the hospital lecture, and was not able to follow the professor at all. From this fact, that medical stu- dents frequently give out, they should be instructed as to the peculiar constitution of the mind.

Dr. Geppert, of Cincinnati, then read a paper on "The Care of the Insane.''

Bureau of Ophthalmology and Otology. — A paper was read by W. A. Phillips, M. D., of Cleveland, on " Acute Suppurative Inflammation of the Middle Ear."

After reading his paper Dr. Phillips related a case from practice, illustrative of a class of cases in which timely operative interference is of the greatest benefit. A little girl, in conse- quence of a severe cold, was attacked with ear-ache (acute otitis media). The second day afterward I was called in consultation, and found, by examination, that both of the drum-heads were bulged outwards and intensely red— the patient suffering ex- treme pain and feverish. She had taken Aeon, internally and warm applications had been made locally. The bulging of the drum-heads was produced by the pressure of inflammatory pro- ducts in the tympanic cavity, and would have favored ulceration of the drum-heads, which latter would have soon ruptured, and were then liable to be partially if not entirely ulcerated away. The indication, then, was plain. An opening through the tym- panic membranes with a broad needle would be sufficient to evacuate the contents of the drum cavity, and the wounds thus made would be far more favorable for healing than they would if produced by ulceration and pressure. Chloroform was admin- istered and the puncture of the membranes was made. A thin, straw-colored liquid was discharged. Instillations of warm wa- ter were to be made into the ear during the next twenty-four hours, provided the pain should reappear. In three days the

NINETEENTH SESSION, 143

openiDgs were entirely healed, and the patient recovered promptly without impairment of hearing.

Dr. Webiiter : How long does it take the puncture in the drum-head to heal ?

Dr. Phillips: In thirty-six hours, and even sooner, the drum-head will be nicely healed. If, however, ulceration attack the edges of the wound, so that a loss of substance occurs then the time of healing will be indefinite. And if the opening be- oomes large, it may never close, but leave a permanent perfora- tion, which is generally accompanied by a chronic aural dis- cbarge that is frequently very difficult to cure. A clean cut through the drum-head will, in many cases, heal by first inten- tion ; .and ulcerative opening necessarily by granulation— the latter being so slow that the edges of the perforation may heal over without the perforation itself ever being closed at all ; and hence, a chronic aural discharge results that might have been prevented by paracentesis.

The doctor was asked what remedies he would recommend as being most efficacious in the hands of general practitioners for the treatment of chronic discharges from the ear, to which reply was made as follows :

Finely powdered boracic acid blown into the ear after the discharge has been removed, is undoubtedly the best application. Other powders are used, but should not be applied without being very carefully watched, as they are liable to form hardened masses, which are often difficult to remove, and may produce ad- ditional trouble. I employ a very simple instrument, of my own device, for a powder blower, which consists of a rubber bulb and tube, like those used in the construction of Delano's atomizer. I insert in the end of the rubber tube a glass tube three inches long, one-fourth of an inch in diameter, and having a calibre of rather more than one-eight of an inch. It is now ready for use. Strike the free end of the glass tube perpendicularly into the powder, and you can thus fill the tube to any desired extent. In- sert the end of the tube into the meatus, and a quick, light grasp of the bulb blows the powder unto the diseased surface. Of oourse, the same thing can be done through a quill or long glass tabe with the breath, provided you are not particular about the neatness of the procedure. Among the liquid preparations I re- gard Garb, acid, five drops to the ounce of glyc. and water, half and half; 8ulp. of Zinc, or Sulph. of Alum, two or three grains to the ounce, as the best applications. If, however, hypertro-

144 OHIO 8TA TE SOCIETY.

phio tissue, or polypi have formed, none of these, including Bo- racic acid, will be of much service. In answer to the question concerning the use of internal remedies, I have to say, that my experience in the effort to cure chronic suppurative discharges from the ear with them has been unsatisfactory. The trouble is local, as this term is understood, and in my Judgment, is best met by local applications. I do not feel certain that I have ever cured a case by internal remedies alone, although I have tried to the best of my ability. Some cases will get well without any treatment— even very chronic cases ; and for that very reason, the few cases I've known to get well under the internal medica- tion alone, I am in doubt at>out as to whether the medicine cured, or whether they would have recovered without it. In other words, theoretically, [ believe in internal remedies for this affection ; practically, I am somewhat in doubt. There is evi- dence, however, to believe that internal and local treatment will accomplish more than either one will alone. About Tellurium. O yes, we've all tried Tellurium on the plan of the ** fish pickle smell ;'' but, for my part, I either never encountered that classic odor, or else Tellurium isn't *' up to snuff." The remedies that have seemed to me to avail the most are Arsen.Iod., SuCph.,Oalc. PhoB., and SUicea.

Dr. McDermott : This paper is certainly of great interest to us. Now here is a fact, that sometimes sweet oil is used as an application. Sweet oil should not be used in healing. Perhaps it might not do harm. I have used it in fungus growths ; but it is likely to become rancid. No doubt it does in some cases pro- duce acute inflammation. The best way to use It is in liquid vaseline. That does not become rancid. Now, another thtng about using water. Be careful not to have it drop on the drum- head, for it will cause intense pain. Let the water strike upon the canal, and it will run down and not give pain. Liquid vas- eline will do, but yet it is not as good as water.

Dr. Webster : I agree with the doctor about the use of sweet oil. It is so likely to become rancid. Yet people will take the risk of putting it in. And they will put in cotton and sweet oil, and camphor and sweet oil, and tobacco and sweet oil. I have used glycerine, and found it gave ease and comfort.

Dr. Morrill : I am a general practitioner. I suffered from an acute attack. Several of these specialists treated me, and were continually prescribing Mercury for me. About two years ago I removed a number of mercurial fillings from my teeth, and have not had prescriptions for Mercury since.

NINETEENTH SESSION 145

Dr. Phillips : I will explain why it is bo difficult to do any- thing in these cases. The drum covering is very narrow. The middle ear is lined by a mucous membrane, and this mucous lining becomes thickened. And in some cases the whole mas- toid process is filled up, There Is the trouble. It is because of that fungus growth. Most of those recent cases can be cured ; but cases that have existed for years are in many instances al- most incurable. As to local applications : Boracic acid has been used a great deal, and that is good. But water injected will make the matter worse.

Dr. Allen : I wish to mention a case examined before the clinic for chronic catarrhal Inflammation. He had amalgam fillings. They were removed, and the patient got well. We do not pay enough attention to mercurial fillings. One of the first remedies in suppurative inflammation is Silicea ; if the charac- teristic fish-brine odor of discharge is present, Tellurium is also good. I would suggest that we pursue the investigation further with Tellurium. We want a better proving.

G. 0. McDermott, M. D., of Cincinnati, read a paper on "Strabismus."

W. I. Miller, M. D., of Cleveland, from the Bureau of Anatomy, Physiology, and Pathology, read a paper on " Specimens of Pathological Anatomy." Dr. Miller ex- hibited some very interesting specimens.

The President appointed delegates to the American Institute of Homoeopathy, and to the Michigan State So- ciety.

The Convention then adjourned for dinner.

Wednesday Afternoon Session. — The committee on President's Address made their report, which, on motion of Dr. Cleveland, was accepted.

The Convention then proceeded to the election of offi- cers for the ensuing year.

Dr. J. C. Sanders was nominated for President, and the nomination was heartily seconded. On motion, the Secretary, Dr. Beebe, cast the affirmative vote, and Dr. Sanders was declared elected. 4

146 OHIO 8TA TE SOCIETY.

Dr. Sanders said :

Mr. President and Gentlemen of the Society : I will only say that I thank you most heartily for this compliment, which is entirely unsought for.

Drs. Wm. Webster and Geppert were put in nomina- tion for first Vice-President.

Dr. Webster having declined the honor, on motion the Secretary cast the affirmative ballot for Dr. Geppert.

Dr. Geppert said :

Mr. President and Members of the Society : I can truly say that this honor is most unexpected to me. I thank you all for it

Drs. M. B. Hunt and W. I. Miller were nominated for second Vice-President.

Dr. Miller declining, the Secretary was instructed to cast an affirmative ballot for Dr. Hunt, and he was duly elected.

Dr. Hunt said :

Mr. President : It is ceitainly impossible for me to make a speech. I thank you all for the honor.

Dr. Beebe was heartily nominated for Secretary, and on motion the President cast an affirmative ballot for his election.

Dr. W. I. Miller was nominated for Treasurer, and the Secretary instructed to cast the affirmative ballot, which he did, and Dr- Miller was elected.

On motion the same Board of Censors that served this year were continued for the ensuing*year.

Dr. Cleveland was nominated, and elected by the bal- lot of the Secretary, to the office of Assistant Secretary.

The retiring Treasurer, Dr. Sanders, made his report. Dr. Sanders said:

I will say that we were somewhat surprised at the size of the bill from the Medical Advance. But I subsequently submit- ted the work to the Economy Printing Company, of Cleveland, who said that they would charge more. It must be, therefore, that this bill is proper, and ought to be paid. I would like to

NINETEENTH SESSION. 147

submit to the consideration of the Society the names of some delinqaent members. I have a long list of men in arrears. I will read a few of them.

Dr. Walton : Mr. President, I would like to ask if there is not a provision for such cases ?

Dr. Sanders : There is ; but I beg to add that I have not held to this rule.

Drs. Eggleston, Flowers, and Barnes were named a committee to audit the Treasurer's report.

The President, Secretary, and Treasurer were made a committee on publication.

On motion of Dr. Sanders, H. C. Allen, M. D., Pro- fessor of Materia Medica in the University Homoeopathic College, Ann Arbor, Mich., was elected an honorary mem- ber of the Society.

PlcLce of Meeting. — Dr. Qeppert moved that Colum- bus be selected, and that hereafter it be the place of meet- ing. Lost.

Dr. Miller proposed Cleveland, and Dr. Geppert pro- posed Cincinnati. On taking the vote, the motion to select Cincinnati was lost. The vote was then taken on Cleveland, and prevailed.

President White said :

I wish to say a word to the younger members. It all de- pends on them to make a success of the Society. I hope they will do their best.

The second Tuesday in May was fixed as the date of meeting next year.

The committee to audit the Treasurer's report made their report.

On motion of Dr. Sanders, a vote of thanks was ten- dered to President White, for his able administration.

• President White said : " I thank you for your atten- tion, and helping me along."

Dr. Flowers moved a vote of thanks to the worthy Secretary for his services, and the motion prevailed.

148 CHRONIC ALCOHOLISMUS.

Dr. Walton moved a vote of thanks to the retiring Treasurer, and the motion prevailed. The Convention then adjourned.

CHRONIC ALCOHOLISMUS.

READ BEFORE THE MINNESOTA HOMCEOPATHIC INSTITUTE.

C. F. MIL8PAUOH, K. D., BINGHAMPTON, K. T.

Dr. Milspaugh's paper, in that gentleman's absence, was read by Dr. Brazil, the most interesting part being the following description of an aggravated case and its suc- cessful treatment :

Mr. S — , aged 48, had been an habitual imbiber of alco- holic liquors for over ten years, and of late so great had its bonds of slavery galled him, that he determined to come East in order to escape his companions while he made the attempt to cast off his fetters. Stopping in Binghampton, he had occasion to consult me. He had had no passage per rectum in eleven days, and was feeling very uncomfortable in consequence. Upon recording his case he gave the following symptoms : Morning, head- aches, during which his head felt, as he expressed it, like a block of wood ; eyes weak ; no desire for business ; all efforts tired him ; chronic anorexia and constipation ; he had eaten nothing for eight days, except a few shreds of raw salted codfish; great hypersesthesia ; every sudden jar or sound startled him spasmodically; mouth tasted sour or bitter; bitter eructations, with frequent mucoid vomiting.

You have all determined ere this that Nux vomica was the only remedy indicated in this case, and I agree with you fully. But then, you know, we are all of us sub- ject to the fascinating influence of theory, and at this time I was under the spell. I had but just theorized that the

a F. MILSPA UOH. 149

chronic effects of any poison may be cured by a high po- tency of the offending substance, and this chance to ride my hobby was too good to waste. I therefore, after evac- uating the bowels with an ounce injection of a solution of oil soap in tepid water, gave him one dose of alcohol cm. upon the tongue, and a vial of Placebo.

The next day he reported himself worse of all symp- toms, except the headache ; that had left entirely. He had used his habitual amount of stimulant, and had eaten nothing. Placebo continued.

Third Daj-. — No change.

Fourth Day. — ^Thinks he feels a little better generally. Does not relish his whisky at all — it tastes bad, and gags him. Has eaten nothing except a dried herring. No pre- scription, as evidently an action has commenced, and it is better to await results.

Fifth Day. — Improvement quite noticeable; he en- joyed quite a supper last evening, but vomited two hours afterwards. Took but one drink to-day.

Sixth Day. — I called upon him at his hotel, and found that he had just eaten a hearty dinner, perhaps of nearly every course; he was feeling, as he expressed himself, "better than for years," and asked me "to take some- thing" to his rapid recovery. I complied by taking "star," while he poured himself a generous glass of bour- bon. As he raised it to his lips the glass fell from his hand, and running to the window he vomited profusely. I left him in his room, he feeling very weak and exhausted.

Seventh Day. — ^Mr. S. reported himself feeling splen- didly; he ate a hearty supper last night, an excellent breakfast this morning, and was prepared to do ample jus- tice to dinner ; no headache ; no cough.

Eighth Day. — Doing finely ; appetite excellent for " four meals a day." I discharged him for two weeks, as he desired to visit the oil regions of Bradford, Pa.

Twenty-second Day. — An erect gentleman came into my oflSce this morning with a frank " How are you, doc-

160 DOUBLE OVABIOTOMY.

tor ? " It was quite a moment before I recognized in him my alcoholic patient, so utterly changed was he, and in a few days he left for home, well pleased with his first ex- I)erience with homoeopathy. I received a letter from him three months after, in which he says: "The smell of whisky nauseates me, and I am certain a taste of it would cause me to vomit. Please send me some of your whisky antidote. It is certainly a grand thing." It is needless to say that I did not send the antidote.

DOUBLE OVARIOTOMr.

PHIL. PORTER, K. D., DETROIT.

Mrs. H., 8et. 54, of sanguine temperament. Never was pregnant. Sent by Dr. L. Younghusband, who had been called in to take the case from a " woman tumor doctor " who claimed the power to " rub away all kinds of tumors," one of Nature's physicians, that are horn^ not made.

Inquiry into the history of the case elicited the facts that the tumor was first noticed about three years ago, as a round ball in the right iliac region, and very movable. It grew rapidly, and was attended with pain.

After seeking relief in various quarters from homoeo- pathic practitioners (she was an ardent supporter of hom- oeopathic principles), and meeting with but indifferent encouragement or advice, she fell into the hands of this " woman " (nature's phys.), who of course was ready at all times to give valuable information relative to the dis- ease. This person claimed to be helping the trouble, but soon abdominal ascites manifested itself, and the patient was abandoned by the self-made doctor.

Careful examination, made the first day of attend- ance, revealed a large hard mass in the abdominal cavity, but owing to the large amount of ascitic fluid nothing def- inite could be mapped out, I then determined to remove

FHIL. PORTER. 161

the liquid in order to be able to arrive at a proper diagno- sis, which was done by one of Billroth's combination tro- cars, and relieved the patient of thirty-six pounds of water. On further examination I discovered two tumors, one occupying the right and the other the left side of the abdomen.

Owing to the low condition of the patient — her tem- perature being sub-normal and her pulse 120 — I called a council, and the result of the deliberation was to operate. The family as well as the patient being extremely anxious to have the operation i)erformed; no encouragement was offered the friends or patient.

After changing th^ residence of the patient, in order to give her all the advantage of good surroundings and as perfect hygienic conditions as possible, I operated in the usual manner for ovariotomy, taking all the precautions necessary in so grave a case.

For three days before the operation she was restricted to a liquid diet exclusively, and on the morning of the operation her bowels were freely evacuated by enema. Having thus prepared the patient, I proceeded to operate, assisted by Drs. Miller, Olin, McGuire, Bailey, and GriflBn. Being quickly brought under the influence of the anaes- thetic (chloroform) by Dr. Miller, I made the abdominal incision from the umbilicus to the pubes. As soon as I had divided the abdominal parietes, a large amount of as- citic fluid escaped, and the tumors were exposed. Before tapping the cysts the abdominal cavity was thoroughly cleaned out. As soon as the abdomen was opened cancer- ous deposits were found, covering the peritoneum, intes- tines, bladder, and omentum. The tumors were then evacuated with one of Wells's trocars, and found to con- tain a thick, creamy fluid, with a large amount of flakes of lymph. The tumors did not present that pearly blue appearance usually seen in ordinary ovarian cysts.

The adhesions were so extensive and vascular that I deemed it unwise to attempt a separation, so I simply

152 CHBONIC OTORRH(EA.

peeled out both cysts and ligated the pedicles in four dif- ferent places. The right pedicle was five inches in width, the left four. The entire mass, including the cyst fluid, weighed sixty-four pounds.

After carefully performing the toilet of the periton- eum, I applied a soft sponge, saturated with equal parts of Calendula and Hypericum^ to the exposed surfaces of the pedicles and adhesions, and closed the incision with silk- worm gut sutures, employing only the deep sutures^ my usual manner of closing abdominal incisions. A soft rub- ber drainage-tube was left in the lower angle of the wound. The abdomen was then dressed in the usual manner, with carbolized gauze, cotton, and bandaged.

No inflammatory symptoms followed the operation, but the patient died on the second day, from exhaustion. Drainage was perfect. The temperature was sub-normal before as well as after the operation.

Out of eight cases of ovariotomy for this year, this must be recorded as the only fatal one.

Detroit, April 27tb, 1883.

"THE USE OF BORACIO ACID IN THE TREAT- MENT OF CHRONIC OTORRHCEA."

H0M(E0PATHIC MEDICAL SOCIETY OP OHIO, 1883.

BY H. A. SHEBWOOD, M. D., WARREN, O.

Of the various chronic affections which the general practitioner of medicine is called upon to treat, thore is perhaps none more perplexing than that of " Otorrhoe.a."

After reading in the Hahnemannian Monthly of De- cember last an account of several cases successfully treated with Boracic Acid in impalpable powder, as prepared by Wyeth & Bro., of Philadelphia, I decided to give the rem- edy a trial, and accordingly ordered some of the medicine,

H. A. SHEB WOOD. 168

and used it in the manner described by Dr. 0. Bartlett, of Philadelphia, in the article referred to. The ear is first to be thoroughly cleansed by the use of absorbent cotton wrapped around a probe, wiping out the secretions of the tympanic cavity by the aid of reflected light from a con- cave mirror with head-band and speculum. The cavity is then packed full of the i)owder, and covered with absorb- ent cotton, to be removed on retiring. The powder to be left until washed away by the discharge, which varies in time with difierent cases from one to several days. Fol- lowing is a report of three cases treated in this manner since January last.

Case 1.— F. Q. A., aet. 26. Railroad ticket agent. Had scarlatina when two years of age, leaving him with per- foration of the right tympanic membrane, and an offensive discharge during this interval of twenty-four years. Has been treated by a number of physicians, but always with- out satisfactory results. First treatment January 23d, fol- lowed by two other treatments, at intervals of three days, stopped the discharge entirely. Patient has had several colds since, and is troubled with chronic naso-pharyngeal catarrh, but to this date (April 25) has not had the least sign of any discharge from the ear. No medicine was given internally during this treatment.

Case 2. — Mary H., set. 21. Otorrhoea of eleven years' duration, following scarlatina. Perforation of both tym- panic membranes* and discharge from both ears. Three treatments, at intervals of three weeks, stopped the dis- charge. No medicine was given internally.

Case 3. — J. B. M., aet. 55. Tubercular subject, and poorly nourished. Otorrhoea of six months' duration. No cause known, except the general impoverished condition of the system. First treatment January 23d. Gave this patient twenty-eight treatments, at intervals of from one to three days. No discharge since last treatment. This patient had Hepar. 3x tr. three times a day, and Hydroline three times a day at meal time. He has con-

IM FVERPERAL ECLAMPSIA.

tinued the internal treatment to date, and has gained sev- eral pounds in weight, and feels better in every particular. These are the only cases that I have treated in this manner, and it is of course too soon to know whether a cure has really been effected in these cases or not ; but the result thus far has been so much more satisfactory than any treatment I have ever used before, that I feel encour- aged to give it a further trial, as well as to watch with in- terest the result in the cases reported.

PUERPERAL ECLAMPSIA.

BT J. J. 8TITBGI8, X. D., GOMNKBSVIIiLB, IKD.

I was called April 29th to see Mrs. W , set. 25, ner- vous temperament, primipara eight months advanced. The telegram which summoned me to attend her stated that she was suffering from convulsions — and these of a very violent nature. Upon my arrival I found her just recovering from the seventeenth attack. The paroxysms began by clinching of the hands, rolling of the head from from side to side ; suddenly followed by violent closing of the teeth, retraction of the head, laborious and rapid breathing, with frothing at the mouth. The attacks lasted about five minutes, and had come on with clock-like reg- ularity every half hour. I learned from her husband that she got up as usual that morning and prepared breakfast — seeming in the best of health. About eight o'clock, while sitting on the lounge, she complained of a sharp pain in the left temple, and shortly after was seized with the first convulsion. For a week or more previous her hands, eyelids and face had been very much swollen, but these symptoms were not looked upon as indicating any serious disorder, and but little attention was paid them. An examination of her urine revealed it heavily loaded with albumen. She had, previous to my arrival, been un- der the care of an old school physician, who had adminis-

J. J. 8TUBGIS. 166

tered faithfully the Bromide of Potassium, in pretty sen- sible doses, but apparently with no result Later he gave the case entirely up, saying that she could not i)ossibly re- cover, and it was useless to do anything more for her.

After the cessation of the paroxysm in which I found her upon my arrival, I administered Bell. Sx^ in water, led, I must confess, by no very prominent indications. I also instituted an examination at this time for the purpose of ascertaining the condition of the os, and whether there was likely to be a premature delivery. I found the os widely dilated, and the vertex engaging. My investiga- tions were cut short by the onset of the eighteenth con- vulsion, during which the child was delivered, followed shortly by the afterbirth. But little hemorrhage occurred. The child evinced no signs of life and the usual restora- tive measures produced no change.

Hoping now for a cessation, or at least an amelioration of the paroxysms, I administered a dose of Stramonium — to the selection of which I was led by the fact that during the intervals the patient seemed very loquacfous, and de- sired all the light possible. Contrary to my expectation, however, at her " appointed time," exactly thirty minutes from her last attack, she was again seized with what I was told was by far the severest paroxysm she had experienced, and was certainly the most severe one I had witnessed. I was beginning -to despair, and- was afraid the grave prog- nosis of my predecessor was going to be verified. I had about decided to resort to chloroform as a palliative meas- ure, when all at once the thought struck me that there might be something in the clock-like regularity of the at- attacksy coming on as they did every half hour. So before resorting to my chloroform, I determined to try the efieot of Cedron^ whose marked periodicity is' its characteristic feature. I administered it at the 6x dilution, and awaited the result with more than usual interest. The attack came on as before, but was much less severe and lasted but a few minutes. This was the last. Her mind wandered

156 CLINICAL CASE,

slightly that evening, and the following day, but on the

third day she was '^ herself again." She made a safe and

rapid recovery.

■ ■^•^

CUNIOAL CASE.

BT H. RING, X. D.

Mr. , 8et. 45 ; weight 165 flbs. ; health generally

good, occasionally some discomfort referred to the stom- ach ; and frequently a sensation of general nervousness. Occupation easy, with sufficient out-door activity. In early manhood he was intemperate in alcoholic stimula- tion, and in the use of tobacco. During the last fifteen years he has abandoned the drinking wholly, but ha8,with the exception of about three periods of time, continued smoking and chewing.

For several years past he has, during periods varying from several nights continuously to several weeks nightly, been greatly annoyed before he could get asleep. He had been entirely free from the trouble only for short periods. While falling asleep he would be startled by a sudden spasmodic constriction over the region of the heart, caus- ing much anxiety. * Pain was felt, at the same time, in the left arm ; and a sensation as of motion of flatus from right to left in the region of the transverse colon, beneath the left side of the chest. No eructations occurred or passage of flatus downward. There was no palpitation of the heart. On feeling the pulse he noticed intermissions in the beats. The paroxysm would pass off in a short time to be repeated, many nights, a second and a third time be- fore he could finally get asleep ; after which he would rest until morning. The pulse did not intermit at other times, and the structural condition of the heart was apparently normal. He was disposed to think that his stomach had much to do with the trouble, although his diet was care- fully attended to. His general nervousness was greater during the days when this night trouble prevailed ; and

AMBBOSIA ABTEMI&IJSFOLIA. 167

he was disposed to refer this to too much tobacco. I en- couraged this opinion, and once had him read in Allen's Materia Medica a part of the pathogenesis of Tabacum, where very similar symptoms are referred to the excessive consumption of tobacco. But he had already, about three times, abstained sometime from its use, — once for over a year, — without experiencing any marked relief.

I had given him Nux. vom. and other remedies with- out appreciable benefit, excepting that from Pulsatilla he was apparently benefited for a short time.

In the summer of last year he appealed to me ur- gently for relief, and on reconsidering the case carefully the verified pathogenesis of remedies led me preferably to medicines which had already been employed, but had failed to relieve.

His father, still living, had been a great sufferer from gout, annually, since early manhood. The son had had no sickness which had ever been referred to gouty inheri- tance.

After studying the pathogenesis of Colchicum, al- though not found to be a close similimum, this remedy was given in No. 35 pellets — four a dose — ^moistened with the 3x decimal dilution of this remedy. He was promptly relieved, and for about ten months has not had the least trouble, his general health being good, although he has continued to use tobacco, as he has done in the last three years.

AMBROSIA ARTEMISI^FOLIA, (RAGWEED.)

FBOM THE TRANSACTIONS OP THE CLINICAL SOCIETY OE HAHN- EMANN HOSPITAL, CHICAGO.

BT S. B. HOLMAN, M. D., BNOLBWOOD, ILL.

The Ambrosia is a coarse, homely weed, and grows in great abundance in waste places and roadsides. The Uni- ted States Dispensatory refers to the weed in connection

168 AMBROSIA ABTEMISIJEFOLIA.

with another of its species, the Ambrosia triUda^ as hav- ing found a place in the Materia Medica of the Eclectics, who deem it an astringent 5nd somewhat exciting. They use it in low forms of fever, like typhoid, and in other conditions of the system in which the vital actions are en- feebled. Like a great many other bitter herbs, it has been employed in the treatment of intermittents. Oti account of its astringent nature, it has been given to check intes- tinal discharges of blood and mucus, and to palliate mer- curial salivation. However, the enthusiastic Dr. Scudder, one of the foremost in the Eclectic School, did not con. sider the weed of sufficient importance to merit a place in his latest work on Materia Medica.

The little that I have learned concerning Ambrosia, its medical properties and their application, has been de- rived entirely from the following sources: 1. By observ- ing its action on hay fever victims who lived where it flourished, and who attributed their periodical attacks to the influence of this weed. 2. From its clinical use, as suggested by its action on hay fever cases. 3. From a per- sonal proving of the drug, and subsequent clinical appli- cation and verification.

Ragweed, as a potent factor, or exciting cause, in the annual blossoming of hay fever, hay asthma, or ragweed fever, as it is often called, has no equal. Why the name, Ambrosia, the classical meaning of which is food for the gods, should have been so sarcastically applied to this par- ticular species of the composite family, is indeed a won- der ; but the gods may well feel proud to have their divin- ity associated with a weed, miserable though it be, when that weed bids fair to become one of the most useful rem- edial agents at our command. But in its relation to hay fever, as the exciting cause, with the exception of the per- tussis-like cough and accompanying epistaxis which it so often produces, I have noticed no symptoms different from those which we find in cases of the same disease with other exciting causes. So, while these cases are incited and ex-

E. JS, HOLMAN. 169

cited by living where the ragweed flourishes, those suffer- ing with asthma proper are, on the other hand, greatly benefited by breathing the atmosphere impregnated with the aroma*of the plant. Nor do hay fever subjects expe- rience any relief from the internal use of this remedy ; on the contrary, they are aggravated by it. I should state, however^ that the tincture and low dilutions were used, and it is possible that the use of a potency high up in the scale might have had an antidotal effect, on the same basis as Rhus tox., which is said to antidote poisoning by the same, if given in a higher potency — the 2;^, for instance.

My attention was first called to the use of the remedy in a case of pertussis, in which the cough and nose-bleed so closely resembled the same symptoms as seen in the hay-fever cases. Drop doses of the tincture put an end, not only to the epistaxis, but to the cough as well. Sev- eral cases of chronic nasal hemorrhage have been cured by its empirical use.

However, not entirely satisfied with the uncertain knowledge obtained by noting its action in cases abnor- mally sensitive to the weed, I concluded to make a mar- tyr of myself by proving the drug on my own person. Beginning with drop doses of the tincture, it was not un- til the quantity had been gradually increased to teaspoon- ful doses, three times per day, that it began to take effect.

The first indication of its creating a disturbance of the vital forces was manifested by .an oppressed or stuffed-up sensation in the chest, with oppressive pain in the left breast ; worse from early evening until midnight ; had to sit up in bed in order to breath with any degree of com- fort.

Close upon the heels of the above symptoms came a dry, wheezy cough ; would fall asleep and awaken sud- denly with spasmodic pertussis-like cough ; face would be- come darkened, eyes congested, and hemorrhage from nose. Later on, the eyes became more angry in appearance,with swollen lids, smarting, watery discharge; nose red and

160 AMBROSIA ABTIMISJEFOLIA.

swollen, with profuse, watery discharge ; head and nose stuffed and dry in the morning ; at times, nose-bleed.

As the effect of the drug wore off, the cough became loose instead of dry and wheezy as before,with copious ex- pectoration of yellowish mucus.

A teaspoonful of the tincture, taken at this stage of the proving, revived all the symptoms with renewed vigor.

Since proving the remedy, I have had occasion to pre- scribe it in three cases of pertussis, and with the following very flattering results :

Case 1. O. P , a boy aged five years, in the spasmo- dic stage of the disease. Has been whooping for three weeks. The boy's father, who is a homoeopathic physician, and also an excellent prescriber, has failed to relieve with the usual remedies. The cough was worse from 8 o'clock p. m. until midnight. If he falls asleep, he awakens suddenly, springs up in bed, and gasps for breath. The cough is wheezy, asthmatic, with pain in left breast. Ambrosia cut this case short in three days. There was very little trouble the first night after taking it.

Case 2. N. P . a boy three years old, brother to

above case. 1 saw him the first day that signs of whooping- cough put in an appearance. There were no special indi- cations for Ambrosia^ but the speedy recovery of the child's brother suggested its use on general principles, so it was given. After five days, there was no remaining trace of the disease.

Case 3. D. K , a girl aged five years, in the spas- modic stage, having violent fits of coughing. The face be- comes purple ; blood spurts from left nostril. The eyes are red, the lids swollen, and there is profuse lachrymation. Al- most constant oppressive "stuffed-up" sensation in the chest is complained of. All the symptoms are worse about mid- night. The first day's use oiAmh'oaia put an end to the epis- taxis, and from this on there was steady improvement ia the cough and other symptoms, with an entire cure at the

CORRESPONDENCE. 161

end of one week. The tincture was given in each instance. Indeed, I have had no success with the dilutions. I usu- ally put a half teaspoonful of the tincture in a glass of water, and give teaspoonful doses every two hours.

The following symptoms, most of which can be found in Prof. Hawkes' "characteristics," I consider reliable: " Stuffed-up" feeling in nose, head and chest ; eyes red, dry, smarting, or watery, with profuse lachrymation. Eye- lids red and swollen.

Nose red and swollen, with profuse watery discharge ; or stuffed and dry ; at times nose-bleed, particularly dur- ing severe fits of coughing.

Wheezy, asthmatic cough, with pain in left breast, and uncomfortable " stuffed" feeling. Whooping-cough, es- pecially when there is nosebleed, Nux vomica adtidotes Ambrosia.

CORRESPONDENCE.

Editor Advance : — Just criticism is the governor of our acts, our words, and especially of making a book. It is well we have critics, and I think it better that they be unjust than to have none at all.

Dr. Phil. Porter, of Detroit, reviewed in the August number of The Advance a production entitled " Practical Lessons in Gynaecology," by Hey wood Smith, A.M., M.D., Oxon., etc., etc., in a somewhat humorous, wholesale, de- nunciative, and, finally, totally destructive manner, were his criticism true ; and I doubt not there was more truth than poetry in his review.

But if one " casts his bread upon the waters," it is quite liable to return, in this late day of American hero- ism. See Dr. Porter's remarks in the same issue of The Advance,- made at the State Medical Society at Lansing, regarding Europe, Hahnemann's German associates, Ger- man provings, etc. 5

162 FEUILLETON.

Now, honestly, would not Dr. Porter's " Homoeo- pathic Materia Medica " and Smith's " Gynsecology " re- semble each other more than any two books you ever saw upon different subjects ?

I hardly think one has the capacity to learn all there is even in Homoeopathy, in Germany, on a flying trip through all Europe of only two years' duration.

A. B. A.

FEUILLETON.

Hanging on the wall of the Chamber of Commerce, in which the Ohio Homoeopathio Medical Society met, we observed the following :

** pro p atria mori gloria est.

Ohio Mourns for 24,591 Gallant Dead.

On Fame's eternal oamping groQnd

Tbelr silent tents are spread* And glory guards with silent round

The bivouac of the dead."

Forgot the Password. — A private in one of tlie compa- nies, who is a homoeopathic student of medicine, was outside the lines last night, and when he came back he had been taking so many homceopatbic doses of something that he quite forgot the password, which was ** Stony Creek." He was stopped by the sentinel, and after deep meditation pronounced the words ** Stony River." The sentinel, who knew him, said that if he'd give him a homoeopathic dose of that word it would be all right. The Hahnemannian student at this hint ** tumbled," and, remem- bering that creek was the epitome of river, gave the word. — De- troit Evening News,

Tub Hahnemann Medical College of Philadelphia. — The Trustees of the Philadelphia College have just purchased a large lot of ground on which they Intend to erect the new Col- lege, Dispensary, and Hospital buildings. The ground is situ- ated two squares north of the new public buildings, near the business centre of the city. It extends from Broad street (north of Race street) westward to Fifteenth street, having a frontage of one hundred and six feet on Broad street, and one hundred

FEUILLETON. 163

and forty-two feet on Fifteenth street. The entire length of the lot is three huiidred and ninety-six feet. The cost of this mag- nificent site is $104,500. This ioolss like business. Our Phila- delphia friends are determined to sustain the reputation the school has always enioyed. They have long felt the need of a new college building and a commodious hospital, and the pre- sent plan appears to leave nothing wanting in this line.

** Jambs Beoos's Hospital, 84 Friars* Vennel, Dumfries. Broken ribs set and attended to on the shortest notice; in fact, all complaints speedily cured. Eaglish, French, Germans and Americans receive special attention and made good. J. B. as- sures his friends aod patrons that he has daily brought under his notice cases of long standing and short standing diseases, which be speedily rectifies, and re-invigorates to perfect health and strength, and in a very short time, and having a very extensive practice he never turns away a case incurable. Eyes and Joints replaced without the slightest pain ; teeth set on easy terms ; and all classes of skin diseases speedily eradicated at three hours' no- tice. Accidents and all kinds of unfortunate cases receive most patient attention. Consultations, examinations, and operations every lawful day at his establishment, 84 Friars' Vennel, Bum- fries, from 8 A. M. to 9 p. m. Advice gratis. Presiding Surgeon — Prof. Beggs. Umbrellas of every description made to order."

Birmingham, Ala., August 15, 1883.

Doctors in Council.— -4 c^ion in Regard to the Practice of TrregularBify—AX a called meeting of the Jefferson County Medi- cal Society, the following preamble and resolutions were adopted :

Whereas, The Jefferson County Medical Society bus, by formal reso- latlons adopted on the 6tb day of December, 1881, condemned the system of contract practice in this county as not being in accordance with the code of ethics of the American Medical Association, nor with the amendments thereto adopted by the Medical Association of the State of Alabama, and also declared in said resolutions its determination to exterminate all such contract practice in this county ; and.

Whereas, Since the adoption of, and passage of these resolutions, there have arisen questions upon which members of this Society have dif- fered in their constructions of the resolutions, both as to what character of contracts are allowable, and also as to the proper course to be pursued by regular practitioners who were called upon to visit patients who are or have been under the care of any irregular; therefore, be it

ReMolved^ First, That the condemnation of the Jefferson County Medi- cal Society does not extend or apply to a certain kind of contract practice

164 FEUILLETON.

or service, sometimes required In conDeotlon with medical staflb of the army and navy, nor to the hospital tax, or sailors In the marine hospital system, nor to a class of public charitable institutions, such as county alms- houses, orphan asylums, city or country pest-houses, Jail, or hospital, as specified in the report of the Judicial council of the American Medical As- sociation, made at its annual session held in Detroit In 1874, but does apply to every other contract for medical services not therein specified.

Second, That every member of the JeflHerson County Medical Society shall hereafter refuse all professional fellowship or recognition to all physi- cians who shall directly or indirectly extend any sort of professional serv- ice or advice to patients under the care of homceopathlo or lrregular(7) prac- titioners; no such service or advice being allowable until the homceopathic or irregular(r) practitioner has been formally and permanently discharged Arom all further attendance upon the case, either as physician, nurse, or in any other capacity ; and all physicians under the ban of this Society are considered, and shall be treated in every way, as irregular practitioners.

Attest: Henry N. Rosser, President.

Albert Q. Douglass, Secretary.

BiKMINGHAM, ALA., AugUSt 16, 1888.

Doctors in Council.— -4c^ion in Regard to ike Practice of Eegular8,(f)^At a called meeting of the Jeffersoo County Hom- oeopathic Society, the following preambles and resolutions were adopted :

Whsbbas, The Jefferson County Medical Society (of Regulars[r]), at a called meeting, dated Aug. 15th, 1883, adopted a resolution placing all prac- titioners of Homoeopathy under the ban of that Society, also all Regular8<r) who shall show any courtesy to said Homoeopaths in reference to any case in which such Homoeopaths shall officiate. ** whether as nurse, physician, or in any other capacity," and.

Whereas, Such <* other capacity" must include his officiating in such case as minister, cook, chambermaid or privy-council, and,

Whereas, The members of this Society and their patients are satisfied with their present mode of treatment, and are entirely independent of the ministrations of said Jefferson County Medical Society members, as doctors, ministers, nurses, cooks, chambermaids, etc., courting as it were, only the good win and social Intercourse of certain of Its members, and

Whereas, Certain members of said Jefferson County Medical Society have been known to contract with the city of Birmingham as city physician, small-pox physician, etc Therefore, be It

Jieaolvedt First, That the condemnation of this Society shall apply as well to physicians doing contract practice for said city as to those practicing similarly with mines, mills, furnaces, or any other wealthy corporations.

Resolved^ Second, That every member of the Jefferson County Homoeo- pathic Medical Society shall hereafter refuse all professional fellowship or recognition to all physicians who shall directly or indirectly extend any sort of professional service or advice to patients under the care of regular practitioners, no such service or advice being allowable until the allopathic or regular practitioner has been formally and permanently discharged from

EDITOR'S TABLE. 165

all ftirther attendance upon the case, either as physician, nnrse, or In any other capacity; and all physicians under the ban of this Society shall be treated and considered as regular practltlonersi and upon frequent repeti- tion of said offense, shall be prosecuted to the Aillest extent of the law.

Attest, A. L. Monroe, President.

A. E. Meadow, Secretary.

BOOK NOTICE.

MINER'S CASE RECORD. Joel A. Miner. Ann Arbor, 1888.

This is the most comprehensive clinical record book we have ever seen. It is not only well arranged for the general practitioner, but the Gynecological form is most complete and forms a most useful blank for ready reference; easily kept and readily refered to. The author says : " Most young practition- ers suffer largely through having only a hap- hazard way of ex- amining their patients. These deficiencies in method which originate in inexperience, too frequently become the confirmed, habits of maturer life. It goes without contradiction, that if a young physician would use a book like the present one until the systematic habit of examining case becomes established, he would feel the beneficial effects throughout his entire profes- sional career.'' No man can become a careful and successful homoeopathic prescriber without properly ** taking the case,'' and this can be done only by writing it out. With an abreviated form like this the labor and time is reduced to a minimum.

EDITOR'S TABLE.

The Sore Heads as usual are coming to the front. They never will believe in the Homoeopathic Department of the Uni- versity of Michigan— never till they get into it.

University op Michigan, Homceopathic Department. — The position of Professor of Surgery made vacant by the res- ignation of Professor Franklin, has been filled by the appoint- ment of Dr. Henry L Obetz, of Illinois. Dr. Obetz was form-

166 EDITOR'S TABLE,

er]y a member of the Faculty of the Cleveland College, and has since followed with great success his chosen practice, surgery. We have abundant reason to know that in his new position he will as usual ''fill the bill/'

The last Legislature of Michigan, with characteristic liber- ality, established and endowed a new chair of Obstetrics and Diseases of Women and Children in the Homoeopathic Bepart- partment. The Board of Regents have appointed to this chair Newton Baldwin, M. D., of Marshall, Mich. Dr. Baldwin is a Michigan boy, a graduate of the University, and formerly part- ner with Dr. A. I. Sawyer, of Monroe. He has spent some years in practice in Staunton, Va. He has taken post-graduate work in New York and Philade1phia,< and more recently settled at Marshall. The doctor's many friends predict for him a success- ful career as teacher. We believe these two chairs are now filled to the satisfetction of the entire profession.

Married —Sept. 6, 1883, Charles L. Hoyt, M. B., and Miss Helen M. Will, at MoArthur, Ohio. Bon voyage.

Married.— Sept. 5th, 1883, R. G. BePuy, U. of M., and Miss Charlotte Lloyd, at Jamestown, Dakota Territory. We «seud greetings.

Dr. Robert Druitt, author of ** Druitt's Surgery," is dead.

Died.— **Our good Dr. G. L. Bailey, (of Battle Creek, Mich.,) departed this life June 21st, after a short illness, being in bed only two weeks."— S. H. Morley.

Dr. J. Q. A. Cofpeen died at his residence at Wyoming, 0.» Aug. 29th. Several weeks ago a little girl five years old, named Cook, was playing on the C, H. & D. Railroad track, and had both feet crushed, one cut off, by the cars. Dr. Coffeen was called in, and, with his brother-in-law, Dr. Shepperd, of Glen- dale, had attended her ever since. While cleaning his instru- ments, after dressing the wound, several days ago, he cut his thumb, which soon became very sore. Dr. Shepperd admonished him to give it good attention, but, though so tenderly careful of others, he neglected himself and, his blood becoming poisoned, he died from the efl'ects.

M. C. Reeves, M. D., U. of M-, has located at Clinton, Mich.

T. L. Hazard, M. D., U. of M., has located at Salamanca, N. Y.

T. H. Turner, M. D., U. of M., removes from Pinckney to Pontiac, Mich.

EDITOR'S TABLE. 167

Jay S. Mead, M. D., U. of M., is at Edwardsburg, Mich., looking after the practice of Dr. Lusk, who is on the sick list.

Jas. T. Martin, M. D., U. of M., receives a Government appointment at the Indian Agency of Skokomish, Washington Territory. ^

F. H. TYiiBR, M. D., U. of M., removes from Sturgis to Mt. Pleasant, Mich., where he succeeds Dr. Stoner, who has an ap- pointment in Montana.

Geo. E. Puqh, M. D., removes to Elgin Hot Springs, Qannison Co., Col. We are pleased to note that the Doctor's health is steadily improving under the bracing atmosphere of the West.

Mbs. S. M. Hicks, M. D., U. of M., and Miss E. E. Bower, M. D., U. of M , are taking a special course in Gynecology, un- der the instruction of Phil. Porter, M. D., of Detroit. Mrs. Hicks locates in Atlanta, Ga., in Sept., for the practice of her profession.

J. B. HUBBBLL, M. D., U. of M., is on the staff of The American Association of the Red Cross. " This Association is for the relief of suffering by war, pestilence, famine, floods, fire, and other calamities of sufficient magnitude to be deemed national in extent. Both it and its auxiliiary societies operate under the provisions of the Geneva Treaty, promulgated at Geneva, Switz- erland, in 1864, and signed then by all the nations of the earth, including the United States, which gave in its adhesion through President Arthur in 1882.'' It did noble work in the Michigan fires and the late floods in the Southwest.

Praotiob for Sale.— a man of experience and good pro- fessional qualifications can step into a practice of $S,000 per year In one of the best cities in the West, if he is prepared to pay for such an advantage. For full particulars address '* Editor Ad- vance."

For Sale.— Property and practice in a village near, and connected by railroad with, a large city. Residents do business in the city. Several villages near. $4,000, in easy payments. For particulars address Geo. W. Smith, 143 West Fourth street, Cincinnati, Ohio.

Practice for Sale.- Desirable, medium, growing practice on s^ shore near New York. Sell furniture, horse, phaeton, medicines, etc., or practice alone, introduce successor, established ten years, price nominal, possession Sept. 1st. Dr. B ,

168 EDITOR'S TABLE.

lock box B— , Woodsburgh, Long Island. N. B. No postals answered.

American Institute of Homceopathy : Report upon the Special Fund for the Bureau of MicroBcopy and Histology.— In 1882 the report of the chairman of the Bureau of Microscopy and Hifttoiogy (Prof. J. Edwards Smitl^) was of so much interest and importance, and it was so evident that the worit done in- volved so much time and expense, that a special fund was raised by subscription, amounting to over two hundred dollars, and placed in the hands of the chairman, to aid him in the further prosecution of his work. At the session of the Institute in 1883 at Niagara Falls, Prof. Smith presented the result of the work done last year by himself and Prof. Wood, and it proved to be of such magnitude and value that the members again raised a special fund for the use of the Bureau, especially to assist Profs. Smith and Wood in continuing their work. The undersigned was made a special committee to solicit subscriptions, and the . following is the result up to date :

H. B. Clark, $10 ; B. R Gardner, $10 ; J. P. Dake, $10; Geo.

B. Peck, $10 ; O. 8. Runuells, $10 ; P. Dudley, $10 ; I. T. Talbot, $10; C. H. Walker, $10; B. W. James, $20; A. I. Sawyer, $10;

C. G. Higbee, $10 ; E. Cranch, $10 ; H. E. Stone, $5 ; J. W. Shel- don^ $5; J. C. Sanders, $10; D. H. Beckwith. $10; Henry L. Obetz, $5; L. H. Willard, $10; C. H. Farnsworth, $10; T. P. Wilson, $10 ; S. S. Lungren, $10 ; A. W. Woodward, $10 ; L. C. Grosvenor, $10 ; R. N. Foster, $10 ; S. Lilienthal, $10 ; J. E. Gil- man, $10 ; Anson Parsons, $5 ; J. E. James, $10 ; H. E. Spauld- ing, $5 ; P. H. Van Vleck, $5 ; B. F. Dake, $10 ; N. Schneider, $10; T. F. Allen, $10; J. H. McClelland, $10; A. R. Wright, $10 ; W. T. Helmuth, $10 ; F. H. Orme, $10 ; W.J. Hawkes, $10 ; J. P. Paine, $5; E. C. Morrill, $10; F. W. Ingalls, $10; Drs. Chase, $10 ; T. L. Brown, $5 ; H. M. Paine, $5 ; N. A. Pennoyer, $5 ; D. S. Smith, $2 ; Lewis Sherman, $10 ; J. W. Dowling, $5 ; H. H. Reed, $2 ; A. M. Bennett. $5.

Nearly every dollar of this is paid in up to date. The list will be kept open until January Ist, 1884, and additioni:l sub- scriptions are solicited. It is expected the fund will be sufficient for the uses of the Bureau for the coming two years. This is the greatest work of its kind ever attempted, and deserves liberal

encouragement.

T. P. Wilson.

Ann Abbob, September 10, 1888.

b^rf^ jjfg.

Editor.

Business Managbs.

Vol. XIV.

Ann Abbob, Octobeb, 1883.

No. 4.

All aubaoriptiona and buaineaa oommunioationa ahould be addreaaed to MEDICAL ADVANCE PUBLISHING Co., Ann- Arbor, Mich. Subacription, $2.00 per annum.

Motion and Rest. — It is a well demonstrated principle in physiology that both growth and maintenance depend upon molecular activity. Interstitial increase of structure requires nutrition and decay. In the animal world this principle is developed to its highest possibilities. But here we must recognize a third factor : Functional activity. The tissue of whatever kind must be brought into syste- matic action. This is most apparent in the muscular structures. Inaction prevents developement. The func- tion of the muscle is contraction. Nutrition with differ- entiation may lay down the primitive fibres so far as to

2

170 EDITORIAL.

show the position and form of the muscle, but it can go no further, unless the function of the muscle is brought into play. Muscular activity in utero is therefore a necessity to the growth of the body. After birth the functional activity is greatly increased and growth is correspondingly accelerated. In the domain of pathology we find much depending upon the excess or diminution of action. That oyer-action is a fruitful source of disease is a well recog- nized fact. It was in recognition of this fact that rest became a potent means of cure. Hinton's classic work, Rest and Pain, develope the practical view of this method, and every wise physician makes constant use of this prin- ciple. He cures many serious maladies by rest But it is equally apparent that in many cases the remedy lies in promoting the activity of the parts. This principle is sec- ond to no other in therapeutics. Upon this fact rests the very general custom of curing disease by exercise. By promoting the activity of an affected tissue we free it from its morbid condition. Also as is well known, when the tissue or organ is not diseased we develope and increase its growth by systematically calling it into functional action. Gymnastics serves a manifold purpose : It cures often when disease is present ; it increases the size and power of the parts, and it gives resistance to, and immu- nity from disease. Best and motion are therefore both, and perhaps equally necessary in curing disease.

AcTTVB AND PASSIVE MoTiON. — As curative agents, motion and rest are applicable to a large number of dis- eases. It is not easy always to say which is preferable in any given case. And it is certain that many times a judicious use of both is of great value to the patient. It having been determined, let us suppose, that a certain case requires motion, we are then met by the question : Shall it be active or passive motion ? Active motion is generally well understood. Walking, rowing, all the various me-

EDITORIAL. 171

thods of the gymnasium are well known forms of active motion. As promoters of health they have unquestion- able value; but in the cure of disease it is certain that great danger lies in this indiscriminate and routine use. Even when patients require exercise they have often been exer- cised to death. It should always be remembered that active motion being that which the patient voluntarily puts forth, produces a double eflFect : First, as is obvious upon the tissue brought into play. This effect is the one chiefly sought. Such action promotes the growth and health of the parts. But, in the second place, all this activity materially exhausts the nerve centres which sup- ply force to the tissue. Just in proportion as the tissue is exercised, the nerve centres are depleted. But as is well known, the nerve centres are the store houses of force. If they fail, all else must fail. If now we can promote the growth of the tissue, and at the same time increase rather than exhaust the amount of reserve force in the nervous ganglia, we have in many instances accomplished a most desirable end. This end is reached by passive motion. By passive motion the tissue is thoroughly brought into play, and the nerve centres are measurably undisturbed. In this way exercise to an almost unlimited extent can be employed with comparatively little exhaustion. This is a very important fact, as any one may determine by experi- ment Not to speak of many other methods of producing passive motion, we desire to call the attention of the reader to what may be called the vibratory method. It can be produced only by the use of suitable machinery. By using a rapidly revolving eccentric an infinite number of delicate blows can be delivered upon any tissue or organ, superficial or deep, or with a larger eccentric, many of the muscles can be brought into use, while the patient is passive and by no means wearied by the exercise. Our present attempt is to awaken an interest in this subject. We would be glad to have the subject more fully discussed in our pages.

172 ABNORMAL OBO WTHS IN UTEBINE OBOANS.

ABNORMAL GROWTHS IN CONNECTION WITH THE UTERINE ORGANS.

READ BEFORE THE OHIO HOM(EOPATHIC 3IEDICAL SOCIETY.

W. WBB8TBR, M. D.. DAYTON, OHIO.

In entering upon this part of the field of Gynaecology, it will be impossible as well as unwise and imprudent to present all the particulars and minutiae in connection with uterine growths. We have, therefore, in this simple essay endeavored to notice only two particular forms of growths, viz., ovarian cysts and hydatid cysts of the uterus, speci- mens of which I have in my possession.

First, we will speak of the multiple ovarian cyst, which is rarely met in private practice. In a practice of thirty-four years I have never met but one case, which I have here.

Simple cysts, authors say, arise from an abnormal augmentation of the liquid in the Graafian vesicles some- times called dropsy of the Graafian vesicles, which is caused by a prolonged hyperaemia of the ovaries. This hyx>er8e- mia being communicated to the walls of the vesicles, is the cause of the hypersecretion, which occurs upon the internal surface — these walls being hypertrophied and perhaps somewhat indurated or compact — render them im- possible to be broken or ruptured ; hence the retention of the constantly accumulating liquid secreted, which is evi- dently stimulated or increased by each subsequent men- struation or attempt at ovulation.

Where there are many vesicles affected, they may not grow to large size — about the size of a pea or filbert. When only a single one or a very few are affected, they may attain the size of a man's head. The case I had was single, on the right side, and the size of a gallon measure, and contained hair, fragments of bones, or rather rudi-. ments of bones or apparent cartilages, and thousands of sebaceous balls from the size of a pin's head to that of an

W. WEBSTER. 173

acom, and a thick, yellowish liquid, and lumps of fat. These filled the whole sac.

In consequence of repeated hyperaemias and exuda- tion on the surface of the peritoneal covering or envelope, the wall may attain the thickness of two or three lines.

In the interior of these cysts with thickened and hy- I)ertrophied walls, neoplasms are often seen in the form of papillae, which at length may fill up the whole cavity com- pletely, and convert it into a solid mass or tumor ; or the papillae may themselves be transformed into minute cysts*, and by endogenetic development of these cysts the simple cyst becomes a multiple cyst. (See specimen.) There- fore, while the simple cysts result from development of the Graafian vesicles, the multiple cysts depend upon a specific alteration of the parenchyma of the ovary itself. The lamellae of the connective tissue, which form the par- enchyma, adhere to one another, forming closed capsules, which are flattened by their reciprocal contact at many I)oint3. Sometimes (writers say) one of the capsules is developed more than all the others, and forms a true cyst larger than the rest of tumor, and in its walls the germs of new secondary cysts are soon formed, which from small cavities enlarge so as to fill the whole cavity of the pri- mary cyst.

The multiple cysts contain different substances in the different cavities or compartments, such as fat, hair, car- tilage, bones, and teeth. The fat is occasioned by excess- ive development of the layer of cells in the pavement epi- thelium on the internal surface of the cysts. The fat is sometimes liquid ; at other times solid, yellow fat, like lumps of tallow.

Hair is found in these fatty cysts, like cushions (vari- ously* colored), of some thickness. They have their roots in the walls of the cysts, provided with sebaceous follicles, or in the layer of epidermis which covers this wall. The teeth are developed in the interior wall of the cyst, in the dental sac. And Scanzoni says that sometimes the cavi- ties are seen filled with loose teeth.

174 ABNORMAL ORO WTHS IN UTERINE ORGANS.

The bony substances proceed from the ossification of the cellular tissue of the walls of the cyst. They may be either long or flat bones, but are said not to resemble the bones of the skeleton.

The cartilages originate in the papillary excrescences which occupy the internal wall of the cysts. These are more rare than bones or teeth.

The size and growth of multiple cysts — the last vari- ety described — vary. At the end of several years they may not attain the size of a goose egg, while some, in a few months, may attain the size of a gravid uterus at full term. The patient from whom I obtained this specimen (after post mortem) had a large simple cyst in the right side, as large a? a gallon measure, as described before. This specimen, which I call a multiple cyst, was in the left side of the same patient, and evidently included the whole ovary. It had been located there, and of the ap- parent size as now presented, for a period of fifteen years previous to her death, which was caused by typhoid fever. I will say in passing, that she was barren, had never borne children, but had menstruated irregularly for a few years, but not for many years previous to her death, which oc- curred at about 40 years of age. Her abdomen at death was as large as a woman's at full term of pregnancy.

The hair in this specimen is three inches long. In cut- ting into it I found several small bones. It was supposed by several of my colleagues at the autopsy, to be ovarian pregnancy. I pronounce it a dermoid cyst, or multiple cyst. If I am wrong in my diagnosis, I wish to be cor- rected, as it is the only case I ever had in my practice. The patient for many years had been sickly, sallow, and never well.

Without trespassing much further upon the time and patience of this Society, allow me to exhibit an interest- ing specimen of hydatid cyst from the cavity of the uter- us. The true cause of this character of growth is a dis- puted point. While all may agree as to its true anatomi-

W. WEBSTER. 175

cal nature and structure, writers disagree whether it can occur independently of pregnancy or not. We are all en- titled to our own opinion. And while we know that hy- datids can grow in the uterus, liver, kidneys, bowels, and brain, in the male sex as well as in the female sex, I am led to believe that they can be produced in the uterus in- dei)endently of pregnancy.

This specimen I removed from a young lady nineteen years of age — a girl above suspicion ; had menstruated rather irregularly and painfully ; had been afficted for several months with enuresis noctuma. Being called in haste one night, by her fatheV, I found her suffering the most intense agony with what they said was her menses, it being her regular period. The pains were extreme, and in paroxysms, as a woman in true labor. Could hear her several squares from her house. My first impressions were that she was miscarrying, not then knowing her his- tory, character, habits, etc. Feeling the importance of an immediate examination, I obtained immediate consent by telling her and her mother that it was perhaps a bad case of retroversion, and an examination was absolutely neces- sary, as well as an operation. In passing the index finger into the vagina, I found issuing from the os uteri a large indescribable mass the size of a foetus of six months. On removing a fragment and bringing it to the light, I dis- covered at once what it was, and by advising her to bear down with her pains, and pulling on my other hand, true labor like, I soon succeeded in removing the whole mass. Her sufferings ceased at once. A few fragments passed away for two or three days. No inflammation followed. I kept her in bed, and on low diet and Aconite for one week, then followed with uterine tonics for a few weeks — Apis, Calcarea Carb., etc.

There have been no signs of a return of the growth. She has menstruated regularly at each period since, with no unusual inconvenience, and is in the enjoyment of ro- bust, rosy health.

176 INTRA - VA OINAL PABA CENTESIS.

I brought these specimens with me for the benefit of my young brethren in the profession, assuming, of course, that all th^se veterans and medical magnates have met and seen thousands of them in their practice before.

INTRA-VAGINAL PARACENTESIS.

BEAD BEFORE THE OHIO HOMEOPATHIC MEDICAL SOCIETY.

OHABLKS E. WALTOIT, X. D.

Paracentesis, as a surgical procedure, is so simple and frequent that it is scarcely worthy of mention in a formal paper emanating from a surgical bureau of a State society. However, certain features may attend some particular case which may render it exceptionally interesting and furnish an excuse for its recital.

Seven hours after the inception of labor, I was called to assist a physician in the delivery of a child. The case was that of a strong, healthy woman, in her third or fourth labor ; knee presentation ; os dilated ; pains fre'quent and vigorous ; no progress ; cause undetermined.

When a woman has been exerting herself in child- birth for several hours, has a dilated os, and there is no progress, the hesitating practitioner should certainly place himself beyond criticism by determining the cause of de- tention.

Dame Nature is not nearly so lenient as her would-be servitors; she frequently kills a patient while they are waiting for her help. Nature is very apt to '' take her course," a course rendered inevitable by the circum- stances, and kind Providence is called in to bless the funeral meats.

After bringing down the feet, a well lubricated hand introduced into the uterus discovered a vast extent of baby ; it seemed as though an embryonic Falstaff were there, so disproi>ortionately large was that abdomen. In

CHARLES E. WALTON. 177

all directions was felt the distended, fluctuating body ; the diagnosis was complete ; we had a case of foBtal ascites, one of the very rarest of foetal dystociee.

With the patient fully anaesthetized, and strong trac- tion made upon the legs, a bistoury slipped along the pal- mar surface of the fore-finger soon cut its way through the left lumbar region into the abdominal cavity, and out rushed the fluid in a veritable torrent. With the collapse of the abdomen the birth was almost instantaneous, and the deformity was before us. Tlie sex was at first indeter- minate, for the empty scrotum looked very like a vulva, and a pubic nodule very unlike a penis. A subsequent autopsy revealed the testicles still in the abdominal cav- ity, and the penis to be very rudimentary and imperforate. A little persuasion resulted in procuring permission to carry off* the trophy of the night's work for a private ex- amination.

Externally, the head and each upper extremity ap- peared to be that of an ordinary child at full term, but the pelvis and lower extremities appeared much too small. In the umbilical region the integument was supplanted by a white, glistening membrane for a space the size of a silver dollar, surrounding the attachment of the cord. Through the collapsed abdominal walls could be felt a tu- mor some five inches long, extending from the umbilicus down into the pelvis, and closely adherent to the walls. A careful injection of the abdominal cavity determined its capacity to be three and one-half pints. Upon opening the cavity the tumor was found to be an enormously dis- tended bladder containing one-half pint of fluid. The muscular coats of the bladder shaded off* into a mem- branous extension completing its upper third, lined with mucous membrane, and identical with that which formed a part o*f the abdominal wall. The caliber of the right ureter was distended to the dimension of one-half inch. The left ureter was occluded at its origin, and dilated into an adjunct bladder at its termination about one inch in

178 PEL VIC CELL ULITIS.

diameter. The left kidney was one-third larger than the right, and its pelvis was dilated into a foetal hydronephro- sis. The undescended testes were hugging either side of the bladder, unable to find their way into the inguinal canals, and the empty scrotum waited in vain their arrival.

To the pathologist we will leave the problem of solv- ing the cause of this abnormal urinary apparatus with its attending ascites.

To the young practitioner we will call attention to the value of introducing the -entire hand in diagnosing the cause of difiicult labors.

To the incipient surgeon we will say that the perform- ance of so simple an operation as an intra-vaginal para- centesis will tend very largely to increase his fame as a skillful obstetrician.

PELVIC CELLULITIS.

READ BEFORE THE OHIO H0M(E0PATHIC MEDICAL SOCIETY.

C. HOYT. K. D., CHILIilCOTHE, OHIO.

This disease has been described under various titles. Thus some of the synonyms are peri-uterine cellulits, peri- metritis, pelvic abscess, abscess of the uterus, etc., etc. It seems to have been generally overlooked by the old wri- ters on diseases of women, although full and distinct ac- counts of it are to be found in the writings of various old Greek and Roman Physicians, probably two thousand years ago.

It is a disease of great importance, and not infre- quently met with in practice. It is usually not difficult of detection, although some cases are quite obscure, and will test the physician's skill. This disease usually occurs after confinement, or is produced by some unlucky operation upon the pelvic organs. It may also be produced by cold

a HOYT. 179

during the menstrual period. This disease may occur at any time of life, from childhood to old age, and is not en- tirely confined to the female sex. Cases of pelvic cellu- litis or abscess sometimes occur in the male sex from cold, or after operations upon the rectum, or urethra.

The pelvis is lined with a fascia which is reflected over the muscles contained within it, and over the pelvic or- gans. It serves to strengthen and separate them. Be- tween this fascia and the organs, or muscles, which it cov- ers there is interposed this loose cellular tissue. It is especially abundant between the folds of the broad liga- ments, also between the uterus and bladder, and uterus and rectum. It is supposed by sopie writers that this cel- lular tissue is increased during pregnancy, the same as the muscular coat of the uterus. Pelvic cellulitis consists es- sentially in an inflammation of this cellular tissue in some part of the pelvis. This disease is usually divided into three stages : The first or congestive stage ; the second or btage of eff'usion, and the third stage, that of resolution, or suppuration.

This disease is usually ushered in by a chill, or rigor, and is soon followed by fever of greater or less intensity, with quick pulse, and hot skin, and all the phenomena of a well marked synechia. Soon the patient begins to com- plain of intra-pelvic pain, and tenderness, which is in a short time followed by an exudation of serum, or liquor sanguinis. The necessary result of this effusion is a swelling in some part of the pelvis, depending of course upon the location of the inflammation.

The pressure of this eflused fluid upon the rectum or bladder often gives rise to severe strangling, or tenesmus, also to sciatica, from pressure upon the sciatic nerve. Our remedies will fail in giving much relief in these cases un- til the pressure from this fluid is removed. Frequently the leg on the side where the efinsion is the greater will be permanently drawn up, and cannot be extended with- out great suffering. This tumor, or swelling, will be of

180 PEL VIC CELL ULITIS.

greater or less extent according to the particular location of the inflammation, and the amount of the effusion.

The swelling is usually at first dense, and hard to the feel, so much so that it might even be mistaken for scir- rhus. In many instances where there is an opportunity to examine the case daily, you can detect the disease advanc- ing, and taking in more and more of the cellular tissue until the uterus becomes fixed and firm in the pelvis. This is of course not always the case, and it will depend upon the extent and location of the inflammation.

The swelling is usually easy of detection by examina- tion through the vagina and rectum, or through the abdominal walls, although some cases come on very slowly and insidiously, and it will tax the physician's skill to make a correct diagnosis. This disease may be mis- taken for pelvic perotonitis, pelvic haematocele, or uterine fibroids. The pain is usually more acute in pelvic peri- tonitis, and the tendency to suppuration not so great. It is usually produced by cold at the menstrual periods while cellulitis* mostly occurs after confinement.

Pelvic haematocele occurs in patients that are weak and anaemic, and where the blood is of a poor quality. It is also incident to the haemorrhagic diathesis. The swell- ing comes on suddenly, and is marked by great and sud- den prostration. Uterine fibroids are of slow growth, and cause little pain. There are frequent attacks of metrorrha- gia, and no tendency to suppuration.

In the treatment of pelvic cellulitis we should, if it is possible to do so, prevent exudation, or if exudation has already taken place, to promote absorption, and removal of the deposit, and by so doing prevent suppuration and abscess. Where the patient has enjoyed good health pre- vious to the attack, and the physician sees the case early, the amount of eff'usion can be greatly lessened. There is no reason why, if we can see our patients in time, that many cases of threatened cellulitis cannot be prevented from going beyond the period of congestion.

a HOYT. 181

Thei'e can be no doubt that we possess remedies that will so act upon the cellular tissues as to check the in- flammation and prevent exudation. Oases that have pre- viously been drugged, or are in bad health from any cause will usually go on from bad to worse in spite of our efforts, and finally end in suppuration, and possibly death.

Among the best remedies in the early stage of this disease, will be found Aconite, Arnica, Belladonna, and Verat. viride. These remedies should be combined with the local application of hot flannels, or cloth rung out of hot water. Hot vaginal injections by means of a syphon. The old fashioned bran poultice is also good, or anything by which you can apply steady heat, and by so doing re- duce the pain and congestion. In many instances this mode of treatment will nip the disease in the bud, and bring about a speedy recovery. In cases where efi'usion has taken place such remedies as Apis mel., Ars., Colchi- cum, Bryonia, Khus tox.. Digitalis, Cantharis, Mercurius, Hellebore, and Sulphur will be found appropriate accord- ing to their special indications in each case. In this stage it is very necessary that the patient be put upon a gener- ous diet, as the weaker and more run down the patient is, the greater the liability to hectic fever and abscess. Such articles of diet as beef tea, eggs and milk, or milk punch, will be found appropriate. The local use of camphorated oil over the inflamed region is excellent. It should be thoroughly annointed with it, and then covered with a thick layer of cotton. If this disease remains unchecked for a period of from ten to fifteen days, there will be a for- mation of pus, and all possibility of aborting the disease ■will be ended. When unable to avert suppuration, give such remedies as Hepar sulph., Mercurius, Cal. carb. and Sulphur, and promote the dischars^e of the pus as fast as I)08sible. The local use of emollients and hot fomenta- tions will also hasten the desired result. After pus has formed the two most common outlets for it are either through the vagina, or rectum, which are fortunately the two most favorable outlets.

182 PEL VIC CELL ULITIS.

The pus sometimes finds an outlet through the uterus or bladder, thus sometimes causing fistulous openings which are diflScult to heal. Some times the pus burrows, and may follow down and find any opening at the groins, or upon the thigh, or, in fact, almost anywhere around the floor of the pelvis. Usually the safest and best place to open the abscess, when it is possible to do so, is at the roof of the vagina, in the posterior cul-de-sac. Here fluctua- tion is easily detected, and the walls separating the ab- scess are thin and the pus easily evacuated. It is some times' opened through the rectum, but the place just mentioned is much to be preferred.

If the abscess points externally it should be lanced as soon as it is ready to discharge freely, although undue haste is unnecessary. Wait until the integuments cover- ing the place where it is going to point have become thin, and the abscess in a condition to be thoroughly evacuated, then open at the lowest point. After the abscesss has been evacuated it may be dressed with a lotion of Calen- dula, or a weak solution of Carbolic acid in water. The patient should be placed upon a generous diet and every thing that will aid her in gaining health and strength re- sorted to. The prognosis should be cautiously made. Much will depend ui>on the general strength and vitality of the patients as well as upon the complicating lesions. This disease rarely if ever runs its entire course without being complicated with other diseases of the pelvic organs, all of which will influence the prognosis more or less.

Some of the most important of these diseases are, peritonitis, haematocele, haemorrhoids, ovaritis, cystitis, urethritis, vaginitis, ulceration of the cervix uteri, ulcera- tion of the rectum and chronic metritis. Any of these diseases wiU complicate the original trouble more or less according to their severity, and will have to be duly con- sidered in making a correct diagnosis as well as prognosis.

Among the most common sequelae of this disease will be found sterility, menstrual derangements, uterine dis-

INFLA MM A TION OF THE MIDDLE EAB. 183

placements and recto- or vesico- vaginal fistulas. In many instances the patients recover their health in every re- spect, except that in the future they remain barren. In such cases the inflammation in some way causes the func- tion of reproduction to be suspended. In the same man- ner menstruation is interferred with, probably either by occlusion of the Fallopian tubes or by some ovarian trou- ble.

Uterine displacements are a very common result of cellulitis, especially so where there the seat of the trouble is in the broad ligaments. As the patient recovers there will be necessarily more or less contraction of the liga- ments and a corresponding displacement of the uterus. Fislutae is sometimes caused by sloughing of the tissues and the discharge keeping up for a long period of time.

In writing this paper I have aimed to call attention to the more prominent points of this disease, as well as to mention in a brief manner what seems to me to be the best treatment. It is a disease of the first importance and quite often met with in practice. It deserves to be thor- oughly studied and understood by every physician, so when called to attend a case he will be able to treat the case intelligently, and by so doing gain honors for himself, and health and happiness for his patients.

ACUTE SUPPURATIVE INFLAMMATION OF THE MIDDLE EAR.

BBAD BEFORB THB OHIO HOMCEOPATHIC MBDIOAL S00IBT7.

W. A. PHILLIPS, M. D., CLBYBLAND, O.

Acute suppurative inflammation of the middle ear is by no means in the aggregate a trivial affection. It de- mands as a rule more skilled attention than is usually ac- corded to it in order to prevent one or more of the follow-

184 INFLAMMATION OF THE MIDDLE EAR.

lowing terminations : 1. A continual offensive discharge; 2. Impairment of hearing ; 3. Death.

The trouble is usually produced in consequence of an acute and severe inflammation of the throat, resulting from various causes, as scariet fever, diphtheria, or a hard cold, the inflammation extending along the mucous lining of the Eustachian tube to the drum cavity. The inflam- mation may, however, begin in the tympanum as a direct result of taking cold. In either case the subsequent course of the disease will be substantially the same, and will accordingly demand much the same general and si)ecial management.

The tympanic cavity has but one outlet, and that a very imperfect one, as a means of drainage, viz.,the Eustachian tube. But normally the walls of the tube, in a part of their extent at lea«t are in opposition, and when inflamed, as they always are more or less in severe inflammation of the tympanic cavity, they are still more firmly pressed to- gether, and hence the dr«m-cavity becomes' closed ; and ah accumulation of muco-purulent or distinctly purulent matter in it is practically an abscess.

The prominent symptom is intense pain in the ear ; and the reason why the suffering occasioned by " ear- ache " is so great is because the mucous lining of the drum-cavity is intimately united with the periosteum, and hence the pain is not unlike that produced by a felon. As the cavity fills with inflammatory products the drum- head becomes distended and reddened. The pressure it sustains soon leads as a rule, to ulceration of its substance and perforations adds a means of temporary or permanent relief to the abscess ; but also generally adds a complica- tion which is a prolific source of trouble. If one-fourth or more of the drum-head be destroyed by the ulcerative process, it is not probable that the orifice thus occasioned will become closed ; although even a larger opening than this may become filled with new tissue bearing a remark- able resemblance to the original. Persistent perforation

W. A. PHILLIPS. 185

of the drum-head constitutes a serious complication for the reason : Ist. That it affords a means of direct communi- cation of the air with the tympanic cavity, which favors the continuance of the discharge. 2d. The loss of sub- stance of the drum-head, and adhesions, render it imper- fect as an element in the mechanism of hearing. It should be recollected, however, that perforation of the drum -head does not of itself necessarily produce noticea- ble impairment of hearing. But when there is perforation, there are also, as a rule, adhesions and a thickening of the mucous lining of the cavity of the middle ear about the foramen ovalis, and hence the vibrations of air do not pro- duce the impression upon the structures of the internal ear which they would otherwise do if the drum -head and lining of the cavity about the foot of the stapes were normal. It is really, then, the catarrhal thickening of the mucous lining of the middle ear that occasions the chronic discharge, and produces the deafness. It is not easy to determine which is the most to be regretted, the disgust- ing fetid discharge, or the impairment of hearing.

But acute suppurative inflammation of the middle ear is never entirely free from the danger of resulting in meningitis, cerebral abscess, or pyaemia, with their so fre- quently fatal termination ; and the anatomical relation of the ear and cerebral structures fully explains the reason of these complications.

A chronic suppurative discharge, instead of being a salutary circumstance as it is often regarded by the laity, and even sometimes by physicians, is a trouble that con- stantly threatens, in consequence of a cold, to develop an acute otitis which is liable to the same complications as the original attack. Periostitis extending from the tym- panic cavity to the mastoid process, and producing heat, pain, redness, and swelling in this situation is generally the first sign that indicates the gravity of the case.

The treatment in the early stage demands that the in- flammation be allayed as much as possible by the use of 3

186 INFLAMMATION OF THE MIDDLE EAR.

applications of warm water carefully instilled into the ear, filling the meatus quite full. A hot flannel cloth should then be placed over the ear. The water should be allowed to remain for five minutes, then by turning the head over on to a towel the meatus is emptied. This pro- cedure should be repeated several times, using the water as warm as can be borne. This will generally be found to be very grateful to the patient, and unless the inflamma- tion is very severe, or unless continued long enough to have induced suppuration and considerable bulging of the drum-head, will often prevent perforation. Warm water may be used in this manner, one, two, or three hours, ac- cording to the degree of pain. During the intervals the ear and side of the head should be kept warm and dry. If the case be recent the direct result of cold, Aconite in- ternally is esj)ecially indicated, and also at any stage of the disease, provided fever be present. If the throat be affected, Mercuriiis, Bell., or Potash in some form will usually meet the indications. When, however, the ear trouble occurs as a complication of diphtheria, scarlet fever, or measles, the medical treatment of the throat should be conducted with immediate reference to the relief of the disease constituting the primary trouble. In the diseases named the symptoms of inflammation of the ear are frequently masked by the symptoms of the original affection ; and hence in all cases of these diseases, espec- ially in young children, the drum-head should be care- fully examined jby the use of a speculum and ear-mirror. If the use of warm water and the indicated remedies do not suffice to relieve the pain and other symptoms, and the drum-head is bulged outwards, the accumulation of the tympanic cavity should be evacuated by puncturing the drum-head with a broad needle. This surgical meas- ure will, in most cases if done at the proper time, not only afford immediate relief of the pain, but also prevent ulceration of the drum-head and a permanent perforation, favoring a permanent discharge and more or less incura-

A SEVERE B URN. 187

ble deafness. At the same time, the danger of an exten- sion of the disease to (he brain or its coverings is greatly lessened. It is unfortunately a fact that many fatal cases of brain disease have resulted from ear trouble as the primary cause, without the attending physician's recog- nizing the ear inflammation as the foundation. Whereas, had the primary cause been early detected, the brain complication might have been by proper management en- tirely prevented. But as mastoid diseases generally pre- cede danger to the brain, it is especially to be emphasized that swelling over the mastoid process should receive careful, and ordinarily surgical attention. In many cases the opening of the tissues down to the bone will not be sufficient ; but trephining the mastoid will be indispensa- ble to the recovery of the patient.

Typical cases could be cited to illustrate this disease in all its stages and degrees of severity from a mild ear- ache to a post mortem, but to teach you the minutiae of the management would require far more space than the limits of one paper suitable for presentation to this society. But the citation of such cases, treated according to the best light thrown on the subject, compared with similar cases neglected or injudiciously treated, would serve to show that aural medicine is worthy of far more considera- tion than general practitioners have given to it through per- sonal study or through the assistance of specialists in this

department.

^♦^

A SEVERE BURN.

BEAD BEFORE THE OHIO H0M(E0PATHIC MEDICAL SOCIETY.

I. V. DI8BBO, K. D., CLBVELAND, O.

On May 27th, 1882, 6 a. m., was called to see Mr. Clark, aged 53 years. Mr. C, a stationary engineer by occupation, while under the boiler attending to some

188 A SE VERB B URN.

duty, had occasion to reach his right arm over a steam pipe in connection with the boiler. While in this attitude the pipe was suddenly forced out of the boiler, the end flying up and catching him under the right arm, and hold- ing firmly against the boiler in such a manner that he received the following injuries :

First. — The right side of the face was burned almost entirely away, as represented by a line drawn from the right ala nasi along the malar prominence and zygoma to one inch behind the lobe of the right ear ; thence along the sterno-mastoid muscle to about an inch beneath the angle of the inferior maxillary bone ; thence downwards and forwards to a point about an inch an a half beneath the lower border of the body of the jaw, near the sym- physis; thence upwards to the point of starting. This burn was very deep, laying bare the entire width of the lower jaw to the extent of an inch and .a half in length, and burning entirely through Steno's duct, also involving the lobe of the ear to some extent. It measured 5^ by 3^ inches.

Second. — ^The posterior half of the left ear was en- tirely destroyed, together with a portion of the scalp immediately behind the ear. This was burned nearly to the bone, and measured two by three inches.

Third. — The back was burned from the outer border of the acromion process on the right side, to nearly the same point on the opposite side. This burn was from six to seven inches in width, about thirteen inches long, and from half an inch to an inch deep — the deepest portion being just above the spine of the scapula on either side.

Fourth. — A very severe and extensive burn in the right axilla, extending from a point two and one-half inches beneath the center of the clavicle, and four inches from the center of the sternum, to the axillary border of the scapula, measuring about eight inches in length, and three and one-half inches in width in front of the shoulder.

7. W. DISBRO. 189

This burn extended down the arm from the axilla about three inches, and about the same distance down the side.

Fifth. — ^There was a deep burn on the right arm, com- mencing near the inner condyle of the humerus, and extending upwards five inches, measuring three inches in width.

These burns all penetrated deeply into the subcu- taneous areolar and muscular tissues, constituting, accord- ing to Dupuytren, burns of the fourth and fifth degrees. Erichsen says ; " Surgically, the fourth degree is the most important. Its importance is due to the complete destruc- tion of the whole thickness of the skin, and the consequent extensive granulating and supurating surl'aces that are left ; the tendency to deformity from the contraction of the cicatrices, formed as they are of entirely new tissue, the great peculiarity and tendency of which is to contract into hard bands and bridles."

My principal reason for reporting this case is the fact that, although the burns were very extensive and deep, there is no deformity from contractions or adhesions of the cicatrical tissue. The only bridling that occurred was where the lobe of the right ear was drawn downward by being involved in the scar on the cheek. This was com- pletely remedied by a very neat plastic operation per- formed by Prof. H. F. Biggar. "tlie treatment of this case, which differs somewhat from that recommended by most surgical writers, was as follows :

1. Constitutional. — The first day he was given suflB- cient morphine to render the pain bearable, after which he took no opiate of any kind. During the first weok he was given Aeon. nap. 1 x in water, dose every hour or two. Under this treatment he rallied from the shock speedily and satisfactorily. His temperature did not exceed 101° F., and that only for the first few da^^s. From the time suppuration had fairly commenced until cicatrization was completed, his treatment consisted of Ars. Alb. 3x, a powder every 3 or 4 hours, and China Off. * 5 to 10 drops

190 A SEVERE B URN.

three times per day, with the exception of a few doses of Hepar sul., Silicia or Causticum as indicated by the char- acter of the granulations. Diet consisted of milk, eggs, beef tea, milk punch, porter, etc. — our aim being to " feed him well," and judging from the fact that within the next nine months, notwithstanding the great amount of suppu- ration— he had gained about twenty -five pounds, we had accomplished out object.

2. Local Treatment. — The first two or three days the dressings consisted of Linseed oil and cotton batting. This was followed by poultices composed of equal parts of ground flaxseed, slippery elm and charcoal, with suflScient baker's yeast to make it of the required consistence. Then poultices were continued until the sloughs had entirely separated. As fast as they became detached they were removed, and the line of separation stimulated with ni- trate of silver, 20 grs. to an ounce of water. At this stage the odor, which had become very offensive, was overcome by means of Thymol and Carbolic acid solutions used as washes. After the sloughs were removed, the resulting ulcers were dressed with Calamine cerate,which is a prep- aration of Carbonate of zinc. The granulations were kept in good condition by the free use of nitrate of silver, 20 grs. to the ounce ; and where they were too profuse and weak, by the occasional use of burnt alum. As fast as the scars were formed they we kept thoroughly anointed with cosmoline. The portion of inferior maxillary that was de- stroyed was treated with sesqui- carbonate of potash 10 grs. to an ounce of water, till it had separated from the sound bone bone beneath, when the granulating surface which presented was dressed with tincture of myrrh and water, 1 to 10. The treatment (local) contained these items of interest :

1. Hastening the removal of the sloughs hy Judicious poulticing, 2. Thorough stimulation of the granulations. 3. Dressing the ulcers with calamine cerate, 4. Keeping the scar tissue well anointed with cosmoline.

A SURGICAL CASE. 191

There was one very noticeable feature connected with the healing process. After cicatrization had commenced the progress was not at all uniform ; on the contrary, it was intermittent, appearing to heal rapidly for four or five days, and then remaining stationary three or four days. This wave-like variation was observed during a period of several months, and I became so accustomed to it that I could tell very accurately what to expect several days in ad- vance. ( SeeDr. V.Grau vogPs Lehrbuch der Homoeopathic. )

Mr. Clark has entirely recovered from the effects of his injuries, excepting the salivary fistula caused by the destruction of Steno's duct. This, if necessary, will be remedied by another plastic operation.

I am indebted to Prof. H. F. Biggar, who was the con- sulting surgeon, for much valuable advice in Mr. Clark's

case.

-»♦»

A SURGICAL CASE.

B. S. HUNT, M. D.. TAW ANA, O.

On Monday morning, Oct. 17th, 1881, I was hastily summoned to attend Oscar R., a little boy nine years of age, who, the messenger informed me, had been kicked in the head by a vicious horse. The boy, while playing in the street, all unconscious of danger, was run over by a man driving in a buggy, being thrown under the horse's heels and violently kicked by the frightened animal. On arriving at the case, I found the patient in a comatose con- dition, all unconscious of the frightful injury he had only a few moments before received. On examination of the ' the case I found an ugly wound on the posterior and left I)ortion of the head, accompanied by a fracture of the skull.

Upon careful examination I found a fracture about one and a half inches in length by one inch in width, on the X)osterior i)ortion of the left Parietal bone, about two inches to the left of the medium line. The piece of bone was almost entirely detached, only a small portion being

192 A SURGICAL CASE.

intact, on the anterior edge, acting as a hinge : The free edge being driven down into the membrane of the brain, rupturing them to a considerable extent, as well as the brain substance itself, a portion of which was seen oozing from the ghastly wound. But it was. impossible to deter- mine the exact extent of brain injury, on account of the haemorrhage from the wound. Seeing that the case was a critical one, and not feeling justified in undertaking the operation alone, I immediately dispatched a messenger for Dr. H. E. Beebe, of Sidney. The Doctor arrived in a short time, and taking in the situation at once, we deter- mined to operate immediately. After thoroughly anes- thetizing our patient, we proceeded to detach the adhering portion of the bone, but experienced considerable of diffi- culty in so doing on account of the tough condition of the bone in a child of that age, and also the care required to prevent further rupture of the brain and its membranes. We finally succeeded in removing the piece of bone entire, and after cleaning the wound thoroughly, put in five silk sutures, drawing the edges of the scalp neatly together and closing the ghastly opening into the vital portion of the human anatomy. We ordered a dressing of ice-water and Arnica to the wound, to be changed often, also put our patient on Arnica 3x internally. Thus we left the case, giving, of course, a very unfavorable prognosis. The next day after the accident our patient rested remarkably well. We changed the local treatment to Calendula and applied a bladder of ice, expecting soon to have to en- counter the symptoms of inflammation. The next day our expectations were realized. Inflammation having set in in the meninges and brain substance. Now we changed the internal treatment to Aconite 1 x every hour, and con- tinued the same local treatment as before. Spasms set in during the next day, lasting from one to three minutes ; there was frothing at the mouth and twitching of the mus- cles of the face and limbs, accompanied by a drowsy and stupid condition between the spasms, which came at inter-

TONSILLITIS: ACUTE AND CHRONIC. 198

vals of one-half to three hours. On the fourth day after the accident the spasms subsided to a considerable extent, but instead he would arise with a sharp, shrill scream, such as is heard in hydrocephalous, and then would sink back into that drowsy state, from which we could only arose him with considerable difficulty. For this condition we changed the internal treatment to Hyoscyamus, with good eflFect, as on the fifth day, the symptoms of inflamma- tion began to subside, the spasms were of shorter duration and longer intervals, our patient resumed a more rational condition, and by the seventh or eighth day was, to all in- tents, as well as if nothing had happened. The wound appeared to be healing nicely, and on the eighth day we took out the sutures. But after about two weeks, the wound began to open, and it seemed nothing would entice it to unite. Soon we noticed small spiculee of bone ap- pearing in the wound, which soon told us that they were the irritating cause. The periosteum being torn from the edges of the bone, deprived it of its nutriment, and finally suppuration loosened the particles, until fifteen pieces in all were extracted, varying in size from a grain of wheat to one-fourth the size of the original piece, and continuing over a penod of more than two months ; when the wound quickly began to heal, aftd in a few days was united to- gether, leaving no landmark, only a slight scar, and a throbbing pulsation of the brain. Thus he continued, and is as well to-day as if nothing had happened, leaving no derangement either of mind or body.

TONSILLITIS : ACUTE AND CHRONIC.

M. P. BUNT, M. D., DELAWARB, OHIO.

My topic is not one belonging directly to the Bureau of Surgery, but it nevertheless treats of a disease fre- quently requiring surgical interference. I hope my few

194 TONSILLITIS: ACUTE AND CHRONIC.

remarks on " Tonsillitis, Acute and Chronic " will not come amiss. Acnte inflammation ol the tonsils, or Qnin- sy, is a disease not infrequently met with in our variable climate during the spring and fall. It is a disease of youth and middle age ; rarely attacks the aged, or children, un- less complicated with some exanthematic fever. The causes appear to be associated with some disordered state of health. A scrofulous or gouty habit, or previous suffer- ing from some constitutional disturbance, seems to render the throat and tonsils especially susceptible to the influ- ence of cold. These we will term the predisposing causes, and direct exposure to the frequent atmospheric changes, or " taking cold," the immediate cause of an attack.

SympUmhs. — ^The premonitory stage is usually ushered in with a chill, followed by high fever and violent head- ache, with cerebral hypersemia and soreness in the limbs and body. At this time we are very apt to mistake the true disease for one of acute meningeal trouble, as the local throat-symptoms do not manifest themselves until the fever has lasted some little time ; but if we examine the throat we will find one side, rarely both, red and con- gested. This is soon followed by swelling of the tonsil and pain of a lancinating, stinging character in the fauces and upper part of the throat, on swallowing. As the dis- ease progresses the suffering of the patient becomes more intense ; the fever remains high ; there are pains in the jaws, and severe suffering in the part affected ; a heavily loaded, creamy and swollen tongue, with foul breath; muffled articulation ; great difficulty in swallowing, yet a constant urging; on attempting to swallow fluids they will frequently escape through the nostrils, causing a great fear of strangulation ; there is an abundant secretion of saliva of a stringy, ropy character, and the patient will be ob- liged to sit forward or lie on on one side to allow it to escape from the mouth. A local examination at this time, usually made with the finger, as it is less painful to the patient, will show us the swelling very much increased,

M. P. HUNT. Id5

completely hiding the posterior wall of the pharynx, run- ning forward in the substance of the soft palate on the side affected, and sometimes as far forward as the incisor teeth, implicating the tissues covering the hard palate. In this manner the disease continues for an indefinite period, until pus forms and is evacuated. In some cases it will form in from forty-eight to sixty hours ; others will run many days before pus can be detected ; nine days is the average time before the abscess breaks. During this time the patient passes his days and nights in suffering and mis- ery ; he can take no solid food, and but little liquid nour- ishment— in fact, frequently nothing is taken in the last twenty-four hours; he obtains but little sleep, and that little of a disturbed character; has difficult respiration from more or less oedema of the tissues involved, and a nervous horror of suffocation. Sooner or later the abscess will burst, if left to itself, when the urgency of the symp- toms will begin to subside ; the patient becomes comfort- able, and expresses himself as wonderfully relieved, and asks for something to eat or drink. The prognosis is usu- ally favorable. Death sometimes occurs from oedema of the glottis, producing suffocation ; rarely from exhaustion.

The chronic form of Tonsillitis, with enlargement, is by far a more common disease. It usually affects children from the second year of life until puberty, but frequent attacks of the acute form in adults will cause chronic en- largement. As pain is seldom a symptom in these cases, the attention is rarely drawn to the local condition until the loud snoring in sleep or thick articulation calls the mother's attention thereto.

The causes which produce this disease are not satis- factorily established. It does not depend on want of nour- ishment or lack of cleanliness, for it is met with in chil- dren of both the upper and lower classes. Neither does cold produce it, although the frequent acute attacks to which these cases are liable may be caused by cold. On the other hand, children who have been " raised by hand,"

196 TONSILLITIS: ACUTE AND CHRONIC,

or eai:ly weaned, or convalescing from some eruptive fever, are liable to this form of disease ; and the scrofulous child is almost invariably aflFected in this way. Another cause my experience teaches me lies with the parents. They may be indimdv^lly healthy, robust people, but too much alike in temperament and disposition to raise healthy chil- dren. In nine cases out of ten the offspring of these mU- matched parents will be affected with some glandular en- largement, usually tonsillitis.

Symptoms. — The symptoms, both objective and sub- jective, are easily detected. It interferes with free respi- ration ; the voice is generally muffled and pronunciation thick; breath offensive; the child snores loudly in its sleep, and often starts and awakes in alarm ; sleeps with the mouth open; inconvenience in swallowing. On in- spection we find one or both, usually both, tonsils enlarged ; the surface uneven, pitted ; the mucous membrane thick and velvety, and small points of a thick, sticky, sebaceous secretion will be observed, marking the orifices of ducts leading into the substance of the gland.

*The enlarged glands are constantly liable to acute at- tacks of inflammation, attended with high fever and ex- acerbation of all symptoms above referred to, and fre- quently violent brain symptoms. Earache is a frequent accompaniment to the acute attacks.

The effects of Chronic Tonsillitis, should the enlarge- ment continue, are sometimes quite serious. Mackenzie says : " The interference of the enlarged glands with res- piration is by far the most serious of their evil results. The occlusion of the nasal channel positively obliges the patient to keep the mouth almost constantly open, and renders him exceptionally liable to the external influences which produce inflammation of the respiratory tract, while the persistent obstruction to respiration leads to serious changes in the walls of the throat. The characteristic de- formity met with in cases of enlarged tonsils is a circular depression of the walls of the chest at about the junction

M. P. HUNT. . 197

of- the lower and middle thirds, corresponding with the at- tachment of the diaphragm internally, and evidently due to the constant, energetic contractions of that muscle to overcome the obstacle to free respiration."

Treatment, — If there is one disease more than another that we, as homoeopaths, can treat successfully, that dis- ease is Quinsy. Of course, the success of the treatment depends to a great extent upon the stage the disease has reached when first called to prescribe. Belladonna is our sheet-anchor in the stage of inflammation. This, with Aconite, if given in time, will abort, or at least cut short, most cases. Usually, however, the physician is not called until the swelling has reached a degree where it would be mere waste of time to exhibit these remedies. Then we have our Mercurius sol. and Hepar sulph. These will either prevent suppuration or hasten it. In the course of the disease we may have symptoms calling for Apis mel., Lachesis, or Baryta carb. If, after every effort to abort the disease proves ineffectual, and we find pus is forming, it is our duty to hasten the process as fast as possible. As accessory measures to the remedies indicated, apply hot fomentations, changing frequently. Allow the patient to hold his mouth over a vessel containing Jiot water, letting the steam reach the affected part. As soon as pus can be detected at any point, let it out with the scalpel or bis- toury, being careful not to wound any of the vessels or tissues unnecessarily. I am aware that some condemn this procedure as unnecessary and uncalled for, but it seems to me if the natural evacuation of an abscess in the throat can be anticipated twenty-four to forty-eight hours by the use of the knife, and thus relieve the intense suf- fering, it is our duty to do it, for the relief is almost in- stantaneous. The after-treatment is not much — a good, nourishing diet, and care of .the throat during the balance of the season, with a viarl of Belladonna 3x in the pocket to take whenever pain is felt in the throat.

The chronic form is much more obstinate, and re- quires a great deal of patience on the part of both parents

198 THE LABORER WORTHY HIS HIRE.

and pjiysioian to successfully treat it. The remedies indi- cated are, for the most part-, constitutional. Calc. carb., Calc. phos., Hepar sulph., Baryta carb., and Sulphur are the remedies most frequently indicated. These, together with a good, wholesome diet, regular habits, and plenty of pure, fresh air, with, whenever possible, a. sea voyage or sea bathing, will work wonders in time. I am certain that most cases can be cured by following this line of treat- ment. But remember that Time and Patience are the two great factors in the treatment of chronic enlargement of the tonsils.

But, should the case have reached that point when we have the " stoop " shoulders, depressed chest walls, diffi- cult respiration with hacking cough, and the child seems wasting away and about to " yield up the ghost " for want of breath, we must resort to more heroic means if we would save a life. Happily, Surgery comes to our relief again, and tells us to remove the offending tonsils. This may be done with the probe, pointed bistoury, or the ton- sillitome. I much prei'er the latter instrument, as there is less danger of wounding the vessels and tissues, and easier managed. K the tonsils be very large, remove a considerable portion, but it is not advisable to remove the whole of the mass.

After removal, give the indicated remedies again, and usually they will not return.

THE LABORER WORTHY HIS HIRE.

president's address INDIANA INSTITUTE OP HOMCEOPATHY.

BT O. S. FAHKB8T00K, K. D., LA PORTS, IKD.

* * If a public hospital or dispensary is established, the builder, mechanics and contractors all expect and freely receive full pay for their services. When the same is in

a S. FAHNESTOCK. 199

running order the grocer, butcher, druggist, in fact all who furnish supplies or aid in running the establishment, af'e fully numerated for their wares or time, excepting the physicians and surgeons. They are expected to work gratuiliously. The honor of a position is consedend suffi- cient pay. But the honor of the office does not free the encumbant from liabilities of all kinds, annoyances of every description nor does the fact of gratuitous service secure him the right of regulating the time or specifying the amount of labor he shall perform. In every other vo- cation when responsibility is placed upon a party and demands made upon his time the renumeration is propor- tionate. Perhaps no better illustrations of public feeling toward physicians can be cited than the demands made upon them for the poor by individuals and state. With the exception of a half dozen localities the provision for the medical care of the poor is of the " cheap John " order. The county commissioners award the position of township or poor doctor to the lowest bidder, and the one on the right side of the question politically, generally has the lowest bid. The chief object of this appointment is not for the benefit of the poor, but to prevent claims be- ing brought against the county for service rendered to those who are unable to pay. He who accepts the posi- tion does not expect to treat the poor nor attend strictly to any of his supposed duties. If that were the intention one certainly could not aiford to do the work for four townships, a town of three thousand inhabitants and county jail, furnishing his own medicines for the paltry sum of $65 per annum, as is the case in one of the north- em counties of this state. No practitioner can well avoid doing a certain amount of charity work, but most of those who serve the county have learned the trick of being too busy to attend acknowledged paupers, until compelled to do so by an order from the township trustee. Because of this the poor often suffer greatly in two ways. First from the delay in getting their calls answered, and secondly

200 THE LABOBER WOBTHY HIS HIBE.

from the hurried and stinted attention given by one who has no personal or financial interest in the case except the profit derived from neglecting it. Many of you probably recall the case of a poor woman who died some two years ago, after thirty-six hours of laVor still undelivered. The township doctor was to busy to answer the call and per- form his duty, for the roads were bad and the weather stormy. Nor could any physician be procured in time to render aid. Each one called upon knew it was a charity case and felt that while the county provided and paid for such service, it was not their duty to do the work and face the midnight storm without compensation. The public press was loud in its denounciations and private citizens profuse in their expressions of contempt for the diflerent physicians, but not one word was said about the law that was responsible for that untimely death. The business men who were violent of speech would not have left their beds that night and traveled over those rough roads, fac- ing the storm, to present some poor and needy person merchandise to the value of ten dollars. No — not they — but if a starving man, woman, or child, robs them of a mere pittance to ease the pangs of hunger, they raise the cry " give robbers the full extent of the law." The pub- lic admires charity greatly, and practices too when it be- gins at home, but deny the doctor the same privilege.

On another occasion a poor man suffered from reten- tion of urine. About 4 p. m. he sent for the township doctor, who as usual was too busy. Nor could any physi- cian be found who would answer the call that night. The trustee could not be found. About 5 a. m. a physician passing that way was called in, and at once emptied the bladder with a catheter. To test the matter he presented a biU to the county commissioners basing his claim for services on the ground that the proper county official re- fused to make the call. Payment was refused, it being held that a competent person was paid for such work, and if any other did it he was intentionally rendering gratui-

a 8. FAHNESTOCK. 201

tons service, and the county were not responsible. Now if for any reason any citizen though he may never have received aid from the county should become destitute and could not obtain food or fuel, the county makes every provision to prevent his suflFering from the lack of these necessities, and there should be equal liberality shown in relation to medical attention ; for the man who cannot pay the doctor is just as diuch a pauper in the eyes of physicians as he who cannot pay for flour is in the estima- tion of the grocer. Those who have never investigated this matter, who have never given much thought to the subject can not conceive the vast amount of needless suf- fering it inflicts upon the poor, nor can they estimate the amount of unprofitable work it forces upon every practi- tioner, in addition to all this, it tends to constantly in- crease the number of professional paupers. In bright contrast to this is the method of at least two counties in the state. There such physicians as are willing to at- tend the i>oor at a discount from the usual fees, notify the trustee and when called to a family unable to pay, they receive an order to render all necessary service and pre- sent his bill, less the stipulated discount to the county of- ficials. Phpsicians who are unwilling to make such dis- count receive no order, and the case is transferred to such as are. When we consider that all criminals, no matter how grave or horrible their crime, or how conclusive the evidence of their guilt, are furnished at the county's ex- pense, attorneys to defend them and that the court in doing this does not let these cases out by the year to the lowest bidder, but allows the defendent with slight restric- tions his choice from the bar, does it not appear like put- ting a premium on crime and practically make felons more entitled to respect than the poor. The course adopted by these counties also reduces the number of medical dead-beats, for the " respectable poor," so called, will make an effort to pay something rather than have it known that they are treated at the county's expense. 4

202 THE LABORER WORTHY HIS HIRE.

And just as the county attempts and does impose up- on medical men, so do individuals. Is there any other business where perfect strangers will have the afFrontry to ask your advice and merchandise, monopolize your time and then cooly walk away saying : " Dr., I have no money to-day — please charge it." Is there any other class of men, who, after giving their time and spending their money, for every case is rf matter of expense to the physician, especially if surgical, knowing while so doing that not one penny will ever be returned, under these circumstances is there any other class, who, because of accident or through the ignorance of communities is com- pelled to pay large sums as malpractic penalties, and that generally to the very dregs of society. Is there any other vocation whose members the railroad and other corpora- tions call on so often and at inconvenient times and wholly ignore when asked for a fee ? If a lawyer gives advice that does not turn out the case as expected, does the city or corporation attempt to force from him the damages re- sulting therefrom ? But when a city is sued for damages caused by defective walk or otherwise, how often the at- tempt is made to throw the blame on the doctor, who nine timefe in ten receives the charge of malpractice as his only fee.

As with others so with the state. It is not backward in its demand on us. It passes a bill and every doctor must write his name in a book and pay the officer a small fee for the privilege. It passes a bill and we are compelled under penalty of the law to fill blanks and make returns, not only without compensation, but in the mtgority of in- stances at an expense for postage and stationary. Not content with this imposed task, it seems to be the i>olicy of every state board to make the work as arduous as pos- sible. They furnish us three different blanks and when a child is bom we have twenty-five or more questions to answer, if still born the questions swell to forty-eight. If a death should occur twenty-three questions are waiting

a S. FAHNE8T0CK. 203

the doctor and so also when certain diseases are met with. Many of these questions have not the slightest bearing on the information contained in or value of any report ever issued by a state boaid. In order to make a complete re- turn as asked for by the board, the reporter is often com- I)elled to make an extra trip sometimes miles away. This must he do and in addition bear his share of the expense in maintaining the very body that increases his labor and never say thank you. The absolute power of the Board of Health cannot be greater than that of the State which gave it birth. The State does not pretend to compel an answer to any question that pertains to more than ordinary and necessary information acquired in treating the case, nor does the State ever in any ot its Courts, be they high or low, attempt to ask the doctor questions whose answer would be a violation of the confidence placed in him by his patient, as does the State Board of Health.

It is not the intention of this paper to belittle the State Board or find fault with its work. It has a legiti- mate and useful field, and the information it collects and gives the public is of material value, but for all this there is no legitimate reason why when all other information and statistics pertaining to public affairs are paid for di- rectly or come through salaried officials, these should be made an exception and a certain class of citizens com- pelled to furnish these without compensation, especially when the very task necessitates considerable time, ex- pense, and often loss of business.

Gentlemen, all these indignities which are heaped up- on our profession, come from what source they may, result from a lack of harmony among the diff'erent schools, and the quarreling of extremists in each school. The early part of this paper aimed to convey a fair representation of the principal schools, the ideas entertained by each, both of themselves and others, and the origin of the diffi- culty. Nothing was said in malice, nothing to intention- ally wound the feelings of any, but that which seemed to

204 ULCERATION OF THE RECTUM,

be the absolute truth has been openly and plainly stated. The number of physicians who advocate liberality in medi- cal relations who do not endorse such lines and views as were quoted from Dr. Cathell's book, who approve the publication of partizan and bitter articles on matters of theory and belief, who have an earnest desire to make all that is true common property and permit the greatest lat- itude in all that is doubtful, is to day large and rapidly becoming larger. It is our duty to aid in the movement, not by renouncing anything we know to be true, not by trying to compel others to believe as we do, but by extend- ing to all the same privileges and charity we have asked for ourselves. As this is done and therapeutics are stu- died and compared with honesty the gap will grow slowly less and less, and while all may not hold identical views they will fraternize as physicians and by unanimity of purpose and action put an end to the insults heaped upon our profession.

Gentlemen, in closing I thank you for the honor con- ferred by your kind suffrages, and it it was the earnest de- sire to merit the respecf of this intellectual body, that led me to adopt a non-partizan view of this case, in the hope that by pointing out some of the causes of the disresi)ect shown us a solution of the problem might be evolved that would be of benefit to physicians at large.

ULCERATION OF THE RECTUM.

READ BEFORE THE INDIANA INSTITUTE OP HOM(EOPATHY.

W. D. HILIi, M. D., GBEBNCASTLB, IND.

I give the above title to this paper, and yet the paper may cover more than is indicated by the title. The au- thors of our text-books have little to say with regard to the diseases of the rectum, excepting, in each will be

W. D. HILL. 205

found a short article on Haemorrhoids. The disease that we now have under review exists higher up in the rectum than the Haemorrhoids. In fact, the Haemorrhoid veins are not implicated. Yet both of these diseases may and sometimes do exist at the same time ; when this is the case the suffering becomes almost unendurable. This disease may be either acute or chronic in its nature, hence we find it in all the stages from simple inflammation to chronic blennorrhoea, and ulceration. Some times there are quile large patches of the gut that are inflamed or ulcerated ; and until a thorough examination is made, little can be known of the true nature of the disease. Too frequently, the busy practitioner makes a great, and it may be an in- excusable mistake, by taking the statement of the patient, who may either withhold or greatly magnify the symp- toms, rather than take the time to make a thorough ex- amination. He thus will pronounce it a case of Haemor- rhoids, and give the remedies which he thinks to be indicated, but to his astonishment he finds that there is little if any improvement, unless it may happen that there is a complication with the Haemorrhoidal disease, when there will be a slight improvement. After a time the pa- tient becomes dissatisfied and applies to some other phy- sician for treatment Now, this second physician may im- prove the case, for if he is a sensible man. and desires to place a feather inJiis cap, he mades a critical examination when he beholds the true nature of the disease, and is en- abled to treat it upon scientific principles, and thus effect a cure. I confess that I have made the above foolish, and I may say unpardonable mistake, but I have come to the conclusion, that " what was worth doing was worthy of being done right."

If the necessary examination is made, wc shall find some of the following pathological changes or apx>ear- ances. It may be a simple catarrhal inflammation like that which is found on any other mucous surface. The little capillaries are distended, infiltration, mucous secre-

206 ULCER A TION OF THE BECTUM.

tion, thickening of the membrane^ patches of the mucous surface may be destroyed, chronic blenorrhoea, ulceration. Now this upon examination is found to be high up in the rectum above the second set of sphincter muscles, and can only be properly and satisfactorily investigated by using a wire speculum made for the. purpose. It is but natural that we should inquire, after making the examination, has been the cause of this trouble.

In the first place, we should be aware of the fact, that the entire mucous membrane is subject to catharral dis- eases, or that certain atmospheric or electrical changes produce diseases of the mucous membrane. These changes effect the terminal nerve fibers that communicate with the mucous surface. These changes in the nerve fibers pro- duce a change in arterial circulation, causing either too little or too great a flow of the blood to, through, and from the parts, so that in a short time we find a local disease of the part is set up. This then may be and is one cause of the disease. Another cause is from the use of purgative medicines. Too many have been taught that it is necessary for them to give themselves a thorough cleaning out about once in from seven to thirty days. The action of these purgatives are anything but natural. They are disease- producing. Every one who will stop a moment to think will acknowledge the truthfulness of the universal law that " action and reaction are always equal but in opposite directions." And yet action may be so great as to destroy the object acted upon. When this is the case, local disease is the result, which is too frequently the case in the use of purgative medicines.

Another cause is the use of medicated injections. In some cases I have not the least doubt that worms are the cause. Sometimes the cause is mechanical. In women it is frequently caused during pregnancy by the pressure up- on the parts, but, the greatest cause, and the one most fre- quently found to exist is constipation. The faeces remain- ing for a long time in the folds of the rectum becomes an

W. D. HILL. 207

irritant, and when the rectum becomes impacted the pas- sage of the large fseces denude the gut of its mucous sur- face and then keeps up the irritation.

It may be well for us to inquire for the leading symp- toms of the disease. There is found a burning, throbbing, tearing pain. The sufferer says, that it appears to him that there is something sticking in the rectum, which causes him to use great exertion to force it out. This state of things is always worse during an evacuation ; so that he is compelled to make many attempts without receiving the desired satisfaction. There is a constant desire to evacuate the bowels. In some cases the bladder is in sym- pathy with the disease, causing retention of urine and even strangury. If it be a women that is diseased she will be troubled with leucorrhoea, and it may be with falling of the wound. The bowels are nearly always constipated, yet the stools may appear natural, excepting covered with mucous or slime, which may be colorless but more fre- quently tinged with blood. This is the acute form. In chronic cases the character of the pain is not so lacerating, but of a dull, aching nature. In this case, the most promi- nent symptom is the constant discharge of a thick yellow- ish and it even may be purulent secretion from the dis- eased surface of the rectum. This secretion is either mixed with the faeces, or else it covers the otherwise nat- ural discharges from the bowels. It sometimes oozes from the bowels, staining the linen. The chronic form is fre- quently attended with catarrh of the bladder, catarrh of the vagina and uterus, and it may be complicated with Haemorrhoids. This much for the disease pathologically and symptomatically. We shall now give our attention to the treatment of the disease, or the means to be used to effectually overcome the diseased condition.

I am aware of the fact that we have a local disease to treat, and if it arises from the cause which produces ca- tarrh then we as well have a constitutional trouble to con- tend with. If the disease is cured it must be by the inter-

208 ULCERATION OF THE RECTUM.

nal administration of the indicated remedy^ and at the same time by the local application of remedies to the dis- eased parts. Some may think that the disease should be overcome by the internal use of the remedy indicated by the symptoms.

It may be possible that cures have resulted from this method of treatment, but they are the exceptions and not the rule. Some of the symptoms may be controled by in- ternal treatment. Indeed, it would be thought strange were they not. Some may say, if some are controlled why not all, and thus a cure eflfected ? This difficulty pre- sents, which prevents the cure of internal medication alone : The mucous membrane in all of the cases before the patient applies to a physician is abraded and even ul- ceration has taken place, hence the passage of the rough, hardened faecal matter passing over this diseased surface keeps up a constant irritation, which prevents the healing process. Then in order that a cure may be effected, there is necessity to correct constipation where it exists, and then apply a lotion of Carbolic acid« the strength of which is to be determined by the condition of the parts. It should be applied at no other time than after the faecal matter has been discharged from the lower bowels. It should be applied through a flexible tube, which can be passed up the bowels above the diseased parts, and the lo- tion should be forced through the tube into the bowel. This should be done as the tube is slowly withdrawn, so that the lotion will come in contact with the whole of the diseased surface. This need not be repeated oftener than twice per week, unless in the most severe and stubborn cases. After the use of the Carbolic acid lotion in many cases Calendula, or Hydrastis lotions will be found to answer as good if not a better purpose in healing the bowel.

If, while using the local treatment, the indicated rem- edies are selected and given, it will be but a short time before two persons are really made to rejoice.

CLINICAL CASES. CLINICAL CASES.

J. W. EI<T, M. D., WAYNE8BUBO, PA«

Case 1. — Arsenicum in Asthma Spasmodicum. Was

called June 24th to see Mrs. J , set. 32, in a paroxysm

of asthma. I found the patient propx>ed up in bed, with knees drawn up ; her head and arms upon her knees. She could not keep still; she was almost suffocating. Face very pale and clammy. Pulse small and quick. Feet very cold. Great burning in the chest. Violent thirst ; drink taken often and in small quantities. This was the most severe attack she ever had. I gave her Ars. 30x one powder every five minutes until relieved. I left her twenty powders, one to be taken every four hours. She has never had an attack since. Says she ei\joys better health than she has for years. She had had asthma ever since a child, and for two years previous to this attack the paroxysms came on every six weeks, always between mid- night and early morning.

Cask 2. — Charley E , aet. 11, was brought to my

office July 15th. Had been suffering from asthma for nine years. They had used every remedy from which they could reasonably expect any benefit. He had been treated by several old school physicians, even patent medicines had been resorted to, but to no purpose. Family history good. The family being free from diseases of the respi- ratory organs. The dyspnoea was most distressing ; could not lie down ; had to sit propped up in bed. The counte- nance bore evidence of great distress. Patient greatly emaciated. Skin very pale. Pulse small and quick, ioud wheezing. On applying the stethoscope, dry, sibilant and sonorous rhonchi could be heard. The impulse of the heart violent, uneven and irregular. He would have a paroxysm once a week, generally occurring between mid- night and early morning. Violent thirst, taken often and little at the time. Cough entirely absent. I prescribed

210 DB. MACFABLAIPS CASE.

Ars. 30x, twenty-five powders, one to be taken every four hours. I also had him use the cold sponge bath to chest every morning.

Aug. 20th. — Had only three paroxysms up to this time, and could lie down quite comfortable. I gave him twen- ty-five powders more, to be taken twice daily. Has had no paroxysms since, though nearly ten months have elapsed.

DR MAOFARLAN'S CASK

Philadelphia, Aug. 2. 1888.

Dear Doctor: Your postal card was duly received, asking me for particulars of my case of loss of bowel tis- sue. The facts are that I was called Saturday, January 30, 1869,'by Dr. W. B. Davis to see Mrs. Anna B. Kensell, aged 37, of 1112 Hanover street, who was suffering with strangulated femoral hernia of right side, of three days duration, since the previous Wednesday. Hernia had ex- isted for three years. Assisted by attending physician and my students, Drs. H. W. Rice and Sam'l Kennedy, her- neotomy was performed, the bowels exposed and stricture relieved by dividing the falciform process of the fascia lata and gumbemats ligament. The sac was opened, a quantity of fluid escaped, and there was brought to view a blackened loop of small intestine. Finding that efforts at restoration of the bowel to a healthy condition would not take place, as perforation and escape of fecal matter su- pervened on fourth day. the diseased loop of bowels was withdrawn and held in position at the cite of the original incision in the groin, the opening, or incision, being en- larged, and, both ends of the bowels presenting, like the muzzle of a double-barrelled gun. From the date of the operation until the 17th of February, all the contents of her bowels were passed through this artificial anus, at that date the septum between the bowel tubes was separated

PROTECTIVE INOCULA TION. 211

or divided and a pad applied over the artificial anus. Feb. 22d she had a movement by the rectum. After that the discharge from groin became gradually less until it ceased entirely and the wound healed. I suppose there was about four inches of the bowel removed. During her treatment the diet was composed of liquid, starchy and animal food^ with Aconite, Rhus, and Ohina. separately as they seemed to be indicated by her symptoms.

The above data I copied this morning from my list of that date. The intestinal loop, I remember, was so soft, black and disorganized, that I have estimated the length removed — ^it couldn't be measured. The patient made a good recovery, and I believe is alive and well at the pres- ent time. Yours truly, Malcolm Macfarlan.

PROTECTIVE INOCULATION: KOCH AND PAS-,

TEUR.

FBOX ** THB I^ANOBT/' LONDON, SNOLAKD.

The controversy which has arisen between the two foremost investigators into the intimate nature of conta- gion— the veteran chemist of Paris and the younger path- ologist of Berlin — is one of which we are only just seeing the commencement. The issues are so important, that it is to be desired that renewed investigation will be under- taken by unprejudiced observers, in the hope that the truth may be revealed. There can be no denying that Dr. Koch has hit the weak points of M. Pasteur's case, and his analysis is all the more vulnerable from the severe and critical manner in which he has dealt with the sub- ject— a style which differs very widely from that of his opponent — a difference partly, no doubt, explained by the admitted diversity in modes of thought, work, and expres- sion between the Oaul and the Teuton. Those who have I>erused the summary of Dr. Koch's reply, that we have

212 PROTECTIVE INOCULA TION.

just published, will note how little agreement there is be- tween himself and M. Pasteur, not only upon the subject of anthrax, but upon those other infectious diseases which have been experimentally studied by the latter. Thus, Koch thinks it indubitably proved that the supposed virus of rabies which Pasteur discovered is identical with that of the septicsemia of the rabbits ; and he says the same of equine typhoid too, thereby implying that M. Pasteur is ignorant of the characteristic microbe of septicaemia in rabbits, or that he has been very careless in safeguarding his observations. Indeed, Koch's strongest attack is di- rected against the method followed by Pasteur in his as- sumption of specific micro-organisms in the saliva of a hydrophobic child, or in the nasal mucus of a horse suffer- ing from typhoid fever, without taking the precaution to isolate the organism and cultivate it before making his inoculations — ^the method which Koch claims to be the 'only safe one for determining the question. It is in an- thrax that the most important issues are involved, for it is only in this disease that the practical application of Pas- teur's doctrines has been made — viz., that immunity from this scourge can be attained by vaccinnating (or rather in- oculating) sheep and oxen with the attenuated virus. Koch admits ths fact of attenuation, and it may be re- marked, agrees with Pasteur and differs from Dr. Klein, in believing that this is due to some change effected in the pathogenic bacilli themselves ; but he does not admit that this change is due to the oxygen of the atmosphere, as M. Pasteur thinks, and by a series of carefully conducted ex- I>eriments he shows how the virus loses its power in culti- vation more or less rapidly according to the temi)erature to which it is submitted. There are graver differences than this, however, which may be summed up in a very few words. The method of vaccination is alleged by Koch to be imperfect. Although an animal previously inocu- lated with a highly attenuated virus is able to resist the effect of a second and more powerful vaccination, yet this

MULTILOCULAR CYST OF THE LEFT O VAB F. 218

is not a universal rule, and a certain proi)ortion of the vac- cinated animals — a number which Koch places much high- er than Pasteur — die from the effects of the secondary vaccination itself. After passing through so severe an or- deal, the survivors should be sufficiently protected, if any real practical value is to accrue from the method. But Eoch shows that, although they may resist further inocu- lations, such animals may still fall victims to spontaneous anthrax. If this be true, where is the protection? and what reliance is to be placed upon the " vaccinations " and " revaccinations " to which so many thousand head of cattle in France and elsewhere have been subjected ? Coming from one whose researches upon this and other infectious diseases have received general approbation for the exactitude and care with which they are conducted, such criticisms as are here offered upon Pasteur's labors must receive attention; for it must never be forgotten that, wide apparently as is the principle upon which Pas- teur has based his advocacy for " vaccinations," applica- ble as it may seem to be to many human diseases, it has yet to be conclusively proved, even in the case of anthrax, where the conditions and nature of the virus have been so thoroughly worked out.

MULTILOCULAR CYST OF THE LEFT OVARY. RECOVERY.

PHIXm POBTXBv X. d., DXntOIT.

Mrs. B , set. 32. Nervous temperament. Niece of

Dr. O. P. Baer, Richmond, Ind. First noticed an enlarge- ment of her abdomen about one year ago, but snpi>08ed she was pregnant, although she menstruated regularly. After the expiration of nearly a year, she called the at- tention of a physician to her condition, who pronounced her disease an ovarian tumor, and sent her to me for an

214 MULTILOCULAR CY€T OF THE LEFT O VAB Y.

examination. I confirmed his diagnosis. She had suf- fered no pain from the growth, and could hardly realize the fact of the presence of a tumor.

On examination I found great distension of the ab- dominal parietes, the skin as tense as a drum head. Two weeks before I saw her she had received a fall which she thought had caused a rapid increase in the size of the ab- domen and loss of flesh and shortness of breath. The girt of the abdomen at the most prominent part was 42 inches. On making the incision, all the tissues were found very thin. The erectus muscle through which I passed was like a ribbon in thickness. Some adhesions to the abdom- inal wall were separated, and the tumor brought well up in the opening, before introducing the trocar. The fluid of the first cyst was viscid mucoid in character, the second similar, but the third cyst contained a thin serum, with ten or fifteen per cent, of blood intimately mixed with it, which no doubt was caused by the injury the patient re- ceived two weeks previous.

After separating all adhesions, the tumors were care- fully drawn out through the opening, and the pedicle ligated with carbolized catgut, and divided with scissors. The pedicle was then washed with Calendula and Hj/per. and dropped back into the abdomen. Then the toilette of the peritoneum was carefully performed, as some of the fluid from the last cyst had escaped into the abdominal cavity, and the wound closed in the usual manner, and dressed with oil silk and carbolized gauze. No drainage tube was employed.

This patient was put upon Hyp. 200, with an occa- sional dose of Bry. 200, or Colcynth 200, for the first two weeks. No bad symptoms followed the operation, the mean temperature being 98^ the first week, and the pulse 89 ; after this, normal temperature and pulse.

I was assisted in these operations by Drs. Miller (who had entire charge of the last case), Olin, Bailey, Pol- slaise, and Griffin. Miss Sarah A. Henderson, M. D., of

THREE CLINICAL CASES. 215

Sandusky, Ohio, Mrs. Hicks, Miss E. E. Bower, and Mr. Martin, of the senior class ot the U. of M., were guests.

Later, I shall report several interesting gynaecological cases, whereby I shall be able to show the superiority of the after treatment under the homoeopathic principle, over that of the old school.

In the last six months I have performed twelve oper- ations which, under the old method, would certainly call for Morphia ; but all pain and restlessness was nicely con- trolled by the indicated drug.

I am satisfied that union of divided tissues is always retarded by Morphine, or in other words, repair is inter- fered with to a greater extent than heretofore supposed by surgeons. What is often called '^ chloroform sickness " is nothing more or less than " morphine sickness."

THREE CLINICAL CISES.

(BARRY AOT) EATON COUNTY MEDICAL SOCIETY.)

WILLIS P. POLHSMTTS, X. D.

Jfr. PrcBident, Ladies and Gentlemen:

I wish to present three clinical cases to you, which may serve " to point a moral" if not to " adorn a tale." There is such a widespread tendency at the present day among the members of our profession "to long for the flesh pots of the older school, for their quinine, morphine, chloral hydrate, bromides, and other narcotics and seda- tives, that a glance at the other side of the question may not be without profit to us as homoeopaths. And thereby the tendency to worship false gods be somewhat re- strained.

Cask 1. — ^Mrs. D , aet. 30 ; married six years ; one

child living, five years old. Was confined two years ago, and lost the child several days after birth ; from the grief

216 THREE CLINICAL CASES.

caused by this loss she had never rallied. Has been under old school treatment, sedative and tonic in character, for the past thirty months. Her present symptoms are as fol- lows : She has spasms nearly every night, soon after going to bed and as she is about falling to sleep. Clonic, convul- sions of the lower limbs and arms succeed each other rapidly. At times only left side aflFected. Often a condition of al- most complete catalepsy is induced. She suffers from much weak faintness, in the stomach, appetite poor, is thin and pale. Menses come too often, blood black, clotted, smells like carion ; accompanied with much pain in back and groins. Leucorrhoea, profuse, yellow, sometimes in lumps, irregular as to time. Is sterile, and suffers from a raw, smarting pain in vagina during coition. Headache in and above eyes, runs up to vertex.

But of more importance are the mental symptoms manifested: Memory is failing, especially of recent events. Much silent grief, will sit and cry for hours; broods over the death of her child ; cannot throw off her bad feelings. Is very easily affected by sorrow. Her con- dition is such that friends fear for her reason. Her medi- cal adviser, a well qualified practitioner of the old school, can only relieve her by increasing doses of sedatives, etc., which already include bromide of potash, chloral hydrate and chloroform.

Her husband comes most earnestly asking if Homoe- opathy can do better. When the case was lost sight of, she had made almo^ complete recovery under Ignatia fol- lowed by Actea.

Case 2. — ^Mrs. R , married seven years ; ailing two

years ; has three children, youngest five weeks old. At birth of child, two years ago, had puerperal fever, was treated by an old school physician ; slow recovery. In the following fall she suffered a severe fright from a double murder and suicide in the neighborhood. As a result, she soon lapsed into the following condition : Could see bears, snakes and wolves about her bed, all seemed so real, al-

WILLIS P. POLHEMUS. 217

though she knew they were not. Imagined friends were present in opposition to the fact. Had a strong impulse to kill her child, as the mother had none in the above-men- tioned case ; feared she should do so in spite of herself. Feared to be left alone, but did not wish to visit among relatives or friends. While in conversation her mind would wander oflF into long trains of thought in which she would forget her companions. Great anxiety about she knows not what. Became so bad that she had sudden at- tacks of insanity, characterized by all these symptoms in an aggravated form. She. and her friends fearing a total loss of reason, and finding their fears were shared by the " scientific" and " rational" physician in attendance, she was put under the care of a less learned member of the same school, from whom she received great relief.

At the time I saw her first, she informed me that she wished to try Homoeopathy, as her former alleviation lived too far to be readily accessible, and she naively adds: " His medicine does taste so bad." She feels herself go- ing on into the same condition as she was before. Also complains of the following symptoms: Is very tired, sleep does not rest her, she is sleepy all the time ; joints sore and stiff; headache in occiput, extends down between shoulders, also in sinciput, duU in character. No appetite, all food tastes the same. Sore, swelled feeling in right groin, much pruritus vulvae. Profuse yellow, leucorrhoea. Prescribing almost wholly upon the mental symptoms of the previous attack, she received Stramonium 3x. Upon this medicament, with occasional doses of Sulphur, she made an almost complete recovery in four weeks.

Case 3. — Mrs. G , aged 24. Married five years, in

which time she has borne three children. Two years ago, while menstruating, she took cold and suppressed the flow suddenly. Has been quite irregular since. Was confined five months ago, and suffered from what she thinks was child bed fever. Under old school treatment she made a slow and partial recovery. Is nursing her child, but men- S

218 THREE CLINICAL CASES.

struates profusely every five weeks, as is her usual custom. Present symptoms: Much tenderness of spinal column; sore pain through the shoulders ; numb feeling in the left arm ; pain in the region of the heart, to shoulder ; " pull- ing down" sensation in heart; appetite poor; stomach bloats; tongue livid and flabby; menses profuse, dark color, bad odor, clotted, last four days ; much pain through the hips and back, of a neuralgic character — makes her very weak ; leucorrhoea before, after, or all of intermedi- ate period — very profuse, yellow, acrid, bad odor. Men- tal symptoms : Much nervousqess ; very excitable, always made worse by the approach of night ; the least noise startles her ; thinks robbers are in the house at night, but is too much afraid to look ior them ; memory failing— e. g., she went to the cupboard three times on the morning of this day for some simple articles, forgetting each time her errand ; much sore pain in eye-balls ; fears she will go crazy, which apprehension is shared by her medical at- tendant.

She improved greatly on Actea 30th, which, with Sepia 30th, made an almost entire change in her mental symptoms for the better.

The above records are submitted, not for their rarity, but, on the contrary, as examples of common cases of in- cipient insanity, in part being hurried to that undesirable goal by injudicious treatment. Coming as they do from the common walks of life, they confirm Dr. Hammond's statement that here is found the majority of insanity's victims.

I hold that such methods of treatment as the old school employs, more than an increasing population, are furnishing the inmates for our two asylums, as well as making a new one imperative.

In all the cases the influence of the puerperal state is manifest as an exciting cause, such observations having been already put on record by Ramsbotham, Playfair, Leishmen, and many other writers on midwifery. Indeed,

CORRESPONDENCE. 219

Esquirol goes so far as to state that post-partem affections gave rise to insanity in from one-seventh to one-twelfth of all cases observed by him.

In the first two, there is the added effect of shock, grief, in the first tending toward that terrible form of hoi>eless alienation — melancholia; in the second, fright tends to produce that no less dreadful condition — homo- cidal mania. The third, simply " Spinal Irritation," with the added drain of concomitant lactation and menstrua- tion, was, by injudicious and non-homoeopathic treatment, being hurried on into a condition of mental unsoundness.

Can we, as homoeopaths, do better ? The individual experience of our practitioners, the statistics of our asy- lum at Middletown, New York, I think give this question a most gratifying answer in the aflRrmative.

The temptation to fly to narcotics and sedatives in nervous diseases is certainly strong, but in the light of the failures of the so-called " scientific medical schools " of to-day, is it best ?

Our Materia Medica is rich in mental symptoms, and we can, I believe, draw upon its stores with confidence that it will bring health to our patients and satisfaction and success to ourselves.

CORRESPONDENCE.

Richmond, Ind., July 26th, 1883. It is Not a Pact.— In your issue for July, page 49, article : Is it a Fact, R. Ludlam, M. D., is made to say ; that, Pregnant Women having Leucorrhea, f%ever have naaaed. This is one man's experience, and so far, so good ; but it does not make the thing an infallible truism. My experience has been very differ- ent indeed. The worst case of nausea and vomating of pregnant women, I ever had, was also, one of the worst cases of Leucor- rhea. It was in a small, nervous, spare and generally pale, del- icate woman ; just turned of twenty-five years. Had been mar- ried about six months when she became pregnant. Commenced being sick in the morning, even before rising; when only about

220 CORRESPONDENCE.

four or five weeks gone. The family physician (Allopath) was called in ; he treated her for two months or more, without the least effect, except for the worse, as she became very emaciated, tremulous and excitable. She was compelled to keep her bed constantly. The sickness was spread throughout the entire day. The doctor finally gave the family notice ; that, the woman was in a most dangerous condition, and that he feared he would have to effect abortion, in order to save her life. A consultation was proposed, and rejected, by the friends. I was finally sent for, and in trying to get her early history, I found she had com- menced menstruating very early ; usually regular, but very free and dark. Was subject to infant leucorrhea from her third year ; often so profuse as to greatly stiffen her linen. This vagi- nal discharge kept on more or less constantly until after quick- ening. The leucorrhea was variable in character, at times thin and watery, at other times yellow or green and more or less the thickness of ordinary cream. I prescribed tobacco smoke, from a merschaum pipe, on the veranda, adjoining her room. The cure was prompt and permanent, and the leucorrhea was cured by Sepia ; giving it high or low, as the condition of my patient seemed to demand it. Aft^r quickening she gained flesh rapidly, up to the time of delivery. Leucorrhea occasionally made its appearance, particularly, when on her feet much. At the seventh month she had some threatening of premature labor, attended with sickness and leucorrhea for a few days, but Pulsatilla con- trolled all unpleasant symptoms, and my patient went swim- mingly forward, had a quick, natural delivery, and a good re- covery. In 28 months she was again caught, and the leucor- rhea, which troubled her occasionally when nursing, became more profuse than ever, and morning sickness with vomiting, followed in as before. I gave her tabacum for a few days, but as the nausea did not entirely subside, I resorted to tobacco smoke, as in the first case, with the same beautiful results. This was a trying and singular case. She never could bear tobacco smoke when well, as it generally made her sick and dizzy. Hence I was so cautious in having the smoking done outside of her bed chamber, that if it did not do, as desired, I could at once cut off the current by closing the window. The smoke was perfectly pleasant to her, and beneficial beyond all my sanguine expecta- tions. Her leucorrhea was controlled in this, as in the former attack by Sepia. The first child was a boy, the second a girl, both did well. I have had numerous cases, where nausea and

BOOK NOTICES. 221

x.

leucorrhea were simultaneous during pregnancy. Having Just had a case in a woman of a strumous habit, who had both troubles almost during her entire preznancy.

I have Just conversed with Dr. Emmons of our city, who says, that his experience corroborates mine.

O. P. Baeb, a. D.

BOOK NOTICES,

MEDICAL ESSAYS, 1S12-1882. By O. W. Holmes, M. D., Hoagbton, Mifflin

A Co., Boston.

This volume of 440 pages contains nine essays; and the mechanical execution is a credit to ike publishing house of Boston. We regret that we cannot say as much with regard to the authors method of treating a scientific subject. "Homoeopathy and its kindred delusions,^' is treated by this caustic writer from the stand point of theory alone, Dot from scientific experimentation. Any experiment, on any subject, to be of the slightest value to the scientific world must be of such a nature, that, the circumstances and materials being given, they can be verified by others and their truth or falsity demonstrated. Where would the science of chemistry be had its experiments been treated by the method of Dr. Holmes? Hahnemann never proposed to submit his discovery to the belief or faith of any man. He simply asked that his experiments be submitted to the crucible of scientific research under given con- ditions, and the failures published to the world. Truth is truth, whether Dr. Holmes believes it or not. Faith can have no place in Science, and ho man ought to know that simple fact better than the author. The simple law of the similars is a verity. Lilce does cure like, whether he wants it to or not. Homoeo- pathy may be d priori tlie most absurd of all his ** kindred de- lusions," and yet be d posteriori true. Light to the blind, and sound to the deaf, may be equally absurd; and Dr. Holmes should not forget that his beli^ cannot change a scientific fact. In verba magistri jurare has never aided science one iota, and the skeptical negations of Dr. Holmes will not throw any light on the subject.

In 1842 this gifted author tried his hand at prophecy in the following: **Not many years can pass away before the same curiosity excited by one of Perkin's Tractors will be awakened by the sight of one of the Infinitesimal Globules. If it should

222 BOOK NOTICES.

claim a longer existence, it can only be by falling into the hands of the sordid wretches who wring their bread from the cold grasp of disease and death in the hovels of ignorant poverty.''

Not seeing it materiatize as rapidly as he anticipated, in 1861 he modified it to suit the time. *' The infinitesimal globules have not become a curiosity as yet, like Perkin's Tractors. But time is a very elastic element in Geology and Prophecy. If DaniePs 70 weeks mean 490 years, as the learned Prideaux and others have settled it that they do, the * not many years ' of my pre- diction may be stretched out a generation or two beyond our time, if necessary, when the prophecy will no doubt prove true." We think the author should have re-written this wonderful prophecy. Since it was put forth Boston has had its fair and raised $100,000 for a homoeopathic hospital ; and while this edi- tion was running through the press another $60,000 has been subscribed and donated for its enlargement. Surely a resident of Boston, and an Emeritus Professor of Harvard who knows so much, should know that homoeopathy does not*** wring its exis- tence from the hovels of ignorant poverty " in Boston. The book is readable and should grace every Medical library, if for no other reason than to enable us to ''see oursil as ithers see us."

** The Popular Science Monthly" for September b^ins with a clear exposition of ** The Germ-Theory of Disease," by Dr. H. Gradle, who, in plain words, showing his command of the sub- ject, explains the theory, defines the extent to which it has so far been found surely applicable, and sums up the evidence on which it rests. Dr. Felix L. Oswald continues his pungent pre- scriptions and recommendations of ** The Remedies of Nature " with a paper on ''Asthma," and its treatment. In "Fire-proof Building Construction" Mr. William E. Ward describes and recommends a system of building with iron and bHon without wood, which he has tried and found practicable and efiective. •'Insanity," by one who has been insane, is a picture, from the inside, of a disease whose moving springs and workings can be only most obscurely perceived from the outside, and offers sug- gestions, derived from the author's own experience, as to points in which the treatment of the insane and the management of asylums should be improved. Mr. E. T. Merrick presents a dif- ferent view of "Our Marriage and Divorce Laws" from that which was given by Mr. Stewart in the June number of the "Monthly," especially as relates to conditions in the Southern

EDITOR'S TABLE. 223

States. In *'How the Earth was Peopled/' by the Marquis de Saporta,the eminent Freeh botanist and palaeontologist, discuss- ing the origin and antiquity of man, attempts to show in what way and by what means the human race became scattered over all the continents at the very earliest stages of its existence. In ** Insects and Disease " Professor A. F. A. King charges mosqui- toes with being the most active and efficient agents in the dis- semination of malarial poison. Several other articles, such as ** The Chemistry of Cookery," "Agricultural Experiment Sta- tions," "Ways of Preserving Food," and "Primitive Map- Making," are of practical or special interest The editor vigor- ously sustains Mr. Adams in his attack on " The Dead-Language Superstition." The late Sir William Logan, of the Canadian G^eological Survey, is the subject of a biographical sketch, which is accoo^panied by the usual portrait.*

EDITOR'S TABLE.

Dr. R. G. DePuy (U. of M.) of Jamestown, Dakota,dropped in upon us the other day.

Died.— The venerable father of Dr. J. C. Wood of Monroe, Mich., recently died f6ll of years and ripe experience.

"Our society is in a flourishing condition. We are organized under the name of Barry and Eaton Medical Society. We meet every three months. The interest is good. At our yesterday's meeting, we had a paper on Diphtheria by Dr. Carpenter of Woodland, and the inclosed. Dr. C. S. Burton is our president and Dr. Chas. Snell of Vermontville, secretary." w. p. p.

In his annual address before the Wayne County Medical Sooiety, Dr. Brodie, the president of that learned body dealt with peculiar stress upon the importance of the microscopical school, the "developments" of which, he added, "bid fair to revolu- tionize the great fabric upon which the present science of medi- cine is based." If that be so, then the " great fabric" must be an arrant humbug, and the very foundation of the "present science of medicine " must be error and falsehood We had half come to that conclusion some time ago ourselves, but not on account of the microscopical school so much as from the innate charlatanry that characterize so much of the practice. It is not a comforting thought for the sick to be assured in thisofflcial and au- thoritative way , that the physicians who are treating them are not sure but they are doing them more harm than good.— ^e. News.

224 EDITOR'S TABLE.

We are indebted to Henry M. Smith, M. D., of New York, for tlie following :

A Curious Sobap of History.— TVon^ocftotw of the Med- ical Society qf the OUy and County of New York.^AX a meeting September 10, 1832, the following persons were proposed for hon- orary membership : John Sing Daroy, M. D., V. P. Medical Society of N. J , by Dr. Piatt; Dr. C. O. Kelly, Surgeon in the British Navy, by Dr.McCaffrey ; R.Dunglison.M.D., of Virginia, by Dr. Caruthers ; Prof. Hecker and Dr. Heyfelder, by Dr. Leo Wolf; S. F. Hahnemann, by Dr. Gray.

At a meeting November 12, 1882 :

Present— Drs. Oleves, Qray, Piatt, Bedford, I. H. Bodgers, Throckmorton, H. Sweeney, Leveridge, Bowron, D. L. Bodgers, Q. Carter, John Stearns, Baxter, Drake, Sheldon, Gilbert, Mill- doller, W. Anderson, Kirby,. James Wright, Stephenson, Sand- ham, Bernheisel, Duval, and others.

Jas. W.Anderson, M. D., of the Island of Cuba,and Samuel F. Hahnemann, M. D., were elected honorary members.

At a meeting July 10, 1843, on the motion of James B. Man- ley, it was Besolved. That the resolution* of this society of No- vember 12, 1832, conferring honorary membership of this society on Samuel F.Hahnemann, f of Germany, be and the same is here- by rescinded. k

Ayes— James Wright, Fenelon Hasbrouck, James Stewart, William P. Buell, Aaron Wright, E. H. S Hoi- den, James B. Wood, John B. Van Kluck, Ashley, Isaac Wood, B. K. Hofftnan, Kilbourne, Whiting, John Stearns, S. Hasbrouck, Bartlet, Vandervoort, Man ley, A. Under- bill, J. W. Bradshaw, B. B. Bobson, O. White, E. L. Beadle, Thomas Pitts, B. W. Budd, J. H. Cheesman, Mar- vin and H. D. Bulkley.

Nays— Benjamin F. Bowers and Benjamin F. Joslin.

On motion of Dr. S. Hasbrouck it was

Resolved^ That the resolution of Dr. Manly be published.

* There was no retolation, It wan an election by ballot.

t Samuel F. Hahnemann had died at Paris eight days previous to this vote, in the 88th year of his age; had been 62 years a Doctor of Medicine (probably more years than the oldest of these votes had breathed); was the author of nearly 200 dissertations on medicine (more medical works than some of them had ever read). Was the founder of a system of medicine (the Homoeopathic) that numbers more followers throughout the world than any other school whatever, and is the greatest boon to humanity even con- ferred by mortal man.

T. P. WII.540X. M. D..

Editor,

Business Manager.

YoL. XIV.

AN'X Akbou, Xo\ ember, \HHii.

Xo. o.

All subscriptions and business communications should be addressed to MEDICAL ADVANCE PUBLISHING CO., Ann Arbor, Mich. Subscription, $2.00 per annum.

The June No. of the Popular Science Monthly, a journal we have so often commended, contains as its leading article a paper upon " Medical Quacks and Quackeries, by Francis J. Shepherd, M. D." The article in question is a mere com- pilation of stories and statements concerning a class of per- sons whom the writer is pleased to call quacks and he adopts Dr. Johnson's definition of a quack as " a boastful pretender to an art he does not understand." In these particular in- stances the art in question is tlie art of healing and the quacks specified, are all medical. Guided by the definition it seems impossible for the writer to fail to include the entire medical profession, from the days of Hippocrates to Hahne- mann. If sober historical facts are good evidences, medical

2

226 EDITORIAL.

art was not understood by its many pretentious practitioners for more than two thousand years. It was an art that had no Materia Medica, no Pathology, and therefore no Thera- peutics in any scientific sense of the term. The theory of the men of those days have been almost universally over- thrown, and their practices almost wholly discarded. It was rarely by good luck, even that any of them stumbled upon any valuable fact or principle. They made great displays of wisdom, they made boastful pretentions to knowledge, they deluded the world by their assumptions of skill, and they gained both money and reputation by attempting to practice an art they did not understand. If to do that is to be a quack, then these men were quacks. There is no escaping this conclusion, for their posterity, the men of to-day, glory in the fact that they have discovered the wrongs, corrected the evils and discarded the errors of theif predecessors. And yet this writer upon quacks fails to include this great class of quacks, and satisfies himself by selecting out a few cases here and there and holding them up to view as sinners above other men. Dr. Shepherd is not a man well informed on this question or else he is unj4ist and untruthful. But the article he writes shows his animus clearly before it is concluded. Of course he is an Allopatliic doctor,'and as he has the miree of the Popular Science Monthlp he does not miss his chance, but promptly impales Homoe- opathy, and attempts to prote it the prince of quacks. At the outset he demonstrates his ignorance of Homoeopathy. In the art of writing Dr. Shepherd, therefore, is himself nothing less than a quack. He can be easily classified by his own showing as one who pretends to an ** art he does not understand." He writes to instruct the public. He only deludes himself and misleads his trusting readers. This is not creditable to the head or heart of even an Allopathic doctor.

In the October No. of the Popular Science Monthly the venerable Dr. Edward Bayard presents us an article on

EDITORIAL. 227

'* HomcBopathy as a Science." From the accompanying edi- torial it is clear that the editor is fairly disposed to offer some atonement for Dr. Shepherd's article, to which we have already alluded. The editor attempts to wash his hands of any responsibility in publishing the views of Dr. Shepherd on Homoeopathy and after disclaiming all feeling of parti- sanship, he then proceeds to overthrow Dr. Bayard's position and in effect cast his influence against the Hpmoeopathic school. He would have his readers believe that in under- mining Dr. Bayard's arguments he is causing the Homoeop- athic system to topple to its fall ; if indeed he does not hold that the outcome of the controversy is to place Homoeopathy Iwrs dn combat This is common to all writers of that school. If once they condescend to write us down we are thencefortl) dead beyond hope. Dr. Bayard's article is full of many good and strong points. He is to be congratulated for the candor and self-possession which so strongly mark his writing. But Dr. Bayard gives only his own views of Homoeopathy, when he says that " Homoeopathy as a science is the law of the vital force," he is talking in a language common enough a half century ago, but wholly out of date to-day. And when he tells us that " disease is the impairment of the equaliza- tion of the vitkl force." he shows us the torce of his early education. The facts of Homoeopathy are one thing; the philosophy of Homoeopathy is quite another thing. The editor in answering Dr. Bayard very properly raises the ques- tion, " Is there any such thing as the vitdl force ?" He coulfl have put it much stronger and said, it is quite universally denied by modern scientists that there is any such thing as a vitdl force. Dr. Bayard's facts are true enough, but the homoe- opathic school cannot be held to endorse his philosophy. The editor of the Popular Science Monthly may demolish Dr. B's. reasons, but he does not, and cannot touch liis facts. Homoeopathy admits of explanation on -modern scientific grounds, and placed upon that ground, the editor would hardly find his task of answering, as easy as when he meets a man schooled in the philosophy of fifty years ago. The

228 THE SCIENCE OF FIBRIN.

journal in question has done excellent service in exposing the errors and evil practices of the Allopathic school, and we have no reason to complain of the showing it has of late given Homoeopathy, but we protest against making the " vitAl force " an}^ necessary part of our philosophy, or that our practices shall stand or fall as the " vitiil force " shall be maintained or overthrown. Homoeopathy is a simple, straight-forward system of Therapeutics, a plain and easily understood method of healing the sick. It may or may not be explained. Put it to practical test; that is all we ask.

THE SCIENCE OP. FIBRIN.

READ BEFORE THE MICROSCOPIC CLUB OF BUFFALO.

BY KOLLIN R. GREGG, M. D., BUFFAIA N. Y.

At the late meeting of the American Institute of Homoeo- pathy at Niagara Falls, I was severely attacked, both pub- licly and privately, for my opposition to the accepted teach- ings about bacteria. Under the excitement of mind incident to those attacks it occurred to me to boil and also to rot some blood and see what the effects of both would be upon the fibrin it contained.

TKe attraction for each other of. the granules of fibrin, on coagulating from the fluid state into granules, and tlieir cohesive power after coming together, appear to be very great; and my idea was to first partially and then wholly destroy that cohesive power, and watch the results. Behold what a revelation! Nothing more marvelous was ever seen in the microscopic world; and a new science has thereby been opened to the study of men.

All the forms that the bacterists ever pictured or saw, in their bacteria, are exactly repeated in boiled blood; and there are many more forms found therein than they have ever mentioned.

There are the so-called ** micrococci " by the million:

I

R. R. GRFMU. 229

there are spherical bacteria, "aggregated in pairs and in fours," or in any other number that may ba wished; there are "chaplets" and *^ rosaries" in great numbers, and straight j'trings of beads by the hundred; there are "dumb-bells," "clubs" and "rods;" there are "straight-rods, sometimes [often] of considerable length, which break up by transverse sub-division into seperate cells; " there are " threads felted " and ^^ felted into swarms ; " there are " spirals " single and double, triple and even quadruple; there are the chains with short and close, and with open and long links; th3re are stocks with lashes on them much like whips, and also " shep- herd's crooks ; " there are " tails " and " spikes " and still other forms ; and all consisting of the fibrin of healthy blood which had been organized by standing, first into granules, then threads or fibrils more or less of spiral form ; and next par- tially disorganized by boiling, to take all the numerous forms to correspond exactlv with what the bacterists have seen in disease and miscalled bacteria.

Rotted blood shows even still more astounding results. It gives far greater numbers of all the forms just named, and many more beside. In it are to be found rings and pieces of rings, hooks and loops, " watch chains " with a loop upon one end and a hook upon the other; crosses and horseshoes, several letters of the alphabet, as I, U, V, X, Y, etc. Indeed there is scarcely anthin*r in the way of form, from a straight thread to a ring and globe, or that a thread or combination ^ of threads or of grannules can be put into, that is not imi- tated more or less exactly by fibrin in rotting blood. I have one Specimen which shows a pair of open pincers; others which show pairs of compasses or dividers open ; canes with heads and some with hooks ; and many exact pictures of the musc« volitantes, or granular threads th:it many people see at times dancing about before their eyes, and think fore- bode serious consequences to their vision. These muscte volitantes which have never been explained, I now see are made up of various combinations of granules of fibrin in the fluids of the eye, and cast their shadows upon the retina, to

230 THE SCIENCE OF FIBRIN,

be thereby perceived. And last, but not least, I have numer- ous imitations in the form of tadpoles and wrigglers and one of the most beautiful imitations of a fanciful letter K that I ever saw.

In short, as it looks to me now, fibrin appears to contain most, if not all, of the formative forces of the organic world. It clearly shows itself to be but one and the first step in organic matter, from the principle of life within us, as this force of life is but one and the first step from its creator. Thus it is that this new knowledge of fibrin must bring us nearer to the beginnings of all living tilings than ever before; and 1 am not certain but it will open up to us in a new light the whole question of generati on in both vegetable and animal life.

In addition to saying that fibrin appears to contain most of the formative forces of the organic world, I will go farther, and say that this force, or these forces of fibrin appear to be in direct and intimate relations with the other forces of the world, if not with those of the universe. One thing is certain, the attraction of the granules of fibrin for each other, and their cohesive power after coming together, are among the most remarkable manifestations of the:?e forces that is to be found in all matter. Even repellant pow- ers of no minor degree are shown by said granules, under some circumstances. In no other way can we account for the almost infinite variety of forms they give under various combinations, than through the powerful attractions for each other under many conditions, and their repellant powers under others. The attraction of fibrin for oil globules and for some other kinds of matter, also appei^r to be very marked.

Well, applying these facts to generation, what do we find? In the germ of every organic thing, fibrin undoubt- edly exists. In fact, it is through the fibrin in them, that form is given to all germs. Tlacing a germ* then under the requisite conditions, according to kind of moisture, warmth etc., for its development, the latent powers of its fibrin are released and set to work. Those released, and astonishingly

i?. R. GREGG. • 231

active powers, attract other fibrin and other matter into the substance of the developing germ, until, through those fibrin forces, thus acting, and all directly superintended by the yet superior principle of life, the ultimate being comes.

And here let me tell the scientists, that if they wisli t(^ study the buildings up of life in all its steps, and in all its forms, whether vegetable or animal, they must study its build- ings down. That is if they will study the disintegration of organic matter under decaj^', they will find 'it going down, step after step, in regular order, from the higher or highest organization, down to the next below, and from this to the next lower still, and so on until it disintegrates into its water- gases, and salts or other inorganic matters.

And in this going down it accurately repeats every step, but in the exact inverse order of its going up. That is, the last step of organic matter under decay, before it dissolves into its inorganic elements, is an exact repetition, but inversely of the first step taken to build up an organism ; and the first step, after death, that disintegration takes, is like the last one taken to perfect the proper combinations of organizations. This may be stated as positively as though it were a law ofmature. and it is not improbable that it is a law.

A rotting leaf or blade of grass shows this principle of dis- organization and it is a singular thing that the fact was never carefully studied, and more of life and its organizations learned through it. I have studied this subject not a little, for over .twenty yeara and am not giving fancy sketches.

If we knew nothing as to how a house were built, and should first see one after it was completed, common sense would not suggest that we begin at the foundation to tear it down to learn how it was constructed, and involve ourselves in the general ruin — which is nciuch the way however that both life and disease have been hitherto investigated. But we would begin at the topmost shingle and take everything apart whether shingles, boards, timbers or bricks, in the inverse order of their having been put together, then we could learn something of the manner and ways of its con-

2:^»2 THE ^CIESCE OF FIBRIN.

struction. And this is precisely what must be done hence- forth in regard to life and disease, if we would ever master the mystery that enveloi)s both them and us.

But we must return to our manipulated blood for proof of what is claimed in our main Issue, or that of bacteria. After conceiving the idea of boiling and rotting blood, I requested my butcher to bring me some healthy bullock's blood, it not being practicable of course to get healthy human blood \\r sufficient quantijty for extensive investiga- tions. A healthy animal was killed one afternoon, and the blood, about a quart of it, brought to me tlie next morn- ing. A half pint or more of this was boiled at noon of that day, for about an hour. Then a small drop of this boiled blood was put upon a slide, and at the same time a sirtall drop of the same blood unboiled was put upon another slide,- so as to carefully compare the two.

Now, as is known, boiling the fluids in which are the real bacteria, kills these organisnis; so if they had secured an entrance into this blood, between the time of its being drawn and of my boiling it, ( tb have developed bacteria in great numbers, as it is claimed they will in a few hours in all fluids in which they grow), my boiled blood should not have shown them at all, or but little if any ; while the unboiled blood should have shown them in considerable if not in great numbers. But the facts were all exactly the reverse. In the boiled blood, as already said, all the forms appeared that bacterists ever pictured, or have spoken of, and many more beside; while in the unboiled blood, but little of those forms appeared at all, and where they did, it was clear to see they were uncombined, or loosely combined, granules of fibrin.

There were tens, hundreds, thousands, tens of thousands and even millions, according to kind, in the boiled blood, of the exact forms that all bacterists have been telling us so persist- ently for many years, were found in the blood of various dis- eases, and are the causes of all the diseases wherein they are found. How was the development of these forms brought

i?. R GREGG. 233

about by simply boiling the blood ?^ This is one of the eas- iest questions in the world to answer.

As has been stated, fibrin coagulates, or organizes, from the fluid state, into granules, and these granules cohere to each other to form threads or fibrils in great numbers, where congestion takes place under disease, in any part of the body. And the same or a similar action takes place in the. blood after it is drawn and allowed to stand quietly a few minutes. It is indeed, to this action of fibrin that the clotting of all drawn blood is due as you know.

Very well, boiling it moderately destroys in part the cohesive power of the granules of fibrin for each other; and gives us an innumerable number of forms just according to whether that cohesive power is entirely killed in some of the fibrils, thus breaking them down in their separate granules, the so-called micrococci of disease; whether it is not so fully destroyed, but enough to break the fibrils up into very short pieces, called bacterium termo, or longer pieces, like rods? clubs, etc., and called bacillus subtilis; or whether it is left still more intact, and then gives us spirals, which are called spiral bacteria; also chains, rings, felted threads, or what not, and all falsely called bacteria when found in disease. And this is all there is of this part of our subject. These granules of fibrin are not, however, all wholly separateil from each other without prolonged boiling. In the specimen boiled for an hour, I had to let it stand and rot for two or three weeks before all the fibrils were broken up into short pieces and granules.

Indeed, fibrin possesses a most remarkable life or tenac- ity of life of its own. In one specimen of the blood boiled for an hour, there is as beautiful an example of orgaization as could be anywhere found in animal life; and which was apparently the result of the organizing forces possessed by. the fibrin, independently of, or separated as it was from all other life, or sources of life. This specimen quite evidently organized on the glass slide, after the drop of boiling hot

2:m the science of fibrin,

blood was placed there, and whilq it was cooling and the liquid part evaporating from it.

Further details of the rotted blood may not be uninterest- ing. I poured a half pint of the healthy bullock's blood into a wide-mouthed glass bottle, corked it as tightly as a closely fitting cork would allow, and placed the bottle where its con- tents would maintain a temperature of lOO*^ to 150°. The first few days there Avas little change to be seen by the micro- scope, in that blood. After that, however, the wonders began, and have not yet ceased, although it is now ten weeks since the experiments began. No paper of ordinary length would allow of the half being told of the marvels that have developed in that bottle. Tliere is ten times, if not a hun- dred times, more life in blood than has ever hitherto been conceived.

At the end of one week changes had begun in its fibrin, by showing much of it organized in a way to give beautiful samples of anastomosing vessels, as though the bottle were full of life— but not as beautiful in this respect as the one specimen of boiled blood had given. As yet few forms of the so-called bacteria had appeared, though there were some to be seen. In ten days the anastomosing vessels were less conspicuous, and more "bacteria" appeared. In two weeks there was still less vascular appearance, and much more evidence of the fibrin parting into separate fibrils, and these breaking up into rods, clubs and granules. In sixteen days nearly all the anastomosing vessels were gone, though there were yet traces of them ; and then " micrococci " (gran- ules of fibrin) began to show by the million, and most of the other ''bacteria," as rods, clubs, rosaries, chaplets, etc., (fibrils of fibrin ), developed by hundreds, thousands and tens of thousands, a.s the case might be. Indeed, in proportion as the fibrin broke down from its first and higher organiza- tion by rotting, in just that proportion did the broken pieces of fibrin appear, and it was truly wonderful the great variety of forms they took. There is scarcely anything in form, as alreadv said, that this broken fibrin did not imitate. From

INEBRIETY IN WOMEN. 285

the film on the surface of the blood in that bottle, I obtained some of the most beautiful imitations of single and multiple linked watch chains, like those worn by both gentlemen and ladies; and others like hair chains.

After that time I examined the same blood every two or three days, for ten days to a fortnight longer, but saw noth- ing of particular interest, excepting the further breaking down of the fibrin into very short pieces and granules, until there was little else to be seen. From that on, I paid little attention to it, only to condemn my indolence in not throw- ing the putrid stuff out ; but fortunately did not do it, because of an undercurrent of hope that there might something further come out of it. And this brings up another chapter of interest

[TO BE CONTINUED.]

INEBRIETY IN WOMEN. ITS CAUSES AND RESULTS-

FROM OBSERVATIONS MADE AT THE REFORMATORY PRISON FOR WOMEN, SHBRBORN, MASS.

BY LUCY M. HALL, M. D.. PHYSICIAN IN CHARGE.

* * He who discovers and eradicates the sources of con- tamination which would result in the outbreak of diphtheria or typhoid fever in a household or a community, does a far better work than he who simply cures or conducts to recov- ery the victims of preventable disease.

In no department of medicine does this question of pro- phylaxis assume so high a degree of importance as in deal- ing with the mighty problems of inebriety, for whether a vice in the beginning, or whether attributable to the action of a diseased nervous organism, inherited or accidentally acquired or whether produced by a combination of causes, inebriety at length becomes a disease in« itself, and demands at our hands all the consideration due to any other diseased state.

Moreover, as the results of this condition are not con- fined to the individual, but are transmissible to the oflfsprin<]r

1>3(> INEBRIETY IN WOMEN.

of the inebriate, burdening the world with beings faulty in organization, in whom the nutritive processes have been [>er- verted from the moment of tbeir earliest action, necessity for prevention of an evil so wide-spread and so lasting, assumes double importance.

Nor are all the conditions antenatal whereby the inebri- ate's children are defrauded of that which is the birthright of every child, a sound body in which a sound mind may expand and develop. These children are too often, in con- sequence of the parental vice, poorly clothed, poorly fed, liv- ing amid squalor, discomfort, and perturbation, subjected to exposure to cold and wet, to cruel beatings, especially to blows about the head ; in short, their congenital deficiencies are so supplemented by post-natal surroundings the most detrimental, that we are often in doubt as to the origin of the defects which we are called upon to note.

I will here state that of eighty-two inebriate married women, I find thirty-two who have been mutilated about the head until from one to twenty scars per capita are visible. In all these cases it was alleged that the injuries were re- ceived at the hands of drunken husbands, and it is safe to suppose that the husbands did not always escape from the encounter unscathed. Amid such wholesale brutality the children are always the greatest sufferers. I find that of four hundred and eight children born of one hundred and eleven inebriate mothers, eighty.-three of whom had inebriate husbands, two hundred and twenty-seven perished in infancy and early childhood; while of the survivors many are in- fants and young children, having apparently but a frail ten- ure of life.

From the standpoint of the sanitarian the results of in- ebriety are too far-reaching, too complicated and perplexing to be fully presented here. In order that the causes of this great evil may be more fully understood, a vast amount of work must be accomplished, and each searcher for truth, in his own particular field, must labor patiently to swell the slowly accuraulatmg mass of material from which finally a

LUCY M, HALL. 237

basis for more well-directed and efficient work in tlie preven- tion or control of inebriety may be evolved.

In the hope of adding something which may aid those who are laboring to the accomplishment of this end, I have directed my efforts toward ascertaining, so far as possible : Ist, The age at which the habit of using intoxicants is most likely to be formed. 2d. Associations, inducements, etc., which led to their use in these cases. 3rd, Condition, occu- pation, and place of residence at the time. 4th, Intoxicat- ing beverages first used. 5th, Place where they were drunk. 6tb, Hereditary influences.

Of the 204 cases examined by me, 132 were committed to the prison for drunkenness, 56 for crimes against chastity and public order, and 16 for crimes against property. Their ages when committed averaged thirty and one-half years. Sixty-five were between thirty and forty-one years of age; forty-nine between twenty-five and thirty-one years; thirty- four between twenty and twenty -six years; and thirty between fifteen and twenty-one years; the remainder were over forty years of age. Fifty-six were serving a first sentence, forty- one a second, forty-two a third, and twenty-six a fourth. Of the older cases many could not tell the number of sentences which they had received. One of them thought she had been committed more than a hundred times. Seventy-three were married, but separated from their husbands; seventy were single; thirty-nine were-anarried, and twenty-two were "widows.

Twenty-seven began to use intoxicating drinks before they were ten years of age; eleven began between the ages of nine and fifteen years; seventy-four between the ages of fourteen and twenty-one years ; thirty-seven between twenty and twenty-six years ; thirty-three between twenty-five and tnirty-one years; nineteen between thirty and forty-one years, and three between forty and fifty-one years. The average age was eighteen and one-third years. Moi^e than (nie-half had formed habits of intemperance before they were twenty-one years of age, and more than one-third

238 INEBRIETY IN WOMEN.

at ^he giddy ages between fifteen and twenty inclusive.

One hundred and thirty-two claimed to have drank socially, and never otherwise ; forty-seven admitted that they loved the liquor which they drank; eleven gave trouble or anger as a reason for the indulgence; fourteen were more or less ill when they began, and I regret to state that in three instances it was alleged that the appetite was awakened by the use of stimulants which had been prescribed by a physician. In the other cases a mother, husband, or some officious friend had recommended or urged their use as a medicine.

One hundred and thirty-two began to drink with female friends; twenty-eight with male friends (20 of the 28 were the husbands of the women); three with male atid female friends together, and seven alone. A few began by drinking beer in mill or shop while taking lunch with their compan- ions.

When the indulgence commenced, one hundred and fourteen were single; seventy- two married; eight married but separated from their husbands, and ten were widows. Forty-eight were engaged in domestic service, forty-four worked in mills, and fifteen in shops (usually shoe shops). One hundred and ninety-seven resided in the city, and seven in the country. One hundred and twenty-eight began by drinking beer; thirty -seven by drinking whisky (usually as punch at first) ; twenty began with wine, and eight with gin ; eleven were unable to remember the beverage first used. A large number avered that they fell into habits of intoxica- tion by first using . a substance familiarly known as tonic.* This beverage is harmless in itself, but when drunk in the company of those who were indulging in stronger drinks it was soon supplemented by beer or other intoxicants and thus insidiously the habit was formed. Ninety-one began to drink at their own homes, forty-nine at the homes of friends, and sixty-four in saloons.

* Made of bops, sugar and water, chained with carbonic acid, and colored with burnt sugar.

LlVy M. HALL. ^ 239

In but one hundred cases were even the most meager details of the family histories obtainable, but these, no doubt, may be considered to fairly represent the class. In- temperance, transmissible disease, or any family neurosis which would be likely to affect the offspring unfavorably were noted.

Of the fathers, sixty-seven were dead.' Of these, twenty- four died of consumption, four of heart disease, two of kid- ney disease, one of scrofula, and one of neuralgia; one com- mitted suicide. In several cases the cause of death was not known. Fifty-six were intemperate, eight were extremely nervous, and three were insane. Of the mothers, thirty- seven were dead. Of these, twenty-one died of consump- tion, three of heart disease, one of cancer, one of epilepsy, thirty-one were intemperate, twenty-five were extremely nervous, and three were insane. Of the brothers and sisters, fifteen were known to have died of consumption and two of heart disease; eight were insane, and two simple. Of the grandparents, four were known to have died of consump- and two of heart disease; two were known to have been insane. Of the uncles and aunts, thirty-two were known to have died of consumption, one of cancer, and one of heart disease; twenty were known to have been insane. In all but eight of the one hundred cases examined were one or more of the above conditions found to have existed in the family. In one case— that of an extremely nervous but intelligent girl— both father and mother were very nervous, a grandfather, brother, and uncle were insane, and two broth- ers were simple.

It may be of interest to add that of these 204 inebriate women, 126 had been guilty of other crimes ; yet in but six- teen" instances did the first commitment of these crimes antedate the habit of drinking. Fifty-three used snuff in the mouth (in Massachusetts a habit confined chietiy to the mill population); forty-three used snufi* in the usual way, thirty-nine smoked tobacco, and three opium. The last named vice is making rapid headway in New York and in

240 i INEBRIETY JN WOMEN.

many of our western cities ; in Boston only a beginning ha? as yet been made, but a swift spread of the evil is feared* Six used opium or morphine hypodermically or per ovem.

Concerning nationality sixty-seven were Irish, fifty-two Irish-American, seventeen American, seven negro, seven of mixed foreign parentage born in America, and twenty-two born in other countries. Of the Irish-born forty-five came to America when young, and claimed never to have used intoxicants prior to this time.

To determine the actual effects upon the system of the habitual use of alcohol is a difiicult or leather impossible task. Yet nothing can be more obvious than that results the most profound and enduring do follow its use. Boehm tells us that "alcohol must be ranked with those narcotics which, after long-continued use, leave behind them perma- nent and enduring changes in the bodily organs. These changes may not be recognized by the minute anatomist, but they may be known very unequivocally by persistent anomolies of function." * In no direction in this abnormal condition and action so constant and so well marked as in those most delicate and complicated structures, the brain and nerves. The^other expressions of a diseased condition, jn the inebriate may, often with a show of reason, be attrib- uted to other causes than the toxic action of Alcohol, but the evidences of the fatal deterioration in these organs are unmistakable.

In classifying the cases which have come under my care I have made four divisions, each embracing, beside its representative members, many who presented minor degrees of variation from the type of the class :

Class I. Here an unstable state of the emotions begins to manifest itself. The woman is often depressed in spirits: weeps easily, and is easily consoled. The most trival circum- stances will annoy and excite her. All the currents of her life are disturbed, and are in inharmonious relations with each other. This is partly from the action of Alcohol upon

♦Ziemssen's Cyclopedia, Vol. XVII.

LUCY M. HALL. • 241

the tissues of the system, partly from the moral protest which is goading the victim with a sense of the ruin in which she is becoming involved.

Class II. In this class we have the psychical disturb- ances more marked. The woman is apprehensive, believes that she is wronged, and imagines every one to be against her, the temper is irritable, and often uncontrollable ; the moral sense is involved ; the perception of what constitutes right and wrong is blurred and distorted ; purposeless lying, deceitfulness, a general absence of integrity and honesty, characterize this condition : and the higher the intellect of the woman the greater the divergence from the normal stand- ards. The patient believes that she can easily reform, and resolves to do so without a moment's doubt or hesitation. The capacity for suffering is active, remorse being a prominent factor in the distress which so often possesses her. The eye is unsteady, and the facial muscles often twitch nervously. Gastric and intestinal disturbances are common in this class, and headache an almost constant accompaniment.

Class III. This is a dual class, and one in which, from the long, continued use of intoxicants, the vitiil forces have gradually come to "equilibrate around new centres," and the resultant conditions have assumed a degree of fixity, from this persistent abnormal adjustment of the life forces. In this class we find ourselves dealing with persons whose reasoning powers and governing impulses have little in com- mon with our accepted standards. All the higher qualities have hopelessly deteriorated. If the woman is a criminal she has but little comprehension of the significance and extent of her crimes; if of a phlegmatic temperament, tlie capacity for suffering is diminished, and the impulses are less active than in either of the preceding classes. The brain and nerves seem to have gone through a stupefying process. The will is weak, and the woman is not troubled with regrets or a sense of her failures. The Divine fire which characterizes our humanity has been almost completely extinguished in her, and she has sunk to the level of tlie 3

242 INEBRIETY IN WOMEN.

lower animals; in some respects indeed she is below the intelligent brute.

If some intercurrent disease does not end life, the patient will remain in this condition for a long period, finally sink- ing into a state of complete dementia. The system in these cases seems to have established a tolerance for the poison, and the nutritive functions are less actively disturbed than in patients of either of the other classes.

In the woman of a more highly nervous temperament, we find at this stage a very great divergence from the pre- ceding type.

Here the system is in a state of rebellion against the unnatural and long continued stimulation. The w^oman is broken, shattered, demoralized. Her condition is one which approaches to a state of permanent intoxication. Her inhib- itory centers have become hopelessly impaired in structure and action; she is excitable to the wildest extreme; she weeps at nothing, and blesses and curses in the same breath ; her anger is easily aroused, and she becomes ghastly in her rage; the discipline of the prison is irksome and often unen- durable to her; she has no control over her passions or her appetites, and she is often aware of this. Said a poor girl of this class to me the other day — she had been returned to the prison after a few weeks of freedom (?; — '' I know I told you before I went out that I'd never drink again. 1 knew then that I could not help myself if I got where the liquor was. Still I am sure I meant to try, but I got drunk the da}' I left here, and have kept so nearly all the time since. I never will try again, for it is of no use; I wish I had a ten years' sentence."

This is only one case of scores which I could mention. That they have passed the limits of responsible action and are under the control of a diseased organism, none the less real because self-induced, cannot be doubted. Protection and not punishment is demanded in these cases. Absolute control is necessary, but not with the surroundings of a prison or a mad-house, for to consign them to either is an injustice.

ECZEMA CURED BY GRAPHITE. 243

There are usually marked physical disturbances in these cases; headache is a prominent symptom, also a dreadful feeling in the head is complained of — a sensation as though it were opening and shutting at the vertex, spinning around, or as though a tight band were about the forehead; a com- mon expression with them is, "my head is crazy." Fine muscular twitchings and tremblings are observed, also the muscles are relaxed and wanting in tonicity. A prominent and constant accompaniment of this state is the generally lowered tone of the system. The vHal forces have been consumed far in advance of the years of the patient, she " often having the appearance of being ten or even twenty years older than she really is, and her powers of exertion and endurance partake correspondingly of this prematurely senile condition — gastric catarrh, or gastritis, bronchial catarrh, affections of the heart, liver, and kidneys are fre- quent but not constant complications. In this stage of her career death often comes to the relief of the wretched patient, and the scene is closed. Otherwise in Class IV we find her parting with the last vestige of her reason, and sinking into the oblivion of hopelegs dementia, tossing in her restlessness and wretchedness toward some wilder form of insanity, or revelling in the splendors of untold wealth and boundless possessions, she goes on swiftly and surely, helpless and mindless, to the death which awaits her.

ECZEMA CURED BY GRAPHITE.

FROM THE ALLGEMEINER HOMO:OPATHIC ZEITUNG, TRANSLATED BY A. MCNEIL, M. D.

BY DR. A3IBER(i, OF ARXSBERii, GERMANY.

I was called on October 1st, 1882, to the one-year old child of an official who had fever arising from a cold which was removed on the following day by Aconite 3. I found the head and almost the entire face of the child covered, by

244 CARE OF THE IXSANE.

black et'zematous crusts and moist pus, secreting spots. 1 was told that this eruption had existed thr^e-quarters of a year. The former attendant had considered treatment unnecessary. Friends had said that it would be injurious to heal it as is so frequently expressed by the public. Cream, fat and the like had been used to soothe it. I also advised against a rapid removal by external treatment. I allowed the cream to be continued, and gave Aethiops antim 8, with such good results that in eight days the child was entirely changed and beautified. But in fourteen days the cure had not progressed further, and after the discontinuance of the medicine no improvement. New vesicles and crusts now# ^appeared. I then gave 6 drops of Graphites, 2(X) in 80 grammes of water, to be given three times a day and then twice in teaspoonful doses. No further prescription was necessary, for during its use and after effects the eruption was cured and now remains seven months after."

[I ask those who deny the presence of medicine or medi- cinal action in potencies above the 10th, to explain how chronic eczema disappeared so soon after the administra- tion of the 200th. — Translator.]

CARE OF THE INSANE.

READ BEFORE THE HOMOEOPATHIC MEDICAL SOCIETY OF OHIO,

BY J. P. <JEPPEltT. M. D., CINCINNATI.

Centralization has been in the past an agency or the pre- decessor of decline, the antecedent of too great development of parts of a unit. In nations one seat of power has pre- ceeded their obliteration. In arts one school predominating has ignored extraneous worth and prevented growth, and with cessation of growth has begun retrogression. In ani- mal nature the development of one quality has weakened or extinguished others. The Glyptodon developed excessively its armor of defense until its carapace became such a bur-

J, R GEPPERT. 245

den as to prevent locomotion and efforts for its preservation and its race died from off the earth. So with communities, the neglect of any duties necessary to preservation weakens them, even the neglect of the insane. The State had better not encourage the pursuit of specialties to too great an ex- cess at the inconvenience of a class ef its unfortunates.

The mind of man needs recreation. Change of study or varietj' of pursuit afford that change of activity which is needed for health. The impaired mind specially needs recre- ation, change, variety. In the tendency to classification that now exists, there is a factor that prevents healthy vari- ety. This method of classification and determination of individuals into communities with a peculiar disease, aggra- vates the condition of those afflicted. The disease feeds upon the deleriorating entities about it. Where there is not a healthy mental condition, the entities proceeding from the minds of those imprisoned in large asylums have a subtle effect on those brought* in contact with each other. We purify other media, as the air, by mingling the pure with the contaminated. The mentally impaired can be better im- proved under a healthy influence than under an unhealthy.

The State has transcended her eleemosynary duties in* providing places for keeping the mentally sick in large groups. This provision relieves the personally responsible of their duties and thus favors the production of like afflict- ed from the same parentage. It removes from divisions of the State the influence members of these smaller brands of government should exercise for the improvement of the afflicted. It makes impossible personal active interest of relations. It renders possible the kidnapping and imprison- ment of sane persons. It makes possible the constant inflic- tion of cruelties that cannot be readily investigated by the public. This system of crowding so many human beings into small compass, many of whom are more humane and fit to be at perfect liberty than those put over them, renders possible that abuse of power, whereby for a money gain, hundreds are abused, starved, fr(5zen, ducked, drowned, ren-

246 CARE OF THE INSANE.

dered physically and mentally greater wrecks than before their entrance into one of the evils of modern life, State lunatic asylums. These asylums have supplied history with some of her most mournful tragedies. The soul-piercing cries of burning victims, the wailings and heart-sickening pleadings of tlie confined are a strong argument against this perpetuation. Who are these persons actively engaged in securing appropriations for erection of these pandemoni- ums? Are they philanthropists? Or are they politicians, seekers after gain in a questionable way ? Do we find active, thoughtful citizens giving this subject the attention it de- serves? What portion of the community know anything of asylums built by the State for them? The abuses are always existing, but they, are so carefully covered from the public that the public is shocked when a Tewksbery rev- elation is made ; yet some of the scandalous practices of that institution are not unique to it. Our State offers too great temptation for mercenary men to avoid the portions made by these institutions. Were the salaries about the asylums rendered so small as to exclude money seekers and allow men of large hearts who appreciate and respect the precept, "The love of money is the root of all evil," then would follow improvement in the treatment and condition of the insane. The results of the treatment of insane in large asylums have not been satisfactory. We have no less insanity at this period of the world than formerly. The State at great expense only changes the bearers of inflic- tions from the sane to the insane. That is on the plea of protecting the public who are sane from assumed dangers from the insane the State positively inflicts on the insane, the many abuses received by inmates of asylums.

We would recommend that all insane persons be kept within their native county, and when no special reasons exist for a change, that the relatives of the insane person to the third generation, be made responsible for his keeping. This disposition of the State to relieve individuals of the crosses of life is not wise. It is as unhealthy for State growth as

CARDIALOIA CURED BY THUJA. 247

fatalism is to mental development or agnosticism is to spirit- ual life. In this craze for building State lunatic asylums may not the question put by Shakespeare appeal to us :

"Or have us eaten of the insane root That takes the reason prisoner?*'

In the treatment of the insane physical influences are more worthy of attention than heroic drugging and physical force. By a kindly directing will we can divert the mind to those fields of thought that rest exhausted portions of the brain and make a perverted activity assume a useful sphere. The personal interested friends of the victim will always be able the better to appreciate the injurious influences and act more wisely than strangers. Through this method we can do what is asked of us in the following lines:

*' (>ans't thou not minister to a mind diseased ; Pluck from the memory a rooted sorrow ; Page out the written troubles of the brain ; And, with some sweet oblivious antidote, Cleanse the foul bosom of that perilous stuflf, Which weighs upon the heart ?"

CARDIALOIA CURED BY THUJA.

BY OR Kl'NKEL, KIEL.

I was consulted on the 10th of March, 1871, by Miss T. ©tas 13, She was weakly with bloated face and thick lips. She has suffered for years from attacks of Cardialgia. They nontinue from half an hour to half a day, attended with frontal headache. The use of food of different kinds is of slight influence : when walking, pain in thighs and legs, not when at rest; paralytic weakness of lower extremities; catarrh of the respiratory tract, cough with profuse expecto- ration, particularly in the day time; involuntary discharge of urine with the cough. I did not learn anything about the urinary secretion. Further, breath fetid, canine hunger even immediately after eating; very depressed mentally, never

24S THREE PECULIAR CASES.

satisfied ; sleepy in the day time, at night heavy, as if stunned. Leucorrhoea. Strong suspicion of self-pollution ; constant dryness of the hair. Thuja 200. (Lehrman's) one dose.

April 21. Two weeks ago she felt exhausted for a couple of days, then occurred urgent pressure to urinate with pro- fuse discharge of urine, mixed with much mucous ; general health much better; disposition very good; fluor albus still present; bloatedness of the face less; still many dreams. Sacch. lac.

I did not learn anything farther till Oct. 17, 1878, when I learned that she had been well until the spring of that year. Then the former mental depression set in, the mem- ory was strikingly weakened, sleep again extraordinarily heavy ; *'when she is awakened, she is quite beside herself;'* frequent discharge of urine ; besides hardness of hearing'in consequence of catarrh of the Eustachian tubes for which she had been treated unsuccessfully at several aural clinics; headache, etc. Thuja 200, three doses in six days.

November 1. Hearing considerably better, the noises still continue, particularly in the left ear ; no headache ; gen- eral health good.

January 22d, 1870. The complaints in her ears gone; general health good. The only complaint is of temporary toothache, for which I gave the apparently indicated remedy Calcarea carb. Since then I hjive not heard from her.

This case contains two more remarkable coincidences of restoration to health in a hopeless condition, after giving nothing twice. Please explain,.

A. McNeil.

• w»

THREE PECULIAR CASES.

BY PROF. J. T. KENT, M. P., ST. LOriS, MISSOURI.

Case I. — Mrs. L. set 36, had been in bed with pelvic cellu- litis. She apparently had been a sufiferer, notwithstanding ample medical attention. There was much tumification of

/. T. KENT. 249

the abdomen and great tenderness of all the pelvic organs, and the tenderness extended to the abdominal tissues and viscera. There was enlargement of the uterus and ovaries with erosion of vaginal portion of the uterus and anterior wall of the vagina. Hot douches per vagina and hot hops constituted her only possible comfort, when her abdomen had cooled from the absence of the hops, pain became unbearable; so she lived and so she was dying. Every change to cold increased her suffering.

Her bowels were constipated, her menses came too soon and her feet were always cold and felt damp. The evidence of her suffering was ample. Her mental state was gloomy. The hop poultices and hot injections were discontinued and she was placed in warm clothing. Calc-c, 85 m (Finke), one dose, was given.

No more medicine was needed. She was able to work in four months and is now perfectly well. Three days after taking the medicine her menses came on with profuse flow and increase of pain ; at the proper time the flow ceased and all the tenderness and previous suffering passed away.

Case II. — Mrs. F., set 84, at The Memorial Home. Some months before I assumed control of the Home this old lady had an attack of vomiting blood. The matron declared there was over a gallon, l^he physician then in charge said he never saw so large a quantity of blood vomited, and expressed his opinion that it was from the lung as he did not see the act of vomiting, disputing the matron who saw the vomiting. The treatment was directed to prevent another hemorrhage from the lungs — large doses of astringents. The old lady continued to decline, and when the attendant acknowledged his impotence in the case, and the friends of the old lady outside of the Home made complaint, I was requested to assume the duties of medical attendent of the Home, and this case with others came under my charge. The matron explained the situation and I immediately suspected that the hemorrhage came from an ulcer in the stomach. The

250 THREE PECULIAR CASES.

dropsical condition prevented a satisfactory examination, but the subjective history confirmed the diagnosis.

But the important thing now is the dropsy. Her limbs were enormously swollen and her abdomen no less so, and her stomach could tolerate nothing but a little milk.

The dropsy having a hemorrhage for its cause guided me to the selection of China, which was repeated at proper intervals in 77m (Finke) ; while she was going down rapidly she began immediately to improve. No other medicine has been given and she is as well as anybody in the Home. As she had been so near the angeh she has the liberty of the house and is a general pet, running three long stair^, visiting all the rooms and chatting and joking everybody. Old peo- ple recover when given the right remedy in suitable potency in a surprising manner. Some years ago I supposed that when an old person become dropsical his or her time had come. At present, I do not declare an unfavorable prog- nosis because of old age, but when the disease causing the dropsy is one hard to manage regardless of age.

Case. — Mrs. S., iet76 also an inmate of the Meinoi-^ial Home came to my charge the same time as Mrs. F. She was drop- sical and asthmatic. The urine was loaded with albumen, and, apparently, she was progressing' to a fatal termination without interruption.

She took Ars. Apis, Apocyn. Lach. with some relief The latter seemed to give the only relief; finally, she was becoming very large; hands, face, limbs and abdomen all oedematous, while Lach. afiforded relief I had decided not to tap. Though she had taken medicine at proper intervals, when there seemed a demand for a repetition, yet the time came when she seemed to get no benefit from the remedy. The suffocation after sleep was the special symptom guiding to Lach. 41m — was the preparation used. Early one morn- ing I was advised as to her condition. She had suffered greatly during the night with pains in the feet and legs, and her feet were getting black. The matron thinking that she was about to die, gave her some whiskey without relief. The

/. r. KENT, 251

great pain in feet and legs, shin turning black, perhaps threatening gangrene, Are. and Lach. had failed, guided me to Tarantula cubensis, which was given, 12x one dose. The pain subsided immediately, the dark color of the skin on legs became bright-red and in a general way, she felt improved and got up. Next night, she slept well until toward morning, when pain in lower limbs returned, Tarant. cub. 12x was repeated, with perfect relief. The medicine has been repeated by necessity about every day since November 20th.

December 1. There is now a fiery redne^ of the skin below the knee to the ankles on both legs, tender to the touch and covered with small blisters. Everybody that looked at it thought it was erysipelas. A serous transuda- tion is going on from the surface of both limbs from the feet to about six inches above the knees, which runs down and drips from the heels and also saturates the absorbent dress- ings in a few minutes. A sheet placed on the limbs as an outer covering must be taken off every hour and another put on as the serum is so^great in quantity. A sheet dried shows very little discoloration but is pungent to the smell. There has been no perspimtion from any part of body. The oedema appears to be going down.

December 25th. The oedema has gone from the face, hands and thighs. The abdomen has become nearly natu- ral in size, and albumen has not been noticed in the urine since December 1. Urine has been very scanty. The legs are covered from knees to ankles with a profusion of flat ulcers which secrete a serous flow, and large yellow crusts are forming.

December 20. (Edema gone out of feet and ulcers are still flat with red, and in places blue margins and red and bluish interspaces on the skin. Yellow scales are [forming. The patient is somewhat prostrated, but says she is more comfortable with the ulcers than with the "bloat" as she nearly suffocated before. Since December 1, she has had an occasional dose of the medicine, as the pain in the legs became severe.

-252 TARANTULA CUBENSJS.

January 1, '83. She shows signs of sinking, though she 6ays she is feeling comfortable except the occasional sharp pain in the ulcers.

It is evident she is going to die, but will she die of exhaustion or will the dropsy return and death occur as usual from such a condition? Such was my querry.

January 9. She died of exhaustion.

TARANTULA CUBENSIS.

BY PROF. J. T. KBNT, M. I>.. 8T. LOl'IS.

Case I. — A young man came to me with a bubo in the left groin. He had been disappointed in that he had not obtained relief from the treatment used. His bones ached, his tongue was loaded, and his breath smelled badly. The tumiiaction was hard and painful, bluish and mottled, with great burning and shai^ cutting pain. It was discolored some dis- tance around and the heat was intense. He took Tarantula oubensis 12x, one powder dry on the tongue three mornings in succession. He returned on the third da}' after taking his last powder saying that he was poisoned. He complained of a wild feeling in his brain and a drawing sensation in the scalp and musjjles of the face. He was in a state of great mental anxiety and said he felt as if he was going to lose his reason. Mental restlessness was marked in his countenance. He could not keep quiet even after I assured him that he was in no danger. His primary symptoms had nearly gone and the bubo had lost its bad color. The next day .he was much improved in a general way and the bubo had nearly disappeared. I saw him again in three days and the im- provement was going on rapidly. The chancre healed rap- idly and in one month he told me he had never been so well.

Case II. — A middle-aged gentleman had an abscess on the side of the face just in front of the ear. Suppuration was

/. 71 KENT, 2^^

advanced and the fluctuation was marked. Silecia had done some good as it had controlled the pain. The cavity was aspirated by a surgeon several times but it continued to refill. After three weeks there was no abatement of the diflBculty. The integument took on a new feature, becoming bluish, mot- tled with great burning and sharp cutting pains. The hardness was extending and the opening gave out a bloody thin excorating fluid of foul smell. He was chilly and nauseated and had symptoms of pysemia. After one dose of Tarantula cubensis 12x an immediate change for the better took place. No more pus formed and he was well in ten days. The dis- colored localization became a bright red and then faded to the natural color. The nausea and general pyaemic symptoms were greatly relieved within twelve hours. No more medi- cine.

Case III. — A lady aged about 30, suffered greatly from a carbuncle on the back of the neck. She had applied many domestic medicines and obtained no relief The tumefaction seemed destined to suppurate. It was mottled bluish and the pain was 'intense, knife-cutting and burning. She was sick at the stomach to vomiting, and at night she was delirious. Her eyes were staring and there was some fever; the tongue was foul and the breath fetid. There was great tension in the scalp and muscles of the face, -She begged for morphine ta "stop that burning and cutting pain.^^ Tarantula cubensis 12x one dose produced quiet immediately and the angry looking tumefaction failed to complete its work ; it did not suppurate. The discoloration was gone in two days, and the hardness soon disappeared also. She regained her normal state very rapidly, and she stated to me a short time ago that she had never had her old headaches since that swelling left her, showing how deeply the medicine affected her whole system.

If a part is mottled (Lach.), bluish, growing dark, with those symptoms, Tarantula cubensis must be the mo6ft appropriate remedy.

254 PENNSYLVANIA MEDICAL SOCIETY.

HOMCEOPATHIC MEDICAL SOCIETY OF PENNSYL- VANIA: ANNUAL MEETING.

The nineteenth annual session of the Homoeopathic Medical Society of the State of Pennsylvania was held in the Aldine Hotel, Philadelphia, commencing September 18th, 1883.

The meeting was called to order by Dr. Hugh Pitcaim, the first Vice-President of the society. Dr. Trites, the Presi- dent of the Philadelphia County Society, then extended a cordial welcome to the guests, assuring them that Philadel- phia physicians would do all in their power to make this meeting a memorable one in the annals of the society. Dr. Pitcaim, after responding to Dr. Trites^ cordial welcome, introduced the President, Dr. Pemberton Dudley, who pro- ceeded then to deliver his annual address, which included a suggestion for the reduction or abolition of the initiation fee of new members, in the belief that it operates to diminish, as well as increase the society's income; also, to allow the appointment of any member to but one of the scientific bureaus, and urging that a larger number of such appoint- ments be made; also, that each bureau shall select some specific subject for the "discussion," which shall be also the subject for at least one of the "papers" presented and shall have the subject announced in the secretary's annual circular.

The "address" then alluded to the evidences of homoeo- pathic progress in the State, as shown by the hospitals, col- leges, journals, standard literature, and the increasing num- ber of its practitioners and laymen, and expressed the belief that the hospital and college improvements in Pittsburg and Philadelphia would give an additional impulse to homoeo- pathic advancement.

The address next refers to the "class legislation," by which ^11 appropriations for medical objects are diverted to the exclusive use of a certain favored class of citizens, while the remainder are left without any such public provision. Particularly is this the fact with reference to the five im-

PEXNS YL 1 'A XI A MEDIC A L SOCIETY. 255

uiense hospitals for the treatment of the insane, with their three thousand beds and their half a million dollars appro- priation annually.

The influence of homoeopathy upon allopathic literature and practice was next discussed, the speaker dwelling upon the systematic and premeditated spoliation of homceopathic literature for the enrichment of allopathic text-books. Allud- ing to the fact that the allopathic code forbids a certain kind of practice, because it is "exclusive," no matter whether it be efficacious or not, the speaker asserted that whatever homoeopathic practice might be, the homueopathic law or dogma was not itself exclusive. It simply declares a certain general fact of nature, but does not deny or even question the existence of any other fact. Continuing, he said :

'•I am not quite done with this subject yet. When it is pro- posed to unify the schools of medical practice, let me ask how it is possible for the homoeopathic school of physicians to be associated professionally with men who hold that medical questions are to be decided, not by the processes of the laboratory and the hospital, but by the methods of the machine politician? According to the allopathic method of deciding certain medical problems, the prop- erties and the habits of the tubercle bacillus, the existence of the invisible corpuscle, the benefit of the antiseptic method and the curative powers of the homceopathic similimum are to be estimated, not by the researches of a Koch, a Norris, a Lister or a Hahnemann, not by the observations of those who honestly and intelligently fol- low the direction of these discoverers, but by the ballot of a med- ical society, not one of whose votes would be challenged, even though the voter could not distinguish an eye-piece from an objec- tive, or a steam atomizer from a saw-mill, and not two per cent, of whom could give a correct defination of homceopathy, 'though ^twere to buy a world of happy days,' or to perpetuate their cher- ished code. If this statement seems overdrawn, let it be remem- bered that the right to decide by ballot whether physicians shall prescribe on the principle of similars implies also the right to say whether they shall employ anti-parasitic treatment in consumption or antiseptic methods in surgical operations.

"It will doubtless be asked, has not the New York J^iate Allo- pathic Society already receded from this absurd and untenable position? I answer No. She has simply extended somewhat the

2:)6 PENXSYLVAyiA MEDICAL SOCIETY.

privileges of her members; but she has not surrendered her author- ity to rescind this action whenever she pleases, nor has she in any way intimated that there is any limit to her arbitrary prerogative. All her members still know that she is their absolute mistress, with power to interfere at any time in their professional relationship.

"It is not pleasant to say things respecting a sister sect of the medical profession, but in no other way can it be shown in what consists the cause of medical sectarianism, and where the responsi- bility for its continuance rests. If I have torn away a mask from the face of our opponent, it is only to show exactly against what and for what our school is contending. Let the word go forth to every corner of our State that medical unity is possible at any time, even without unanimity of belief. But let it be thoroughly under- stood that even with unanimity on purely medical questions, there never will be— there never can be — unity or harmony or peace in the medical profession until the right of one physician to control the medical belief or the professional conduct of any other physi- cian is absolutely renounced and forever repudiated. In our rela- tions with our patients we, as a school and as individual physicians, acknowledge no master save the dictates of conscience and of judg- ment and the laws of the land, and these only will we obey.

"Fellow-members, it is because of the facts I have thus stated that we are met to-day as a distinct organization of physicians, not, only to preach this new medical gospel, but also to defend the liber- ties of those who accept it. In our deliberations we shall sadly miss the counsels jof some who, since we met a vear ago, have gone into the more immediate presence of the Master Physician — Ashton, Rousseau, Marsden, Malin, McClatchey. Distinguished among their brethren, learned, faithful Christian physicians, every one. What higher earthly tribute could they merit? 80 long as their names shall linger on our lips and their memory in our hearts, so long may the influence of theif teaching and example be seen in our lives. May this occasion be to us all a season of mutual profit and improvement, and from what we shall gather here may we each be enabled, in the year that is before us, to mitigate pain, to prevent suffering, to avert threatened disasters and to save precious lives. Our mission, as a distinct profession, is of Heaven; our daily work is holy. Let us walk worthy of the vocation wherewith we are called."

Dr. R. E. Carutliers, Chairman of the Bureau of Organi- zation, Registration, and Statistics, reported that the State Society now numbers 170 active and 16 corresponding mem-

PENNSYLVANIA MEDICAL SOCIETY. 257

bers. During the past year five members were lost by death. Two new societies were formed in Beaver and Schuylkill Counties. Three new medical clubs have been organized, — the Hahnemar^nian Society, of Reading, the Philadelphia* Medical Club, and the Northwestern Medical Society of Phila- delphia. Our college and hospitals are in a flourishing con- dition.

Drs. William A. Phillips, of Cleveland, H. C. Allen, of Ann Arbor, and E. Hasbrouck, of Brooklyn, were then intro- duced to the society, and extended the privileges of the floor.

The reports of bureaus now being in order, the Bureau of Obstetrics then reported through the chairman, Dr. Millie J. Chapman, of Pittsburgh.

Dr. Caruthers's paper consisted of the report of a case of puerperal convulsions, in which the first convulsion ap- peared about one hour after labor. Gelsemium and other remedies were prescribed. Chloroform failed to check the convulsions until it was administered just at the first mani- festations of the prodroma of the attacks. The patient finally lapsed into unconsciousness, and remained so for twenty-four hours. When she recovered, she had lost the use of the right arm and leg. There was a sensation as if the paralyzed parts were drawn. The urine was retained. It contained no albu- men. There was no dropsy. The labor was rather precipi- tate and no doubt anticipated the normal date of delivery by reason of the preceding attack of cholera morbus. Dr. Caru- thers's experience had been, that most cases like the preced- ing die.

In the absence of the author, Dr. Chapman read a paper on ** Puerperal Mania," by Dr. S. W. S. Dinsmore, of Sharps- burg, in which were recorded three cases of this troublesome complication of the lying-in state. Hyoscyamus cured the fii*st case after the failure of Aconite and Veratr. vir. Ignatia and Hyos. were used in the second case.

Dr. J. Nicholas Mitchell having been called away from the meeting, Dr. Chapman proceeded to read his paper on 3

2)8 PENNSYLVANIA MEDICAL SOCIETY,

** Puerperal Statistics." Among the two hundred consecutive cases reported, Dr. Mitchell had had an unusually large per- centage of complicated cases, owing to many of the cases having been seen with other physicians and with the stu- dents at the college. There were four cases of placenta pre- via. All the mothers and one of the infants were saved. These cases were treated by tamponing the crevix with Barnes's bags, removing the placenta, and delivering the child. In a case in which craniotomy was performed, every- thing went all right, when the mother got up to go to the bath-room, and fell in a faint ^nd died, owing to the embo- lism of the pulmonary artery. Decapitation was performed in a case -of impacted shoulder and trunk presentation. The mother made a good recovery.

The report of the bureau being before the society for dis- cussion, Dr. John C. Morgan expressed his horror at the idea of taking infantile life. In a practice of thirty years he had never been obliged to take the life of the infant to save that of the mother. He had performed craniotomy in a few oases when the infant was already dead.

There being no further discussion, the bureau was de- clared closed.

Dr. John K. Lee, of Johnstown, being the only member of the Bureau of Clinical Medicine present, at the request of the society read Dr. W. J. Martin's paper on "Clinical cases in which infrequently used remedies were employed." Case 1. A primipara, after recovery from her confinement, could only urinate when on her knees. Pareira brava cured. Case 2 and 3 Pain in the hip and about the sciatic nerve, which was aggravated by motion and relieved by rest. Dioscorea cured, after failure of Bryonia. Case 4. A male patient, set. 33, was annoyed by a small quantity of urine trickling down the leg after each act of micturition. Picric acid. Case 5. Similar to the last, was cured by Petroleum after Picric ac. had failed. Case 6. A lady contracted cold ; cough, with sore chest, scanty menses, rapid pulse and even- ing fever; chest sore on percussion; cough was dry and

PENiy.SYLVANIA MEDICAL SOCIETY. 259

worse at night: violent eructations accompanied tlie cough. Phos. failed but Ambragrisea cured.

Dr. Lee also read Dr. Joseph E. Jones^'s paper on *'A Rare Case of Ascites/' which required numerous tappings. The total amount of water removed from this case, would fill six barrels. The patient died, but no post-mortem examina- tion was permitted.

The time for adjournment having arrived, the remainder of the Report of the Bureau of Clinical Medicine was laid over until the afternoon session.

AFTKKNOON SK.SSIOX.

The Report of the Bureau of Clinical ^ledicine was re- sumed. Dr. Clarence Bartlett read abstracts from his paper on '* Locomotor Ataxia." Attention was directed to the etiological relation between syphilis and ataxia. The dis- crepancies between different authorities on this subject, were spoken of The speaker did not believe that the true rela- tions between these diseases were yet understood. Out of fifteen cases under his care, six had had syphilis. In speak- ing of the diagnosis of the disease, particular stress was laid on the importance of the eye symptoms, the lightning pains, and the absent patellar reflex. None of these symptoms were considered pathognomonic, but their association with each other placed the diagnosis beyond question, even though no ataxia be present. Hydropathic and electrical treatment was recommended in conjunction with the reme- dies employed. Those recommended were Argent n., Arg. phos., Zinc, Zinc, phos., Alumina, Gelsem., Silic, Ergot, Phos., Bell., Picric ac.

Dr. John C. Morgan next called the attention of the so- ciety to the gluten preparations as a remedy in constipation.

By request of the society. Dr. Caruthers read abstracts from the Allegheny County Society's paper on "Albumin- uria." The first symptoni of nephritis noticeable is usually dimunition in the amount of urine passed. The urine then becomes opaque, and contains albumen, casts, blood and epithelium. There is tenderness in the renal region, swell-

260 PENNSYLVANIA MEDICAL SOCIETY.

ing of the eyelids in the morning, and finally, general dropsy which may, in severe cases, cause death by its mechanical effects. In unfavorable cases, the patient i^a.sses into a coma. The usual course of the disease is to recovery, but the dis- ease may become chronic. The first symptom noticed in chronic cases is usually aniema, with amemia and debility - without apparent cause. The peritoneum is the first serous cavity to be invaded. Vomiting and occasionally diarrhoea appear. The cerebral symptoms are of the convulsive form. Albumen is large in quantity. Granular kidney may exist for a long while without symptoms. It usually niakes itself known by slight albuminuria, with frequent calls to micturi- tion, the specific gravity of the urine being low. Headache, bronchitis, indigestion, retinal, cardiac, and vascular changes appear. The fatal result comes from uraemia. Reference was then made to the lardaceous kidney. In the way of treatment, the diet recommended was milk, gruel, arrow- root, buttermilk and weak broths. Meat in large quantity should be avoided. In the chronic form car^ should be taken not to interfere with any organ which may be acting for the kidneys. Perspiration should be encouraged. A mild and dry climate is the best. Remedies: Arg. n., Ars., Ars. hydrag., Benz. ac, China, Eup. pur., Hell., Nitr. ac. Dr. Cooper considers Arsen. hydrogen to be our best remedy for renal haemorrhage.

Dr. Bernard s paper on the '* Treatment of Idiopathic Goitre '' was read by Dr. Caruthers. Calc. c. Kali hyd.. Spong., and Iodine were among the remedies recommended.

Dr. Ivins then read the following abstracts of the paper on " Phthisis" by the Philadelphia County Society :

Pulmonaiij Phthisis.— There are now three forms of pulmonary consumption admitted to exist, -caseous phthisis, tubercular phthi- sis, and fibroid phthisis,— all of which tend to produce similar re- sults, viz., consolidation, followed by destruction of the lung-sub- stance, associated with wasting of the blood and the tissues of the body. The symptoms of each form, however, present numerou> differences, and for the take of clearness and convenience, I will take up teach variety separately and treat the symptoms accordingly.

PENNSYLVANIA MEDICAL SOCIETY. 261

Gaseous Phthisis. — This form presents three types of cases, which, in order of frequency, are the chronic, subacute, and acute, or phthisis florida. This latter variety should not be confounded with acute miliary tuberculosis^ which is a febrile affection, due to the ■tieposit generally, through the body, of the gray tubercle-granules, and is a constitutional, not a local disease.

The chronic variety comes on so insidiously that it is impossible to tell with certainty when the first symptoms presented them- selves. There is a history of repeated colds of gradually increas- ing severity; pach severe cold is accompanied by chilliness, some fever, pains in chest, loss of appetite, and persistent cough, with expectoration of muco-pus. H«emorrhage in a varying degree, may also be present. After one of these attacks, it is found that instead of the cold getting better, the cough and expectoration increase in severity and persistency; that there is a daily morning chilliness, with an evening rise of temperature, accelerated pulse, and the train of symptoms so well known. Well-marked physical signs are now developed in the lungs, and as they progress, the severity of the other symptoms, becomes greatly increased, till at last the pa- tient succombs to the great drain upon the vital forces.

Subacute Variety, — The onset is not so gradual. There is a similar history of a severe cold (catarrhal pneumonia), in an appjirently robust individual, with the usual train of symptoms, the patients often being confined to their beds for a week or two, the symptoms go from bad to worse, being interspersed with interr vals of repose.

The achte variety is one continuous advancement with no remis- sion of symptoms, or severity of the symptoms. It runs its course in a few weeks. It begins as a catarrhal pneumonia involving the whole of one or part of both lungfi. It commences abruptly with <;hilline88 and high fever; associated with these symptoms, are profuse and exhausting night sweats, with intense prostration and adynamia; the emaciation is marked, and the appetite wholly want- ing; dyspnoea, cough, and expectoration, which is often streaked with blood or is bloody. These symptoms persist and increase in violence, and in a short time, the case necessarily terminates fatally.

Tubercular Phthisis.— The hereditary type of the disease usually comes under this head. These cases begin either by loss of appetite, indigestion, decline in weight, etc., without any physical signs or an attack of haemoptysis may be the first symptom. Usually, however, the onset is characterized by a short dry cough, which is rather more troublesome at night, preventing sleep, dys-

262 PENNSYLVANIA MEDICAL SOCIETY.

pnoea, pains in chest, increased respiration, with some nocturnal perspiration. The heart's action is accelerated by slight causes, the pulse is soft and compressible. In the beginning, the bowels are constipated, but diarrhoea soon sets in, appetite is poor and progress- ive emaciation exists. These symptoms all increase in severity, the indigestion, cough, expectoration, and night sweats becoming very troublesome. Haemorrhage is the most alarming symptom to the patient (and often to the physician); it varies from merely streaking the sputa, to quantities Fufficient, to prove immediately fatal ; frequently a quantity of blood is swallowed, entering the stomach, where it is acted upon by the gastric juice, and, when subsequently it is vomited, it has the appearance of bsematemesis. After the hemorrhage has been arrested for some days, small-sized blackish clots are expectorated. The hsemorrhage is brought on by paroxysms of coughing, or is due to the prolonged and intense strain which the vessels have undergone. Many authorities, especially followers of the German school under Niemeyer, say that "capillary htemorrhige, either bronchial or pulmonary, is the cause of tuber- culosis." Clinically we admit that haemoptysis is the initiatory symptom of phthisis to which the attention of the medical attend- ant may be called, but on close examination, we will almost invar- iably find that for weeks and months previously, the patient has been gradually losing flesh, has felt unusually weak, that there have been suspicious febrile symptoms, slijjht cough, etc. Hiemoptysis is due to something already wrong in the lungs, be it tubercular or not; if not tubercle, it is harmless, and probably due Jo cardiac causes or to some trouble of the general vascular system. As the case pro- gress, auH^mia is marked: there is oedema of the dependent parts, great debility, increased frequency of the pulse but wanting in tone. The urine is more or less febrile in the early stages, and contains excess of tissue destruction ; finally it becomes watery and deficient in solids; albumen or sugar may be present. The disease may pro- gress steadily, either rapidly or gradually, from bad to worse, but, as is well known, pthisis, as a rule, does not advance by continuous progress, but by a serie.^ of successive invasions, separated by inter- vals ofjmprovement, followed by exacerbations

Fibroid PfUhisis, — This form of consumption is a disease of ma- turied life, and is extremely rare in patients of less than thirty years. It is the most chronic form, and its early history is that of bronchial catarrh, it being years before the lungs are attacked. The symp- toms are about the same as in the other varieties, only far more gradual in their onset.

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The complicati(m8 must frequently met with in the course of pulmonary phthisis are affections of the larynx and trachea, bron- ehitis» pneumonia (catarrhal) pleurisy, perforation of the pleura with consequent pneumothorax, enlargement of the external absorbent glands or of those of the chest and abdomen, meningitis or tubercle of the brain, tubercular peritonitis, ulceration of the intestines, especially the ileum, fatty or amyloid liver, fistula in ano, Bright's disease in its various forms, diabetis, pyelitis and thrombosis of the veins of the legs.

Diagnosis.— When the disease is well advanced, the abnormal physical signs are usually quite conspicuous, and the cognition of pulmonar}' consumption presents no difficulty. Besides the mere recognition, it is desirable to obtain, if possible, a correct knowledge of its seat and extent, its stages in different parts of the lungs, and its nature and origin. This can only be acquired by a careful con- sideration of the history and presenting symptoms of the cases, as- sociated with a thorough systematic examination.

Laryngeal Phthisis. — Under thisdivision of the subject Dr. X. F. Ivins discussed the question whether this manifestation of the disease ever precedes the existence of lung tubercle. He then des- cribed the two varieties — acute and chronic — and dwelt particularly upon the differential diagnosis of the disease in its various stages, The treatment, both medicinal and hygienic, was carefully consid- ered, and, in certain instances in which the apparently indicated homoeopathic remedies fail to give satisfactory results, he advised local applications as effective aids to the hom<ieopathic remedial action.

This finished the Bureau report. Dr. J. K. Lee, of Phila- delphia, opened the discussion by praising the indefatigable industry of the gentleman representnig tiieir county society in the preparation of their paper; but he considered the local treatment recommended a? innovations that should be checked, as they were in direct opposition to our law of cure.

Dr. Morgan, like Dr. Lee, had great respect for the gen- tlemei^who understood thoroughly the use of instruments of percision in diagnosis. Still these cases, diagnosed so ac- curately and for which local treatment is recQmmended, are, pome of them, similar cases to those cured by, the earlier homoeopaths who had .no special knowledge of the disease they were curing.

204 PENNSYLVANIA MEDICAL SOCIETY.

Dr. Ivins replied that he always preferred to cure with the indicated remedy when possible. He had had cases sent to him where good prescribers had failed to cure, and he was obliged to use, in these, local measures.

Dr. Lee thought that this was an acknowledgment of the deficiencies of our materia medica; or is it an acknowledg- ment of the inadequacy of the law of cure.

Dr. Farrington considered that it was the duty of si)ecial- ists to improve our materia medica in the line of their specialty. To his mind, the homoeopathic remedy never failed in its mission of cure.

Dr. Ivins agreed with Dr. Farrington, and said that where he could find the true remedy he would not give local treat- ment.

Dr. E. Hasbrouck diverted the discussion to albumin- uria by remarking that Fuchine 2^ or 3^ in his hands never failed to reduce the quantity of albuaien in the urine, but that was all the good it did.

Dr. Bartlett asked if the gentlemen present, considered it any more Homoeopathic to use Fuchsine as a routine rem- edy in albuminuria, than to use Morphia iu like manner to relieve pain. In either case, we might occasionally make an accidental homoeopathic prescription.

Dr. Hasbrouck disclaimed any disposition on his part to use Fuchsine as a routine measure, as, in the case just spoken of, he merely administered the remedy for experimental pur- poses.

Dr. Ivins spoke of Graph, and Fluoric Ac, as remedies for goitre.

Dr. Morgan said that when, in the later stages of phthisis, oedema of the feet and diarrhoea set in, amyloid degeneration of the kidney was present, as shown by an examinajion of the urine in these cases.

Dr. H. C. Allen thought that routine measures in hy- giene were no better than routine measures in prescribing remedies. Each patient should be treated according to his case, and not according to the name of his disease.

PENNSYLVANIA MEDICAL SOCIETY. 265

Dr. Bartlett, replying to Dr. Morgan, said that he had examined the urine in ^we cases of pthisis with diarrhoea and cederaa of the feet, and had failed to find anything abnormal.

On motion, the discussion on the report of the Bureau of CHncal Medicine was declared closed.

The chairman of the Bureau of Sanitary Science reported that no papers had been received by him. By vote of the society, it was resolved to hold a discussion on the subjects belonging to the bureau.

Dr. Farrington spoke of the advantage of leaving the trap off of the main drain of the house. This main drain should be ventilated by a pipe five or six inches in diameter, running up to the roof of the house. If the main drain is trapped, and there is no ventilating shaft, then all the air between the trap and the house is dead-air, and is very pois- ous. Each water closet should have its trap or its ventilat- ing pipe.

Dr. B. W. James said that it was not only necessary to have good drainage in one's own house, but also to have the neighboring houses well drained before we can assure our- selves that our hygienic surroundings are perfect. Sewer gases may be forced out of the drain pipes into houses, by the flooding of the sewers with water, through the culverts. This may be assisted by imperfect traps. Health authorities should look after the plumbing. Rules should be adopted by which they shall appoint sanitary engineers. In London and Liverpool, when a tenant rents a house, the owner thereof gives him a certificate of its sanitary condition.

The time for adjournment having arrived, further dis- cussion on Sanitary Science was deferred until the evening meeting.

The society then visited the Library and Reading Room at 100© Arch street.

lTO be i-ONTINl'ED.J

2<Ui A CLINICAL CASE.

A CLINICAL CASE.

BY r. G. WILSON, M. D., 8T. CLOUD, MINN.

Mr. A. B., aged 30, scrofulous constitution. Came to the office Oct. 17, with this history : Caught cold the 15th while working in the rain. In the evening had beating, bursting headache, high fever, backache, unrest. The 16th the head- ache continued with anorexia and sore throat. Is used to sore throats. Felt very weak. Now the posterior part of the tonsils and pharynx are covered with diphtheritic membrane; neck somewhat swollen and stiff. Lymphatics swollen on left si<le, on which side the soreness began, and very sensi- tive to touch. Mucl\ ptyalism, breath offensive, fluent coryza.

The remedy was plain and the attenuation and frequency of giving it were based upon Dr. Gregg's successful experi- ence in this disease. Lach. m. one dose. In the evening he was very weak and tired.

18th. Restless all last night. Headache less, tonsils swollen more, membrane about the same. In the evening throat easier. Sweats from least hot drink. Quite hoarse.

19th. Sleepless last night, but feels better generally this morning. Hawks up inouthfuls of mucus, which tastes sour; dirty yelow color, stringy and hafd to raise. Gave Lye. **, every four hours; I think this was a mistake. The patient was improving, and notwithstanding the above indication to which he called my attention without any questioning, the action of the Lach. should have been continued. I realized this fully after leaving the house, and in the evening, on finding little or no mucus raised, gave Lach. m; one dose.

20th. Slept better, can swallow more easily. Food Alls np immediately. Hawh up mucus again with the sour toMe, Uvula much elongated and covered on the end and posterior surface with the membrane. The symptoms were elicited by the indefinite question " How do you feel to-day ? " for I was not looking for Lye. symptoms. It seemed so well indi- cated, however, that it was given, one dose, mth. attenuation.

SLEEP, 2H7

21st. Much better every way, throat clearing up. Can move neck freely.

22d. Uvula clear as well as most of the throat, but quite tender, can swallow well, appetite returning.

23d. All right except a little weakness from abstinence of food, etc.

The room was fumigated every morning with Sulphur, which doubtless had a good dynamic effect also. Placebo of Alcohol 10 git. in a teaspoonful of water every four hours. Other cases will be treated similarly but with more confi- dence in the result.

SLEEP.

READ BEFORE THE HOMCEOPATHIC MEDICAL SOCIETY OF OHIO,

BY R. B. JOHNSON, M. D.

What is sleep? It is that condition of the system where all voluntary actions of the mind and body are at perfect rest. And the importance of this subject will be better real- ized when we consider that at least one-third of the life- time of every individual is spent in sleep; and it is as essen- tial to every one, who would enjoy good health, that they should have this sleep as it is that they should have good food to eat. And I do not know but it is more so, for who has had the courage to test the human system to its utmost capacity in this direction and tell us how long life can be sustained without sleep; whereas Dr. Tanner and various others have tested the power of the system in abstaining from food and found that for forty days or more life can be sustained without food, but I doubt whether it can be done without sleep. How important it is then to know how to sleep and get the most benefit therefrom.

In order to consider this subject more thoroughly I shall divide it into when to sleep, where to sleep and how to sleep.

2es SLEEP.

Now it has been said that there is a '' time for all things,

a time to laugh and a time to weep, a time to live and a time

to die, a time to wake and a time to sleep." and the time to

, sleep is when we can get the most rest out of the same

amount of time.

Now when a person is awake and in action he is using up the vitality that is stored within himself, that is he is throwing off the life-giving elements of tlie system, and is taking on those that tend to bring on decay and death ; but when we sleep the order is reversed and we take on those elements we lose when awake, and throw off those that tend to produce death. Now when we examine into the vegetable kingdom we there find the same order preserved, but those elements that are death to the animal kingdom are life to the vegetable; therefore when the vegetable world is sleeping or giving off the element that are detrimental to it, in the greatest profusion is when man can get the most of those elements which are calculated to build up his system and it is an established fact that this is done in the night time, and that then is the time for all to sleep who would enjoy good health. But alas, how many there are who spend their nights in other ways than that designed by the Creator of the Universe! and alas for the results in broken down constitutions and premature deaths.

In the second place the question where to sleep will depend largely upon circuqastances, but wherever it is it ought to be in a room that is well ventilated, where pure air can be obtained at all times, and free from malarial influ- ences. In malarial districts it is best not to sleep near the ground as it is there that this poison to the human family lingers, and it is said that it does not rise over fifteen or twenty feet above the ground and that those who sleep above this are apt to be exempt from its influences even in very malarious countries.

To show how people are mistaken in reference to pure air I will relate a case. Was called to see a lady who lived in a very malarious place, who was shaking furiously every

R.B, JOHNSON. 269

day with ague ;, she was very indignant to think that she should have the ague when she had taken so much pains to prevent it and have pure air to breathe, and one of her pre- cautions was that she had slept out of doors under an apple tree all summer. Of course she shook, and who would not have done so? Then, as I said before, if in such a country get up as high as you can to sleep, and then, by all means have plenty of fresh air in the room. But ntow after choos- ing the proper time and place it will not give you good sleep if certain other rules are not observed about how to sleep. But before I speak further of this let me say something of the bed to be used. Now, I am not going to say, as many do, that we must sleep on a har4 bed of some kind ; but will say of whatever material it is composed have it comfortable. Place it in the room so it will extend north and south so the electric current of the atmosphere will run parallel with the body, and for aged, weak and debilitated or rheumatic per- sons, insolation of the bed will add much to their comfort and health, and they will arise in the morning much more* refreshed and invigorated than they would be were this not done.

Now then, when retiring leave all care of patients finances, or anything else that tends to disturb or distract the mind outside of the bed-chamber. Do not talk with your companion of anything disagreeable or anything that may bring on a discussion, but have everything as pleasant and serene as possible, and thus being at peace with ourselves, fellow-men and our God, we will be prepared to receive and appreciate " Nature's sweet restorer, sleep," and ** blebs the man who invented sleep."

Now, if we as Physicians, who are the conservators of the health of the people would give more attention to this subject and instruct our patrons therein, we would have more healthy people and a fewer number of nervous and debilitated persons, and we would not be called so often to hear complaints of sleeplessness, nor make so many pre- scriptions to make them sleep.

i'WO CASES OF ECZEMA CAPITIS. TWO CASES OF ECZEMA CAPITIS.

BV S. E. BURf HFIKLD, M. D., LATROBK, PENNSYLVANIA.

Case I. — Nov. 1st, 1881. L. P , boy about one year

old, large head, fat, florid. Has had an eruption in patches on his head and neck for two months. The ulcers suppurate profusely, are 4^ep, with wide red edges, tending to spread in rings. The discharge mats the hair and forms into thick ticabs on the head, neck and face. All the sores very tender to touch. Cervical lymphatic glands, swollen and hard. Various common remedies were used by the mother without having any curative effects. Being called to see the child I prescribed Hepar s, c. ^, in solution thrice daily. In a month under this treatment alone the eruptions were all completely healed, and in the intervening two years the child has been perfectly well.

Case II.— Sept. Ist, 1882. J. H , male child aged

about four months. Healthy when born. One month ago an eruption appeared on his head, beginning behind his oars. The eruption rapidly spread, soon covering a large portion of the scalp, and all the folds of the neck. The hair was matted into thick tangles. A sticky, acrid, foul, clear fluid exuded from all the sores, making new excoriations and sores where it touched. In the folds of the neck deep ulcers appeared, and the skin was red and inflamed by the discharge. The mother had tried home-cures and various old women's remedies, and still the child's head got scabbier. A noted old school physician and surgeon prescribed for the child without benefit, and shortly afterwards gave it as his opinion that the case was incurable as it stood. The parents not wishing to abandon attempts at getting the scabs cleaned off consulted me as a downier resort Called to see the child and considered it curable, indeed so gpeat faith had I in my medicines that I asked for a month in which to cure the case. As Oraphites was plainly indicated, I prescribed, as is my custom with this remedy, the 30th potency. This med-

RHUS HADICANS. 271

icine given in solution twice a day for three weeks, completely cured one of the woM cases of eczema capitis I have ever seen. Only a few scars were left to mark the location of the deeper uclcers. The child has continued well ever since, and in fact from a puny infant has rapidly developed into. a fine, hearty boy.

RHUS RADICANS.

BY CHAS. B. GILBKRT, M. I>., \VASHtK(iTON, D. C.

This remedy huB been so little used that the following cases are copied from the American Joumnl of Hoinaopathy^ August 15, 1846, p. 100 :

Case I. Miss B. W., aged 52, of scrofulous diathesis formerly subject to sick headaches ; sixteen years since left fore-arm and hand became partially paralyzed, supposed to come from glands about the neck enlarged by scrofula ; fifteen years since during a severe attack of what was sup- posed to be sick headaclie, became apoplectic, followed by nearly complete paralysis of the left hand and arm, since, which they have been useless, pulseless, nearly bloodless, numb, prickling — with occasional turns of severe pain in the whole arm, which were almost insupportable — flabby, dimin- ished in size and greatly so in strength, using the right to help raise the left. She was fretful, touchy, eaisily discour- aged and inclined to weep, excitable, unhappy; general health delicate. July 1st, 3 pellets 3 dilution ; passed a rest- less night with much severe aching of the back of the neck, shoulders, instep and toes of left foot, with severe tingling and prickling of the left arm and hand. Repeated the dose on the evening of the 2d; the pains continued severe through the 4th, and extended to the whole left arm and hand which seemed swollen, and the veins which had usually been per- ceptible to the sight or feel, became full, blue, hard and painful.in the extreme; in addition there was dizziness of the head, slight turns of faintness, great inability and complain-

272 ' on AS B, GILBERT.

ing, less than the usual api>etite, insecure feeling when walk- ing, or unsteadiness of gait, free motions of the bowels and abundant discharge of pale urine. On tiie oth the symptoDCts began to abate, and on the 1st of August, she was doing one-third of a day's work in sewing (was left handed) with steadily increasing strength and was improved in general health and si>irits.

Case II. Mrs. H., aged o5, of sanguine, nervous temper- ament; has been sick three years; was treated one year ago without avail ; has pain on the top of the head in the morn- ing, with swinuning in head when stooping or rising, cloudi- ness of the eyes, soreness of the mouth and throat, dry cough in the morning, attacks of tearing pain, sometimes stinging and sharp, commencing in the stomach and extend- ing to the sides and shoulders and nape of neck, with stiflfness; distress in stomach like a weight, bitter from eat- ing; sense of fullness in stomach; erucUitions ; cannot bear even the presence of light cloths ; bearing down or pressing pain in bowels ; pain in left side as if something adhered to ribs; constipation; pain in hips and legs as if in the bones, like rheumatism ; jerking of the feet in the evening; numb- ness of tlie arms with prickling in the fingers : fatigue from walking and excessive debility; sleep disturbed; pain in stomach at night; the pains are tearing, stinging and press- ing and shifting from one side to the other, and at times on both, some aggravated by movement, others better from lying down and rest; suffering aggravated on change of weather. The attacks had occurred daily at 5 o'clock v. m., and almost always waked her from sleej) in the night; there had been no intermission for months. " I was struck with the peculiar stinging, pricking pains of this case as corresponding to those I had experienced in my own person from the above drug. On the 26th of June last, at 4 p. m., 1 gave 3 globules of the 3d dilution. 8he had no attack that day nor has she had any since — her health improved and it is now good.''

The first case is by Dr. Barlow, of New York, and the second by Dr. Snow, one of the editors.

STRABISMUS. 273

STRABISMUS.

READ BEtX^RE THE OHIO STATE HOMKBOPATHIC MEDICAL SOCIETY

BY G. C. M<: DERMOTT, M. IJ., PROF. O. AND O., PUI.TK MEDICAL COLLWiE, CINXIM-

NATI, OHIO.

Strabismus or squint may be said to be an affection of childhood; at least in true cases of convergent squint it has its begining at an early age in life, and may exist throughout a life tinje.

It is the seeming indifference given to this deformity by the physicians generally, that I wish to make a suggestion, viz., the imjxjTtance of its early coirection. Hypermetropia is that condition of the refraction in which the eye-ball is too flat from before backwards, or its antero-posterior diameter is too short; the retina lying within the focal distance of the crystalline lens, and as a consequence images formed upon it being indistinct and blurred. To remedy this the refrac- tive power of the lens must be increased, which is accomp- lished by a greater convexity of its surfaces, the result of the muscle of accommodation upon its suspensary ligament

In the emmetropic, or normal eye, this effort of accom- modation is only called into use for near objects, which at the same time though, requires more or less convergence of the optic axes in order that they may be directed to the same point. Hence it is seen there is a co-ordination between these two muscular actions of convergence and accommo- dation; and which is not disturbed by the faulty shape of the eye-ball which is merely an imperfect development of an external organ.

In the hypermetropic eye, the accommodation is neces- sary for vision of distant objects, for which no convergence is required; but the co-ordination of the central ganglia over- powers the visual requirements and the internal recti con- tract with the ciliary muscles. These ciliary muscles are constantly active during the waking hours, and the internal recti receive more than their share of nerve influence and 5

274 STRABISMUS,

are called upon for more than their due share of functional activity; as a result, they may become hypertrophied, or come to preponderate ove^ the external recti, and their state of frequent contraction produces a tendency to structural shortening. The effect of this is, that the axes of the eye- balls, in a state of perfect rest, are no longer approximately parallel, but distinctly and equally convergent.

At the age of two or three years when the child b^ins to view small or. near objects, he requires a still greater convergence eflfort of accommodation in order to see them clearly, and in doing so he makes a corresponding effort of convergence, with the result that, as his eyes start from a point of acquired convergence instead' of from par- alleliam, their total convergence becomes greater than is necessary, and they are both directed to a point nearer than the object, so that double vision is produced. In order to see clearly, and to avoid the double images, the child renders one eye more divergent, so that it may be directed to the object; and as the two axes have become combined in a relation of convergence, instead of in their original relation of parallelism, it follows that, when one eye turns outward to fix the object, the other turns inward in a greater d^ree than before, or squints. In some children, in whom the refraction and the acuteness of vision are alike in the two eyes, and in whom the external recti are of equal strength, it is a uiatter of accident which eye will be directed to the object, and which towards the nose, and the squint is then said to be alternating. Sometimes one eye squints, some- times the other. But this equality of sight and of muscular power is not. common ; and the majority of children can direct one eye more readily than the other, or can see with it more clearly. When this is the case, the employment of the best eye becomes instinctive; it is always directed to the object, and the other always squints. The squint is then said to be fixed, and under such circumstances the vision of the squinting eye will usually undergo a steadily progressive deterioration.

FEUILLETON, 275

It is this amblyopia from non use that complicates and endangers an eye, which compells us to remark that an early correction is most urgently demanded, and should always be suggested to the parents.

When the sight of both eyes is good, and the squint is uncomplicated by paralysis, it is always curable, not only partially and thus correct a manifest deformity; but per- fectly, so as to restore harmony of position and movement under all circumstances, by a well-planned and skillfully performed operation or operations.

As long as the squint is alternating, the operation may be postponed without injury; but as soon as the squint becomes fixed, unnecessary delay will probably involve impairment of sight in the squinting eye ; and this, besides being a loss to the patient, will interfere with the excellence of the result.

FEUILLETON.

Dr. Wm. E. Payne of Bath, Me., seems to have been the first to give Kali bi. in croup and published an article in the Ilomceopathic Examiner for March, 1846. Now that its use in such cases has been rerified so often, it is worth something to his friends that it should be known to whom the credit is due. He was an honor to our school— a Prince among men. c. b c.

Dr. Robert Burns says, "Th^true function qf a medical society is to gather together and then diffuse knowledge, to encourage independent inquiry, to survey from time to time by the light of mutual reflection, the positions attained, and thus to seek sound guidance in the application of our knowledge to our practical duties." How true the above and still, how little appreciated by the profession, "In union there is strength," yet witness the meagre attendance we have at our State Society, compared with the large number practicing in this State. To save ten dollars, many practitioners will remain at home and accumulate ignorance rather than obtain knowledge on subjects pertaining to their pro- fe.ssion. p. p.

Hot Water as a Gargle— Dr. Ritzy has found hot 'water systematically employed as a gargle of great benefit in overcoming

276 FEUILLETON.

the sendation of rawness incident to acute pharyngitis. He founds that the use of hot water paled the red and inflamed mucous mem- brane more or less permanently. And, so far as unpleasant personaK sensation went, it cured the pbayngitis. He also believes that this simple plan of treatment would prove beneficial in diphtheria, in patients old enough to gargle intelligently. In ordinary tonsillits hot water, he thinks, would hai;iclly fail to act well. The water should be used as hot as can be well borne, and gargling should be practiced for several minutes at a time, and repeated every twenty minutes, p. p.

Artificial Respiration. The following simple method of pro- ducing artificial respiration, is known as McDaniel's and is worthy of the general practitioner's consideration. The method is an improvement on Hall's or' Svlvesters, and is given, a^' taken from The New Orleans Medical and Surgical Jouimal.

"After the invention of the spirometer by Hutchinson, it was soon ascertained that the chest is greater in the erect form than in any relieved or recumbent position. This is a great fact for physi- ology for pathology and for therapeutics. The chest is a cylinder,, and the diaphragm is a piston, whose pump motion varies the chest capacity, and causes an ingress and egress of air. In the recum- bent position the liver and other contents of the abdomen press upon the diaphragm and diminish the chest capacity . In changing from the recumbent to the erect position, this pressure is gradually removed and the chest capacity is increased. It is obvious that all that is necessary to cause air to enter the lungs, is to change the- patient from any recumbent or any inclined position to the erect one; and all that is necessary to cause the air to pass out of the lungs is to move the patient back from the erect to any inclined or recumbent position. But I hate discovered that th*^ increase of capacity in the chest is slow and small in moving from the recum- bent position to an elevation of forty-five degrees, and rapid in ascending from forty-five degrees to the erect position. It Is, there- fore, not essential in practicing artificial respiration to move the patient through the whole range from recumbency to erectness, but is sufficient to use only the upper half of this range, merely moving^ the patient from a forward inclination of forty-five degrees to the erect position and back again. Every upward and backward movement produces ^n inspiration, and every forward and down- ward movement an expiration, and the two together a complete respiratory act. By regularly repeating these acts, artificial respira- tion is rythmically performed, and can be prolonged at will. Any

BOOK NOTICES. 277

one will find Ihat if he leant forward from the erect poeition to an inclination of say forty five degrees, he will mechanically and involantarily expire, and if he moves back to the erect position he will mechanically and involutitarily perform inspiration. He can- not, by any power of volition, prevent the result or reverse it. This simple movement of upward and backward to the erect posi- tion, and downward and forward to a sufficiently inclined position, regularly repeated, constitutes my proposed new method of artificial

respiration." p. p.

<■»

BOOK NOTICES.

A DICTIONARY OF MEDICINE: Indadins General Pathology. General Thera- pentics. Hygiene and The Diaeasee Peculiar to Women and Children. By Vari- ous Writers. Edited by Richard Quain. M. D. Third Edition. D. Appleton & Co., New Yorlc. We have purchased the above and added it to our library

because it seemed to be a valuable work worth the buying, and so

far as we have looked it over, it more than meets our expectations.

It is jet "Medical Encyclopedia v and in no sense a "Dictionary."

Oar readers better look it up.

THE AMERICAN HOMCEOPATHIC PHARMACOPCEIA. Second Revised Edition. BoBricke&Tafel.

The second edition of this valuable work has been recently

published under the supervision of J. T. O'Conner, M. D. The few

botanical errors which crept into the first edition have been care-

tally corrected, and both editor and publisher deserve the thanks

of the profession. No medical library is complete without it.

BAND-BOOK OF ELECTRO THERAPEUTICS. By Dr. WIlhelm Erb. With

Thirty-nine Wood Cuts. New York, Wm. Wood St Co.

It is almost needless to say thai the author is a distinguished Professor at Leipsic and an acknowledged authority upon the sub- ject upon which he writes. For pne in search of the latest infor- mation upon this subject there is no better work extant. The pres- -ent volume is the June No. of " Wood's Library of Standard Authors ** for 1883, and is one of the most valuable of the present series. The work is well illustrated, and if carefully btudied will enable any one to master thoroughly the whole question of Electro Therapeutics.

THE MEDICAL STUDENT'S MANUAL OF CHEMISTRY. By R. A. WnTHAlT?, A.

M..M.D. New Yorlt.Wm. Wood&Co.

Already our shelves are crowded with works on Chemistry. Those devoted to students are especially numerous. Our first

278 ED J TOR'S TABLE.

impression is that another book is superfluous. A carefiil perusal of this manual will dissipate such an idea. To the medical stndent this book will prove of incalculable service. The principles of chemical science and chemftcai physics are well treated in the opening chapters. In this way the student can pass to the consid- eration of special chemistry an4 can appreciate the operations and manipulations with which the work closes. We heartily commend it as a text-book of rare value.

THE DISEASES OF THE EYE: THEIR MEDICAL AND SURGICAL TREATMENT. By J. H. BuFFUM, M. D., O. et A. Chir., Prof, etc., Chicago Homoeopathic College. One Hundred and Fifty Wood Engravings, Twenty-Five Colored Lithographs.' Chicago, Gross & Delbridge, 1885.

As Avant Coureur of the coming year sure to be full of jeood things comes this new candidate for public favor. We have taken it up with interest, scanned its well filled page.s, and now lay it down with a feeling of satisfaction because it has met our expecta- tion. Defects, the work undoubtedly has, but they- are none of them serious and can easily be rectified. For the first time we have a representative work in this department. It is well written and handsomely printed, and we congratulate the author upon his success and upon the fidelity he has shown in maintaining right methods in his treatment. The student and practitioner need not hesitate to add this book to their library.

EDITOR'S TABLE.

Married. — At Hanover, Ind., on October 1 1, by the father of the bride, J J. Sturgus, M. D., of Connersville, Ind., to Mary, daughter of the Rev. D. D. McKee. No cards. The doctor has just *been appointed physician to the Nisqually Agency at New Tacoma, W. T., the terminus of the N. P. R. R. Salary $1,200. We extend our congratulations; and hope to hear from time to time how "Lo!'' takes to little pills.

Died.— Dr. Chas. H. Crane, Surgeon General of the U. S. Army, died Oct. 10. He had only held the oflice one year.

Died.— At Cincinnati, October 8, of gastric fever, Mrs. Crawford, wife of Professor J. M. Crawford, M. D., Registrar of Pulte College.

Died.— Chas. E Blumenthal, M. D., L.L. D., of New York, late editor of The American Homceopath^ died .Oct. 11. He was one of the most noted linguists of New York, familiar with Hebrew,

EDITORS TABLE, 279

AmbiG, and Sanskrit, as well as most of the modern languages of Europe. He was Grand Commander of the Grand Lodge of Knight Templars. His body was cremated at Washington, Pa., and the. ashes deposited by the side of his first wife in the country cemetary at Carlisle, Pa.

Rbmoved.— Dr, B. A. Bradley from 135 W. 12th to 504 W. 7th St. Cincinnati.

J. T. Martin, M D., U. of M., has also received a Government appointment, as physician to the Indian Agency at Skokomish, W. T. Salary $1,000.

Dr. N. p. Smith, of Oakland, III., succeeds Dr. Obetz, at Paris.

Dr. H W. Hawley removed from Toledo to Cincinnati, Ohio, and formed a co-partnership with Dr. M. M. Eati)n.

Sherman's Pharmacy of Milwaukee has recently ispued a vefy neat and extensive catalogue and physicians' price list.

BoERBCKE <& Tapel's Pharmacy at New Orleans, has removed into new commodious quarters, 154 Canal street.

Walter Y. Cowl, M. D., removes to 152 W. .S4th street and his laboratory will be at the northeast corner of 9th avenue and 34th street, NY.

H. M. LiFKix, M, D., U. of M., goes to Anamosa, Iowa, where he succeeds Dr. Hall, who is taking post-graduate work in the Univer- sity of Michigan.

Dr. I. T. Talbot, of Boston is reported by the papers to be recovering from a dangerous attack of septicemia, the particulars of which we are not informed.

CiRo DE SuzzARA Verdi, M. D., has returned from a two years sojourn in Europe and settled at 1121 I7th street N. W., Washington, D. C. He will give special attention to nervous diseases.

Halsey Bros, have dissolved. The Chicago and Detroit phar- macies will be conducted by Tappan Halsey, the junior member of the late firm, while C. S. and G. E: Halsey enter the wholesale manufacturing business at 12 Madison St.

Any persons having purchased a copy of the U. S, Pharmacopctia of 1870, and desiring a list of the corrections since made therein, can procure same by sending a two cent stamp to Wm. Wood c^ Co., Publishers. 56 and 58 Lafayette Place, N. Y.

Science of September 28 and October 5 contains a very able arti- cle on "Climate in the Cure of Consumption.'* which will well repay perusal. This weekly is becoming a popular and able exponent of the latest developments in the scientific world.

280 EDITOR'S TABLE.

A. McNeil, M. D., our well, known contributor has been appointed professor of Materia Medica in the new Homoeopathic College in San Francisco. We congratulate the doctor on this rec- ognition of his abilities and wish him success in his new field.

Thb meeting of the .\raerican Public Health Association in Detroit, Nov. 13-lB, bids fair to be a representative gathering. We hope to see a large attendance. Many valuable papers will be read, and the question of Active and Associate members will be settled.

Dr. F. H. Orme, of Atlanta, Ga., met with a fearful accident recently by being overturned in his buggy by a runaway horse, and having both arms broken above the elbow. It came near costing the doctor his life, but from late reports we are glad he is happily recovering.

Dr. C. Lippe is preparing a second edition of his Repertory, and incorporating with it B<eninghausen's Repertory which has never been translated from the German. This will make it a very desirable office companion. But its usefulness would be greatly enhanced to the busy man by the addition of different type to distin- guish the value of the remedy.

There appears to be a lurking suspicion among some of our leading pharmacists that the experiments made by Dr. Smith, of Cleveland, to ascertain the relative purity of the diflferent brands of Sugar of Milk and Pellets were not quite impartial. To obviate any possible objection of this kind, in the interests of the profession^ and the members of the American Institute who furnish the funds with which to continue the experiments; and for the repntation of those men who are using their utmost endeavors to produce pure and reliable pharmaceutical preparations, we suggest the following: That the President of the Institute procure samples from the phar- macies, and that each sample be-iuumbered and the name and num- ber be retained by the president] the number and samples only to be given Dr. Smith. Neither should the pharmacies know when nor for what purpose the samples were procured. This could be safely entrusted to the good judgment of the President. Justice to all nterested would be secured by some scheme like this. h. c. a.

The annual meeting of the Medical Society of the County of New York for the election of officers, occurred October 22. It is needless to say it was a lively session. The ticket of the "Old Coders," although headed by a man of the fame, ability, unblemished reputation and rare personal magnetism of Dr. Thomas, was defeated by a majority of from 130 to 17") in a meeting where 600 members were present. This decided victory for "freedom of opinion" has

CORRESPONDENCE. 281

rang the death knell of the "Code" on Manhattan Island, i{^ not in the Empire State. It is needless to say that "this is none of our ftmeral." Nevertheless, when we see the American Medical Asso- ciation resorting to very questionable means to stifle discussion or prevent an attempt to modify its code; or when the American Sur- gical Association can deliberately expel one of its ablest members because he would not renounce his opinion at the ipse dixit of the Association, we cannot help feeling an interest in the contest at least, or an inclination "to pat the upper dog in the fight/* h. c. a*

CORRESPONDENCE.

ABORTIVE TREATMENT 01 GONORRHEA.

Dear Editor :^Who, among our homceopathic brethren has not a "pet" prescription or an injection ready for every case of gonor- rhoea that presents itself for treatment? and yet, how often that said "pet " prescription has failed us. Now, I desire to inflict upon your readers my ''pet" injection, one that is growing in popularity on account of its simplicity and non-irritating properties. It is aqua fevems, (hot water) and, when once employed faithfully, according to directions, becomes the "pet" treatment for all cases of acute gonorrhoea. One thorough application of hot water, in twenty- four hours, is equal in benefit to several injections of Zinc, Plumbum, Nitrate of Siher, Permanganate of Potassium, Hyper-sulphite of Soda, Hydroitin, or even green tea, during that time.

We reason first, that, two surfaces, in a diseased condition, in constant and close apposition with each other will be, as a matter of course, unfavorable to recovery, hence, to separate these inflamed walls of the uretha by hot water injections, each injection retained by compressing the glans penis for a period of five minutes, and repeated for twenty minutes at each seance will produce a mechan- ical result — dilitation of the uretha. Second, it removes all the gonorrhoeal discharge, a constant source of irritation to the uretha, and is, therefore, salutary in this regard ; and, thirdly, the well- known action of hot fomentations or hot water, upon all inflamed tissues is so beneficial that we need not dwell upon its applica- bility to gonorrh-^a. And, lastly, no danger to be apprehended from two powerful astringent injections, to be followed by cystitis or a stricture.

The indicated remedy should be given internally. p. p.

282 CORRESPONDENCE,

Always order this injeciion to be given with a good hard rubber penis syringe and the water at as high a temperature as can be tolerated by the patient, and you will be as highly delighted with the result as your victim.

Respectfully, P. P.

GYNECOLOGY.

SuB-iNvoLUTiON OF THE Uterus. — We have selected a part of a valuable lecture, given by Dr C. Gushing of San Francisco on the above subject on account of its great importance and close relation- ship to our general practitioners. There is no disease in gynecology, that causes more unhappy homefl with distress and suffering than sub-involution and none more susceptible to proper treatment.

The lecturer "considers premature assumption of domestic duties after parturition as one of the most frequent causes of this unfortunate condition, and he formulates the following sound advice to physicians : "

**If it is possible to do so, I know of no better investment of time and money than for a woman who is raising a family, to devote at least a. month following her delivery to rest and quiet^ and as free from excitement of any kind as may be. Unless she is confined to her bed by poor health, it is the only opportunity a mother of a family has to remain quiet long enough to get really rested ; and I would advise you to inculcate, in the most thorough manner, the minds of your puerperal patients with the idea that a full month must be given up to rest and recuperation after delivery, and that a portion of each day after getting out of bed must be spent upon a lounge or couch for several weeks. Of so much consequence do I consider this advice, that I would again urge you to use all your eloquence to show your patients the advantages to be derived from a month's bodily and mental rest following confinements. P. P.

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Editor.

FiriL PORTER. M. D..

Gyne<oi,o<;uai. Editor.

Vol. XIV

Ann AitHoij, Dkckmhku, 1ss3.

Xo. <).

All subscriptions and business communications should be addressed to MEDICAL ADVANCE PUBLISHING CO., Ann Arbor, Mich. Subscription, $2.00 per annum.

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THE .SCIEXCE OF FrRRIX.

READ BEFOUKTHE MrCROSCOPICAL CLIB OF Bl'FFAI.O.

IJY RoLLiN R. <;ri:<;i.. .M. D., Ml FF.VJ.". n. v.

[Continued froai No. '\\

From what was ob-served in tlie boiled blood, [ had said to two medical friends that I t)elieved atVr the fibrin had given up by rotting, all its hiirher anini;i[ life and organiza- tion, it would then take on the fonn-s of Hl)rin in vegetable life; and that herein might be found tlie secret or connect- ing link, in similaritv of forms, between the fil)rin of blood disorganized in and by disease, and the re.d bacteria in the lowest order of vegetable life, as in mouM. stagnant water, etc.

But after seeing that nothing of the kind took place at the end of four weeks, that idea was given up as the hope of too excited an imigination, and matters settled down to

281 THE SCIENCE OF FIBRIN.

what was considered cooler thinking on the subject. Two weeks more passed, and ray sample not having been thrown away yet, this idea of a second and vegetable life in fibrin, came over me with still greater force than before, and I pre- pared a new specimen for examination, and behold what an- other revelation !

New life and organization had been taken on, but in the main, of an entirely different character. There were still myriads of granules of fibrin to be seen in some parts of the field, even cluster;? of them, containing enormous numbers; but there had been a secondary net-work formed, in meshes entirely different from anything before developed. There were nuclei, or centers of exceeding brilliancy, from which fibres started out in two, three, or more directions, to meet like fibres, ffom other centres, and thus was the net-work con- structed. There were also great numbers of large cells show- ing "cleavage" or the binary sub-division by which cells mul- tiply— the beginnings and completion of it in much beauty. At this time too, ''tadpoles" and ''wrigglers," or forms much like them, appeared in large numbers. At six weeks and four days, there were still different developments, the net- work was different, and there were other differences shown, which we must however pass, for still other marvels.

At seven weeks the secondary net-work was entirely gone from most parts of the field, but the centers from which the threads started t) mike that work were there in all their brilliancy, and wbat may it bo supposed were the appear- ances then? Many of those centers had a halo surrounding them, much like the sun, or much as this is frequently pic- tured, though of far greater beauty than ordinary imitations. Nor was this all. The granules of fibrin had re-appeared in great numbers in nearly every part of the field, excepting for a short distance around each of those bright centers; and here the field was entirely clear of granules, as though they had been absorbed or attracted into those centers, and there consumed to keep up the brilliancy of th^ latter. It was, indeed, no great stretch of the imagination to fancy one's self

R. R. GREGG. js^

in the midst of a process of universe-buildings in a micro- scopic way, with central suns, and their planetary systems (granules of fibrin), around them, but at considerable dis- tiince therefrom. Some of these centers had a halo extend- ing out for more than a quarter, or even less, of their circumference like comets, some half, some three- fourths, and some all around, as though many of them were in process of construction, while some were just completed. All this, I am well aware, sounds much more like romancing, than like sober talk ; but scientists can prei)are their own speci- mens, and see how much of this is fancy, and how much of reality there may be as a foundation for such a description. One thing is quite certain, they will be interested in what they see; if not surprised at it.

At this time too, the ''tadpoles" and " wrigglers" had disappeared, or nearly so. A long search found but few of them. And in several specimens there was no net- work to be foun<l now, excepting at one small i>oint, where it showed in much beauty, but in the main different from any- thing before that. What more changes there may be I know not, l>ut am awaiting developments with much interest.

Thus is fibrin shown to be one of the primary and ori- ginal creations, at least in organic njiture; and it^^ granules are the most remarkable ''impersonations of immortality" to be found in this world. In no other way can be explained their various arrangements and re-arrangements again and again into such an almost infinite variety of forms as they show, and all from their own inherent forces apart frvim all other 8ourc<\s of life.

This fact of fibrin giving up its higher or animal life, and taking on a lower or vegetable life under decay, brings up the whole question of ''cultivation" and "staining" of bacteria, about which so much has been said: but it would require too much space to discuss those points here. One thing, however, I will speak of. The fibrin appeared to eat up, or attract to itself, all the rest of the contents of that bot- tle, the blood corpuscles, fatty matters, albumen, salts, etc..

28() THE SCIENCE OF FIBRIN.

and thereby had the food supplied to enable it* to develop all the great variety of forms that it went through.

But it may be asked what has all this to do with dis- ease, and the germ theory of its causation? It has just this to do with it. Inflammation and suppuration are always a rotting process, and the blood congested in the inflamed parts is rotted by the suppuration. The fibrin in the blood so congested, organizes naturally as stated; first into granules which join to form fibrils, and these into bundles or mem- branes. Next, suppuration breaks it all up in the inverse order, mermbranes and bundres into fibrils, fibrils into pieces, and these into granules, thus giving the bacterists all the forms ever seen in diseased products, from micrococci to rosaries, and from rosaries to *' motile filamentous bacteria," or "tadpoles" and " wrigglers," or any other forms they have ever seen. And not one of all these forms in disease is bac- teria at all, but the organizing and disorganizing particles of fibrin; not a germ in any sense of the word whatever, but simply a result, not a cause of disease.

To evade the results of these very damaging revelations the bacterists may, however, do as they have repeatedly done before wlien criticized, viz: change me, as they have others, with greet carelessness in not preventing bacteria from get- ting into my specimens from the atmosphere, and from that developing in tlie rotting blood. Professor Koch, of Berlin, last spring very unjustly charged Dr. Formad, of Philadel- phia, with carelessness in his work, though this wixs evidently done with the greatest care ; and simply because the latter, thoifgh a strong believer in bacteria, disagreed with the for- mer on some points.

But they must not take that course in this case. It will do them no good if they do. There is too much of this sub- ject to be set aside by quibbles. I grant that I was not very careful in keeping my samples from the air, beyond corking the bottle pretty tightly, and that I opened it freely when- ever I wished specimens. But nature is not so exacting as are the bacterists, in requiring conditions almost impossible

R. R. (UiEOG. 287

of fulfilment, to learn what she does and how she does it. Once the key to her work is found and evei-y thing is made as plain and simple as it is possible to wish; and she then leads the true observer on step after step to greater and still greater wonders, which are impossible for the human mind, even the most imaginative to conceive without first seeing them.

To confirm this it was perfectly easy to see how all the assumed bacteria of disease are made. The bacterium termo or rod-like bacteria, are :iiade by the fibrils of fibrin breaking up into short pieces or rods; and the micrococci by these pieces then breaking up into the separate granules of which they are constituted. The rosariee are made as follows: A ring of fibrin will form around a globule of oil, many exam- ples of which I have, then under deca v, some of the granules or a longer or shorter piece, will fall out of the ring, and the balance of the granules constituting the ring will partly sep- arate, to give it a beaded appearence, when the rosary appears. The chains are made by fibrils doubling upon themselves at or near their middle, and then twisting up, precisely like twisting a piece of twine, then doubling it and letting it twist upon itself— thus making a close twist, or close links, if hard twisted, or long links if loosely twisted. The doubled end forms the loop or ring for that end of the. chain, while if not doubled in the middle, the larger end of the fibril will curl, to form the hook on the other end of the chain. The "tad- poles" and 'Svrigglers" were made in an equally simple manner. The secondary net-work spoken of, when breaking down, would show a separation of all the threads but one or two, from the central nucleus or head from which they started; and if but one thread were left this would form the body or tail of the "tadpole/' and the nucleus its head; or if two threads were left attached to it, then it would be two- tailed as some were.

If it should still be insisted upon that I was careless in my manipulations of the rotting blood, I was nevertheless cautious enough to wash a large clot of blood until every- thing but fibrin was washed out of it, so I knew I had nnth-

1'88 THE SCIENCE OF FIBRIN.

ing hut fibrin to deal with. This I also boiled and rotted, and treated in various ways to see what it would do, and it told much the same story in many particulars, though it wns not so rich in developments as the rottintr blood, simply be- cause it had nothing else to feed upon as in the latter case. The facts thus gained, I used for frequent comparisons, to avoid errors in conclusions as to what was seen in the blood, and was thus aided greatly in my work.

Furthermore, I was careful to put the thinnest possible fihn of organized fibrin from a washed clot of healthy bloo<l, upon a slide, and closely examine that; which, by the way, some bacterists h{ive evidently never done. In this way, and with the very first specimen I tried, I obtained a perfect re- production of some cuts or micro-photographs of " anthrax bacilli," which Dr. Belrteld, of Chicago, furnished last win- ter, in connection with his ''Cartwright Lectures," and pub- lished in the Neio York Medical Record^ the 24th of last Feb- ruary. How any physician ot intelligence, who had ever examined organized fibrin, could have furnished such cuts and called them "arithrax bacilli," is entirely beyond comprehen- sion. The only rational conclusion is that the Doctor never examined healthy fibrin, to see how it did look.

Why, from the fibrin in the fluid of a blister, caused by friction, on the hand of a perfectly healthy boy of thirteen, I obtained beautiful specimens of '' micrococci" and '^ bacillus subtiles." And this brings up one of the most astounding results in all this chapter of wonders. After that blister- fluid had dried on the slide, its fibrin presented the most beautiful imitations of ferns, mosses and even of corals, I ever beheld. They remained in that form for three or four weeks; but, (and here the great wonder comes in\ these forms have now, at the en<l of six or seven weeks, and on that dry slide, more than three-fourths of them, entirely changed, and in the main, present wholly different appear- ances. There are the most exquisite cactus-like kind of growths that it is possible to conceive of. Now, also, several excellent imitations of star-fish have appeared. How all

R. R. GREGG. 289

this has been brought about on that dry slide, I, of course, know not; but it has been done. This secondary and cac- tus-like growth appears to have formed and grown on the sur- face of the fern-like and mossy growths that preceded it, traces of the latter being still seen in the distance behind the former. This shows the fact, that fibrin can be *' cultivated," as the bacterists say of their claimed bacteria;, and as would appear now, is the only thing that can be cultivated in this manner.

And here too, in these manifold developments of the granules of fibrin, we find the long* sought connecting link between vegetable and animal life; and it is not impossible that this may settle the whole question of evolution. Possi- bly, moreover, we may here find evidences oi spontaneous generation or something akin to it, but this I cannot yet ac- cept.

Even from the water in which a few choice potatoes were thoroughly boiled for eating, and a drop or two of the water put at once upon the slide, boiling hot, I obtained "micrococci" in great numbers, and " bacterium. termo" in less but considerable numbers; and something of the same from the milk of both raw and cooked green-corn. Fibrin is contained in all vegetable structures.

If one wishes to see the most awkward and coarse imi- tations of vegetable growths, fern-like and otherwise, and at the same time the most delicate and exquisite, they must ex- periment with water in which potatoes have been boiled. The difference is owing to whether the fluid dries slowly of itself on the slide, or is dried quickly by heat, the latter giv- ing the exquisite forms.

And here I will indulge in a little speculation. Fibrin certainly must have several kinds of life, to go through all these changes or evolutions, and that spontaneously when separated, as it was, from all other life. In no other way can we account for such astonishing developments as I have seen, and herein detailed. Well, when disease attacks us, it of course lowers our vitality, and renders the principle of life

290 THE SCIENCE OF FIBRIN,

in us- incapable for the time of domiyating fully over the life and great activity of all the fibrin within us, as it does in health, keeping this up to its higher work and purposes, for the needs of our higher existence. Then, some of this fibrin in us, though comparatively little of it, freed from full control, begins to manfest the activity of its own life, and first shows that kind of growth in which it has the strongest life, then the next after that, a'nd so on down. And in this way different diseases show a different loss of control of our life over that of fibrin, thus allowing this to develop in different ways in different diseases to correspond with all the bacterists have ever seen in disease, and called vegetnhh parasites.

Since the foregoing was written I have received from England the Loivhn Summary of August 22d, 1883, sent nie by some one who had marked an article on yellow fever, which starts off* thus: *'A series of investigations into the origin of this pestilent fever have just been made by Dr. Domingas Frieze, a Brazilian physician. Dr. Frieze has dis- (»overed that the bloo<l of the patient contains a minute point, and in one form or another continues in existence after the death of the patient.'' This *' minute^ point" is the inevitable granule of fibrin from the patient's own blood, coagulated into granules, or '' points,'' by the fever. And the fact of its ''continuance in existence,'' ''after the death of the patient/' is due to the life of the fibrin which does not die with the patient; but goes on developing into "one form and another." long after animal life has lost all control of it. as I have already sufficiently pointed out.

A few words now in a general way. If half that I have claimed on this subject be true, then it has already passed beyond a mere personal matter, or personal triumph, and l)ecomes a great public question. And being that, the pro- fession in this city may well take an interest in it, as of no little consequence to the future credit of our city. Further. I will say that there is sufficient talent in the profession in this city, if men will only forego all prejudices and examine

NURSING BABIES. 291

the subject solely upon its merits, to settle all points of it right here for the world and for all time. That certainly would be something worth working for, and one man cannot well do it all alone in any reasonable length of time.

Why should this not, in fact, become a national ques- tion? Professor Koch and his co-wojkers in this field have the German government to sustain them and to supply ample funds for all needs; and Professor Pasteur has the French nation at his back, voting him large sums to carry on his wor)c. But this must not be construed as an appeal for national aid in my work. The truth ivlll stand without national help. It is error alone that that needs support. But I want to see this subject, this science of fibrin, built up to what it can be made by the tal^t of this country alone; and not longer see our home talent accepting error for science, simply because it comes from abroad.

It is possible, indeed it is very probable, that I have made some misti\kes in piy hurried investigations, but after ample allowance is made for many mistakes, there will still be facts and marvels enough left to fully satiety all Reason- ably exacting and reasonably critical investigators.

Our knowledge of disease, and of its beginnings and progress is going to be greath/ extended by thorough investi- gations into the action of various diseases ui)on the organi- zation of the fibrin of our blood; and also by the effects ot disease upon our blood corpuscles. Nor in this work must the effect of all diseases upon the natural and healthy pro- portions of the constituents of the blood be overlooked. These few points thoroughly investigated will lift much of the mys- tery from three-fourths or more of all morbid ])henomena.

NURSING BABIES.

BY J. F. EDGAR, M. D.

"Doctors differ" of course, but the thoughtful, clear headed ones are beginning to see that the digestive troubles

•JiL^ XCR^IXG BABIES.

of babies and children are caused by their stomaelis being exhausted by too frequent nursing or feeding.

And they are tamjid to cry by tJieir mothers or nurses! Most mothers will at once sharply deny this; but I assert it earnestly — the Iniby is taught to cry!

Baby seldom gets his nourishment till he cries for it. If he cries again from colic, or a bent pin, or any irritation, the nipple is shoved in his" mouth tu quiet him ; at night when the stomach is beginning to get out of order and baby is restless, the ni]»ple is agjiin shoved in his mouth, sometimes every hour — more or less — exhausting the bnbies digestive powers, and exhausting tlie mothers as well, also depraving the milk. ' Then ai^ain, the bal>v being rused in this wav, as he gets older and wants to i)lay, but being hungry, comes to the mother and cries till she puts the nipple in his mouth — he nurses a short time, jumps down and plays awhile, comes back and whines for more, gets the nii)[)le again, piobably three or four times till he is asleep. Now you all know^ that is wrong, — try eating that way yourself. If a baby's, reactive power wasnt far ahead of an adults, they couldn't stand it any better than you coidd. But the stomach's *' patience ceases to be a virtue" after a longer or shorter time, and the baby has indigestive bowel trouble, and so called "sick from teething/' and many of them die, and it wasnt the mother's fault— or the doctor's, " for they did every thing they could."

That was it exactly, ''did everything they could" to weaken the baby's life force.

I can't leave my weak criticism of the habit of giving the child the nipple every time it cries, till I speak of the expression of a six year old child whom the mother was still nursing, and wdio got her linger burned, and cried in agony, and constantly, although- many soothing applications iiad been made to the burn.

Suddenly she said, "Mother give me the titty quick! that will sto}) my crying; why didn't t think of that belbrel'' And it did stop the agonizing sobs at once, and after a few

/. F. EDGAR, 293

draws from the breast, she jumped down and went about her play.

* * * ♦ 3|C * *

I have been in labor with this subject a long while; will not some of the profession take it up and help me out with it? The proposition, as I understand it now, is to have r^ular hojurs to nurse the baby, and nurse it full at those hours, and at no other time. The hours I have selected are 6 and 11 a. m. and 4 and 9 p. m. thus giving a full night's 'rest to both mother and baby. At first, baby may waken in the night, but by tu'rning him over, or patting, or a little water to drink, — sweetened if you wish, — for baby will soon learn that his crying will not bring him the nipple till the regular time; and those times ought to have some kind of noise that the baby will learn to recognize as feeding time, and I have this day written the Seth Thomas Clock Co. to see if they can't make an apparatus to strike only at those hours.

The worst crying babies I have ever seen when nursed or fed as I have described in the foregoing, when I could pur- suade the mother to change, to nurse only at regular periods, long apart, soon changed their temperment and health to that of a child to near what a baby should be.

And distinctly understand that when the' baby is nursed it is to receive a full supply ; if it is not furnished naturally by the mother, then give her remedies that will increase the flow naturally, and supplement that with artificial food till the desired quantity is attained. And if feeding is resorted to, either wholly, or partially, do not use rubber nipples and feeding bottles, but teach the baby to drink it out of a small glass, which he will learn in a day or two, then let him finUh with the mother^s nurse at all times.

Upon another thing let me write my 'condemnation: the practice of some mothers, who having an abundant flow of milk, waking a sleeping baby in the night, or at other times, to nurse out the swollen breast, because it hurts them. They don't deserve the sacred name of mother. I invite the opinions of the profession on the foregoing subject.

2«4 TUBERCLE ONLY A LESION OF SCROFULA.

TUBERCLE ONLY A LESION OF SCROFULA.

TRAN'*LATED BY O. B. MOSS, M. D

In looking through VArt MMical, I find under the head of (.ieneral Pathology, the article whose title is given above, from the pen of Dr. Piedvache. Since this article was writ- ten, (1880), Dr. Koch has become famous by his researches respecting the etiology of tuberculosis; and even now other well known observers claim that the same kind of micro- organisms, which Koch claims to be the basis of the tuber- cular disease in the lungs, may be found in the sputa and feces of the healthy! Thinking, therefore, that, while these disputes are being carried forward by able pathologists, it might not be amiss to review the. subject briefly from the point of view of our French confrere I take pleasure in offer- ing the following to the readers of The Medical Advance:

To the readers of VArt Medical^ as to the pupils of Tessien and of M. Jousset, pulmonary phthisis is nothing else than a scrofulous affection. It is the same tubercular products localized in the meninges, the serous coats, the testicle^ kidneys, etc.

It is a <iuestion of nosology, independent, more or less, of diffusion and frequence of the tubercular lesion in the manifestations of scrofula, constitutional disease, character- ized in consequence by the multiplicity of morbid products.

To discover what these are from amongst those affections which have a tubercular nature, is then a question of path- ological anatomy, of which the solution is not indispensable to the constitution of the unity of scrofula and to the nega- tion of a so-called tubercular diathesis, — of the tuberculose: in a word, following the harmonious terminology in vogue. Do they not also say i^crofulom? But we shall see this study develop another forced conse<[uence, which is that arthritic and herpetic phthises have existed.

The discovery of tubercle in affections like King's evih Avhite tumors, lupus, for example, constitutes a potent means

0 B. MOSS. ' 295

of conviction, a veritable proof by analogy of the absorp- tion of tubercle through scrofula, although, let us not forget, insufficient by itself to carry evidence unliess joined to the totality of clinical characteristics.

The importance of this fact had been well understood 4)y Dr. Thaon, (of Nice,) commented on by M. Jousset (Art Midiccd). He pointed out tubercle in King's Evil, and drew from it a very weight}' argument for the place of phthisis in nosological list. This proof appears to me to have been extended and precisely stated in the recent excellent work of Dr. Brissaud, prosector of the course of pathological anat- omy for the medical faculty. A short analysis which we will make from it will not fail to interest the readers of a journal which has, whether designedly or not, inspired all these ideas and formulated a long time in advance of all this doctrine.

The German, Friedlander, demonstrated first, in 1871, the anatomical identity of tubercle and certain products of scrofula, particularly lupus. It is just, nevertheless, to ascribe to Bazin the honor of the discovery, in spite of the evasions which we will reconsider. No one will question the scrofulous origin of true lupus; it has incontestably the stamp of that malady.

Continuing the works of Charcot, and under his sug- gestion, Brissaud found in scrofulous products, in the fungi of white swellings, tubercle exactly identical with that of common phthisis. (Revue Menmelle de Medicine et de Chirur- gie, 1879.)

These facts were not satisfactory and could not be easily accepted, for one can not pass in a day from the negation of scrofula, as a lesion, to the complete comprehension of its phases of evolution. Also H. Martin first, then Grancher, pointed out the so-called differences between the tubercle of scrofula and that of phthisis. The full-grown tubercle, that is to say, the gray granulation, was never seen in scrofula by Grancher particularly, which leads to this enormity (only when by chance, as we shall see presently, the granulation is

296 TUBERCLE ONLY A LESION OF SCROFULA.

met with there) that scrofula ceases to give place to tubercu- losis. It is necessary, then, that our age should have for- gotten every nosological idea, to subordinate the knowledge of a morbid species to a simple problem of pathological anatomy. Strange confusion! One realizes very well never- theless that it is not the true ground which the mind seeks so much as clinical arguments. The tubercular disease is recognized; says H. Martin, by the generalization of its lesions. According to this statement, how much of phthisis localized in the lungs would be foreign to the so-called tuber- cular diathesis? And yet, is it a disease usually, and of its nature generalized, of which the lesions can not be localized? For example the purulent diathesis, which can be explained as a single or circumscribed lesion ; rheumatic endocarditis, etc. To distinguish a morbid sj)ecies, one ought to require the sum total of specific characters, a distinct evolution, while attentive observation teaches us that generalized or localized phthisis is a phase, a period or a form of the evo- lution of scrofula. Primitive phthisis, or phthisis in its incipiency, is only an apparent exception which one meets in all constitutional diseases. Tertiary syphilis offers many analogous cases.

Brissaud, to whom it is time to return, takes up judic- iously the anatomical constitution of the tubercle. Does it ])0S8ess a specific element? First the cell of Lebert had its day; the giant cell, which Schuepfel announced a short time in Germany as characteristic, is seen in several other pro- ductions; it does not exist as a special element. But they believe generally to-day (Koster, Brissaud) that what is peculiar in this morbid product, is the arrangement of ele- ments, that is their reciprocal relations to constitute what they have named the primitive tubercular follicle, visible only under the microscope. It was composed at the centre of one or two giant cells with their ramified prolongations, and at the periphery of a layer of cells called epitheloid.

The casejication is effected from the centre to the peri- phery; this is moreover susceptible of transformation into

O. B. MOSS. 297

fibrous tissue, which clearly proves that tubercle has a nat- ural tendency towards recovery. The accumulation of a more or less large number of these follicles, their complete or regressive state, accounts for the diverse forms admitted by Laennec: miliary tubercles — granulations — unformed tubercles in masses of variable size — encysted tubercles. - The casefication commences always through the centre of the agglomerations.

Behold then the grey granulation, semi-transparent, divested of its preeminence; the four forms of Laennec have the same anatomical constitution. And one can no longer argue from the absence of the granulation in caseous phth- isis, in scrofulous lesions, to call in question the presence of true tubercle.

But still, is the al)sence of the granulation Constant in cases of this nature? We shall see that it is not, as it is true that it is nothing else anatomically than a mode of grouping follicles, and clinically a form more grave. Bris- saud has encountered it in effect sufficiently often in local tuberculization of scrofulous origin, in the uterus and ovaries, in white tumors, in the lungs around the centres of the tubercles of recovery of Cruveilheir, the same centres which Bazin described under the name of pulmonary scrofula. Brissaud relates from this last category two or three curious observations.

The history of the anatomy of lupus is not less inter- esting. Bazin admitted formerly its tubercular nature, while the Germans considered it as a common lesion, con- cerning tliemselves but little about scrofula for which Lebert had not found the proper anatomical element. Unsettled by the works of Auspitz, Bazin changing his opinion, after- wards regarded lupus as fibro-plastic. But Friedlander. taking up the old ideas of French dermatologist^^, showed ' tubercular infiltration of the skin in this affection, the same as for scrofulous ganglions and articular fungosities. Never- theless Volkman imagined this ingenious theory, that scrof- ulous affections Avere onlv tuberculoid.

29S TUBERCLE ONLY A LESION OF SCROFULA.

The return of these German works to France has been extremely unwelcome, though we know that Brissaud has already taken up the investigations and verified with perfect iexactitude the conclusions of Friedlander. While the lesion of lupus exists in 'the skin, the scrofulous gomme, tuberculous also, has a sub-dermatic localization. They have not met then so far the granulations formerly classi- fied, but that is not necessary. The French school has returned with reason to the true doctrine of the unity of phthisis: Grancher in particular is a very warm partisan of it. One may then enquire of him, by what claim caseous phthisis is a true tubercular affection more than any other local tubercle lesion, if all the anatomical forms of tubercle are not equivalents? Brissaud goes on to conclude — and it is a marvel to see how a just notion of pathological anatomy could make him understand the higher and more difficult nosological solution. The right path always conducts to the truth.

Does it result, says our author, from the existence of true tubercle in scrofula, that this is going to disappear before that? No, he judiciously replies, because all lesions of scrofula are not tubercular. What results, on the con- trary, says he, is that the scrofulous (?) diathesis absorbs to its profit the so-called tubercular diathesis. Scrofula is not an ephemeral malady; it continues for years like syphilis, and tubercle is an anatomical detail of that diathesis; but it does not represent a unique morbid variety any more than it is fatal and inevitable. In otiier terms, the scrofulous are not more condemned to have tubercles than are the syphil- itic to have gommes; but both are equally menaced. From the day when one becomes scrofulous as from the day when one becomes syphilitic one is exposed to the superlative manifestations of the diathesis. Does this conception exclude incipient phthisis from scrofula which occurs unexpectedly in a subject reputed to be exempt from every scrofulous accident? Never.

One can only take up here the term diathesis applied

ANAL FISTULA. 299

to scrofula, and the incorrect idea that one becomes^ scrofu- lous as one becomes syphilitic. It is stately language not unworthy of VArt MMical, to the doctrines of ^ which it is a splendid homage. May these doctrines born of the genius of Tessier be powerful to impress the mind !

I will take the liberty of adding to the discussion of the author an indispensable corollarj^. Since, in effect, phthisis is an affection of scrofula, and since in another form its characteristic anatomical lesion is found in other scrofulous affections, it still would not be known as an arthritic or herpetic affection ; it is a stern consequence. And arthritic and herpetic phthisis are suppressed into naught. Also nothing indeed hinders the herpetic or gouty from becoming phthisical; that is seen every day, because it is possible that they be at the same time scrofulous. But M. Pidoux, the early master of all these phthises, has nevertheless taught us that the most fortunate occurrence for the hepetic or gouty, who have become phthisical, is to see the gouty and herpetic manifestations freely reappear, for then the tuber- cular malady can be more easily checked. The learned inspector of the Bounes Srprings has himself seen there what he has called elements of antagonism. ' That is remote from this theory for the identification of phthisis with gout or herpes. Brought back to their true point, these very substantial facts usher in a new day more favorable to prac- tical consequences, and merit a special study for which this is not the place.

ANAL FISTULA.

M. RORABACHER, M. D., BATTLE CREKK. MKH.

Without desiring to occupy space or time with a disser- tation upon' the inception and history of this disease, we will confine ourselves briefly to that which most interests the busy practitioner, viz: The treatment of this most obsti- nate and perplexing disease.

800 ANAL FISTULA.

In the outset let me say that the surgeon is scarce ever made aware of its presence in his patient, particularly in females, on account of delicacy, until it has made consider- able inroads into the constitution, and consequently much valuable time is lost, and the disease has become aggravated by delay.

Fistuhe may for convenience be divided into two plasses, the complete and incomplete; complete when it has an external perineal opening, and an internal or rectal opening; and incomplete when the sinus or canal does not enter the intestine. Formerly in nearly all cases, resort was had to the knife as a means of cure. This was done by thrusting a probe-pointed scalpel or history into the external opening of the fistula, the finger or a round stick the size of the finger into the rectum, and then by one sweep downward and out- wards, divide the sinus, sphincter muscle, and all intervening tissues. It is against this treatment that we wish to raise our protest, not only because of its many signal failures and consequent inconvenience to the patient, but because we believe there is a better way, and one far more pleasant to both surgeon and patient.

When the surgeon is made aware of the presence of an Anal Fistula in his patient his first duty is to carefully and slowly examine, by probing, every part of the sinus to ascertain its direction, and branching if any; this determined he should then take a small pledget or tent of fine absorbent cotton, and inclose some finely pulverized Sulphate of Zinc, introducing it into the sinus, making sure that it is pushed to the bottom or to its opening into the intestine. This will not cause the patient severe pain, but simply a burning in the parts for an hour or more. It will thoroughly destroy the pyogenic membrane forming the walls of the sinus. This is the first and most important step towards a cure. After two or three days we shall find this membrane to have completely sloughed out, leaving the opening or canal ina healthy condition for healing, which must be assisted as rapidly as possible. We are now to take another tent of

CHEESY PSEUMOMA. 30T

cotton saturated witli plain Cosmoline and introduced into the opening, pushing it to the bottom, to prevent the canal from healing externally before it does at the bottom. This will insure healthy granulations which will soon close up the canal from the -bottom whilst it is open externally giving drainage for the necessary discharge. As to internal reme- dies, the general condition of the patient must govern our prescribing, but material aid will be given by such remedies as Caust., Graph., Silica, Sulph., and perhaps Merc. The patient should not be allowed to walk much during the healing process.

If this mode of treatment is closely followed, fiiilure need not occur, and the terrible abhorrence on the part of patients to the use of the knife obviated.

CHEESY PNEUMONIA OR CHRONIC PHTHISIS PUL-

MOXUM.

BY <;. N. ftRKiH.VM, M. I)., 011ANI> RAI'IDS.

Mrs. Scott has been failing in healtli for three years. Is. now at her climaxis not having menstruated for three months. Has been troubled with a cough for three years and constantly getting worse, and her strength also has steadily diminished and more especially for the last six months. Attending physician has treated her for bronchitis which may have been the charact r of her disease at first. She has a bad record in family history as most of her friends have died of consumption. Percussion shows dullness of most of the up]>er third o^ the right lung and tenderness from percussion stroke. Auscultation gives brochophony and mucus roles of a suspicious character. Expectorates a thick yellowish muco-[)urulent matter. My theory is that a chronic bronchitis has progressed downward until casts have blocked the air-cells, and by pressure strangulated the circu- lation mostly in the ca])illaries in this part of the lung. This has caused exudation also from the walls of the blood-ves-

302 CHEES Y PNE UMONIA .

sels of a fibrinous nature which are of the nature of tubercle or histologically follow probably the laws of tubercle. In this way a large per cent, of our consumptives come to us. Her temperature is only a little above the natural but her pulse sums up over 100 per minute. She has night sweats very little appetite and is sleepless and nervous. Has chills which begin on the hands and run up the back; hot hands and feet and flashes of heat. Is troubled with an irritable bladder, weakness of chest from talking — says she coughs most in the morning. Gave Sulphur 100 m., (Fincke.) one dose, to be followed in two days by Lachesis 200 at night on going to bed. Reports in one week. Night sweats nearly gone, cough greatly ameliorated— raises less and feels much better. Continue Lachesis at longer intervals. Reports in two weeks. Pulse down to 90 per minute, continues to improve. This patient has now been in our charge for five weeks and seems progressing well. We had grave doubts about her recovery when we took patient owing to her age and antecedents, and so expressed ourselves to her huyband. We ordered Trommer's Ext. Malt to be taken three times a day and plenty of out of door excercise. We also ordered her the free use of milk and cream and a good diet; that she should be carefully wiped off after sweating, with alcohol and rubbed dry; that she should wear silk next the skin over the chest and on her feet.

This patient came to us after visiting Detroit, and con- sulting a physician who diagnosed a tubercular affection of the apex of right lung and selected for her treatpient Sul- phur 200 and Calcarea Carb. 200 in alternation, which she had taken for one week with a slight amendment as she thought, upon the cruder drugs taken for the three years previous. The improvement, if any, is no doubt, from the use of Sulphur and not the Calcarea. But the quick response from the one dose of 100 m. shows how much better its action, and this supported by Lachesis a valuable remedy for the menapause seems to have accomplished all that could be desired.

PESXSYLVAh'lA MEDICAL SOCIETY. _ 303

H05ICE0PATHIC MEDICAl. W)CIETY OF PENNSYL- VANIA: ANNUAL MEETING.

[Coi tin lied from No. h.\

EVENING SESSIQ^vJ.

Ifv. B. W. James resumed the discussion by making remarks on the poor ventilation of school- rooms. Frequently the heater and ventilator were on the same side of the room! so that the air came out of the heater and immediately passed upwards, and out of the ventilator without warming the room.

Dr. J. F. Cooper said that in the construction of our buildings, we should see that ventilation should be so attended to, that the inhabitants breathe the air in as natural a condi- tion as possible. In some of the buildings in Europe, fresh air is procured by forcing it in by a fan kept in constant motion. Sufficient attention is not paid to the ventilation of public halls. If the air in these should be surcharged with carbonic acid, many who are compelled to breathe it cannot resist the drowsy influences thus engendered.

Dr. L. H. Willard spoke of impure food and drink. He •referred to an epidemic of typhoid fever under his observa- tion which was undoubtedly due to impure milk.

Dr. B. W. James said that while in England a year or so ago, he called on Dr. Richard Hughes, who told him of a number of cases of typhoid fever he was then treating, arising it was supposed from drinking contaminated milk.

Dr. Trites thought that from the discussion this evening, one would be led to believe that to have a house in a sani- tary condition was impossible, yet such things were feasible. We should have sanitary inspectors, whose business it was to enforce all sanitary measures in the construction of houses.

Dr. A. R. Thomas said that before we could regulate matters under discussion, we would have to uYiderstand the causes of disease. It really looks as if the germ theory of disease will answer many puzzling questions.

Dr. J. F. Cooper then closed the discussion by making a

304 PENNSYLIANJA MEDICAL SOCIETY.

few remarks; and Dr. A. R. Thomas, chairman of the Bureau of Patholog}^ and Pathological Anatomy presented his report. But two papers were presented by ihis bureau. One on the ''Pathology of the Blood" by Dr. A. R. Thomas, and the other "On the Arrangement of Living Matter" by Dr. W. C. Goodno. These papers were read and referred for publi- cation. No discussion ensuing, the report of the Bureau of Ophthalmology, and Otology, Dr. Wm. H. Bigler, chairman, was declared in order.

Dr. Bartlett in his paper "On the Etiological Relation be- tween chronic suppurative otitis media and brain disease" contended that disease of the middle ear, was liable to be fol- lowed by cerebral disease, not by reason of suppression of the original disease, but by extension of the primary inflam- mation to the brain by continuity of structure.

A paper by Dr. Jos. E. Jones of West Chester, was then read by title.

Dr. Pemberton Dudley presented by synopsis, a paper on the "Physiology of the Middle Ear.'' He explained that under the received theory, that sonorous vibrations are trans- mitted across the tympanum by the swing of the ossicles, the fact that the ear can appreciate a number of notes at one time, cannot be understood. The additional fact that destruction of the membrane with consequent loss of the ossicular function, does not destroy the auditory sense, fur- nishes strong evidence that the old theory is either entirely wrong or else at least incomplete. His own view is, that sonorous vibrations do not cause movements of the ossicles la inass^ but oscillatory movements of their purtkle^ only, and that in^all probability most of the vibrations are transmitted through the tympanic air, and not through the ossicles at all. the function of the latter being chiefly and perhaps solely, to "set'' or "attune" the tympanic membrane in the first place, and {hy pressure of the stapes against the cochlear fluid) the membrane of the "round window" in the second place.

Dr. Bigler read a paper on the " Relation of Ophthalmos- copy to General Medicine" of which the following is an ab-

PENNSYLVANIA MEDICAL SOCIETY. 305

stract. There are certain general symptoms that depend upon certain conditions of the eyes, and can only be remedied by treatment of these. Such are the head-aches and neuralgia, dependent upon muscular and accommodative asthenopia, and are relieved only by the use of proper glasses. There are certain diseases of the eye, dependent upon systemic condi- tions, and therefore to be remedied only by attention to these, as disturbance of the sexual organs. Disorders of digestive organs affect the eye, producing muscie volitantes. Serious deterioration of vision often results from disease of the teeth and jaws. Retinal affections sometimes attend chronic liver complaints. Catarrh occurs in diabetes, and certain forms of retinitis in Bright's disease. Certain abnormal conditions of the pupil are noticed in various diseases of the nervous system. Retinal hemorrhage may point to atheromatous blood-vessels, hypertrophy of the heart, or impending cere- bral apoplexy. The changes in Bright's disease, point so unmistakably to it that the diagnosis can be pronounced even before the onset of albuminuria. Locomoter ataxy can frequently be diagnosed by the ocular symptoms before the staggering gait has occurred. Meningitis is frequently recog- nized first in the eye. Finally, in localizing tumors, clots and lesions in the brain, the ocular symptoms are of the highest importance.

The report of the bureau was now placed before the so- ciety for discussion.

Dr. Farrington referred to a case under his observation of a little boy, eet. twelve years, who had a series of nervous symptoms which led his physicians to diagnose brain dis- ease. The fitting of proper glasses cured. >

Dr. H. C. Allen believed that specialists often overdid matters. They will have every third or fifth child wearing glasses. He had seen cases in which specialists had pre- scribed glasses, and afterwards, when these patients had im- proved in healthy under homoeopathic treatment, they were enabled to throw glasses aside.

Dr. William A. Phillips, of Cleveland, Ohio, said that in

30G PEXNS YL VA N/A MEDIC A L SOCIETY.

no disease did the general practitioner more frequently fail in his treatment than in chronic otorrhoea. He is also apt to counsel his patients to let the disease alone. Yet this trouble may go on and produce fatal brain disease. Only recently a professional friend called on him and spoke of his little daughter's case of otorrhoea without apprehension, j^et the symptoms were such ns to show that brain disease had already set in. That child died in a few days. The sooner the discharge can be cured, the sooner will the patient be out of danger. Dr. Allen spoke of cases cured by the general practitioner. Those were cases in which there was apparent myopia after the spasm of the muscle was relieved ; then there was no necfessity for the use of glasses. Myopia of school children is produced only by continually working at close objects. In answer to a question by Dr. Morgan, Dr, Phillips said that the symptoms in the fatal case of otorrhoea, were headache, fever, rigor, tenderness over the mastoid, and beginning stupor.

Dr. B. \V. James thought that these ear troubles should be cured as soon as possible, for there is great liability of ex- tension of the diseased process to the niastoid cells. In some cases, it is advisable to make local applications.

Dr. H. C. Allen said that specialists having their atten- tion directed to certain subjects, were apt to run in grooves. Having their thoughts continually directed to the eyes, they were very apt to neglect constitutional symptoms, and apply topical applications where the general practitioner woul,d cure the patient with his constitutional remedies.

Dr. Higler disagreed with Dr. Phillips regarding the cause of the trouble in the cases wearing glasses referred to by Dr. Allen as having been cured. These were cases of hyperme- tropia. Weakness in the muscle of accommodation produced by poor health, caused asthenopia. The remedies building up the general health, the asthenopia was cured.

Dr. Morgan said that in some cases the emmetropic eye may be affected with weakness of the ciliary muscle, and may require convex glasses for its relief.

PENNSYLVAXJA MEDICAL SOCIETY. :m

There being no further discussion, the bureau eh)sed, and the meeting adjourned until the following morning.

SECOND DAY. — MORNING SESSION.

The report of the Bureau of Paedology was called for, and Dr. M. M. ^Walker, the chairman, responded by reading a paper by Dr. S. F. Shannon on *' Gastritis."

A paper on '* Haemorrhage from the Umbilicus," by Dr. J. R. Mansfield, was presented on behalf of the Germantown Medical Society. The paper closed with the^ report of the case of an infant, five days old, in which haemorrhage from the umbilical cord set in. Re-ligation of the cord and Hama- nielis locally, relieved for awhile. Then styptic cotton, nitrate of silver, compresses, and persulphate of iron were applied, with no avail. At last, a subcutaneous ligature was applied about the umbilicus, but the child soon afterwards died.

Dr. Van Artsdalen then read a paper in which he treated fully of the etiology, symptomatology, etc., of ** Cyanosis."

Dr. J. C. Guernsey read a paper on ** Convulsions." The following are a few of the remedies recommended, with their indications: A mijl nitrite , unconsciousness, inability to swal- low. Hepar in cases caused by injury after Arnica fails. Bryonia^ cases arising from repercusJrion of measles. Camphor, from suppressed catarrh of the head or chest. Cuprum, after the spasm, the child twists and turns until another one comes. Hydrocyanic arid, spasms affecting muscles of the face, jaws and back, blueness of the surface of the body. PloHna, in ansemic children, tonic spasms without loss of consciousness. Stannum, convulsions with the cutting of each tooth, worm symptoms. Stramonium, spasms better in the light and worse in the dark. Veratr, vir,, anaemic sub- jects, from exhausting diarrhcea. Indigo, when there is great tendency to frequently recurring spasms.

Papers were then read by Dr. E. S. Sharpless on '* Intes- tinal Worms," and by Dr. M. M. Walker on ''Intestinal In- flammations."

Dr. Hasbrouck, of New York, opened the discussion bv 3

308 PENNSYLVANIA MEDICAL SOCIETY.

remarking that Pelleterine was his favorite remedy for tape- worm. He knew of no symptom which indicated positively the presence of tape-worm, except the passage of segments of the worm itself. In the treatment of pin-worms, he used in- iections of salt water followed by inunction of lard.

Dr. M. M. Walker had met with four cases similar to those of Dr. Mansfield, and all proved fatal, and in all, the physician was blamed for not tying the cord properly.

Dr. Skeels referred to endocarditis during uterine life as a possible cause of cyanosis. He believed that convulsions in children are frequently due lo mismanagement of the cord at birth.

Dr. Betts spoke of the natural method of separation of he child from the placenta in those cases in which there is no physician to interfere, namely, severing of the cord by violence at a point about three or four fingers' breadths from the umbilicus. This is the point at which we should ligate the cord, and in doing this good silk should be used. He was in the habit of dressing the cord with absorbent cotton in his cases. Some cases of haemorrhage from the umbilicus, are due to haemaphilia.

The discussion was then closed. The President next called for the report of the Bureau of Surgery, Dr. L. H. Wil- lard, of Allegheny City, chairman.

Dr. John E. James read the records of four cases of car- buncle in which Hepar was indicated. The first case was that of a man, aged sixty years. The carbuncle here was sur- rounded by indurated spots. The pain was intense. After taking the remedy one day, the pain was relieved ; healthy pus was discharged from the carbuncle. The small openings over it became more numerous. The entire slough came away in a week, and in a short time the sore was healed. Hardly had this taken place when a new carbuncle began about six inches from the first. Hepar was given with a bril- liant result. The other cases were similar to the above, and were all promptly cured by Hepar.

Dr. L. H. Willard read a paper on *' Bryonia in Injuries

PENNSYLVANIA MEDICAL SOCIETY. 309

of the Spine." He spoke of a lad who received a slight injury to the bdck, and who was permitted to go about as usual. Pour days after the reception of the injury, he could not walk or sit up in bed. The spine was sensitive to a very slight touch, BeUadonna, Arnica^ and Pulsatilla were given with no benefit. Bryonia was next given, and the improvement was satisfactory. The remedy was discontinued and aggra- vation set in. Recovery went on again after the renewal of the remedy.

Dr. McClelland read a paper on *' The Radical Cure of Inguinal Hernia." He recommended that an incision be made over the hernial tumor and the hernial sac exposed. Then the hernia is returned without opening the sac if it is reduci- ble. If necessary, open the sac to effect reduction. If it has not been opened, it is invaginated, and the hernial aperture is closed with two or more sutures and dressed antiseplically . If the sac has been opened, it can be removed in whole or in part; stitches introduced, and care taken to secure drainage. Results are more satisfactory when healing by granulation has taken place.

Dr. L H. Willard reported a case of subglenoid disloca- tion of the humerus, in which the patient could, with the hand of the injured side, touch the shoulder of the opposite.

Dr. Lefever reported an interesting case of a foreign body in the rectum.

Dr. John E. James, in discussing Dr. Willard's case of dislocation of the shoulder, said that he presumed that the ligaments of the joint must have been longer than normal to permit of this motion of the hand. In one case of inguinal hernia in which Dr. James had operated and removed part of the omentum, he neglected to take the precaution to stitch the mass in the ring. While a cure was effected, it was only temporary.

Dr. McClellarid referred to a case of inguinal hernia in which he removed part of the omentum, but neglected to stitch the omentum in the ring. The case made a good recovery.

310 PEXXS YL VAN/A MEDIC A L SOCIETY.

Dr. Williird had used carbolic acid, one to five, to pro- mote rapid suppuration. He did not agree with Dr. James that there were relaxed ligaments in his case of dislocation at the shoulder-joint, as the humerus in effecting reduction went back with a snap. He thought that thf explanation of the symptom could be found in the fact that the patient had pos- terior and lateral curvatures of (he spine.

Drs. Hasbrouck, Burr, Walker, Betts, Dunning, Jones, and Phillips, of Cape May, continued the discussion on car- buncle; after which the Bureau of Materia MedicaHhrough its chairman, Dr. Pitcairn, reported the following papers as having been presented for consideration by the society.

"A Study of Piscidia Erythrina," by Dr. J. V, Morgan; "A Schema of the Proving of Picrate of Zinc," by Dr. H. Pit- cairn; "Provings of Jessamine," by Dr. L. H. Willard; "Provings of Arctium Lappa," by the Chester, Delaware, and Montgomery County Society; "Verifications of Baptisia," by Dr. .Joseph K. Jones; *' Verifications of Lycopus," by Dr. H. H. Reed; "Verifications of Pulsatilla and Sulphur," by Dr. R. C. Allen; "The Homoeopathic Materia Medica," by Dr. I. I/efever; and "Comments upon Remedies for Post- Nasal Ca- tarrh," by Dr. E. A. Farrington.

Of the last named paper, we give the following abstracts: Fagopyrurriy is the remedy where each exposure is sure to in- crease the catarrh, with formation of dry crusts and granular- like appearance of the posterior nares and intolerable itching, which the patient tries to relieve by the use of his tongue. jE^cidm hp., cold extending into the posterior nares, and also down the pharynx, with dryness and a scraping or burning feeling, mucus drops down and causes choking; haemorrhoi- dal complications Sinapis m., dryness of the anterior nares, and also in the pharynx ; dryness of the posterior nares, with slightly lumpy secretiop. Wyethia, pricking, dry sens ition in the posterior nares ; granular appearance of the pharyngeal mucous membrane. Perdhorum sedoide^, when there is a con- tinual feeling as though the posterior nares were moist ; sen- sation of fulness in the nose and ears; posterior nares raw, as

ri:\\syL i a nja mkdiva l society. si i

if denuded. Osmium, cor yza., sneezing, ns if from snuff, larynx sensitive to the air; small lumps of phlegm loosen from the posterior nures and larynx; severe pain in the larynx, worse when talking and coughing. Teiicrlam, when there are large irregular clinkers hawked from the posterior nares. Cinnabar^ when the post- nasal discharge is of a dirty yellow color. Sul- phuric acl'i, when the discharire trickling down from the nose is of thin consistence and of a lemon-yellow color. Saponin j touch, tenacious mucus extending into the larynx. QaiUqjay cold in the head contracted in warm, damp weather. Sangui- narina nitrate, when there are rawness and soreness in the pos- terior nares and hawking of thick yellow, sometimes bloody, inucu.s. Antinioaium sulph. aur., excessive secretion from tbe posterior nares. In syphilitic cases, we think of TherldioiXy AuTi'm^ and Kalr hiidriodicwm.

It being rather late in the day, discussion on the Bureaus of Materia Medica and Gynaecology, was postponed until the closing ses8i')n.''

In the afternoon the guests took a drive through Fair- mount Park, and in the evening attended tlie banquet, at which Dr. Dudley jiresided and Dr. J. C. (luernsev acted as toast-master. Addresses were delivered by Drs. A. H Thomas, McClelland, Phillips, Allen, Farrington, Peek, Hunt, and Maguire.

THIRD DAY.

The society was called to order, and discussion on the papers presented by the Bureau of Materia Medica ivas de- clared in order.

Dr. Pitcairn narrated the histories of several cases of post-nasal catarrh with offensive discharge, in which Ant. Sulph. Aur. cured.

Dr. Betts spoke in commendation of Dr. Farrington's efforts to bring togetlier the remedies and their indications for certain regional difficulties. These collections may be of use in other ways than that indicated by the author. He referred to the transfer of such indications from the mucous mem- brane of the larynx and pharynx to that of the genital canal.

31 2 PENNS YL VAxWJA MEDIC A L SOCIETY,

We have only partial provings of remedies acting on the lat- ter region. We may make up part of the deficiency by the transfer referred to. In this way we may increase our thera- peutic resources, and so be enabled to do away with much of our local treatment. The old-school physicians are doing away with local treatment, and constitutional measures are rapidly coming in favor with them. One of their number uses Actea vac. and PtUsatillay and another declares that E}rgot in post-partum ha3morrhage is useless.

Dr. H. N. Martin did not agree with the last speaker, re- garding the transfer of indications from one region to another. For instance, Pulsatilla gives a thin, milky, cor- rosive discharge from the vagina, and a thick, green and offensive discharge from the nose. It may be possible to transfer indications of some remedies, as Bc^lladonna, but not all.

Dr. H. 0. Allen agreed most heartily with Dr. Betts. He made a plea for the cultivation of a purer homoeopathy, and the abandonment of local applications and routine in prac- tice, as exemplified in the treating of diseases by name. The advanced men of the old school, particularly the specialists, are abandoning the local for the constitutional treatment, while some of the specialists of our school are forsaking the constitutional treatment of Hahnemann for the delusion of local treatment. In closing his remarks he referred to sop- ping the head with water or\ce or twice a day as a cause of nasal catarrh.

Dr. B. W. James used local applications only when nec- essary. He questioned the propriety of collecting our reme- dies in domestic treatises, etc. Young physicians, instead of studying the Materia Medica, consults in his work on prac- tice, a certain class of remedies, and he finally begins to think thaib he cannot go out of that class. His experience did not confirm that of Dr. Betts. Remedies that relieve a mucus discharge from the nasal passages are not sufficient to relieve the same character of discharge from other portions of the body.

. PENNSYLVANIA MEDICAL SOCIETY, 313

Dr. Dudley expressed his doubts concerning the signifi- cance of the direction to treat patients and not the diseases. He always thought it was the physician*s duty to treat the diseases and not the patients. It is our duty to direct our remedy at the unity of the group of symptoms. Each symp- tom in the case probably has the same central origin. We have to deal with symptoms as the outward expression of an inward disease. We ought to leave the patient for the time being out of sight. Where, however, any dyscrasia exists, that must be taken into account.

Dr. Betts, in replying to the remarks of Dr. Martin, said that the milky leucorrhoeal discharge is due to the admix- ture of mucus from* the vagina. The discharge from the uterus in such cases is similar to that from the pharynx when Pulsatilla is indicated.

Dr. Martinis experience did not permit him to agree with Dr. Betts regarding the ability of Pulsatilla to cure thick greenish discharges from the uterus.

There being no further discussion, the report of the Bureau of Gynaecology was called for.

Dr. Betts read a few extracts from the paper on "Lacera- tion of the Cervix," by the Lehigh Valley Homoeopathic Medical Society.

Dr. B. W. James opened the discussion by remarking that the men who cut the cervix years ago are the ones who to-day advocate the sewing up of these lacerations.

Dr. Smedhy said that, in order to cure our patients, we must frequently employ local as well as constitutional means. From an extensive experience among allopathic gynaecolog- ists, he had observed that they cured the local conditions quicker than we do, but frequently they are unable to re- lieve the nervous symptoms of the case. We cannot cure these cases with medicines alone. Educated allopaths now individualize their cases of laceration of the cervix, and they now know when to operate and when not. Some cases in which there is marked congestion of the uterus require to be treated by scarification. In other cases the Nabothian fol-

;^I4 PENXSYLVAMA MEDICAL SOCIETY.

licles must be opened, but with these measures must be com- bined constitutional treatment. Cases of dysmenorrhoea must be individualized. The cervical canal changes at the menstrual periods. At times it may be impossible to intro- duce the uterine sound between the periods, yet this can readily be done when the menstrual How comes on. Her- mann's investigations lead him to state that in fifty per cent, of the cases of anteflexion, there is no dysmen(»rrhoea. Some patients have dysmenorrhoea without anteflexion. In mar- ried women with sterility and dysmenorrhoea, stenosis of the cervical canal may be suspected, and dilatation usually effects a final cure.

Dr. Martin said that he sometimes adopted local meas- ures, but tlien only the mildest. He then made an eloquent plea for the more thorough investigation of uterine and vagi- nal diseases by the general practitioner. The eye or throat must receive a thorough examination, but scarcely ever the uterus. Caustics, while they frequently heal erosions, prepare the way for cancer.

Dr. McClelland agreed with Dr. Smedley that members of our school neglect too much the local treatment of these cases. There are certain cases in which the manifestations are purely local, and these, constitutional treatment will not cure.

Dr. H. W. James said that in many cases lacerations healed of themselves sutticiently to give a good result.

Dr. Sartain did not believe that as long as we have Cimi- cijiiga^ we have any need of the scarificator. Recarding the influence of uterine flexions before gestation in causing cer- vical lacerations, she could not see how this could be. Some cases of cervical Ificeration, can bo cured by internal treat- ment, and others re(iuire to l)e healed by operation.

Dr. Smedley did not wish to be understood as recom- mending scarification as a routine measure, for in truth, it was needed but rarely. Anteflexion rarely causes a tendency to laceration during labor. Where the anteflexion is marked, the fundus bends on the cervix, and there will be a place

PENNSYLVANIA MEDICAL SOCIETY. 315

where the circulation is poor. In these cases laceration may occur.

Dr. Betts closed the discussion by remarking that we should never, in the treatment of a case, be guided by the dictum of another, but we should individualize each case, and do for that case without fear, favor or prejudice, to the best of our ability. Regarding the benefit to be obtained from the repair of lacerations of the cervix, Dr. Betts said that so suc- cessful had been the results of his own operations, that no matter who shall proclaim them useless, he should still keep on operating.

This <*losed the scientific business of the session.

The Committee on President's Address then made its re- port, which was accepted.

During the different sessions, the Board of Censors made supplementiiry reports, recommending for membership the following gentlemen : Drs. P. O. B. (xause, William P. Mullin, Joseph Hancock, E. E. Davis, William T. Maguire, Isaac Crother, J. H. Reading, S. V, Ross. II. D. Saylor, W. P. Weaver, William Tearsley, Sarah J. Coe, J. W. Coolidge, J. S. Skeels and Samuel Brown.

Drs. H. C. Allen and W. A. Phillips were elected honor- ary members, and Dr. Richard Hughes, of Brighton, England, a corresponding member.

The resignation of Dr. A. W. Koch was presented, but was unanimously not accepted. ^

The resignation of Dr. H. A. Kimball was accepted.

The election of officers for 1884 resulted as follows:

President, W. R. Childs, M. D., of Pittsburgh ; First Vice- Preeident, Charles Mohr, M. D., of Philadelphia; Second Vice- President, H. Detwiler, M. D., of Easton; Recording Secre- tary', Clarence Bartlett, M. D., of Philadelphia; Correspond- ing Secretary, R. K. Caruthers, M. 1).. of Alleghany; Treas- urer, J. F. Cooper, M. D., of Allegheny; Necrologist, M. M Walker, M. I)., of Germantown ; Board of Censors, J. K. Lee, M. D., of Philadelpliia; L. H. Willard, M. 1)., of Allegheny, and Harriet J. Sartain, M. I)., of Philadelphia.

316 ACONITE AV CHROXJC CONDITIONS.

It was unanimously decided to hold the next meeting in Pittsburgh. The Allegheny County Medical Society was made the Committee of Arrangements.

The Trej^ident announced the Committees and Bureaus for the year 1884, and the session then adjourned.

ACONITE IN CHRONIC CONDITIONS.

BY (Has. B. fill.BERT. M. P.. WASHINGTON, D. ( .

Ca.se I. — A young man about 5 ft. 9 in. high, thin, with light hair and blue eyes, was in the habit of being out late at night with '^' the boys'' which finally brought on a dull pain at the base of the brain, that nothing but a good night's sleep would relieve. - He afterwards married and " settled down.'' He lost his right arm just below the elbow in the late war and is a government clerk. In Sept. 1876, his symp- toms were as follows:

Walked into the office in a dull and listless way, looking as though he had not a friend in the world. Very low spirited, and had doubts about getting well. Sudden feeling of pressure upwards in the head; feels in the head as if he would face to the right, to which side he staggers when walking. Wakes suddenly from sleep with an indescribable feeling of fear of something, he knows not what^ an " all gone " feeling at the epigastrium, in which, as well as the head, there is a throbbing; draws very short breaths for ten or fifteen minutes (probably not one-half of that, G.), after which attack passes off* though it may return before he falls asleep; these attacks sometimes come on while he is undressing, or in the morning while dressing, not through the day. During these attacks the heart is much quickened. Feeling of fullness in left side. Numb, prickling feeling in left arm running up to shoulder. Eyes weak when the trouble is bad and when looking intently at anything white. Constipated. An infinite variety of sensations all over which he cannot describe or even recollect, they are so nura-

CIJAS. B. GILBEHI. 317

erous. A few powders ot Aeon. **. \w a week he walked into the office with a quick, springy step, his head up, and his countenance bright and cheerful; "have not had an attack for a week until yesterday, but I was sight seeing with friends and climbed the donie of the capitol. and last nij?ht had a slight attack." Aconite *^.

June 1st, 1879. Had no return and had to be reminded of the symptoms one by one. Turning to Guiding Symptoms we find:

No. 2. Vertigo, staggers to the right. " 3. Fullness and heavy feeling as if something would push out of the forehead.

No. 5. Sensitive to light x x ; light dazzles the eyes. *' 8. Anxious expression.

" 17. Palpitation in pit of stomach with peevish anx- iety.

No. 29. Anxiety, difficulty of breathing, flying heat in the face, sensation of something rushing into head.

No. 32. Numbness of the left arm ; can scarcely move the hand ; tingling of the firigers.

No. 36. Numbness, tingling; left side. Formication now in one, now in another part.

No. 42. Direction : towards right side ; staggers to right in vertigo.

No. 46. Fine pinchings as from needles here and there.

It is so common to give Aconite for fever, to which I contend it is not homoeopathic, and for little else, espe- cially in chronic conditions that I report this case with much satisfaction. Besides it shows what a valuable mirror the Guiding Symptoms is, for the case is perfectly pictured there. It has seemed that Aconite is rarely indicated in this cli- mate, Bryonia and Rhus tox, seeming to take the place that Aconite does west of the Mississippi river.

In March last, a plethoric man got chilled in a north- west wind about 4 p. m. When I saw him at 11 p. m., he was going from one side of the bed to the other, grunting and groaning, his joints all swollen and very painful, high

318 IS FLA MM A TJON.

fever (the cliilliness had ceased), and very much afraid that be was going to have rheumatism, (lave Aconite *• in water, every hour ; at 2 a. m. he went to sleep and when he woke at 6 a. m. the swelling and excitability were all gone and much of the restlessness, but his fever tons as high <i8 ever, and it did not come down at all until he got Rhustox. when it rapidly and permanently subsided. "Intlammation" is not ^' fever." Pathologists may theorize as much as they please in the dead house, and pathology is good, while Ther- apeutists cure in the sick room by means of the remedy that covers the facts of the case — the symptoms. It is much better to know much Materia Medica and little pathology, than much pathology and little Materia Medica, but better still to know both. However, in the first case detailed above, I didn't stop to ask what remedies affect the solar or other plexus, but the similinuim according to the symptoms, €ured.

INFLAMMATION.

READ BEFORK THE HO.VKEOPATHir MEDIi'Ar. SOCIETY oK OHIO.

J. r. ANIiER.-'ON, M. 1).. MAN^KIKrt.

There is no subject that concerns tlie surgeon so innch as that of infidtmnntion.

In all his dealings with the nml-conditions of the hum m organism, inHamination is an universal ct>ncoinitjint ihreat- <?ning to do either the work of destruction or repair. It is the pillar of cloud, and the pilhir of tire of which the vigi- lant surgeon should never lose siglit. Here we reach a' point which discriminates het\veen art and science. We can readily conceive how an Esculapian may achieve renown by an artistic wielding of the knife, hut to meet the exigencies of an inHamination rniuires none less thnn a skilled Hahne- mann ian.

Tiieories however efficient in order to cope successfully with diseases, must he supported l)y intelligent environment.

J. a ANDERSON. :H9

Many of the vague theories of the older pathologists arc l)asj?ino away and more recent investigations into the sciences of pathology and histology have accomplished much that will result in clinical advantage to the practising surgeon. For the sake of brevity we will try to avoid details and take a casual glance at the histology of inflammation.

In the inflammatory process we have three factors prin- cipally concerned, viz: 1st, the vessels; 2nd, the blood; and 3rd, the inhibitory nerves

The vessels serve as avenues through which the blood and elements of nutrition are conveyed to various parts of the body, for purpose of repair and growth. They are divided into three classes, viz: veins, arteries and capillaries; the latter of which are the terminal extremities, and claim the greater consideration in this connection as in them are concerned the various phenomena of nutrition as well as of inflammation. The larger vessels are formed of well defined organized tissues which are lost in the capillary system. These capillaries may be considered as semi-organized pro- toplasmatic cylinders with calibre so small as to admit of but a single blood globule at a time. These lumen, how- ever, seem to be capable of expansion and contraction, which in lieu of the absence of contracted tissues may be accounted for somewhat after the manner of protoplasmic and emboid vibrations.

The second factor or blood may also be divided into the separate parts, vis: The red cells or corpuscles, the white or lymphoid cells and the lymph or fluid part. The lymph is al)out equal to both the bulk of the red and white cells, and the white cells as one to 800 of the red. They serve as conductors of impressions to various parts of the body and are divided into two classes, the afferent and efferent, the former conveying impressions to the cerebro-spinal axis, and the later in the opposite direction, or toward the capil- laries.

In health the white corpuscles array themselves along the anterior portion of the lumen of the vessels as though

320 INFLA MM A TION, !

t

to protect these walls from the influence of the red cells which are ladened with oxygen. These white blood corpu- scles consist largely of protoplasmic substance and from their tendency to penetrate and insinuate themselves through the surrounding textures, have received the name of ameboid or migratory cells.

These white cells are important factors in this connection, as they bear an important part in the inflammatory process which will be refered to hereafter.

The lymph is a colorous aqueous fluid capable of rapid coagulation when at rest and exposed to atmospheric influ- ences. Although much has been writen of this substance, yet we may safely say that it is but meagerly understood at the present day. There have been experiments made for the purpose of demonstrating that perpetual motion is not necessary to its perpetual liquifaction, yet we incline to the opinion that at the normal temperature, motion is a neces- sary concommitant •to its normal consistancy. If this be true it also serves an important part in the process of inflam- mation and assists to establish more plausibly the migratory theory.

Although the nerves are lost in the capillary vessels, yet it IS agreed that they maintain an important influence over the workings of the capillary system, conducting impressions to and from the seat of irritation.

As the nerve fillaments can not be traced to the capillary vessels it is thought by some that there is no direct commu- nication of the capillaries with the nervous system. This theory has been weakened, however, by experiments per- formed with some of the lower forms of vegetable and animal life organisms such as the aquatic plant (confervx) and the protococacus family. In these we have remarkable instances of a purely physical automatism. There is no nervous system to call forth the motions of these active forms, they are brought about by the endowment of the protoplasm contained within the vegetable cell which extends itself into the motile filaments. If we take a higher form of vegetable

J, C. ANDERSON. 321

automatism as the sensitive plant {mimosa seiisativx) or the Venuo 6 fly-trap {Dionaea muscipiila) we have an illustration of protoplasmic conductility. In the Venus's fly -trap, as in the sensitive plant, the contraction is not in the part which is itself irritated, but in a distant part; recent investigations demonstrate the fact that tlie communication between the part touched and the part wliich contracts is eff*ected by a continuous thread of protoplasm passing from cell to cell. Through these illustrations we are enabled to glean an idea of the manner in which the nervous system may exert an influence over the capillary and nutritive organs although we may be unable to trace nervous flllament.s into the sub- stance proper.

The capillaries are formed of connected enlongated cells, lamellae, which become curved and joined together as a tube.

Through the blending together of stellate cells is formed a very delicate net-work, and through the interstices of this net- work the wandering lymphoid cells find exit to the sur- rounding tissues.

This migration or pjissing out of the cells takes place much more rapidly when the parts are in an inflamed -condition, partly because of the enervation of the vessels themselves thus widening the interstices, and })artly from increased action of the heart. Through this process we are -enabled to account for the phenomena of swelling that accompanies any great amount of inflammation; and thus it is that Strickers opposition to the migratory, fails of that plausability that otherwise gave some force to his opposition to this theory. ,

One of the misleading causes of Strickers experiments 4n this direction, is that they were conducted principally with tissues that are incapable of inflammatory action.

With the foregoing theoretical hints we may draw the following practical conclusions: 1st, that the seat of an inflammation is largely under the influence of the inhib- itory nerves and intimately allied with the functions of nutrition. 2d, that motion is a necessary concomitant of life.

322 A NTO-KLEPTOMA NJ A

nutrition, repair and growth, and that a condition of stasis is fatal to either. Considering the extreme delicacy of these or- gans we also learn that but a very slight degree of distortion may set up a conditi(m favorable to the most destruction inflammation, which many with Inyself have no doubt wit- nessed in the practice of forcible distention in fractures, in morbus coxarius, and other similar exami)le8. Also of the fatal consequences that may follow the indiscriminate use of opiates in cases of deep, injurious wounds, etc., when the organs of nutrition may be paralyzed ai d the reparative efforts of tliese delicate organs thwarted in their efforts to heal such wounds. For a practipal illustration I only need to refer you to the lamentable treatment of our late President, James A. Garfield.

ANTO-KLEPTOMANIA? (vSTEALING FROM SEO ).

BY J. F. BRUWN. JACKSON, MICHU.AN.

I have just had a very curious somnambulistic pheno- menon brought to my notice. The patient, if she may be so called, i^an Irish woman of the ignorant class, aged 41, tlie mother of nine children, the youngest about four months old.

The history of the matter under consideration, as given me by her is about as follows: She conceived the idea some during her wakeful hours of laying aside or saving one half of the money given her on Saturday nighis by her husband for some special occasions, whenever they presented them- selves, in other words "laying up for a rainy day."

This occurred to her some three or four months ago. Soon after this she fqund that her money had been tampered with on Saturday night, and half of it or about that disap- peared. At first she supposed that her husband had taken it from her, but this he persistently denied, and she believed that he told her the truth as no such thing had transpired before during their twenty years married life. She then thought the children or some one else guilty of the theft, but could get no trace of the purloiner nor money.

/. F, BROWN. 32:^

The thing remained a mystery to her till one Saturday night a short time since, when she awoke in the night and found herself standing in the room, near one of the children's beds, pocket-book in hand, a part of the money gone from it, and the balance of it in her hand. On this occasion it contained the night before J$1.85, the 85 cents was disposed of, and the $1 was in her hand. This circumstance con- vinced her how the money had disappeared, but not where; nor has she been able by the strictest search, to find any of it. She says that in aJl, some 816 or SIS have disap- peared.

On one occasion she put away a small sum on Saturday night to pay the milkman at his next call, but when it was brought forth, half of it was gone. The most that disappeared at one time was $1.75.

At one time since she discovered the way in which her money disappeared, she gave the Saturday night's amount to her daughter and told her to put it away without telling her why. She says she did not know exactly where the child put the money but knew nearly where, as they had a certain box where they kept their valuables. Part of the money w.is gone as usual.

Before she awoke in the night and understood the matter, she and, her husband had several disputes about her being up in the night, he asking what she was up for, and she denying heing up at all.

She has not told any member of the family of her dis- covery and seems to be sensitive on the matter partially breaking down at one time while relating these incidents to me. Says she does not drink except occasionally a glass of beer. Says her husband only drinks occasionally. At first I was disposed to be incredulous but the xnore I talked with her, and questioned her, the more I became convinced she was telling me a truthful story. She applied to me to see if anything could be done to check her propensity to steal from herself.

What is the similimum? 4

324 CASES FROM PRACTICE.

CASES FROM PRACTICE.

BY S. U, NEW YORK.

1. Rev. Mr. B., a Methodist minister, had intermittent fever a year ago in New Jersey, and though frequently sus- pended, it obstinately refused to yield entirely. Last May he returned to New York city to take charge of an up-town con- gregation. September 10th, he went in the forenoon to his dentist to have a tooth filled and during the operation he was taken with a most severe chill. Carried home he nearly screamed at every jolt of the carriage. After three hours shaking, a short stage of dry heat followed, and to this suc- ceeded a drenching, sour s nelling perspiration with relief of all symptoms. Sambucus, 2c., in water, during the perfect apyrexia. Four weeks have since passed, our Dominie has attended the annual conference and enjoys his meetings.

2. Mrs. K., wife of a physician, lean, lank, and over forty, labors for years under the idea of having an organic heart affection, which is sure to kill her one of these days. Sep- tember 12. For a week, patient could not lie down at night, as her heart beat so violently that she was afraid she would choke, and the palpitation could be seen as well as heard. There was bloated ness of the pit of the stomach, perfect dread of eating, as it increased the palpitations, burning pains in stomach and throat, relieved by discharge of flatus Several drugs seemed to be indicated, but only Oxalic Acid corresponded fully and the 2 c. Oxalic Acid, gave per- fect relief to all the symptoms. The night after taking it she enjoved a comfortiible night's rest. Appetite returned, the heart remained more quiet, but she still complained of a dry titilating cough as if from dust in the throat, coming on par- oxysmally at night and waking her from a good sleep. Cal- carea Carbonica, 2 c, acted charmingly. An invalid for years and still she responded quickl}' to the simile. Probably Cal- carea phos])horica or Calcarea oxalica will bring her out all right.

CYANOSIS. 32r)

Many members of our school have a perfect horror of prescribing Chininum Sulfuricun^ or of Calomel, and still we meet often cases where no other drug is the simile. Thus there are cases where our Nux Vom., Ipecacuanha, Natruni mur., Eupartorium or Arsenicum, or any other remedy did well and removed every symptom but the intermittent with a clear apyrexia. Here Chininum and nothing else is the indicated remedy and it will remove that symptom whether you give it Ix or 2c. The individuality of the patient decides the potency.

In cholera infantum, when Mercurials are indicated, I often succeeded with Calomel, after the failure of the Solu- bilis. Its stools are well-known and the more tenesmus and burning (chafing) the more it is indicated. It is sometimes difficult to differentiate it from Iris versicolor, but the latter has more exhaustion and debility from the very beginning of the disease; in fact there is very little exhaustion Avhere the Murcurials are indicated.

CYANOSIS.

READ BEFORE THE HOMEOPATHIC MEDICAL SOCIETY OF OHIO.

BY J. C. TRICH, M. D., FINDLAY.

Tnis is not, strictly speaking, a disv'ase but merely a symptom. Cyanosis proper is characterized by a blue color of the face, extremities, sexual organs, and generally mani- fests itself soon after the birth of the child. The blue color is most distinctly perceived when the child is exerting its muscles or lungs, especially when crying or nursing.

The more marked the blue appearance of the child, the more irregular is the beating of the heart, tiie action of which is tumultuous, accompanied by a buzzing noise and bel- lows murmur ; the child frequently faints away or is attacked with suffocative spasms, and the least physical exertion is followed by a labored panting respiration, bloated face, pro- truded eyes and tremulous intermittent pulse. These pur-

326 /. e. TRICH.

oxysms sometimes last two or three hours and terminate by a deep sobbing respiration, after which the breathing grad- ually becomes easier and the blueness is again confined to the previously mentioned localities. Cyanotic children as a rule cut their teeth very slowly and with difficulty. Later on the disease is characterized by fainting fits, hemorrhages from the lungs, nose or bowels, and dropsical symptoms as in other organic affections of the heart make their appearance.

Some of the mal- formations existing in this disease are: 1st, The foramen ovale in the interventricular septum is not closed ; 2nd, the aorta arises from the right and the pulmon- ary artery from the left ventricle; 3rd, the ductus arteriosus botalli remains unclosed. But by far the greater number of cases belong to the first class named.

Causes, — The proximate cause is the non-closing of the foramen ovale and ductus arteriosus botalli, the pulmonary artery being generally contracted.

Prognosis generally unfavorable.

Treatment, — Unfortunately Homoeopathy can claim but little in the treatment of this affection. The greatest num- ber of cures has been brought about by following the plan first advocated by Prof. C. D. Meigs which is: Place the child on the right side, head and body raised to an angle of about 30®, and if necessary maintain the position for weeks and even months. .

On assuming this position the blood in the left auricle, will press the value of Botalli down upon the foramen ovale, and if the child should belong to the first class named, the chances of a cure are enhanced by compelling all the blood of the right auricle to pass by the iter ad ventriculum on to the lungs to be aerated. Professor Meigs claims to have saved at least 100 children by following this course. The purpose of this short paper was not to advance any new theory or plan of treatment, but merely to state that in two instances I have verified Dr. Meigs' plan and should I have any other cases in the future I would not hesitate to pursue it and should expect good results to ensue.

FESTINA LENTE. 327

FESIINA LENTE.

BY WM. JEFFERSON fiUERNSEY. M. I>.

The following rules are gathered from observations by men who oiLght to know, and whose success in practice proves that they do know, " whereof they speak."

Sympathy for the sufferings of those intrusted to our oare, anxious entreaties of friends and relative^ and the gibes of skeptical neighbors, all tempt the worried doctor to '*hurry up the cure." As a check on this pressure to such ruinous haste, let the reader cut these ridea out and paste them in his Materia Medica and there review them from time to time.

'Tis here that the adage quoted above is proven a truth in verity.

The writer has repeatedly verified every one of the rules, and only regrets that he has so many times, to his sorrow, neglected to be led by them.

RULES.

1. Never prescribe until you are sure of your choice of a remedy. (Study the case at the bedside, or give S. L. and wait till you reach your office, l)ut do not give a temporary medicine. The first prescription may " make or break.")

2. In the first prescription, or subsequently on chang- ing to another remedy, give but one dose and wait. (One <lo8e will often cure a case. If it does not, more can easily be supplied. Some cases are very susceptible and easily aggravated, which may confuse you and must delay the cure).

3. If found necessary to repeal a medicine already pre- scribed, give several doses of the same potency in water, or of a different potency dry.

4. After repeating a medicine, allow an interval of rest without medicine.

5. Let the patient have plenty of Sac. Lac. (How cari we expect the laity to have faith in the "one dose" system when so many of the profession ridicule it?)

328 FES'llNA LENTE.

i\. Give no medicine so long as the patient continues ta improve.

7. Do not be tempted to deviate from Rule 6 because ^ new symptoms arise if the patient is really better.

S. 8o loni^ as the patient grows no worse, even if not better, in a disease that would probably increase in severity without treatment, it is favorable and should go without medicine. (Dr. C. Lippe recently related to the writer a severe case of dysentery for which, at the first prescription, he gave one dose of a remedy well indicated. The patient, who had been growing rapidly worse, was found the next day at a statu quo. No medicine was given. The next day discovered precisely the same state. No medicine. On the following day the case was almost well. A great many remedies require a rest, and as the aggravation had ceased, the Doctor rightly concluded he was '^ making his point.")

9. If a relapse into the same symptoms follow an ameli- oration from the single dose, that remedy must be rt pea ted. (See Rule 8.)

10. If new and important symptoms appear, be ifure beyond a doubt whether they do not belong to the remedy just given. If they do, wait. (These new symptoms may be an aggravation of the remedy. If you cannot remember them as belonging under that drug, look it up rather than spoil the case by a change >. '

11. If there is no improvement and there has not been any, and the case is one that would probably remain so without treatment, review the symptoms to see whether the remedy last given is still indicated before changing to another. If you are satisfied with the fin^t choice, repeat it as suggested in Rule 3.

12. If the disease is a " periodic" one it is favorable if the next attack following the administration of the first dose is in the slightest degree lighter, shorter or later ; or if it is mark- edly the reverse, viz.: very much heavier, longer or earlier. In either case, wait, — Horn. Physician.

SANITARY .\fEASURES. 329

SANITARY MEASURES APPLICABLE TO VILLAGES^ AND COUNTRY HOMES.

READ BEFORE THE HOMEOPATHIC MEDICAL SOCIETY OF OHIO.

BY L. P. STURTEVANT, M. T>., CONNEAIT.

Science, being the general principles or leading truths relating to any subject, arranged systematically, it becomes nece>sary for the welfare and stability of that science to have its peculiar tenets presented to the public in such a manner that they will obtain a hearing, and make an im- pression upon them that will cause the testing of those te- nets. And the results arising from such a test will be the measure by which the worth of that science will be deter- mined. In view of these facts, we have a perfect right to ask, how have the truths of sanitary science been received ; what have been the results obtained by tlie testing of the truths heretoforje advanced?

As to the reception of the principles and tenets of this science, we know that it has varied according to the times, and manner of its presentment. Some nations have made them a part of their religion; others have incorporated them in their laws, making a violation of them a crime against the government. Later the people became less careful from var- ious causes and accordingly their thoughts were turned into different channels until they were nearly lost sight of. And when they were again awakened to the fact that something must be done to stay the progress of some particular disease or epidemic their efforts were all tlirected to that end; and when some new trouble arose, or some one fancied that he had found a solution of the problem, a new tlieory was advanced, until there was and is now such a confusion among, and apparent contradictions between writers and teachers, that the people in common are led to believe that it is all nonsense.

And although there are not the contradictions that are

380 SA NIT A R Y MEASURES.

. supposed to exist, yet the manner in which these truths are presented, and the language and terms used by some are so abstract, and by others so ambiguous and learned, treating of bacteria, mycoclenus, micrococci, vibrione^, monecels, and other forms that are without forms, that they are in turn re- jected. Then again nearly all that is said on the subject is b^ those living in our larger cities, and deals with those phases that concern them and their clientage as sewer gas, ot which we of the country know but little by experience, and there- fore they fail to get the ear of a large portion of the people. And if I can present anything new, or bring to remembrance any former thing I will feel thankful. The air we breathe, and the water we drink are the subjects we will have the most to do with sanitarily; air being the principal one. It follows then that we should possess some knowledge of this agent in order to instruct others. In considering this ques- tion there are four points to be borne in mind.

* 1st. " The amount of air necessary for the performance of the respiratory process.

2nd. The means of ascertaining when air is impure; and, if impure, what substances are mixed with it.

3rd. The means of purifying impure air.

4th. The diseases due to a deficiency of quantity, and alteration in the quality.''

t"The first question can be answered both by calcula- tion and experiment.

By calculation Dr. Parker finds that 2,082 cubic feet of air must be supplied per head per hour to so dilute the pro- ducts of respiration, J and transpiration from the sound body, as to keep the air fresh and pure.

From numerous experiments in which the outflow of air was measured, and the carbonic acid simultaneously deter- mined, he found that at least 2.000 cubic feet per hour must be given to keep the carbonic acid at its normal level of five

♦Libran' of Universal Knowledge.

+1 bid.

;Libr^r>'of I'lilvorsal Knowledge.

L. P. STURTEVANT, 3;II

or six in 1,000 volumes and to remove the odor huniamm or fetid smell of animal matter."

It is difficult to lay down any rules in regard to the amount of fresh air required in sickness. The vitiation of the air by the products of combustion of lamps, etc., must not be overlooked. *"The composition of dry air may be roughly estimated to consist of four volumes of nitrogen, one of oxygen with a slight admixture of carbonic acid, and a mere trace of other substances.''

t "The impurities may be divided into suspended mat- terSf gaseous substances and special impurities.

Among the suspended matters are to be found the germs of organic beings, both animal and vegetable, such as bac- teria vibriones, fallen spores of fungi, etc., minute particles of inorganic are also often taken up by currents of air and remain in suspension. Among gaseous substances which merely pass into the air either from natural causes or from manufactories are various compounds of carbon, sulphur, nitrogen and phosphorus, with oxygen and hydrogen which it is unnecessary to enumerate here. Besides which we must notice organic vapor from decomposing animal matter, which has been called carbo-ammoniacal.

Amongst special impurities those caused by respiration are the most important." *"An adult mm, under ordinary

^Science In short chapters, W. M. Williams.

conditions, gives off, in 24 hours, from VI to 16 cubic feet of carbonic acid by the lungs, and a certain additional quantity, not determined by the skin. Watery vapor ranging from 25 to 40 ounces, together with an undetermined quantity of organic matter, which is partly suspended (as particles of epithelium, etc.,) and partly made up of organic vapor. This vapor, when collected and condensed from a large volume of respired air, is found to be nitrogenous, and has a very fetid smell." Here then is a most powerful source of vitiation, and one, over which we can and should have control, by

♦ n)id.

t Library of Universal Knowledge.

332 SANITARY MEASURES.

ascertaining whether our clients occupy small bed rooms^ and sleep, as ma,ny do with closed doors, and the bed-clothes drawn over their heads, thereby compelled to breathe the same air over and over again.

And who can tell but what many cases of consumption arise from this very source, where no hereditary conditions exist, but are charged to contagion or bacteria, when it should be blood poisoning.

Also many disordered conditions of the whole alimen- tary tract.

On the other hand I would not be understood to advo- cate the indiscriminate opening of windows, and exposing the tender surface of the mucous membranes to the damp and cliilly air at night, for I think that a fruitful source of throat and lung difficulties; but would advise the entrance of air through other rooms, at a rate not to exceed two feet per second as that to most persons is perceptible and gives the sensation of draft. Another point I would like to make here, as bearing upon the subjects of ventilation and impurities in the air, is that of open fire-places and grates.

"We all know that when air is heated it expands largely, and becomes lighter bulk for bulk than air of a lower temperature; and therefore if two portions- of air of unequal temperatures, and free to move, are in contact with each other, the colder will flow under the warmer and push it upward." Now let us bear this fact in mind ; also the height of the upper edge of the fire-place, which is on an average of 24 inches, and see what the result will be in a room fitted with one or more windows a trifle leaky, the same number of doors in a like condition, and a fire-place in which coal is burning; from 10 to 20 per cent, of the heat is radiated into the room, the rest is forced up the chimney by an ascending current of air, as is demonstrated by the presence of smoke entangled with it, and this is evidently done by the cooler air which flows into the room from some- where, and which must get under it in order to lift it. In

L, P. STURTEVANT. o^^

ordinary rooms this supply is entirely dependant upon the defective construction, ♦ bad joinery."

" It enters through the crevices about the windows and doors, no especially designed opening being made for it. Usually the chief inlet is the space under the door, through which pours a stream of cold air which spreads out like a lake upon the floor. At the same time more or less is enter- ing at the top and side spaces of the doors and through win- dow crevices. And as it is colder than the air of the room at the place of entrance it immediately falls to join the stream entering under ihe door. Now when we remem- ber the height of the fire-place which is the outlet of this stream or lake of cold air, is 24 inches we have the ex- tent of ventilation by their aid. Below this level there is an abundance, above it there is none; the "cat on the rug, and our feet have an abundant supply "-—of fresh air, but as we are addicted to sitting on chairs, our breath- ing apparatus is brought above the level of ventilation. The atmosphere in which our heads are immersed is prac- tically stagnant, loaded with impurities in suspension and which are being constantly drawn into our lungs, contam- inating the blood. And when the season arrives for the abolition of fires a resort is had to patent medicines, or va- rious teas or infusions to ^^cleanse the blood " we are told ; which (to use a homely phrase), is like locking the barn after the horse has been stolen. There are two means of purifying the air, viz : removing the cause of contamination and dis- infection.

In removing the causes look to the sleeping rooms, to the cellars, the pantry, the wash-house, the back yard and the water closet. Allow no vault to be dug in the ground, but build it of brick, plastered inside with mortar, and a daily use of dry earth as a deodorizer. Do not fail (through a feeling of modesty) to mention these subjects at your daily visits, for in so doing you will render more aid to the cause

♦Science in short chapters, W. M. Williams.

:{34 CAPSICUM NOTES.

of sanitation, than by endeavoring to write long and learned dissertations, on the subject, that are never read, and banish more of the diseases which are directly traceable to these different sources, such as typhoid fever, cholera, dysentery, diphtheria, consumption, scarlet fever, erysipelas, rheuma- tism, carbuncles, and a host of others than can possibly be done by any other means.

CAPSICUM NOTES.

BY H. S. GUEKNHKY, M. I).

There are a few general symptoms of this remedy, when- ever found, that are worthy of deep consideration no matter what the pathological condition may be supposed to be.

One of the most important of these in prescribing for the sick is jx sensation of conHtriction. It must be unquaUfiedly a sensation of constrictmx somewhere, experienced by the patient For instance a sensation of constriction in the fauces in sore throat or catarrh of the thront or of the posterior nares — the same sensation also in Diptheria. A sensation of constriction in the chest in asthma or other affections of the chest, coughs, etc. A sensation of constriction in urinary difficulties, as in dysuria, gonorrh(Bu, etc. A sensation of constriction in the rectum in dysentary, diarrhcBa or constipation.

In catarrh of the posterior nares when the secretion is tough and fibrinous requiring great effort to draw it into the mouth, particularly in the morning.

Fifteen ye;irs ago I drew the attention of the profe.-sion at large to the value of this remedy when there was inflam- mation of the petros portion of temporal bone, as a '*key note," and it still remains, and always will remain, an infal- lible ^'guidmg symptom."

All affections that conmience in the back and gradually spread all over the body, as in intermittent fever where the chill commences, unqiuillfiedly in the hack and spreads thence over the bod v.

" CORRESPONDENCE. 335

Another symptom of great value is a sensation as if cayenne pepper had been applied to the part affected. For instance in the throat or upon any of the mucous surfaces — on the scalp or other portions of the skin.

Samuel Hahnemann observes that individuals of a rigid fibre are not as a rule, favorable subjects for the action of this remedy.

Capsicum is a very searching remedy having a very deep action and should never be prescribed lower than the 30th attention and a much higher insures a more favorable result. We should be very slow to prescribe another remedy after Capsicum. Of course the above symptoms must take super- ior or inferior rank with others, as the totality is brought under consideration, and its administration must be accord- ing to the rules laid down in the organon of Samuel Hahn- emann.

CORRESPONDENCE.

To Tht Editor of the Medical Advance:

In the October number of the Advance, pages 191 and 192, is quite an interesting account of fracture of the cranium in a boy nine years of age. But there is one feature of the case which I think will bear criticism.

It is stated that he was violently kicked by a horse and that the doctors *' found him in a comatose condition, all un- conscious of the frightful injury he had received. It was found necessary to remove broken fragments of the skull. This was done "after thoroughly anaesthetizing our patient."

Will those doctors be kind enough to give the reason for "anaesthetizing" a patient who was already in a "comatose and unconscious condition? It must have been a mistake and should not be allowed to go out to our profession un- questioned.

. I have known allopathic surgeons to make this blunder, but the above is the first I have observed in our school. I

336 CORRESPONDENOE,

hope none of our surgeons will repeat it for, although no great harm may arise from it, they will be subject to ridicule if it becomes known to their old-school rivals. A Senior.

Editors of tfie Medical Advance:

It has not been my privilege to attend, and take part in the proceedings of the Homoeopathic Medical Society of the State of Michigan for some years past, nevertheless I have anxiously watched for the transactions to appear in our Medi- cal Journals, hoping to receive partial compensation for what I regard an incomparable loss to any physician who has a desire to cultivate the social and profit by the moral and mental influence which is always so perceptibly felt at those meetings.

In years past it was my good fortune to be present at one of those annual gatherings, when by request I gave my expe- rience with Sulph. High, in the treatment of intermittent fever.

You just ought to have been there ! I can smell the fumes of sulphur when I think of the warm reception they gave me.

I must confess I have always felt a secret desire that some of the members then present might in the future have an opportunity of proving the remedy sufficiently, to obtain the much talked of pathological results, or tissue changes.

I feel a deep interest in all Medical subjects, but an €speci{fl interest in drug provings as practiced by Hahne- mann and his corps of faithful followers, who have given us our large and valuable Materia Medicii, out of which I would not willingly erase one symptom.

I am confident that any physician who will follow the l)lain rules as laid down by Hahnemann in his Organem will not only gain confidence in our law of cure, but in attenuated medicine as well. I. Dever, M, D.

The new Library of the University of Michigan is at last finished, dedicated and ready for use. Over one hundred thousand dollars have been expended in the structure, and it now contains one of the largest collection of books in the United States.

EDITOR'S TABLE. 337

EDITOR'S TABLE.

"It is now over 50 years since I first read the Organon. I just begin to comprehend it." Ad. Lippe.

"Men who cut the cervix years ago are the men who to-day advocate the sewing np of these lacerations." B. W. James.

H. N. Guernsey, M. D., of Philadelphia, is at work on a book : ■**The Natural Philosophy' of Disease, and the Natural Method of its Cure," with numerous illustrations from practice.

Died. — A. M. Woodruff, M. D., at Las Vegas, N. M., of haemo- ptysis. The doctor went South a year ago to try the beneficial ■effects of a change of climate for a disease of the lungs. He was evidently improving up to the time of his sudden death. He was a very successful practitioner, one we can ill afford to lose. He was interred in the familv vau^t at Ann Arbor.

Indiana.— -We are to have two new ho.spitals in our State,and I see no reason why the Homseopaths are not entitled to the medical control of at least one of them. I liave a petition in pamphlet form now ready for publication, to go before the senate and legis- lature, and I want the name of every Homoe ipathic physician in tlie State attached to it. Send your name at once and ask your neighbor to do the same, as list closes January 1."

J. p. Grabill, M. D., Union City.

Pennsylvania State Society. — During a business trip East, being desirous of seeing how they did it in the City of "Brotherly Love," we arranged to take in the Pennsylvania State Society. Tlie. officers of the Philadelphia County Society had charge of thi' local arrangements, and nothing was left undone to make the meeting both pleasant and profitable. Everything was complete. Too much praise cannot be bestowed on the County Society for their effortd. The reader will naturally ask, what effect had thi.s elabo- rate and feultless programme on the attendance? Well, not much. The attendance was not so large as at Michigan State Society, and would have been considered fair in Kansas. Iowa or Nebraska. When we take into consi eration that there are over 700 homoeo- pathic physicians in the State, 300 of whom are in the county of Philadelphia, we can only imagine "what might have been," and have come to the cnnclusion that all the "Kilkenny cats'* are not found in Michigan; that even in the city of "Brotherly Love," there are members of the profession who "agree to differ.

Among the visitors we noticed Phillips of Cleveland, Has- brouek of Brooklyn, and Peck of Providence. The programme was

338 EDITORS TABLE,

well carried out, the papers of more than average ability, hot some of the best, especially those of Drs. Goodno and Thomas, of the bureau of pathology, went by the board without discuasion. One of the most interesting discussions was that on Sanitary Science, which was brought about by a flank movement on the part of Dre. Cooper and B. W. James. When the Bureau was called, Dr. Cooper, Chairman, found himself without a paper, and moved: ''That the time allotted to the Bureau be devoted to discussion on Sanitary Science." The subject was broad, and the members improved the opportunity. It was the most brilliant strategic move of the session.

The HomcBopathic Library and Reading Room was visited on Tuesday evening. The Association, at considerable expense, has purchassd the libraries of the late Drs. Hering and McCiatchey and laid the foundation of a fine library. They need better and more commodious rooms, which will come in due time.

The old college building on Filbert street, in which so much good work has been done, sadly needs something. It certainly is not a credit to the school or the State, and the arrangements for a new building and hospital were not premature.

The drive in Fairmount Park, which contains about 3000 acres, and the stop to *' water the horses," at the resting place on the beautiful Wissahickon, was charming in the extreme. Sandwiched between the Business Manager and the Managing Editor of the Hahnemannian Monthly ^ we enjoyed it ''immensely." We hope some day to be able to extinguish our indebtedness by showing them the College Campus and the romantic Huron.-

The banquet was most elaborate. Mine host, of the Aldine hotel, knows how to entertain a State Medical Society. We respect- fully suggest, that in future the banquet of the American Institute, be managed by the officers of the Philadelphia Couilty Society.

SPECIAL NOTICE TO OUR READERS. Many of our reculers have written, askincr when their subBoriptions are due, and we. take this method of inform- ing tbem Each subscriber can now see the date to which he has paid (see Nov. issue ) . If our subscribers will prompt- ly remit the small amounts due, we can afford to increase to 64 pages and publish semi- monthly » without increasing the subscription. All subscriptions are pay able in advance. Our printer needs the money, and early and prompt payments will enable the publishers to fUmish a better journal. If you are in arrears pleaee favor us with a prompt remittance.

T. P. WIIiSON, M. B.,

Editor.

Pfl[II< PORTEB, M. B.,

Oyneoolooical Editob.

Vol. XIV.

Ann Abbor, January, 1884.

No. 7.

All subsoriptdons and business oommunioations should be addressed to MEDICAL ADVAKOE PXTBLISHINa CO., Aon Arbor, Mioh. Subscription, $2.00 per annum.

H. O. AIjLEN, M. D., Business Manager.

'*The Vital Force. ' — In the November number of laat year, we took exception to Dr. Bayard's position as set forth in the Popular SdeTice MoniMy, in his explanation of Homoe- opathy, that, as a science, it "is the law of the vital force." Dr. P. P. Wells, in a late number of the Homoeopathic Pky- 9ician^ has discussed the question at some length in his peculia;r way. Allowing all he says to be true, it deduces him to the absurdity of attempting to prove a self-evident proposition. When the point at issue is assumed by either party, to say the least, it cuts out the party, so assuming, and argument is ended. We cannot, therefore, follow Dr. Wells, since to our mind, the question is debatable, and worthy of study; and is one which cannot be settled by flippant asser- tions. It is also clear, that so broad a question cannot be properly discussed in a brief editorial. We are not^ how- ever, disposed to leave the controversy as it stands at present. We repeat, that the facts of Homoeopathy are one thing; the theories which help to explain them are another thing. It

340 ^DlfOniAL.

is a necessity of the human mind to have things explained. The best of all explanations, is a demonstration. A thing whicfi can be demostrated is a scientific fact. We, however, incorporate much into science so-called, which we cannot demonstrate; and we explain all stich things by the help of theories. Many points are settled by the theory of avihority. An ecumenical council, a synod, a conference or an individ- ual, is often considered suflBcient. There are persons who would take Dr. Wells' statement upon almost any question as a final settlement of it. Upon this theory it is only neces- sary to point out what the authorities say; and most of the hard questions that might otherwise vex the mind of man, are in this way answered and disposed of. Next to the theo- ries of this sort, stand theories founded on imcigination or superstition. Given a series of phenomena, apparently inex- plicable, and all you have to do, is to construct an ideal cause. The ocean, the forest and the air, were once filled with imaginary beings, who drove the winds about, made the seas boil and hurled thunderbolts through the heavens. Spirits, malign and benign, filled every unexplored corner of the universe, and became the eflScient source of its myste- rious phenomena. For centuries, imagination backed by authority, covered the whole ground, and solved all riddles. Subsequently, Science came into the field, and claimed her right to answer, these puzzling questions. This she does in two ways: First, by demonstration. She repeats the phe- nomenon at will and shoWs every step in the experiment In this way she curbs and controls imagination and destroys the specters of superstition. But secondly, science must employ theories respecting many things she cannot demon- strate. But such theories are always essentially scientific theories. They hold no relation to the theories of authority or imagination, because in essence, they always correspond with the facts of sciences.

Now to the point at issue. The phenomena of life were easily settled a thousand years ago by imagining a life prin- ciple to exist in the living body. This theory came to us

EDITORIAL S4I

first by authority. The Bible settled the question when it declared that God breathed into man and made him a liv- ing being. We had the authority of the Church for it, and that was enough. But the imagination now holds the same theory in place as a convenient solution of life's mysterious problems. ' It is however a theory, whether true or false, that has in it no element of science. Once it was potent to shut out all investigation. Life was " a sacred mystery," and we could raise no question which the "life principle" could not solve. But during the last century, the investigator has invaded the domain of life and stripped it of much of its mystery. And upon that small part which yet is not capa- ble of demonstration, it has resolutely placed well defined scientific theories, and so, in efiect, shut out the old imagin- ation of a "life principle." As scientists we take Matter and Force as our ultimates, and out of them construct, where needed, good working theories, to which we hold tentatively until demonstration shall come up take final possession. We have no need to go outside of the laws which govern matter and force, to understand life and disease, and the nature of drugs and the mode of curing disease. Nothing can help us on with more certainty than Chemistry and Physics, if prop- erly applied. Upon these Homoeopathy can stand with no fear of falling. We reject the assumption of a " life prin- ciple," first, because it is an unscientific theory; and sec- ondly, because it is not needed to account for the phenom- ena of life or health or disease. And we more especially object to making it the foundation of the Homoeopathic healing art, because it is quite too shadowy and untenable; and we can only lose by resting upon a false foundation. Dr. Wells declares that "without this force as a chief factor, Homoepathy has no philosophy; neither can there be without this force included in it, any rational philosophy of life health or sickness." And he adds as his l)elief that "it is indispensible to a useful and successful practice of this phil- osophy." But what we want is not a rational philosophy but a scientific philosophy; and that we certainly have, and it

342 PRACTICE OF MEDICINE AS A BUSINESS.

as certainly shuts out all superstitious beliefs in the old and exploded notion of a "life principle" otherwise known as "the vital force."

THE PRACTICE OF MEDICINE AS A BUSINESS.

READ BEFORE THE POLK COUNTY, IOWA, MEDICAL SOCIETY AUGUST 21, 1883.

BY CHABLES WOODHULL EATON, M. D.

The suggestions I am about to offer before you, will, I am sure, excite much mental comment and individual opin- ion while being read in your hearing. Let me ask at the outset that this comment and opinion be expressed fully and without reserve. Criticism is what the writer desires, and it makes little difference whether that criticism be pro or con, when one is assured it is, at all events, friendly. Further, no one save myself only has known the contents of this paper. It in no sense conveys the sentiment of my immediate colleagues, nor does it voice the opinion of that office of which I am one of the working members. They are in happy ignorance, both Dr. Linn and Dr. Morgan, of the exhibition of crankism which I have prepared for this evening.

Two things, then, in the practical life, not of medicine, but of the doctors of medicine, have arrested my attention. They have not arrested this attention because sought after by the inquiring mind. The challenge has come startlingly, persistently, and in spite of preconceived opinions. They confront one at every turn in defiance of inherited notions of the exalted plane occupied by the professions.

The first is this. There is not among my acquaintance a single successful practitioner who has been out of college long enough to draw the line between theory and fact, ideal and real, and who has given his confidence to me, who is not now planning to get out of the practice of medicine, or

CHARLES WOODHULL EATON, M. D, 343

resolving that he will at some future day — not so very dis- tant either. When I say successful practitioner, I mean those whose prominent position as honored physicians, and large earnings in dollars and cents make them the ones ordinarily supposed to be the most fortunate. Those who find them- selves not making as rapid strides toward high position and fat practice as they had hoped, are, of course open to the suspicion of having been soured by hard experience. Of these I have nothing to say. My point is the almost unan- imous dissatisfaction of those who are already at the top. Dissatisfaction in failure is one thing. Dissatisfaction in success is quite another, and challenges our attention.

Two physicians, occupying positions with which you and I would be abundantly satisfied (at least we think we should), have expressed themselves to me within a week. The way of putting it was characteristic of the men. Said one, "I don't blame any man who leaves the practice of medicine. I have more than once felt like doing so, haven't you?" The other, "Some day I expect to throw up the whole damned business."

If you will allow me, then, I will pin up this proposi- tion before you. That the successful doctors are greatly dis- satisfied with (not medicine, but) the practice of medicine. Hold this clearly in mind while we follow up the second fact in practical medical life, which clamors for attention.

Every year you meet many worthy young doctors looking anxiously for a location. I grant that there be many who deserve no location and no success. But they do not form a legitimate factor in the present discussion. They must be left out of consideration now, while we are speak- ing of the industrious, honest, clever, competent fellows, of whom there is a goodly number. They look the ground over as carefully as their pocket books will admit, and fin- ally settle in what seems to them, all things considered, the most promising field for their endeavor. With what feelings do they make this* decision, and open the modest office, and hang out the freshly painted sign ? I say, with what feel-

344 PRACTICE OF MEDICINE AS A BUSINESS.

ings, I do not say with what thoughts. For in their fresh and beautiful loyality to medicine, to Homoeopathy, they do not allow themselves any such nihilistic thinking as this paper betrays. But they have feelings which they cannot suppress, and yet do not confess; and the ill-concealed feel- ing is that, after all, it is a miserable game of chance, instead of a business demonstration, whether they have located well or ill, whether they have before them a business success or a business failure.

But the uncertainty of location is not the end of the misery, it is only the beginning of it. How is business to be worked up? How established in a legitimate and honor- able way? If he hopes it may be in part from his church connection, he can but despise himself for making his bouse a house of merchandise. If from his brother doctor's fail- ures he yet feels a conscious littleness. For the chances are that his neighbor is as competent as himself, and it always hurts an honest man to hear his brother craftsmen tra- duced, and know that he profits by the misunderstanding or misrepresentation of which his colleague has been the victim. If he is to get business by masonic membership, by the clap- trap of society, by personal display or brag, by rapid driving in and out of the town, going in desperate haste to see '*no one no where," still he is degraded by the unconscious conciousness that these methods do not belong to a sturdy straight-forwardness, — that they have a tinge of falsehood and dishonesty about them.

Would you and I be willing to do as a practitioner of this place is doing, i. e., dropping into the homes of her patrons at any and all times, in a social way, to express her great interest in them, — the motive being to get and keep their patronage? Would we be willing to do it? Is the interest and friendship expressed, quite sincere and quite honest? Does she wish to be understood, or does she delib- erately wish to deceive and pull the "wool" over their eyes? Which?

Our young man cannot advertise through the press in

CHARLES WOODHULL EATON, M, D. 345

such a way that it shall be of any service to him, for the code forbids it, and rightly, for this reason. When mer- chants advertise attractions, the public is fairly competent to decide what is true and what is not as to goods and prices, and judge between the claims of rival houses. Moreover, it is comparatively a small matter. But where the life and health of themselves, their wives and their little ones is at stake, with the added imifortance of the matter, they are at the same time left incompetent to judge rival claims in newspaper columns. So reputable doctors agree against advertisements, and depend upon their established character, thus forcing from the charlatan^ who spreads his claims in public prints, the confession that he has no established character and can- not depend upon any such broken reed.

In fact, our young graduate is left to succeed or fail on the lucky chance of some prominent case, or the sheer force of months or years of waiting worthiness. Three possibili- ties stand before him. Methods which lower his self-respect, pluck and indomitable waiting. Which shall he take? Which ought to satisfy him ? Which would satisfy a sound business test? Which would satisfy us?

To look at the same thing from another stand-point. A doctor told me recently of his desire to take up for his department the diseases of children. He wished to make that his work. Certainly it was a legitimate desire. Cer- tainly it was a legitimate thing to do. Could he take charge of all the croup in his town, his experience would both insure a better success, and the tabulated results would be worth more for the literature and progress of medicine, than if the same number of cases were divided among a dozen doctors. More than this, he would grow more expert than he 'of divided attention, in interpreting the signs of speechless infancy. I shall never forget the time when an old lady kindly volunteered to me the infor- mation that when a baby smiled in its sleep, it had the colic. I was a graduate in medicine and surgery, yet my face turned as red as my whiskers, because I never had

346 PRACTICE OF MEDICINE AS A BUSINESS.

heard the statement and could neither aflSrm nor deny. I do not yet know whether it be true or not, and my friend, could he pursue his favorite work, might solve the problem for me.

But though his purpose and ambition are perfectly legi- timate and laudable, neither he nor I could devise any way by which he could place his purpose before the people, which would be either legitimate or laudable He cannot de- pend upon the fraternity, as can the oculist, for in the present state of affairs, any physician who should refer the children, or infants merely, to another practitioner, would be supposed to advertise his own incompetency, and would cut the nerve of his own reputation. In short, there is no method open, giving reasonable promise of success, by which my friend may honorably take up his preferred work.

Here, then, is the second proposition. There is no In- timate business method by which the young doctor may establish himself in general practice, or in most departments of special work, which will bear an ordinary business test as to risk, probabilities, possibilities, and time demanded in establishing on a paying basis. Now let us couple with this the first proposition, namely : that the successful doctors are greatly dissatisfied with the practice of medicine. These are very grave propositions. Even if we do not admit their whole truth as they stand, I believe we see enough of truth about them to make them very serious statements of an unfortunate condition of affairs in the direction named, which ought not so to be.

What, then is the matter? And what are you going to do about it? These are the questions at the solution of which I do not assume to have arrived. These are the ques- tions I would propose for discussion. But as you may pos- sibly expect the first suggestion of a remedy from the one who is first to make suggestion of disease, I will outline for you my thought in this matter, prefacing only that I do not conceive that I have made a great discovery of the universal panacea. I would only offer a few sentences regarding that which commends itself to nle as one way of abating the un-

CHARLES WOODHULL EATON, M. 7>. 347

fortunate conditions, to which attention has been drawn, surrounding the practice of medicine.

It is doubtless true that these conditions are of compar- atively recent growth, and are still growing and to grow. There were centuries in which medicine and law and theology were veritable dictatorships. They were looked up to as super-human. Their dictum unquestioned, their authority unchallenged, their attainment possible to but few, they were subject to no such external pressure of jealousy lest they assume too much, and of skepticism as to their wisdom and power to accomplish the best for their clients, bom of the dififusion of technical knowledge; nor internal pressure from the armies of young men who now crowd into the professions as the goal of their ambition, thus making competition sharp. Look at the New England clergy of a century ago, and of to-ddy. As the progress of the human race gives us reason for believing, they are broader, as a class, and deeper, and worthier to-day than they were a cen- tury ago; yet possess but a modicum of their former author- ity. A New England clergyman of eminence, whom all alike delight to honor* has recently called attention, in one of our prominent Reviews, to this decline of authority. Not to be deplored, but welcomed, — not as showing the decline of the clergy, but of their authority only, which but marks the rise of the whole people. Is not this true of law ? Is not this more than equally true of medicine? And are we not surrounded by altered circumstances, and confronted with the call for altered methods of conducting our work?

Notice again, the tendency of the world, in all the varied departments of its work toward organization. Per- sons are everywhere giving away to institutions. The law of the division of labor is projecting its lines of separation among all men, like the reaching out of the spears of ice on a freezing pond or frosty window pane. The government of the Massachusetts Bay Colony has divided into the sharply

•Prof. Q60.:P.;FiBher, Yale Divinity School.

348 PRACTICE OF MEDICINE AS A BUSINESS,

defined departments of the legislative, executive, judicial. The tutorship of youth has been taken from the preacher and given to schools, colleges, universities. The monied man of the town has given way to the bank. The spinning wheel has been silenced in the hum of thousands of armed and cunning fingered factories. We no longer kill our own beef, or build our own houses, or bury our own dead. Even our wives and mothers no longer make our shirts, our hair is simply clipped by a curious mechanism, and doubtless the very youngster of succeeding generations will be spanked by machinery.

Theology has organizcrd and subdivided into Boards qf Mission, home and foreign, Boards of Publication, Boards of this and Boards of that, Sunday schools, choirs, schools of learning, almost without end. Law has done the same. Witness its many courts, from the justice's, to the United States Supreme. Medicine has done the same in the matter of the education of its men only, with the addition of a cer- tain degree of specialization among its teachers, which the necessities of college work have compelled. With the vast majority of the working men in medicine, and in all com- munities, with exceptions insignificant, there is no organiza- tion, no division of labor. The whole work of medicine is piled* in one heterogenious and chaotic heap. Any doctor may drop in any town, and with all the other doctors there, on an equal footing, go in for anything and everything that may be gotten hold of, — helter skelter, pell mell, pushing, crowding, snatching, backbiting, inhuman, every man for himself and the devil take the hindmost. Come on young man. We invite you to glory and honor. Join this intensely jealous, intensely selfish, jostling set, and taste the dignity of the profession of medicine. Come join this tribe of Ishmael, where every man suspects every man's hand to be against him, where each one supposes each other one would be glad to tear him down that he might climb by his spoliation; come join the clan so ordering its work that it makes a bid for every influence that tends to degrade the character of its

f

7

CHARLES WOODHULL EATON, M. D. 349

])ljj^ ^^dual members, and see what a glorious and noble and

th^^^thropic a thing is the practice of medicine. What of

^ €7 ^ Why its clientage is organized into churches who

'^o^^^^eir men. Law? It has its court and judges in the

^^^ insignificant hamlet. It is left to medicine to take pos-

t<^ ^^ of the country in true gorilla style. It enjoys that

^T3tion alone.

\8 it not time for us to be ashamed of ourselves and

VfeWn to do better ? Is it not time that we learn the lesson

which all the rest of the world has already learned ? Is it

not time that we understand that the countersign of success

is to-day not competition but combination ? Is it not time

that we devise methods which shall cement rather than

sunder us ? That shall gather together clinical experience,

rather than scatter it to the winds? That shall hinder,

rather than help, the incompetent and vicious ? " In union

there is strength."

We can have before our eyes continually the benefits derived by the staff of a medical school from the organiza- tion and division of labor which the neccessities of teaching compel, and never see that we might enjoy the same benefits, carried beyond the rudimentary, which is an incident of school work, towards the complete, in every town of any ^^e, without incurring the necessity of establishing a medical school. The advantages which they so reap we see on every hand. Each may work in his chosen department ^^^ 18 thus enabled to be at the head in one thing, rather taan good on an average in many things. The reputation of ® individual is the sum of their combined reputations, and ^^ j^ii g^j.g experts, the resultant reputation is the best •^®®^t>le basis for helping on the progress of medical science. *^^d of that fateful and wellnigh fatal isolation which ^ ^^^^"^ps the rank and file, their close association ensures . interchange of experience, that friction of mind on ^ which makes keen for insight and apprehension. j^,^^^^^hy may not the same advantages be secured in every ^^ large enough to really demand the services of three or

350 PRACTICE OF MEDICINE AS A BUSINESS.

more doctors? Let them join their forces as a firm under any arrangement of detail which seems best. Call themselves a Medical Institute if they think proper. Or a college if' they prefer. For the primary meaning of that term is a society of men engaged in common pursuits, as for instance the electoral colleges of our system of president choosing. Let each man have his department of work. Let them have a building devoted to their business, thus creat- ing a medical center, and at the same time lessening business expenses. I lay great stress upon the creation of a medical center, a place, the place where the medical work is done. When a man w^nts to stay a day or two in a town, he goes to a hotel. When you want to buy exchange you go to a bank. When there is need of the establishment of equity we turn to the courts. There should be a place, or places, par excellence, to which should turn the thoughts of those needing medical service, as a matter of course in the same sense as when under other circumstances they turn to the hotel, the bank, and the courts. In such a firm, each one may delight in the growing reputation of all the others, and do for their up-building what he could not do for his own, — what they in turn will do for his. In a very large sense, the reputation of the individual will be the sum of their com- bined reputations. In doubt there is an abundance of counsel, and no fear of conflicting interests. The gyne- cologist will not be worn out with worry about an eye he does not understand, the children's doctor will not be com- pelled to turn from cholera infantum to a gunshot wound. Standing shoulder to shoulder, they pursue their work bear- ing each others burdens. With but one department of work resting upon the individual, with abundant counsel in their own household, with yoke fellows holding up the reputation of each in those times which try it, with the mental disci- pline of association, with its warmth instead of isolation's chill they are under the most favorable circumstances for discharging a doctor's duty in the most successful, most manly way, and without that working care which makes

CHARLES WOODHULL EATON, M. D. 351

men gray and breaks them down. It frees them from temp- tation to deceitful ways and petty meannesses.

It puts the medical work into organized business channels, and young men will either enter the work with reasonable assurance of success, as in entering other business houses, or keep out altogether. In other words, it eliminates the haphazard element in the matter of location and establish- ment of business. Even advertising would be possible, though I should say unnecessary and undersirable. For quacks fight shy of each other. They have the seeds of disintegration within themselves, and could not maintain such organizations. So' every such association would by its existence be a guarantee of the standing of each of its mem- bers. In classified experience, each town of two or three thousand inhabitants would thus become of equal worth with the present value of a large city hospital. It would tell immensely in the taking of towns for homoeopathy. One of our men who is all alone in an Iowa town which the census of '80 put at 3,500 inhabitants, said to me the other day, "Had I had a competent colleague when I broke down under a practice of one thousand dollars per month for three succes- sive months, the old school would never again have had a smell of practice in this town." Living and starving, all told, they now have thirteen "regulars" in that town. Suppose they had had a working Institute of Homoeopathy of four mem- bers, say, in that town. What think you?

Think, too, what advantages such an organization would aflFord for the training of the medical student. It is not necessary to take the time to point out how great the improvement would be over the present system of precep- torship. The mere mention of the matter secures its recog- nition in all our minds. Understand, I do not hold up to your vision a medical millenium. I have not yet to learn that firms have their misunderstandings and quarrels. And large towns would have rival colleges. I can see rea- sons for apprehending frictions here and there. But these are greatly to be preferred to the individual frictions and

352 PRACTICE OF MEDICINE AS A BUSINESS,

integral rivalries which now obtain as the result of the pres- ent methods of medical practice.

But I forbear. I shall weary you. To you I leave further suggestions, pro and con, as to this or other plans. I believe that there is a call for a change in our methods which is thrust upon us by the very progress of civilization. I may have caught a glimpse of the direction in which that change is to come, and I may not. It will do us good to consult regarding it, at any rate. One word of criticism on the plan suggested, and I will yield the floor. It is this. It is Utopian. I regard this criticism, however, as construc- tive, not destructive, — as for and not against. I should be sorry to ofier you any plan which would not be Utopian. It was a Utopian idea of Hahnemann's that he could recon- struct and regenerate medical practice on the one law of similia; a law which was not new, and had been repeatedly recognized before his day. Yet now we are, at least, in par- tial possession of this promised land. We have entered upon the borders of this Utopia. It was a' Utopian idea of Professor Morse's that he could write messages afar off by the aid of lightning. We now dwell in the midst of that Utopia. It was Utopian in the extreme, that conception of the possibility of transporting the human voice, preserving its individuality and indentity, many miles. But the daily possession of that Utopia has ceased to be a surprise. It may be Utopian to suppose it possible that the grand multi- tude of devoted men engaged in the practice of medicine will ever be organized into anything like a compact army, by its combined strength conquering and to conquer. But it is the unexpected that happens, and in all other departments of the world's work we are continually marching into and taking possession of Utopias apparentljr more distant.

To disband the ranks and discharge the practitioners of medicine, of Homoeopathy, would be to cause the sending up from every household a cry of despair. There can be no doubt that the world needs and must have its doctors, for whom, after all, it has a warm and kindly place in its big

MASTITIS A ND MA MM A RY BA NDA OES. 1^53

heart The service must not be deserted. And if in our day the practice of medicine be found to have drifted, in its daily practical expression, into such position as that the best men find it hardly tenable or endurable, then the duty rest- ing upon our shoulders is not desertion, nor honorable self- discharge, but the removal of those rocks of offense which wear out and ex^perate the veteran, and perplex and dis- tress the raw recruit.

MASTITIS AND MAMMARY BANDAGES.

BY PHIl/ PORTER, M. D., DETROIT.

We have often been amused, from time to time, by read- ing the many theories put forth by our professional brethren, of the proper treatment of" mammary abscess," and the reme- dies advocated were almost as numerous as the cases to be met with. While not attempting to give anything better than has already been published, we do desire to present some of the methods of bandaging this part of the body, which to many, is a source of great perplexity and annoyance.

The first we give, is a very simple method of treating mastitis, one employed in England, and in our hands, has given good satisfaction.

First, with this bandage, we use freely, warm olive oil, as an emollient and also, for the purpose of creating external stimulation of the breast, we cut a piece of lint, the size of each breast, allowing it to come well under the axilla, leav- ing a hole for the nipple to pass through for the infant to nurse, and saturate the lint thoroughly with the best olive oil and envelope the breast; next cut a piece of oiled silk, the shape and size of the lint, and cover this over the breast, so as to prevent the oil from soiling the clothing. In all cases this should be applied at the first sensation of pain or swelling in the breast. As the lint — or two thicknesses of old linen cloth that is soft, will do — becomes dry, moisten with more olive oil. This must be persisted in if necessary. The

354 MASTITIS AND MAMMARY BaNDAG^,

action of the oil not only prevents the obstruction of the milk-ducts, by its heating and emollient properties, stimu- lating the capillaries around the base of the gland, but it also causes the milk to flow from the excretory ducts {ttdyuli Utcti- feri) involuntarily, or what is better understood in the phra- seology of nurses and "old ladies," causing the breast to run. If the breasts become very painful, we apply the ordinary supporter of adhesive strap, passing from one shoulder to the other and under the breast. In width, at the breast, two inches, this, to many, is all the support necessary.

When any other bandage is required we resort to one of the different forms given in Dr. C. H. Leonard's book on ban- daging.*

The first cut is to represent bandaging the left breast and is indeed, a comfortable bandage for a woman just up from the parturient bed. It not only gives support to the breast but also to the body, and if applied as directed, will remain in place, an important feature in all dressings.

The directions for making and applying some of the dif- ferent forms of mammary bandages we give from Dr. Leonard's work. Bandages of all sizes should be kept on hand in every physician's ofl&ce as much as any other necessary part of a practitioner's outfit.

We know it requires some extra effort, on the part of a physician to study and make him or herself, familiar with these bandages, but when once mastered, what a satisfaction it is.

THE CROSS OF ONE MAMMA.

Description. — The bandage is made from a roller, eight yards in length by two inches in width.

*A manual of bandaging, adapted for self-lni traction, fL60.

PIUL PORTER, M D.

355

Application, — Place the initial end of the bandage,

1, beJow the diseased gland I the left for exanople, and I confine by a horizontal cir- jcular turn about th^ body,

2. Continue on around the I body till you come to a

point below the diseased mamma, when you ascend obliquely across the chest to the opposite shoulder (the right in this case) thus finishing course 3. Course Fio. M— .Cross of one Mamma. 4 is a horizontal circular

turn about the body, in line of courses l^and 2; whilst course 5 is similar to that of course 3. Continue on in the same manner till the bandaga is exhausted when you confine it by pinning, as usual.

t7««8.— As a "sling" or support for an inflamed breast; and also for exercising a compression upon the gland, when occasion may demand it.

TRIANGLE OP THE MAMMA.

. Description.— This, should be made from a triangle hav- ing a base one yard in length and a heighth of eighteen in- ches.

A'ppKcation,—?\2iCmg the base of the triangle, a, at the xiphoid cartilage, carry one end obliquely up over the op- posite shoulder, b, and the other end b, below the axilla of the diseased side, and tie them together at the back. ! The apex of the triangle, c, is FiG.65.-Triangie of the Mamma. then to be Carried Upwards

2

356

MASTITIS AND MAMMARY BANDAGES

over the shoulder of the diseased side, and confined to the extremities of the triangle, at the back.

Uses, — Similar to the preceding; but it is more especially adapted than it, for retaining cataplasms and other dressings to the gland, and the region about it. Is n^ore easily applied than the above, and makes an excellent suspensory bandage for the mamma.

BOURSE OF THE MAMMA.

Description, — A pieqe of lint, ten inches in length and eight inches in width when folded at the centre. Cut then the folded corners a and B off by the dotted lines o-d, and e-f; stitch, then, the whole together from g to f; viz., G-o-D-E-F. This done, to each of tlie two corners at g, and the two at h, stitch a narrow strip sufficiently long to meet and tie, with its fellow, (the two in- r,(.. gfi. ferior) about the body, and (the two

superior) about the neck.

AppUcatlon. — Introduce the diseased gland into tlie bourse a, carry the two ends, b and b, iround the neck, the one on one side, and the other upon the other, and confine them by tying Conduct, now, the two inferior ends, c. c, horizontally about the chest, and tie either there, or Fig. 67.-Bouree of the Mamma, after grossing them, bring for- wards and tie in front.

Uses. — As a supensory of the gland in cases of hyper- trophy, or extreme fiaccidity of the thoracic walls, or dis- ease. Also useful in confining cataplasms, or other dres- sings.

CROSS OF THE TWO MAMM.E.

Description, — This bandage should be made from a roller, twelve yards in length by two inches in width.

FHIL PORTER, M, D.

357

Application, — Place the ini- I iial end midway between the low extremity of the xiphoid cartilage and the umbilicus, and, going from right to lefbt confine it by a single horizon- tal turn, 2. Continue on in the same course, till you come to the right side of the chest when you mount X)bliquely -crusrt oi m« iw» Mjisunia;. " upwards across the chest to the left shoulder, thus finishing course 3. Course 4 is a horizon- tal turn about the chest. Continue on about the body, hori- zontally, till you get to the left scapular region, when you mount obliquely upwards across the back, to the right side of the neck, and then descend obliquely downwards across the front of the chest, below the left mamma, thus finishing course 5. Course 6 is made similarly to course 3; course 7, to course 4; course 8, to course 5; course 9, to course 6; course 10, to course?; course 11, to course 8; course 12, to course 9, and so on until the roller is exhausted, when you confine as usual.

Uses. — In case of disease of both breasts where suspen- sion is required; also for compression, and.for the retaining of dressings. It m not a very stable bandage, besides being open to the objection of cording the neck somewhat. For retain- ing topical dressings, or for suspension, the triangular mam- mary caps, see figure 65, would be preferable*

Note. — Mayor's system may be used in making this bimammary bandage by simply applying the Triangular Caps of the Mammae, one to each gland ; the two apices being confined as described upon page 78, or else tied or pinned together. This would then be known as The Bimammary Triangle,

Two Bourses may also be employed ; each being made and applied similarly to that one described above (see Fig. 67).

358 COLLEGE OF PHYSICIANS AND SURGEONS.

PROCEEDINGS COLLEGE OP PHYSICIANS AND SUR- GEONS OP MICHIGAN.

DETROIT, NOVEMBER 26, 188S.

Under "Miscellaneous Business" Dr. Gilchrist oflTered the following:

Resolved, That this preamhle and resolutions be signed by the president and recorder of the College of Physicians and Surgeons, of Michigan, and sealed with the seal, and, together with such addi- tional matter as they may see fit, be sent to the board of auditors of Wayne county, this state, without delay.

Wherbas, The Homeopathic physicians of this city and county are entirely without representation- in the city and county ; and

Whereas, We are informed that a county physician is soon to be appointed by the board of auditors of Wayne county ; and

Whereas, The patronage of Homeopathic physicians is esti- mated to represent at least one third of the taxation of this city and county and is therefore justly entitled to representation in city and county appointments ; therefore

Resolved, That the president and recorder of the College of Physicians and Sun<eons, of Michigan, a medical society composed of Homeopathic physicians in the city of Detroit, and county of Wayne, be instructed to request the board of auditors, of Wayne county, Michigan, to appoint some nominee of this association, county physician, to fill the vacancy soon to occur by the termina- tion of the present incumbent's term of office, as an act of justice to a large portion of the tax-paying interests of this city and county.

Dr. Porter moved as a substitute, that this society nom- inate Dr. Bailey, for the position of county physician, and that the chair appoint a committee of four including him- self to visit the Board of Auditors in the interests of our nominee. The substitute was accepted by Dr. Gilchrist and carried unanimously. The president then named Drs. Gilchrist, Porter and Gaylord to form said committee. Dr. Porter, the lecturer for the evening, wished to be excused from reading his paper, as, on account of press of business he had not been able to finish it in a manner which the sub- ject merits. On motion of Dr. Gaylord he W£ts excused ; and the society opened under the head of '^clinical reports?^

Dr. Bailey related an obscure case of "venereal sore"

COLLEGE OF PHYSICIANS AND SURGEONS. 859^

which he could not fully diagnose. From the description given by him it is supposed to be either an ^' herpes progen- italis'" or a chancroid. The consideration of this case, gave rise to quite a lively discussion as to the proper treatment of chancroid, some of the gentlemen advocating'the use of caus- tics, others condemning it; but all agree that if used at all they should be employed with care as much trouble may result from too frequent applications.

Dr. Gaylord reported the following: An elderly lady while crossing a street tripped and fell, striking upon her nose; was taken to her home, complaining meanwhile of great pain in back of head and neck. This happened on Sunday. To-day (Monday) there is complete anaesthesia of scalp covering vertex and occiput, and also of back of neck. Dimness of vision in right eye and constant humming or buzzing noise in head. The pain and humming are increased by lying on the back Dr. Gilchrist pronounces it a case of concussion and thinks it will prove troublesome.

Dr. Porter reports two cases of interest. The first was sent to him by Dr. Olin and presenting the following condi- tion: Canadian French, 27 years of age, had been mar- ried; two years ago she had, what the attending physi- cian pronounced chronic diarrhoea, which had continued off and on until the present time.

At the commencement of the diarrhoea she had suppres- sion of the menses, which condition still exists. She pre- sented a healthy appearance, no cachexia or scorbutic indi- cations were visible, but on making an examination he found the perineum entirely gone, down to the sphincter ani, a recto-vaginal fistula about two inches above the outlet, and a stricture of the lower portion of the sigmoid flexure, in extent about one inch, which would admit of the passage of a uterine sound only. The uterus was fixed in position, but no cellular infiltration was detected. No history could be obtained ^that would indicate pelvic cellulitis, or syphilis. The patient had never missed a days work, and could not remember having had any discharge or ulcer ab*out the

1

860 COLLEGE OF PHYSICIANS AND SURGEONS.

vagina. The doctor proposes to operate on the stricture first, after which he will operate for the relief of the fistula and for the restoration of the perineum.

The second case was one which he said was outside his usual line of practice but will relate it on account of its inter- est to the general practitioner.

A boy five years of age, was run over by a public wagon, sustaining fracture of upper third of femur and some internal injuries. About three weeks after the accident the doctor noticed a swelling over the region of the greater curvature of the stomach, painful to the touch, elastic and resisting. The ch^ld vomited stercoraceous matter for two or three days. Bowels usually move regularly, but occasionally has an attack of diarrhoea lasting for about twenty-four hours. Ordered emollients which was followed for a week. At present no tenderness or pain. On pressure tumor did not recede much, does not feel like a hernia, cannot detect any separation of recti muscles. The child is restless from weight (5 lbs,) attached to leg, but not from the tumor. Urine mixed with blood, and associated with tenesmus vesicae. Is greatly emaciated. It is now six weeks since accident; shall remove dressings from leg to-morrow. Would like to ask members what they would pronounce the tumor, and if they ever saw a similar case? Dr. Gay lord thinks it is a hernia. Dr. Gilchrist was of the same opinion at first, but has changed his mind. It is rather large for a rupture, and yet the stercoraceous vomiting and history would seem to indi- cate that form of diflBculty. Dr. Porter thinks one point should not be lost sight of, namely, that the tumor did not make its appearance until three weeks after the injury, and the swelling came on by degrees, and was painful to the touch. The doctor stated that he would be pleased to have Dr. Gilchrist see this case with him to-morrow.

Dr. Gilchrist moved that the Recorder be instructed to send the transactions of this society to some medipal journal for publication. This was carried unanimously.

On motion adjourned. J. M. Griffin, Recorder.

COLLEGE OF PHYSICIANS AND SURGEONS, 361 DETROIT. DECEMBER 8, 1888.

Meeting called to order by the Vice-President.

Dr. Wm. R. McLaren, was elected lecturer for March, 1884.

Dr. Phil Porter, the lecturer for the month, read a paper (his second and last) on "Peri Uterine Cellulitis,^^ The lec- ture being an interesting one and exciting considerable dis- cussion.

Dr. Gilchrist stated that while he was greatly interested in the paper as read, he could not fully endorse all that the author said regarding the classification nor treatment. He thinks that much confusion would be avoided if only two divisions ot this disease were made ; has seen many cases, and in his opinion absolute rest should be enjoined, and such means used as will hasten the formation of pus in the acute and retard it in the chronic cases. Hot water siiould be used guardedly, and if used at all should be employed in the early stages before supuration had obtained. CaL carb, has served him well as a prophylactic, preventing the formation of pus. SUicea is indicated in secondary formations.

The Doctor spoke of a peculiar pain in the epigastrium, produced by this drug (Silicea) when given frequently, would like to know if any of the gentlemen present had observed this peculiarity, and also if they can tell him what will relieve it?

Dr. Craig is of the opinion that most cases of Peri Uterine CeUtUitis will recover if proper remedies are employed ; has used a mixture composed of Aconite and Hamamelis, locally, with good results. He thinks that many puerperal inflam- mations are produced by a clot of blood or shred of mem- brane remaining in the uterus. Apis mel, has served him well in many cases, and he thinks that we would obtain better results from this drug if more attention was given to the proper preparation of it.

Dr. Porter, is sorry thepe two gentlemen were not present at his" last lecture, as in it he referred to some points that they have mentioned, and making the two divisions sug-

362 COLLEGE OF PHYSICIANS AND SURGEONS.

gested by Dr. Gilchrist. Thinks the gentlemen misinterpreted him, as he is speaking of Peri Uterine CeUviitis and not of Pehfic OeUutitis, and be maintains that there is a vast differ- ence between the two diseases.

Dr. Lasse does not think hot water should be considered as a poultice, nor as producing the same effect. He thinks the idea is to get the contraction produced by extreme heat.

Dr. McLaren, reported a case of Peri Uterine Cellulitis which he cured, notwithstanding a number of physicians gave an unfavorable prognosis in the case. Pus had formed and was escaping. He introduced a speculum and injected Iodine 1x50, into the opening from which the pus ^as seen to escape. Also used the Iodine externally bathing the abdomen with it, and gave the same remedy internally. A speedy Recovery was the result.

Dr.*Gilchrist adds, that in the above case, which he saw with Dr. McLaren, the Iodine was * prescribed on strictly Homoeopathic indications.

Dr. Porter wishes it understood that he does not lay down any set form of treatment for these cases, but that each one must be carefully studied and the proper homoeopathic remedy selected. He can not see why Dr. Craig should use the Acon- ite and Hamamelis together; does not think it the prope thing to do.

Clinical Reports. "-Dr. McLaren presented the following case for counsel: Woman, married, always enjoyed good health, but for the last few years has suffered With mem- branous dysmenorrhoea; can discover nothing Abnormal about the uterus, either as regards its size, appearance, shape, or position. Never had leucorrhoea. The Doctor stated that he had used every remedy he could think of as having any bearing on the case, but with negative results. At last he decided to dilate, which was done by using a sea-tangle tent, giving his patient relief for three (3) months, after which the trouble returned, and during the last attack the uterus expelled the membrane exhibited here to-night Among the remedies given were. Bromine, Borax, Cauloph, Helon.

THE TRAINED NURSE AS A TEACHER 368

Dr. Porter thinks that Dr. McLaren is asking us to prescribe for a name which we as homoeopaths will not, and can not consistently, do. He, for one could not prescribe un- less he could have more symptoms.

Dr. McLaren then stated that the woman seems to be in perfect health, aside from this trouble and presents no more symptoms than he has given.

Dr. Craig, '*If a given remedy will remove a false mem- brane from one mucous surface, why will it not from another ? Why will not Kali Bich or any remedy used in membran- ous croup relieve such a condition as we find in membranous dysmonorrhoea ?"

Dr. Gilchrist, " because this is not a false membrane." On motion adjourned. J. M. Griffin, Recorder.

THE TRAINED NURSE AS A TEACHER.

May I tell you what a good trailed nurse mp-y teach, and can teach ? How to recognize a fever, how to compare the local temperature of the several parts of the body, and how to equalize them ; she knows that ever so many feeble children might have been saved, if but the feet and legs had not been allowed to get cold ; how to bathe, when, and when to stop ; how to regulate the position of the^head— I remem- ber quite well the case of inflammatory delirium which would alwavs be relieved by propping up the head — ^how to treat intelligently an attack of fainting ; how to render cow's milk digestible by repeated boiling, or lime-water, or table, or farinaceous admixtures; how to feed in case of diarrhoea;, how to refuse food in case of vomiting; how to apply and when to remove cold to the head ; how to ventilate a room without draught ; and a thousand other things. She will also use her knowledge and influence in weaning the public of the use of nostrums, concerning which hardly anything is known except what you have to pay for the promises of the label. She will break the public of the indiscriminate use of quinia, with its dangers possibly for life ; cure you of the

. 864 ALLOPA THIC POVERTY.

tendency of making the diagnosis of malaria the scapegoat of every unfinished or impossible diagnosis ; she will teach you that the frequent and reckless domestic use of chlorate of potassium leads to many a case of ailment,^ to chronic poisoning possibly in the shape of Bright's disease, or to acute poisoning with unavoidable death. These are but very few of the things she can do, and but a little of the knowledge she can best distribute. With the aid of the class^ of women who frequent our training-schools, the public at large must and will gain, in a short time. Let the number of the schools be increased, and increase the number of pupils, and every one of them will be a teacher and an apostle of sound information on sanitary and hygienic sub- jects. And let nobody leave this place to-night without intending to aid an institution as helpful as this. — Popidar Science Monthly,

ALLOPATHIC POVERTY.

BY A. MACNEIL. M. D.

There are a few individuals that have been associating themselves with us who are very energetic in their efforts to form a union with the dominant school of medicine. It occurs to many of us that we have no objections whatever to* those persons forming that union for themselves. The only diflSculty is in getting in to that body, as we are not aware that the school is eager to receive them. In order that such persons may go in a state becoming to them I have no- doubt that a brass band, even one as expensive as that of the New York Seventh Regiment, will be hired and paid for by the homoeopathic school to escort them over to the allopathic camp. It is well that we should know what is the repast to which we are ii^ited to participate, not by the host, but by the would-be guests. I therefore translate an article from the "Allg. Wiener Medizinische Zeilung" of February 20^ 1883. It being a report from the clinic of Prof. Nothnagel of the University of Vienna, one of the greatest author-

, A. MACNEIL, M. D, 365

ities in medical therapeutics, of which our allopathic col* leagues can boast.

The Professor in lecturing on pleuro - pneumonia says: "In my opinion we can only speak of therapeutics of acute infectious diseases, when we have specific reme- dies, and it is to be hoped that medicine (regular) will- in the course of time reach to that degree of perfection. Such specific remedies we possess in Quinine in malaria, Salicy- late of soda in acute rheumatism of the joints and lod. kalium in syphilis. As we have come to the conclusion that croupous- pneumonia is in many cases an acute infectious disease, so we must therefore seek for a specific remedy for it. The indiccUio causalis cannot be overvalued, and we now turn to the symptomatic indications. Digitalis and Veratrin are administered to reduce the temperature. But, however, Digi- talis does not reduce the temperature, except as it reduces the frequency of the pulse, and is therefore unnecessary in pneumonia. Traube has only introduced it experimentally. Veratrin causes a rapid fall of the temperature, but it fre- quently results in collapse, and consequently T emphatically warn you against its methodical use in pneumonia. We must not do anything against the fever except when it reaches a dangerous length or height, for in many cases the fatal result arises from a failure of the activity of the heart. Anything which depresses its activity must therefore be avoided, and in very many cases the high temperature does it. This we can control only by the anti-pyretic process. But it does not follow that we must stimulate in every case of pneumonia. We must individualize, not treat routinely. We should stimulate only when we see that we have a cach- ectic patient or when in the course of the disease a failure of the heart is discovered. Lately the Iodide of potash has been administered on the first and second days, but I cannot dis- cover any favorable effect of it. The symptomatic treatment must only be directed against the irritation to cough, the pleuritic stiches, etc. We have in our cases no reason to depress the temperature or to stimulate, we must therefore

366 A LLOPA THIC FO VERTY.

treat them expectorily. I deny that the expectant treat- ment of pneumonia is general, only it is applicable in the individual cases also."

Prof. Nothnagel speaks very confidently of Quinine as a specific in malaria and Iodine salt in syphilis. But we should remember that by other illustrious authorities of his own school, that their drugs have been pronounced as of doubt- ful value. I can quote well known names, showing that Quinine produces deafness, blindness, insanity and death. And Prof. Zeissl of the chair of syphilis of the same univer- sity recommends expectant treatment in syphilis, (vide his work "Syphilis" Band II. page 354,) Prof. Kaposi, also pro- fessor of Dermatology and Syphilis, in Vienna University says. Hebra and Kaposi Haut Krankheiten, Band II, page 526, "Although their ulcers (chancres) owe their origin to a specific virus, yet we are still in our complete ignorance of the physical and chemical nature of this virus and as all empiricism has left us so far in the lurch, we are not able to oflTer a specific remedy for chancre." He therefore prescribes same treatment as in ulcers of the legs, viz., a palliative one.

It is for such as this that homoeopaths are asked to give up their tried remedies that fail only in unfavorable cisea because we are not sufficiently acquainted with them. Ask the homoeopath that knows that he can cut a case of pneu- monia short oflf in any stage, to give up his treatment and adopt the treatment of those who openly acknowledge that no treatment at all is better than theirs. Ask him to give up his treatment of intermittents, which he has proven reliable in a thousand cases for a treatment, that those who are beet acquainted with it, viz. its professors acknowledge is danger- ous to sight, hearing, reason and life. Ask hini to give up the specific remedies for syphilis, in which he has a time hon- ored confidence, for that which their most illustrious profes- sors whom I have quoted prefer no treatment to. Verily! I recommend veteran lightening rod peddlers to go to those men to get their soft cheeks indurated up to the mongrel standard.

CLINJCAJ, REFLECTIONS. 367

CLINICAL REFLECTIONS.

BY AD. LIPPE M. D., PHILADELPHIA.

NOSEBLEED, CASE I.

A child (girl), six years of age, was brought to me some four years ago with violent nosebleed. Her mother stated that the child has had repeated, and now more frequently returning generally nightly recurring attacks of nosebleed for which both Schools of Medicine had been consulted, and the child had had therefore a variety of treatments. For the purpose of fuUy taking in the situation the nose was examined^ and there we found in the right nostril a very large polypus. Merc, corros. subl. was administered in a High Potency^ and the nosebleed ceased; it did nevertheless return less violently at much longer intervals, always worse at night, and the remedy was again administered on these occasions, till finally there was no more nosebleed, and the polypus was also no more. About 18 months later the bleeding began again, now from the left nostril, worse at night, a very small polypus had made its appearance, but after the nosebleed was again checked by Merc, corros. subl. the polypus also dis- appeared, and the rapidly growing little girl enjoys perfect health.

Oommenta. — Hahnemann taught us how to apply the law of the similars for the cure of the sick, how to ascertain the sick-making properties of drugs, how to examine the sick and obtain a correct description of each individual case and thereby find ourselves enabled to find the similar remedy among the proved remedies constituting a reliable Materia Medica of his own creation, to which were added such drug provings* as were made at later periods ; he also advised us how to administer the similar remedy in appropriate doses. Guided by these simple methods we could not fail to see at once the similarity of Merc, corros. to the case, and we there- fore cured this individual case of nosebleeding. In our days we find a professed Homoeopath, a member of the Interna- tional Hahnemannian Association — which was founded over

868 CLINICAL REFLECTIONS.

three years ago for the avowed purpose to protect our healing art from growing departures— coatending that he has found a ^ecific, for nosebleed, which will cure it under all circumstan- ces. The day has long passed by when medical men were found bold enough to declare that they had found a specific for the cure of a disease or for a single symptom of a dis- eased condition ; medical men of all schools have found by the only reliable test, the clinical experiment, that such claims as specifies in the sense above mentioned are '* Cfcim- frcw." Nevertheless the Gothamite with his highly poten- tised nostrum, a specific for nosebleed, is not only permitted to remain a member of the I. H. A., but the absurd claim is sustained and defended by members of the I. H. A. to the detriment of the claims of the infallibility of the methods of our healing art called by its founder "Homoeopathy."

NOSBBLBED, CASE II.

A lady over 50 years old had suflfered for many years from hypertrophy of the heart; she had been much relieved by the homoeopathic remedies administered to her. On the 14th of February, 1882, she called at my house at noon to await my return to the oflBce at 2 p. m. She had scarcely arrived before she was for the first time attacked by a violent nosebleed. When I arrived at 2 p. m. I found her, having lost a very large quantity of blood which was rapidly flowing from her nose, in a fainting condition. We took in the situa- tion and concluded that this now very dangerous nosebleed must be controlled at once, her heart's condition led us to administer at once a remedy controling a variety of hsemorr- hages, Cactus grandiflorus. We put a few pellets of Cact. gr. C. M. (Fincke) on her tongue. In less than five minutes she was enabled to lay down in a very exhausted condition, the nosebleed had ceased. We provided her with a small bottle of this remedy with the request to again take a few pellets should this alarming nosebleed return. Three months later it returned, but was promptly checked at once by taking the remedy; since then she had no return of it and her heart-, disease is at present much better than for many yaars.

AD. LIPPE, M. D. 369

OommerUa. The specific for nosebleed was not known then, and if it had been known it would not have been administered on the vague assertion of a professing homoeo- path that this specific would cure all cased of nosebleed. The prompt action of Cactus grandiflorus in this grave and alarming case might have induced us, were we not a consis- tent homoeopath to proclaim it "a specific for nosebleed." But as one of the great requirements of our healing art is to *^ individualize^^ we are fully impressed with the correctness of Hahnemann's methods and shall in the future as in the past continue to individualize. In this case we find in the provings of Dr. Rocco Rubini, of Cactus gr. symptom 33 *^profuse epistaxis which ceases in a short time." The many heart and chest symptoms of Cactus gr. are so well known and so well rendered by its prover that it has become an indispensable remedy in many heart diseases, but it would be preposterous to declare Cactus gr. a specific for hyper- trophy or any other disease of the heart. The true healer will carefully discover the similar, but still diflfering sym- tomSjfor instance, between the heart constrictions peculiar to Cactus gr. and Lachesis, here we find the repeatedly con- firmed differences. Cactus gr. has the painful sensation as if the heart was held and clutched by an iron hand <Symptom 64, "sensation of constriction in the heart, as if an iron hand prevented its normal movement"). This symptom was confirmed first by Dr. Dunham, Homoeopathic Monthly I. 4. Lachesis has "constriction of the heart as from an iron band." If we desire to develop Homoeopathy it behooves us to keep on "individualizing;" if we desire to make it a fail- ure, if we progress backwards without reflection, we return to the old, but easier method of prescribing by generalizing. Prescribe for pathological conditions, for names of diseases, and if we progress backwards into the last century without reflection of course we talk about specifics, or introduce old exploded notions in therapeutics. The above cases are only given to prove the infallibility of Hahnemann's methods which were the result of his "inductive philosophy." Hahne-

370 NATURAL APPETITES.

mann investigated first, and then under his inductive method, now adopted by all truly scientific men, he ^^progreased.^^ Other men of a different sort, only seeking "labor saving methods " progress and want others to also progress wUhovl method on reflection, and by and by prove by their own actions that they are " false prophets." Liber OenesiSf Caput III, 19. In sudore vuUvs tui vesceris pane.

NATURAL APPETITES.

In order to distinguish a poison-stimulant from a harm- ' less and nutritive substance, Nature has thus furnished us three infallible tests :

1. The first taste of every poison is either insipid or re- pulsive.

2. The persistent obtrusion of the noxious substance changes that aversion into a specific craving.

3. The more or less pleasurable excitement produced by a gratification of that craving is always followed by a depres- sing reaction.

The first drop of a wholesome beverage (milk, cold water, cider fresh from the press, etc.) is quite as pleasant as the last; the indulgence in such pleasures is not followed by re- pentance, and never b^ets a specific craving. Pancakes and honey we may eat with great relish whenever we can. get them, but, if we can't, we won't miss them as long as we can satisfy our hunger with bread and butter. In mid-winter, when apples advance to six dollars a barrel, it needs no lec- tures and midnight prayers to substitute rice-pudding for apple-pie. A Turk may breakfast for thirty years on figs and roasted " chestnuts, and yet be quite as comfortable in Switzerland, wh^re they treat him to milk and bread. Not so the dram-drinker: his "thirst" can not be assuaged with water or milk, his enslaved appetite craves the wonted tipple — or else a stronger stimulant. Natural food has no eflPect on the poison-hunger ; Nature has nothing to do with such appe- tites.— Popular Science Monthly.

HOW TO TREAT HARD CHANCRE. 371

HOW DO YOU TREAT HARD CHANCRE? •

Manayunk Noy. 1888.

Dear Doctoral &m collecting statistics of the results of Homoeo- pathic treatment in Venereal Diseases. Will yon aid me by- answering the following questions :

How do you treat hard chancre? Remedies most frequently used. Indications, potency? Do you use local treatment, if so^ what ? Are yoa able to prevent secondary symptoms ? How do yoa treat secondary manifestations? What remedies in skin affec* tions? What in affections of mucous membranes ? State potency and dofie. Same for tertiary syphilis. How long do you keep a patient under treatment? What is average duration of your cases ? Hereditary syphilis. How many cases, forms of the disease, treat- ment, resolts? Yours fraternally,

W; B. TRITES, M. D., Lectarer on Venereal Dlaeaies, Hahnamann Medical College, Philadelphia.

If Dr. Trites is in search of statistics of the homoeo- pathic treatment of venereal diseases, we fear he will be UDSUccessfu]. "A rose under any other name would smell as sweet;" but a chancre cauterized by a man receiving his degree from a homoeopathic college,would not necessarily con- stitute it homoeopathic treatment. The homoeopathic phy- sician can suppress syphilis by the cautery as well as any- other physician. The treatment of Ricord will not materi- ally differ in results because applied by a professed Homoeo- path. We were taught at college, that the treatment of syphilis was one of the exceptions of the law of cure ; and 4oT years we faithfully followed our instructions. We are convinced that under that treatment, secondary and consti- tutional symptoms are, in the majority of cases, unavoidable ;: hence we have abandoned it for the safer, milder, more scientific (because more homoeopathic) method of Hahne- mann and Dunham. Under this treatment we do not inter- fere with the "blossom" — the local chancre or bubo — hence there is no secondary, tertiary, or hereditary syphilis ta treat, or would not be if all cases were treated in this way. If our law of cure be able wlien rightly administered, to rob

cholera, croup and yellow fever of their terrors, why is it not 3

^

372 HOW TO TREAT BARD CHANCRE.

able to cope with ague, gonorrhoea and syphilis? Hahne- mann says it is; and Dunham and Hering and every other homoeopathic physician who has faithfully followed his instructions, corroborate his statements. And yet many of our homoeopathic practitioners, who rarely find it necessary to resort to palliative measures in croup, diphtheria, pneu- monia, or cholera, do not hesitate to suppress ague with quinine, gonorrhoea with astringent injections, or treat hard chancre with caustics. Below we give the treatment of Hah- nemann and Dunham to which we respectfully refer Dr. Trites for facts if not for statistics. It is our homoeopathic treatment. H. C. A.

"The syphilitic miasm is much more general than the miasm of sycosis. For the last four centuries, it has given origin to a vast number of chronic affections.

The treatment of syphilis is only difficult when there is a complication with the psoric miasm, after it has broke forth from its latent condition. Sometimes^ but rarely, syphilis is complicated With sycosis; whenever this complica- tion exists, it never exists without the additional complica- tion of psora.

In the treatment of syphilis, three different conditions may occur. First, the syphilitic disease may exist in its genuine form, together with the chancre, or, in case the chancre should have been removed by external applications, it may exist with the bubo, which must then be considered as the representative of the chancre ;♦ secondly, it may exist without being complicated with another miasm, though both the chancre and the bubo may have* been removed; and thirdly, it may exist in a state of complication with another ^hronic miasm, either with the chancre or bubo, or after their removal by local applications.

The chancre generally appears between the seventh and fourteenth day after the infection has taken place ; it rarely

*In rare case^, the bubo U the first and immediate result of impure ooltion, ivithout any previous chancre; generally, however, it is consequent upon the removal of the chancre by local applications, and Is, tn this case, a troublesome representative of the latter. •

HOW TO TREAT HARD CHANCRE. 373

appears either sooner or later, and generally affects the parts which have been first tainted with the virus. The chancre first appears in the form of a little vesicle, which is soon changed to a painfully stinging ulcer, with an elevated bor- der. This ulcer may remain upon the same spot during the life time of the patient, tind, although it may become en- larged, yet the secondary symptoms of syphilis will never make their appearance as long as the chancre remains.

The allopathic physician, not knowing that the entire organism has become infected with the syphilitic miasm, even before the appearance of the chancre and immediately after the impure coition has been accomplished, looks upon the chancre as a simply local ulcer which ought to be removed by the external application of desiccating and cauter- izing substances, and which will remain quite harmless, pro- vided it is not left too long on the skin ; for, in this case, the absorbing vessels might carry the poison into the internal organism, and, in this way, produce a general syphilitic affection, whereas these evil consequences might be avoided by a speedy removal of the chancre. This is both the doc- trine and the practice. By this practice, the physician deprives the internal disease of its vicarious symptom, the chancre; and, by the removal of the chancre, he forces the disease to embody itself externally in the more troublesome and speedily suppurating bubo. And after this too has been removed, as is foolishly done, by external treatment the disease is forced to manifest itself throughout the organism with all the secondary symptoms of a fully developed syphilis. This unavoidable development of the internal syp- hilitic disease generally takes place after the lapse of two or three months. So far from relieving the patient, the physi- cian positively injures him.

John Hunter asserts :* "Not one patient in fifteen will escape syphilis, when the chancre is removed merely by local treatment;" and in another part of his work, (p. SSI'— 553) he assures us : "that the local removal of the chancre, should

^Trefttise on the Venenl Diseases, Lelpslc, 1787, p. 6S1.

874 HOW TO TREAT HARD CHANCRE.

it even have been accomplished ever so speedily, was always followed by an outbreak of the internal syphilitic disease."

" The same doctrine is emphatically taught by Pabre, who says 'that the local removal of the chancre is always fol- lowed by syphilis; that Petit had cut off a portion of the labia of the genitial organs of a woman, which had been aflTected, for some days, with veneral chancre; that the wound indeed healed, but that the syphilitic disease never- theless broke out.'

It is incredible that physicians, in spite of the expe- rience and emphatic statements of such great observers ,^ should have shut their eyes to the fact, that the veneral disease existed already in its fulness in the organism before the chancre had made its appearance, and that it was an unpardonable mistake to remove the chancre by external applications, and to consider this local removal of the chan- cre a complete cure of the disease. On the contrary, by this local removal of the chancre, the syphilitic disease was not only forced to ramify into its secondary symptoms, but the physician deprived himself of a sure and infallible indication of the thorough and permanent cure of the inter- nal disease. As long as the chancre existed, the organism was yet tainted with the syphilic virus ; whereas the disap- pearance of the chancre consequent upon the internal admin- istration of appropriate remedies, was a sure sign of the inter- nal disease having been completely and permanently cured.

"In my practice of fifty years' duration, I have never seen syphilis breaking out in the system whenever the chan- cre was cured by internal remedies, without having been mismanaged by external treatment; it mattered not whether the chancre had been left standing for years, increasing all the while, as every vicarious symptom of any other chronic nciiasm will do, for the simple reason that the internal dis- ease is progressing all the time, and induces a consequent development of the external symptom.

"As soon as the chancre is removed by external remedies, the syphilitic disease which is engrafted upon the whole

now TO TREAT HARD CHANCRE. 376

organism as soon as the infection has taken place, manifests its series of secondary symptoms.

"Hence it is that the internal disease is most efficiently and most permnantly cured while the chancre or the bubo are yet in existnace as its vicarious types. Of this genuine and unadulerated syphilis it may be said, thcU there is no chronic miasm, nor a disease produced by a chronic miasm, which is mare easily cured than syphilis,

'^ In that stage of the syphilitic disease where the chancre or the bubo are yet existing, one single minute dose of the best mercurial preparation is sufficient to effect a permanent •cure of the internal disease, together with the chancre, in the space of a fortnight. Of course such a cure can only be -effected when the syphilitic disease is not complicated by some psoric affection ; it is especially in young persons of a cheerful temper that a speedy cure may be anticipated; psora being in a latent condition in such persons, neither syphilis nor sycosis can become adulterated by that miasm. A few days after the medicine has been taken, and without the 4ise of external application, the chancre is changed to a pure •ulcer with a little quantity of laudable pus, which heals of itself without leaving the slighest cicatrix, or even spot, the ■color of which is different from that of the sound skin. This is a convincing proof that the internal disease has been -completely annihilated. Inasmuch as the chancre is the •external indication of the internal disease, this disease can- not be considered cured as long as the internal remedy has not acted sufficiently to remove even the slightest trace of ohancre from. the skin," — Hahnemann's Chr» Dis, Vol. I p. 115.

"Touching this disease I desire to say, that in so far as my experience in the treatment of it is concerned, I have not found it less amenable to treatment than other constitu- tional maladies. The patient, otherwise in vigorous health, who presents himself for treatment, without having previ- ously saturated his system with drugs, and without having

876 HOW 70 TREAT HARD CHANCRE,

undertaken to eradicate the morbifio poison by caustic appli- cations to it^ primary local manifestation, the chancre — such a patient, if Mercury be indicated by his symptons, will be cured as readily and by as small doses as though his disease were something of a totally diflferent character. (A preju- dice to the contrary exists.) And my profcfssional experience satisfies me, that in these, as in other cases, the high potencies, and infrequent doses, produce a more speedy and effectual cure than low potencies and frequent doses do. But inas- much as I do not regard the chancre as the ^*fons et origo | mali." but rather as the blossom and product of a constitu- tional infection which already prevades the system, I am not in so great haste as some are to destroy the chancre, well satisfied if, under internal treatment, I perceive it gradually ' heal by healthy granulations, no other symptoms meantime i appearing. Above all, I dread .the local treatment by caustic, j the much-vaunted method of Ricord. For observation has satisfied me that even a majority of his patients, discharged as cured through the local cauterization, present, after the lapse of from one to eight weeks, all the signs of secondary syphilis, and become candidates for, and victims of, the 'con- stitutional treatment'

It is not every case, however, of so-called chancre, for which Mercury is indicated.

That which is now denominated chancroid, and which, being a shallow and flat bottom ulceration, shows a ten- dency to spread irregularly and indefinitely, having never well-defined outlines nor a lardaceous bottom ; but exud- ing a thin, serous discharge, and which is probably not at all syphilitic in its origin, does not call for Mercury, and is not benefitted by it ; indeed is rather aggravated. I have found the totality of the symptoms to indicate Nux vomica more frequently than any other drug, and under this a speedy cure to follow.

The form of chancre in which Mercurius is indicated is the regular indurated Hunterian chancre, with the lardace« ous base."— Z>unAam'« Afat. Med,^ Vol. II, p. 225.

ALCOHOL AS A REMEDY. 377

ALCOHOL AS A REMEDY.

I do not intend to deny that the use of mild alcoholic ionics, as a substitute for the frightful remedies of the mediae- Tal Sangrados, is a decided improvement, but, still, it is only a lesser evil, av first step of a progressive reform. Alcohol lingers in our hospitals as slavery lingers in the West Indies, as the witchcraft delusion lingers in Southern Europe. Has alcohol any remedial value whatever? Let us consider the matter from a purely empirical stand-point. Does alcohol protect from malarial fevers? It is a well-known fact that the human organism can not support two diseases at the same time. Rheumatism can be temporarily relieved by producing an artificial inflammation; a headache yields to a severe toothache. For the same reason the alcohol fever afiTords a temporary protection from other febrile symptoms — i. e., a man might fortify his system against chills and ague by keeping himself constantly under the stimulating influ- ence of alcohol. But sooner or later stimulation is followed by depression, and during that reaction the other fever gets a chance, and rarely misses it. The history of epidemics proves that pyretic diseases are from eigfU to twelve times more destructive among dram-drinkers than among the temperate clashes; rich or poor, young or old, abstainers are only cen- tesimated by diseases that decimate drunkards. On no other point is the testimony of physicians of all schools, all times, and all countries, more consistent and unanimous.

Is alcohol a peptic stimulant? No more than Glauber 's- salt or castor-oil. The system hastens to rid itself of the noxious substance, the bowels are thrown into a state of morbid activity only to relapse into a morbid inactivity. The effect of every laxative is followed by a stringent reac- tion, and the habitual use of peptic stimulants leads to a chronic constipation which yields only to purgatives of the most virulent kind.

Does alcohol impart strength? Does it benefit the ex- hausted system? If a worn-out horse drops on the highway.

878 CLINICAL NOTES.

we can rouse it by sticking a knife into its ribs, but, after staggering ahead for a couple of minutes, it will drop again, and the second deliquium will be worse than the first by just as much as the brutal stimulus has still further exhausted the little remaining strength. In the same way precisely alcohol rallies the exhausted energies of the human body. The prostrate vitality rises against the foe, and labors with restless energy till the poison is expelled. Then comes the reaction, and, before the patient can recover, his organism has to do double work. Nature has to overcome both the original cause of the disease and the effect of the stimulant — Popular Science Monthly.

CLINICAL NOTES.

J. T. KBNT, M. D.. ST. LOUIS, MO.

Case I. — W. B. says he has had several chills and that they are increasing in severity. The first he noticed of his departure from health was a peculiar burning of his skin, his face swelled and looked red, especially about the eyes. He thought it was erysipelas. The burning and itching were intense. It felt so badly that he could not resist pinch- ing and scratching. His eyes closed from the rapid swelling and his neck got too big for his collar; over the chest the itching and burning were almost maddening. He applied cold water to his face which gave him con^fort and reduced the swelling so he could open his eyes. In spite of the itch- ing and burning he must keep in a warm room. In spite of the local relief from cold the general state was made worse from cold. The urticaria went back and the chills came on beginning in the hands and feet. Chill 12 to 1 for several days, then 10.30 a. m. every other day. Chills begin by a dry cough which lasts until fever is marked. He climbed upon the heater and piled clothing over him during the chill and did not become even comfortably warm until the fever warmed him. Thirst only during chill, for large quantities of water. Bones ache during chill and fever.

J. T, KENT, M, D. 379

Fingers cold and dead during chill and the numbness wears off during the fever. Gushing diarrhoea during chill. Fever is not very marked and there is no sweat. During apyrexiay he must wear heavy clothing to keep warm; he is much affected by weather changes. Great restlessness day and night. The amelioration from warmth is a marked feature of his whole case. Rhus tox 1 M. cured. No more chills.

The beginner might think of Apis in the above case on account of the urticaria and the thirst during the chill, but there was no suffocation attending the eruption, and the amelioration from warmth must exclude Apis. Rhus has no characteristic place for a chill to begin, nor special time, but the gushing diarrhoea and aggravation from cold gener- ally and more especially the chill beginning with a dry cough must point to Rhus as the most appropriate remedy.

Where there is a gushing diarrhoea during chill or fever, and urticaria, Elaterium should be consulted. It is charac- teristic of Hepar to have urticaria during the chill, of Rhus Ignatia, and Apis during the fever, Rhus, Hepar, and Apis during apyrexia, of Elaterium after the chills have been sup- pressed. But I have never seen the urticaria crop out incompletely during the apyrexia and seem to get relief by a gushing diarrhoea, in cases cured by Elaterium. It has been only a clinical observation.

Case II. — Mr. T , aged 35, a travelling man, with

syphilitic history, came back from one of his western trips, with the following symptoms. Numbness in fingers and soles of feet, with much awkwardness of all his motions. The staggering was marked and he walked on a wide base. He could not distinguish between small objects with his fin- gers. His manual movements were irregular and would miss his purpose. His movements thus far were not more irreg- ular by closing the eyes. His staggering was no worse when walking with his eyes closed. The reflexes, tendon patella and ankle joint were abolished, and he had to wait a long time for his urine to start. Fulgurating pains coursed through his limbs and back and he was in a general way going down

380 CLINICAL NOTES.

in bodily health. He says he has had these symptoms three months and they have grown stronger every day. His vis- val apparatus has been defective a long time but there are no new symptoms traceable to the probable nervous state. Every seveh days he got one powder dry on the tongue — Alumina met. 200 of Lehrmann, no other medicine. A change for the better took place after the second dose. He took four doses in all. Every homoeopathist conversant with our literature must see a resemblance between this case and the one cured by B5nninghaiisen. While the symp- toms in both cases ar^ analogoas to signs of sclerosis of pos- terior root-zones, yet, the essential features are wanting. But the action of the remedy, as applied for a purpose, is just as demonstrative. While it, in my judgment, is evident there was no sclerosis, it is highly probable that a disturbing factor was at work in the tracks of co-ordination, the poster- ior lateral columns ; and in time a grave pathological change would have been established.

Case III. — Rheumatism, aching ^nd soreness in muscles and joints, compelling him to move after a few minutes and find a new place in which he seems more quiet. Rhus 1 M. Next day no improvement and no change in symptoms, except growing worse generally. The pain in the ankle joint feels as if sprained, joints and muscles sore to touch. He says, "I move all the time; when I get into a new place I feel better but very soon the bed in the new place feels like iron and I must move. The moving I am compelled to do not from an innate restless pain but from the hardness of the bed as it seems to me." It must be observed that Rhus tox could not cure this case, yet at my first visit the language was calculated to deceive. Arn. must be the most appropriate remedy. The soreness which gradually grows worse by the pressure of the bed and the peculiar pain and soreness as of a sprain pre- cluded any other remedy. Arn. 1 M. was given in water. The pain and soreness were gone at the end of three days. Sulph 6 M., one dose finished the cure. He was out of the house on the eighth day.

KALI BICHR0M2CUM IN HEADACHE. 381

Case IV, — Mrs. P., aged 36, rhuematism many month* in lower extremities, after failure to cure with strong reme- dies, Quinia, Salicylic acid, Colch. and Iodide potassium, concluded to try linament. Strong applications were made with relief to the lower extremities. I was sent for, the messenger saying Mrs. P. was dying. I found her sitting upright in bed with great pain in the cardiac region, quick, sharp, irregular pulse, smothering breathing, clothing alt removed from neck and breast, choking and gasping — covered with perspiration and very palid. She got Lachesis 41 M. (Pincke) in water. Immediate relief followed, and she was able to lie down; although she was relieved of the more distressing symptoms, , it was evident that she was in great danger as the pain in the heart remained only slightly abated. The dianger in these cases need not be mentioned here, and I will only say, it appeared to be as usual a dangerous case of rheumatic endocarditis from met- tastasis. She took Abrotanum 6th and 12th. Recovery waa gradual from the beginning with the remedy and finally complete. She says that she now enjoys better health than ever.

KALI BICHROMICUM IN HEADACHE.

T. L. HAZARD, M. D., SALAMANCA, M. Y.

Was called Aug. 25th, 1883, at 1 a. m., to see Mrs. G — , 37, but having a case of labor on hand did not reach heF until 5 A. M., when she was much better. She had been hav- ing a severe attack of headache, to which she had been sub- ject all her life. It is evidently hereditary, as her mother has always been subject to sick and nervous headaches, and a sister has suffered for years in the same way. These attacks came on every few days and for months had been continually growing more frequent and more severe. The pain was located chiefly in theforehead, just above the eyes; but there was likewise some in the occiput. It was so severe

382 KALI BWHROMICUM IN HEADACHE,

as to compel her to go to bed and remain perfectly quiet; was somewhat relieved by pressure and lying down. Always before the attack she became blind. The blindness lasted but a short time, and as it passed off the headache began with ter- rible violence. If the pain did not immediately appear, she would continue to have repeated attacks of blindness until the headache came on. The menstrual period is prema- ture, and is always preceded for three or four days by one of these headaches. Has always been exceedingly nervous. Foui^ years ago she lost her husband and only child, since which time she has been more nervous than ever. ,

From the relief from "keeping perfectly still,'' Bry. was given with but slight improvement. Gels, did no better. On the evening of Aug. 27 I was again called and found the original condition greatly aggravated. Evidently the simil- limum had not yet been found. The most peculiar symp- tom, and evidently the most important one for selecting the remedy, was the amaurosis which always preceded the head- ache and passed away as the headache appeared. I gave Kali bi. 6x. In an hour and a half the pain had nearly ceased. She slept well that night and had no return of the headache for nearly a month, when an attack was caused by walking four miles during her menstrual period. Since that attack, with the aid of an occasional dose of Ignatia, she has continued to steadily improve in health and strength, having had but one attack, and that a comparatively light one, in four months, and in neither of the two attacks since August 27 has she had amaurosis. Her last two menstrual periods have been regular. She eats well, sleeps well, is less nervous, feels better in every way, and enjoys life more than she has for years. And all this in spite of the fact, that an Allopath had told her six months ago that she need expect no relief until after the menapause. This case verifies our Materia Medica teaching in the University of Michigan, viz : That the selection of the remedy is of the first importance, the vital question; the attenuation a matter of personal experience, a secondary affair altogether.

PVI.SATILLA IN MALPOSITION OF F(ETVS- I PULSATILLA IN MALPOSITION OF THE F(ETUS.

CHARLRS B. GILBERT, M. D., WASHINGTON, D. a

In the Institute transactions for 1868, Dr. H. N. Guern- sey requests, in his report on Obstetrics, that observa* tions in regard to the action of Puis, on malpositions be recorded.

Mrs. S. 29 years old, medium size, dark brown hair and eyes, pleasant disposition, came under my care April 12th, 1863, pregnant since the last of November, and apparently with dropsy of the amnion. She had been very miserable from the first, though very well at the time of conception. The child lay exactly across her with the head on the left side. I prescribed for her from time to time, as her symp- toms seemed to indicate, but though much better in many, ways the position was the same. But on June 12th she had depression of spirits, but becoming cheerful when a friend came in to cheer her up ; abdomen aUemaJtdy hard and soft ; . swollen feet and ankles. Now she got Puis. 200, (Lehrman) a dose morning. and evening, and in thirty-six hours the foetus had dropped its head into the pelvis and kicked its heels up into the liver which got many a hard dig after that, though the motions when becoming severe were much con- . trolled by different remedies; her mood became cheerful, and she felt better in every way. See also Investigator VI.- 139, BriiMh Journal XXXIX-422.

" There are some, I presume, who will deny that Puis. 200 can regulate the muscles of the uterus while they would be willing to acknowledge it from the tr. To such I wish to quote from Croserio in regard to the use of Puis, in cases of post-partum hemorrhage : — '

" Dr. KoUenbach, of Berlin, affirms that he has never obtained any effect from the employment of Puis, or even of Secale, when he has administered them to excite the expul- sive contractions of the uterus during labor; this positive

384 PULSATILLA IN MALPOSITION OF F(ETVS.

assertion on the part of an honorable colleague would have made me doubt myself, and, notwithstanding my fifteen years' experience, always followed by the same result, I should have hesitated to recommend so decidedly this remedy under these X5ircumstances, and should have feared that I had not well observed my cases, and awaited new experiencjes ; but seeing the doses used by this practitioner, I am no longer astonished at the difference in our results. Dr. K. commonly used the Ir. and never above the third dilu- tion, from three to five drops at a time ; he has given five drops of the tr. of Puis, to a woman in labor ; the woman experienced nothing but great uneasiness without any in- crease of the pains I This effect of a dose truly poisonous, will cause no astonishment, if we consider the excessive sus- ceptibility of the woman at this time, and that the augmen- tation of the expulsive pains is a reactive effect of nature ; how, then, shall this reaction take place from the effects of so enormous a dose upon a vital force,. exhausted, so to speak, through the pains and other circumstances of labor ? Nature outraged, confined by this mass of poison, can no longer re- act regularly; besides, the crude drugs exercise a violent general action upon the whole organism, which hinders it, so to speak, from perceiving the particular affinities with the <lifferent organs.

In this manner the observations of the Berlin physician and their contradiction to my own are explained : and this contradiction furnishes a new proof of the necessity for employing the high dynamizations in the circumstances under consideration : for if I have only proposed the num- bers under thirty, it is that I may not shock the ideas gener- ally accepted by the Homoeopathic public, for I am con- vinced that the 200th and above would be much more in their place than the dilutions ordinarily recommended in this work, committed, as they were in great part, to writing before I had recognized the advantages of the high prepara- tions." "^

PER818TkNCE OF FORMS OF DISEASE, 386

PERSISTENCE OF FORMS OF DISEASE.

A disease remains the same in essence, no matter whom it attacks or what its severity be in the individual case. Each contagious disease breeds only its own kind, and no other. When we expeiiment with an isolated, disease-producing germ it causes always one and the same affection, if it takes hold at all.

But evidence is beginning to accumulate that, though we can not change one species into another, we can modify the power and activity, in short, the virulence, of parasites. Pasteur has shown that when the bacteria of chicken cholera are kept in an open vessel, exposed to the air for many months, their power to struggle with the animal cells is gradually enfeebled. Taken at any stage during their decline of virulence, and placed in a fresh soil in which they can grow, be it in the body of an animal or outside, they multi- ply as before. But the new breed has only the modified virulence of its parents, and transmits the same to its pro- geny. Though the form of the parasite has been unaltered, its physiological activity has been modified: it produces no longer the fatal form of chicken-cholera, but only a light attack, from which the animal recovers. By further enfeeble- ment of the parasite, the disease it gives to its host can be reduced in severity to almost any extent. These mild attacks, however, protect the animal against repetitions. By passing through the modified disease, the chicken obtains immunity from the fatal form. In the words of Pasteur, the parasite can be transformed into a " vaccine virus " by cultivation under conditions which enfeeble its power. The splendid view is thus opened to us of vaccinating, some day, against all diseases — in which one attack grants immunity against another. Pasteur has succeeded in the same way in another disease of much greater importance, namely, splenic fever. The parasite of this affection has also been modified by him, by special modes of cultivation, so as to produce a mild attack, protecting against the graver form of the disease.

386 AMERICAN INSTlTUfE.

Pasteur's own accounts of his results, in vaccinating, against anthrax, the stock on French farms, are dazzling. But a repetition of his experiments in other countries, by his own assistants, has been less conclusive. In Hungary the immu- nity obtained by vaccination was not absolute, while the protective vaccination itself destroyed some fourteen percent of the herds.

Yet, though much of the enthusiasm generated by Pas- teur's researches may proceed further than the facts warrant, he has at least opened a new path which promises to lead to results of the highest importance to mankind. — Pcpvlar Science Monthly,

AMERICAN INSTITUTE.

The next session of the American Institute will be at Deer Park. Md., a delightful summer resort on the line of the Baltimore and Ohio R. R. The location is central and of easy access from all parts of the country, north, east, south and west. There are three express trains, daily, each way, and you are landed at the foot of the hotel lawn, about three hundred yards away, thus avoiding the annoyance and incon- venience of cabs and omnibus lines. The hotel is one of a number owned by the B. <fe 0. R. R. Co., and under the eflS- cient management of W. J. Walker, Esq., Supt. of the hotels of the company. It can accommodate about six hundred guests. The dining room will seat five hundred. The table is bountiful, all that could be desired, and well served. We dined there on Sunday, the 16th of September, the last din- ner served in the hotel for the season, and even during the confusion of closing he must be extremely fastidious, who could find fault with such a table or such a service. The rooms are large, well ventilated, well carpeted, well furnished. The halls are spacious and from the broad verandas, the view of the valley and surrounding mountains is charming. The dancing-hall in which the s^sions of the Institute will be held, will only accommodate about two hundred. It is

A PROVING OF EPIPHMUS VIRGINIAN A, 387

scarcely as large as the parlors of the International in which we met last year, but there was always room and some vacant seats to spare. To accommodate the Institute the house will be opened one week earlier than usual. We will have it all to ourselves. There will be no other societies to occupy en- gaged rooms, as did a Dental Society last year at Niagara. Deer Park is situated on the crest of the AUeghanies about three thousand feet above sea level. The mountain air is bracing the scenery delightful, the roads excellent, and the oppor- tunities for walking, riding or driving unsurpassed; the drive to Oakland, six miles west, being highly spoken of. But the fine trout fishing and splendid shooting should be taken cwm grano salis. The stream just in front of the hotels in the valley, is said to contain fine trout, but it is owned by ex-Senator Davis of West Va., and public fishing is prohi- bited. Besides, members of the Institute do not go to these annual gatherings fo angle for game of this kind. They have " other fish to fry," other work to do. On the whole we think the selection a fortunate one, and the Institute under many obligations to the efficient chairman of the R. R. Commit- tee, Dr. Cowperthwaite, of Iowa City. h. c. a.

A PROVING OF EPIPH^GUS VIRGINIANA.

READ BEFORE THE OHIO HOMCEOPATHIC MEDICAL SOCIETY.

BY RALPH KORDBN, M. D., QROVEPOBT.

. Orohanche virginiana (Linn). Beech Drops. Cancer Root Eaariliclvb. Qapwort.

Nat Ord., OrobancftacecSy Broom-Rape Family.

E. virginiana. — Stems slender and bushy-branching, with small and scattered scales and two sorts of flowers, scattered in loose spikes or racemes, with minute bracts. Upper flow- ers conspicuous, but seldom ripening fruit, with tubular four- toothed corolla, and long filaments and style; lower flowers small and short, seldom opening, but fertilized in the bud. —

Gray. 4

388 A PROVING OF EPIPH^OUS VIRGINIAN A.

1. — 1882. — April Ist, 5:30 p. m., took one drachm of tine. 6 p. M., some pain in right temple, also a very slight pain in left temple. Lasted until going to bed.

2. — May 15th, took half a drachm of tine. No marked symptoms for an hour; then took half a drachm more. In fifteen minutes marked pain in right temple, with slight pain in left, which lasted for three hours, and then left a dull, heavy pain in temporal regions, worse in right side.

Also viscid saliva, and almost constant desire to spit

No marked change in pulse.

3.— June 23d, took 60 drops of tine. No symptoms for an hour; then repeated this dose. Almost immediately felt «light pain in left temple, sensation of fullness in fore part of head, peculiar, sticky, viscid taste in the mouth.

3:30 p. M., marked pain in both temples as if from pres- sure of the finger-ends in the temporal fossae; worse in left side, and lasting until evening.

4. — 1883. — February 1st, 1:30 p. m., took one drachm of the Ix. In twenty minutes slight pain in left temporal region ; viscid taste and saliva.

2:30, repeated the dose. In fifteen minutes sensation of fulness in the head, scalp felt tight, could not read because the words seemed to be blurred ; and when I went to write could not make the letters I wished to; also found myself using the wrong words. Occasional piercing pain in right temple.

By 8 p. M., had taken two more doses as above. Head- ache in right temple, full feeling in fore part of head, eyes smarting, saliva viscid.

Had headache in left temple during the night, in bed, especially on raising up.

February 2d. — Morning: Felt better; no pain in head, but a sensation as though something was wrong there, espe- cially in the fore part; very bitter taste in the mouth.

11 A. M., took half a drachm of Ix. 2:30 p. m., severe pain in middle of forehead which came suddenly and lasted only a few minutes.

RALPH MORDEN, M. D, 389

2:45 p. M., took half a drachm more. From that time until retiring had severe headache in fore part of head, worse in right temple.

5. — February 7th, feel as well as usual and free from pain. At 8:40 a. m., took half a drachm of tine. In five minutes had severe pain in middle of forehead. At 9 a. m. it was severest in the right temple. Working in the open air makes it worse.

9:45 A. If., took another dose as above.

10:30, severe, continuous pain in right temple.

11 A. M., same pain still severe, some nausea, general languid feeling.

February 8th. — Headache occurred occasionally all day, with pain in left shoulder and knee.

Felt, for several days, uneasy feeling in fore part of head, also had difficulty in passing stool, although the feeces were soft.

6. — I induced a young friend of mine to take some of the drug, but as soon as the head pained he desisted, and could not be induced to go on with the proving. He de- scribed his head pain as a pressing in the temples from with- out inwards; none on the left side. He also had the peculiar condition of the saliva which I have endeavored to describe.

I find the Ix dilution produces more marked and lasting symptoms than the mother tincture.

Clinical applications of Epiphfegus :

1. Mrs. S., set. about 26: Nervous temperament. Slight figure ; dark hair and eyes. For a long time has been sub- ject to headache whenever she went from home "a- visiting,'* or was subjected to any excitement or from any extra physi- c«^l exertion. The pain was through the temples, and all over the head ; it was always accompanied by great nausea and vomiting, which did not relieve.

Gave Epiph^gus 3x, 5 gtt., in water, twice a day between ' the attacks ; and when she felt the paroxysm coming on I directed her to take the above dose every twenty or thirty minutes.

890 A PROVING OF EPIPH^OUS VIROINIANA.

She complained that the medicine gave h^r palpitation and made her feel very weak. Said she thought it would have killed her. I then reduced the dose. Result: entire relief, and for a long time she would always carry her "head-ache medicine" with her when she went visiting, which she can now do with an immunity before unknown to her.

This case occurred over a year ago, and only once has she had an attack, and then it was in a mild degree.

2. Mrs. D., set 35 or 40, consulted me last fall. Said she had been subject to "sick headache" from her girlhood whenever she went away from home, or underwent any unu- sual exertion. She had never found any relief until she had a night's rest.

Prescribed as in Case 1, and did not hear from her for several months, when she said she was very much better, but had not continued with the medicine " for fear it would in- jure her health." Has since, under direction, continued the remedy, and is now entirely exempt from her headaches.

3. Mr. N. came in the night for medicine for his wife. Said she had come from town with a terrible headache. Could give no symptoms. Prescribed Epiph^gus 8x, which entirely relieved after the third dose.

4. Mr. K., set. 38, had been complaining of headache for some time, I had given Nux vom., on account of gastric dis- turbances, with only temporary relief. Epiph^gus 3x cured permanently after the second dose.

" I have treated a number of other cases with marked benefit, and have not failed in any case where the headache was induced by going from home, or from exertion. Have tried it in cases of headache coming on at the menstrual period, but have failed to obtain any results."

The late Dr. E. C. Beckwith was the first to direct my attention to Epiph^gus. — [Dr. Morden has made a very good beginning. Provings with the attenuations, should now be« made so as to bring out some of the finer characteristics of the remedy. — h. c. kJ]

THE VILLAGE DOCTOR, 391

THE VILLAGE DOCTOR.

It may be that your finely-educated and well-informed city physicians know better what a sick man needs, but they do not begin to know as well as the old village doctor what that sick man wishes. It may be that your beloved and well- brushed M. D. cures more diseases, but he has never learned how to make his patient forget the disease he cannot cure. Your city physician is a business man. He is always in a hurry. He yanks your door-bell, startling you from a re- freshing nap. He brushes by the servant who opens the door to him, and comes into your bed-chamber with the air of a constable whose d\^ty it is to throw you and your family out into the street — a constable who enjoys doing his duty because "business is business." He strides to your bedside and jerks your hand from under the coverings, as if it held something that had been stolen from him. You are afraid of him, and wish he would get through and go away. He orders you to put out your tongue much as a Prosecuting Attorney would if he expected to find some evidence of crime upon it. He flips out a massive gold watch that marks the quarter seconds, counts your pulse, says you are a very sick man, and coldly tells you that if you have any business matters to settle you would better be about them. He orders your terrified wife to bring a spoon and a glass of water while he is directing a Latin prescription to his friend the druggist, who charges him no profit on personal pur- chases. He doesn't want the spoon jind water; he only wishes to order somebody to do something.

If you want a physician to cure your ills, the city M. D. will do. But if you want somebody whose warm sympathy will make you forget that you are sick, come here and try the old village doctor. He never rings a bell. Why should he, since he knows every nook and corner in every house in the village? He is, so to speak, a member of every family in the village, and a most heartily welcome member, too. With his little leather medicine-case, containing a few staple d^rugs.

892 THE VILLAGE DOCTOR,

not forgetting plenty of caldmel and the necessary instru- ments for cupping, he enters at the back door as gently as the perfumed breath of a bright May morning. The figure may not be just the thing, for the doctor grooms his own horse, and his perfume is of the stable ; yet there is something kind and sympathetic in his manner that seems to smell sweet to the soul. After his brief chat with the housewife in the. kitchen he finds his own way to the little front bedroom, the wife following, wiping her hands and bare arms on the wrong side of fier long calico aprou. If his patient be asleep he stealthily tip-toes back to the kitchen and says h e will wait. Seated on the door-step just outside the open door, he whittles, and talks in low tones with the wife as she goes on washing the breakfast dishes. Piece by piece he learns every symptom, every little particular of his patients last night ; and then, when the conversation ceases and the wife goes quietly up the narrow back stairs to make the children's lit- tle bed, the old doctor sits and peels long curly shavings oflf the yellow pine stick, softly hums a good old Methodist hymn, and thinks and thinks what he should do next for his sick man.

Half the forenoon is gone when the good wife comes to the door and says, in the same old subdued tone to which she has habituated herself: "Doctor, he is awake now." The old doctor slowly lifts himself, unkinks his stiffened joints, kicks his legs out to straighten down his trousers, shuts his big bone-handled knife, brushes the shavings from his shiny clothes, and goes to the bed-room. The sick man slowly turns his head toward the doorway, smiles sadly, puts out his long, white, bony hand to him and whispers hoarsely: "Well, doctor? " which is a sick man's favorite form of ask- ing how his doctor thinks he is getting along. The old doctor raises the blue paper curtain and slowly draws a chair close to the bed. "Oh, you're looking ever so much better to-day. We'll have you out hoeing potatoes in a day or two." The old doctor knows this is false ; knows that no human power can prolong the man's life a month, but he is

THE VILLAGE DOCTOR. 395

one of these great good men who live above the necessity of tcilling the truth on all occasions. "You're getting on nicely. Don't you see you've got more color in your hands ? And your eye looks brighter than it has for a month. A very sick man couldn't sleep as you did this morning. Why^ I've been here two hours and you've been sound asleep and snoring every minute o' the time ; ain't he, Mrs. Sandford ? '^ The poor wife is almost afraid the doctor exaggerates, but there is something so wholesome in the old doctor's manner and so encouraging in his words that she quite forgets her troubles, and becomes even chirper in her efforts to assure her husband that the doctor is right. While the little woman moves softly about, gently dusting this and that piece of furniture, turning the shutters so that the sunbeams creeping toward the bed may not climb up and get into the eyes of the sick man, the old doctor urges on the conversa- tion, adroitly turning the subject from sickness and trouble^ and even from health and prosperity, with which the sick man might make painful comparisons. Soon the room is changed from a chamber of death and despair to a panorama of scenes pictured by the doctor in his relation of his recol- lections and experiences. The sick man turns his head to catch every word. He is an interested listener while the old doctor sits there and relates as actual personal history a hun- dred and one things that never happened to any body. Wh}r should he stop to ask himself whether truth is mighty so long^ as he can see that falsehood is prevailing over his patient'^ despair, and causing him to forget whether he is sick or well? A writhing of the sick man's face and the placing of his thin, clammy hand upon the breast tells of a sharp pain. Quick, the opiate? There, he sleeps I Now all is well. Ah, yes^he sleeps. He will not wake again. Death came to him as in a pleasant dream. He knew it not, and hence he died but once. Kind-hearted, warm old doctor I Dear old cow- ard, who never fights disease, but surrenders at its first ap- proach, and labors lovingly to smooth the way to death I Blessed old bungler, who gives no dying man the warning

394 VERATUM, ALB, AND ARNICA M.

that would turn his latest hours to business cares and save his heirs a world of worriment and loss I Who does not love this doctor?

VERIFICATIONS, VERATRUM ALB. AND ARNICA M.

J. N. LOWE, M. D., MILFORD, N. J.

Case I. Mi^s F., aet. 19 yrs., was suddenly prostrated with symptoms of acute indigestion, nervous prostration, and headache; evidencing the following concise phenomena: Vital depression; coldness of the cutaneous surface; a vaso- motor congestive tendency, with a corresponding impair- ment of the normal functions of innervation, circulation and digestion; without thirst and sweat.

Veratrum alb. 200, one dose dry. Decided reaction (vital) in from ten to fifteen minutes. Improvement con- tinued to complete restoration without repetition of the dose.

It will be noted that the "red letter" symptom, (cold sweat,) was absent in this instance ; nevertheless Veratrum alh, 200, acted illustriously — and gave us the quick, sharp, and decisive result, which we desired. If we had assayed pallia- tion or substitution, we should have widely missed our mark, and perhaps kept an innocent patient invalided, lor an indefinite period of time.

Case II. Arnica M. in Cardialgia. Mrs. A., aet. 35 yrs. Symptoms, — Sore all over ; pressive cutting pains in epigas- trium; nausea and retching ; precordial pressure; oppression of chest; spasmodic griping in stomach; oflFensive eructations Gave Arnica mont. 20c. Continued until three powders were taken. Result : a prompt dismissal of the complaint.

When the * Law of the Similars' is challenged — ^thrown into the crucible, and tried in the court of material agnos- ticism— these plain cases, with plainer characteristics, are always true in furnishing strong testimony to the truth ; and without the vaunted material molecule, are able with **naught" to confound that "which is." Mahomet, "must go" to the mountain.

CORRESPONDENCE. 396

CORRESPONDENCE.

Medical Advance :

In your December number, page 336, " A Senior " desires to know the reason an ansesthetic was given to the boy who was already in a comatose and unconscious condition. Doubt- less the physician who reported the case wijl be quite ready with an answer. I, of course, know nothing about this case only what appears in these pages, but say that the important disideratum generally during a surgical operation, is to keep the patient quiet — immovable. This lad, though comatose and unconscious, may have been thrashing about violently and this the anaesthetic effectually controlled. Therefore, it appears that the proceedings may not have been justly de- serving the pointed criticism of "A Senior."

Wm. D. Foster. Kansas City, Mo.

Medical Advance:

In the last number of The Advance, there are some admir- able rules of practice laid down by W. J. Guernsey, M. D. " Rvle 3. If found necessary to repeat a medicine already prescribed, give several doses of the same potency in water, or of a different potency dry." Now, for the benefit of one reader, at least, will Dr. Guernsey please explain the differ- ence between a dose in water and a dose dry on the tongue? Can a few pellets of any potency, prepared in water, and re- peated at intervals of one, two or three hours, be considered a single dose ? Or what are we to infer from rules three and nine ? A.

Medical Advance :

I am somewhat surprised that Dr. RoUin R. Gregg should find it necessary to construct a fibrin theory to account for .bacteria. The compositions of the substances discussed, (bacteria and fibrin) are in no way similar. Fibrin is a nitrogenous body, muscle forming, destitute of cellulose, whereas, bacteria is mostly composed of cellulose, and

396 BOOK NOTICES.

destitute of fibrin. The former (fibrin) is soluble in the alkalies, the latter is not. There is nothing more clear, chem- ically and botanically, than that bacteria belongs to the veg- etable kingdom, and nothing more certain than that fibrin is an animal product. Since these facts are indisputable there can be no foundation for his theory.

Thomas Taylob, M. D., MicroBcopist Dept. of Agriculture, Washinfl^ton, D. C.

BOOK NOTICES.

NATURE OF. MALARIA, and its pecoliaritieB of origin as to place. By J. W. Dow- UNQ, M. D. A reprint from the transacttons.

The author has evidently bestowed much thought on this sub- ject and it will well repay a careful peru^l.

THERAPEUTIC HAND BOOK OF THE U. S. PHARMACOPCBIA. By R. T. Edb, M.D. Wm. WoOD,&Co.,N.Y.

This very convenient concise and practical reference book is well arranged for the busy practitioner (of the other school). It is printed in the excellent workmanship of Wm. Wood & Co.,

PHYSICIANS SPECIAL RATE CHECKS. By W. J. Guebnsky. M. D.. PhUadelphla

This is a very ingenious device, by means of coupon tickets, to cut off the doubtful patrons. "A delicate way to insist upon pay- ment from suspicious persons.*' It ought to save many times its cost every week.

PHYSICIANS ERASABLE TABLET CALL BOOK.

Dr. Leonard has also, from his practical brain, presented the profession with a very convenient erasable tablet call book, to be used until filled and then the names drawn off into a day-book or the old fashion ledger. This tablet will accommodate sixty names and is made in the form of any ordinary memoranda book with a pocket on the inside for papers. It is not thicker than a letter and consequently does not take up much room in the pocket.

MANUAL OF GENERAL TECHNOLOGY, including prescription writing. By Edward Curtis M. D. New York : Wm. Wood & Co.

This is one of " Woods Pocket Manuals " and is devoted to the Pharmacology of the Old School. It could not fail to be of interest to a physician of that practice. The best method of prescribing Alio*

BOOK NOTICES, 397

pathic drugs is well set forth. The dangers as well as the follies to which their methods are liable are clearly described, but the one great folly of combining drugs is elaborately explained and enforced as though it had not been demonstrated a thousand times to be both useless and unscientific. Still here is a book worth reading, for if we ourselves don't do it, we like to see how others do it

FOR MOTHERS AKD DAUGHTERS. A Manual of Hygiene for Women and the House- hold, niustrated. By Mrs. E. G. Cook, M. D. 12mo, extra cloth, 11^. New York : Hygienic Publishing Co., 917 Broadway.

This is a sensible, motherly, sisterly book, written in a clear, plain, yet delicate style; a book which ought to be in the hands of all women, and girls old enough to need its counsel. It treats of topics on which hinge more of the world's woe than it has an idea of, because so much of silent suffering finds no voice except the sigh; no record except in pale cheeks and broken constitutions. Men can do no better thing for their own comfort and prosperity than to promote whatever is calculated to bring health and happi- ness to woman, for that will bring joy to the household. What can more sadden, discourage, and hinder a man than the chronic ill- health of his wife and daughters? We fancy if husbands and fathers could appreciate the worth, to them and their families, of the con- tents of this book, thousands of copies would find their way to the bands of wives, and would constitute a present more valuable than silks, furs, or diamonds.

The work opens with a chapter on the importance of physical culture, which is followed by chapters on the bones and muscles; the brain and nervous system ; the sPtructure and care of the skin ; hygiene and ventilation ; intemperance ; a chapter devoted to bread and butter, in which there is a careful analysis of the processes of digestion, in which this matter is made plain and practical. A large portion of the book is devoted to the subject of displacements and other diseases to which women are subject. The feeding of chil- dren ^ the rights of children; the question of educatioi^ etc., are all discussed, and the work is fully illustrated by a number of fine en- gravings. It is a handsome volume of over 300 pages, beautifully bound, and would be a most acceptable present to either wife or daughter.

UTERINE THERAPEUTICS. By Hehby Minton, A. M., M. D. A. L. Chatterton. Publishing Co. New York: 1884.

On the title page we find the following : *' I hold every man a debtor to his profession, from the which, as men of course do seek to receive countenance and profit, so ought they of duty to endeavor

398 EDITORS TABLE.

themselyes by way of amends to be a help and ornament there- unto.—Bacon." This, we take it, is intended as an apology to the profession, for forcing upon them another literary effort; and, no wonder the author feels a certain amount of timidity, when he realizes how some works have been received, especially from a gynecological standpoint. Yet,* this work, so different from others of our school, requires neither apology nor explanation. It speaks for itself, and is competent to stand on its merits.

After a careful examination of its pages, we feel like saying, as did Solomon, " the end of a feast is better than the beginning of a fray." Yes, indeed, tiom the first page to the last is this work worthy of every practitioner's praise. It is a "dish for the Gods,*' seasoned with pure homeopathy and garnished with verified symp- toms— a rich boon to us all.

It is a work for which there was the most urgent need, and while we recognize that a treatise of this nature and character most, to a greater or less extent, be one of compilation, still it conuins such a complete review of the symptoms of uterine disorders, with their treatment, that we are compelled to acknowledge our deepest and most profound gratitude to its author.

The general arrangement is modeled after "Bell on Diarrhoea" or "Allen on Intermittents," and he could have selected no better plan. The book is written in a clear, concise manner, and yet not brief enough to tire or confuse the reader, and is intensely inter- esting to any one who has given gynecology special attention. The work, as the name indidates, is one of therapeutics, and as we pass through it, we miss many familiar cuts and plates, always employed in gynecological works, to attract the eye or demonstrate some pet theory — the use of an instrument or operation — not to mention sections of frozen anatomical subjects, with the poor uterus so changed in its appearance that we almost fail to recognize the organ. These omissions, however, only enhance the value ot the work in our estimation.

This work requires no recommendation at our hands— only praise — and we, therefore, desire simply to express our sincere thanks to Db. Minton for this book. Chatterton is making bis mark as a publisher. Phil Porter.

EDITOR S TABLE.

MARRiED.^Dr. H W. Roby and Miss Sarah Collier, of Topeka, Kansas, December, 1883. The doctors of Topeka made the happj couple a handsome wedding gift. We send greetings.

EDITOR'S TABLE. 399

Dr. Rufus J. Hyde and Miss Laura Caldwell, at Ihe residence of the bride's parents, Eaton Rapids, Dec. 5th, 1888.

Miss Anna L. Laub, M. D., (U. of M., class of '83,) to G. F. Bar- tholomew, Esq., and now resides at Valparaiso, Ind.

M. P. Austin, M. D., (U. of M. '81) and Miss Mary E. McDonald, all of Minneapolis, Dec. 25, 1883. • A happy New Year to the happy pair.

Died.— Sept. 25, 1883. John W. Byrkett, M. D., in Chihuahua, Mexico, where he had gone in search of health.

Rbmovau^.— E. D. Bottorff, M. D., from Philadelphia, Pa., to Ash- tabula, Ohio ; C C. Pillsbury, M, D., from Atkinson, 111., to St. Clair, Mich. ; J. G. Gundlach, M. D., from St. Louis, Mo., to Ottawa, 111. ; C. P. Ailing, M. D., has located at 112 E. Swan street, Buffalo, N. Y.; W. A. Hubbard, M. D. succeeds the late Dr. Hurlburt at Marion, la.

Dr. J. F. Edgar has removed his Pharmacy to 28 East Short Street, Lexington, Ky. The doctor can fill all orders.

M. M. Eaton, M. D., and wife have gone to Jacksonville, Florida ior the winter.

Dr. F. J. DiCKBY locates in Shreveport, La.

The present number contains sixty-four well filled pages.

Dr. Hbring used to say : "Some people will persist in being animals, and using only the five senses. They do not believe it and therefore it is not so."

Sidney Smith is quoted as saying: "Never try to reason the prejudice out of a man. It wasn't reasoned into him and it cannot ba reasoned out of him."

The Popular Science Monthly still holds front rank. It is as good as a large library every year, and costs only $5.00. If you do not read it take our advice and do so.

The Physician's Memorandum Book, by J. A. Miner, Ann Arbor, Mich, is a convenient visiting book. Its clinical columns are often very useful at the bedside. We use it.

The Physictan's Diary, for 1884. The Medical Record visiting list of Wm. Wood <fe Co., is up to the usual standard of excellence; handsome, concise, compact, well -arranged.

Correction.— In our last issue Dr. J. F. Brown's article on Auto-Kleptomania was incorrectly given as Anto-Kleptomania. This is chargeable to — well, charge it to the devil.

A Western paper says : " Sam Weldom was shot last night in the rotunda by Harry Parsons." Next to the heart, the rotunda is about the worst place in which a man could be shot.

Physicians Visiting List, for 1884. P. Blackston & Son, & Co.,

400 EDITORS TABLE.

Philadelphia. !^ most valuable and complete pocket companion for the busy doctor to just put it right down so it will not be forgotten. Price $1.00.

Dr. M. H. Parmblbb writes to the Toledo Bee a very interesting and valuable article on "The Old and The New Code." It discussee the historical side of the questioni with great clearness. It should be offered to the profession in pamphlet form.

Pbactioe For Salb. — In one of the best towns in Southern Ohio, county seat, population 3,500, two railroads, one just graded, will be in operation by June 1, 1884, good country and free pike roads. For particulars address, Medicus, care Medical Advance Publishing Co., Ann Arbor, Mich.

Dr. Gillard's Sanitarium, at Sandusky, was full the entire sea- son. It will be Enlarged for 1884. The doctor has all the modern appliances for using electricity in chronic diseases, and apparently is doing good work. Physicians who do not make a specialty of chronic diseases would do well to consult him.

A New Insane Asylum is to be established at Westbro, Mass., and the Legislative Committee have agreed to recommend the placing of it into homoeopathic hands. To this the Allopathic School has offered no objection, and it is likely the Legislature will so order. We are indebted to Dr. Talbot for the above informa- tion.

Transactions op the Hom(£Opathic Medical Society op Pa., 1883. This is a well presented volume of 382 pages and out promptly on time. There are a large number of valuable and exceedingly practical articles, of which the members may justly be proud. Such a volume should spur other state societies to renewed efforts.

The 33d Annual Meeting of the Homoeopathic Medical Society of the State of New York, will be held in the Common Council Room, City Hall. Albany, N. Y., on Tuesday and Wednesday, Fel)ruary 12th and 13th, 1884. The session will open at 10 a. m., on Tuesday. The Annual Address will be delivered by the President, Dr. Everitt Hasbrouck, of Brooklyn, on Tuesday at 8 p. m.

A. P. HoLLBTT, Secretary.

" It is reported that all the anatomical material which a medi- cal school (a regular (?) medical school too) in a neighboring state, has been able to "raise" thus far this season, is limited to a nine- months old babe. This innocent little infant has been doing duty for the entire class. Cadavers seem to be scarce in that neighbor- hood, but just wait until those students get their degrees!"— Jf«di- cdl Age.

EDITORS TABLE, 401

Edith, the only daughter of Dr. Moses T. Runnels, who died of laryngeal diphtheria on Wednesday morning was an unusually bright and loveable child of about four years, who had endeared herself to all who knew her. She was sick a week, and the most careful nursing and skillful treatment were powerless to arrest the course of the disease. She was Ji>uried at Crown Hill, yesterday af- ternoon. Her parents have the sympathy of all who knew her —IndianapolU paper,

BuTTBR Test. — Physicians are often called upon to display their knowledge of chemistry in various ways, and to assist them we give the following, as taken from the Sanilarian, "Sulphuric Add is said to be a simple, but certain test for adulterated butter. Fresh, pure yellow butter, by the slightest contact with Sulphuric Acid, turns almost a pure white, while butterine made from ani- mal fat, changes to a deep crimson. When lard or other oils are Ised, the colors are diversified— showing all the tints of the rain- bow.

Fob Sale. — ^Adams' Electropathic Institute, corner High and Spring Sts., Columbus, 0. This is a rare chance for any physician who makes or desires to make a specialty in the use of electricity. Bath tubs with hot and cold water for electric baths. The most complete stock of apparatus and batteries for therapeutic purposes in the state. Good business, well established, reputation widely known, location the very best in the city. Will sell for a very little more than the fixtures will invoice. Good reasons given for desir- ing to sell. Address, F. S. Adams, M. D., Columbus, 0.

Sanitary. — Dr. John Honeyman, in the Saniiarian, claims th^t houses built with low ceilings are healthier to live in, and more economical. In a long paper, on the subject, he demonstrates the fact that high ceilings are pernicious to health. He states I can ^' prove that, other things being equal— that is, that, giving two rooms of different heights, but of the same capacity, having the same size of chimney opening, the same area of window, door, and opening, the lowest will be the cheaper, the more commodious, themore comfortable, and the healthier dwelling of the two.''

A Live Medical Society. — ^The College of Physicians and Sur- geons, of Michigan, a report of the transactions of which appears in this number, is the only Homoeopathic society with which we are acquainted that has weekly meetings. Its members are active and enthusiastic, and are doing good work, both for themselves and the profession. Officers eleoted for 1884 were Phil. Porter, M. D., President ; E. P. Gaylord, M. D., Vice-President; J. M. Griffin,

402 BOOK NOTICES.

M. D., Recorder; J. G. Gilchrist, M. D., Corresponding Secretary; R. C. 01 in, M. D., Treasurer. Any Homoeopathic practitioner in the State is invited to attend the meetings and participate in the dis- cussions. Every large city should contain such a society.

Absorbent Cotton as a Dressing for the Umbilical Cord. From the American Journal op Obstetrics. — We give an extract of a letter written by Dr. Babcock, of Evansville, Ind., on the above subject, which for simpUcitv and convenience of application, is in- deed worthy of consideration. There are few physicians, who cannot carry with them, in their buggy or otherwise, a quantity of the ab- sorbent cotton. The experience of Dr. Babcock, is, that the cord ^ came off perfectly clean, and left no " smell nor irritation," and one — ^the first — dressing was all that was necessary. The cord must be enveloped in quite a pad of cotton, no grees or oil applied, and left alone until the cord drbps off, which is, in about four or five days. The Doctor thinks this method will diminish umbilical hernia, and keep the child sweet and clean, and is, we think, an improve- ment over the "rag'' usually employed for a dressing. While the cotton dressing is nothing new, to many of our practitioners, we consider it of enough importance, to again be presented.

P.P.

Premature Sexual Development. — ^The following cases are taken from the American Journal of Obstetrics as of more than ordin- ary interest. The first case is a child of two years and seven months old, who began menstruating, when only four monthi old. Her periods are regular and last from four to five days. She now weighs forty-nine pounds. Her form and features are of those of a girl twelve years old. The mammary glands are well developed, about the size of small oranges. The mons veneris is covered with a full growth of hair and is quite prominent The external labia is simi- lar to a well developed woman. The child has never shown any dis- position to handle herself, and |s quite modest with her mother and especially so with her father. Her likes and dislikes are of a child much older. Parents not related. Family history perfect. The only case of the kind known in their family. The future of this child, particularly the sexual history will be extremely interesting. In a Brooklyn Museum they have, what they call a "Baby Venna" on exhibition. She is only three years old, and weighs sixty-five pounds. Her features are of a young lady, and the mammary glands are fully developed. The vulva has changed and the pelvis widened to the size of a girl of eighteen, but she has nevigr men- struated. P. P.

J^^

K^

i .'"-" -^^

^s,.:j&

T. P. WIIiSON, M. D.,

Editor.

PHIIi PORTER, M. D.,

Gynbcological Editor.

Vol. XIV.

Ann Arbor, February, 1884.

Xo. 8.

All subscriptions and business oommHnications should be addressed to MEDICAL ADVANCE PUBLISHINO- CO., Ann Arbor, Mioh. Subscription, $2.00 per annum.

H. C. ALLEN, M. D., Business Managrer.

"Of my merit you yourself must Judge All is I dont drink no speret, An I haint signed no plodge."

We are honored with a copy of an "Introductory Ad- dress, delivered before the Medical Class of Dartmouth Col- lege," by Louis Elsberg, A. M., M. D., Professor, etc. Among the many things it contains we find the following as worthy of notice.

"I counsel you to beware, from the very beginning of your studies, and through life, of all 'one idea '-ism, all isms and all patbiesi Exclusive sectarianism, whether in the ordinary every- day occupations, whether in politics, in religion or in medicine, leads not to the true, and not to the good. Evil is its only fruit. In the State, fanning the blaze of unscrupulous party- warfare; in the Church, instituting persecution for conscience' sake; in the Healing Art, sacrificing thousands suffering with remediable ills, it wraps the cloak of self-sufficiency around its hideous nakedness and with charlatan effrontery proclaims aloud: * Within my circle is the truth and there is no truth outside.' I beg you to avoid its narrow platform I From to-day on, keep ever present before your mind the

404 EDITORIAL.

proper estimate of a Physician. Etymologically, the word implies a student of nature, nature's scholar. A Physician is a man who, free from the influence of exclusive systems, makes use of every means— medicinal and surgical, physical and psychical — that has been discovered or invented, that is capable of curing the sick or al- leviating their sufi*ering. He accepts no unproved theory and re- jects no proved remedy from any source. He utilizes for the benefit of his patients ascertained truths, whethei derived from scientists or quacks. From the air above and the waters below; from the artificial chemical laboratories and the bowels of the earth, he draws his weapons. His surgical appliances embrace nearly every material under the sun. Creation yields him its minerals, its herbs and animal substances; its light, its heat and electricity. The vary- ing seasons and the different climates; the various occupations of men and their very thoughts and feelings, — all he employs as his legitimate tools! Accord to no man the name of Physician who bases his medical practice upon any exclusive system; keep your- selves free from everything that would make you deserve to be called, and never Allow yourselves to be called, by any sectarian designation. Gentlemen, I beg each one of you to resolve to be- come no * allopath,' no * homoeopath,' no *hydropath,' no *elec- tropath,' nor any other *ath;' but to resolve to become a physi- cian!"

If this were not offered as serious advice it would excite our laughter. It is quite on a par with Lowell's character, who putis forth his claims for excellence in the lines we have above quoted. These words should have been placed on the title page of the Address, and they might well be chosen as the motto of the "most modern" of the allopathic school. This is the latest fashion out. But this address is a curious example of the contradictory states of mind an allopathic professor will get into. The author throughout dogmatically states his views upon a variety of subjects. Upon Pathology and Chemistry and Physiology he gives his views with great freedom. He even gives us figures, which represent his ideas of health and disease, and he dogmatically states to his hearers without any apology, the truth as he understands it, upon a score of important points. He is very brave and wise and communicative, until he touches the question of

A RINQINO APPEAL, 405

therapeutics, and all at once he is as limp as a Medusa out of its element. As to "the modus operandi of drugs," having no opinion of his own, be outlines the views of others, including those of Hahnemann, and then magisterially lays them all aside as "too confined;" "too limited to embrace within their scope the whole range of nature" — as though "the whole range of nature" had to be embraced in the law of therapeutics. No wonder he cannot find the simple truth when he is ranging the stellar universe for that which lies before his feet. But he makes bold to assert that, "the right course to follow, diverges from all these one-sided generalizations." What a comfort it must be to his students to find out that positive knowledge of the healing art is an ignis fatutis and that all there is to it is an attempted reductio ad ahsurdum. The point of absurdity is certainly reached when his students spend their money and time, hoping to learn something positive about the healing art, and are finally turned loose upon the commons to browse as best they may along the high ways, and by ways of the world to become no "ath" and follow no path. All such poor vic- tims, together with their so-called teachers should be safely housed within the protecting walls of an institution for " The Feeble Minded" where they would be "free from every- thing" that would make them liable to being charged with knowing anything about the art of curing disease.

A RINGING APPEAL.

INTRODUCTORY ADPMF^SS DELIVERED AT THE LONDON HOMCEO- PATHld HOSPITAL; OCTOBER 5, 1883.

-^

BY J. COMPTON BURNETT, M." D.

In medicine, as at present known to the world, the only really catholic practitioner of medicine is the broad-minded scientific homoeopath. He alone is not sectarian, but pro- gressive and universal. As we go on, if you will do me the honor of listening to me, I shall hope to show you that we

406 A RINGING APPEAL.

practice homoeopathically, not, as our calumniators tell you, because we are narrow sectarians and desirous of holding a distinctive position by ourselves, but because we have gone over the entire field of drug therapeutics, and tried ail sys- tems and methods. Mark you what I say, because this is very important. We have gone over all systems and metjbods of the drug treatment of disease; we have studied their va- rious merits and demerits, and this in a genuinely catholic, non-sectarian spirit, and having thus covered the whole ground, we find Homoeopathy the best. Let your minds dwell upon this point a little, for it alone explains the seem- ing, paradox of our position. At the first blush it seems per- fectly obvious that a medical man who adopts a peculiar mode of practice must necessarily be a sectarian. We, as hopseopaths, are bitterly reproached with this, ^any of the best of the profession say to us, " Drop your name and all will be well, and the breach will be healed. We have no objection to you, but to your name." Then why not drop the name? I will tell you. We cannot drop it, because Hom- oeopathy is practically unknown to the bulk of the profession and exists as a separate thing. It is really not we who keep the name alive, but the ignorance of the profession of the sub- ject. When the entire profession advances up to the present standpoint of Homoeopathy, then the word medicine will include it ; and having no separate existence, it could not, in the nature of things, have a name to go by, except as the heading of a chapter in history. What Homoeopathy now means is the most advanced point in therapeutics, and this extreme van cannot be given up till the entire profession have reached it. When we say we are homoeopaths, we do not mean that there is in medicine nothing else but Homoeo- pathy, but we mean that in the curation of disease by medi- cines we have found the law of similars our best guide. We have arrived at this extreme point, not by springs and bounds, or in a hurry, but after going over all the rest of the field and leaving that as less advantageous. Hence our be- ing homoeopaths is not the outcome of narrow sectarianism

/. COMPTON B URNETT, M, D. 407

or love of a distinctive name from any motive whatsoever, but the result of a broad, eclectic, catholic survey of the entire field of therapeutics. We do not say there is nothing but our homoeopathic advance point; by saying we are hom- oeopaths we indicate our position in the great field of drug therapeutics, and in indicating our own we characterize the position of others. And our characterization signifies that all other modes of using drugs are far behind us. We do not say the others have no existence : no, we merely say they are /ar behind us, and hence do not exist for us, just because we have something better — so much better that we wax warm in our zeal, we beceme enthusiastic, and beckon to our allopathic friends in the rear to come on, to press forward to where we are. Now, our orthodox friends in the rear have no knowledge of the topography of the region occupied by our army in the van; they remain behind, where we used to be lang ayne, and steadfastly refuse to believe we are any- where at all. We shout back to thenl that we are in a glori- ous country with immense resources, and ask them to join us and help us to occupy it and cultivate it for the advan- " tage of humanity, and therefore of us and of them. But they will not. believe us. So, remember that if any of you medical students aspire to be in the very van of therapeutic science, you micst find yourselves with us. You cannot help it. Of course, you may abjure the birthright of a free man- hood, and join the crs^pto-homoeopaths. Well, they serve a purpose. So did Judas. And to whom, think you, comes the serene satisfaction of duty done? Not to the crypto- homoeopaths, who merely serve as a kind of co-operative asses' bridge; they are what schoolboys call sneaks, and a sneak's reward is theirs. I envy them not. They will do nothing great; they will never feel great, they will never feel noble, they will never 6e great; for no sneak ever yet became great. That divine afflatus which makes a noble heart bound on to greatness of aim comes not to the sneaky crypto- homoeopath If we aim high we may mount to goodness and greatnesa of soul and deed, but the sneak is a miserable

408 A RINGING APPEAL.

groveller even when at the highest. Some of you may not share these sentiments. Well, I am content to hold them with the choice few; or, if need be, alone. Now, if the pro- fession at present, for the reasons given, cannot be our judges, and if only medical men can be admitted judges of medical questions, how are the claims of Homoeopathy to be settled? How is the world — i. e., our fellow human beings — to know whether our opponents or we are right? The only way at present open to us is to show that Homoeopathy cures better than other systems of drug treatment. Gentlemen, there is no other way open to us; either we must be false to thera- peutic truth and to our common humanity, or we must fol- low this course till better times dawn, till the general profes- sion advance to within speaking distance of us. What, do you say you would recommend an appeal adpopiUumf Did you not yourself admit that only medical men can ade- quately grasp the subject? Yes, I do admit that; but we must do our best, and our best at present is to convince the people, and so compel the profession to listen to us and give us fair play. But an appeal ad populum is beneath our dig- nity, and is unprofessional. Well, if so, then that dignity is a false sheen and no reality, and the profession is an enemy of mankind. As for me, I will prefer the mens conscia reetiy and will do my duty. You may hiss these sentiments if you like, but I hold them, and I will express them, and am pre- pared to stand or fall by them. What! do you tell me that I|Can hold that our Homoeopathy is a great life-saving truth, and yet I dare not proclaim it? What! do you mean to tell me that Homoeopathy cures disease better than any other known mode of drug healing, and yet I must hush it up because an interested, prejudiced editor calls it a **fad"? Do I read that Homeopathy minimizes the hideous ravages of small-pox and robs cholera of its terrors, and yet I may not make it known? It is known to me — thanks to tfie im- mortal Hahnemann — thanks also to my honored master and predecessor in this chair, Dr. Hughes — it is known to me that Aconite will jugulate a simple fever, and shall I seek to

/. MA RION SIMS, M, D. 409

hide this knowledge, of which I and mine have the immense advantage, and thus, hiding knowledge, put myself on the level of a common nostrummonger ? Why should you and I have the boon of such knowledge and not others too? Are we priests of the Dark Ages, that we should band ourselves together to shut up the knowledge of the curative action of drugs, and our mode of finding it out, within our own magic Druidic circle that we call the profession ? Do those of you who are such strong professiona^ists really mean that? If you do, then you are at liberty to burn my doctor's diploma, or throw it into the nearest gutter; for if that is the spirit of the profession of medicine, I would rather be outside it. If that is really the aim of the medical profession, it becomes in the aggregate merely a huge co-operative association of nos- trumsellers; and then to be professional must mean not to impart any knowledge of outsiders, to the end that profits may never grow less.

■ 4«» ■

J. MARION SIMS, M. D.

Dr. James Marion Sims, although not of our school, was indeed a benefactor to his race, and in recognition of his de- voted service to mankind, we feel called upon to pay more than a passing notice to his memory.

To us, it is doubly a sad duty, to record Dr. Sims death, as we were personally acquainted, and under obligations to him for past kindnesses. We met him at Paris in 1880, and had several conversations on matters pertaining to gyneco- logy, and when we left for Vienna and other places of inter- est, on the Continent, he gave us letters of introduction, which were like talismanic signs, admitting us to opportuni- ties, without which, we could not have obtained the benefits we did. This obituary is, therefore, but a slight testimonial of our appreciation of his kindness, when he knew we were of the homoeopathic school, and his words of advice, relative to special practice, made an impression, never to be forgot- 'ten. How little did that man fancy, by his few words, he was shaping the destiny of another I

410 J. MA RION SINS, if. D.

Dr. Sims was nearly seventy-one years of age. In 1835, he entered into general practice at Montgomery, Ala. It was in this city that the light of his genius iSrst shed its rays and Marion Sims name became prominently associated with medical science.

Energetic and assiduous as a practitioner, he at once gained the confidence of his patients and of those who met him in consultation. Having always the higher objects of the profession in view, he never descended to those lower arts of attracting business, by which the practice of some physicians has been disgraced.

His indefatigable and persistant labor, in the mechani- cal branch of medicine, soon gave him notoriety. By a mere accident, as it were, he was led to conceive the idea of a perineal retractor, which was called Sims speculum, and is known the world over. While at Montgomery he established a woman's hospital, where he revived thfe operation for the relief of genito-urinary fistula, with success^ which gave him reputation all over the United States. His mechanical ingeniousness displayed in making gynecological instru- ments, at once pointed him out as a rival of the celebrated Sir. J. Y. Simpson, of Edinburgh. T'is true some have ques- tioned his priority, in claiming his speculum as original, as an instrument similar in construction was disintered from the ruins at Pompeii, and described nearly a century ago, yet, even if this be true, to Dr. Sims mufet be given the honor and credit of reproducing the lost speculum. He moved to New York in 1850. Here he devoted his entire time to his speciality, and soon became celebrated throughout the world, from his bold writings and innovations upon surgical grounds.

The great success of Dr. Sims, both as a writer and a practitioner, lay, we believe, in the practical character of bis work. He was a man who thoroughly went into and was fully acquainted with all the minutise of the treatment of diseases peculiar to women, down even to the details of nurs- ing, and the preparation of the patients food. Evidence of this will be found all through his writings.

THERAPEUTIC VALVE OF MOTION. 411

In 1860 he went to Paris, where he published a work on gynecology, which is now one of our standard text books.

During his stay in Europe he performed several opera- tions, which were original with himself, at Vienna, London, Paris and many other places, receiving the highest enconium and decorations from the French, Italian, Belgian, Portu- • guese and Spanish governments. France conferred on him the Order of Knight of the Legion of Honor, and the Belgian government the Order of Leopold I. He was elected an honorary member of almost every scientific society in Europe.

In 1868, he returned to New York, but remained only for a short time, returning to Paris in 1870, and became an interested organizer of the famous American Ambulance corps, in the Franco-Prusian war. Unfortunately he be- came late, in life, involved in a quarrel, or misunderstanding, with some of his New York colleagues, Drs. Emmet and Thomas, over some matters pertaining to the management of the Thomas Hospital, which so embittered his life, that he never became reconciled to his own home and practice again.

He was honored by the profession, who elected him to the highest position of their gift, President of the American Medical Association, and the Fellows of the American Gyne- cological Society also paid him a compliment by electing him chief executive ofl&cer of their organization.

Phil Porter.

THE THERAPEUTIC VALUE OF MOTION.

BY G. H. PATCHEN M. D., BURLINGTON. IOWA..

So much has been written about the value of rest in the treatment of many forms of disease that its therapeutical importance is generally understood and appreciated. But the fact that motion^ in an active or passive form, possesses an equal if not greater therapeutical value, is scarcely compre- hended by a large majority of the profession, and even if comprehended, the principles governing the details of its

412 THERAPEUTIC VALVE OF MOTION.

application are so little understood as to render it of very- little, if any, practical value.

It seems diflBcult to account for this lack of definite knowledge when we consider that many years ago, Ling, the celebrated Sweedish physician, devised a complete system of therapeutics consisting only of active and passive move- ments based upon a most thorough and perfect knowledge of physiological and anatomical laws.

Ling's methods have been in operation for more than forty years with the most satisfactory results, frequently cur- ing forms of disease that drugs alone were not able to over- ' come. They are especially adapted for the treatment of a large class of chronic diseases for which, by the use of drugs alone, there seems, often, to be so little help.

Rest and motion are, in reality, only relative terms. Absolute rest of the entire body is almost a practicable im- possibility, and, were it possible, it would in a short time prove a dangerous remedy. Motion, in some form or degree, is an absolute necessity to the perfection of those physiolog- ical and chemical changes upon which health depends.

Rest causes stagnation of vital process and diminished vigor of general vital function, and, while it may be neces- sary, temporarily, for the repair of an injured part, or on account of an highly inflamed condition of certain organs, the restoration thus brought about is always at the expense of the general vitality.

In the presentation of cases for treatment it is often an important question to decide whether motion or rest should be employed.

As a general rule it may be safely stated that rest should be made use of in the treatment of all acute conditions of disease, where the normal activities are in excess, while mo- tion, in some definite form or degree, should be employed in all chronic conditions of disease, where the normal activities are deficient. But the line separating these distinct princi- ples can not be too rigidly drawn. There are many condi- tions, both in acute and chronic forms of disease, where rest

Q, H. PA TCHEN, M, D. 413-

of a part can be most judiciously combined with motion of other portions of the body.

From a remedial standpoint there are various kinds of motion, each producing distinct eflFects ; but they all may be considered under the general heads or classes — active and passive.

Active motion comprehends all movements that originate in the will of the patient and are executed by the patient himself without assistance. This definition would, of course include all kinds of voluntary exercise, even that pertaining to labor. But it is not our purpose to consider the merits of general exercise as a remedial measure (although without doubt it has many), as its effects are not definite or specific enough to enable them to be successfully employed for thera- peutic purposes.

Active movements promote nutrition and increase the strength and endurance of the muscles brought into use, and the afflux of arterial blood towards them. Thus by judi- ciou3 use of them the nutrition and consequent functional activities, of any portion of the body, where muscle exists, can be increased. Another, no less important result of the proper » employment of active movements is the derivative effect that can be induced by directing the afflux of blood firom any part to a group of muscles more or less remote. Thus a congestive headache can be relieved by making use of such movements as will direct a flow of blood to the feet and legs.

Chronic cases of congestive headache, that are caused by constipation and torpor of digestive organs, can be cured by the use of such movements as will cause a flow of blood to the abdominal region, and, at the same time, strengthen the digestive functions and increase the peristaltic action of the intefcitinal tract.

Passive motion comprises all movements by which the whole, or any designated portion, of the body is moved by some external source of power and independently of the will of the person operated upon. There are many varieties of

414 THERAPEUTIC VALVE OF MOTION,

»

passive motion, each having more or less distinct effects. Massage, which includes several distinct forms, such as rub- bing, clapping, knocking, pulling, stretching, etc., is, perhaps, the most familiar. Vibratory motion is another valuable form. Its special province and effects will be considered further on.

Passive movements promote secretion and excretion. Continued pressure upon a part (which, perhaps, might be called a paradoxical form of passive motion) as every one knows, will cause absorption or wasting away of the part to which it is applied. " It is a fact, confirmed by the experi- rience of many years with the movement cure, that all pas- sive movements, as pressure, vibration, stroking, etc., done either by the hand or with instruments, increase the absorp- tion of the diseased organic parts, which may be vascular glands, or other natural parts of the body."

The fact that motion, in some form or degree, is abso- lutely essential to the perfection of all the various vital pro- cesses that are necessary for the maintenance of life and health, is too little appreciated. But a studious investiga- tion of what is constantly taking place within the body, will make it very plain and demonstrate its importance We shall find that, at least, three distinct forms of motion con- tribute to the proper action of all the various physiological changes. First we notice the motion that accompanies all the chemico-vital changes incident to nutrition. This in- cludes all those complex phenomena associated with the di- gestion and assimilation of food, the oxidation of the blood, and the reduction of waste matters to their simplest forms in order to insure their speedy exit from the body. Vital chemistry, in its physical aspects, does not differ from any other, and motion to some extent — at least a change of form and place — is necessary to all chemical changes whether oc- curring outside or inside of the body.

The next form is that of involuntary muscular action. This motion is widely distributed and subserves a most use- ful purpose. To this class belong all of the rythmic move-

f O, H. PA TCUEN, M, D, 415

ments of the various organs and regions of the body, such as those of the chest, heart, arteries, diaphragm, abdominal mus- cles, alimentary canal, &c. These movements are associated with organs and regions that maintain and control the most important vital functions. By a most beneficent and wise arrangement, their action is, to a very great degree, inde- pendent of the will or of voluntary control and is in con- stant operation. They assist to a great extent the move- ments of the first class, and, although limited in degree, yet, by means of their continuous action, their aggregate effect is considerable.

Movements of the third class are derived from the action of the voluntary muscles. This includes every variety of muscular exertion and is very comprehensive in its effects. While, undoubtedly, life might be indefinitely prolonged by the combined assistance rendered by the first and second classes of motion, it is very certain, that, unaided, they are not suflBcient to maintain life and health in their most vig- orous perfection. No matter how strong the constitution, it soon becomes enfeebled unless frequently reinforced and in- vigorated by voluntary exercise. Again, in this relation there is a very important physiological fact very little understood, which is, that muscular action is the natural counterpoise. to nervous action, and, for this purpose alone, it should be in daily use. Foster calls the muscles " Master tissues of the body," and truer words were never spoken. From this fact the observing physician can derive therapeutic hints of in- estimable value.

Voluntary muscular exercise contributes, in many ways, to the perfection of physiological processes. It directly ac- celerates the circulation and oxidation of the blood; in- creases the functional activities of the liver and intestinal canal; promotes the absorption of ingested fluids; hardens muscle, and increases its growth and strength; promotes the nutrition of all portions of the body ; overcomes the action of gravitation which would cause stagnation of the blood and other fluids and consequent congestion and inflam-

416 THERAPEUTIC VALUE OF MOTION, ^

mation in various organs and, in many other ways, shows itself to be an indispensable factor in the problem of life and health.

This hasty review of physiological processes, enables us to see to what extent vital phenomena depend upon mechan- ical agencies and how readily they may be affected by them

If, as is undoubtedly the case, disease is nothing more or less than modified vitality, occasioned by some imperfect or diminished action of the mechanical part of vital activi- ties, might it not be reasonable to infer that it can be re- moved and health re-established by such mechanical pro- cesses as will restore the deficient physiological action in those parts in which it is lacking.

The inference is both logical and practicable and embod- ies the fundamental principles of the movement cure. Move- ments, in some of the forms previously mentioned, can be so applied as to affect any organ or organs of the body, increas- ing vital action where it is deficient and decreasing it where it is in excess, thus restoring that harmonious equilibrium of the different organs upon which health depends. When the patient possesses a considerable degree of strength, the single or active movements may be used. When the debility is, great and nervous action excessive, the passive and passive- active or duplicated movements are most effective. Dupli- cated movements are those made by the patient with assist- ance. They are of two kinds. In one the power to make the movement is partially supplied by the operator. In the other the movement is made entirely by the patient, but the quality^ amount and duration of the movement is entirely un- der the control of the operator. Duplicated movements are the most important, in a therapeutic sense, of all others. " They may be confined mainly to any particular anatomical division or physiological function, to the nerves, to the mus- cles, or may influence all together. They are adapted to the most feeble invalid, or to the strongest persons, and need never produce effects beyond the requirements of the invalid or the intention of the operator."

Q, H, PA TCHEN, M. D. 417

There is one form of passive motion of great value in the treatment of many of the severer forms of chronic dis- -ease which seems to be but little known by the profession, but I am sure it will grow in favor, as a therapeutic measure, when its virtues are better understood. I refer to vibratory motion already spoken of. Its nearest analogue is massage, but it is much more important and effective, producing re- sults that the latter can never hope to obtain.

Its proper administration requires the use of mechani- cal, rather than manual power, because, in order to secure the best results, the vibrations must be given with a rapidity that would exhaust the strength of the most willing hands. Motion at the rate of 1,000 or 1,600 vibrations per minute, continued for five or ten minutes at one application, is neces- sary in many cases.

Many machines have, at different times, been devised for this purpose, but, undoubtedly, the most ingenious and suc- cessful, are those invented by Dr. Geo. H. Taylor, of New York. For convenience of application and effectiveness of purpose, they leave nothing to be desired. They can be ap- plied to any part of the body ; their application causes no pain and they are capable of giving vibrations at any de- sired rate of speed.

In a therapeutic sense, vibratory motion means a great deal and has a wide range of application.

When a disease becomes chronic, it is because the vital powers are so enfeebled that they are no longer able to main- tain, to a suflScient degree, some of the three forms of activ- ities that we have found necessary to health, and there is, consequently, stagnation or obstruction, some where, that needs to be removed. If the chemico-vital processes are, from any cause, insufficient, the obstruction will be the result -of improper oxidation, or imperfect reduction of waste mat- ter, and an important vital part may, in this way, become affected. If the motions of the second or third class become deficient, there will occur inactivity or congestion of different -organs, which will result in serious disease. In either case

418 THERAPEUTIC VALUE OF MOTION.

there will be deficient heat, deficient respiration and slug- gish capillary circulation.

As we have shown these conditions to be greatly influ- enced and controlled by movements subject to mechanical laws, it follows, in accordance with the law of the correlation of forces, that vibratory motion may become a sovereign remedy for any and all states which these conditions may induce.

What are some of the efiects of vibratory motion ? If we subject a portion of the body, say the leg, to its action for a time, what is the result? The entire mass is in a state of rapid vibration, say at the rate of 1,000 vibrations per min- ute. The first efiect experienced will be a sensation of heat. The sensation is real. The foot and entire limb become warmer; the skin is red and itching. There is evidently more blood there than before, and it is in a more active state of circulation. The limb feels much as it does after a brisk race except there is no feeling of exhaustion or fatigue, be- cause no demand has been made upon the nerves or will power for support of voluntary exertion of any kind. Where does the heat come from ? From several sources. In accord- ance with the correlation of force just mentioned a part of the motion to which the limb has been subjected has been transformed into heat and a considerable degree of heat has been also developed by the friction of the fluid and semi- solids of the leg against each other. Although unaware of it, by any immediate sensible efiect, other important changes, in addition to the production of heat, have been efiected. A portion of the motion has been transformed into chemical energy, and all the chemico-vital activities have been stimu- lated and quickened. The oxygen, held in solution by the blood, comes into more vigorous and immediate contact with oxidizable material and a more perfect oxidation and elimi- nation of waste material is the result.

That oxidation and elimination of waste material is in- creased by the action of vibratory motion, is proven in several ways. First and mainly by the appearance ot eliminated

Q. H. PA TCHEN, M. D. 419

matter. The urine soon becomes greatly increased in quan- tity, and is of a clearer color. There is more urea and less uric acid. The skin becomes softer and more moist, showing increased elimination of insensible perspiration. Tongue be- comes less coated, and the sallow complexion assumes a more natural color, all of which effects are ample evidence of more perfect reduction an.d elimination of obstructing material. Absorption is increased. Swellings and even scrofulous en- largements become less, and gradually disappear. Rheuni- atisin vanishes. Pains and inflammations of parts contigu- ous to the point of application, are lessened and healthful action gradually restored. The capillary circulation is ac- celerated. The frequency of the pulse is often lessened from five to fifteen beats per minute for some time after a treatment, showing less obstruction in the circulation. The nutrition of the muscles is promoted and conversely nervous activities are soothed and diminished. The appetite is in- creased, and the sleep becomes more prolonged and tranquil. There is soon noticed an exalted feeling of strengtli arid vigor, and, in almost every way, there appear signs of im- provement, which, with proper management, will continue until health is fully restored. There are other very import- ant eflfects to be derived from the proper use of vibratory motion, and as its power, to cure many kinds of deformities, paralysis, neuralgia and other nervous affections, but a con- sideration of these subjects must be left to some future occa- sion. The object of the paper is to show the possibilities of motion, in its various forms, as a therapeutic agent, and, to encourage study and investigation of its merits and methods. It will amply repay investigation. Did space permit cases illustrating the different effects and methods of application could be furnished in abundance. In order to use motion, as a therapeutic agent, with the greatest success, its effects and best methods of application must be most thoroughly under- stood. This requires an immense amount of study and ex- periment. But happily this arduous task has been so greatly lightened by such eminent and enthusiastic explorers in this

420 NER VO US PREGNANCY.

line of medical thought and practice, that we shall do well enough to accept as true the results of their experience, and endeavor to properly apply them to cases in hand.

Like other powerful remedies, its misuse will be followed by harmful results. Until individual experience with it, in a variety of cases, has either confirmed or corrected theoret- ical knowledge of its application, it should be cautiously used and the eflfect of each administration closely observed^ PVoperly administered it cannot fail to do good.

NERVOUS PREGNANCY.

BY J. M. PACKLER, M. D., PLYMOUTH, O.

I was called in the night of July 16th, to a case of sup- posed pregnancy. On arriving at the house, I found two women that had borne a large family very much excited over the case. They had everything arranged in due order for the expected baby. I was introduced to the j»atient who gave me the following history: "I am the mother of six children and am sixty-five years of age. I ceased menstru- ating at forty-five." She said her time had come; and that she had been in pain all night. Was certain that she had felt motion at four and a half months and had frequently felt great motion of the child ever since. During the first months had sickness at the stomach as she had with her other children. Her abdomen had gradually enlarged and she was positive that she would have a baby and that very soon. I watched her pains carefully for some time. They had all the appearance of being genuine labor pains and everything appeared all right except her age. I placed my hand upon her abdomen during a pain. I could distinctly feel a using of the abdominal muscles. Her abdomen was full and large enough to be pregnant at full term. I made a careful digital examination, and discovered not only the ab- sence of any presentation, but a normal cervix, resembling that of an unimpregnated uterus. I informed her that she

CURES BY DR. KUNKEL, 421

was not pregnant. It almost created a panic in the house- hold. Some of the parties present denounced me as a quack, and were for sending for another doctor. I took the field against all of them and gave them to understand that I knew what I was doing. I ascertained that her bowels had not moved for three days. I informed her that I would give her a cathartic, and call again in three or four hours. She still persisted with her belief of pregnancy and also with her pains. The two lady attendeyits said that if I left they would have the baby before I returned ; and that I had better not go. I gave her a good dose of Podophyllin and on my return I found that her bowels had moved three or four times freely. Her pains had been regular all the time during my absence. I made another careful examination, and then ex- plained the whole case to her and she gave it up. I gave her some medicine and told her to get up and when it was bed time to go to bed and sleep all night. I informed the lady attendants to put up the little clothes that they had out airing and go home. My patient went to bed and slept soundly all night and when I called in the morning she said * that she felt like a new woman.

CURES BY DR. KUNKEL.

IROM THB ALLEQ. HOM. ZEITUNG.

BY A. M'NEIL, M. D.. JEFFEB80NVILLB, IND.

I received a letter December 26, 1882, from Schwerin, saying that Frau St. has been sick for five and a half years and confined to her bed. She is 45 years old. Different diagnoses have been given by her attending physicians. One said she was senemic, another that her blood was too thick. The cause of her sufferings is fright from a thunder storm at night. On the following day she could not speak. There is paralysis of the lower extremities, but whether it set in im- mediately after the fright or followed later is not clear from

422 CURES BY DR. KUNKEL.

the letter. However, there is paralysis now. She is sleep- less, has internal anguish, violent pressure in the pit of the stomach, as from a stone, accompanied by diflBculty of breathing and attacks of suffocation. Hot internally, and externally freezing; internally constant restlessness and anguish. I sent Cuprum lOx, six doses, a powder every evening.

On the 31st of the following March I received the foUow-^ ing letter. "I communicate the joyful news that my wife has been well now for six weeks. She can now do her own housework. The night after taking the last powder she was very sick. She also passed the next night very badly and vomited a bowl- full of green bile. After that she became better every day. I would have written you sooner, but I wanted to see if the cure would be permanent."

Gardialgia, June 24, 1881. N — A waiter, set. 26, has suffered from stomach troubles as far back as he can remember, but he first had a violent attack of cramp in the stomach when twelve years old. His mother suffers in the same way, but not so intensely. He has constant pressure in the pit of the stomach, but particularly after eating heavy food, and vio- lent pain which he says is constricion. In such an attack he rolls on the ground in agony. It very frequently continues ten to twelve hours, and at times eyen longer. In lying down there is some amelioration of the pains. Sometimes immediately after dressing himself in the morning, and while yet fasting,' has the "most fearful" pains. During the attacks the pit of the stomach is swollen and hard. At night he is on the whole more free. Stools, hard like stones, often very scanty, knotty, and difficult to discharge. Eructations relieve. At times sweetish taste. Plumbum lOx, six doses, one every seventh evening.

July 5. — Essential improvement. The pressure on awakening in the morning has entirely disappeared. The pressure in the stomach has not been noticed much only twa days. No more violent aitacks. Stood still hard. Continued the prescription. After the use of the last six powders the

A. MCNEIL, M D. * 423

patient has been free from his suflFerings and since then they have not returned.

Procidentia Uteri, Frau Z. — cet. 44, consulted me on the 29th of April, 1882. She had suffered in 1868 from rheumatism of the joints. She had three and a half years ago a difficult delivery with hernia umbilicalis and fal- ling of the womb. She also had hemorrhoids during her lying-in. The uterus came out on every slight exertion and she must then go to bed. She also complained of pal- pitation on walking, depression of spirits, disposition to weep, at times paralytic weakness of the legs, and vertigo on rising from a seat. In the Spring there is always an aggra- vation of all her symptoms and great weakness. The spleen is sensitive on pressure and enlarged. Natrum mur lOx, six doses, one every seventh evening.

I first heard from heron the 1st of July. She feels con- siderably better, perceives no falling of the womb. Same prescription.

September 11. — There was continual improvement, but now she is not so well. The uterus comes down and threat- ens to protrude, headache particularly when sitting, and in the morning on awakening, restless when sitting, heat going upwards to shoulders, coldness between the scapulae. Sensation of going to sleep of the left leg when sitting, pas- sing off when moving. Sepia lOx, six powders, one every seventh evening.

December 13. — Essential improvement, or rather no morbid phenomena remain. She has danced vigorously without any ill effects. The eyes which I forgot to mention, felt burning, became red, etc., are essentially better. Pres- cription continued.

February 13, 1883. — She sent word she was perfectly well

(To many this case may appear incredible, but as I have cured one of not so long continuance, it is to me perfectly credible. A. McN.)

Eczema, M. — set. 28, has suffered for years from an eczema of the right cheek, which itched but little and is painless. At

424 PROORESS AND REFLECT.

times it disappears spontaneously. Then his general health suffers, the tongue becomes coated, bitter taste, etc. He is full blooded, has suffered what was probably pneumonia. Almost every year he has had shorter or longer periods of nose-bleeding. Usually he is quite well, however. When he looks downwards he has tearing in the head. June 23, 1881,^ one dose Calcarea carb 200, but as this was unavailing only increasing the suppuration, I gave him Antimon, crud 200» one dose.

August 24. — The cheek has improved considerably, less pus, more for last three days ; Sac. lac.

September 23. — I saw him and the eczema had entirely disappeared and no gastric troubles had ensued.

(I ask every reader to decide in his own mind if these are cures or not. A. McN.)

PROGRESS AND REFLECT.

By Ad. Lippe, M. D.

The Medical World has of late been treated to a series of new discoveries, made by a prominent member of the Interna- tional Hahnemannian Association, and as this Association was originally created to help eliminate from the American Insti- tute, erroneous departures from time to time offered by some of its members and not combatted or rectified by the Insti- tute itself, it is the strangest sight in all medical history that the I. H. A. is now standing sponsor to a heresy never before thought of earnestly. It is true that Law half a century ago offered to amend our universal law of cure, but the heresy died out very soon. And this Internationalist publishes a new manifesto in the November number of the Homoeopathic Physician, page 357. The clinical notes are ostensibly an offset (not an answer) to a paper on epistaxis, published in the August number of the Homoeopathic Physician^ page 233, and the questions asked the discoverer of new laws and methods are answered in a very singular manner. The dis- covery of the new law was, " that morbific products of a dis-

AD. LIPPE, M. D. 425

ease highly potentized will cure the disease itself," and we were then and there puzzled to know how to treat epistaxis under that newly discovered law; puzzled, because if it were a law it had to be universally applicable. The discoverer, and Grotham is overflowing with them, now goes back on his own newly discovered law, and tries to foist on the profession, *^ specifics for speciAc diseases^ An unproved remedy is de- clared to have been discovered, and homoeopathised by a Gotbamite, and he offers it, not to the profession at large, not a bit of it, he offers it to the few select doctors (not healers) who are not afraid, have not been afraid " to progress and re- flect afterwards," to progress into the dark ages long before Hahnemann's days, really out of sight even of a regenerated Allopathic School. The newly discovered specifics will regu- late the "circulation" either way, stop the flow of blood, or start it like the spigot to the homoeopathising apparatus- No matter what causes epistaxis, no matter what the char- . acter of the discharge is. Here we have it. Epistaxis of all sorts is always and invariably cured forever by a nostrum homoeopathised by a new discoverer in Gotham, the name of said nostrum only to be divulged to the few pathologicians who will progress backwards, labeled I. H. A. into the last cen- tury of darkness. As the discoverer of all sorts of new laws,, methods and nostrums seems to be utterly and totally ignor- ant of homoeopathy and its history, we shall for the last time attempt to say a few words to this new prophet, although he is labeled I. H. A. The common tribe of physicians claimed in the last century that Peruvian bark was a specific for inter- mittent fever. A thinking allopathist by the name of Dr. Cullen, who investigated before he advanced, asked the ques- tion in his then very celebrated work on Materia Medica,. and says, whereas, Peruvian bark does' cure some cases of in- termittent fever, but does not cure others, we must investigate under what circumstances it will cure that disease. Samuel Hahnemann solved this question by proving the tincture of Peruvian bark on himself. It then became an established fact that the law of the similars was the only law of cure, and on

426 SEWERAGE,

reflection Hahnemann progressed and proved more drugs and left us his gigantic master work his Materia Medica, and in his Organon he left us the key for the application of the unerring law of the similars for the cure of the sick. It is evident that tlie proving of drugs was the first step taken to demonstrate the possibility of applying any law of cure; it is also evident that this had to lead to "Individualization." The above mentioned discoverer, has, if he ever knew any- thing about the history of homoeopathy, undertaken to pro- mulgate new laws, new methods, not in harmony with, but entirely antagonistic to Hahnemann's teachings. This modern prophet wants the lazy physicians to progress and accept specifics and the homoeopath isation of medicine by means of potentization. The plain fact is that a member of the I. H. A. offers a new system of practice, a caricature never before heard of and asks to have this caricature acknowledged by the I. H. A., and the medical world in general as ** Homoeo- pathy." Whatever the merits of these new discoveries and methods may be, it is certainly evident that homoeopathy can have nothing to do with it, and no thinking member of the medical profession, with just a little 'logic within his grasp will progress and then investigate this latest of all cari- catures of a medical system.

- •-^•►►-

SEWERAGE.

The following remarks were made at the late sanitary convention in Ionia, by Dr. T. P. Wilson, of Ann Arbor, in reply to Dr. Lyster, of Detroit, on sewerage :

Dr. Wilson : " I suppose a man might as well be out of the world as out of fashion. It will not add to my reputa- tion to say that I am opposed to the principles and practices of the sewerage system. It does not seem to me to be based upon science or common sense. Let us for a moment look into the necessities of the case. Upon a given area upon which a city stands, it is necessary that the rainfall — some- times abundant — must be disposed of. This can sometimes be done best by open gutters, and so conduce to the cleanli-

SEWERAGE, 427

nees of the city. There can be no serious objection lo con- ducting this water through properly constructed pipes placed in the ground.

" In addition to this, we h'ave the slop waters of the kitchens, dish water and wash water from the laundry. This water contains soap, grease, dirt, and a small amount of ani- mal and vegetable substance, and without any special risk all this might be thrown into the gutter, or underground pipes, and along with the rainfall conducted into a flowing stream, without detriment to the river.

" Besides these, we have to deal with animal and human excreta, which must be disposed of by removal. The pro- ducts of the stable we wisely gather up and use for fertiliz- ing the land. Why should we not connect our stables with the sewerage and thrust the ofFal down the pipes, and have it all discharged into the river? Every one knows that that would be expensive and wasteful. But in disposing of hu- man excreta, we act more unwisely still. To extravagance and cost we add untold danger. Stop and think a moment why it is that the sewerage of the city is so dangerous ; breeding disease and destroying life. Is it the rainfall? Is it the slops from the kitchen or laundries? No, it is the human excreta that makes the sewage and the ** sewer gas " so pois- onous. Deliberately w^ connect our water closet with the sewers, and contaminate the whole system; and send into the adjacent river a flood of corruption that makes that river, for miles, a breeder of pestilence. We spoil its fair waters for fish and beast and man. And we boast of it all, as the perfection of sanitary science.

'^I do not hesitate to say that this is all wrong. It might be endured if there were no other way of disposing of human excreta. We know, however, there is a better way. Earth- <;loset8 have abundantly demonstrated their utility. If our sanitary engineers would stop a little while in their work on sewers and perfect the method of removing the excreta of the closets in a dry form, we would save a large amount of mon- ey, we would greatly increase the amount of our fertilizing

428 8EWERAQE,

material, and we would almost certainly escape the contain* inating and disease producing effects which are due to our sewers. This city (Ionia) is facing this question to-day. It is proposed that she shall have a system of modern sewers^ with water closet attachments. Her streets are to be dug up and pipes laid down that shall carry their contents into yon- der beautiful river, making the water inexpressibly foul along the banks of the valuable farms for miles below your city. This will be an expensive way of depreciating much valua- ble property; and it will amount to placing under your fair city a prolific breeder of disease and death, for which you will pay large taxes and still larger doctors' bills. All this can be avoided in the manner described; and I counsel you to the wiser course.

" Dr. Lyster's paper needs no words of commendations. It is an admirable statement of a bad th ing, and could not be better, unless after describing so well the sewer system at present in yogue, he advised you to discard it."

Apropos to the same subject we publish the following from the Springfield (Mass.). Republican:

"The public generally will watch with interest Boston's experiment of leading its sewage into deep tide water. The entire cost has been $4,544,282, and the building of the sew- erage is spoken of as "one of the greatest engineering feats of the age." It may seem a little hypercritical to express a re- gret on this inaugural day of great enterprise that Boston did not see fit to include in its plans all the possibilities in the case. London has taught the world that a nuisalice can be turned into a profitable product available for agriculture. The market gardeners about the city eagerly take up all the sewage fertilizers turned out at the London works, and find them even better than what they buy in the market. At Pullman, the infant city of Illinois also, the revenue derived from the sale of the manipulated sewage is a good and fair interest upon the money invested in the works, to say noth- ing of the incalculable benefit to the community in the solu- tion of a serious difficulty.

ANTISEPTIC SURGERY. 429

THE PRESENT STATUS OF ANTISEPTIC SURGERY *

BY WM. TOD HELMUTH, M. D.

CALENDULA OFFICINALIB.

I must say, as far as I have observed, by actual results in the treatment of wounded surfaces — for I have never given any microscopical trial to ascertain its value as a ger- micide— that the calendula officinalis has given me equal, if not better, results than carbolic add, and while I acknowl- edge the fact that since the " bacteria craze," and the " car- bolic excitement," I have yielded to the popular cry and used carbolic add in different proportions and in different so- lutions, yet I am convinced, other things being equal, that calendula^ from its peculiar action on suppurating surfaces, is a medicine that sooner or later must receive the attention which its virtues deserve. I am quite aware of the follow- ing facts, that in the past five years, when I have been em- ploying carbolic add preparations upon wounded surfaces that have not appeared to be progressing as favorably as I thought they should, I have substituted calendula with surprising re- sults. In many cases of breast amputations and large wounds, I have employed merely cleanliness and the solu- tion of ccdenduia, one part to four of water, with a most sat- isfactory termination of the cases.

LISTERINE.

Before closing, I wish to say a word regarding a prepa- ration called listerine, which has answered my expectations, as vulnerary, in some instances better than carbolic add, and, in others equally as well as calendula: This substance is composed of thyme, eucalyptus, baptisin., gavltheria, and mtniha arvensiSj benzo-boracic add. I have never used it internally, but have employed it quite extensively in general and hos- pital practice, as a safe and most agreeable disinfectant and

♦ Being the conclusion of a paper presented to the American Institute of Ho- moeopathy. June. 1888.

430 ANTISEPTIC SUROBRY.

healer. I placed a quantity in the hands of Dr. J. M. Ward, of the Hahnemann Hospital, and desired him to note its use- fulness in operations, and to give me a record thereof. His communication reads as follows:

" I write this letter for a double purpose, not only to ten- der thanks, but to afford you an idea of our estimation of the eiiicacy of listerine as a disinfectant. It has been used in quite a variety of surgical cases with marked benefit.

" A case of resection of the entire ulna and a portion of the radius, by yourself, was afterward treated at each dress- ing by syringing the wound with a * solution of listerine.^ In another case of yours — a ' carcinoma of Douglas' cul-de-sac of the vagina,' lifeless in its nature, and considered by you a oase in which operative procedures were out of the question, accompanied, however, by its characteristic malignant odor— at your suggestion, listerine was used with complete success, in the abolition of the odor entirely, so that the room of the patient was made pleasant for the victim of the disease, and more agreeable to Ihe physicians and friends.

" In a case of tracheotoiny, by Dr. J. M. Schley, listeriru was used as a dressing with the best of success. Dr. L. L. Danforth after excision of the coccyx, which recoveretl speedily — listerine promoting the granulating process, and act- ing a^ an agent of importance in the cleansing of the wound. From observation of its practical value in these and other •cases, I can recommend it as a most valuable disinfectant, and worthy the careful attention of an operator as a promo- ter of the healing process, and in securing proper disinfec- tion of the wound. I attribute much of its worth to the fact of its being a compound, and one that contains a number of the most valuable agents of disinfection, and aids to the heal- ing of wounds.

" It cannot but be regretted that its expensiveness will, to a certain degree limit its usage, and surgeons thus be de- prived of ita medicinal qualities. Could this be overcome, it« reputation will rapidly extend, and its introduction be largely increased."

D YNAM1C8 OF SANITARY SCIENCE, 431

In addition to this I have employed the listerine in the case of septicaemia following injury to a large and pendulous fatty tumor, in the dressing of ovariotomies ; as injection, into old sinuses ; and also in the preparation and preserva- tion of wet specimens. In a remarkable specimen of re- moval of a parovarian cyst, showing the expansion of tho broad ligament, the ovary and the Fallopian tube, I packed the cyst with absorbent cotton, saturated with listerine (one to four), and found it not only perfectly preserved, but flex- ible and soft (not hard and shrunken as we find in most pre- served specimens) after several months. The cost of the ar tide is rather against its general use in large hospitals, but in the smaller institutions and in private practice, it is worthy of general introduction.

THE DYNAMICS OF SANITARY SCIENCE.

OR THE REl.ATIONS OF THE NATURAL FORCES TO THE ETIOLOGY OB EPIDEMICS.

BY E. R. EGOLE8TON, M. D., MT. VERNON, O.

Here is the diflSculty: On the one hand, we have Bcrard» of Health, municipal, state, and national; Bureaus of Sani- tary Science, in local, state and national Medical Associa- tions; irresponsible experts; individuals with scientific pro- clivities; the man with a theory to establish ; — all these, and more,v are clamoring for the public ear. And yet ie it not true that their songs are pitched upon the same or a similar key? It is unquestionably true, at any rate, that a single theme is twanged and thrummed into our ears unceasingly — Filthl Filth in the air we breathe ; filth in the earth be- neath ; filth in the lakes and seas ; among the flowers and trees; in ocean waves and haunted caves; in swamp and brake, on hill and moor, in city, town, village, hamlet, every- where is festering filth. Sometimes keen, frosty, purifying winter heaps up or concentrates the mortal miasm; again in

432 D YNA MICS OF SANITAR Y SCIENCE.

some mysterious fashion it bursts its bonds, and, sweeping down from bleak hills and hill-sides, takes up its destructive march. Or, yet again, the genial, vivifying heat of summer is but the train which explodes the myriad magazines of mortal miseries. On the other hand are the few who are not satisfied with these explanations as exclusive causes for the outbreak of epidemic disease, or for the low, degenerative states of the human economy which are seen to prevail over wide areas, nor for the excessive degree of susceptibility to / disturbing influences which at times obtains, and they seek in the orderly procession of Nature's methods, in which from the fructification of the germ at one extreme, to the final chemical and mechanical dissipation of its result at the other, there is neither " variableness nor shadow of turning," a key to the momentous problem of public health.

Now, again, here's the difficulty. Neither view ofiers complete explanations. It is beyond dispute that decom- posing vegetable, animal and refuse matters aire a fruitful source of disease; but this fact afibrds no explanations for typical phenomena, for virulence or malignity. It is true that extraordinary heat, excessive humidity, prolonged ex- tremes of heat or cold, or other unusual phenomena which impose upon the human economy conditions unfamiliar, are sources of disease; but they represent more nearly individual weaknesses and proclivities than the phenomenal degenera- tive types which fail of explanation in the causes assigned. In another vi^w of the case it must be admitted that in- fluences purely atmospheric perturb the plane of health average; — the seasons characteristically disturb; fluctuationB disturb; extremes disturb; while opinions of no mean weight bear heavily in favor of disturbing influences froji without — from the varying interdependent relations existing between members of the solar system. But all this inadequately ex- plains the complication. The fact is that neither the ground more commonly taken by sanitarians, nor that held by be- lievers in occult influences — both in the sense of exclusive- ness, to a degree, is correct, for the claims of one are neces-

E, R. EQOLESTON, M. D, 433

eary to more completely substantiate the claims of the other. Nor do both together cover the ground, for there are still the factors known only by aid of the microscope — animalcular and fungoid germs and products, which also belong to natural conservative processes, and are found in almost all atmos- pheres, and in all putrefying decompositions.

Sanitary Science inaugurates its investigations by col- lating certain facts — diseas^e phenomena. Praiseworthy effort is made to trace the relations between these phenomena and certain causative agents. I say certain causative agents, because therein lies a criticism. It being assumed that a specific disease originates in a specified miasm, the effort is made to prove the relationship without the often determin- ing characteristics of intervening phenomena. When typ- hoid-fever is epidemic, for instance, it being assumed that matter in a state of putrefying decomposition is the cause, it is taken for granted that such conditions exist. But it may happen that no such conditions can be found — then what? It does not satisfactorily answer the question to refer to poisonous germs wafted by the winds from long distances, which lacks the precision so essential in investigations of this character. Again the assumed cause may be found, and in startling abundance, but there is no typhoid-fipver. Why not? It is evident, in this case, that like causes have not pro- duced like effects. It is safe to say that emanations from de- composing animal and vegetable substances are sources of disease, because the air becomes laden with deleterious sub- stances; but the sanitarian must be able to say under what peculiar conditions the poison peculiar to typhoid-fever is generated. He alludes to favoring atmospheric states; — what are they, and how do they modify decomposition?- He alludes to an epidemic predisposition; — what is that, and what produces it? He alludes to individual or class suscep- tibility;— what influences determine the susceptibility ? But the most puzzling query of all for Sanitary Science to answer is this: What is the cause of the widespread states of low vitality, or conditions of least resistance to disturbing in-

434 D YNAMICS OF S ANITA R Y SCIENCE.

fluences, which so almost invariably precede, or are contem- poraneous with, the march of all destructive epidemics? Scarcely less puzzli-ng than the preceding is the query : Why are the grand epidemics periodic, or cyclical? The fact is ad- mitted by sanitary scientists that cholera is endemic in India; that it occurs sporadically every year; that it becomes epidemic and terribly destructive once in about eleven years. May it be that drainage, ventilation, collections of decompos- ing matter, of hygienic regulations reach a climax of badness in about such periods, or may it not be that other factors with intermitting power determine the question of pestilential virulence? Let us see. Physical science admits the cholera cycle in India, but it likewise admits contemporaneous phenomena; — as, epidemics of other diseases in other parts of the world; extraoi:dinary vicissitudes of temperature; sudden and extreme meteorological disturbances: a disor- derly progression of the seasons; marked electrical and mag- netic variations ; sun-spot activity, and the recurring positions of the planets. These are facts, and period after period of the same length brings a recurrence of the same phenomena. Are they but accidental coincidences, or are they the like effects from like causes which the scientist must endorse?

Without consuming more time with what may be termed the mechanical side of the question, and presupposing that it has also its dynamical side, I proceed to it at once, and shall attempt to show that electric, magnetic, ozonic, and atmos- pheric states are subject to extreme disturbances, on account of an inherent unstableness, as well as on account of influ- ences external to the earth and its atmosphere; that such disturbances predispose to disease; that the resulting diseases are typical, epidemic, or endemic, and degenerative. The following preliminary propositions are taken as starting points :

I. Atmospheric, or Positive. Electricity, is subject to ex- tremes of fluctuation — (a) as to present quantity ; (b) as to locality; (c) as to intensity ; (d) as to polarity. These fluc- tuations exert an influence upon the nervous system of ani-

E, R. EOGLESTON, M. D. 43.>

mal life, prejudicial or otherwise. It tends to establish au equilibrium with negative states.

II. Terrestial, or Negative Electricity, is subject to the same fluctuations, under the same categories, and tends to an equilibrium with positive states. Its varying intensities and conditions characteristically affect the vitality of animal existences through the agency of the nervous system.

III. The interdependent relations existing between at- mospheric and terrestrial electricity are subject to deviations and perturbations. While it is true that the positive und negative reciprocities are maintained more or less perfectly, it is still true that remarkable temporary fluctuations ob- tain, so great, indeed, that total change of polarity may oc- cur. Disturbances of these relations whicli exceed the not very well defined boundary which marks individual toler- ance, produce proportionate disturbances in the animal econ- omy.

IV. Atmospheric Pressure, of itself, is in some degree responsible for the varying conditions of animal bodies; while if taken in connection with the electrical and other phenomena which invariably accompatny its changes, we may take for granted its predisposing power in epidemics.

V. Ozone, or superoxygenated oxygen, is the product of the action of free electricity upon atmospheric air. Its presence in a normal degree in the atmosphere, conserves health ; if excessive or deficient in quantity, its effect is de- structive, at one extreme by superoxydation, at the other by carbonization. In presence of epidertic conditions one or other of these ozonic states prevails.

VI. Assumingthat interdependent relations exist among members of the solar system ; that these relations are sub- ject to variations according to the varying positions of plan- etary and other bodies; that these may produce excessive maximal or minimal states of electric tension which tend to supervitalize or devitalize animal bodies ; and that these con- ditions may operate through long periods of time, and over wide areas of the earth's surface, it is claimed that electric

3

438 FIBRIN A ND BA CTERIA,

FIBRIN AND BACTERIA,

A REPLY TO DR. TAYLOR.

I am somewhat surprised that Dr. Thomas Taylor should assume so much, either under or over the high sound- ing title of "Microscopist, Dept.of Agriculture, Washington, D. C," as he did in the January number of the Advance; and at the same time, in one short paragraph, give so much evidence of knowing so little about fibrin as he does therein, I would respectfully recommend him to read up on the sub-, ject and learn of Liebig's discovery ; **that the characteristic solid constituent of muscle, which has been usually known under the designation of fibrin, is in reality essentially con- formable in all its chemical relations with coagulated albu- men; and is at any rate much more nearly allied to it, than it is to the fibrin of the blood." Let him learn this I repeat, then he will not assert so confidently that " fibrin is mus- cle forming." And if he will read other authors he will find that fibrin is almost the only food of the serous membranes and their allied structures; while albumen is the only food, . aside from a little of the salts and fatty matters of the mus- cles or muscular cells.

Again, if Dr. T. will read that greatest of all authorities on Physiological Chemistry, Professor C. 6. Lehmann, and find him saying that, " it is a chemical fact that pure fibrin is incapable of complete solution ;" he will be less willing to allow his pen to betray his want of knowledge by saying that V fibrin is soluble in the alkalies." But if he is not satisfied with the foregoing let him rot blood for six months under con- stant warmth of 100° to 200°, and see its fibrin go through all sorts of net-work, cellular and other formations, and the fibrin-granules come out at the end of that time unscathed in all their whiteness and purity. If he watches this pro- cess closely too, he will learn much of the secret of cell-de- velopment, which has already been seen and another great point gained. Or if that is not enough then let him try the

ROLLIN R, GREQU, M. D. 439

destruction of fibrin by digesting it for months in chemi- cally pure nitric acid; or boil it for weeks, then burn it black and to a crisp, triturate that to an impalpablb powder and treat it with the strongest nitric acid, and at the end of all that still find its granules as pure and fresh for further work as ever. This may open his eyes a little more to the true nature of fibrin and what it is capable of doing. While doing that, moreover, he should not overlook the fact that every time he allows or brings fibrin back, no matter how, from its successive net- work, cellular, or whatever other for- mations, to its primary granules, these ever and always pre- sent the same size, the same color, the same everything, even to motion in many of them, that he has seen in disease and called micrococci ; if he has ever seen the latter.

After Dr. Taylor has familiarized his mind with the truth of the foregoing statements, I would next request him to make the following experiments. Let him stir some fibrin out of fresh warm blood, wash it in water first thoroughly boiled, until the blood corpuscles, salts, fatty matters, every- thing in fact but fibrin is washed out ot it, leaving it a pure, beautiful white. Then he will know that he has nothing but fibrin to deal with, and little or nothing to mislead him; and he may know from the use of his microscope, if he does not know it already, that his mass is made up entirely of threads of fibrin interwoven with each other in every direction to make up the mass. Then let him take an ounce or more of this, put it into a cup containing two or three times its bulk of distilled water, or water that has been first boiled two or three hours, set the cup aside for the fibrin to rot, and watch the results daily. In twenty-four hours he will see that his threads of fibrin are even then breaking up a little into rods and spirals, from a quarter to half an inch in length under a power of three to four hundred, and already beginning to show not a little motion. In twenty-four to forty-eight hours longer he will find both rods and spirals appearing in greatly increased numbers and showing the most violent activity; the former often darting and the latter whirling spirally in

440 FIBRIN AND BACTERIA.

Buch rapidity that it is difficult, impossible sometimes, to see what they are until they slow down to a more leisurely move- ment. I'he rods come from the straight threads, or straight parts of the threads, of fibrin, breaking up into the lengths named; and the spirals come from the spiral threads, or spi- ral sections of fibriu threads, breaking up in like manner; and both taking an independent motion characteristic of the form they have. By watching them still further he will see that, as day by day passes,, these rods and spirals break up into shorter and shorter pieces, each of which again takes up an independent motion of its own, but spiral or fish-like^ according to whether it is crooked or straight. In the pro- gress of this watching he will see produced all the so-called bacilli and spirochaetes of disease that he has ever seen, in hundreds and thousands sometimes in a single view; and all in rods or spirals of broken threads of fibrin. Within a month I have seen in different specimeijts of rotting fibrin, hundreds of Kock's bacilli tuberculosis, or such as look pre- cisely like those in a specimen prepared in Ebuth's labra- tory in Germany last summer, and recently brought to this city by the physician who saw it prepared. I would defy any microscopist in the world to tell the two forms apart. Following up his observations many days longer he will see these shorter rods and spirals of fibrin breaking up still more, until, finally, they break up into millions of their pri- mary granules, each of which again takes an independent motion. I have many times seen tens of thousands of these granules of fibrin at a single view, and all under the most violent activity.

There are two or three other points of interest in this connection. I have seen hundreds of rods of fibrin break- ing in two, or almost broken in two, in the middle, (which is the reason of such being called Schizomy cites) ^ but still held together slightly; and each trying to establish a separate motion of its own, until they fully parted, and each would then go off independently. Another point is, that in the breaking up of the rods of fibrin they will keep on breaking

ROLLIN B. QREGG, M, D, 441

until they are reduced to what appears under a fourth object- ive about the sixteenth of an inch in length ; aud remain at that length without further breaking, longer by several days, than at any other step in their disintegration down to the granular stage. And still another point is, that after the rot- ting process has gone on a week or ten days, these rods of fibrin are softened, so they will then begin to take color into them, but not before. And this is suggested as the reason why Koch did not succeed in staining his assumed cholera bacilli, as it has been said that he did not, when he went to Egypt last summer. Pure and uncomplicated cholera is a terribly rapid disease as all know, and not a disease of sup- puration; hence it comes and ends in death or convalescence, before the rods of fibrin which may be formed in its secre- tion, have had time to soften, or the rotting by suppuration to soften them, to enable them to take coloring matter. The " rice water," or characteristic discharges of cholera, being mostly nothing but serum from the blood, they of course contain more or less fibrin, which must organize, as is its great function to do under all favoring circumstances, into rods etc., and these he found in those discharges but not yet softened. In all the suppurative diseases on the contrary, where a week to ten or more days are given to the suppura- tion, and especially in tuberculosis, the fibrin rods are soft- ened and can then be colored, or will take color.

Now, it will not do the slightest good for Dr. Taylor, or any other professed microscopist or scientist, to pooh at, ridi- cule or deny all this. The experiments are too easy of repe- tition and verification. I have repeated them all dozens of times, and made many hundreds of observations with essen- tially the same results every time. If Dr. T. begins with stirring fibrin out of fresh blood, and washing it most thor- oughly, then sets it aside in distilled water to rot, I repeat that he will know thafrhe has nothing but pure fibrin to deal with; and may know that this is made up of an enormous number of threads, both straight and spiral combined. Very well, there is no other possible way that these threads are or

442 FIBRIN AND BACTERIA

can be disintegrated by the rotting process, excepting by their being first broken up into pieces, or into rods and spirals, and these breaking by successive stages into shorter and shorter pieces down to their ultimate granules. And there is nothing else in the decomposing mass that stands for or represents the broken threads of fibrin, excepting these rods and spirals of the same, either with or without motion. The fibrin threads are not dissolved, but are broken up in successive sections as described. The broken pieces of the threads of fibrin are therefore iiecessarily present and mtcst be accounted for, but I repeat there is nothing seen in the whole rotting process that does or can account for them, but said rods and spirals. Precisely the same is to be said when the rods and spirals break up finally into the ultimate granules that constitute them. Millions of granules of fibrin then ap- pear, and as I have already said, I have seen tens of thous- ands of them at a single view, and all of them in the most violent activity. The bacterists, however, would call all these micrococci. But what has become of the fibrin-granules all this time if these falsely assumed micrococci are not they ? Remember that the granules of fibrin cannot be destroyed. Rot- ting them six months does not destroy them ; the most powerful acids do not destroy them after months cf immer- sion therein; then where are they, and what are they in our rotting specimen, if they are not what have been so long sup- posed to be micrococci? The size, the form, the color, the demeanor, the everything about them is right to show them to be fibrin-granules and nothing else. Besides, they corre- spond in every particular with the free granules of fibrin to be found in fresh blood, and seen in every specimen of per- fectly fresh fibrin that can be prepared. And this they are and not micrococci. • '

In conclusion allow me to further say that, after Dr. Taylor, "M. D. A. W. D. C." has learrted all these things and a hundred times more about fibrin, he will know better than to rely upon his own sad want of knowledge, or misuse his official position and title in attempting again to so cavalierly

MEDICAL JURISPRUDENCE. 443

set aside, or throw distrust upon, the results of over twenty years of study by another, whose foremost and only thought or care all that time has been to go to the bottom of this whole subject and find the tnUh^ no matter whose theories it might uphold or overturn.

RoLLiN R. Gregg, M. D. BuPPAix), Jan. 30th, 1884.

AN INTERESTING CASE IN MEDICAL JURISPRU- DENCE.

BY F. H. ORMR, M. D., ATLANTA, QA.

The case here given is one worthy of preservation in the annals of medical jurisprudence — the facts having been fur- nished to the writer by Col. H., of the bar of Atlanta, he hav- ing been the counsel for the defendant.

Miss A., of T. county, was a pretty blonde, but with a reputation for virtue that was not above suspicion. In course of time it was observed without suspicion by her neighbors, that her figure was undergoing a not uncommon change — her abdomen becoming protuberant, while her waist steadily broadened. The usual time for this sort of development having passed, the young woman herself having given no indications to the contrary, a new addition to the community was looked for. Instead of this appeara^nce, after a short re- tirement Miss A. was seen about the neighborhood with about the same proportions she had shown before the above men- tioned enlargement had taken place. The altered condition was not accounted for. No mention was made of a child. "Murder" and "infanticide" were terms that were at first whispered, and afterwards became open charges. Every member of the community was " down on her," no sym- pathy was shown, no friend attempted to defend her. The evidence of her guilt accumulated with the putting of this and that together, a hue and cry was raised, and a true bill of indictment was found.

444 MEDICAL JURISPRUDENCE.

When the case was called for trial the young woman ap- peared, without giving indication of embarrassment. Upon being questioned by the people, she replied that she was without counsel, and without the means of employing any. Col. H. was appointed to defend her. He suggested to her the importance of his moving for a delay, that he might have opportunity for acquainting himself with the case, and pre- paring himself for her defence. She insisted that there should be no such motion, and, after a brief interview the case was put at once upon its trial.

The testimony proved her questionable character for chastity, her gradual enlargement, and the general opinion of all the women of the vicinity that she was pregnant — no one having expressed a doubt of it, and the defendant not having been heard to make denial. One witness had seen something suspicious behind the back-log in the chimney place; a colored preacher had found a baby in a bag, near a creek, and had buried it, but was not sure that he could point out the place ; the little ten ye^ir old brother of the ac- cused even, was placed upon the stand to testify that he had, at a certain time, heard the cry of an infant. The evidence was all one way.

At this stage of the proceedings, her advocate observed that the defendant was surprisingly calm, and approaching her, remarked that she saw how the case stood, and asked if she had any witnesses with w hich to rebut this mass of tes- timony. "Yes," she answered, "I want Mr. Brown, one of the jurymen, put upon the stand ; his wife had a case just like mine." Mr. Brown, being sworn, testified that his wife had once gone through the same course of enlargement^ everybody supposing, as she and he did, that she was pr^- nant, and at the expected time she was delivered of a shape- less, fleshy mass, the result of a false-conception, a blighted ovum, or a mole, such as has been known to occur in the virgin womb.

The testimony of the former witnesses when analyzed by the skillful advocate was shown to amount to nothing more

DEADLY WELL WATER. 446

than an impression that the woman was with child, due to the augmentation of her size. The cry that the little brother heard, when inquired carefully into, as to the time of its oc- currence, was connected in time with a certain camp-meeting time, which was proved to have been nearly a year before the supposed birth, and possibly the whole story was pre- pared for him, or imagined, or he may have mistaken the cry of some other animal.

The composure of the accused under such a weight of evidence was now accounted for -she was conscious of her innocence, and had an abiding confidence that she would not be convicted. An efifective speech from the counsel caused a general revulsion of feeling; the ill-will which had been felt by all was changed to sympathy for one who had been unjustly subjected to a cruel prosecution, and a prompt verdict of acquittal was readily obtained.

Lesson: "Things are not (always) what they seem."

DEADLY WELL WATER.

A novel suit, which will test the responsibility of the Brooklyn city authorities to allow water in a pump well to become "stagnant, impure, poisonous, unclean and danger- ous to human life and health," is pending trial in the Supreme Court of that city. The plaintiff is John Danaher, a resident of DeKalb avenue, who sues to recover $10,000 for the loss of his sons, Charles M., aged six years, and Thomas P. Danaher, eleven years, whose deaths were, it is alleged, caused by drinking impure water from a well near the plaintiff's residence. The complainant alleges that the city has charge of the wells, and therefore should prohibit nuisances in them and preserve the public health.

Health Commissioner Raymond has, within the last year and a half, condemned as dangerous to health the water of fifty wells, of which thirty have been closed by order of the Common Council.

446 SPINA BIFIDA.

SPINA BIFIDA.*

READ BEFORE THE HOMCEOPATHIC MEDICAL SOCIETY OF OHIO.

BY C W. CARROLL, M. D., SIDNEY.

One of the most frequently seen of congenital malforma- tions is spina bifida.

It is a protrusion of the spinal membranes and arach- noid fluids through an imperfectly developed vertebral <5anal, hence it is properly called a hernia of the spinal theca.

It is caused by a lack of development of the neural arches of the spine; very early in intra-uterine existence, the sub-arachnoid is deprived of its natural support.

Ranke considers the absence of the lamina and spinous process of the vertebree to be due to the non-separation of the ectodema from the medullary layer in the lumbar and sacral region.

It is not our purpose to consider those mal- formations which are wholly incompatible with life, such as a complete •deficiency of all the lamina of the spine or extensive fissures of the bodies of the vertebrse. But we desire to direct your -attention to the character of the tumors. These sacs are gen- erally covered by healthy integument, occasionally we find it greatly modified. Caees have been seen in which the skin was hard and coriaceous, sometimes much thinned, but rarely it is altogether wanting. When the skin is congenitally ^leficient a fibrous material occupies its place, if this be absent a bluish red membrane is exposed to view, the spinal <lura mater.

The derma many times is at first normal in thickness but owing to the pressure exerted from the accumulation of fluid within the tumor, it becomes thin and membranous. Even the dura mater has been wholly wanting leaving only the arachnoid forming the sac or tumor. The fluids may

*See frontispiece.

G. W. CARROLL, M. D. 447

ooze from the sac when the coverings are thus deficient, even when no aperture exists, but under these circumstances ulceration occurs and the sac finally bursts.

The tumors contain only cerebro spinal fluid. In figure one at A is represented the connection of the internal arach- noid or cerebro-spinal fluid. The external heavy dark line B, represents the sub-arachnoid fluid which is between the external and internal layers of the external arachnoid mem- brane, while the broad dark lines, C, passing through the column is the internal cerebro-spinal fluid and this com- municates with the interior' of the sac. Not only is the liquid of the canal in direct communication with the tumor, but often does the spinal cord, cauda equina, or some of the spinal nerves attach themselves to the posterior wall of the tumor. I believe you will observe this intimate connection of the cord with the sac where the tumors are sessile more often than in the pedunculated variety:

The symptoms of spina bifida are comparatively few but quite prominent. The tumor is always in the median line and invariably attached to the bones, the aperture in the canal can readily be felt if the tumor be not too well covered or tense. When the integument becomes attenuated the tumor is rather translucent, rendering somewhat visible the Cauda equina or the spinal nerves only.

The contents of the sac can in some instances be pressed back into the canal which also is connected with the ventri- cles of the brain — hence increasing the tension of the fonta- nelles or the size of the hydrocephalous. Other malforma- tians frequently accompany spina bifida the most comm6n of which is club foot.

The violent symptoms showing great disturbance of the cerebro-spinal center occur just before the fatal termination, as the tension of the tumor increases convulsions or paral- ysis is produced; death usually occurs shortly after these conditions set in and being the result of this functional dis- turbance of the cord.

Although the greater number of cases of spina bifida

448 SPINA BIFIDA,

have a fatal ending, there are others with favorable termina- tions. Where such termination occurs the tumors do not increase disproportionately with the growth of the child and closure of the orifice happily takes place, and indeed some- times, though rarely, there happens that an almost miraculoufl cure has followed spontaneous rupture of the sac. The great barrier to successful treatment of this malformation is the imminent danger of exciting a diffuse inflammation of the membranes of the cord and brain. Even slight injury to the cord or spinal nerves might terminate in gangrenous soften- ing of those parts. We therefoife learn that much depends upon a few favorable conditions.

It can truthfully be said that in the greater number of cases of spina bifida, it is a most delicate question as to what course of treatment we should pursue. When the child otherwise seems in good health and the sac free from ulcera- ation, slight pressure ought to be produced by a well-pro- tected shield, in hope at least to arrest further progress of the tumor.

We might be so fortunate as to find the orifice between the sac and the canal obliterated. When such is the case active surgical measures are highly commendable; ligature or excision either are followed by satisfactory results.

The mode of treatment now in vogue is injection of the sac by an Iodine solution ; the American method is to with- draw a portion of the fluid from the tumor before injecting. In evacuating the fluid care should be taken to avoid any injury to the cord, a small trocar or aspirating needle should be used and never ought the operator enter the tumor in the median line but to one side and pointing to the center of the sac In case the tumor refills as fiast as the fluid is removed, we must abandon the procedure for the result could only be fatal.

Sir Astley Cooper's method of treatment is certainly a good one, that of frequent tapping and the constant applica- tion of light pressure.

Wishing to call your attention to one of the most rare

REMEDIES DRY OR IN SOLUTION, 449

and peculiar forms of spina bifida, we present a case which came under the care of Prof. H. H. Baxter, Cleveland. Child twenty-one months old; spina bifida of the occiput, figure 3 represents shape of head and tumor and their corresponding proportions. This child, during the greater part of life, took nourishment freely and seemed rather healthful, with this exception and the hydrocephalic condition that you see indicated by appearance of the head.

The sac was considerably pedunculated and the cover- ing consisted of integument, cellular tissue, dura mater, and arachnoid membranes. The postmortem also revealed the brain almost liquid with numerous patches of pus, the sac contained more than two quarts of fluid. Figure two repre- sents the occipital bone convex surface; A is the deficient portion of bone through which passed the membranes and fluid extending within an inch of foramen magnum which is marked B. Many of the bones both in face and cranium were well- developed. Thrs is one of only six or seven cases of which we have any knowledge.

REMEDIES ADMINISTERED DRY, AND IN SOLU- TION.—THE DIFFERENCE.

J. N. LOWE, M. D., MILFORD, NEW JERSEY.

It has already been well said (and we accept the saying) — viz.: that the technique in the preparation of homoeo- pathic remedies has the aim to enable the drug molecules to come in the most intimate contact possible with the tissue elements, especially with the nerve-cells of our organism. For this reason the medical substance is "atomized" as it were, t. e., divided into the smallest constituent particles; in this state then, brought in contact with the mucosa of the oral cavity, it is able not only to penetrate the tissues and directly to act upon the ramifications of the nerve-fibre, but transferred to the blood, also to come in contact and enter into relations, according to the laws of chemical and physi-

\

450 REMEDIES DRY OR !N SOLUTION.

ological affinity, with those tissues which possess the sus- ceptibility to react upon it. Upon the irritation of the drug- molecuies as cause, a change of Junction of th« respective tissue-elements follows as effect or reaction. But, if a func- tional change in a tissue-part is produced by contact with the drug-molecules, it manifests itself through the entire chain of subsequent effects, even if the drug irritation or the impetus of all these motions and reactional results has not become an object of cognition ; indeed the vegetative processes within our body, even if the attention is directed upon them, take place as it is well-known, mostly outside of the sphere of our consciousness or, into the region beyond conscious- ness. All that is perceptible to us are certain terminal results in the chain of occurring effects which received the impetus from specific drug-molecules when they come in contact with cellular elements of our organism. The deter- minant processes of motion, e, ^., within the domain of our nervous system, are al ways molecular processes only, t. e,y they are based solely upon vibrations, or other motions of the minutest material particles within the axis-band of a nerve-fibre, and escape all perception and control, even upoa application of the most sensitive instruments, although the muscular activities resulting therefrom are very conspicuous. For the reception of this atomized medicinal substance, or potence the mucosa of the oral cavity fully suffices, and it is not at all necessary that such a drug preparation should enter the stomach, in order to develop its effects. It is, more- over, for this very reason more reliable in its action, since the substances introduced into the stomach are altered, more or less in their nature, and liable to chemical changes by the digestive secretion and the process of digestion."

When a patient is in a state of delirium, or is uncon- scious and moribund, medicine necessarily should be ad- ministered in solution. But in such instances, it occurs to us, the quantity should be simply large enough to be read- ily absorbed in the oral mucosa. However, we have no du> tumy nor ex-cathedra dogmas, to impose.

ARSENICUM AND BAPTISIA. 451

A physician and correspondent of the U. S. Medical In- vesHgatoTy — a few years since, stated that in a case of metror- rhagia which he had had in charge — the flow was promptly controlled when he gave a certain remedy dry upon the tongue — after the same remedy had no effect, given in solu- tion. For the sake of becomming more fully and decisively, satisfied, he again gave the remedy in the same potence in solution; the flow promptly recurred — and again was con- trolled, and permanently, from a like potence of the same remedy administered dry.

The demonstrations of our past experience impel us to believe, that Dr. W. J. Guernsey's "Rules," embrace the truth. To those who do not pursue a strictly legitimate course of pure homoeopathic principles and practice, they are of little worth. To profit by them presupposes quite an accurate knowledge of the Hom. Mat. Medica, and an unde- viating adherence to the "Law of Similars." This au fai accompli^ can only be acquired by much dilligent study, and hard work. There is nothing "come easy," "slip-shod," or casual, concerned in the acquirement of a competent under- standing of the philosophy of human existence — the philos- ophy of homoeopathy — homoeopathic therapy, and practice.

ARSENICUM AND BAPTISIA.

A COMPARISON.

BY S. ULIENTHAL, M. D.

ABSENICUM. BAPTISIA.

Astbensia accompanied by Asthenia with excessive pros- great restlessness and anxiety, tration and exhaustion of even sometimes by frantic des- strength. Mental fog. peration.

Great tranquility and cheerful- Mentally restless, but too life- ness, followed by terrible rest- less to move; confusion of ideas lessness and anxiety, worse after as if drunk ; feels scattered about midnight ; dread of death when and cannot get the pieces to- alone, gether. 4

452

ARSENICUM AND BAPTISIA.

ARSENICUM. BAPTISIA.

Tormenting delusions and hal- Low muttering deliriae. lucinations.

Stupor broken by anxious Stupor and unconsciousness, moaning. '

Great weight in head, which feels confused as soon as it is moved. Periodical headache.

Whirling vertigo and buzzing before ears.

Dull, heavy, pressive headache, with feeling of fullness and tight- ness of the whole head, with drowsiness.

Vertigo and weak feeling of entire system, especially of lower limbs and knees.

Swelling of the lids, pain on moving the lids, as if they were dry and rubbed against the eye* ball.

• Tickling, itching, burning eyes.

Photophobia, vision obscured and weakened.

Ophthalmia in all its different parts.

Eyeballs feel sore and lame, with great confusion of si^ht.

Eyes feel swollen, slight lach- rymation with burning.

Partial paralysis of lids, cannot keep them open.

Buzzing, singing, roaring in Dnll hearing; roaring in ears ears, with hard hearing as if the with mental confusion, ears were stopped.

Profuse, ichorous, offensive otorrhoea.

Cannot bear the smell or sight of food.

Stoppage of nose alternating with fluent coryza, causing burn- ing and smarting at nostrils.

Soreness extends to posterior nares;' when sneezing and blow- ing nose, epistaxis.

Sunken, yellow, ghastly fea- tures ; skin around mouth livid, face cold and sunken.

Flushed, dusky features, with a besotted expression.

Swelling and inflammation of Cracked lips, with bleeding the lips; bleeding of the lips; and ulceration of the bowels;

S. LILIENTHAL, M.D.

453

ARSENICUM.

painful tumor in the lip, with tearing, biting, burning pain, worse by touch,! n the air, at night.

(Esophagitis, sore throat when swallowing as from an internal swelling; spasmodic constriction, as if a ball came up in the throat. ' . (Gangrenous inflammation of throat.

Taste gone or bitter, sour, pu- trid.

Appetite abnormal or lost, with cravings for acids or coffee.

Nausea, periodically returning, with sensation of great weakness, worse during rest and motion.

Vomiting with great anguish, often immediately after eating or drinking.

Epigastric and umbilical re- gion sensitive to touch ; constant

jaw dropped, sordes on teeth and lips.

Swollen, bleeding gums; pain- ful to touch ; teeth seem longer, become loose, sensitive to pres- sure.

Tongue dry, as if burnt, de- prived of sensibility, excoriated at the tip with biting, burning pain.

Great dryness of the mouth and excessive thirst, but drinks only a little at a time.

Bad odor from mouth with malignant ulceration.

Teeth and gums sore, by press- ing with fingers large quantities of blood ooze out.

Dry. parched, thickly coated tongue; feels as if had been scraped, and sensation extending to fauces.

Mouth and tongue very dry; aphthae and putrid ulceration of the buccal cavity, with salivation, slight pain ; foetor oris.

CEsophagus feels as if con- stricted from above down to stomach, can only swallow water.

Dark putrid ulcers" in throat, painless.

Filthy taste; foul or bitter, nauseous taste.

Averse to nourishment or stimulants, but constant desire for water.

Feeling as if it would be a re- lief to vomit.

Retching and vomiting; desire to vomit, but without nausea.

Sinking, gone feeling in stom- ach, fainting.

454

ARSENICUM AND BAPTISIA.

ARSENICUM.

painful burning in region of ■stomach) with great anguish and feeling of weakness, feeling as though the stomach were dis- tended.

Burning pains, confined to sin- gle parts of the abdomen, or gen- eral, especially in hypogastric re- gion; great thirst and restless- ness, tossing and turning.

Diarrhoea, stools scanty, though irritation is great, of dark color, very offensive followed by great prostration.

Burning in bladder and ure- thra ; urine scanty ; great desire, but isability to pass urine ; urine turbid, cloudy, mixed with pus and blood ; albuminuria.

Yellow, acrid leucorrheea; in- crease of menstrual flow, even metrorrhagia in feeble cachectic women.

Constant tickling in trachea, provokes a cough, a feeling of rawness, soreness and burning in chest; scanty, tenacious mucus hard to dislodge.

Cough dry, fatiguing, paroxys- mal, worse at night, by drinking, motion and in fresh air.

Asthmatic constriction of the chest, dyspnoea, whistling res- piration, burning in chest, peri- odically recurring, worse at night.

BAPTISIA.

Constant burning distress io epigastrium, severe, colicky pains in umbilical and hypogastric re- gion, rumbling in bowels.

Constant aching distress in stomach and abdomen; right iliac region sensitive; pain in liver and gall-bladder, worse walking.

Fetid exhausting diarrhoea causing excoriation; thin, wat- ery, offensive diarrhoea, day and night; involuntary stools, often painless.

Urine very highly colored and scanty ; alkaline, fetid.

Menses too early and too pro- fuse; lochi» acrid, fetid.

Aphonia or hoarseness; pain- ful swallowing or speaking, and as if she wanted to raise much.

Tickling in throat provoking cough ; elongated uvula.

Asthmatic oppression of chest, with frequent yawning, worse from motion, better after resti dyspnosa with a tjght cough; sharp pains in chest when tak- ing a long breath.

8. LILJENTHAL, AT, D. 455

ARSENIOUM. BAPTISIA.

Precordial anguish, restricting Throbbing of heart, whose pul- respiration; irregular, violent sations seem to fill the chest, palpitation, worse when lying on* back.

Restlessness of limbs; exces- Aching in limbs from his fin- sive weakness and exhaustion of ger ends to his toes. Entire sys- limbs; cold limbs. tern feels weak and languid.

Sleep does not refresh; toss- Excessive drowsiness, restless

ing, twitching, jerking in dis- sleep with vivid, frightful dreams. turbed sleep; vivid, anxious dreams.

Incomplete intermttent, fever General fevers more than in-

often at night, thirst only during ter mitten ts. sweat; sweat at the beginning of sleep.

Inflammatory swellings with Prostration, with disposition of

burning, lancinating pains; drop- fluids to decompose; discharges

sies; atrophy; burning, corrod- and exhalations fetid, ing discharges.

Rhus has too much of an erethistic character to be com* pared with Baptisia; we find nowhere in the Sumachs that blood decomposition so characteristic of the latter ; in the secretions we find acridity instead of fetor, and notwithstand- ing its paralytic tendencies, we meet everywhere ameliora- tion from motion, a symptom which we could not expect in the extreme prostration of Baptisia.

The number of drugs which devitalize and decompose the blood is a large one; we need only mention the snake poisons and the Carbons, and still what a diflference is be- tween them, how each preserves its own individuality. Com- pare the putridity of the vegetable charcoal with the putre- facient power of the rattlesnake, and this again from the erethistic Lachesis and Naja. How the diflTerent mineral acids, of such great value in zymotic diseases, show their individuality and cannot be taken hap-hazardly one for the other. It is just this individualization of the drug which we miss in all our works on Materia Medica, and then we need

456 EVPA TORI UM PERFOLIA TVM,

a comparative Materia Medica to point out their modalities. Such works are far more the need of the day than these con- tinual squabbles on account of high or low potencies; such works would convince everybody of the great benefit inherent to Homoepathy, and that these can only be available by relying strictly on the law of similarity, and by prescribing carefully according to it. — North American Journal for Febru- ary.

EUPATORIUM PERFOLIATUM.

FROM THE SECOND EDITION OF THERAPEUTICS OF INTERMITTENT

FEVER.

BY H. C. ALLEN, M. D.

Characteristic. — Adapted to diseases of old people; worn out constitutions from inebriety.

Pains; osteocopic, affecting the back, limbs, head, chest, particularly the wrists as if dislocated, the eyeballs; the more general and severe the better adapted. Like Bryonia, they are accompanied by headache, constipation and pain in hepatic region, but here the similitude ends.

In Bryonia, the perspiration is profuse, easily excited by motion, and the pains compel patierit to lie still upon the painful side.

Pains as if broken; come quickly and go away as quickly (reverse of Stan.).

Vertigo; sensation as if falling to the left (cannot turn! the head to the left for fear of falling, Col.).

Followed well by Natrum mur and Sepia.

Aggravation. Motion; drinking; uncovering.

Type. — Tertian ; double tertian ; rarely, double quartan, and then only when changed from original type by Quinine. All types may be cured by it. Anticipating.

Time. — 7 a. m.; 7 to 9 a. m.; 7 to 9 a. m. one day, lighter chill at 12 M. next day; 10 a. m.; 12 to 2 p. m.; 5 p. m. Will

H. a ALLEN, M. D. 457

cure without reference to time, when totality of symptoms are present.

Prodrome. — Insatiable thirst, but drinking cause-s naxtsea and vomiting^ and hastens the chiU. Sick Btwrmch and thirst night before paroxysm. Thirst, sometimes for warm drinkg (Case, Ced.), from one to three hours before the chill; he knows the chill is coming because, " he cannot drink enough " (knows chill is coming because she is thirsty, Caps., Cinch., Nat. m.) ; yawning, stretching, pain in cack^ especially above right iUium, and the bones of extremities as if broken. Colicky pain in the upper abdomen (Coo ; painful soreness of the eye-balls, must be covered, before and during chill (covered during entire paroxysm, Nux v.). Hungry, (Cina).

Chill. — With intense thirst; but drinking water increases the nausea, and causes bitter vomiting (drinking causes vomiting, Ars. — drinking increases the chill — Caps.). Chilliness with excessive trembling and nausea (from the least motion). Chill' iness in the morning, heat throughout the whole day, but no per- spiration. Chill may leave for a few minutes and return again, but no heat in the interval (revei-se of Ars., which has alternate chill and heat). Shivering increased by motion; tense throbbing headache; pain in back and bones of extrem- ities; moaning with pain; distressing pain in stomach and spleen. Yawning and stretching ; more shivering than the degree of coldness warrants. Must be warmly covered (Nux. v.). Begins in or may spread from the bask, or run up the back, (begins in back between the shoulders, Caps., Polyp. — begins in lumbar region, Eup. purp. Lach.). At close of chill nausea and vomiting of bitter fluids and bile, aggravated by drinking, or after every draught vomiting (Caps. — sour vomiting at close of chill, Lye).

Heat. — Preceded by thirst, which is often felt most be- tween chill and heat (Ars., Cinch.), or there may be little thirst, when cephalalgia and bone pains are increased ; trembling, faint from motion ; great weakness ; cannot raise the head while fever lasts ; cheeks mahogany red ; throb- bing headache ; internal soreness from head to foot, all over

458 EUPA TORIUM PERFOLIA TUM.

the body (Arn.) ; sleep with moaning. Seldom any nausea during this stage, but bitter vomiting (sour vomiting, Lye) occurs at close of heat if absent at close of chill. Heat and lachrymation. Much shivering even during heat. "-4 sxoallow ofwaXerxcill make him shiver''^ (will make him shudder, Caps.). Pain in scrobiculus cordis. Fever in the forenoon, preceded by thirst early in the morning, but no chill ; attended by fatiguing cough, and not followed by perspiration.

Sweat. — Generally scanty, or absent altogether, in which case the headache continues for several hours after the fever m gone (Ars.). When there is much perspiration, U brings relief of all pains except cephalalgia^ which is increased (sweat relieves all pains, Nat. m.). Coldness during nocturnal swecU Perspiration; at night giving no relief; during sweat the slightest movement of patient, or jar of bed, willcause tran- sient chill to run through the frame, especially along the back on uncovering (Nux. v.) ; not debilitating if profuse (reverse of Cinch, and Carb. v.) When chill is severe, sweat is light or wanting and vise versa.

Tongue. — Coated white or yellow. Taste, insipid, bitter; food has no taste (Dros.). Desire for ice cream; thirst. Paleness of mucous membrane of mouth (Fer.). Cracks at the commissures of the lips (Nat. m.). Canine hunger after Quinine.

Apyrexia. — Imperfect; very little remission. Jaundiced hue of skin and conjunctivae: loose cough; if any sweat, it is attended with chilliness and worse from motion and uncov- ing. Bone pains are present in every stage, and only gradually disappear with disappearance jf sweat, feels worse morning of one day, and afternoon of next. The severity of vomiting has relation to the time of eating ; the nearer the meals the surer to vomit : first of ingesta, afterwards of bile, which is usually bitter. " Eupatorium perf., both by its 'pathogen- esis and clinical verification in practice, is one of the most valuable of the Materia Medica in the treatment of western intermittents."' — J. S. Douglas.

To this statement I would add that its efficacy is not

H. aALLEN,M,D.

459

bounded by latitude. Sometimes it corresponds to the genus •epidemicus, and will alone cure every cas^, particularly if occurring in autumn. It vies with Arsenicum, Cinchona and Natrum mur, as one of our sheet anchors in this disease ; its symptoms are "clear-cut" and well defined; its action prompt and decisive. It has cured in all potencies from tinct. to cm. "Eupatorium has been a favorite remedy with tl\e most successful practitioners where remittent and intermittent fevers have prevailed epidemically in miasmatic districts, along rivers^ at fisheries, on marshes, and their sev- eral neighborhoods."— C. J. Hempel, S, CJ, I., p. 696.

EUP PDRP.

lype. — Double tertian. 'Kme. — Difierent times of

day.

/Vodrom^.— Bone pains in arms and legs. Dry, hacking -cough in spells.

ChiU.—No thirst, or thirst for lemonade and acid drinks. Chill begins in lumbar re- gion, thence extends over body. Nausea as the chill is leaving, but no vomiting.

Heat. — Long-lasting; thirst, bone pains, as the heat is passing oflF (Cina., Cinch.)

Sweat. — Chilly ,when chang- ing position ever so little dur- ing sweat.

Apyrexia. — Vertigo, with falling to the left.

Urine ; profuse, urging, scalding.

EUP PERF.

Type. — ^Jertian.

Time. — 7 to 9 a. m. one day ; 12 m the next.

Prodrome. — Thirst several hours before, with bone pain and pains in back.

C^iZi.— Great thirst for cold water. Chill, with bone pains, pains in back, gaping, stretch- ing, throbbing headache. Bit- ter vomiting at close of chill. Drinking hastens chill and causes vomiting.

Heat. — With sleep; moan- ing, increased headache. "A swallow of water will make him shiver." (Caps.).

Sweat. — Bone pains disap- pear with disappearance of sweat.

Apyrexia. — Jaundiced hue: great weakness; anaemia, liight chill and profuse sweat, or shaking chill, and light or wanting sweat.

460 PRACTICAL NOTES,

PRACTICAL NOTES.

BY 8. L., NEW YORK.

1. G. S., 25 years old, compositor and steady at his work, took it in his head to quit work and instead of paying his board to his mother, whom he tenderly loyed, squandered his former earnings and his savings. No entreaties of his mother changed his mind, he was full of grand, wise ideas; labored under the delusion that the world is coming to an end and that he is appointed the judge over mankind. Dur- ing all these four months he steadily lost flesh, though his appetite was enormously increased, quantity he wanted, not caring for quality. His mother brought him before my clinic, and on account of the last symptom he received I odum, 200, three powders; one each night and placebo's. These pla- cabos, he took for three weeks and his mind has fully re- gained its balance.

We find under lodum ill-humor, aversion to work, fixed, immoveable thoughts, but here instead of the mental symp- toms; it was the physical symptom; voracious appetite and increasing emaciatioii, which led to selection of the remedy.

2. J. M., 80 years old, has nearly every winter a bron- chial catarrh, easily relieved by the usual treatment. This year it seemed more stubborn and failed to yield. The poor old man could not lie down; as soon as his head touched the pillow, a spasmodic cough-paroxysm set in, and after all he expectorated only a little phlegm. After the paroxysm he fell from sheer exhaustion into a dose, his head resting on his hand, as leaning backward would also produce cough, though less severe. During the day he felt moderately com- fortable, but weak and feared his end was close by. After the failure of many remedies the study of our Materia M^^' ica led us to Oroion iiglium, 200, which has among its sjoiP* toms (Clotar Miiller); cough much worse at night whenlyi^^ in bed, compelling the patient to jump out of the bed and sleep in a chair or to walk about the room on account of sense of suffocation.

DR, SWAN REPLIES. , 461

We find this symptom neither in Allen, Hering or Lippe, but we can vouch now for the accuracy, for the first night after taking a powder of Croton father M. remained the whole night in bed and slept good, as the few light paroxysms did not disturb him. Without any other medi- cine he is now fully recovered and enjoys his life again.

DR. SWAN REPLIES.

Mr. Editor: — In the article "Clinical Reflections/' in the January number of The Advance, the writer refers to a "specific for nose-bleed, which it was asserted^ would cure alt cases.^^

No such assertion was ever made. In an article in the November number of the Homoeopathic Physician^ I referred to a drug which I had found efficacious in every case of epi- taxis that I had treated. There was no claim for a specific, for I do not believe in specifics — except that a drug may be called a specific for a case, in which all the symptoms are covered by the drug action. I like honest criticism, but do not think it honest to put words in the mouth of another, that were never expressed, and then attacking him on the falsehood. Of course his statement will be read by hun- dreds, who will never know that it is not true. The same writer sometime since stated that I claimed that the potenti- zation of morbific products made them Homoeopathic to any disease. What I did say, was, that it made it Homoeopathic ta the disease which produced it, and Hahnemann is my authority for that. Sam'l Swan, New York.

BOOK NOTICES.

RECEIVED : Uterine Therapeutics. By Henry Minton, M. D., A. K Chattertoiv, Publlahlng Co. New York.

COUGH AND EXPECTORATION: A Repertorial Index of these Symptoms. Edited by £. Jbmminqs Lee, M. D., assisted by Geo. H. Clark, M. D. A. L. Chatter* ton. Publishing Co., New York, 1884.

A MATERIA MEDICA OF DIFFERENTIAL POTENCY. By B. F. Undkbwood, Ph. D., M» D. a. L. Chatterton Publishing Co., New York.

462 BOOK NOTICES.

A TREATISE ON INTRACRANIAL DISEASES; Inflammatory, organic and symp- tomatic. By C. P. Hart, If. D.' Published by F. E. Boerlcke. HahnenutDn Publishing House, Philadelphia.

AN OBSTETRIC MENTOR; a handbook of homoeopathic treatment required during Pregnancy, Parturition and Puerpural Season. By Clarence M. Conakt, M. D. A. L. Chatterton Publishing Co., New York.

HARVARD AND ITS SURROUNDINGS : Published by Mosbb Kinq, Cambridge.

This small volume of 100 pages is profusely illustrated, and gives an admirable history of this first American college. Price, $1.

KINO'S DICTIONARY CfF BOSTON : With an historical introduction by Obobge E. Ellis, D. D.

This volume of 518 pages gives a very complete history, both past and present, of Boston and its institutions. It is apparently free from the suspicion of being "written up" for the benefit of itfl advertising patrons. We wish we could say as much of many simi- lar works of other cities.

PRESIDENTS ADDRESS MEDICO-CHIRURGICAL SOCIETY, NEW YORK: By Dr. E. p. Fowler, pp. 34.

This address was delivered in 1882, and we nave long waited for the opportunity to give it the notice it deserves. This we can- not do even now as we have not the requisite space. The abilities of the author are unquestioned and he has exhibited them to both ^ood and poor advantage in this address. His labored attempt to demolish Homceopathy oi at least to prove the teachings of the Organon fallacious is not likely to do much injury with studi- ous and thinking minds, but this address may, if read, mislead those who depend upon others to do their thinking. If all the <loctor says is true, it simply leaves us in the quagmire pretty much where Hahnemann f-mnd medical science and art when he came into the world. This will not do for we know that the Organon has done much to lift us out of the bog and to plaee our feet on solid ground.

HOMiEOPATHIC PRACTICE AND PRINCIPLES OP MEDICINE: By W.R Dick- enson, M. D., Proseesor of Theory and Practice of Medicine in the Homoeopt- tbic Medical Department of the University of Iowa. Mills <& Co. Des Moines.

Our examination of this work has been done with unusual •care. We desired to be fully acquainted with it before offering any opinion as to its value. We do so now, believing that we are war- ranted in giving it our heartiest commendation. With so much ex- cellent medical literature crowding the market, it is no small mat- ter to offer the public a book so comprehensive and important as this. The author, however, after several years experience asamed-

BOOK NOTICES. 463

ical teacher, is well qualified to write upon medical practice, and we believe that he has given to the profession a first-class practical treatise. Its 730 pages are well filled besides being well printed . and substantially bound. We shall g^ve it a foremost place among oar text-books on practice, and have no hesitancy in commending to our readers as representing in the main the best of modern scien- tific methods in treating disease. As a work on general practice we have extant nothing better.

ST. NICHOLAS. Edited by Mrs. Mary Mapbs Dodoe.

The New York Tribune once said : " In the avalanche of immoral literature that threaten's the children, some strong, vitally whole- some, and really attractive magazine is required for them and St^ Nicholoi has reached a higher pl&tform, and commands for this ser- vice wider resources in art and letters, than any of its predecessors or contemporaries." The reference to the wide resources in art and letters commanded by St, Nicholas was never more fully illustrated ' than by the extraordinary list of attractions which that magazine announces for 1884. The following will be some of the leading con- tributors : Louisa M. Alcott, Captain Mayne Reid, Maurice Thomp- son, Charles Dudley Warner, Elizabeth Stuart Phelps, Julian Haw- thorne, Mary Mapes Dodge, Rose Hawthorne Lathrop, George W. Cable, Susan Fenimore Cooper, "H. H.," W. O. Stoddard, J. T.Trow- bridge, Hjalmar Hjorth Boyesen, Frank R. Stockton, Joaquin Mil- ler, Mrs. A. D.T. Whitney, Celia Thaxter, Lieut. Frederick Schwatka^ E. S. Brooks, Chas. G. Leland, John G. Whittier, C. P. Cranch, and scores of other distinguished writers. The best artists and engravers illustrate the magazine. It has been truly said that the reading of St. Nicholas is*'a liberal education" for the boys and girls who are fortunate enough to have it. In no other book or periodi- cal is instruction so happily blended with recreation and amuse- ment. The price is $3.00 a year, or 25 cents a number.

A DIQB9T OF MATERIA MBDICA AND PHARMACY. By ALBERT Merbell,M D. P. Blaxiston, Son & Co .» Philadelphia.

In some particulars this is the most remarkable work on Ma- teria Medica, which has appeared in years. The bold innovations^ and the advanced positions so frankly assumed by the author, will make it a ready target for criticism. If favorably received and fairly tested they will revolutionize the therapeutics of the Allopathic school. In the preface the author says: "Truth is the property of no one school of medical philosophy, and as each possesses special merit, it is the duty, as it should be the pleasure, of progressive and concientious physicians to dispassionately examine all remedies and

464 EDITORS TABLE.

curative methods and exercise in perfect freedom the right to adopt such as commend themselves as useful for the cure, palliation, or prevention of disease. In this spirit this work has been written, and though not willing to unqualifiedly indorse any single dogma of existing schools it is conceded that to fairly determine their re- lative merits, the special remedies and methods of each should be employed, whether what is claimed as their fundamental principle is admitted or not.*' He has also found the common sense proposi- tion enunciated by Hahnemann about one hundred ye^rs ago, that "a definite knowledge of their action can only be obtained by the employment and study of drugs singly, i. e. not mixed with one another as in the conglomerate pharmaceutical compounds of the day." He honorably gives Hahnemann credit for the preparation of remedies by trituration and recommends the decimal tritura- tions from the first to the tenth. This is, according to many in oar school, the limit of drug power, the line at which the microscope cestses to detect the presence of the drug. But he not only advo- cates the single remedy, but says, "it should be administered in small doses, repeated until the desired effect has been produced, and then withdrawn." Doctor Merrell should have taken one step' further and advocated the proving of drugs on the healthy as the only rational basis for a Materia Medica. Perhaps he will do this if a second edition be called for. Now it only remains to be seen whether such outspoken (not unheard of) innovations in the practice of ancient physic will be accepted and adopted by the profession, as facts, on the author's ipse dixit, or whether he will be disciplined by the American Medical Association for his presumption.

EDITOR'S TABLE.

Dr. R. B. Rush, of Salem, O., made us a brief visit, and looked over thQ University, and especially the Homoeopathic Department

J. P. Sutherland, M, D., appears as the new editor of the New England Medical Gazette. If he had not already been there some time incog, we might extend congratulations, as it is we wish him and his Journal success.

Dr. R. 6. DbPuy, of Jamestown, Dakota, against whom a huge black-mailing scheme was set up, has come out triumphant before the courts and is receiving the congratulations of his friends. The papers call for the speedy punishment of the black hearted con- spiritors.

Dr. Footers Potbntizeb. This is a new instrument invented

EDITOR'S TABLE. 465

by Dr. GK30. W. Foote, of Stamford, Conn., and is warranted to make the highest attenuations on the Hahnemann Centesima] scale with great celerity and exactness. The Doctor will tell you all about it if you write him.

Indiana Institute of Homceopathy. This long established and model society, will hold its Eighteenth Annual Session in Indian- apolis, on April 30 and May 1st. Our readers will do well to make a note of it, and when the time comes take it in by all means. Our Hooeier brethren never miss fire.

Thb St. Louis Periscope, of Homoeopathic Medicine and Surg- ery a monthly journal edited by Prof. E. C. Franklin, A. M., M. D. The initial number first received promises well for the new venture. We have no doubt the editor and publisher are competent to give their patrons their money's worth. We heartily wish them success. Thb North American Review, for February, maintains the excellent reputation of this standard periodical. It addresses itself to thinking men in every walk in life — to all who would reach well -digested, non-partisan conclusions on subjects of public inter- est, it is invaluable. It has the reputation of impartially presenting both sides of the question, thus insuring the broadest view of all matters in controversy, and enabling the reader to judge under- standingly, on which side in the confiict of opinion, the truth lies.

Dr. McLaren, of Detroit, reports a case, (see page 362) of dys- menorrhoea, in which there are no symptoms. This case must be anomalous. Hahnemann says : "It is as impossible to conceive as to demonstrate by human experience that, after the removal of «very symptom of a disease embraced in the totality of perceptible phenomena, anything but health should, or possibly, could remain, or, that after such removal the morbid process of the interior could still continue to be active. " Organon §8. If the Doctor will care- fully and prayerfully study the taking of the case" (Organon ?83— 110 Inclusive) and Dunham's anamnesis, he never will see another <;ase of disease without symptoms.

No Morphine. In a letter of recent date Dr. F. H. Orme says : *'I believe you know that my injuries were an oblique fracture at the middle of the right humerus^ and ah oblique and comminuted fracture at the surgical neck of the left humerus. This latter was exceedingly painful, and difficult to manage, and required the fourth setting before I was satisfied with it. Although the sufi'ering was terrific and long continued, and although advised by physicians to take narcotics, I determined to go through without them, and did so. I made a more satisfactory recovery in consequence, and avoided

466 EDITORS TABLE.

the danger of the "opium habit" which is so popular. Am now in my usual health, with a little increase in weight, and friends tell me I " look better than ever."

"27ie Century has the effect of greater luxury in editing than any of the rival magazines." — The N, Y, Nation and Evening Pott, Dec. 6, 1883. "From the very start this magazine boldly took up a forward position, and it has boldly and splendidly maintained its place. With each number has been clearly manifested its aggres* sive and intelligent enterprise, and far-reaching have been the results. During the past year, The Century has outdone its former work in almost every one of its departments. Some of its engrav- ings have been amazingly fine ; several of those in the December number are particularly so— the portrait of Peter Cooper especially. And its reputation has been, to our mind, as much widened by its improved excellence on the literary side as on the artistic.

American Pharmacy Abroad. — The aggressiveness of American enterprise received a very striking illustration at the late Interna- tional Pharmaceutical Exhibition held at Vienna, in the display of products from the laboratory of our energetic countrymen, Messrs. Parke, Davis & Co., of Detroit, Michigan. We notice in the reports as published in the domestic journals, and from the special corres- pondence of foreign journals, that this display while exciting much interest from its scientific features, attracted more than ordinary notice from its artistic beauty and finish among the non-profeesional visitors. This lay interest was, doubtless, largely due to the special attention given the display by the £mperor and the Archduke Karl Ludwig. These royal visitors manifested unusual interest in this exhibition of American taste, and took occasion to especially com- pliment the firm, through its representative, on it« enterprise and skill. We congratulate Messrs. Parke, Davis & Co. on the distin- guished recognition of the artistic excellence of their laboratory products. Their intrinsic worth needs no commendation from us; this has long been conceded by the profession. The gold medal awarded them by the Vienna Exhibition is but an endorsement of the esteem in which this scientific commercial house is held in this country, where it is best known. — HalVs Journal, The writer of the above might have added, had he known the firm as well as we do here at home, that as manufacturers they are not only enterprising but hfynest The utmost care is taken, especially in the preparation of their Normal Liquids to secure uniformity of strength and quaW ity. The members of the homoeopathic profession who find it nec- essary to use fluid extracts, will find these much more reliable.

li.'Cfe'* Vf Gee '± Pei-ine K York

^r^SiIuu^^

,^=^■-

->>sr

T. P. WHAOlf, H. B.,

Bditob.

PHII. POBTER, H. B.,

GTinKX)LOOICAL EDITOB.

Vol, XIV.

Ann Arbor, March, 1884.

No. 9.

All subscriptions and business oonununications should be addressed to MEDIOAL ADVANOB PUBIilSHINa GO.', Ann Arbor, Mioh. Subscription, $2.00 per annuTn,

H. O. ALLBN, M. D., Business Manager.

The World Moves. — The College of Physiciana and Sur- geonSy of Detroit, has decided to take up the Organon for consecutive study. This is a step in the right direction. By a careful discussion of the principles of the Organon^ and the study necessary to enable them to discuss it understand- ingly, many of the members may be enabled to see new therapeutic light. And we sincerely trust that the study will enable them not only to see new light but to practice it also. THere are other homoeopathic societies that might with advantage follow this example. If we are to judge by their practice, so far as many members are concerned, the Organon might as well have been written in Sanscrit. It, however, requires something more than a simple reading, something more than a discussion: it demands years of study ere it is mastered. A student would be poorly pre- pared for an examination in mathematics who had only read Euclid's Geometry. It must be studied. After fifty years of

468 EDITORIAL,

hard and original work by the most careful observer the medical world has yet produced, the Organon — the founda- tion stone of the science of therapeutics — is given us as the result of his experience. Hering, Dunham and Haynel quenched their thirst at this fountain. Guernsey and Bayard and Wells take counsel from its teachings. Lippe says: "It is now over fifty years since I first read the Organon. I just begin to comprehend it."

And it is possible that even Hahnemann *'builded wiser than he knew/' when he gave us its almost prophetic instruc- tion.

Take for example his masterly advice how to examine a patient, which at the time it was written was an unheard of innovation in the history of Medicine.

"In chronic diseases the investigation of all symptoms should be conducted as carefully and circumstantially as pos- sible, and made to penetrate the minutest details, because they are most peculiar and most unlike those of acute affec- tions, and also because they can never be too accurately considered for the purpose of successful treatment. Again, chronic patients are so inured to sufiering, that circumstances however charcLcteriatic and decisive in the selection of the remedy^ are rarely if at all, mentioned by them, but rather consid- ered as a part of their unavoidable condition. It rarely occurs to them that other small or great deviations from the healthy condition, might be connected with the main disease.

*'A physician accustomed to exact ohservaiion^ may approach the true condition of an epidemic so closely that he is ena- bled to construe a characteristic image of the same, and even to discover the appropriate homoeopathic remedy.

"By writing down the symptoms of several cases of this kind, the sketch of the disease will gradually become more complete; without being enlarged by additional phrases, it will be more closely defined (more characteristic), and made to embrace more of the peculiarity of such collective diseases. General signs, such as want of appetite, sleeplessness, etc., ar€f specified and defined. More prominent and special

EDITORIAL. 469

symptoms will be made conspicuous by proper notation and constitute the characterUtics of the epidemic,

^^ When all the prominent and characteristic symptoms, collectively forming an image of a disease, have been care- fully committed to writing, the most diflScult part of the work will have been done.

"The search for a remedy consists in the comparison of the totality of the symptoms (of the sick), with the symp- toms of our proved drugs. In making this comparison, the more prominent^ tmcommon and peculiar (characteristic) fea- tures of the case, are especially and almost exclusively con- sidered and noted; for these in particular should bear the closest similitude to the symptoms of the desired medicine^ if that is to accomplish the cure. More general and indefinite symp- toms, such as want ot appetite, headache, weakness, restless sleep, distress, etc., unless more clearly defined, deserve but little notice on account of the vagueness."

To thus examine a patient and carefully record the symptoms is the most diflBcult part our work. To simply write down a train of symptoms is of little use to the phy- sician or patient. But the difficulty consists in selecting the symptoms which are guiding or charaqj^eristic of this partic- ular case. Dunham says: "To select the remedy after a masterly examination and record of the case is comparatively an easy matter." But to take the case after the method of Hahnemann, requires a greater knowledge of the natural history of disease, of human nature and of the Materia Medica, than is possessed by most of us.

But it has been said that this method is " impracticable,'' " inconsistant with our modern business ideas," " would be impossible to do a large business if we wrote down the symp- toms, etc., etc." J.ust here is where Hahnemann was right, and we are wrong. That it is exact and scientific, no one will deny. Can it be put into successful practice? There is the rub. Those who have tried it, do a large business and pronounce it a success. It is the first attempt to reduce the practice to a systematic basis. Our Oculists have adopted it

470 D YNAM1C8 OF SANITAR Y SCIENCE,

in their measurements of vision. Our general practitioner has established his office hcurs^ and to those who will give Hahnemann's method a trial, we predict its adoption. It is not only the most accurate, most scientific, but by far the most expeditious method ever yet proposed. It will do away with routine prescribing. It will be the death-knell of alternation. It will kill the gigantic fraud known as ^'dilutionism," because under this plan our practitioners will learn Hahnemann's great lesson that it is upon the sdeetion of the remedy^ not the dose — ^the perfect simillimum, not the attenuation — that the cure-work depends. h. c. a.

THE DYNAMICS OF SANITARY SCIENCE.

OB THE RELATION OF THE NATURAL FORCES TO THE ETIOLOQY OF EPIBEMIGB.

BY ■. B. KO«LI8T0M, M. D., KT. VXBHOll, a

[Ccnuiudedfium ihe Janwxry JVo.]

Among the various circumstances which may excite or depress the evolution •f electricity within the body, may be mentioned the ingestion, or not, of proper quantities and qualities of nutriment; its perfect or mal-digestion and ab- sorption; its complete or incomplete assimilation; the prompt rejection or retention of waste, and the conservation of the force so generated. These are important matters in view of the high or low degree of resisting power which is their im- mediate result, because the body will well or ill endure the exciting or depressing external influences accordingly. The living body is electrically positive, and so is the atmosphere. It may be taken for granted that if the evolution of positive electricity in the animal body is normal in degree, then, the atmosphere being electrically positive also, nO antagonism exists between them. But an electricaUy positive extreme imposed upon an already positive object at a mean, must impart to it of its abundance, until no antagonism exists ;

E, R. BOOLESTON. M. D. 471

hence the object becomes positively charged to an extreme degree. So, likewise, if a positive influence of low degree be brought to bear upon an object at a mean, the influence withdraws force from the object until their antagonism dis- appears, with the result that both are below a mean. The inference is plain, that the human body being overcharged with positive electricity from an extremely positive atmos- phere, or having its norm degraded by an atmosphere of low tension, loses in resisting power and falls an easy victim to pestilential influences. For, whatever may be claimed and admitted as regards extreme conditions of the atmosphere, it is beyond question that animal existences are conditioned to a mean.

In general, much that is true of positive atmospheric electricity, is also true of negative Terrestrial Electricity. But in special terms marked differences exist, and notably so as regards the relations of the latter with animal life. Here there are no antagonisms, but there are reciprocities. In the former case we observed a struggle, so to speak, be* tween varying degrees of a positive force, a struggle for equalization ; but in the latter we have to deal with both positive and negative states, and the struggle is for «n equil- ibrium. It is to be presumed that the positive electricity of a living animal body at a mean bears a close reciprocal rela- tionship with the negative electricity of the earth upon which he stands, at its mean. As long as the equilibrium prevails, or is modified only by a wave-like oscillation which represents the inherent elasticity of the polar forces, no marked disturbances may occur on this account, but once the boundary of elasticity overreached, and the struggle be- gins. The animal frame, evolving positive electricity and receiving in kind from the atmosphere, may evolve too little or receive too little, on account of depressing conditions in both, to preserve an equilibrium ; or the negative states may be overpowering, or so small in degree as to almost lose their counterbalancing power; in either case, the loss of equi- librium is the loss of the conservative element which is the

472 D YNAMICS OF SANITARY SCIENCE.

prime condition of a healthful animal existence. There being given, then, such conditions of least resistance, on which are imposed other material or immaterial elements of excitement or depression, are not the requirements of pesti- lental activity more or less completely met?

In the reciprocal relations existing between the electric states of the earth and its atmosphere there are elements which may assist to a comprehension of this matter. In the outset it is fair to assume the existence of an equilibrium between these forces. Having previously assumed the pos- sibility of a state of equalization between a positively elec- trified animal body and a positively electrified atmosphere; and that an equilibrium may exist between a positively elec- trified living animal body and the negatively electrified earth upon which he stands; and that modifications of these conditions which tax the powers of resistance beyond a cer- tain degree are prejudicial to animal existances, we now in- quire as to the probable effect of fluctuatin electrical recip- rocities. A chief characteristic of electricity is itsunstable- ness — that is, it is in a state of constant fluctuation, or ebb and flow. Now if, as seems to be the fact, it be generally ac- cepted that solar heat is positive electricity, then it follows that the earth in absorbing the heat rays become less and less negatively electrified, while at the same time the objects upon its surface become more positively electrified. Whether it might be within the range of natural possibilities that the unbroken accession of positive electricity through the solar heat rays would at least neutralize negative states, may not be a question based upon strictly legitimate premises, but common observation gives the hint for the extended idea, in the arid, treeless desert; in the drooping, stunted, fruitless vegetation in times of drought; and in the lassitude, weak- ness and prostration, mental and physical, of all animal life, which obtains in seasons of excessive dryness. Whatever the possibilities may be, the fact is that the universal regu- lator, moisture and its evaporation, are happily always pres- ent in some degree, so that the tendency toward an equili-

E. R, EOOLESTOK M. D. 478

brium finds in it a means for its accomplishment The pos- itive heat rays are poured upon the negative moist earth, but instead of being absorbed, a large proportion is carried back by the vaporization of water, the absorption of the res- idue being within the limit of excess. Other factors are at hand as means to preserve an equilibrium : Darkness — or the absence of solar rays; so much of positive electricity as% has been absorbed during the presence of heat rays is parted with again to the atmosphere, to further evaporation, and to the uses of organic formations ; vegetable growth, vast quan- tities of electrical energy being exhausted in these processes. Students of meteorology are well aware that during what is known as high barometer, or high pressure, when cooler puri- fied air is being poured down upon the earth's surface from the upper regions, that a more highly positive condition of the atmosphere obtains. Of course, then, the upward cur- rents, which are displaced, and which are loaded with moist- ure and poisonous materials, have had their positive stat« neutralized, and the more so the longer the air has remained in contact with the earth's surfae. There being por- tions of the earth's surface whose meteorological' state is that of perpetual high barometer, others -that of per- petual low barometer, still others where it is periodically high or low, and again others where there is constant fluc- tuation, it may be appreciated, by inference, at least, what a tremendous tax is laid upon animal life, the resisting powers of which are conditioned to a mean. The animal whose habitat fallis within range of these barometrical variations might become habituated, doubtless, to the new condition if it were perpetuated suflBciently, but just there is the difficul- ty, it does not perpetuate itself; but instead, this extreme may be followed almost immediately by the other. Under such conditions animal life necessarily loses in resisting power. There being given, then, the struggle of animal life to equal- ize its electric state with that of a positive atmosphere ; its struggle toward an equilibrium with the negative electric earth; its struggle to maintain harmonious relations with

474 D YNAMICS OF bANlTARY SCIENCE.

the fluctuating high and low degrees of electric tension which exist between the earth and atmosphere ; then if to these conditions there be added other elements which shall prejudicially excite or depress, are not the predisposing fac- tors for epidemic activity present in a d^ree that shall de- termine an outbreak ?

As preliminary to a study of the effects of electricity upon an animal body, it must not be forgotten that it is charged positively to its norm, and in that state its charge is not phenomenal, becoming so only as the charge is increased or decreased, so that its range is above or below the norm. Let it be borne in mind, also, that it is only positive elec- tricity which is appropriated, the effect of negative electricity being of a neutralizing character exclusively.

Positive electricity has the property of a general stimulant Like other stimuli, the stage of excitement, from either an overdose or a too prolonged application of it, may run over into spasmodic action, hypersasthesia, anaesthesia, paresis or p^alysis. It may be inferred that active or hyperasthenic inflammatory affections are made possible, because the body is electro-positive in excess. On the other hand, n^ative electricity has the property of a general depressant. Under its action, and because of its abstracting power, all of the bodily functions are performed less vigorously in proportion to the loss of positive power. It is to be inferred, then, that when adynamia, zymosis and sepsis characterize the type of prevailing diseases, it is because the conditions are — not electro-negative, but of a positive grade below the norm, and that in proportion to the abstraction or neutralization of positive electricity.

In making these distinctions I hope it is observed that emphasis is laid upon this proposition: That no such thing as a negatively-electrified living animal body exists or can exist. It is as well to say that under certain circumstanoes the absorptive and secretory organs have exchanged their functions; as well to say that the circulatory fluids are inter- changeable, as between arteries, veins and lymphatics; or

if. A. moLESTOlf. M. t). 475

that the biliary secretion may act as a solvent of albumi- noids. Such anomalies have no existence; then why the claim that so anomalous a phenomenon may present itself as that of a being which has a prime condition 6f its exis- tence an electro-positive state, may under any sort of cir- cumstance, have its prime condition changed to a diametrical opposite?

The process of abstraction or neutralization of positive electricity results in chemical changes, which are those of decomposition— dissolution; hence they are electrolytic, and are representative of diseases of degenerative type. It is true that over-charges by positive electricity likewise result in degenerative changes, and the criticism might be ur^ed that retrograde metamorphoses being characteristic effects of either class of phenomena, the distinction is a practicable one, but I think upon reference to some other recognized conditions it will appear to be not well-founded, for the latter will be seen to be consecutive to previous stages of exaltation. Defective nutrition or non-use of an organ eventuates in hyper-sensitiveness, functional degradation, powerlessness, and atrophy, successively ; over-nutrition or over-stimulation of an organ eventuates in hyper-sensitiveness, functional degradation, powerlessness, and atrophy, also successively. Why, then, is the premise unsound, that hyper-excitation by positive electricity, and electro-positive abstraction by negative states, should each result in annihilation o£ vital- ity, and that through a series composed of the same steps, but by opposite directions? Another good illustration of the point involved may be found in the trophic changes in- cident to some affections of the spinal cord, the same or a similar degeneration resulting from either atrophic or hyper- trophic diseases. Now mark the stage of these processes at which the peculiar epidemic disease element finds its proper nidus or the peculiar elements necessary to its development. In conditions representing the abstraction or neutralization of pos- itive by negative electricity, it is at that point where the vital resistance is unequal to the onsetting morbid force; in con-

476 TOTALU Y AND INDIVIDUALITY.

ditions representing electro-positive force in excess, it is at that point where the vital resistance is unequal to the onset- ting morbid force. They are precisely the same.

TOTALITY AND INDIVIDUALITY.

VERIFICATIONS.

BY J. T. KENT, M. D.. ST. LOUIS, MISSOURI.

Case I.— Thuya: A lady who suffered from sycotic ex- crescences became reduced from repeated hemorrhages. When she would go for some time without the loss of much blood her totality of symptoms was similar to Thuya, but an ex- haustive flow would add several symptoms to the original picture and mask the individuality of the true chronic dis- order. One symptom in particular was a cold feeling in the left side of the head; another, cold damp feet These would make a young man most naturally think of Calcarea, but a closer study must result in a conclusion that Calcarea could only result in a failure to cure until Thuya had removed the sycoctic nature of the disorder. The cold sensation is not found under Thuya, but the case made a good recovery, be- cause it was similar to the ruling features of the case. Now because Thuya removed the individuality of a case with the cold left side of the head, it is no sign it will even remove that symptom. It only shows that the individuality of a disease must be known; such information is best acquired by observation in the wilderness of symptomatology. The path- ologist might score this as a victory for himself, but he only has learned it irom a careful individualization of symptoms.

When the evidence of a chronic miasm is suppressed by- acute symptoms, the acute symptoms should be removed by a remedy corresponding to the acute or last appearing symp- toms, after which the individuality of the chronic miasm will be manifested by its true expressions or symptoms. These little things were well known to the great Hahnemann, and are taught in the Orgarum and Chronic diseases.

/. T. KENT, M. D. 477

No Homoeopathist can make a truly homoeopathic pre- scription when the individuality of a disease is unknown, or only partly known. The individuality can only be known by observing and knowing all the symptoms. When a woman calls for treatment with a pessary in her vagina, she will most likely fail to obtain a correct remedy because her symptoms are masked or changed so that the totality does not express the individuality of the disease. The pessary should be removed, and the disease permitted to express it- self in the language so well known to every true Homoeo- pathist. After a week the symptoms will most likely express the individuality, in its totality of symptoms, and then an appropriate remedy can be found. There is no other way known. These things were all known to the great Hahne- mann. The ignorant pretenders use supporters and smile at the Organon^ and go on with their failures; they seem to glory in their ignorance of the true heahng art

The physician who does not individualize uses Morphine to stop pain and reports his ignorance to the society, having the audacity to ask what remedy he should have used. The question asked, no less than the failure, shows that he is not acquainted with the teachings of the Organon. Each case must be studied with a view of its own individuality. The physician who is not competent to direct the appropriate remedy is not acquainted with the individuality of his case; and with such ignorance of his case, how can even a more competent physician inform him what an appropriate remedy might be? The questioner could prescribe for his own case as a general thing if he would individualize correctly. These are the ones who are wise enough to direct remedies on their knowledge of pathology, only to fail, and then have the audacity to ask for the right remedy to be pointed out.

Cask II. — Murex Pub: Mrs. K — aged 40, a midwife. She complained of the abdomen; she believed she had a tumor. Severe knife-cutting in region of uterus running up to left mamma ; pains, undefined, running up and through the pelvis, worse lying down ; aching in the sacrum, dragging

478 TOTALITY AND INDIVIDUALITY.

down in the uterine region as if the uterus would escape. Empty, "all-gone" feeling in the stomach. Greenish-yellow leucorrhoea, with itching in labia and mons veneris; intense sexual desire. The os uteri was said to be ulcerated and eroded, and it was sensitive to touch.- The contact of the linger with the cervix brought on the sharp pain that she de* scribed as running to the left mamma. The uterus was en- larged and indurated. She had been the mother of several children ; had had several abortions, and was accustomed to hard work. She had been treated locally by a specialist of acknowledged ability, and she had taken many remedies of his selection as well as from her own medicine case, all very low. Her catamenia quite normal.

To take up the important and guiding features of this case we must compare several remedies, but principally Murex and Sepia.

The cutting pain in the uterus has been found under Ourare, Murex and Sepia^ but Murex is the only one pro- ducing a cutting pain in the uterus going to the left mamma.

The "all-gone," empty feeling in the stomach is character- istic of both Murex, Phos. and Sepia.

Throbbing in the uterus, belongs only to Murex. The dragging down is common to both Murex and Sepia, but the sexual teasing only to Murex. Both have a yellowish green leucorrhoea. Pain in sacrum is common to Murex, Sepia and many others. " Enlargement of bowels " is found in Allen under Murex, not mentioned in Minton's Uterine Therapeutia. The pains in Murex go upward and through, worse while lying down. In Sepia the patient is better lying down, and the pains go around.

Murex 200, one dose was given. She was much worse for several days. Then improvement went on for two weeks. The remedy was again repeated. One year later she com- plained of a return of her symptoms. One dose was followed by relief, since which time she has made no complaint, but praises the individualizing method.

J. 71 KENT, M. D. 479

Case III. — Silicba : Frank H , a compositor in the

Globe-Democrat office, St. Louis, came to my office to have a tumor removed by the knife. It had been removed twice and was called a recurrent fibroid. It was the size of a hen's eggj and very hard, located in the left side of the neck, not connected with the parotid, though growing a little below it. I advised him to give me time to prepare him for removal. I took his symptoms and found that he was better by wrap- ping up even the head. He was timid in going into a new enterprise, though abundantly able to perform the task. He lacked confidence in his awn ability, yet when he had begun he would do weU.

He took Silicea, 6m., April 1, 1883. Six weeks later he called, and the tumor was reduced one hiilf. Sil. 72m. dry, one dose. Six weeks later almost gone. January 23, 1884, Sil. 72m., one dose. The tumor has disappeared. This pre- scribing has been commented on by a large number of friends, who think the one dose business a mystery. He got no Sac. Lac, as I had his confidence. I did not prescribe for the tumor, but the patient. My prescription could not have been different had the tumor not been present.

The tumor was not included in the totality of symptoms as it was not a symptom; it furnished no part of the guide to a remedy. The symptoms expressive of the whole state ex- isted prior to the tumor, and it wajs the language of this pre- existing state that I must read, as out of this pre-existing state ffcew the tumor. I must interpret the language or ex- pressions of cause, not effect. The man who is guided by path- ology can use the knife. To use the knife is but to acknowl- edge one's ignorance of a method, by which he can avoid cutting.

Case IV. — Phosphorus : Mrs. G , widow, 42 years of

age, was afflicted with periodical attacks of Choreic Spasms. I called at the house one day and removed a tumor from the hand of her mother, and the excitement brought on the most intense spasmodic jerking of the whole body. Whenever a thunder storm is raging she has these attacks^ said her mother.

480 TOTALITY AND INDI VID UA LITY.

They last two or three hours. I administered Phos. 6m. dry, one dose. Thunder does not affect her now. She never had another attack. Her whole constitution and mental state have changed. She considered herself an invalid and ex- pected no relief.

Case V. — Sepia : Mrs. K , a married woman, 28 years

old, came to me from the country, with what a gynecologist had called a prolapsus. She was a tall, slim woman, other- wise in good health. She was wearing a Hodge pessary. She could not walk or stand long without her '' ring." She came to the office in a carriage. I removed the ring and gave her Sac. lac. At the end of a week I had noted the following ' symptoms:

The urine passed slowly, and she must wait a long time for it to start. Sepia., Lycop., Am., Hepar, Zinc, Cann., ind. She was greatly constipated, and always felt a lump in the rectum, even after stool, Sepia. She complained of a hungry, empty feeling in the stomach, Sepia, Murex, Ign. Hydrastis and many others.

She always had a bearing down in the pelvis, as if the uterus would issue from the vagina,' Sepia, Murex, Lillium tig, Nux, Natr., Puis, etc. She must press on the valva with a napkin for relief. Sepia, Murpx, Lillium. She often crosses her limbs to prevent the uterus from escaping, Sepia. Tall slim and sallow, Sepia. She got Sepia C. M. (Fincke). one dose dry and Sac. lac. It is three years since this case called, and she has never needed a physician since; she was aii in- valid before. The one dose cured her.

Case VL — Lillium tig: The above lady went home and sent me a similar case. She called it ^'a case just like mine." She was a short stout woman, dark hair and eyes. She had worn a Hodge pessary for a year. She was unable to be about at housework, without the pessary. I removed the pessary and informed her that she would need to visit my office every day for a week or so. She was given Sac. lac. and every day I noted symptoms, until at the end of a week I believed I had the symptoms that expressed the indivi-

BELLADONNA IN TOBACCO POISONING. 481

duality of the disease. The most marked feature was her mental state. The remedy that would cure this case must have mental symptoms of prominence in its picture. She complained of a wild feeling in the head, and feared she would lose her reason, Lillium. Bearing down in the pelvis as if the uterus would protrude, Sepia, Lillium, Murex, Natr., m., Nux., v.. Puis, Pod, and others. She must press on the vulva with the hand to prevent the parts from pro- truding, Lillium, Sepia, Murex. There were some flying pains going through the pelvis and down the thigh like those found in Lillium. She took Lillium tig, 30, for a day in waterl and then Sac. one week. She had then improved so much that she had walked over the Zo5logical garden, which she had not undertaken even with the pessary in situ. She was sent home with a few powders of Lillium 200, to use as per instructions, viz., to be used when she felt a return of the difficulty. One year later she wrote me that she had taken one of the powders, and was keeping the others with great care. For this last case I was presented with a check of $50, over and after the full payment for my services. The husband said it was the cheapest doctor bill he had been called to pay. One gynsecologist had receipted a bill for $200, and this was but a small part of the "«icA; experwee." It may not pay as well to practice pure homoeopathy, but it is the honest way.

BELLADONNA IN TOBACCO POISONING.

The efficacy of. Belladonna, in bad effects from smoking, was graphically demonstrated to the writer by the following incident in the army, he being at the time (1862) hospita- steward of the 27th Pennsylvania Regiment, in winter quar- ters at Hunter's Chapel, Va.

One afternoon the orderly sergeant of Company C called at the tent of the assistant surgeon of the regiment, the late Dr. Max Heller, almost beside himself with a furious head- ache. He stated that having made a bet of being able to

482 CLINICAL VERIFICATIONS.

Rmoke ten strong cigars within one hour, he did smoke eight in forty-five minutes, when a furious headache compelled him to desist. Being present at the time in the tent, Dr. Heller, turned around to the writer remarking: ''See here, Adolphus, give him some of your pellets; I cannot do anything for him." I had a pocket case of two hundredth potencies along, and inexperienced as I was at the time, gave the man six pel- lets of Belladonna^, dry on the tongue. Within less than fifteen minutes the sergeant called again, and a more aston- ished face I never saw before. He protested that the pain had ceased entirely, and wanted to know what wonderful medicine I had given him. Since then I have had frequently occasion to administer Bell, for bad effects from smoking, and invariably with good success. A. J. T. in Jan. Bulletin.

CLINICAL VERIFICATIONS.

BY D. B. MORROW, M. D., SHERMAN, TEX.

If observant homoeopathic physicians would truthfully collect their clinical experiences, the virtues of homoeopa- thic medicine would be so well defined as to make its prac- tise a pleasure. This they do not do, but are homoeopathic quacks. *' As much an allopath as an homoeopath, using the most appropriate system, &c," read none, think little, spend most of their time telling Maunchausen stories of their won- derful cures, and never add anything to the general stock of knowledge.

Cask i. — Vabiounum: During the winter of 1882 and 1883, we had here a little small-pox epidemic, the allopathic city physician treated all the cases (excepting one which oc- curred in the practice of Dr. H. C. Morrow,) and mistreated that one, as he probably did all the others, since one-third of all the cases died.

Greorgie Upton, a child of five years, not vaccinated, seized with fever and violent spasms, for which I prescribed as in- dicated, small-pox a square away, but no chance to take it

D. B, MORROW, M. D, 483

The fifth day an eruption was out, saw it with Dr. H. C. M., the blisters were thick and confluent in many places, palms, soles, throat, and pallate— fever subsided, and child comfort- able. Only one of the family of five had been vaccinated. The mother had a child in arms ; were poor, living in two small rooms; and because of the opposition in our clientage to . our visiting them while attending small-pox patients, we determined to turn the case over to Dr. W. the city physi- cian.

We had a third trituration of Variolinum, from Luytie's which had been standing uncorked in a drawer for a year, of this a small portion was dissolved in aqua dest. and diluted in alcohol, making a fifth potency ; of this potency we gave ten drops in a small glass of water, and administered two teaspoonsful to every member of the family, and left a small bottle of Swan's c. m. m. potency of Variolinum with the re- quest that they administer another dose before Dr. W. was called. This they did not do. And with the further request that when Dr. W. abandoned the case, this medicine should be administered, a dose each hour until better. Then a dose every three or four hours until recovery was assured, when it wsB to be discontinued.

The city Dr. confirmed our diagnosis ; pronounced it the worst case he had seen, and vaccinated the family, and they said ** it took;" but of this latter statement we are doubtful, because we have done considerable vaccinating here and have yet to see a healthy vaccine pox.

A time arrived in the progress of this case when Dr. W. said, "all that can be done for the child is nursing," and the nurse said "he can't live until morning," and went to attend to other cases. Then Mr. Upton gave the Variolinum as di- rected. He said that in twenty minutes after the first dose, the child was better, and in an hour he considered him out of danger; patient made a good recovery, but was badly marked about the nose and mouth. The worst feature was in the throat. There was no bad odor about the patient dur- ing dessication. Mr. U. had two very small sores on his

484 CLINICAL VERIFICATIONS,

head, supposed to have been varioloid. None of the other members of the family had any disease whatever, while all other vaccinated parties who were exposed, had varioloid. The facts in the case made all the old women in the neigh- borhood deny that it was small-pox.

Case ii. — Thuya: Mrs. (Jeorge Piere, wife, second hus- band, aged 35, sanguine, red hair, emaciated, had a severe . neuralgia over, and in, and about left eye; had suffered for several weeks continually. Her allopathic doctors said noth- ing could be done but to take large doses of Morphine and Quinine, and to keep on taking it. The domestic doctor of the neighborhood was dosing her on Chlorate of potassa, for a sore throat. Eye bandaged, could bear no light. Relieved the pain in about five minutes by means of magnetic passes, so that she stripped off the bandage and looked straight into the flame of a kerosene lamp without pain, and had the first good sleep that night for weeks. -At a subsequent visit in daylight, she said : " Now there are my hands." The palms were exfoliated, hacked, bleeding and sore. Said it must have come from vaccine some years before, when she had a very sore arm, and since then had been troubled with sore bunches about the rectum and genitalia,. which one of the doctors had once removed with scissors. These were not now present Hands and neuralgia worse ever since. Thuja 200, followed by Sulph. 200, and Arsenic 200, quite restored her to health.

Case III. — Apis-Syphilinum: Letta Keam. This was a bright little girl of 5 years, enjoyed usual good health with the exception of enlarged and irritable tonsils. Had just recovered from a mild tonsilitis, when her father who was preaching in " the Territory," obtained some good scab from a good Indian brother, and on bis return to the bosom of his family vaccinated them all. There was a snow fall and the family was exposed incident to packing for a move to the Territory. Mr. K. called for croup medicine, Aconite was sent. Next day was summoned to the case. Feverish, a croupy cough, tongue indicated mercury. Tonsils much en-

D. B, MORROW, AT, D. 48.5

Urged and tender, rubbed her nose, ground her teeth, and had slight perspirations. Her palms were in much the same condition as Mrs. P's, only not so sore (pityriasis palmaris). Mercurins iod. and Bell, reduced the tonsils ; Kali bich. Phos. Aconite, Hepar sul. Spongia, were of no use and she died of asphyxia after fresh cold caused by '*the old women remov- ing two or three flannel wraps while she was sweaty." All the family were sick with their arms. Mere. iod. relieved them, but the other two children still had a croupy cough. At this time my attention was called to the palms which were just getting sore. It came as a watery blister, and spread until the epidermis was thrown off. On this indication I gave Apis and followed with Arsenicum. Recovery was speedy. It is probable a similar condition to the palms existed in the mucous membrane of the larynx of Letta, and that a few doses of Apis would have saved her life. The family re- turned to allopathy. Other cases might be narrated, but enough to show that vaccine may be worse than small-pox, and that Variolium in any potency is in my opinion a much safer and more certain prophylactic. There is a form of pemphigus prevalent here, looks like a pock, is often con- fluent, and persistently reappears. Treated a year and lost my reputation trying to cure a family of five who all had it, with non-specific medicine, becoming more disgusted than they. I gave Thuja 200, all went, but returned. I then gave Swan's Syphilinum c. m. m., a few doses, and that pemphigus was cured. The family claims it to be from impure vaccine, but the large quantity of " Old Adam'* inherited may be an equally good explanation.

Case iv. — Strangulated Ovary : S. Thomas, aged 25, brunette, grass widow, one child, deceased. Suffered much with pains at the monthly nisus. Lay crouched up like a dog for four or five days. Severe pains in left side, which extended to back and chest, chills and a great deaFof nau- sea. Ipecac, relieved ; indicated by the nausea and a wheezy bronchial cough. Not so bad at next month, yet painful. Had a hernia at the left inguinal ring. Placed on

486 CLINIC4.L VERIFICATIONS.

her back the hernia disappeared, but pain continued. In- troducing my finger through the ring, could feel at top a rolind, smooth, firm little body, very sensitive, and made the patient retch and gag painfully when I pressed upon it. Diagnosing this as the left ovary caught in the ring. I flexed the limb to remove as much tension as possible and reduced it. No pain or nausea at any subsequent period. Several other doctors had treated this case a long -time and two or three had fitted trusses on to that ovary, which, of course could not be worn. All these cases live in the city of Sher- man, Texas.

Case v. — Arsenic vu : Mrs. S. M. J., aged 66, a grand- mother. Had suflFered a long time, some fifteen years, with ill health, some trouble about the genitalia. Had been ex- amined numerous times by diflFerent doctors and operated upon with only temporary relief. Disgusted with doctors, had settled down to be sick until she died ; but through the urgency of her daughter and other friends in ouf clientage, concluded to try me, but would not be examined.

Got a good rehearsal of symptoms, most remembered during all those years. Dizziness, in bed or out was promi- nent, sudden smotherings in the house, doors and windows had to be thrown open. Had ague a great deal. The trouble was a small tumor with a sinus that discharged a watery fluid all the time. Urine burned and scalded, and was inter- mittent, and parts looked blue to her. Gave Ars. as anti- dote to ague, medicine and dyscrasia, followed by Sulph. Cornin and Silicia. Steadily improved, ** better than for years" &c. Was treated by letter. A year later, while visit- ing her daughter, she permitted me to examine, and I found a small polypus growing from the mouth of the urethra. She said it had grown much smaller under treatment I snipped it oflF with small scissors, and she declared herself cured.

Case vi. — Maggie B., blonde, delicate, small. Returned from boarding school at St. Louis, sick. Had always employed a homoeopathic physician ; was now forty miles from one, so

D. B. MOttROW, M. D. 487

an allopath was called by the mother, but Maggie refused to take the medicine (very properly). So Dr. H. C. M. was called. Found her suffering from a fever, with complete stoppage of urine, with small ulcers in the labia and all the parts very sensitive. He drew the urine with a catheter ; adnainistered what seemed necessary and returned to town. He could not leave other patients again so I visited her. Pound her still suflTering ; could not introduce catheter be- cause of extreme sensitiveness and a spasm of spincter that, as the mother said, was like pushing against a bone. Admin- istered chloroform, which relieved spasm of spincter, and urine' was all voided. She urined and complained; per- spired some. One cheek, hand and foot were cold, the other hot. Puis, having these symptoms, was administered with- out relief. Merc, and Ars. were no better. Caustiem did not relieve. Having to return to town, was summoned back im- mediately. This time she refused chloroform. Induced her to take a warm sitz bath, which was partially successful. Next day I sat and watched through the day. At 2 p.m. her cheeks flushed up carmine red, which gradually paled oflf toward night One cheek hot as before, the other red and cold. Tongue coated white, costive, two or three degrees of fever. Motion of ale. very little if any increased. Admin- istered Lycopod. 200 in water, and left the room*. In twenty minutes was called by the mother. Maggie had voided the urine naturally, and had a natural stool.

Left orders to give Lye. and Lach. on alternate days, and returned to town. Did not visit patient again. She made a good recovery in about two weeks. In this case the follow- ing symptoms are confirmed : Typhoid fever, with consti- pation, waking with a peevish mood, scolding, screaming, nervous irritation. Burning heat with short breath, pale face and starting while asleep, circumscribed redness of face. Burning in female urethra during micturition, so bad as to cause her to cry out. And the following added: Ulcers in labia; liability to pass urine; one cheek cold, the other hot and red, circumscribed. Alternating heat and coldness of cheeks.

438 CLINICAL VERIFICAIIONS.

One cold, the other hot. One foot cold the other hot, the patient not knowing it. One dose of Lycopodion would have probably cured the case quicker than any more or other medicine.

BY O. p. BLATCHLEY, M. D., PLANO, ILL.

Case I.— Nat. Mur: June 30, 1882. Anthony O., aged 21. Ague 18 months ago in Michigan, was treated allopath- ically without benefit, changed climate three times, tried many infallible cures; no relief. Fever, tertian, chill 10 to 11 A. M., Nat. mur. SO. Complete cure as soon as began the remedy ; no chill after first dose Sept, '83. Has had no ague since.

CaseIL— Rhus.Tox: Oct. 10, 1882, Mrs. L , aged 68.

Five years ago handled ice; next day could not move, was lame ; three days later facial erysipelas ; three days later ter- rible pains all over, and especially in region of heart. Was treated for about five months by the best allopath in town, and gradually recovered, but never could sleep at night, un- less under strong narcotics. Must jump out of bed, and walk fast for a few minutes, from ten to fifty times each night; worse in stormy weather. The woman lias a wild restless expression. Rhus tox, 3x, three times a day.

October 20, no relief Rhus, tox, 30x, three times a day. Oct. 30, cured. Jan. 10, 1884; no return of trouble.

Case III. — Calcarb: June 29, 1882. George C ,

aged 38. Father died of Phthisis at 47. Has been failing three years. Treated in New York City, Meridan, Ct, and Port Chester, N. Y., but failed all the time. Present symp- toms. Cough with enormous expectoration of pus; coUi- quative sweats day and night; loathing of food; pUlse 112, temperature 103; right lung gives loud mucous raid in upper portion ; pad like protrusion over epigastrium ; cold feet and hands. Gave Cal. carb 30x.

July 27. Reports himself as perfectly well.

September 15, 1883. Has not coughed or seen a sick day since treated.

TRYAL,M.D, 489

BY T. RYAL, M. D., ASHLAND, O.

Case 1. — Little girl, aged five years. Nervous tempera- ment. Had been under treatment by a Homceopathist eight weeks — six weeks for Whooping-cough, and the past two weeds for the present trouble. On the evening of October 21 her temperature was 105°, and pulse 144. The physician in charge reported that the temperature and pulse had been at this rate in the evening for four days, and probably longer, as no record had been kept; the morning temperature ranged from 104° to 105° during the same time, and the morning pulse 120 to 130. Patient would start up suddenly every half hour or oflener; pale and red face alternately; tongue, two white stripes on the side with a red streak in the middle; tenderness ever the right ileo-coecal region; abdomen dis- tended ; frequent desire to urinate with difficulty in starting. Gkive Bell. 1,000, two powders, the second to follow two hours after the first; then placebs. The next morning, the 22nd, temperature, i02; pulse, 116. Evening temperature, 103; pulse, 122. Bell. 1,000, three powders, one every two hours, followed by placebs. On the morning of the 23rd, temperature 101, pulse 108; evening, temperature 104, pulse 126. Thinking that the increased fever symptoms this even- ing arose from the fact that the mother had violated orders in giving solid food, I gave Bell. 1,000, three powders, one every three hours, followed by placebs. On the morning of 24th, temperature 99i, pulse 108; evening temperature, 1031, pulse 126. BeU. 1,000, one powder every three hours followed by placebs. On the morning of the 25th, temperature 104, pulse 126. Realizing that we had an aggravation from the medicine, I gave one powder of Hepar 100,000, to be followed by placebo. Evening of the same day, temperature 102}, pulse 114; placebo continued. Morning of 26tb, temperature 98}, pulse, 100; evening temperature, 192}, pulse 126. On the 27th and 28th gave Arsenicum without any benefit. On the morning of the 29th, I gave Gel. 1,000 three doses, one every two hours, followed by placebo. An hour after taking the Grel. I was sent for in great haste to see the child. They

490 CLINICAL VERIFICATIONS.

reported that her pupib had dilated very much, also that her face had become very red, which had in a great measure disappeared when I arrived, which was about two hours from my morning visit. I took her temperature and found it normal; her pulse 103. As the sudden change in the child's appearance was evidently from the effects of the (Jel., I made no change in the medicine. Patient rapidly conval- esced without further medicine for eight days, when she was encouraged to walk and eat Dutch cake, when 1 was again called and found the temperature 102, pulse 126. Gave Bell. 1,000, two powders, followed by placebo. In 24 hours the fever had disappeared.

The above case had been eight weeks under treatment by a low potency man who gave Bel. 1 x, Gel. 1 x, and Ars. 1 X, as he thought the symptoms of the case indicated. We learn from this case that high potencies relieve patients of the bad effects of low potencies, and that high potencies pro- du -e very marked changes in a few hours. I think that this patient could not have recovered under the use of low pot- encies.

Case 2. — Arnica. — Mr. T. , aged 43. Had jumped

out of a buggy and alighted on a stone with the right half of his right foot which produced a numb sensation. About the middle of the following night, which was about ten hours after the accident, I found the patient in great distress ; he thought that one of the bones of the foot was fractured or luxa I gave arnica 1,000, one powder. In a few seconds he stated that he was partly relieved ; in about half an hour he was asleep and slept soundly till morning. He stated that he could walk on his foot with very little inconvenience the next day, and had no further trouble.

Case 3. — Hepar.— Little boy, aged 6 years, son of a Homoeopathist Coughed during the spring and summer, worse in wet weather, took cold easily, complained of being cold and chilly, slight eruption on face.. I gave Hepar 100,- 000, one powder at bed-time. He had two or three hours of restlessness during the night. The next day four or five

SEVEN SURGICAL FOLLIES, 491

evacuations, and in the evening an eruption was manifest on different part of the body. I saw him about ten days after taking the medicine, when he seemed to be well; his father also stated that the boy was well. How very strange that some HomoBopathists do not believe in the eflSciency of high potencies. ■

SEVEN COMMON SURGICAL FOLLIES. '

READ BEFORE THE WEST CHESTER MEDICAL SOCIETY..

BY JOHIf B. BOBEBTS. M. D.

In complying with the request of your committee, I shall offer, this evening, some criticisms on a number of prevalent surgical methods and opinions which I believe to be fallacious. If I cast down and trample in the dust any idols dear to the hearts of my hearers, I trust they will receive my iconoclastic doctrines with the thought that my own folly has, in many cases, been my teacher, and that I do not attempt to force conviction upon the members of this Society with any other weapon than words.

If any one of you will watch with careful scrutiny any series of operations done for various lesions and by various surgeons, you will have frequent opportunity of observing the commission of the seven follies that I shall describe. Sometimes you will see a single operator committing nearly every one of them in as many minutes. I call them the ether folly, the incision folly, the sponge folly, the styptic folly, the suture folly, the adhesive plaster folly and the dose folly.

The ether folly is almost universal. Often have I heard physicians say of a patient, " He couldn't be etherized; I had to give chloroform." Now, the fault was not with the patient, but with the doctor. I doubt there being an individual or animal in the world that cannot be ansesthetized with ether properly administered. It must, however, be given in large quantity and with little air. If given in small quantity and with much air, as chloroform should be administered, the

492 SEVEN SURGICAL FOLLIES

excitement stage will only be overcome with ipuch difficulty and loss of time. When the napkin saturated with ether has once been placed over the patient's nose and mouth it should not be removed- As it becomes necessary to replen- ish the anaesthetic, let the etherizer turn up the corner of the ether napkin and quickly dash upon it a fluid ounce of the anaesthetic; or let him pour it on the outside of the napkin, and cover this with a large, dry towel. To remove the nap- kin entirely from the face, while the stoppel is being taken from the bottle, and the ether slowly poured out, is too ridi- culous for credence. Yet it is the usual method. During' this interval the patient takes two or three inhalations of pure air, and thus neutralizes the effect of most of the ether previously inhaled. There is one symptom, however, that demands removal of the ether towel for a moment. It is the blue and congested face, due to spasm of the respiratory muscles, that often occurs soon alter the commencement of etherization; when this is seen, the patient should be given an opportunity to take one deep inspiration of air. The towel should then be immediately replaced. A tendency to retch does not indicate cessation, but continuance, of etheri- zation, since a fully etherized patient never vomits. If food actually comes up into the fauces, the patient must be given a chance to expel it, lest a particle get into the larynx. This, however, takes but a moment, after which the ether must be quickly resumed. If the trachea becomes full of rattling mucus, the patient should be turned on his abdomen with the head dependent and the ether perhaps removed from his face for a moment, until the mucus has an opportunity to escape from the mouth. I do not advocate giving ether care- lessly, but I assert that it is usually given inefficiently. More danger is to be found in this long-continjied inefficient ether- ization, than in the prompt method I describe. To gain the patient's confidence, I get him to breathe deeply with his face covered with a dry towel for about a minute before pouring on the ansesthetic. Squibb's ether is in no way su- perior to that of other reputable manufacturers.

JOHN B. ROBERTS, M, D. 498

The incision folly is not quite as common as the one just discussed. Still it is often exhibited in both hospital and private operating. It consists in making a cramped cutane- ous incision, instead of one suflSciently large to fully display the tissues needing examination. A cut of the skin three inches long is no more dangerous in itself than one two inches long. Indeed, in many cases it is less so, because the surgeon, having sufficient room to see, does not tear and stretch the underlying tissues, so rudely ; hence less suppu- ration occurs and more rapid union i8 possible. In opening abscesses, as in general operating, a free cut is more satis- factory to the surgeon and more beneficial to the patient than a mere puncture or button-hole incision. Let us keep from this folly, then, by using a keen edge and a free hand in making cutaneous operation wounds.

What I term the sponge folly is the habit of employing sponge^ for absorbing blood from wounds, when napkins or towels are always obtainable, and are far less liable to intro- duce septic material into the wound. Sponges, while too ex- pensive to be thrown away after each operation, are cleaned with great difficulty. Servants and nurses, therefore, not ap- preciating the importance of thorough cleansing and disin- fection, often neglect this duty. Hence I prefer towels, and if I do an operation at a patient's house, always use clean towels obtained there. Thus I secure an almost certain im- munity from purulent or septic dirt in the articles used for absorbing blood. Perfectly clean surgical sponges are the rule. At the Polyclinic I use, for this purpose, to a consid- erable extent, Japanese paper napkins, which are thrown away after being once used. Absorbent cotton is too expen- sive for such uses, except to a limited extent, and, besides, has a tendency to leave filaments entangled in the wound.

The stypic folly is the commonest and most ridiculous of the surgical traditions of the present day. When occlu- sion of each bleeding vessel by ligation, torsion, or acupres- ure is not required (and it seldom is for arteries smaller than the facial), moderate direct pressure is all that is demanded.

4W SEVEN SURGICAL FOLLIES.

Styptics should not be used, because not needed, and be- cause, in many instances, they impede union of the wound. After an operation let the surgeon tie the large vessels, wipe away the clots, put in the sutures, apply moderate equal pressure by compress and bandage, and he will have no need of hot water, alum, tannin, or that vilest of all styptics, Monsel's solution.

The objections to styptics are these: —

Their traditional reputation leads to their use when liga- tion, torsion, or acupre^ure is needed. If they fail to arrest the bleeding, valuable time has been lost, and the pasty clots often formed by their use render isolation and liga- of the tion vessels difficult. Many styptics, though not all, delay union by irritating the cut surfaces and inducing sup- puration.

In my hospital and college work, pressure and ligatures are the, only haemostatic agents I require. Indeed, pressure will often take the place of many ligatures. I recently ex- cised an entire breast, with part of the great pectoral mus- cle, and only needed three or four ligatures. I have often, however, seen many unnecessary ligatures applied in such cases. In these days of absorbable ligatures, the practice is not as objectionable as in former years, when tnany long strings, to act as setons, were left hanging out of the wound.

The suture folly next claims attention. I do not refer to the erroneous opinion, long held, that sutures should not be used in the scalp. This tradition has been disproved so often that few surgeons would now hesitate to use sutures as freely in the scalp as elsewhere. What I call the suture folly is the adherence of many to the theory that silver wire only should be employed for suturing purposes. Nothing could be more fallacious. Do we use silver hare-lip or acupressure pins? Why, then, employ silver sutures, when iron wire is stronger and far cheaper? When large and gaping wounds require the sutures to stand much tension, silver wire, if used, must be very thick. Iron wire of much smaller diam-

JOHN B. ROBERTS, M. D. 495

eter, and therefore much more flexible, gives an equally strong suture, and in addition to being better adapted to the purpose is much cheaper. I recollect that, in hospital prac- tice, nearly eight years ago, I discarded silver wire, which cost one dollar for each small coil, and bought, at a hardware store, enough iron wire, for ten or fifteen cents, to last liiany months. The nicest iron wire I have seen, and which I now use for the purpose, because it is strong, very flexible, and free from elasticity, can be bought for five cents a spool. If it becomes a little rusty, it can be rubbed clean in a moment should the operator object to the smaller amount of oxide of iron upon it.

The adhesive plaster folly is common. You all have seen stumps, after amputation, enveloped more or less com- pletely in strips of adhesive plaster placed between the su- tures. Of what use are they? They obstruct free drainage, become softened and loosened by the pus, if there is much discharge, give more or less pain when removed, and do no good. If the flaps are properly made, the sutures correctly applied, and the stump neatly and evenly bandaged, the ad- hesive plaster becomes useless, and is merely a disadvantage to the patient's comfort and recovery. Adhesive plaster has little or no value in surgery, except for making extension, and preventing motion in cases of fracture.

I believe that operative surgery will be greatly improved as a scientific entity, when sponges, styptics, silver wire and adhesive plaster are discarded in the dressing of wounds. If you have these articles for this purpose, in your oflSces, I pray you to throw them away. They are needless, worth- less, and detrimental. It is our natural adherence to what is traditional that impedes progress in this as in other branches of scientific learning. We need, indeed, a Leo and a Constantine to destroy these valueless relics of ancient sur- gical worship, as we need an Alexandrian fire to consume the thousands of worthless splints and instruments that are still described in surgical text-books to the confusion of the stu- dent and the damage of the community. — The Polydimc.

406 INTERESTING GYNECOLOGICAL CASE.

INTERESTING GYNECOLOGICAL CASE.

PUNCTURE OF THE GRAVID UTBRU8 WITH ESCAPE OP THE INSTRU- MENT INTO THE ABDOMINAL CAVITY.

BY PHIL POBTKB, M. D., DSTBOIT.

Last July we were called in consultation with a physi- cian who desired our assistance in removing a catheter from the abdominal cavity.

The following is the history of the case: Mrs. R — , age 32, pregnant three months. Owing to the distressing symp- toms of nausea and vomiting, attendant upon her gestations and the alarm of the husband and attending physician, from the rapid emaciation of the patient, the doctor was prompted after a consultation with another practitioner,* to produce an abortion. With an ordinary gum elastic catheter, No- 11, he proceeded to introduce the instrument into the cavity of the uterus, and although obliged to use some force, the instru- ment passed in readily enough about four inches. Then withdrawing the stilet he curled the catheter up in the. vag- ina, left it. At the time of the introduction of the catheter the woman complained of a good deal of distress and sharp pain in the hypogastric region and at once commenced vom- iting, which was kept up until the physician returned two hours later. On examination he was horrified to find the the catheter had disappeared. On placing his hand over the abdominal wall, the parietes being very thin, he was able to detect the instrument as it rode over the top of the intestines. The patient at once presented that peculiar anx- ious expression that is almost always present when the peri- toneum has been wounded. The doctor, becoming alarmed, at once sought our professional aid in the matter.

Judging from the message sent that we had a case of cesarean section, we fortunately included some ovariotomy instruments in our gynecological hand case, and promptly responded to the call. On arriving at the scene of action, we

PHIL PORTER, M. D. 497

found a nevo-hysterical woman, small and very much ema- ciated, a cold and clammy surface with constant nausea and vomiting; pulse 130, temperature i03.°

Realizing that the patient had been suffering for twelve hours and that her chances were rapidly being exhausted we decided upon first cl eaning out the entire uterine cavity, hoping thereby to find the catheter curled up in its interior. Twice before we have been lead to suppose that an instru- ment had escaped into the abdominal cavity, through the uterus, when it was found in the interior of that organ.

After placing the woman on the table, an examination revealed a case of retroversion, which, no doubt, accounted for the reflex nausea and vomiting, which patient had been suffering from. Had this been corrected in the first or sec- ond month no doubt the woman would have escaped all this mutilation.

After forcibly dilating the cervix, we succeeded in clean- . ing out the contents of the uterus, except the placenta which we did not think it wise to remove at that time. Not meet- ing with our anticipation in finding the catheter, we pro- ceeded at once to open the abdomen, which was done in the usual manner for laparotomy, and the lost instrument found tucked in under the lower and posterior border of the liver. Performing the operation as rapidly as possible owing to the feeble condition of the patient, who twice became cyanosed, and was with diflSculty resuscitated. Closing the abdominal incision with silk-worm gut sutures, we placed the patient in a bed, which had previously been warmed with some bottles of hot water, and gave her a hypodermic injection of whiskey.

The recovery of this patient was rapid and gratifying, the third week she being able to attend church.

The doctor's mistake was, in not recognizing the posi- tion of the uterus and passing the catheter up through the anterior wall which was at this time (gestation) easily punc- tured.

We account for the disappearance of the instrument by

498 ALCOHOL AND LVNQ DISEASE.

suction, the anti-peristaltic action of the intestines being sufficient to draw the instrument up into the abdominal cavity.

Strict antiseptic precautions were employed — that is, cleanliness — nothing else. Time consumed for the laparot- omy, as taken by one of the assisting physicians, was just eleven minutes. From the nature of the case, we are com- pelled to omit the name of the physician who called us and the location.

ALCOHOL AND LUNG DISEASE.

Sir— In your vslluable suggestive notice of the Harveian Society's ** Alcohol " report, which I regret I did not see until to-day, you seem to credit the committee with the conclusion that alcohol rather antagonizes lung disease. Allow me to explain that this is not so. Our inquiry showed, I think conclusively that, excepting pneumonia and pleurisy, lung diseases carry ofif a smaller proportion of persons given to excess in alcohol than of the general population. But we go no further, and I have not the slightest doubt, as one of the committee, that alcohol only '^ protects " from death by lung disease those whom it carries off by other maladies. Section 36 of the report contains a recognition of this dis- placement of the mortality from the more common diseases, and in opening the discussion upon the report at the society I pointed out more fully that the heavy demands of phthi- sis, bronchitis, etc., amounting to about 35 per cent, of the whole adult mortality, could not be satisfied after alcohol had exacted its tax in the shape of liver, kidney and brain diseases. The positive efifect of alcohol in producing or pre- disposing to lung disease, as to which I have personally no doubt, can only be brought out by other methods of inquiry, which did not come within the scheme of the committee.— T. Morton, M. D., in Lancet.

H0»' 1 BECAME A SURGEON. 499

HOW I BECAME A SURGEON.*

BY WILLIAM TOD HELMUTH, M. D., NEW YORK.

In the year eighteen hundred and fifty-three, A few months after I took my degree (Which styles me a "regular" H. M. D.), On the Institute books 1 enrolled my name. Being young in years and unknown to fame, (The inference there I hope you'll excuse); Well, I borrowed the money and paid my dues, Which, as far as my recollection can get, I think I have not repaid as yet.

Be that as it may,

Without more delay I went to the Institute that very day, To hear what the old fellows all had to say. Williamson, Hempel and Kirby and Gray, Bayard and Joslin, McManus and Small, Dake, Hering and PiUte, I heard them all.

Throughout that meeting I could not but feel,

That the spirit which ruled those men was — zeal:

Zeal for the system and zeal for the dose;

Zeal for applying similia close;

Zeal for the proving of medicine pure;

Zeal in proclaiming each wonderfid cure.

My friends, 'twas this zeal, right be it or wrong, That laid the foundation so broad and so strong Of this Institute young — as it was in those days - Xow crowns it with glory and honor and praise.

ExciLse the digression, the moments are fleeting. And let me get back to that Institute meeting.

My nature's susceptible — very, I own it,

And years and gray hairs suflice not to tone it.

So the zeal of the rest

Enveloped my breast; And as nothing but symptoms and provings would stand At .the meetings in those days, I too took a hand; And to show to the members of science my love, I asked the committee for something to prove. *Read at the Banquet of the American Institute of Homoeopathy at Niagara Palhi. See frontispiece.

3

o()0 now 1 liKCAMh A SUJiOEON.

Alter some months' delay,

On one beautiful day. And if I remember aright 'twas in May, There cauie to my office a nice little box, With a nice little letter from J. liedman Ooxe. *' Dear Doctor," he wrote, **I enclose you a vial Of wondrous secretion; pray give it a trial. The bottle is small, in unpa<rking don't break it; The liquid is viscid; before you can take it lleAt gently, then wipe off the vial and shake it. Then pour out exactly ten drops in a spoon. And swallow it quickly, and if very soon Queer symptoms develop-just write them to me. As ever of old, your friend, J. U. C. P. 8.— If you knew all the trouble 1 ha<i In procuring a dog undoubtedly mad. You'd drink the solution with infinite pleasure Regarding each drop as a wonderful treasure."

**Good graciousi" 1 said to myself, then a pause;

A stiff'ning sensation surrounded my jaws

I seemed to be looking at things in a fog

And the atmosphere round me smelt strongly of dog.

And just at that moulent I felt that my zeal

Was ebbing quite rapidly out at my heel.

But 1 plucked up my courage and worked at my chin.

Its suppleness seeme^l as it ever had been.

And the thought flashed across me 'twere better that 1

Should ask a few doctors this virus to try,

If bad opisthotonos came with each breath.

To end in convulsions and coma and death.

With meekness the pleasure to them 1 would' give,

Enroll them a^s martyrs- and I myself live.

The difficult que^stion wjis, who should 1 ask

To enter upon such a dangerous task V

Who would assit me to prove? was the topic;;

Who, who would engage in the act philanthropi ?

There was Kellogg and Talbut and Dow ling and Cook—

1 carefully noted these naiues in my book

And Angel and Ludlam. 1 thought Uiey might do,

At least, to develop a symptom or two.

Each man was ambitious and brim full of knowledge.

All eag(U' for glory and just t»ut of college.

WILLIAM TOD HELhfUTH, M. D, 501

Allow me to mention,

'Twas not my intention To cause such a terrible sequel.

To tell it e*en now,

I truly avow, 1 scarcely can find myself equal.

But I made a dilution as Boericke makes, And gave to each vial just two hundred shakes, Increasing succussion as, Jenichen did, By pounding the vials on pads made of kid. Then I sat down and wrote each of my friends: "Dr. Helmuth*s kind greatings this vial he sends For a proving, and trusts that with infinite care Each prover will give it a trial quite fair. Must take it when fasting,'* I finally wrote, "And as it develops each new symptom note. 'Tis slow in its action, as often appears, For the virus is known to be latent for years, But when the zymosis you once can detect The prover will never know what to expect. Be careful in using." In closing I said, " No more is obtainable—Doggy is dead."

My letters were posted and day after day,

I waited to hear what the provers would say.

Not a line, not a symptom, however, appeared.

My reason was staggered; I really feared

That though I was acting as sly as a fox,

That I might be victimized sadly by Coxe.

The virus most certainly taken they had.

But nobody yet seem inclined to go mad.

So I musingly muttered^ ** These provers won't die.

They took it—I alter my mind -so will 7;"

And immediately swallowed a dose of the same

As my friends who were patiently waiting for fame.

Yet tortures terrific we had to endure —

Incubation was slow zymosis was sure.

Remorse consumes my soul to-night,

When I, in guilt arrayed. Behold, oh, dreadful, dreadful sight!

Those wrecks that I have made.

Those lovely youths, so fair and true.

5()2 . HOW I BECAME A SUROEON.

Great gifts of promise had; No matter how they seem to you They are all raving mad.

The briny tears course down my face;

The deed, indeed I rue it; And though a melancholy case,

I did not mean to do it.

KKLL0«O*S PROVIM*.

Kellogg took the first dose he sits over there —

He rolled in convulsions and lost all his hair;

By turns grew facetious, then solemn, then cunning,

.\jid finally took to atrociously pimning.

He barely recovered an imperfect cure;

Now* he*8 constantly crying: ''Inmre.men, inmre!^^

Talbot's provinu.

On Talbot it acted quite strangely, poor fellow! My oldest companion grew dropping and yellow. He ran off to Boston one night l)y the boat; The very next morning he cut a child's throat. Then departed for Europe, and since he came back, Ha«* continued at windpipes of children to hack.

dowling's proving.

Ten drops at a dose given twice to young Dowling,

(rave symptoms quite pathognomonic and howling:

Developed so quickly that I grew afraid,

That in dosing himself a mistake he had made.

His body began very soon to expand.

And his heart grew the ])iggest in all of the land.

The Institute knows it, so why need I tell

What Lake George and New Brighton remember so well.

COOKF/S PROVINrJ.

The strangest developments came from our Cooke; He thirty-five drops of the medicine took; From being loquacious he grew quite laconic, And then was overwhelmed with a mania masonic. Society's devil, he laid up in chains; Now carbolic acid for cancerous pains Is the latest of 'symptoms; they all have been queer. And brake out quite suddenly year after year.

^?

WILLIAM TOD HELMUTH, if, D. • oOS

AN ANGELL'S proving.

On Angell, with whom manji songs I have sung. At midnight, by lamp light, while yet I was young. The virus but one single symptom defined; 'Twas pity for those who were going it blind. In his letter he states, " that hell certainly try To put all he knows into somebody's eye. He was writing a book and its title would be Instructions to people to healthfully see," It finally came, as you all may have seen; 'Twas published by Campbell and done up in green.

ludlam's proving.

When Ludlam was young he was shy of the girls; Would blush to his eyes at a shake of their curls. If him you desired to worry and vex, 'Twas only incumbent to mention the sex. *

I find from my book,

In toto it took Five drops to .develop a genius.

So new and complete,

Each woman he'd meet He declared was an absolute Venus. From that time to this, all he says or he does In public, or private, or lecture-room **buzz,*' Has only one object and only one aim, The attempt (tho' 'tis futile) the fair sex to tame. He carried them round like an autocrat Turk, To list to his teachings and help in his work.

THK author's proving.

But listen, my friends, how it acted on me: I went into fits, and then went on a spree. And when I recovered I scarcely could see; From that very moment my pretty left eye Close up to the internal canthus did lie. And there it remains by day and by night. Impairing my beauty and marring my sight. Strabismus convergens, if but in one eye. Is a source of most constant discomfort, and I, Beholding the wreck of those beautiful boys, Saw them losing their reason, deprived of the joys Of exuberant manhood, and shrieking with pain,

504 COLLEGE OF PHYSICIANS AND SURGEONS,

Said " damn iV^ Excuse me; I never again For friendship, or science, or money or love, Will ask your committee for something to prove. 1 did my whole duty, have had quite enough; Give somebody else all your poisonous stuff.

Then, then it was, fellows, I ftrst saw the light, And surgery beautiful dawned on my sight. I studied its present, I delved in its past, • And found what my spirit had yearned for, at last. Found science and art in proportion so grand. The effort of mind with the dexterous hand. Combining th tinsel ve^ with such exquisite care. And yielding results so remarkably fair, That I bowed down in silence and bended my knee. And claimed the department belonging to me. I saw what I thought was my pathway in life. Discarded all provings and stuck to the knife; And though I've been fairly successful, 'tis true. There's one thing in cutting I never can do. I may cut out a bone or extirpate tumors, 1 may amputate limbs and evacuate humors. Kill every bacillus and aspirate sacs. Apply plaster jackets to carious backs, Make beautiful noses by art rhinoplastic. Cure pulsating tumors with bandage elastic, I may stretch every nerve, perform herniotomy, And advocate still supra-pubic lithotomy, I may do all this cutting with ecstacy — but I never will dear old acquaintances cut. And I hope in return that wherever I be No dear old acquaintance will ever cut me.

COLLEGE OF PHYSICIANS AND SURGP:0NS OF MICHIGAN.

Detkoit, Dec. 24. 1883.

On motion the subject of miscellaneous business was taken up. Under this head Dr. Porter brought up the con- sideration of professional cards, their proper form and use, as laid on the table at the last meeting. He thinks this society should take some action in the matter, not for the

COLLEGE OF PHYSICIANS AND SURGEONS. oO:>

purpose of disciplining those physicians whose cards were presented, because as they are not members of this body we have no authority over them, but simply to lead in a much needed reform,'' and he hopes that each member present will place himself on record in this matter. The cards referred to, read as follows :

No. I.

M. D.

Surgeon and Physician. Ol^telricij and Diseases of Women and ("hiUren a Specialty. IVeth Extracted. No. 2. '

M.D.

The Doctor has been in practice thirty years, and fifteen years in Detroit.

Dr. Bailey thinks if a man is in general practice, his name, address, and office hours are all that are necessary in his card; but that one devoting himself to a specialty has a right, if he wishes, of mentioning that fact. For a number of years he included" Disea.ses of the Rectum," with the other matter on his card, and did not think he was violating the code, as he really does pay special attention to the treat- ment of those diseases. But of late he has not mentioned it. Considers it in very poor ttiste for a physician to men- tion so many specialties, and as to mentioning the number of years one hns practiced, it is very improper.

Dr. Olin most heartily despises, and discountenances anything that savors of quackery. He has on his card sim- ply his name, address and hours, but thinks a specialist, as in Dr. McGu ire's case, should have the privilege of mention- ing his specialty, if he wishes to do so.

Dr. Griffin endorsed what had already been said, and stated that he had a lot of matter on liis first cards that he soon became ashamed of and has since used a plain card.

Dr. Porter thinks it proper for a specialist to mention his specialty, but insists that a man who treats "Diseases of Women and Children," practices "Obstetrics," and "Extracts Teeth," is not a specialist and does wrong to fill his card with such a statement as we find in " No. 1 " of the cards exhibited

5(m COLLEGE OF PHYSJCJANiS AND i^UKGEONS.

Dr. McGuire says we practice medicine with three objects in view: First, for the benefit of our patient; Second, for the benefit of ourselves; Third, for the benefit of the profession. A specialist may mention his specialty, because by so doing he invites to his office just the kind of work he wants, and is not apt to be bothered with calls to do general work. And it is a convenience to the patient requiring the services of a specialist. He does not confine himself to any one form of a card, uses them both with and without a notice of his specialty.

The question thus arose as to the propriety of a special- ist doing general work, and the unanimous expression was that there were cases in which it was eminently proper. As. for instance, that of a man consulting an occulist and while under treatment for the eye trouble, some other trouble should develop and require immediate attention, it would be an injustice to the occulist to ask him to discontinue his treatment while the patient consulted a general practitioner, and an injustice to the patient, to compel him to hunt up another physician and pay an extra fee for something that the occulist could as well relieve.

After transacting some other business relating to the finances of the society, an adjournment was had.

Dec. 31, 1883. — Dr. Gilchrist, the lecturer for the month, read a paper on " Erysipelas" considering, first, the Semio- logy; second, the Etiology; third, the Pathology; fourth, Prognosis, and fifth, the Treatment.

In speaking of the etiology of this disease, the lecturer stated that there should be no question as to its contagious- ness, and while he is not willing to accept the theory of germ implantation, he is at a loss as to what is the real cause. He thinks the mean organisms may be carriers of the disease, but does not believe them to be the cause. Imperfect elim- mation of the excretions of the body, he mentions, as being a frequent cause. All things seem to point to the material character of the poison, but the question is, what is the poison?

COLLEGE OF PHYSICIANS AND SURGEONS. 507

He thinks the proof of the germ theory is purely pre- sumptive, and while bacteria may be a cause, it is not a spe- cific one.

As to the semiology, the Doctor spoke of the necessity of recognising the disease early, and in cases of traumatisms, should be apprehensive when the wound became dry. He emphasised the value of the thermometer as a means of diagnosis in this as in other diseases, and in differentiating between the allied affections, erysipelas, septicaemia and pyaemia.

Prognosis is always uncertain, but under judicious homeopathic treatment, is much more favorable than under the old school.

The treatment is chiefly medicinal. He does not coun- tenance the use of any medicated topical application what- soever, but spoke of non-medicated applications, such as dry flour, cotton batting, etc., as being useful in some cases.

Calendula was mentioned as being the best antiseptic, because a vulnerary. When the swelling is excessive, he recommended making numerous small cutaneous incisions to relieve the tension and let out the secretions. When suppu- ration obtains, open freely and secure perfect drainage. The diet should be non-alcoholic, nutritious and abundant.

A number of remedies were mentioned, but the two most frequently indicated are Arsenic and Rhus tox.

Dr. Younghusband, being present, was invited to partici- pate in the discussion, and spoke at some length, compli- menting the lecturer on the manner in which he had pre- sented the subject, and stated that he fully agreed with him, in the statement that erysipelas, septicaemia, and pyaemia were allied affections, even though each has its characteristic peculiarities. He considers these three diseases sisters, and their mother is lymphangitis. In fact he believes them to be lymphangitis, having their origin in the lymphatics. He also thinks that puerperal peritonitis should be included in the sister-hood. He stated that leucocytes will not be found in the tissues, primarily in this disease, but that the lymph

rm COLLEGE OF PHYSICIANS AND SURGEONS.

spaces or sacks will be found to be packed full of micrococci, giving the tissues the appearance of being injected, this leads him to believe the prime cause of these diseases to be the micrococci. He thinks those who denounce the germ theory are unfair, because they simply denounce the theory and know and acknowledge their inability to prove that it is not the true one.

Dr. Gilchrist thinks argument on this question is futile as both parties are well provided with authority. He ack- nowledges the value of the teachings of some of those who advocate the germ theory, but thinks they should not be accepted in toto. The truth he believes to be somewhere be- tween the two extremes.

Dr. Gaylord thinks there is not much that he can add to what has already been said on the subject, but fully agrees with the lecturer that medicated topical applications are not to be used in erysipelas; has known many agents to have been used, but rarely, if ever, followed by good results. Paint- ing the part with colloction has benefited some cases by lessening the sensitiveness and swelling.

.Doctor Porter believes that most authors agree that this disease is really lymphangitis. He understood the lecturer to say that the disease rarely if ever affected the chin, but he (Dr. Porter) has had three attacks and all on the chin. He also agrees with the lecturer that the thermometer cannot be estimated too highly ^s a means of diagnosis, and is surprised at the ignorance of the value and use of this instrument as displayed by some physicians. The hour being late Clini- cal Reports were omitted.

On motion adjourned.

Jan. 21, 1884. — The society convened at the usual hour with the President, Dr. Phil Porter, in the chair. Dr. J. G. Gilchrist, the lecturer for the month, presented a paper on "Purpura," which was listened to with marked attention on account of the rarity of the disease. The lecturer stated that purpura was a condition in which there was a circum- scribed effusion of blood in the upper layers of the skin and

COLLEGE OF PHYSICIANS AND SURGEONS. 5011

under the epidermis proper, usually occurring without any special constitutional associations, and yet it may accompany some disease during its course and often followed with hem- orrhages from the mucous membranes or into a serous cavity. The aetiology of this disease is somewhat obscure. It has been known to attack children of tender age — but a few days old — and again people of all ages. Women seem to be much more susceptible to the hemorrhagic attacks than men. Not infrequently the disease is associated with Bright's disease and diseases of the heart, also with phthisis, rheumatism, diseases of the liver, leucocy thsemia and different fevers, and in fact the hemorrhages may come on in patients of the most different constitution and general condition, from that of health to the most debilitating disease.

The anatomical character of purpura is confined, prin- cipally, to the capillaries of the skin and mucous membrane. The hemorrhage is due, no doubt, to the rupture of the capil- lary blood vessels over a small space and the blood being deposited into the connective tissue, filling the spaces between the follicles of the hair and the lymphatic cutaneous ducts, which are abundant in all parts of the skin and mucous membranes. The peculiar color that is seen from the effusion of blood, and the changed condition of the hsematin set free from the red corpuscle, of green, blue and yellow tints are characteristic of this disease. From the formation of hsema- toidin there is often left permanent pigmentation of the skin. Post morteniH reveal, in fatal cases, extravasation into the pericardial, pleural and peritoneal cavities. Extravasa- tion into the muscles and even into the bones and periosteum may occur.

Pathology seems to settle upon three conditions: (1) On an alteration in the coats of the blood vessels; the deli- cate membrane covering the capillaries offering but slight resistance to the arterial pressure: (2) a changed condition of the blood itself; the salts not having their proper propor- tions, and (3) both of these conditions combined.

The varieties were treated under their respective names :

510 COLLEGE OF PHYSICIANS AND SURGEONS.

Purpura simplex, purpura rheu matica, purpura hsemorrhag- ica and symptomatic purpura.

The prognosis is generally good, but frequent attacks are apt to occur.

A number of remedies were mentioned, those most fre- quently called for being Arnica, Carbo. veg.. Bell., Crocus, Ipec, Cinchona. Styptics are sometimes called for to control the hemorrhage.

In the discussion that followed Dr. McGuire stated that he had seen but few cases of purpura hemorrhagica, and in these Phos., Phos. acid and Cinchona had served hira well.

Dr. Walsh has seen a number of cases, one in particular being a peculiar one. It followed an attack of scarlet fever, ai)d the peculiarity of the case was that even slight pressure upon any part of the body would produce hemorrhage from the part. There was constant hemorrhage from some part of the body, but the patient's appetite was insatiable and the great amount of food taken, kept up the strength until the hemorrhage could be controlled.

Jan. 28, 1884. — Society met at the usual hour with Dr. Phil Porter in. the chair. Dr. Gilchrist, the lecturer for the month, being out of the city, no paper was presented, and the college opened under the head of '^Clinical Reports from Practiced Dr. Bailey called the attention of the college to a peculiar symptom which he had noticed in his boy, who for the last two or three years, since having the measles, has been subject to sore throat. During the last few days he has had an attack of tonsilitis on right side; noticed noth- ing unusual until last night he found the boy's fore arras were covered with a rash having the appearance of measles, except that the color was a dark purple. This rash was unaccompanied by any itching or burning, and disappeared on pressure. Would like some physician present to explain the cause of the eruption.

Dr. McLaren states that while he is unable to account for the eruption, he should feel no alarm on account of its presence; has noticed an eruption of the character described

COLLEGE OF PHYSICIANS AND StJROEONS. 511

above on the chest, in cased of follicular tonsilitis, but does not remember having seen it on the arm. Should think of Baryta Carb. or Iodine in /lonnection with the treat- ment.

Doctor McGuire related a case of retinal hemorrhage in which Secale 200 was used with good results, controlling some of the most distressing symptoms in a remarkably short time after its administration.

The patient presented for treatment and an examination revealed loss of vision in one eye and strong threats of im- pairment of vision in the other. Lach. and Phis, did well at that time giving considerable relief.

About two weeks ago the patient returned complaining of violent headache in the region of cerebro-spinal arxis, run- ning up into the eyes with scintillations before the eyes denoting congestion. Phis, and Lach. were given this time but with negative results. Verat. Vir. would control the headache in a measure; Bell, the same but no other effect would be produced by these remedies. The headache was aggravated by lying down and was accompanied by great sensitiveness of the brain and cord. Secale 200th was given at this time and complete relief obtained within twenty-four hous. There has been no return of the trouble.

Doctor Porter stated, while he did not consider this meeting a high potency convention or a branch of the I. H. A., he felt called upon to report a case wherein the 200 of Sulphur, one dose, had relieved a chronic condition that had existed seven years.

The patient had been treated for morbus coxsb senilis, a condition often occuring in advanced life and associated with a scrofulous diathesis ; and had just left her bed, where she had been suffering from counter extension of a weight attached to the foot.

On examination the doctor found there was shortening of the right leg, but it was due to a tilting of the pelvis, and no symptoms of hip joint disease could be detected. The doc- tor could not give a diagnosis, further than to say the tilting

512 COLLEGE OF PHYSICIANS AND SURGEONS

of the pelvis was probably due to a neurotic condition of the lumbar muscles of the back.

The Sulphur was prescpbed simply on account of its similiarity to the other symptoms, such as pain, leucorrhoea, gastric, aggravation, amelioration, etc., with no regard to the prominent complaint of the patient. The relief was so marked and astonishing that the family could hardly realize the fact. The patient lias returned home and last week a letter was received, stating that she was never better in her life.

Like Dr. McGuire, I desire to report this case, simply on its merits. As a rule we are both prescribers of low poten- cies, but these two cases we present for what they are worth. Please do not understand me, however, as apologizing for administering a high potency, for the best cures I have ever had in my practice, have been through the 30ths and 200ths.

Doctor Bailey would like to know the experience of the gentlemen present with Tarantula in spasmodic conditions. The doctor meniioned one case that he prescribed for with- out seeing the patient, and the only symptoms he could elicit was that the patient would suddenly fall in a fit, and was addicted to the use of alcoholic stimulants. Gave Tar- antula 30 every alternate day one dose. The patient has had but one attack since and that one about six months ago.

Doctor Porter has used it in the 12th in one or two cases of epilepsy, and has always been satisfied with the efiect The symptoms that leads him to select this remedy is that the patient in falling alwa}'^ turned to the left.

Doctor McGuire remembers the first time he used the remedy, from the peculiar results that followed its use. The case was one of locomotor ataxia and a prominent symptom was cold feet. Could not get them warm. Gave Tarantula 30 and when next he saw her, was told that the'feet were so hot, she had to keep them out of bed. The remedy was dis- continued, and the patient instructed to take a dose when- ever the feet were cold. This was done, one dose being suf- ficient to keep the feet warm for three weeks.

COLLEGE OF PHYSICIANS AND StJRGEQNS. 518

Dr. Foster related a case that he treated without seeing the patient. The man was living in another city and wrote him that he had had an attack of mumps followed in two months by swelling of the testes and enlargement of the spermatic veins; had consulted a number of physicians in his own town but was told nothing short of an operation would return him. Wished Dr. Foster's opinion. The doc- tor wrote him that he could not give one without see- ing him, but sent some powders of Ars. 30, which the man took, and reported that the miimps had returned and swell- ing left the testes. The man made a good recovery except that the spermatic veins are still enlarged.

Dr. Porter suggests suspensory bandage to assist the var- icose condition of the parts as the spermatic veins are not supplied with valves and therefore slow to lessen their cali- bre, if not assisted by a support or position. The doctor begged the privilege of calling the society's attention to Dr. Foster's report, especially that part which referred to the Cleveland physicians, as coming through the patient. We should always regard with suspicion any second-hand re- marks relative to a pathological condition or diagnosis, when coming from such a source. We doubt whether any physi- cian would suggest, or even think of castration in a case of parotitis.

Dr. McGuire related an interesting case of "Graves Dis- ease." The case came to him for treatment some time ago. Examination revealed paralysis of superior rectus muscle. Came back soon after with ptosis and immobility of the eye; subject to severe headache. Elicited the fact that she ran against clothes line and fell, striking the head upon some hard substance; since then had seen double. R. Arnica, followed by Conium which reheved the headache and vomit- ing, but measurements since then show protrubrence of the the eyes. Has tried Digitalis in various potencies, also Verat Vir.. Amyl Nit., and Galvaniasm.

Under the head of miscellaneous business, Dr. Porter exhibited a new female catheter he had constructed, which

514 SIMPLE DIAGNOSIS OF DIABETES MELLITUS,

would, he thought, avoid producing cystitis, when compelled to resort frequently to catheterization. The objection to the old instrument was, first, the eyelet or clot was too large and lessening the calibre or diameter of tube, allowed the blad- der to contract more firmly around that portion of the cath- eter and forcing the mucous membrane into the slot; com- pelling the operator to resort to some force to remove the instrument. This would soon set up an inflammation; sec- ond, the old instrument is so short that the patient is always more or less liable to be soiled with urine. This catheter has the same calibre its entire length, and is perforated with thirty-six small holes, too small to admit any portion of the mucous membrane, and in addition has a coupling attach- ment of part hard rubber with the balance soft rubber tub- ing, to carry the urine to a vessel along side of the bed.

Dr. Porter offered tbe following resolution, which was accepted: "That this society shall take up for consideration, at every meeting, under the order of miscellaneous business, Hahnemann's organon; commencing with the first paragraph and continue the subject." J. M. Griffin, Recorder.

SIMPLE DIAGNOSIS OF DIABP:TES MELLITUS.

Dr. Chamaux, of Vichy, after a large number of obser- vations, writes as follows :

. Every time that a new patient presents himself at my oflSce for consultation and often passes his tongue over his lips in the course of conversation, I suspect him of being a diabetic subject. All diabetic patients continually moisten their lips with the tongue in conversation.

It may well be that some people do this for some season or other, outside of the disease just given, but, as a rule, it is almost an infallible symptom of polyuria diabetica.

This year I have examined 134 diabetic patients, each one of whom presented this peculiarity.

This symptom is, of course, easily explained by the dry ness of the mouth and mucous surfaces in this condition.

WILLIAM TOD tlELMtlTlL 51/>

WILLIAM TOD HELMUTH.*

THE POET SURGEON.

William Tod Helmuth, M. D., of New York City, was born in Philadelphia, Pa., October 30th, 1833. He is the son of John H. Helmuth of the same city. He received his edu- cation at St. Timothy's College, Baltimore, Md. In 1850, he commenced the study of medicine, and graduated in 1853, and immediately commenced the practice of his profession in Philadelphia. It was during his early life that he conceived that taste for surgery, which has remained with hiiii from that time to the present. In 1854-'55, he oflBciated as Dis- pensary Physician of the Homoeopathic Medical College ; a report of his services, as such, is to be found in the Phila- delphia Journal of Homoeopathy for the latter year. During this period he was also Prosecutor of Surgery to Dr. Jacob Beakley. In 1865, being then 22 years of age, he was elected Professor of Anatomy in the Homoeopathic Medical College of Pennsylvania, and, in the same year, he published a work entitled ** Surgery and its Adaptation to Homoeopathic Prac- tice," consisting of 650 pages. During this time he was also a contributor to many literary periodicals.

In 1858, he removed to St. Louis, and, shortly after, be- came one of those who originated the Homoeopathic Medical College of Missouri, in which institution he was oflfered and accepted the chair of Anatomy. He was subsequently elected one of the Surgeons of the Good Samaritan Hospital, a posi- tion which he held till he removed to New York city. In 1862, he published a monograph on "Diphtheria," which soon passed to a second edition. In 1866, he delivered the annual address before the American Institute, and in 1867, was elected President of that body, then holding its session in New York City. In 1868, with a view to perfecting him- self in surgical science, he made a tour on the continent of Europe. In 1869, he organized the St. Louis College of

• See Frontispiece.

4

516 WILLIAM TOD UELMVTH.

Homoeopathic Physicians and Surgeons, being its Dean and Professor of Surgery until he left the West. In 1870, he re- ceived a pressing call from his professional friends to take the chair of Surgery in the New York Homoeopathic Medical College, being also appointed Surgeon to the Hahnemann Hospital and to the New York Surgical Hospital.

Dr. Helmuth is a member of the American Institute of Homoeopathy (its President in 1867), of the N. Y. State Hom. Med. Society, the Hom. Med. Society of the County of New York, of which he has been president, a fellow of the Medico-Chirurgical Society, of which he has been Vice-Presi- dent, and an honorary member of the societies of Massachu- setts, Rhode Island and Connecticut. In a late visit to Paris he was elected a member of the ''Societi6 M^dicale Homceo- pathique de France."

Amidst his professional duties he has managed to con- tribute many and valuable additions to homoeopathic and other literature, both in prose and verse. In 1864, he started, in connection with H. C. G. Luyties, Esq., the pharmaceutist, Ihe Western Homasopathic Observer, which he conducted dur- ing seven years, till he left St. Louis. He has also given to the public a valuable monograph on "Cleft Palate;" also two other brochures entitled " Interesting Surgical Cases " to the New York Society, and •* Ten Cases in Surgery," besides many other monographs and miscellaneous literary produc- tions, both in poetry and prose. In 1870, he removed to New York, entered upon the professional duties of- the col- lege, and became associate editor of the New England Medical Gazette. In 1873, he joined Dr. T. F. Allen in the editorship of the New York Journal of Homoeopathy, the organ of the New York Homoeopathic Medical College, conducted under the supervision of its faculty. During the greater part of this time he was busily engaged in the publication of his greatest work, containing about one thousand pages, and illustrated with over four hundred wood-cuts, entitled "A System of Surgery," which is now in its fourth edition. His articles have been for the most part surgical ; and in all the homoeo-

WILLIAM TOD HELMUTH. 517

pathic journals are to be found his contributions to medical science.

Since his residence in New York he has, besides lectur- ing regularly and holding clinics at the college, contributed to general and surgical literature. Essays upon "Nerve stretching " "Excision of the rectum " with cases, "Reports of his surgical clinics," "A contribution to Gynecological Sur- gery" first published in the American Journal of Obstetrics^ and an elaborate treatise on " Supra-pubic lithotomy " — which operation Dr. Helmuth holds superior to all other of the cutting methods of removing stone from the bladder — have been given to the profession, while numerous interesting surgical cases coming under his observation and his knife have appeared in many of the medical periodicals. Besides these medical productions he has published a miscellaneous collection of prose and verse, entitled " Scratches of a Sur- geon " and a little weels, " A Steamer Book " designed for light reading when crossing the Atlantic.

Many of his poems are familiar to all, or at least to most of the homoeopathic profession; one of the latest and best appearing in the present issue of the Advance. Since the year 1855, he has lectured every y^ar — save one year during the war when all business was in a state of semi- dissolution — making nearly thirty years of active service in the lecture room.

It is believed that the first amputation recorded in the American homoeopathic periodicals made by a Homoeopathic Surgeon was reported by him.

He had no capital to start with in life, but commenced unaided, after graduation, without a dollar. He has experi- enced the full meaning of hard work and hard knocks, hav- ing worked his way up from the bottom to the top of the ladder, by the sheer force of indomitable energy, dash, bril- liant talents, and extraordinary skill in his chosen branch of science.

In 1859, he was married to Miss Pritchard, of St. Louis, by whom he has two children. Whatever may be the posi-

518 SURGICAL CASES.

tion to which Dr. Helmuth may attain, he can always carry with him the satisfaction of feeling that he is indebted for it to none but himself. Without interest or influential friends to back him, having no favoritism extended to him, he boldly grasped the difficulties of his position, determined to succeed, and has done so by an uncommon display of *'pluck " in combination with rare ability. Although comparatively young, he has probably done more for surgery aud its litera- ture in the homoeopathic school than aigr other man in the country.

SURGICAL CASES.

BY C. C. HUFF, M. D. JAJKE8T0WM, DAK.

Cask I.— H. C. — Aged 42, farmer. Injury consisted of a deep, and clean cut wound of the posterior part of the leg, caused by a mowing machine. The seat of injury was at or near the point of muscular and tendinous union of the Tendo Achillis. On examination I found the entire muscular por- tion of the parts involved cleanly cut, to the complete expos- ing of both bones of the leg; hemorrhage had been consider- able; was at the time bleeding profusely, and was only checked by the ligation of several small muscular arteries. Neither of the principal arteries were injured. After thor- oughly satisfying myself that all hemorrhage had ceased, I allowed a short interval of rest, after which I adapted the edges of the wound, and closed it with eight silk sutures, The patient remained for a short time in my office, and was then removed to his home. After being-carefully placed in bed I applied a carbolized dressing of Olive Oil and Carbolic Acid, and left the patient comfortable and in good spirits.

On my return home, I had a plain splint made, which when applied, would extend the foot and cause relaxation of the muscles involved. This splint worked nicely, and the wound healed very quickly, without a drop of discharge, and

I,

a C. HUFF, M. D, . 519

on the thirteenth day after the accident the patient was able to walk, and improved steadily, all traces of his injury being removed.

Case II. — M. B. — Aged 45, minister. An injury of the left forearm, caused by the explosion of a shotgun, the pa- tient was shooting wild geese when the accident occurred, being probably half a mile from his house, reaching the same in a short time, unassisted. I was hastily summoned, and on arriving found the patient suffering from a frightfully lacerated wound of the forearm, the skin, superficial struc- tures, and anterior muscles being very severely torn and burned. The longitudinal portion of the wound was seven inches, and transversely at the widest part it was three inches ; the whole surface of the wound was more or less rough and uneven. At the radial side of the wound the artery could be clearly seen pulsating. There was but little hemorrhage, due partly to the burning no doubt, and the application of moderately warm water soon checked that. I resolved to save the arm if possible, and did not deem it justifiable to handle the wound much. After cleansing the wound as thoroughly as I deemed it prudent, I dressed it with lint saturated in carbolized oil, placed the hand and arm in a posterior splint, and gave Am. 3x internally. This treatment was kept up for ten days, with occasional changes to Aeon. 3x and Ars. 3x, as conditions presented.

The progress of the case was slow for a week, then im- provement began and steadil3r increased, the edges of the wound gradually approximating, except a portion of the Ulnar side, which seemed to delay for some reason. During the operation of dressing one day I discovered a small dark spot underneath the tendon of Flexor Carpi Ulnaris Muscle. In probing I found a hard substance which required consid- erable force to remove ; when removed it proved to be a piece of the gun stock of considerable size, it had entered the arm at the time of the accident and penetrated the tendon going so deep as to cause the tendon to close over and cover it en- tirely. The injury to the tendon was such that before long

520 BOOK NOTICES.

it gave way ; after that the wound continued to heal rapidly, and in fifty days from date of injury the patient was dis- charged, cured, and at Ho time was there a great amount of actual pain in the wound proper. Most all his real sufiering came from the Ulnar side of the hand, ring and little fingers. This pain he described as a drawing, pulling sort of pain, that seemed to draw the fingers up, yet they always remained in place, with their fellows. Constant and careful passive motion was kept up during treatment tod the patient has very little impaired motion.

BOOK NOTICES.

LECTURES ON FEVERS. Delivered at the Chicago HomoBopathlc Medical College, wl^h a few additional lectures. By Prof. J. R. Kippax, M. D., LL. B., Profeawr, etc. Gross <& Delbridge. Chicago: 1884.

We have here a fine volume of 460 pages, and we are prepared to give it a hearty welcome, for, in all respects, it is a substantial addition to our medical literature. It is well written, elegantly printed and substantially bound; and we have placed it among our books of ready reference. Heretofore we have taken Loomis (allo- pathic) on fevers, and a smaller work on continued fevers, by Wil- rose, also an allopathic work, as the best of modern works on the subject, but on a careful comparison of these, we find Kippax's work to include all the good points of the other authors, with a large amount of important information not known to those authors. Dr. Kippax is a decided germ-theorist, and he makes the fullest possible use of the theory in his^tiology of the disease he is treating. On this point we take emphatic issue with the author. We could wish he had taken his position upon the question less dogmatically; but, we are not disposed to quarrel with him, nor to flatly deny that he is right, but we shall hold for Ihe present, and probably for a long future, that the theory is unproven. In pathology and diag- nosis the author has left nothing to be desired. His charts of the various fevers are admirable, and are of immense service to the medical student. The indications for remedies are very full and well chosen, while the comparative drugs in brackets add a many- fold value to the indications given. This is really a grand work, and our readers may buy it at sight, and hold us responsible for all damages.

EDITOR'S TABLE. 521

EDITOR'S TABLE.

Died: T. W. Robertson, M. D., of Battle Creek, of pneumonia, age 36. The profession in this State will receive the announcement with extreme regret.

Died: W. C. Leech, M. D., of Marion, Ohio, died February 4. The doctor was widely known as a caustic and instructive writer, and leaves a large practice.

Removed: H. L. Clark, M. D. (XJ. of M.) has removed from Grass Lake, Michigan, to Fremont, Ohio. W<hat is our loss is Ohio's gain. We predict success for the doctor in his new field of labor.

Removed: Geo. B. Foster, M. D., from Detroit to Mt. Clemens as resident physician to the Mineral Springs Bath Co. Dr. Sasse, who has held this position for the last four years goes to Germany for special study.

A GOOD, well-established practice in a thriving village with a fine farming country surrounding it, for 'sale cheap. Will introduce successor. For particulars correspond with L. R. Daniels,

Sherwood, Mich.

PoPULAE Science Monthly for March, 1884, is unequaled for interest and velue. Its many articles are brim full of the best. The highest standard of excellence is maintained by editor and contrib- utors and we commend this journal to the household as well as to the office. If we can keep our science popular, we can help to bring the world up to the high plane of general intelligence and we can hold it there if the people will only read.

Transactions of the American Institute of Homoeopathy, 1883. J. C. Burgher, Secretary. This ample volume is the best of evidence of the growth of the Homoeopathic School. It does not in all respects meet our ideal of what work in the Institute should be, but we find in it so much to admire that with all its faults we hold it in high estimation, and we regard the book as a full return for the expense of membership. This consideration alone should induce thousands who are not members to send in their names without fail to the next meeting at Deer Park. Don't forget it good reader.

Annual Address Before the Homoeopathic Medical Society of the State of New York, February 12, '84. By Evart H. Hasbrouck, M. D., Brooklyn, N. Y. We confess to an inborn fear of addresses coming from the above quarter. We have seen some such that gave us far more pain than pleasure. President Hasbrouck has, however, given us something worth reading. It is a genuinely good

522 EDITOR'S TABLE.

thing. It takes us back to former times when men in high places talked sensibly about Homoeopathy. Not for a long time have we found a better campaign document than this. It ought to be scat- tered broadcast for it is candid, clear and convincing^ .

North American Review. — Whether the United States are to regain their former pre-eminent rank as a commercial and naval power on the seas, is a question that no American can contemplate with indi£ference. The subject is discussed with marked ability in the North American Review for April, by the Hon. Nelson Dingley, M. C, who opposes the oroiect of admitting foreifl:n built ships to American Register, and by Capt. John Codman, who is well known as a zealous advocate of that measure. Judge J. A. Jameson in the same number of the Review, discusses the question, ''Shall Our Civ- ilization be Preserved,^' pointing out the means that are at band for withstanding the various agencies, physical, moral and intellect- ual, which threaten to overturn our existing civil and social institu- tions. Dr. Felix L. Oswald writes of ** Changes in the Climate of North America," with special reference to the increasing frequency of disastrous floods." An interesting number.

Our Colleges :— Several colleges have held their commence- ments this month. Up to date the following have reported :

Hahnemann^ of Chicago, heads the list in point of numbers with 127 graduates, eight of whom are ad eundem — one in 16. Prof Ludlam says in his annual report: '*No feature of the college work is more gratifying than the fact that this institution is now recog- nized as of the superior kind, to which pupils who have taken their first and second terms in a preparatory or a provincial medical school may come for their final instruction." "Provincial medical school" is good. The dean must have been in his happiest ironical mood when he wrote it, particularly **that superior kind."

New York comes next with 52 graduates, six of whom are ad eundem — one in nine. Among the latter we notice the name H. W. Hartwell, M. D., CU. of M., '83) Department of Medicine and Sur- gery.

Chicago, has 39 graduates and the largest class in the history of the college.

SL Louis, March 6, fourth on the list in point of numbers has 20. The honorary degree was conferred on Professor Edmonds. The class validictory was delivered by Alice B. McKibben.

University of Iowa, March 4, has a graduating class of 12. The annual address was delivered by Prof. T. P. Wilson, M. D. The exercises were held in the Opera House which was filled.

V

JOSEPH H. PULTE, M. D.

y^i:f#^}^^"

P. WIUSOM, M. D.,

Editor.

PHIIi PORTER, M. D.,

Gynecological Editor.

Vol. XIV.

Ann Arbor, April, 1884.

No. 10.

All subscriptions and business oommunioations should be addressed to MEDICAL ADVANCE PtTBIjISHINa CO., Ann Arbor, Mich. Subscription, $2.00 per annum.

H. O. AIjIjEN, M. D., Business Managrer.

, Principles of Medicine, No. 1, — Introductory. We have on all hands a surfeit of medical art. Each school of prac- tice has its own cherished and much venerated methods of treating disease. We are supposed to have the principles and practice of medicine taught us by our writers of text books; these are sometimes spoken of as the Science and Art of Medicine; but when we come to open a book which treats of Therapeutics we fail to find any principles laid down. In several pretentious volumes before us, written by different authors, the title page of each is " Theory and Prac- tice of Medicine," but there is nothing pertaining to theory in either of the works. There are also several other works entitled "Practice of Physics," "Practice of Medicine," "Clin- ical Medicine," etc., in all of which the art, the practice, the method of curing diseases is fully explained, but there is an utter absence of information of the principles upon which

te4 EDITORIAL.

the art is supposed to rest. This seems to be all wrong; at least it is a very unsatisfactory state for medicine to be in.

If we inquire into the cause of this we will find it orig- inating in two things; first, the allopathic school is confess- edly without principles such as its practitioners and teachers would care to formulate, because such as they have are con- tradictory, incoherent and therefore unrelated. The allo^ pathic school can, in the nature of things, have no system of principles. This accounts for the fact that they have never attempted to teach the Principles of Medicine. A well- known author of that school, Williams, in his "Principles of Medicine," treats of nothing but General Pathology and Therapeutics. In the second place the homoeopathic school is not without principles in its teachings, but as these are the things most controverted, as they form in fact the great bone of contention over which the various factions have warred so many years, the authors of text-books in the Hom- oeopathic school — those who have written upon Theory and Practice — have been almost as reticent upon the question of Principles as their Allopathic confreres. By way of special treatises upon Medical Principles, Hahnemann's Organon must take precedence. It is, and always will be, a masterly exposition of Medicine, so far as the principles of Therapeu- tics are concerned. Dunham's fragmentary writings, the works of Joslin, Rau and Hempel have each in their way treated of Medical Principles, and are all worthy of careful study. But none of those, in matter of comprehensiveness, meets the wants of the modern student. Investigation to-day takes a much wider range than in former years. The Prin- ciples of Medicine must be discussed from the stand-point of modem science. Not philosophy alone but chemistry and physics have important light to contribute and it cannot be otherwise than a mark of wisdom to admit these important factors into the discussion. If the readers of the Advance will patiently follow us from month to month we will en- deavor to outline this subject and so suggest how it might

I

EDITORIAL. 526

be amplified bo as to place the art of healing en rapport with

modem thought.

■ <■» ■

Dear Pellet: — Your arrival at our sanctum brings much pleasure. You represent the Ohio Hospital for Women and Children, for the benefit of which you inform us a fair is to be held — at least some flowers, and a luncheon are to be had. Pleasant inforrpation, that, to a hungry editor two hundred and twenty-five miles away from the seat of war. More than that, the exact locality of the luncheon does not appear recorded on your sweet face. If it be up town, down town, over the river or on the hill-top is what no fellow can find out by you. Think of it, gentle Pellet, a man with his vitals gnawed by the demon of hunger and not knowing which street car to take. If fortune should place a stray policeman in his way and the right route be found ima- gine if you can the mental condition of a man who upon his entrance is presented with a menu of thirty distinct articles by two hundred ladies. Dear, sweet Pellet, your table com- mittee— Cincinnati's most charming dames and damsels — could have but one eflTect upon a famishing man, his appe- tite would be forever lost. Is this your deep design to feed the multitude through their astonished eyes? Would you — could you ask a man not in the regular army to face so many charming waiters and venture to take his pick? In our opinion every decent man would go hungry to his grave rather than discriminate. Our devil says he would have gone through the course with every individual waiter; but then our devil was born hungry and besides that he is wealthy. At this juncture the editor's wife puts in her oar. ** Don't you see, my dear, the thing has gone by two weeks ago?" Then alas there is nothing left but to light the col- ored fires and ring down the curtain with many thanks to the fair editor of The Pellet and many good wishes for the success of our many friends in Cincinnati who are so ably maintaining their Hospital over whose dome you may be sure floats the banner of Similia.

526 FIBRINE AND BACTERIA,

FIBRINE AND BACTERIA.

REPLY TO DK. GREGG.

BY THOe. TAYLOB, M. D., WASHINGTON, D. C.

On page 438 of your interesting monthly of February last, I find what is called a reply to my short paper on Dr. Rollin R. Gregg's views relating to Fibrine and Bacteria. I. judge from his reply that the Doctor rides a high horse and ignores the modest professional buggy, but I hope neverthe- less to convert him to more accurate views than he at present entertains.

It will be remembered by your readers that I stated in my few remarks of Dr. Greggs' experiments that fibrine is soluble in the alkalies and that cellulose, the external cell- covering of bacteria, is not, thus giving a test for bacteria as distinguished from fibrine. I also said that "fibrine is a muscle forming substance and cellulose is not.'* Dr. Gregg in his answer denies that fibrine is soluble in the alkalies or that it is muscle forming and quotes Liebig as saying that, ** fibrine relates chemically more to coagulated albumen than it does to the fibrine of the blood." Suppose it does. Both are soluble in the alkalies. " Digested at the temperature of the living body in dilute solutions of ammonia or of potas- sium or sodium-hydrate, fibrine dissolves." Arthur Gamgee, p. 36. Edition 1880.

"Coagulated albumen is soluble in caustic potassa." Dal- ton's physiology, p. 84. Edition 1861.

" It is highly probable that the animal organism possesses power to transform albumen into fibrine or caseine or vice versa. * ♦ * The principal bulk of an egg is albumen * ♦ * yet from these are produced the fibrine in the chick's muscles, also the horny tissues and feathers. In suckling a young animal, it is evident that caseine must be similarly transformed, or if we reverse the examination, the parent gets her milk (so rich in caseine) fi-om blood which contains none." Symington, Brown's Chemistry, Boston, 1855.

THOS, TA YLOR, M. D. 527

"When fibrine is subject to a solution of nitrate of pot* ash at a high temperature it becomes soluble and very much resembles albumen." Johnson, Thurner's Chemistry, Re* vised Edition.

" Fibrine is soluble in a b\%. per cent, solution of potas' sium nitrate if digested with it for some time at a tempera- ture of 30° or 40°. It is similarly soluble in sodium chloride and in a ten per cent, solution of magnesium sulphate." "In water containing one part hydrochloric acid per 1,000, fibrine dissolves in a few hours at a temperature of 40° * * * and is converted into acid — albumen." Physiological Chemistry of Arthur Gamgee, M. D., F. R. S. Published by McMillan & Co., London, 1880.

"Fibrine * * * sparingly soluble in dilute acids and alkaliea and in neutral solutions. * *" Fewness Man* ual of Chemistry, 1873.

" Fibrine is soluble in water at ordinary temperature, passing into solution only at very high temperaiii^re, or after a great length of tirtie, and then becoming totally changed in character."

" In dilute alkalies it swells up * * * and is more sol- uble than in dilute acids. In neutral saline solutions * * it swells up * * and gradually dissolves."

"Suspended in distilled water at 70° it becomes more opaque and loses its elasticity. Its solubilities are thus identical with those of coagulated albumen."

" Fibrine — Gluten. — Fibrine receives its name from the circumstance that it enters largely into the composition of the muscular fibre of the animal." "It is best obtained by whipping a quantity of fresh drawn blood with a bunch of twigs * *. It is not soluble in the acids, but dissolves readily in dilute solutions of the alkalies. Fibrine obtained in the above manner from either venous or arterial blood appears to possess essentially the same properties, and when turburated with solution of nitrate of potash at a high tem- perature, it becomes soluble and very much resembles albu- men." Fowne's Manual of Chemistry, p. 491, 1873.

528 FIBRINE AND BACTERIA,

" Muscular fiber properly consists of a substance which is soluble both in potash and acetic acid. Page 584, Mulder's Physiology, 1849.

"If we dissolve coagulated albumen in dilute potash lye, digest the solution some time at 60° to 70°, and then precip- itate, with acetic acid we obtain a snow-white precipitate.'^ " Fibrine * * * in coagulated state forms the principal constituent of muscle." * ♦ * "In fresh condition it is easily dissolved in acetic acid and in alkalies." L6wig'8 Organic Chemistry, 1853. Philadelphia, A. Hart, publisher.

I might quote Foster and fifty others but enough has been given to prove that Fibrine and coagulated albumen are soluble in the alkalies and are muscle forming.

The Doctor says that " If he will read authors he will find that fibrine is almost the only food of the serous mem- branes and their allied structures; while albumen is the only food * ♦ • * of the muscles or muscular cells."

"Muscles — * * * Their structure is always fibrous." * * * "The chief substances contained in them are fibrine, albumen and gelatine. Hie two latter substances Rte contained chiefly in the membranes which envelope the fibers." Johns- ton, Turner's Chemistry, p. 498, edition 1867. The Doctor in writing of his experiments says: '*If he watches fibrine of rotted blood go through all sorts of net-work, cellular anA other formations * * * he will learn much of the secret of all-development which has already been seen and another great point gained." Are we to understand from this, that Dr. Gregg is the first to make the observation, that the sub- stance of living fibrine conforms to a law common to every form of protoplasm, (there is no dead protoplasm)? " Blood rotted for six months" cannot on any known principle pro- duce living cellukir fibrine. The forms therefore which he observed in rotted blood are not living cell formations. The motions of fibres or granules is no positive indication of life. The openings he sees may be simply holes such as are com- mon to baker's bread. But the Doctor has discovered that the granules of fibrine no matter how treated with acids and

THOS. TA YLOR, M. D. 529

fire are always present, the same size, the same color, the same everything, even to motion in many of them, and he infers that when I have seen such granules in disease that I have called them micrococci. This is the conclusion the Doctor arrives at after twenty years study in his special branch and discovery ! Dear Doctor I am sorry that you have spent twenty years in your fibrine studies. It has nar- rowed your vision, ruflBied your temper, and prevented you from reading up the most common place experiments relat- ing to bacterian culture.

Did you even try to cultivate fibrine granules — t/ot*r hoc- teria — either before or after you burnt them to test their pow- ers of reproduction? Had you done so, you would have saved your midnight gas and may be an aching head. Since you are gifted in giving advice, please take a little and read up Mulder's Physiology, where you will find your little granule and fibre depicted, and even the cells of fibrine portrayed in picture form. How different a thing are bacteria proper from your fibres and granules. The simplest of all the forms of bacteria — spherical bacteria, an agent which from the very inception of life upon the earth, has continuously per- formed a function without which the successive generations of plants and animals could not have existed; and stupen- dous as is its work, it is an agent so minute that twenty mil- lion individuals of its class might be inclosed within a globe small enough to pass through the eye of a cambric needle.

Let us theoretically put the Doctor's discovery to a com^ mon test. Let a portion of his fibrine and granules be sub- jected to a suflBciently high temperature in water to sterilize the mass, and place a portion of his wigglers thus treated in a properly, sterilized, clear, nutrient fluid (after the fashion of Pasteur) for a sufficient length of time, to give his fibres and granules a chance to reproduce their kind. At the same time put a drop of water containing real bacteria into another sterilized fluid as above. It will be found after th« lapse of a few days, that the fluid containing the Doctor^s bacteria will not cloud the water or his bacteria be increased in numbers^

530 BACTERIA VS, Fl BRINE.

Whereas in the second experiment the real bacteria will have clouded the nutrient fluid and the bacteria greatly increased in numbers, thus demonstrating, the erroneous character of Dr. Rollin R. Gregg's philosophy. It will be remembered that the Doctor's bacteria are not affected by boiling or burn- ing, or the action of nitric acid.

With regard to cellulose, a substance destitute of nitro- gen, convertible by nature or art into starch, dextrine or glu- cose, a very different substance from fibrine, the latter con- tains the elements of bacteria, but the former does not. Now since I have shown that fibrine is soluble even in water under the conditions stated, the soluble parts however small, would supply sufficient food for the propagation of bacteria, and when we take into consideration Dr. Gregg's exceedingly loose method of conducting his experiments, the presence of real bacteria in his solution is easily accounted for. Scien- tific men who conduct bacterian experiments, would not give his methods a moment's consideration, well knowing that any watery solution of protides would supply food for bac- teria.

The Doctor desires me to test his experiments ; such ex- periments generally considered are a common place matter with me but not for the purpose of entering into competition with nature in creating living things. The most we can do is to supply suitable food to the ever present spores, and in this way admit of the possibility of their reproduction.

BACTERIA VS. FIBRINE.

BY FRANCIS R. DAY, M. D. CHICAGO.

Since April, 1882, various journals have from time to time published articles from the pen of Dr. Rollin R. Gregg, of Buffalo, on the " Science of Fibrin," in which he boldly challenges the existence of bacteria or micro- organisms, and attempts to prove that all the great workers in this depart- ment of biology have been laboring under delusions, and have

FRANCIS R, DA 7, M. D, 531

been investing little bite of fibrine with the moat dreadful powers.

In the January number of the Medical Advance, Dr. Taylor, of Washington, tried to put Dr. Gregg on the right track, but failed utterly in his endeavor. In fact, a fibrinous exudation seems to have covered Dr. Gregg's entire field of vision so as to prevent the perception of truths established by other observers-

In his experiments, made with a view to building up a "Science of fibrin " he has taken the most approved methods for developing myriads of the bacteria of putrifaction. No more successful measure could be adopted for that purpose than to rot a quart or two of beef's blood in an iron pot ex- posed to the air for six months at a constant warmth of 100*^ to 200° F. Any microscopist who could not find any quan- tity of micrococci, bacteria termo, and spirillum, in such an infusion might as well sell his instrument and go into some other business.

If Dr. Gregg were to examine water from a stagnant pond, or decomposing urine he would, no doubt, find the same forms which he calls '' granules, rods and spirals of fibrin."

Does the doctor think that by the microscopical appear- ance alone, he can prove that those forms are derived solely from the threads of fibrine? Upon his observations alone does he dare to deny the existence of all pathogenetic and non-pathogenetic bacteria?

He calls for others to verify his experiments ; would it not be well for him to verify the work of others? Let him cultivate his bits of fibrine by the gelatine method through successive generations, let him inoculate an animal with the youngest progeny, and produce the symptoms of disease.

Let him examine the blood or tissues of this animal and find microscopic forms identical with those cultivated. Be- fore he casts aside the germ theory of disease in toto^ let him read Prof. Gradle's work on " Bacteria and the Germ Theory of Disease," or Section vii of Zeigler's " Text book of Patho- logical Anatomy," or "The Cartwright Lectures for 1883,"

532 ABNORMAL CELLS IN TRICHINOSIS,

and there learn a few facts about bacteria that have been ee- tablished on a basis that he can never shake with his " Sci- ence of fibrin."

Will he not believe these men? Has he verified the works of Koch, Pasteur, et al. and found them wrong ? Does he deny the existence of the bacillus anthrax? Does he think that he can work in this department of science with a i inch objective? If he answers these questions in the af- firmative, I can only sigh sadly to myself; " alas I the fools are not all dead yet."

ABNORMAL CELLS IN TRICHINOSIS.

BY L. YOUNOHUSBAlfD, M. D . LL. D., DETROIT.

Two specimens of pork, supposed to be trichinous, were sent me for microscopical examination, one from Niles, and the other from Dr. O. R. Long of Ionia. In the former I found several trichinae; in the latter only two cysts, after a very long and careful search. I sent some of the Ionia meat to my friend, Dr. C. Henri Leonard, of the Michigan Medical Col- lege, an enthusiastic worker on such cases, who made a strict examination without finding a single cyst. He found a fun- goid growth, the character of which lead him* to believe the animal had been seriously affected with actinomycosis. I saw the same fungus myself but supposed it to have grown on the meat after death. Dr. Leonard may be right in his views. At a somewhat later date, he saw and carefully ex- amined the Niles pork, but not until his opinion of Ionia meat had been published. He declared both kinds to be so badly diseased as to be unfit for food, and in this I think all agree with him, except Pro£ Stowell of Ann Arbor.

We both found the muscles of each kind very full of pe- culiar looking oval or lemon-shaped cells, which we pronounc- ed abnormal and pathological. Several slides were shown to different physicans in this city, and all, as I am informed, declared these peculiar cells to be associated with some dis* ease.

L. YOVNQHUSBAND, M. D. 533

A reporter of the Detroit Times, called upon Dr. Leonard and myself to get information on the subject of trichinosis and our views on the. diseased pork.

The publication of those interviews created a stir among microscopists through the State. The opponents of our views had stated that the only dangerous element in connection with this pork was the parasite; that the meat itself was far from being an agent injurious to health. They brought Prof. Stowell from the University to settle the matter, which he tried to do in his own way, but made a " bad mess of it." He declared the Niles pork normal with the exception of the million of parasites in it, and the cells pronounced peculiar and abnormal by the Detroit doctors, were nothing more nor less than adipose tissue, such as is formed in very fat healthy animals. This decision was supposed to be a " settler," com- ing from so distinguished a personage, and a timely hint for certain ones to take a back seat.

The Ann Arbor professor with his confreres of the Grif- fith Club of Microscopy had this decision published in one of the daily papers as a joke, over which they had a hearty laugh. These gentlemen evidently forgot the old adage, *' who laughs last, laughs best."

From the outset, I took the ground that these cells were abnormal and of degenerative nature, produced by these par- asites. Since, I have fully demonstrated the truth of my posi- tion in regard to them, it is now well understood and conced- ed on the part of nearly every one having examined my slides, that these cells are abnormal and not healthy adipose tissue. The testimony I produce is so absolutely true that Prof. Stow- ell dares not deny nor attempt to refute it. My large experi- ence in examining pork with trichinae in it establishes me in the opinion held by other investigators that the muscular tis- sue in trichinosis consists of an enormous increase of the pro- toplasm of the sarcous elements, which by confluence produce globular masses of a high degree of luster, apparently desti- tute of structure and in appearance greatly resembling fat.

In microscopy more than in any other science, we fre-

534 ABNORMAL CELLS IN TRICHINOSIS.

quently meet with things having great resemblance to each other, when judged by the sense of sight only, though greatly differing in nature or essence which the microscope is utterly unable to detect. What are we to do in such cases ? We invariably have recourse to reagents or tests furnished us by the chemist. Now, to the vision even aided by the best ob- jective in the world, no one could positively say these pecul- iar cells were composed of fat, although greatly resembling it. They looked like adipose tissue to me as they did to Prof. Stowell . I said, I will test them on this point, I therefore im- mersed the section in turpentine, an excellent solvent of fat, but this agent could not dissolve them. I also] tried to dis- solve them in the oil of cloves, a powerful solvent of adipose tissue, with like results. But there are other methods of test- ing for fat I carefully washed these same slides undissolved by turpentine and oil of cloves, immersed them in a certain dilution of carmine, and mounted them in Canada balsam. I then examined the mounts under the microscope. The sight was a beautiful one. Many of these cells, which before treat- ment had a high degree of luster resembling fat were stained a beautiful deep red. But fat cells cannot be stained by car- mine as all histologists know. It requires such reagents as iodine and osmic acid to do it. I notice in these same slides, that some of these peculiar looking cells are only half stained — the other half looking as bright as ever, showing that a fatty metamorphosis simultaneously with colloid metamorphosis is also not infrequently found in the same cell. Hence we see that in these peculiar cells we have two pathological de- generations, viz. fatty, and colloid, and these conditions are the outcome ot parenchymatous myositis, set up by the action of the embryos of trichinae. In these slides I find the colloid degeneration greatly in excess of the fatty degeneration. Such colloid cells are ever present in typhoid fever, frequent- ly found in typhus, acute miliary tuberculosis, uraemia, small pox, scarlet fever, and from what I have learned in my ex- amination of these and other specimens of such pork, I am sure they are nearly always to be found in trichinosis. Prof.

CVRMS SY DR KXJNKEL, 635

Stowell's blunder consisted in not making a careful examina- tion of the slides. The slides I mounted, were exhibited and carefully examined by experts attending the Wayne County Medical Society. I am informed by gentlemen who were present at that meeting, that these slides sustained the posi- tion taken by Dr. Leonard and myself. I am also informed that the subject as discussed will be printed in Detroit Lancet.

CURES BY DR. KUNKEL.

VERIFICATION OF THUJA.

[From the A.Ug. Ham. ZeUung, of EelL]

The cases of gonorrhoea, in which Thuja o. .c. c. is the remedy, are not frequent, at least they have not occurred very often in my practice, even if not exactly seldom. That Dr. C. W. Wolf^ advises Thuja in every recent case is to me incomprehensible ; it is routinism. There are no new ideas against forms of disease. We are not by any means limited to such procedure as to experiments. The patient who has a sycotic gonorrhoea is affected in his general health ; spirits depressed, aching weakness, lame feeling in the lower ex- tremities, sleeplessness, etc., aie the usual concomitants of a sycotic gonorrhoea. Thuja restores the general health in an extraordinary short time, while the local complaint goes off gradually. Next to Thuja, in these cases, is Phosphoric acid.

It is otherwise when scrofulous (psorie) individuals are infected. The general health is unaffected, but the affection will not yield to the usual treatment and the squirting doc- tors say it belongs to the ingeious category of the " obstinate.'*

Of course in these cases the drugs must be employed more concentrated. For awhile the suppression succeeds, perhaps, but on every occasion, of cold, coition, error in diet, the gonorrhoea returns. It is diagnosed a " hew infection." Only the antipsorics can cure these thoroughly. The pro- cess is first increased discharge, very gradually a decrease. The same thing prevails in malarial patients who qpntract

536 CURES BY DR, KUNKEL,

gonorrhoea. In these, as in the former cases, a transfer of virus is not necessary to cause gonorrhoea. In many cases coition itself does it. On the other hand, we cannot cer- tainly believe in a communication of " psora " by coition.

Whether malarial gonorrhoea occurs everywhere, aa fre- quently as here, is doubtful, as in this place although inter- mitten ts are not frequent yet malarial sickness very often happens. The treatment of this (malaria) most frequently requires Natrum mur. indicated by the following symptoms : Of tlie first importance, cardiac phenomena; increased im- pulse, irregular ; also intermittent beat of the heart with nor- mal sounds; often great prostration; aching of the l^s, particularly of the knees ; depressed lachrymose disposition, but very changeable; chlorotic condition with chest : horripi- lations; aggravation of the condition in the forenoon ; pains in the loins; constipation; sleepinessin the day-time; weak- ness of digestion ; momentary relief of the gastric pains by eating, etc., etc. These symptoms have often guided me to the right remedy, viz., Natrum mur.

(I believe I am the first to have called attention to gon- orrhoea, being frequently under the control of the epidemic remedy, and I am glad that the distinguished Dr. KunkePs experience is corroborative of mine, for the malarial gonor- rhoea he speaks of is really saying, in different words, that the remedy which is curing intermittents, etc., also cures gonor- rhoea. A. McN.)

GONORRHCEA.

K. — Consulted me on April 4, 1881. He had suffered for 14 days; had used injections inefiectually. His general health is affected. Paralytic weakness of the legs ; always depressed and irritable; sleeps badly; always restless and tossing about in bed; appetite unchanged. The prepuce begins to be oedematous. Thuja 10, one dose.

April 8. — Improvement of the general health ; discharge less; no oedema; Sac. lac. After ten days there is no trace of the complaint, although it was impossible for him to ob- serve a proper regimen.

CURES BY DR. KUNKEL. 537

W. — A man of 33 years has had gonorrhoea for ten or twelve days, The discharge is scanty.. On urinating the pain extremely violent, even to fainting. He feels very much affected ; aching of the legs, etc.; six or seven years ago had an attack with more copious discharge, but not by any means as painful. On the 20th of June, 1882, he re- ceived Thuja 10, one dose.

July 1. — At first the discbarge increased, then ceased en- tirely; now there is a slight secretion; some pain in urin- ating; general health, " nothing at all ails him;" Sac. lac. In fourteen days the disease had entirely disappeared.

Henry P. — Consulted me about his two-year old daugh* ter on February 1, 1880. She has been sick for a year. She was vaccinated about a year ago, whether successfully or not did not learn. She is restless and sleepless; cries much; frequent urination often painful; vulva often red; canine hunger; abdomen extremely swollen (a regular toad's belly,) which increases and is often hard. She cannot eat all the time. One dose of Thuja 50 (of my own preparation.).

I did not hear from her till January 10 of the same year. She was perfectly well, all functions normal, the toad's belly had disappeared.

OPHTHALMIA GRANULOSA.

B. — actor, 25, has suffered for a year. He was treated for eight weeks in an ophthalmic clinic where his eyes were cauterized, but without any benefit. There was much sup- puration, particularly, at first. Now mostly in the morning. General health, bad; weak; aching of the legs; sleep bad, with difficulty of falling asleep and sleepy on awakening in the morning; slow and difficut discarge of urine; spirits de- pressed. I can not learn the etiology. Thuja 10 for six days. At first increased suppuration; general and local improvement; sleep normal; improved immediately and refreshed in the morning; discharge of urine not much ; sup- puration inconsiderable and only in the morning. The granulations and vascular injections as good as disappeared.

Sch. — A girl of 8 years was brought to me on January

538 CURES BY DR, KVNKEL.

12, 1880. She has suffered for four years from itching of the genitals, so that she rubs herself against a chair at every opportunity. From this scratching there occurs " spasms " i. e. jerking in all the limbs with stiffness. After these jerk- ings, headache. Bad smell from the moun ; restless sleep ; frequent urination. She is now suffering from varicella, coming in new crops and leaving grass-like vaccination marks. Thuja 10, for six days.

February 14.— The itching has entirely disappeared. For the first couple of days, " little sick." Now nothing abnormal.

ASTHMA.

Paul B. — actor, six and one-half, was vaccinated the year of his birth. Before that well nourished, since then ema- ciated. Through the entire winter slimy diarrhoea, eruption on face and scalp. When the eruption, is temporarily re- moved by external applications, there is always aggravation of the diarrhoea and the general condition.

In his third year he was attacked by measles. Since then asthma day and night, whistling, wheezing, respiration even in sleep. The attacks always occur from the least cold, but always when he has not a cold. At these times the erup- tion continues, but disappears spontaneously ; then' he is always "intensely" sick; repeatedly alter such disappear- ance he has had gastric fever.

August 2. — Thuja 10, one dose.

September 12. — He returned. He had no fever, neither paroxysms. There is nothing abnormal observable, except in the morning on awakening he is somewhat irritable; Sac. lac.

December 16. — Until a couple of days ago entirely well. Since then some whistling respiration, particularly at night; grinding of the teeth, etc. Investigation revealed undoubted helminthiasis, which was removed by some doses, say Cina 6. He has remained sound and well; as I have repeatedly con- vinced myself by observation.

A. McNeil.

DRVG PHOVllfO. 539

DRUG PROVING.

BY AD. LIPPK. M. D.

The first object is to procure the drug or other matter to be proved in its purity; then to make a full statement as to how and where it was obtained and how it was prepared* The preparation of chemical substances was always given in detail by Hahnemann, so as to insure the reproduction of precisely the same chemical substance in the future. Plants should be collected by the prover, if possible, at the right season and where they grow on their original soil; for instance, a flower taken from the Cactus grandiflorus grow- ing in a hot-house will not make a good preparation, either for provings or as a curative ageni This preparation should be made, as it was made, on the spot where the Cactus grows wild, and at the right time and season, when the flower opens at night and fills the atmosphere with its fragrance.

If the drug be taken from the animal kingdom, the ani- mal should, if possible, be preserved and subsequent sup- plies should come from the same species, and under similar circumstances. The few drops of poison taken from the Trigonocephalus Lachesis by Dr. Heri^g, in Surinam, over fifty years ago, has sufficed so far to supply all the demand for Lachesis. What is more, the identical snake from which the poison was taken is still preserved in the Academy of Natural Sciences of Philadelphia. Prepara- tions taken from the same species of snake, while confined in cages in menageries or any public institutions, cannot reasonably be expected to have the same medicinal power as those from the wild snake brought alive to Dr. Hering by the Indians in the country where it was caughi

THE DOSE.

We know that one contact with an infectious disease, one inhalation of malarious air, one sudden mental emotion, will cause a succession of phenomena and symptoms, which finally end either in a full recovery, by what is termed the

540 DRVO PROVING,

crisis or throwing off of the diseased condition of the or- ganism; or else, if the organism' be in too feeble a condi- tion to resist the influences, or if the efforts of Nature to bring about this crisis have been interfered with by violent means, (i e,, energetic treatment), the system succumbs to the overpowering influences, and death is the consequenca This observation of the natural causea of natural dis- eases must serve us as a guide in ascertaining the sick- making properties of drugs. If we wish to ascertain the artificially diseased condition drugs produce upon the healthy, we make our experiment by taking one dose of the drug; and as we do not expect an immediate effect from a contact with an infectious disease, experience teach- ing us that it requires days, hardly ever less than three days, before the effects of such a contact become percep- tibly developed, so we cannot reasonably expect an imme- dediate perceptible development of the sick-making effects of the one dose of the medicine to be proved. If there is no effect perceptible after, say five days, we will have to pro- ceed just as we do when we administer medicines for the cure of the sick; finding ourselves not susceptible to the drug to be proven, we must take either a lower or higher preparation; and when no effects follow this, we may take the potentized drug in a watery solution until an effect is perceptibla When the question arises what preparation of the drug we should take in that ane first dose, we may aa well consult Hahnemann, who tells us, in paragraph 128 of his Or ga no ft, that substances, if proved in the crude state, by no means show the richness and fullness of their sick-making powers; that the dormant powers of the drug are developed by potentization; and that we obtain a better knowledge of the properties of drugs if we take a few pellets of the 30th potency. Fifty years ago, the 30th potency was the highest potency known, since then innumerable experiments, both on the healthy and the sick, have f idly established the fact that a greater degree of sick-making power is developed

j

AD. LIPPE, M. D. 541

by much higher potentdzations. When Hahnemaim advised a few pellets of the 30th potency as a proper dose for test- ing the drug, knowing that its medicinal powers are devel- oped by potentization, his followers tried the experiment, and ascertained that the highest known potencies are endowed with a proportionately higher medicinal property than the crude substances or lower preparations possess. All depends upon the only reliable test, experiment; who- ever will make this experiment honestly, will find that a single dose of the highest potency will cause a succession of symptoms much more distinctly marked, much more characteristic than any other preparations before used, even in the single dose or in repeated doses/ We have, for instance, this day, no other provings of Theridion than those made by the 30th potency, we have provings of Lach- nanthes made by the highest potency than known (76m.) and the symptoms obtained in this manner have been con- firmed by clinical experiment

REGIMEN DURING THE PROVING.

The prover will do best to continue his usual diet and habits in general, as a deviation from them would neces- sarily cause some changes in his condition, and these might erroneously be attributed to the effects of the drug he proves. At the same time, he should for this same reason, avoid all possible mental excitement and, above all, any exposures to the changes of the weather or to cold. Such exposures, during the development of the sick-making prop- erties of a drug, might, as we know it did in several deplor- able instances, fix upon the prover ailments for life. We know that a person suflFering from an acute disease has to be very careful not to expose himself to influences of men- tal disturbance or the weather, which in his ordinary state of health, would effect him only temix)rarily; but which, during an acute illness might, and often does, leave their marks, disturbing his health during the rest of his life.

542 tjNi VEttsrrr op lo wa.

THE DAY-BOOK.

The prover would do well to give first a description of himself — age, sex, temperament, former ailments or dis- eases, habits and the influence which changes in the weather have on him. Next, a full description of the substance or drug proved, how and where it was obtained and how it was prepared. Next mention the dose and the time of the day. This self-examination should be as carefully con- ducted as the examination of a sick person. A daily jour- nal should be kept, in which nothing is omitted; some symptoms, or groups of symptoms, may often reappear, they should be very distinctly related again, as these fre- quently recurring disturbances, however long they may continue, often denote the most characteristic symptoms of the substance or drug proved. And, as in the examination of the sick, so in proving, the experimenter should describe very minutely under what circumstances certain symptoms appear. Also state whether food, changes in the weather, exercise or rest in certain position, causp new, or aggravate, or ameliorate old symptoms.

Finally, let us remember that the proving of drugs of all kinds and by many persons, will not only increase our abil- ity to cure the sick, but will also forever settle many, as yet, disputed points, such as the possibility of finding a drug which can produce symptoms forming the exact similar to a known pathological condition — a disease. Proving will settle forever the disturbing posological question; provings, and their practical utilization, will confirm the infallibility of the only Law of cure — Similia similibus eiirardtir.

HOMCEOPATHIC DEPARTMENT OP THE UNIVERSITY

OF IOWA.

Last evening, March 4, 1884, occurred the seventh annual commencement of the Homoeopathic Medical Department of the State University. The opera house was packed to its

UNIVERSITY OF IOWA. 548

fulleet capacity. On the stage were President Packard, Pro- fessors Cowperthwaite, Dickinson and Clark of the depart- ment, Dr. Baker, of Davenport and Dr. Stillman, of Council Bluffs, also some members of the Board of Regents. The following is the programme as given :

Music— Overture University Band

Invocation Rev.H. M. Thompson

CLASS VALEDICTORY.

D. W. Dickinson, Ph. B Sanitary Needs

MUSIC.

Selections from "Bohemian Girl," Instrumental Quartette

Conferring of Degrees By the President, J. L. Packard, LL. D.

MUSIC.

Selection University Band Sextette

ANNUAL ADDRESS.

Prof. T. P. Wilson, M. D., U. of M The Old and the New Prophets

MUSIC.

Waltz, 'Tm Duftigen Qnien," Instrumental Quartette

BENEDICTION. MUSIC.

Grallop University Band

Mr. Dickinson, the class valedictorian acquitted himself to the entire satisfaction of the audience as well as of friends. Mr. Dickinson will be remembered as a graduate of the Aca- demic department of University with class '81. The flowers were elegant, the ladies of the class, especially, receiving very beautiful baskets. The music of the evening was splendid, especially when we take in consideration that the members of the qut^rtette had had scarcely any practice. Dr. Wilson's speech was highly appreciated. The foUowiiig is a short synopsis of what he said:

The advent of prophets into the world's arena, has marked most of the great epoch's of the world's history. A thousand instances might be cited, in which their coming has changed the entire tide of human affairs. The time of their coming was always peculiar. The ancient prophet was sure to come when, for a long time, the current of events had remained unchanged, or, when some gigantic wrong reigned supreme. Then the people cried, when will a prophet arise?

544 UNIVERSITY OF IOWA.

For they knew that, when the prophet came, there would be a revelation wide, deep and lasting. Kings would be dethroned and empires overturned. Yet the ancient prophet was seemingly the prophet of human forces. From whence he came perhaps none knew, but his words smote like a hammer, they burned like fire, they rent in twain like the lightning's flash. The ancient prophet was an iconoclast He broke all laws and customs, and fearlessly shattered every sacred image. But they tell us the race of people is dead and we must henceforth go on in darkness. Look now at this picture and see if it is so. The speaker then sketched the office aad work of the signal service. The chief officer sits in his cushioned chair at the capital, and holds in his hands the iron reins, that are curb and bit on the horses which are of fire, and they go in and out with all the veloc- ity of thought, and gather up the facts of nature from all quarters of the land, and bringing them all in, they lay them at the feet of this man, and bid him prophesy of the morrow. And so the events of to-morrow are known to us through scientific prophecy. And if to-morrow, why not fifty or a hundred years hence? Already our modem pro- phet is able to tell us how many will be bitten by mad-dogs the coming year, how many will commit suicide, be burned up with coal oil, and be disappointed in love. In the lap of the living present, lies the coming future. Religious systems, political parties and governments, might forecast their future, if their leaders were only wise. Heine in Germany, Mira- beau in France, and Garrison in America, were true national and modern prophets — they had true divining powers. Their prophetic declarations were all fulfilled. When will our teachers and leaders become wise enough to foresee what the future has in store for us? What a happy day will it be, when the nations of the earth shall no longer bow down in ignorance, and crawl in the dust of superstition, but rather standing up in the liberty wherewith knowledge shall make them free, shall look with perceptive vision over the universe, and behold what lies in the prolific womb of the future, as

GYNECOLOGICAL INSTRUMENTS. 545

easily as we now behold what lies entombed in the mighty mauseleums of the past.

The following is a list of the graduates : Francis Keller, George W. Barr, Alfred Thomas, Will C. Meredith, D. W. Dickinson, Bessie E. Perry, Mrs. Carrie Wilbur, Charles W. Pyle, Albert T. Huxley, Fred A. Remington, Mary A. Meyers, O. W. Hartman.

GYNECOLOGICAL INSTRUMENTS.

BY PHIL. PORTEB, M. D.

NEW SPECULUM.

We trust the profession will pardon our audacity and assumption when we claim for this instrument an improved Sims' speculum or perineal retractor.

Recognizing some faults in the old time honored specu- lum that has made for its originator a name now famous the world over, we determined to correct them, if possible, and yet retain the superior points of the old instrument.

With Sims' retractor we found the blade at a right angle with the handle which prevented its being used in the dorsal position, on an ordinary gynecological chair or table, for operations in the vagina, and owing to the peculiar shape of the speculum, the patient's clothing must be thrown well back from the hips, exposing her person, which is an objec- tionable feature in our American practice. We also found it necessary, when working in Sims' position, to construct a flange or shield on the upper side of the blade, to pre-

546 GYNECOLOGICAL INSTRUMENTS.

vent the overhanging buttock from obstructing our view. We then decided to do without the extra blade — ^a super- fluous article — and place a handle at an obtuse angle with the blade, which would not only obviate the above objections of Sims', but give us an instrument much better to manipu- late and not awkward to hold.

The advantage of this speculum over Sims' can be bet- ter appreciated when employed by one familiar with the old instrument.

UTERINE DRESSING FORCEPS.

We also present to the profession a pair of uterine dressing forceps which more than meets our expectations. The special advantage of this forceps over the others is, its pelvic curve near the points, which prevents the hand from obstructing the operator's view when working about the cervix.

The sliding clasp on the right hand side, with the large thumb piece, enables the physician to fasten or retain any dressing, stem, tent or bougie, without holding on to the instrument

The spring is made very soft, to avoid tiring the hand, a fault that is usually associated with all spring forceps.

FEMALE CATHETER. *

As before stated in this journal, we have had constructed a catheter for evacuating the female bladder of which we now present a cut.

The greatest objection to the present form of female catheters is the large eyelets or slots at the point of the in- strument, which allows the bladder to contract firmly around that portion, and, as the calibre of the- tube is less at that

SANITABTY NEEDS. 547

part, the mucous membrane will be forced into the apertures and the tissue injured more or less a& lorce is used to with- draw the catheter. Let this be repeated for several days and cystitis follows.

This instrument is perforated with thirty-six small holes which provides plenty of space for the escape of the urine and the size of the tube is maintained its entire length, • not presenting any surface or space for the bladder to con- tract about.

We have also had an attachment or coupling piece added which permits the use of small rubber tubing, of any desired length, to convey the urine from the bladder to a vessel along side of the bed, thus avoiding soiling the pa- tient's clothing.

SANITARY NEEDS.

D. W. DICKINSON, JB., M. D.

How people shall be bom and reared so that they shall attain the highest social and physical development is a vital question.

A man's life is a march from the cradle to the grave and each step should mean an advance physically, mentally, morally, and death be the result of physiological decay. That we have fallen far short of securing this is patent to all, so much so that the sigh for relief is heard upon all sides and eyes are opening to the enormity of man's deteriora- tion. Intelligent people are asking : How did he become so? What are the causes which have operated to pro- duce this result? and what is still keeping him in this condition?

548 SANITAR Y NEEDS,

Created in the image and likeness of God, originally he was perfect ; nor can we cast the blame entirely upon that far away Adam of Eden, but must recognize that each one is in a large degree the Adam for himself and progeny.

Emerson says : " We are all entitled to beauty, should have been beautiful if our ancestors had kept the laws; as every lily and every rose is well. Because of this our bodies caricature us and satirize us."

In our greed for gain ; in cultivating our minds to cope with great problems ; in drinking the cup of pleasure to its dregs, we lay too great a burden upon our bodies. The strain is too much, and the machinery either ceases to move, or, maried and unsightly, it goes creaking and groaning reluc- tantly along.

True we know more about rules of living than formerly, and lay greater stress upon their observance. Our advance- ments in science have furnished us weapons to skillfully combat the lurking miasm and destroy its effects. With all our knowledge and resources we should be a long distance farther on toward the millenium of correct living; but we have allowed certain morbid influences to continue in exist- ence for ages, and many others to creep gradually in. It is well that we reflect upon our condition and see if we cannot seize this dilemma by the horns and work out a radical cure for ourselves and generations yet unborn.

There is a universal natural law called heredity, which has exerted its power upon the human race for good and for evil from all time. The evidence of its influence is more striking and cumulative in the lower orders of animate nature because increasing diversity multiplies the factors which modify each other and obscure the relations between cause and effect. In the varieties of fruit, the many roses, the different breeds of horses and cattle, you behold its action. In man, look at the family of Bach in music, Titian in paint- ing. Fox in diplomacy, and see how constantly genius is transmitted through successive generations. Much of our life is pre-determined. What it shall be is almost entirely in

D. W. DICKINSON, JR., M. D. ^ 549

human hands. The instinct, the impulse, the bias are pa- rental. Its power in disease is equally great.

See that fair maiden of twenty with the hectic flush upon her cheeks, grown so thin that a breath of air seems sufficient to waft her away, with voice so feeble and faint that each word seems the last. When were the seeds of that disease planted ? We say at her birth.

Behold that statesman now in the prime of life, just reaping the rewards of years of toil ; with mind still vigorous to win future renown, but with a body that will not bear him on. There lurks within a gnawing, lancinating pain which will not down — a malady which is slowly but surely sapping his vitality. When did he receive the germs? We say at his birth.

There is a child with face as blank as the mind which gives it expression, with incoherent speech and uncouth movements, an example of heredity. ^

While pre-existing tendencies are the maintaining causes, there reside in the air, food, water, and in the manifold influences of human society the exciting causes, which deter- mine the appearance and variety of disease. Pure atmos- phere to breathe ; uncontaminated water to drink ; unadul- terated food to eat, and pure society are essential to health. Prom the Pontine mashes of Rome and the flats of the Poto- mac rise noxious vapors; a pall for the deaths they entail. A pestilence rides upon the wind sweeping down the people like grass before the blade. In a hundred preventable ways we inhale the seeds of disease. Man has but one companion in his ominivorous habit. He sends his ships to every clime to cull articles to please his palate unmindful of their injur- ious effect on his stomach. " Hunger is physiological, appe- tite is pathological," and he becomes a gourmand, a dyspep- tic, and suffers from many dire complaints that he may grat- ify the latter. Are these all? Cannot heredity with the man- ifold modifications his envirionment can cause be enough for man to encounter and subdue? Yea, enough but not all.

For six centuries the improper use of narcotics and

550 SA NITARY NEEDS,

stimulants has exerted its power among civilized nations, feeding and augmenting a depraved sensual appetite.

From that day to this they have swept down the decades like a whirlwind with ever increasing fury and force, until, like a devil incarnate, they defy all restraint and threaten the very bulwarks of existence. First came tobacco from the west, then tea and coffee from the east The fanci- ful dreams of a morbid De Quincy gave opium a push into the stream of appetite. There is alcohol the king of these poisons, wine hoary with age, and the anaesthetics, chloro- form, ether, and chloral hydrate, which have been added to the list within the last half century. The history of their introduction and habitual consumption is replete with sad but intense interest. Like a kite against the wind they seem to flourish by opposition. Under the erroneous name of stimulants they become necessary to life, second only to food and air.

By every device known to ingenuity, people have sought to hide and neutralize the visible marks of their ravages. They have allowed their use with silence and apology rather than argument. It is not necessary to an intelligent body of readers, to argue the evil results of their abuse. Their very mention pictures to the mind the mental wrecks they have caused, the base passions they have aroused and the splen- did physiques they have marred and ruined.

We can not now claim to have mentioned all the causes of mental and physical degeneration, but only the principal and most preventable ones. It is inconceivable that man, having been given an inquiring spirit to search, an intelli- gence to apply, and an inborn hope to use efficiently means for counteracting these noxious influences, should be disap- pointed and foiled.

The past has demonstrated in the use of cinchona in fevers and vaccination in small-pox what can be done. The last few years have seen all nations awakening to the &ct that proper sanitation will rob man of half his ills. In the past they have turned a deaf ear to the warnings of sanitary

J

i>. W, DICKINSON, JM,, M. t). 551

science, but now an interest is growing in the investigation of causes, in making efficient quarantines, and in preventing the spread of disease. The progress is too slow. • Movements are made as though it were a doubtful experiment. The cit- izen does not realize his duties to the nation, to the profes- sion, and to himself in this question. His first duty is the safety of the republic, then the promotion of the six precepts set forth in the preamble of the constitution. Inasmuch as public health is essential to domestic tranquility, to the gen- eral welfare and even to justice, it is of the highest import- ance that this receive his attention and legislation. We have progressed so far as the formation of a National Board of Health, and some State Boards have been created. In their short existence they have done a grand work, but a grander is in prospect when they shall have received due recognition. A law giving less than plenary rights to a board is but a mockery of power and will inevitably bring such a body into unpleasant complications with citizen, council and gov- eAiment. When we say they may simply advise such and such a measure ; when we say they cannot put their hands in the public purse to carry out projects of reform we make of them a figure head. When statistics show one hundred thousand deaths and two hundred thousand cases of pro- longed sickness from neglect in one year ; when an enumer- ation of the most preventable diseases includes the worst scourges of mankind, can we be too prompt in instituting measures for their eradication ? Will millions spent in main- taining a profession whose duty shall be to enforce sanitary precautions, overbalance the untold amount lost in the lives, time and work of these citizens ? If " all a man hath he will give for his life " is true, the acts of society are inconsistent. This is the great mystery of humanity, " Health is na- ture's simplest faith." While its laws are fixed, irrevocable and eternal, yet they are easily understood. If long life, unalloyed happiness*, ecstatic pleasure are the recompense for simply walking in its broad paths, and premature decay, pain and sorrow and ungratified desire, the certain penalty

652 8 A NITAR Y NEEDS

for wandering in the tangled by-ways that stretch far away from it in unknown lines, why need anythibg be said as to wherein their interest lies. But the sanitarian, while abashed at -the simplicity of his lessons, yet knowing the stubborn incredulity of the world, realizes the magnitude of his under- taking. Ask the dying millionnaire all that he has for a new lease of life and he clings to his gold. Ask the legislator what are the most important considerations affecting exist- ence and he will reply, mental and physical health, yet ht scarcely recognizes that this momentous question needs any legislation.

The state appropriates millions for, and points with pride to its public works, many being homes for the victims of disease, but the unostentatious work which shall bring moral and physical health to its citizens is almost wholly forgotten. Look at the charity lists of the legislatures— nearly all in the interest of existing evils, and but little towards aborting or preventing them.

It is a sign of advancing civilization when public atten- tion is directed in a practical way to the hygiene of the peo- ple. The world is beginning to see that the introduction of sanitary science has opened a new chapter in human history, a history which will be read in aftertimes with admiration and amazement; admiration for the physician's wise endea- vor; amazement at the opposition to so beneficent and&r- reaching a measure. We are not looking forward to a phys- ical millenium, but to a lessened mortality and stronger life for man. To this end the people must join hands with the physician in a persistent work. "Eternal vigilance is the price of health," and each working in harmony will bring health to the nation. It is health " that beautifies the babe, ennobles the man, glorifies the woman, which no wealth can purchase, no ancient lineage or exalted station secure." Health is the priceless talisman of beauty; health is the pat- ent of nature's own nobility; health is the crowning glory of womanhood and of all humanity, the source of all earthly happiness, the mainspring of every human pleasure.

ULCERATION OF THE INTESTINE. 563

ULCERATION AND PERFORATION OP THE INTES- TINE AND APPENDIX VERMIFORMIS.

BY E. R. BLUS» M. D., DETKOIT, MICHIGAN.

It has been my fortune to see four cases of this remark- able complaint, and as the symptoms and diagnostic marks are so uniform in all, I wish to recount them.

On being first called to a case of this kind, the physician may surmise that hie patient has colic, if he see him early in the attack. At his next call he will find greater urgency of all the symptoms and may then suspect that there is local inflammation of the intestines, or peritoneum, or both. The pain is usually quite circumscribed at first, and may be felt to proceed from a given point not difficult to determine. From this point it will radiate or extend, more or less, over the entire abdomen. There is not much, if any, febrile action manifested by heat of surface, although the pulse will usually be more frequent but small.

The ulcerative process, before it results in perforation, may be going on, I have reason to believe, for many months and even years, without causing any alarm or even being suspected by the physician or patient. But when the perfor- ation is complete, and thereby the liquid contents of the bowels allowed to escape into the abdominal cavity, a crisis immediately comes which can only end in the speedy death of the victim. He goes into a collapse which in some respects, resembles that of cholera, except that there is no diarrhoea. There will be ^ cold sweat on the forehead and vomiting of blood or a substance looking like tobacco-spittle. He will be pulseless, and that with the intense burning sen- sation internally, may lead the physician to inquire if the patient may not have taken Arsenic, accidentally or other- wise, although the absence of diarrhoea would contra-indi- cate such a conclusion. But in any event the patient will be a corpse in from 18 to 20 hours from the time the perforation occurs. When this takes place the physician in reviewing the case, may rest assured that he has had a case of perfora-

654 TJLCMRATlOtf OF THE INTESTINM,

tion of the intestine, or appendage, and for his own satisfac- tion and the satisfaction, of the friends of the patient should ask for a post-mortem examination. Some 18 years ago I was asked to make an autopsy in the caae of a boy of 10 or 12 years, the son of a physician, who had died in a manner very sudden and unusual. On opening the abdominal cavity from one to two quarts of fluid, €>f a sero-purulent character, poured out. In the vermiform appendix was found an ulcer about the size of a white bean which completely perforated that tissue. In contact with it was a small fsecal or calcar- eous substance which had formed, to all appearance, at that point, and which had given rise to the ulcerative process. In the month of January of the present year I was called to a young man of 18 years whose case presented all the condi- tions above recounted. He died in 18 hours to the astonish- ment of his parents, who supposed him to be in prime health and strength. I explained the matter as being undoubtedly that of perforation of the intestine or vermiform appendix and solicited an autopsy. This was granted, and next day in company with Dr. H. P. Mera, of this city, it was held, when a case of perforation of the appendix, precisely like that above mentioned, was found.

Twelve years ago I had one of these cases where the perforating ulcer was in the small intestine near its junction with the colon; and six years ago a similar one in the trans- verse colon, both terminating fatally in 18 to 20 hours from the time when the perforation was completed. I said above that this ulcerative process might have been going on for months, if not for years. The evidence of it is this: in ofl of these four cases the ulcers had an ancient appearance being perfectly black like an old tooth which has been undergoing decay for years. In one of the above the patient had had puerperal peritonitis four years before, and had never been fully well afterwards, having at times a sudden and severe pain at the spot attended with pallor of face and usually temporary faintness. Indeed the latter was present in all the cases recited above. Parents could recall having frequenfly

CBlCAQO BOMWOPATHIC COLLEGE. 556

noticed, for a year or two, in the lost children — for three of the above cases were children— expressions of pain in the bowels with clapping their hands to the abdomen for a mo- ment, with marked palor of countenance and faintness. All these symptoms and manifestations however are likely to be overlooked until after the death of the patient. Then it may be clearly seen from the rapid termination of the case that you have not had any natural disease to contend with, and this explanation will be quite sure to secure for you a post-mor- tem examination. This is a part of the transaction you should not omit, for otherwise the friends of the patient will never be fully satisfied regarding the cause of death, as nearly every doctor to whom they recount the circumstances of the case, will give it a diflferent name.

In two instances of sudden death in this vicinity, which, from all the manifestations must have been of the character presented above, the attending doctors disagreed to sqch an extent as can only be considered a discredit to our profes- sion. " Inflammation of the bowels," " Heart disease," " Dry cholera," *' Biliousness," etc., were the varying conclusions arrived at. An autopsy alone will convince all.

CHICAGO HOMCEOPATHIC COLLEGE.

The eighth annual commencement exercises of the Chi- ceLS^o Homoeopathic Medical College were held at 2 o'clock? March 6th, in Haverly's theatre. President Foster gave his annual report, speaking of the past year as a prosperous one, in the number and quality of students and in finances. As many as 2,400 patients received treatment at the college dis- pensary, 900 of the cases being surgical. The County Hos- pital, so near at hand, gave unsurpassed facilities for medical education. Thirty-nine students composed the class of 1884, and all had been found "virorthy of diplomas.

The faculty valedictory was then given by President R. N. Foster, and although long, did not flag in interest. He spoke of the class before him as just born, Alma Mater hav- 3

5o6 cmCAOO HOMCEOPATHtC COLLEGE,

ing cut the cord that bound them to herself, and sent them forth to a more independent life. Only experience could nurture them. The path to success was a straight line, with no deviations of quackery. Medicine was a tact as well as an art, and when the young doctor had settled in a live place, let him attend to business and his .patients would attend to his reputation. A Homoeopathic doctor was never a cyclone but a gentle and refreshing breeze. Though pursuing his profession with enthusiasm and singleness of purpose, he should not neglect the other relations and amenities of life. After the '^Song of the Spinning Wheel," Dr. George Zim- merman gave the class valedictory, a well-written and well* delivered address, with touches of pathos and humor that were appreciated. He emphasized the claim on the doctor to be pure, a bringer of sunshine to the sick room. The fac- ulty had left no stone unturned. Might the noon day of his classmates be aglow from the sun of success and songs of suf- fering relieved make happy the twilight of life. An address by the Rev, Dr. Thomas was another enjoyed feature, embodi- ing as it did some laughter-producing descriptions of old- time practice. Of the three chief professsions, law was unchanging, a certain quantity, while as to the doctor of medicine and the doctor of divinity, it was sometimes uncer- tain just where they were. A man with a bad lawyer would only lose a case, and without a minister could come to God and heaven, but what the suffering outside world wanted unanimously was to get cured when ill, and the value of a skillful doctor was above price. A sacred and high function was that of the physician, a helper of morals and souls as well as bodies. In conclusion, Chicago was congratulated on its character of a great center for medical education. The college quartette and orchestra again officiated pleasurably, and the exercises terminated.

SPEECHES AND VIANDS.

Concluding the literary exercises of the Chicago Homoe- opathic College yesterday was the social reunion of the grad-

J

STRA WS. 557

uating class, juniors, alutnrfi, faculty and guests, in a ban- quet at the Grand Pacific Hotel in the evening. About 150 ladies and gentlemen assembled in the parlor of the hotel to pass into the ladies' ordinary about 9 o'clock. Music during the supper and speeches, was furnished by an attending orchestra and the quartette of the graduating cliiss.

STRAWS.

BY It. M. BBODERICK, M. D., DBCATUR, MIClt.

[The remedies appended ore merely suggeftlive.] «

Nature often points out the articles of diet through the patient's craving for such.

In diseases of the nervous system there is often an in* crease of appetite, Nux., Cina., Lach.

In mental derangements craving is a bad sign.

In exhaustive diseases, diarrhoea, typhoid, typhus, and some severe diseases of the brain, when the patient after complete loss of appetite for days, suddenly and eagerly swallows everything oflfered, an unfavorable prognosis should be given. Such a symptom, instead of being hailed with delight by the anxious attendants should be regarded as an extremely unfavorable if not a fatal symptom, by the physi- cian. It should call our attention to Hellebore.

In phthisis pulmonalis the teeth are of a ])early color.

Grinding or -gnashing of the teeth indicates some irrita- tion of the intestines as worms; Cina., Merc: when in old people, it precedes aploplexy ; Bell., Op.

Pale gums indicate chlorosis; Ferrum: blue in cyanosis and scurvy; Merc: brown or black in typhoid; Rhus., Bry, Bapt., Arsenicum.

A bluish or slate colored strip on the gums in lead poison- ing, Sulph. acid, Plat.; a pink line in phthisical persons, Phos.

In diabetes the gums recede from the teeth rendering them loose. When they are spongy looking and of a bright red color, soft and compressible, they indicate caries; Merc, Aur. m.

658 BfkAWlS,

A bright, dry^ shining tongue indicates irritation of the mucous membrane of the stomach and' bowels ; Ars., Bell., Ant. t.

A dry, yellowish, * or bright red tremulous tongue is found in. cholera; Arsen., Bry., Carbo., lod., Rhus., Verat.

A dry, rough and cracked tongue, with elevated pap- illsB, shows the abuse of mercury j Sulph., Nit. acid.

A very bright red tongue in violent inflammation of intestines, or in the second stage of pneumonia; Ant. t., Sulph., Rhus., Hyos. • A white, light coating in rheumatism; Arnica, Laurocer- asus, Hydrastis.

In suppurative inflammation of the liver a curdy or creamy coating of tongue in streaks; if it adheres firmly the disease is not abating, but if it begins to clean from the edges, it indicates a speedy recovery. If it cleans in the middle first and then becomes coated again it is unfavorable.

A dark brown or black, fissured or cracked tongue with red edges is found in typhoid; Rhus., Bry., Bapt., Are., Hyos.

In acute nervous diseases a tremulous tongue indicates danger; Hyos., Bell.: but in chronic form it is not so unfavor* able.

When the patient in showing the tongue does not return it to the mouth, it indicates disease of brain; Hell. Hyd., Ac.

A clean red tongue with papillae prominent; Arum, Rhus., Nux.; or a furred tongue with the papillee appearing through the fur indicates scarlatina; Bell.

A reddish tremulous tongue in mania a Potu ; Bell., Hyos.

A thick yellow fur on the tongue with bitter taste; Cham., Pod., Merc, Dul., Hydr.

A pale, flabby tongue with large papillsB, indicates gas- tric derangement; Nux. v., Colch.: also met with in chlor- osis; Sulph., Ferr.

A sharp pointed tongue is met in irritation and inflam- mation of brain. Stram.

H. M. BRODERICK, M. D. 559

Ptyalism is sometimes a symptom of pregnancy; Jabor* andi. It is a favorable sign in confluent small-pox.

The saliva of pregnant or lying in women is milky ; is frothy in hydrophobia, epilepsy, apoplexy or tetanus. It is a blue color in poisoning by lead. It has sometimes been observed to be yellowish in liver complaints and jaundice.

Waterbrash is a symptom of induration of the pancreas; Nux., Carbo., Merc.

Salty eructations in hysteria; Ign.: in hsematemesis; Puis.

Sour eructations in cancer of the stomach ; Carbo. Nux., Con.: sweetish precedes hsematemesis; Aeon. Kreos.

Eructations of sulphuretted hydrogen4ndicates that ucer- ation of stomach has begun, or an. abscess has opened .into it; Hepar.

Vomiting: The sooner it occurs after eating, the higher up in the intestines is the disease seated.

In great debility of the stomach, green substances are vomited. Aeon., Ant. t., Cham.

In contractions of the intestines, hernia, peritonitis there is vomiting of feeces. Opium.

Rumbling of the bowels and emission of flatus are good signs, in fevers, diarrhoeas, dysentery and cholera.

If vomiting ceases after eating small portions of food, it indicates ulceration of the bowels; Mur. ac

Constipation in old people is conducive to health and comfort. It occurs at the beginning of most acute diseases. When it suddenly occurs during a disease instead of diar- rhoea, it is an unfavorable symptom. Irritation, conjestion, or preternatural collection of blood in the bowels produces diarrhoea.

Persons who eat much and exercise but little, seldom have alvine evacuations. Nux., Sulph., Bry., Pod.

If feces pass quickly and free from odor, it is favorable ; but unfavorable if delayed and foetid except in scrofulous phthisis.

Purging occurs in dentition; Arsen,, Cham., Ipec,

5«0 STRA WS.

Rheum.; in measles, Apis., Merc^, Scilla; in small-pox, Amm. c, Camph., Ham.; in gout, Nux. Colch.; in childbed fevers, Col., Ipec, Merq.; in inflammation of peyers and mesentenc glands and typhoid fever; Bapt, Apis., Am., Carbo. V., Merc,, Mur. ac; Rhus. ; if it be preceded by vom- iting it is a good sign.

If diarrhoea occurs soon after eating it indicates inflam- mation of the mucous membrane; China. Ars.

If pain before stool, it indicates irritation, inflammation or ulceration of the rectum or colon. Col., Rheum., Pod., Lep., Merc.

Tenesmus occurs in inflammation of colon; Bell.; or rectum. Aloes; hemorrhoides, Ars., Nux. Sulph.; worms, Aeon., Stanu., Sulph.; dysentery, Merc, c, Mag. c. Kali, b., Nux., Nit. uc; in abscesses, Merc. Sulph.; in retroversion and impregnation of uterus, Puis., Dulc, Cham., Sulph.

Diarhopa is unfavorable in the last stages of consump- tion, dropsy or cancer of the uterus.

Long lasting diarrhoeas occur in chronic enteritis, Amm. c, Hyos., Pod.; in ulceration and tubercular diseases of the bowels; lod.

Pain on going to stool may be occasioned by inflation of the rectum or acrid fevers ; Pod.

The sphincters act with great force in cholera and catarrhal afiections; Arn., Merc, Sulph.

Involuntary evacuations indicate paralysis of the sphinc- ter, and occur in apoplexy; Am., Hyos.: in concussion and organic disease of the brain; Arn.

The quantity and appearance difiers. If it is a whitish .)rown, it shows a deficiency of bile; Pod., Merc. Lept: it may contain a mealy sediment which indicates irritation and ulceration of the bowels; Pod., Nit. ac.

The meconium is brown. In the child at the breast the feces are pale; in adults small, soft and found; in old age hard and globular. In children it is yellow; in adults brown, and in old dark brown. Green herbs give a green color; black fniits, iron and tomatoes give a black color;

MENORRHAGIA, 58]

Rheum gives yellow, and Sulph. an odor of sulphuretted hydrogen.

If it be profuse with diminuition of strength it is called colliquative; Amm. c, Cal. c, Ferrum, Euphorb., Elater- ium. Zanthox.

If undigested food passes with the feces, it indicates irritation or inflammation of the stomach and is called lient- eria; China., Nit. ac, Ferr., Ars., Pod.

Serum resembling clear water, sometimes like mucus and sometimes turbid, is passed in irritation of the bowels, or where there is suppressed secretion of some organ, or from saline purgatives or mercury; Bry., Puis., Opium, Jalap.

Watery evacuations are bad in chronic discharge from the testes, Pod. ; nor do they relieve except in dropsy.

False membranes, or even parts of the intestines may be passed and still recovery is possible; Puis., Canth.

Pas is passed in ulceration of the rectum or large intes- tines; and in abscess of any abdominal organ opening into the tract; Phos.

The stool is fatty in phthisis, Cal.; and bloody in irrita- tion, congestion, inflammation and ulceration of the intes- tines and liver, Ant. c, Merc, c, Carbo, Ipec, Ham., Nit. ac. ; piles, cancer and fungus growth, Ars., Ham., Hydras., Sang, ; if it be clear and red it is from the lower part of the rectum, Ars., Ham., Ipec; if dark brown it is from higher up, Ham., Aeon. ; if relief follows its passage it is favorable.

MENORRHAGIA.

BY L. B. RICHAROe. M. D., STAFFORD SPRINGS, C»NNECriClIT.

Hamamelis — Nux vomica, — Jan. 10, '83, received telegram to call on Mrs. E. On my arrival found a "regular" in at- tendance ; had been for two days. It was a case of menor- rhagia at the climacteric; had received ergot in appreciable

562 MENORRHAGIA.

doses ; nearly all sorts of local applications ; was then ** packed " and a large stick of alum was in the cervix, but still the flow continued. Found I was to act as counsel with the attending physician.

There was no pain, and the character of the flow could hardly be ascertained; recommended Hamamelis internally, and if they desired, a local application of Pond's Extract of Hamamelis. It seems they had not much faith in my pre- scription, but soon sent for another " regular ; " and again the next morning for still another "regular;" but the pa- tient went on from bad to worse for two more days, when the husband resolved to use my prescription, which he did with a happy result ; for in a few hours afterwards the flow ceased.

In March she had another attack ; the " regular " was again called, and again was she tamponed, and injections used. Even tincture of iodine thrown into the uterus with no other result but to cause severe pain. Again was I tele- graphed for. This time I resolved to treat the case or not treat it. The " regular " was dismissed.

The only symptoms I could find on which to base a pre- scription were, ^^awaking after 2 a. m., with inability to sleep again; and the fact of her always eating highly seasoned foods. Gave a dose of Nux v.; left powders of Sac. lac. and one popder of Nux v. to be taken at 9 p. m.; all local applications discontinued. Galled next morning; patient had slept well all night; first time in several weeks; flow very much lessened. Left Sac. lac. and one powder, Nux v, for 9 p. lA., which was probably a mistake, as she reported next morning " did not sleep quite as well as the night be- fore, but the flow had entirely stopped."

Was called again in May ; sent Sac lac. and one pow- der of Nux V ; flow ceased in a few hours, since which time she has been well, except soon after the last attack men- tioned had an uncontrolable desire for sour things only, fresh horse-radish in vinegar especially, which Nux v did not relieve, but a few powders of Hepar did.

JOSEPH H7PP0LYTE PULTE, M. D. 563

JOSEPH HYPPOLYTE PULTE, M. D.*

Dr. J. H. Pulte, was born October 6th, 1811, at Meschede, in the Prussian Province of Westphalia. His father, Hermann Joseph Pulte, M. D., was the medical direc- tor of the government institutions for the education of mid- wives, and as these institutions had to be organized all over the newly-acquired provinces, he was especially deputed for that purpose, besides presiding over the institution confided to his care.

Completing a classical course at the gymnasium of Soest, and a medical course at the University of Marburg, he accepted an invitation from his eldest brother to accompany him to America, where he intended to locate in St. Louis, Mo.

In the spring of 1834 he sailed for the United States to reach St Louis via New York. On his journey through Pennsylvania, however, the Doctor was induced by a personal friend to stay in Cherryville, Pa. Here he formed the ac- quaintance of Dr. William Wesselhoeft, at that time residing at Bath, nine miles from Cherryville. Dr. Wesselhoeft was the first to induce him to test the merits of homoeopathy by actual experiments. These trials were so successful that Dr. Pulte became, enthusiastic in his devotion to the new doctrines, and at once entered with great zeal upon the study of homoe- opathy; henceforth he did not shrink from any hardship or exposure necessary to acquire a complete knowledge of the same. It was difficult and expensive in that early time (1834) to procure the means of prosecuting the study of homoeo- pathy. There were then no text- books; a greater part of the facts and practical knowledge existed only in manuscript sent to America from Europe, and circulated to be copied and studied.

The first attempts at a more systematic treatment of Asiatic cholera were thus transmitted to the Northampton County Society of Homoeopathic physicians, in manuscript, from Europe, and by its members copied and studied. Dr.

<S€e firontisi^eoe.

564 JOSEPH HYPPOLYTE PULTE, M. H

Pulte soon joined a society of homoeopathic practitioners who had united themselves for mutual advancement in knowl- edge, under the name of the Homoeopathic Society of North- ampton County ; this was the first one of the kind on this continent It was no doubt in these days a difficult task to belong to a society and to do justice to its requirements. But the members were seldom found missing at these friendly gatherings; their example being more worthy of imitation by many homoeopathic physicians to-day. The greatest acces- sion to the society was made when Dr. C. Hering, of Phila- delphia, joined its number and took up his residence at Al- lentown, to preside over the academy, which had been formed by this small band of Hahnemann's disciples. Dr. Pulte re- cognized in Dr. Hering the man of genius, and submitted cheerfully to the moulding influence which such a mind would naturally have over others. Besides attending to the numerous meetings for scientific and other purposes, frequent occasions would offer where public addresses had to be de- livered, or poems to be read. He never shrank from any work thus laid out for him. •

Six years of great activity of body and mind were thus passed, giving and receiving instruction, healing the sick ; but during which he never relinquished the intention of joining his brother in St. Louis and bringing him into the light of the new doctrine. He did not, however, carry this into execution until the academy was dissolved. After the closing of this institution, the various physicians connected therewith, went to different and larger fields of labor.

Dr. Pulte took up his march again westward to St. Louis, whither he intended to go six years previous. He travelled in company with an intelligent Englishman, Edward Giles, whom he made a convert to homoeopathy theoretically, but who wanted practical proof.

He tarried in Cincinnati to give his friend Giles an op- portunity of witnessing cures by homoeopathic remedies. For that purpose he opened a private dispensary, where some of the sick children of the poorer classes congregated to get

JOSEPH HYPPOLYTE PVLTE, M. D. .^65

relief. This was during the summer, and summer-complaints prevailed. Mr. Giles was astonished at the speedy cures, and it seems so were bIso those more nearly concerned ; the poorer classes told the richer, and the latter also soon sought the doctor's aid. In less than six weeks' time Dr. Pulte was in full practice in Cincinnati, and on account of the numerous engagements he had to fill, relinquished the idea of going to St. Louis.

In the autumn of this same year he was united in mar- riage to Miss Mary Jane Rollins of Pittsburgh, a lady who soon shared his enthusiasm for the science of homoeopathy, and who ever after rendered him valuable aid in pfeparing his medicines and assisting him even in his professional duties. Much of the success of Dr. Pulte in Cincinnati was due to the sustaining sympathy and strength of character of Mrs. Pulte.

In 1846 he published his work on history, in German, entitled Organon of the History of the World. His purpose in •this work was to develop a philosophy of history and its elevation to the rank of one of the natural sciences. The work was regarded with favor by Humboldt, Guizot, Schel- zing, Bryant, Bunsen and Lepsius. In 1850 he published a work on domestic practice, which had a large sale in this country, and was reprinted in London and translated into Spanish. Its arrangement was entirely original, and the book seems to have pleased the public so well that no book of similar size and import in the homoeopathic literature has had such a circulation throughout the world as this. He was. one of the editors of the American Magazine of Hom- oeopathy and Hydropathy, during the three years it was pub- lished, and in 1863 he published the Woraan^s Medical Guide, This book was also republished in England and translated into Spanish. Dr. Pulte was the first to urge the practicabil- ity of girding the world with the telegraph. During a visit to Europe in 1848, he brought the subject to the attention of several governments, and through Humboldt ^as in a way to secure important aid from the Emperor of Russia, when the Hungarian war broke out and the project was frustrated.

566 JOSEPH HYPPOLYTE PULTE, M, D.

A memorial upon the same subject, proposed by Dr. Pulte was presented to the United States Senate, by Salmon P. Chase, and received attention from that body. The doctor's plan was to carry the wires across Behring's Strait, and thence across Asia to the principal cities of Europe. The same idea was afterwards taken up by Major Collins, and in another way has since been carried into effect. During the preva- lence of cholera in Cincinnati, in 1849, the doctor had the pleasure of seeing the homoeopathic treatment triumphant beyond any other. Homoeopathy, after this trial of 1849, was firmly established in the whole West and South, many physiciafls of the old system embracing this method of prac- tice, more or less through the agency and influece of Dr. Pulte.

In 1852, Dr. Pulte accepted and filled the chair of Clin- ical Medicine in the Homoeopathic College of Cleveland, and he afterward filled the chair of Obstetrics in the same insti- tution. In a public address called the "Science of Medi- cine," during this time, he pointed to the cell as the real starting point of the pathological development; here already were indicated the principal features of that pathological edifice which Virchow afterward erected into his famous cellular theory.

In 1845, the centenary year of Hahnemann's birth, he was appointed to deliver the annual address before the Amer- ican Institute of Homseopathy, which met in Buffalo, New York. In the same year he was solicited to accept the Pro- fessorship of Homoeopathy in the Michigan University. Dr. Pulte was not only a learned and thoroughly practical phy- sician, but was also a very intelligent and public-spirited citi- zen, and aside from his professional duties found much time to devote to public affairs.

He was recommeded to President Johnson for the Aus- trian mission, by the Hons. Bellamy Storer, Alphonso Taft, A. F. Herr and others, and was promised the support of the Hods. Carl Schurz, B. Eggleston, W. S. Groesbeck, and other prominent statesmen, in case his name should be sent to the Senate.

Membranous croup and diphtheria, 567

He was the author of numerous poems, written and published chiefly in the German language.

In the fall of 1872, Dr. Pulte delivered his last course of lectures at Cincinnati, at the college which bears his name. The writer had the pleasure and privilege of hearing these lectures, and can bear testimony that they were highly appreciated by the class. In 1873 a severe illness led to his withdrawal from the active practice of his profession. A maxim of the doctor's was, that "the height of all pleasure was an increase of knowledge ; " and he may be said to have spent his whole life in the pursuit of this greatest pleasure.

Dr. Pulte died February 24, 1884, at the advanced age of seventy-two years. He suffered much during his last illness, which was characterized chiefly by inability to sleep and to take food. He remained. conscious, however, and in full pos- session of all his faculties until within an hour of his death, which he awaited with a calm and Christian-like spirit, and which came at last like a slumber. The remains were conveyed to the Spring Grove Cemetery, and borne to the vault by twelve of the profession of Cincinnati, who acted as pall-bearers. This sketch may be fittingly closed by simply adding the motto of Dr. Pulte's family : *' VirtuU ad aatra.'' S. R. Geiser, M. D.

"SUCCESSFUL TREATMENT OF MEMBRANOUS CROUP AND DIPHTHERIA."

BY J. B, WOOD, K. D , WB8T CHEBTEB, PA.

Under the above caption Doctor Falligant, of Savannah, Georgia, proceeds to give his successful treatment of ihe&e two, much to be dreaded diseases, in the March number of the Hahanemannian Monthly. I am pleased with the fact that he cured his cases, but with what he cured, or the modus op- erandi of cure, I am unable to learn anything that will be of service to me in the treatment of similar cases. For instance he says that, " his treatment consisted of Hepar sulphur Ix? Spongia tinct. five drops; Kalibich.crtide, 1 grain, in a turn-

568 MEMBRANOUS CROUP AND DIPHTHERIA.

bier of water — of these three solutions he gives — (does not say how much) every half hour day and night incessantly. In addition I employed the steam atomizer, putting in the sup- ply cup some lime water, into which I dropped some 20 or 30 drops of turpentine dissolved in sulphuric ether, which being prepared with one part turpentine to -6 or 7 parts of ether, was equivalent to using about 4 or 5 drops of turpentine at a time. The atomizer was used from five to ten minutes every hour, day and night, until the case was relieved."

This he gives as bis general treatment of all cases of mem- branous croup.

He says, '* that in several cases of diphtheria I have since used the same local treatment with the atomizer, and with remarkably satisfactory results. In these diphtheric cases I usually give belladona tinct.; nitric acid (5 drops in a tum- bler of water) in alternation every hour (and in violent cases every half hour) and I use in the throat with a brush or atomizer as may be advisable, a solution of i brandy, i wa- ter, and 15 grains of potassium chlorate to each ounce of the liquid; I generally apply this latter every hour to every two hours in light cases, and in severe cases I use the mixture of turpentine and alcohol every fourth hour." This constitutes his treatment of diphtheria.

Now I am at a loss to understand how the homoepathic physician is to learn anything about the action of remedies by such mixtures of medicine as he proposes ; and to know to which one of the series is to be attributed the cure of the case or cases. It has been my lot to be called to very bad cases of membranous croup, such as the parents were without any hope of recovery, and I confess that I saw nothing in the case to flatter me that I was soon to fill the parents' hearts with joy instead of sadness. The child was breathing as in the last stages of membranous croup, struggling and fighting to get its breath. I saw that something must be done quickly, if at all, accordingly I took a preparation of Kali bichromicum 1-lOth and put enough of it in a tumbler of water to make it quite yellow, and strong enough to produce emesis, this I

CLINICAL NOTES, 569

proceeded to give in teaspoonfui doses every five minutes un- til emesis was produced, then at longer intervals, after which the child was relieved and soon got well. Now was it not the Kali bichromicum in Dr. Falligant's prescription that cured his case? Then why envelope the medicine that cures in the midst of a multitude of others internally, and several others through the medium of an atomizer ?

His treatment of diphtheria is also objectionable in the same sense; not that he cures, but that it is impossible for him or any one else to say what remedy did it. When I am called to a case of Angina fav^ium. I examine the throat care- fully, and if 1 find it not much inflamed, with fungus spots forming on the tonsils or pharynx,! at once give Kali bichro- micum 1-lOth as I would in croup, and in the course of two or three days the deposit disappears. The remedy is the more strongly indicated if it should be accompanied by a stringy expectoration. Belladona Ix is an excellent remedy for this affection if the throat be a bright red color and extend u^ on to the hard palate, and Apis mel. Ix, if accompanied by a stinging pain. I trust the Doctor, in the further treatment of cases, will individualize more carefully, so that we may know the remedy that cures ; but I must confess that his re- port of cases reminds me of an old man that came to my fa- ther's mill more than fifty years ago who brought a mixture of several kinds of grain to be ground for feed, which he de- nominated a jumble compound.

CLINICAL NOTES.

BY J. T. KENT, M. D.

Eryngium aquatium 30, cured a lady who had suffered with the following urinary symptoms: For two years she was compelled to pass urine about every half hour night and day ; the urine was scalding. There was burning during and sometime after passing urine. She was greatly reduced in flesh firom the continued painful urging and loss of sleep. She often lost her urine in bed because she became so

670 cohrmspondencr

exhausted it was impossible for her to awake in time to accommodate the call. The mrine was not examined chemi- cally but was high colored and strong smelling.

After taking the remedy during the day she arose only twice the following night, after which she slept well and rap- idly recovered her strength and flesh. She was upwards of fifty years of age. No cause could be discovered for the irritable bladder.

I have seen similar bladder symptoms cured with this remedy (Eryngium aq.) when used in the ^, 3x, Gx. 12x,30x, in a surprising manner. The continuous teasing^ and dribbling, drop by drop^ smarting and burning night and day, I have often seen disappear under its use.

It is uncommon for the exaggerated sexual desire to be present, unlike Canth.

The patient is generally better in a warm place, unlike Apis.

CORRESPONDENCE.

Medical Advance :

The letter from your correspondent "A," (January num- ber), escaped my notice until to-day or a reply would have been attempted at an earlier date.

1. "Explain the diflTerence between a dose in water and a dose dry on the tongue." The answer to this query may be found in the Organon, § 286. "In using a solution of this kind, a much greater surface supplied with sensitive nerves, susceptible of medicinal influence, is .brought in con- tact, with the medicine." Besides this advantage we thus obtain a higher potency of the medicine; and, (a fact noted by many observers), a medicine when prescribed the second time to the same patient will act better if given in a different manner.

2. "Can a few pellets — prepared in water, and repeated — be considered a single dose." A dose is " the quantity of medicine given, or prescribed to be taken at one time^^^ (Web-

OOttttESPONDENCE. 571

ster). *If an entire powder of pellets, say of two grains, be taken at once that is a dose; if it is divided into three equal parts and but one part taken at a time, at certain intervals, each part becomes a dose; and so if the powder is dissolved in several spoonfuls of water, whatever quantity is taken at 07^ time constitutes a dose whether it be a tea or tablespoon* fill, or the whole of the solution* I have heard a directly opposite definition given to the word but this has been the result of confounding the word prescription with do8e. A prescription is that which is ordered for or handed to the patient after consultation to betaken *'as directed." A dose is a fraction or the whole of that according to the manner in which it is taken, and each prescription may thus contain many doses.

3. "What are we to infer from rules three and nine?'' The former is explained in the above. Rule nine reads " if a relapse into the same symptoms follows an amelioration from a single dose, that remedy must be repeated." If one dose had had a beneficial efifect the choice of it must have been a wise one, and after its good effects cease, or if a ** re- lapse into the same symptoms " occurs what more rational thing can be suggested than to give the patient more of it.

There is no graver error committed by us than that of yielding to the temptation to constantly administer medicine. Ijct us carry smaller medicine vials and more Sac. lac.

Wm. Jefferson Guernsey,

4430 Frankfort Ave., Phila. February 15, 1884.

Medical Advance :

As Chairman of the Bureau of Materia Medica for our State Institute, I have been exceedingly troubled to assign work to my associates; and in corresponding with the chair- men of the same section of other States to see by what rule they were guided, I found that my troubles were their troub- les also. 4

572 CORRESPONDENCE.

In our own State, and in many others, it has been the custom to select some drug for proving, thereby somewhat enriching our Materia Medica. But really, what does it amount to?

Most of us chairmen of this, the most important of Bu- reaus which our State organizations possess, have been raised to the position of chairman or director of the section, from the rank and ifile of the profession by the appointment of our local President, not because of our knowledge of Materia Medica, but (perhaps) for the reason that our Bureau had not made a satisfactory report in previous years, and they thought it had come our turn to assume its command this year and see what we could make of it.

Now, supposing this to be the case, I would respectfully ask. How fit are we to assume the local Directorship of this Bureau? How do we know what drug to have our local Bureau prove? And suppose we do prove a drug, what does it amount to?

In many cases our Bureaus do not contain more than four to six observers; and in the matter of drug proving, what does their dictum prove?

If their labors are recorded in the Transactions of their respective States— -which they undoubtedly will be — there must be many individual symptoms finding their way into the " proving " which have occurred to but one of the observ- ers, not to the whole body of provera, and hence may be unre- liable as guides to cure sick people, being of value only as individual curiosities; whose place belongs in an Encyclo- pedia, but not in the winnowed and sifted Materia Medica, the hand-book of the every-day practitioner.

Now, if you agree with me so far, you wUl probably ask, what are we going to do about it? And in answer I' propose the following plan for your careful consideration :

In the first place, our State Bureaus of Materia Medica are altogether too small to have much authority regarding a proving which is to be incorporated into our Materia Medica as established facts, and to be taken from thence as remedies

CORRESPONDENCE. 573

for the cure of the sick. We need Tnore workers in this department of our art; and not only more workers but co-op- eration in their work.

We have twenty-six Homoeopathic State Societies, be- sides the American Institute, Western Academy, American Pfedological Society, and the American Ophth. and Otol. Society, which is certainly material enough for us to be ena- bled to make harmonious Sonclusions concerning the value of drugs if we would only act in unison.

Assuming that each of these societies has a Materia Medica Bureau in its organization of only four members, we would have a total working force of one hundred and twenty, whose dictum on any one drug would be of such a character that the profession at large would per force respect, and would command confidence.

Let this force, if you please, be divided into a northern and southern regiment, and prove or re-prove those drugs which are indigenous to their latitudes, or vice versa; so shall we be enabled to determine definitely what acclimatization influence, if any, drugs possess over provers who live in localities where the plants c^rew.

Let this force be under the control of some of the first scholars in Materia Medica in the country, who will agree upon a plan of action, the new drugs to be proven, or the old ones to be re-proved, who will also constitute the Board of Materia Medica of the United States, whose duty it shall be to scrutin- ize the work done by local or State boards. It seems to me that were such a plan as this pursued, so much mare good could be accomplished by having the work through6ut the whole country systematized, and under the guidance of a Board of Mat. Med. Directors composed of able men, who arc wholly competent to direct this work, than is now made pos- sible by the custom at present pursued, by allowing each State to proceed in a go-as-you-please manner; with its local board composed of men who have no special aptitude for this, the most important branch of medicine.

Consider also the very great advantage • such a system

574 CORRESPONDENCE.

would be to this supervising board. Tbey would be as gen- erals having an army under them. They could formulate their plans with the assurance that their Captains (i. e. the chairmen of the different State Bureaus of Mat. Med.) would carry them out; so that necessarily a much more orderly and systematic method would be the outcome, instead of the dis- order which prevails at the present. It seems to me also that did each State know that it was h part of an integral U. S. Board, they would have much more enthusiasm in their spe- cial work than they have to-day; for men like to be gov- erned, if they be but governed well.

Let this Supervising Board be elected by the physicians at large, or by the members of the American Institute, as you see fit, and let them not be harassed by restrictions. Throw upon them the burden of formulating a plan of action-^-as is thrown upon generals in the army — and we, their captains, the Chairmen of the different States, will carry out their orders: Then, and not until then, will our work amount to something.

I beg of you, my dear Doctor, to give this plan your earnest consideration, and to let me know of its imperfec- tions, vrith suggestions for improvement. The plan was forced upon me, as I said before, by the diflSculties of selecting a subject for my own local Bureau to work at, and I find that my diflBculties are net mine alone, but are common to other Chairmen. We are ripe for orders from a Supervising Board, and ready to obey them, and to carry out the plans of those who know much more than it is possible for individuals to know: receiving from them the answers which perplex us to find to the questions we must put to ourselves. "Shall our local Bureau prove a new drug this year, or re-prove an

old one. If so, what shall it be?"

Arthur A. Camp,

[The above plan of Dr. Camp meets our cordial ap- proval. Instead of tearing down this edifice in order to perfect it, this would do it after the plan of the Austrian provers.]

BOOK NOTICES. 575

BOOK NOTICES.

RECEIVED : PROCEEDINGS OF THE NAVAL MEDICAL SOCIETY, conUinIng the annual address of the President, Dr. A. I. Gihon, U. S. N.

HISTORY OP TREPHINING : By W D. Fostee. M. D.

THE REASON OF THE FAITH THAT IS IN ME: By Sam'l Swan, M. D.

DETERIORATION OF THE PURITAN STOCK AND ITS CAUSES : By JxNO. El- lis, M. D.

ANTISEPTIC SURGERY : DefinlUon and Historic Mention, By J. H. Mc Clel- LANP, M. D.

DO HOM(EOPATHS 'TRADE UPON A NAME?"; By F. H. Orme, M. D., At- lanta, Georgia

ALLOPATHIC OPINIONS OF HOMOEOPATHY: By F. A. Webster, M. D., Nor- folk, Virginia.

THE NEED OF CERTAIN IMPROVEMENTS IN PRESENT METHODS OF CAR- ING FOR THE INSANE: By H. R. Stiles. A. M., M. D.

ANNUAL REPORT OF THE GRAND MEDICAL EXAMINER, EMPIRE ORDER MUTUAL AID, N. Y. By H. M. Dayfoot, M. D.,- Rochester, N. Y.

LEONARD'S PHYSICIAN'S OFFICE-DAYBOOK.

This isaneatly, as well as practically arranged form, for a busy practitioner's day-book. It will accommodate twenty-five fresh names every day and is good for four years. In the back part of the book is arranged a place to keep a complete record of all obstetrical cases, which in itself is worth the price of the book. An obstetrical record, is a valuable addition to any physician's library. The price of the day-book is $2.50, post-paid to any address. p. p.

ACONITE. FROM A PHYSIOLOGICAL BASIS : By Wm. Owens, M. D.

This monograph, the author says is written, " with an honest purpose and sincere desire to improve the facilities for the therapeu- tic application of the Homoeopathic Materia Medica." Whatever the object may have been, or however honest the intention, it is very doubtful if the schema be an improvement on that of Hahne- mann, certainly not on those of Dunham and Hering. Far better to present the simple facts, and allow each man to make his own deduc- tions, and draw his own conclusions, in his own way. The " Phys- iological Basis" maybe a favorite one for Prof. Owens, while another man equally honest, equally earnest, may not be able to apply it at all. H. c. A.

>76 EDITOR'S TABLE.

EDITOR'S TABLE.

Rbbcovbd : Geo. M. Ockford, M. D., from Vincennes, Ind., to Revere, Massachusetts.

We are indebted to the Habnemannian Mohthly for the like- ness and sketch of Dr. J. H. Pulte.

Dr. Greorge H. Higgins is associated with Nicbo. Prancis Cooke, M. D., at 58 State street, Chicago.

Removed : W. K. Knowles, M. D., has removed to Bangor Me., and taken the office and residence of the late Dr. Gallupe.

M. M. Eaton, M. D., has returned from his annual winter hegira to Jacksonville, Florida, and resumed practice in Cincinnati.

The Central Homoeopathic Medical Association of Iowa cele- brated the 129th anniversary of Hahnemann's birth day on the 10th of April. Thanks for a cordial invitation.

The Governor of Kentucky has recently appointed Drs. Wm. L. Breyfogle, J. C. McReynolds and J. A. Lucy, members of the State Board of Health. ^Resignations will now be in order.

We regret to learn of the serious illness of P. G. Valentine, M. D., Editor of the late Clinxccil Review of St. Louis. Typho-malarial fever with brain complication. We trust he will soon be at work again.

Ohio State Society. — The 20th annual session of the Homoeo- pathic Medical Society of Ohio, will be held in Cleveland, May 13th and 14th, 1884. Every physician in the State should be present. There will be much business transacted of importance to all. Are you on a bureau ? If so, send your topic at once. If not on a bu- reau, volunteer papers will be very acceptable.

H. E. Beebb, M. D. Secretary.

Michigan State Society. — The fifteenth annual session of our State Society will commence on Tuesday, May 20, at 10 o'clock a. m., In Royal Templar Hall, Detroit. In behalf of the Society, I ear- nestly request you to be at the meeting, and assist in making our society worthy of its name, and securing for it the position it has a right to claim among sister societies. I am requested by the Pres- ident of the College of Physicians and Surgeons of Michigan to call your attention to the fact that a regular weekly meeting of the Col- lege occurs on the evening preceding the opening of the State Society, May 19, and that all members of the State society, actual or prospective, will be heartily welcomed to the privileges of the College. The Bureau of Microscopy has arranged for a soiree, or microscopic exhibition, on Tuesday evening, when a large number

EDITOR'S TABLE. 577

of microscopes will be used, and a fine display of histological speci- mens made. In view of all these facts, it is very sincerely hoped that nothing of an ordinary character will prevent your attendance. The Corresponding Secretary, Dr. L. T. Van Horn, of Homer, Mich- igan, is prepared to furnish all who make application to him certi- ficates entitling the holder to reduced fare over all the roads in the State, except the Wabash. In writing, pray state over which road the journey will be made. .T. G. Gilchrist, Sec.

American Institute op Homobopathy. — I have the pleasure to announce, officially, that the Institute will convene in its 37th annual session at Deer Park Hotel, Md., on the Baltimore & Ohio railroad, the third Tuesday (17th day) of June next, at 10 o'clock, a. M., and continue in session four days.

The President, Secretary and Chairman of the committee on railroad fares and hotel rates and accommodations met Mr. W. J. Walker in conference at Deer Park, March 8, 1884, to complete arrangements for the meeting, with the most satisfactory results. The entire hotel (which has a capacity for accommodating six hun- dred guests), together with the extensive grounds, walks, drives, groves, etc., have been secured for the exclusive accommodation of the members of the Institute, their families and friends who may accompany them, to the exclusion of all other guests while the Institute is in session. The hotel will be in readiness to receive the members of the Institute Monday, June 16th, but will not be reopened for the general public until June 22. Hotel charges $2.50 per day, a rebate of fifty cents from the regular rate. The annual banquet, and music will be furnished by the hotel management. The rooms, cuisine, menu, and attention to the wants and comfort of the guests are guaranteed to give entire satisfaction to the most exacting. The railroad fare over the great trunk or main line of the B. & O. R. R. and its branches will be full fare one way {half fare). Efforts are being made to secure reduced rates on other roads.

The members of the various bureaus are at work; and their respective chairmen anticipate full reports. Sufficient information is already In the hands of the Secretary to warrant the statement that the attendance will be larger than usual, and that one of our Trans-Atlantic colleagues, (Dr. Richard Hughes, of Brighton, Eng- land), and possibly others will be present. Full particulars of the arrangements will be given in the forthcoming announqement.

Blank applications for membership may be obtained from the undersigned on application. J. C. Burqher, M. D,,

General Secretary.

r^^^^%^^^^^%^

-^'^

T. P. WIIAOa^, M. D., PHII. FOBTER, M. D.,

Editor. Gynecological Editob.

Vol. XIV. Ann Arbor, May, 1884. No. 11.

All subsoriptions and business oommunications shoiild be addressed to MBDIOAL ADVANCE PUBUSHINO- CO., Ann ArbCM*, Mich. Subscription, $2.00 per annum.

H. O. AIjIjEN, M. D., Business Manager.

The Vital Force. — ^The reader will remember, that Dr. Bayard, of New York, published some time since, an able exposition of Homoeopathy in the Popular Science Monthly. In that article he attempted to commit the entire Homoeo- pathic, School to the ancient and obsolete theory of "the vital force." What is exactly to be understood by "the vital force," was not defined by Dr. Bayard, nor has it since been defined by his friends and defenders. We have taken it, however, as synonymous with "the vital principle;" and this, we are informed, means the principle or force upon which life depends — the cause of life, or in other words, life itself. To the position assumed by Dr. Bayard, we took exception in a late editorial. Oiir criticism drew from Dr. P. P. Wells — a gentleman in almost all respects the most com- petent in the profession to discuss the subject — a masterly reply, published in The HomospcUhic Physician, To Dr. Wells we made answer, as the readers of this journal know, reas-

2

580 EDITORIAL.

eerting our unbelief in the existence of such a principle, and pointing out the fact that scientific men^-especially physiol- ogists— generally discarded the theory. * We did not hesitate to pronounce the theory untenable and unscientific, but also one entirely apart from all that is understood as Homoeo- pathy. Imagine our surprise, when, upon opening the last number of Tlie Homoeopathic Physician, we found another Richmond in the field, and ourself confronted by a third -champion of the vital force theory. Dr. B. Fincke shies his castor into the ring, and comes gallantly forward to defend the vital force. Whether this means that Drs. Bayard and Wells have handed over their gloves to their valiant con- frere and retired from the ring or not, we know not. In any case they have every reason to be satisfied with Dr. Fincke^ championship. If it were a case of life and death, the cause could not be more vigorously, ofiensively and defensively maintained. We have no desire to meet Dr. Fincke on the ground he has chosen, for it does not seem to us likely to throw any light upon the question we are considering. If the existence of the vital force is so very "self-evident" it needs no argument to support it, and without much waste of words, it might be demonstrated so that we all could see it. Now will Dr. Bayard or Dr. Wells or Dr. Fincke please give us the much needed demonstration? What office does the vital force perform in the living structure? Electricity, light and heat we know by their phenomena. Leaving them out of the account, we cannot explain many things which we observe. Scientifically speaking, we know whence they come -and whither they go. We assume the existence of an all- pervading ether, because it is necessitated in explaining a vast group of phenomena. Now, if the vital force stand upon the same basis, let us have an end of the controversy and let us have the demonstration. It may be true as Dr. Fincke says, "The vital force is a fact which every birth, every death and daily life can testify to;" but if so, what is the specific form of that testimony? If the vital force exists in living structures, surely our physiologists should take some

EDITORIAL. 681

cognizance of it. It could scarcely escape their recognition. In fact, if it was "self-evident," they would not be likely to overlook it — much less would they discard it. True, the older physiologists were devout believers in this principle; but this was in consequence of their inability to otherwise explain the phenomena of living structures. The later phys- iologists, however, have thoroughly investigated the body and find no occasion for a vital force hypothesis; least of all, do they find it displaying itself with all the remarkable plain- ness asserted by Dr. Fincke. Says John William Draper, (Human Phys. p. 26) : " Such a preposterous doctrine will not bear the touch of exact science for a moment. It is only a relic of the old metaphysical system of philosophizing, which accepted a name in lieu of an explanation." Says Carpen- ter, (Human Phys, p. 25) : " By resting in the assumption of a ' vital principle ' or * organic agent ' as afibrding a sufficient account of all that is mysterious in the nature of life, we really remove it from the domain of scientific inquiry; just as if the visitor to a cotton factory were to give up in despair any attempt to acquaint himself with the meaning of the several processes that go on before his eyes, and were to regard it as a sufficient account of the transformation of raw cotton into woven calico, that it takes place by the agency of a 'calico making principle'." If now we examine the well- known writings of Dalton, Kiiss, Marshall, Kirkes and Fos- ter, not to mention the writings of many others who are authors of modern text-books upon physiology, we find they make no mention of a vital force, for they find none, and see no need of it in the human economy. Jn Hahnemann's day the vital force theory was everywhere prevalent. That he accepted the theory and assumed it in his writings is true enough, but should that bind us to a oelief in it after mod- em physiological investigation has assigned it to the tomb of the Capulets? Since Hahnemann's day many scientific theories have been exploded and many new scientific facts have been discovered, but neither one nor the other has dis- turbed the foundations of Homoeopathy. Dr. Fincke dares

682 EDITORIAL.

US to produce a philosophy of Homoeopathy founded upon science. We hope to be able to make at least some small con- tributions to that end. Let us build it, if at all, upon solid foundations.

The Hom(EOpathic Department of the University of Michigan, is completing its ninth annual course of lectures, under circumstances, that can not be otherwise than grati- fying to its many friends. That its unquestionable success should excite wonder and admiration, is but just and proper. It cost twenty-five years of hard work and thousands of dollars to place this department upon the campus. When the forth coming history of that memorable struggle shall be read, it will then be seen what toil and sacrifices were necces- sary to give Homoeopathy '*a local habitation and a name" in the University. And we are glad to know, that most of the noble men who fought this battle for justice and truth, are yet alive to enjoy the fruits of their labor. They have lived to see this institution put upon a durable basis, with as little prospect of feilure, as the University itself. It was never the fault of the legislature of Michigan, that Homoeo- pathy was for so long a time kept out of the enjoyment of its just rights. And when the legislature found at last a way to have its wishes in this respect obeyed, it provfded ample means for the maintenance of the school. It was perhaps natural that, in the formative process, mistakes should be made and that among the friends of the school, difierences should arise, and that these should lead to controversies and strife, so that the iq(ipression became wide and deeply im- pressed upon the public mind that war and not education^ was the being and end of the Homoeopathic Department of the University of Michigan. This was untrue and hurtful, but it did not prevent the idea from being maliciously kept afloat. There has never been in this institution, at any time, any more antagonism than is common to the history of all such schools. Nor has there been for over three years past, any serious disagreement in or about the department. It is

EDITORIAL, 688

time therefore, that this false impression of strife in Michi- gan, should be laid aside. A ^' Higher Standard of Medical Education for men and women," has from the first, been the supreme object of this school. Endowed as it is by the state, it is the only medical college that can afiford to put the requirements up to the highest standard. This it has done, and maintains those requirements, and at a sacrifice, of which not many men even dream. A few of the points gained by our school are worthy of notice. First, the prelim- inary examination, though not so high as that of the Boston school, is of such a character, as to ensure students capable of pursuing their medical ' studies. It eflfectually keeps out a class of ignorant persons, who should never be allowed to undertake the study of medicine. It has kept many students away from our school, but that requirement will nevertheless stand as it is, so long as this department continues. In the second place, the practical work of the school is of the highest importance to students. What we demand, is a large amount of laboring work. This includes Chemistry and Histology. The amount of practical work that is done by our students in Chemistry alone would show how thoroughly educated they must be in elementary science, and not one of them is allowed to graduate who is not com- petent, and has exhibited his skill in, analysis of urine. The chemical laboratory of the University, where all this work is done, is not excelled in any institution in this country. The work in Histology is in all respects equally thorough. Practical work with the microscope, is here a necessity. Every kind of tissue, normal and morbid, is put under the strictest investigation. Besides this, each student is taught the art of staining and mounting, so far as to become a ready adept at the work. Of how much value all this is to the scholar, one can scarcely estimate. The profession may rest assured, that our students not only do all this work, but that they beomein no small degree enthusiastic in the performance of it Let it be remembered, that we have definitely taken as our motto "The Higher Medical Education of men and

584 PATHOLOGICAL PRESCRIBING,

women " and we propose to show how far we can make that motto good. Other and more important facts we must leave for a future number.

<>►

PATHOLOGICAL PEESCBIBING: A "SCIENCE FALSELY SO-CALLED."

E. J. LEE, M. D., PHILADELPHIA.

There have been from Hahnemann's day to the present, those in the homoeopathic school, who desired to base their prescriptions upon the pathological condition, presumed to be present in a case under treatment These would-be pathologists, embrace two classes — the one holding to this view from a lazy desire to make homoeopathic prescribing an easy routine affair; the other, from a belief that pathol- ogy is the only true basis upon which they could build a rational therapeutics. In other words, one class is lazy and insincere; the other, diligent and sincere; yet both are, as we think, wrong. To the first class, we have naught to say, unless to repeat Hahnemann's warning, that " in a science in which the welfare of mankind is concerned, any neglect to make ourselves masters of it, is a crime;'' to the second, we say: while respecting the opinions of all sincere and dil- igent laborers in the medical vineyard, we nevertheless be- lieve the facts of science are against your views.

But a few words as to pathology in the Old School It has been made much of by the allopath, and why? because, forsooth, he has no system of therapeutics worthy to be called scientific.

To cure disease, says he, we must know its nature; we must learn what each disease is, its causes, its character- istics and its conditions; then, and only then, can we ra- tionally combat ii "Pathology dictates the maxims of rational practice," says Aitkin. This is, in brief terms, about the allopathic idea of the practical scope of pathology; and very plausibly it reads, but can one act* on it? Is it true

E. /. LEE, M. D. 585

even when judged by allopathic practice? Do we know anything of the internal nature of disease?

If pathology is the only rational basis for scientific thera- peutics, and if it be, at present, anything approaching an exact science, then surely those diseases whose pathology is considered best-known, should be most amenable to treat- ment; and conversely, those whose pathology is unknown,, or especially dubious, should be but poorly handled. We all know that this relation between pathological knowledge and curative ability does not exist in the Old School Let any doubting Thomas briefly review in his own mind a few diseases whose pathology is considered best known, and see if the curative power of that school has increased with its boasted pathological knowledge. To be fail*, let him take almost any of the acute diseases these being con- sidered definite in their course and self-limited as to time; to judge allopathy upon its treatment of acute disease, is to give them an opportunity to show up their best work; to judge them upon their chronic cases, would be really cruel. To any one who thus briefly reviews allopathic practice of to- day, judging them out of their own recorcjs, it must be evi- dent that pathology has not advanced them to a better cura- tive skill.

If then, pathology does not aflford allopathy the great assistance in curing that is claimed for it, it is well for the homoeopath to ask, how does it aid us, and what is the prop- er sphere under our law? No one will deny that the thor- oughly equipped homoeopathic physician should be well educated in physiology, diagnosis and pathology, as well as in therapeutics, though the latter should be the chief cor- ner-stone of medical education; all these to be used under and subject to our law. He who places any branch of med- icine in an improper sphere, or to a wrong use, misuses cvnd perverts it: He who misuses pathology cannot justly de- cry him who neglects its use altogether. Of the two errors,, in our school, the abuse of pathology is the greater. Every

586 PATHOLOGICAL PRESCRIBING.

branch of medicine has its proper sphere and use under our law; in that place it does much good; out of it, incalculable harm:

Said the late Prol J. H. P. Frost: "In its full and proper sense, pathology includes all that can be discovered of the patient's deviation from the normal standard of health; and comprehends alike aZi Ihe ^aympioms,' morbid conditions, iheir consequences and their causes. Such pa- thology (which alone is worthy of the name of science,) becomes the perpetual study, in the living subject, of the homoeopathician, and this all the more as he renders him- self liable to be called a * symptom-coverer.' This patho- logical condition does not exclude post-mortem examina- tions; it may end with them, but it never begins with them. It embraces alike the purely subjective or sensational symp- toms; all physiological or functional deviations, and all objective or external morbid changes in form or color, in structure and in tissue. And if the practitioner of the * symptom method' overlook any of these causes, indica- tions, or consequences of disease; if he fail to * render unto Caesar the things that are Caesar's,' and neglect to give to each class and particular emdence of pathological deviation its JUST value, in making his prescription, his diagnosis and his prognosis, he will come to grief, and his patient with him. Indeed, we think it cannot but be obvious to every intelli- gent and candid mind, that no class of physicians more anxiously study and weigh the just value and due relaiive importa^ice of pathological conditions, and consequently that none are more thorough students of pathology, prop- erly so-called, than are those of the * symptom-method ' persuasion."

That learned and veteran homoeopathist, P. P. Wells, M. D. said:

** But if the symptoms are the only guides to the selec- tion of the curative, what becomes of the vaunted pathol- ogy of which we hear so much, and so often, from those who

E. J. LEE, M, D. 587

Bre slightly informed as to its nature, place or inii)ortance in our practical duties. To guard against the wrong use of this yaluable science was another occasion for giving us this eighteenth section [of The Organon]. To put it [pathol- ogy] as a teacher in the selection of curatives, to the exclu- sion of the symptoms from that function, is to put it where it has no place in a rational system of healing, certainly none under the control of a natural law, which discloses the <5urative relationship as existing in the similiarity between the symptoms of the drug and the disease. Where, then, is the practical use of this so highly prized science of pathol- ogy ? In the duty of prescribing for the sick, its use is lim- ited to aiding a right understanding of the nature and value of the symptoms revealed in the case in hand. Beyond this it has no function in the process of prescribing. Pathology, to illustrate, teaches a difference between inflammations and neuralgias. Both are attended by pains of the severest Mnd, but this science teaches that these have a different significance and often different importance, as the case in hand belongs to one class or the other. A knowledge of the science of pathology will enable us to relegate our case to its proper class, and there its function ceases. It cannot go beyond this; and having decided the case a neuralgia, say the remedy is Aconite or Bell or Bry. or Colocyn. or Hyos. or Loch, or Merc, or Nux. or Puis, or Rhus, or Spig., or either of the many remedies which a given case may demand for its cure under the law. To attempt to give to this science this decision [?. e., the choice of the rem- edy,] is to imx)ose on it a function wholly out of the sphere of its legitimate use."

The lamented Carroll Dunham wrote:

" Physiology and pathology themselves tecich us that the science of pathology can in no sense serve as a basis or foundation for the science of therapeutics." Again: "But these advances in pathology, great as they have been, have iiot altered the relation which the phenomena of natural dis-

588 PA THOLOQICA L PRESCRININO.

ease bear to those of drug disease. These phenomena respect- ively, whether rudely apprehended, or clearly and fully un- derstood in all their relations and inter-dependencies, stiU bear the same relation to each other expressed by the law Similia Similibus Curantur. And we can imagine no possible development of the sciences of pathology and pathogenesy which could alter this relation."

Thus we see that the pathological condition of any case is included in the totality of the symptoms of that casa As a part of this totality, the pathological state is known and given its full value; as a something outside of, and separate from this totality it has no place nor function, save to da harm.

The real homoeopath is a student of minule pathology; the allopath and his homoeopathic imitator are students of superficial pathology. To illustrate, to the true homoeo- path every case of the same (nosological) disease is a study, to the allopath it is not so. To the real homoeopath every syphilitic ulcer is a study; he notes its size, color, rapidity and shape of growth, its discharges and its general con- comitant symptoms; to the allopath, and his homoeopathic imitator, a chancre is a chancre, and for it he has his spe- cifia To the real homoeopath every case of pneumonia is a separate study, though he knows they are all of inflamma- tory nature, and in their gross features very similar; but he is not satisfied with a superficial knowledge of these gross features; he dives deeper, and then he discovers that eacb case of pneumonia is different fi'om every other. These minute differences are to the true homoeopath the guides ta the selection of the proper remedy.

Hypothesis has no part nor lot in the homoeopathic pre- scription; the homoeopath does not attempt to translate the simple, truthful language of the symptoms into the ever changing, and always unintelligible, jargon of pathological diagnosis. A diagnosis of the symptoms of any given case might indeed point to fatty degeneration of the heart, or

E, J. LEE, M. D, 589

to a cirrhosis of the liver, or to some other curtificial classi- fication; nevertheless, the true homoepath administers the remedy indicated by the totality of the symptoms, not stop- ping to ascertain whether or no that remedy has ever caused fatty degeneration or cirrhosis. Any attempt at a pathological basis, for homoeopathic prescriptions, must at once exclude mental and subjective symptoms, and these are often our surest guide to a proper selection, even though they be pathologically insignificant.

Having endeavored to briefly outline the sphere and use of pathology as a part of that totality of symptoms, which our law alone recognizes as the true basis for a correct homoepathic prescription, let us examine a few of the argn. ments adduced by those homoeopaths who believe that pathology is the only true basis for therapeutics.

One of these would-be pathologists, whom we select as a specimen of his class (not, indeed, because of any especial merit on his part), writes: "Muriatic acid, the acknowl- edged remedy for zymotic blood-i)oisoning, when debility, with erethism, prevails, gives us bitter putrid eructations, gulping up of contents of stomach into oesophagus, some- times going down again; empty sensation in stomach, ex- tending through whole abdomen, but no hunger; morbid longing for alcoholic drinks; vertigo, with nausea; heaviness in occiput, with obscure sight, worse with eflPort to see — all symptoms hinting squarely to nervous debility."

*' Nitric acid: Liver and spleen enormously enlarged and deranged is the keynote to the dyspepsia, curable by Nitric Acid." (Then follow some general dyspeptic symp- toms).

*' Lactic acid is frequently prescribed in the Old School in atonic dyspepsia, as well as in irritative dyspepsia, and cases of acidity and heartburn are quickly relieved if given before meals." (Here, too, follow some dyspeptic symptoms of a general nature).

Then continues this teacher of homceopathy: "We see

590 PATHOLOGICAL PRESCRIBING.

from such comparisons that superficial prescribing will not do, and the totality of the symptoms means the pathologi- <5al state which we have before us, be it a functional or cd- ready an abnormal organic one. We may be lost in a wil- derness of symptoms, if we fail to consider the pathologi- <»1 characteristic which gives us the key-note to all the other symptoms. Thus, and only thus, our Materia Medica must be studied, as in no other manner its study becomes easy, its strict application more definite."

" Superficial prescribing will not do,'* says this learned homoeopath; and by superficial prescribing, we take it, he means " symptom covering.'' Now, it has just been shown that the totality of the symptoms includes the pathological condition of the patient; the pathological condition told in the simple, truthful language of the symptoms (felt and seen,) untrammelled by any hypo thesis. How then can ^'symptom-covering" be "superficial prescribing;" is not the term more applicable to him who prescribes on a patho- logical hypothesis?

Which is most superficial, to study every case as a new and separate disease, giving due importance to all symi>- toms; or to treat all cases of the same (nosological) disease as similar, basing such treatment upon a few general fea- tures common to all and ignoring the many features wherein they differ? What is the practice of these would be pathol- ogists and teachers? They are those who see nothing in a gonorrhoea or a leucorrhoea or an otorrhoea but the discharge ; this they endeavor to dry up, modelling their treatment after the foolish ostrich, who hides only his head, hoping that his body may not be seen. It is said that a professor in an homoeopathic institution teaches his pupils that Phos- phorus is the remedy for broncho-pneumonia, and Bryonia i/?r^ remedy for pluro-pneumonia! There is indeed a kind of " superficial prescribing " that will not do, — fior heal!

"Superficial prescribing will not do, and the totality of the symptoms means the pathological state," says our

E. J. LEE, M, D. 591

teacher. This, put in plain Anglo-Saxon means that quinia is pathologically the remedy for intermittent; morphia, for neuralgias and kindred pains; cathartics, for constipation. Carry out this list fuUy, and you have the precept and prac- tice of the liberal-minded, would-be pathologist of to-day, who is often wrongly called by the honorable name of hom- oeopathist

" Liver and spleen enormously enlarged and deranged, is the key-note to the dyspepsia curable by Nitric Acid,'' says our teacher. Here the hypertrophy of liver and spleen is the pathological key-note, around which what would other- wise be a " wilderness of symptoms," to this mock-healer, are now evenly and orderly arranged. As Nitric Acid has never, so far as therapeutics are aware, caused any hjrper- trophy, "enormous " or otherwise, of spleen or liver, it will be seen that our scientific friend bases his "pathological key-note," without which he would "be lost in a wilderness of symptoms, upon a clinical or empirical hint" Truly, a noble path to guide one out of a " wilderness of symptoms;" it has only been trodden for some few thousand years.

"It is in the nature of the science of pathology that it always ought to be in advance of one certain knowledge regarding the treatment of disease," declares Dr. Aitkin, a high authority — ^f or some. If this be acknowledged, then the question of the use of pathology in homoeopathic thera- peutics is settled; for pathology is not "in advance of our certain knowledge regarding the treatment of disease;** nor will it ever be in that position, if our law be true. And those who believe pathology is thus in advance, cannot believe in the truth of our law.

The gentleman, whose pathological vagaries we have been noticing, once declared that: " when men like Dr. Car- roll Dunham, and Dr. , make an assertion — ^men who

never left anything undone in their lives, I believe it Dr. Dunham knew his pathology as well as any one." Having such an high and just opinion of Dr. Dunham, (who please

592 SEWER OAS AND BAD PLUMBING.

remember, "knew his pathology ") we hope this gentleman will listen now to him, " who being dead yet speaketh."

Dr. Dunham wrote "And those of our school who insist upon pathology as a basis of therapeutics, who look upon the single objective symptom and its nearest organic origin Bs the subject for treatment, and who deride the notion of prescribing upon the totality of the symptoms, and claim to be more than mere symptom coverers, in that they discover and aim to remove the cause of the disease — ^these colleagues are as false in their pathology, according to the highest old-school authorities, as they are faithless to the doctrines, and impotent as to the successes of the founder of the homoeopathic school"

SEWER GAS AND BAD PLUMBING.

Sewer Gas is not a new thing. It wi^ an old-time super- stition that every cesspool had its familiar spirit, which as- sailed the inmates of adjoining dwellings. During the fif- teenth century the Paris sewers were said to be infested by a basilisk, the glare of whose demon eye struck dead all who dared approach him. Even medical men accepted this belief^ and, though many workmen in the sewers died from malaria, nothing was done to protect them.

Sewer gas may be known by a faint, sickly odor, often hardly perceptible, which causes headache and nausea, if breathed for any time. It is far more dangerous than a foul stench, because so little noticeable. The contents of drains, cesspools, and sewers decompose and develop gases, which being light and expansive find their way readily into houses especially at night when doors and windows are closed and pure air carefully excluded. Every inch of unventilated waste pipe in a house, when lined with soap or grease can create this gas. If plumbing is badly done and if there are cracks or joints made with putty instead of lead, or if traps dry out or are easily syphoned, sewer gas can more easily

SEWER OAS AND BAD PLUMBING. 593

enter and do mischief. So also where there are fires or stoves, the draft sucks the foul drain air into living rooms, even through very small openings. If the supply of pure air is abundant in a house, then these foul gases will be diluted and made less potent in their influence. If, however, as is the rule, there is no ventilation, but skylights and windows are closed tight and the dwelling is redolent with the fumes of cooking and odors from the cellar, then the sewer air is intensified and its presence less perceptible. Its effects are most felt by weak persons. Men who are out of doors much of the time or away from home, suffer less than women and children who lead a more sedentary life and are constantly subject to its influence. Yet in many business oflBces, mer- chants, lawyers and others are debilitated in consequence of the proximity of foUl plumbing fixtures.

Where sewers are small, well flushed, with a proper grade and properly ventilated, and when not filled with waste steam to promote decomposition, or with their ends below tide level to cause back pressure, there is little risk of trouble from foul gases. But these conditions are rarely found. Hence the need of a trap to disconnect the house from the sewer. With such plumbing as is found in most modern houses, it is not desirable to allow the sewers to " breathe through house drains," as some few persons recommend. It is the duty of the public authorities to ventilate the sewers by perforated man-holes at frequent intervals. If there are enough of these they will give great relief to the sewer air, without annoyance.

All amateur schemes for ventilating sewers by connect- ing the latter with huge gas lamps, furnaces, factory fires, etc., are futile, and have failed in practice. The length of the sewers is so vast — 341 miles in New York — and there are so many openings at street corners, etc., that devices of this kind must be multiplied indefinitely to do any good, and their cost would be enormous.

What is the remedy for sewer gas? 1st To make sure that the plumbing of a house is well executed, of good ma-

694 SEWER OAS AND BAD PLUMBING.

terial and that it is properly trapped and ventilated. Lead soil pipes are never to be permitted, nor if possible any un- derground or concealed drains. Tile and brick drains, sach as are found in old houses beneath cellar floors, are almost invariably defective, and they should be replaced by cast iron pipe carried along the cellar wall. The soil pipe — of full size^ with the end left open — should be extended through the roof. This extension must be of cast iron and not of galvanized iron or tin. A trap should be placed on the main drain between the house and the sewer or cesspool, with an air inlet on the house side, open at the ground, so as to flush the entire sys- tem of plumbing with pure air. Traps are to be placed on all fixtures and each should be air piped to prevent syphon- age. No soil pipe or ventilating pipe should connect into a chimney flue unless carried up through the flue above the top of the chimney. No refrigerator waste pipe or overflow from a tank or cistern should connect directly with a sewer or cesspool. Pan water closets are objectionable, or any closet without a cistern to keep it well flushed. Lastly, all plumbing work should be periodically examined, say once a year.

Every cesspool should be open at the ground level, and also ventilated by extending the soil pipe, of cast iron and not galvanized iron, above the roof of the house, with the end wide open for ventilation. Keeping such receptacles tight, as is common, is putting a powder magazine, or charnel-house, in proximity to one's home. Leaving them wide open supplies positive protection. A cesspool should never be placed under a house, nor less than 100 (feet from a well, and should be regularly cleaned out and disinfected,.

If possible, plumbing fixtures should be located apart from living-rooms. Where water closets are situated in the interior of dwellings they should have a ventilating shaft of galvanized iron carried to the roof and kept heated by a gas- jet. With such provisions and a fair amount of ventilation by openings through sky lights, by open fire places, etc., there will be no risk from sewer gas. Even if a leak occurs under

CARE OF THE INSANE. 595

such conditions, the sewer air is so diluted as to be harm-

Sewer gas cannot be cured by chemicals. Disinfection as ordinarily practiced is only a sham. Prof. Chandler says : " Disinfectants are useful in sick-rooms, but not for counter- acting sewer gas. The use of these modern abominations, which pretend to kill the germs of disease, patent disinfecting machines, water closet purifiers, etc., is pernicious. The man who uses them virtually confesses that his house is unclean and that the bad odors need to be hidden or perfumed. Pure air, and plenty of it, is the best cure for sewer gas."

CARE OF THE INSANE.

BY SHELDON H. TALCOTT,

Superintendent of Middletown Asylum.

The insane are sick people, and their suiferings, while some times apparently imaginary, are, to them, realities of the mo6t formidable nature. They think themselves the vic- tims of persecution ; that their friends have deserted them ; that their fortunes are broken ; that their homes are ruined ; that their prospects are blasted ; that their bodies are full ot incurable diseases; that their lives are useless; that their souls are lost; that the favor of both God and man is turned away; and that they are doomed to perpetual torment. Surely such sufiferers demand our warmest and most unre- mitting sympathies. These persons are irresponsible, and seek to perform the most horrible and shameless acts. They do not hesitate to accomplish suicide or homicide, or both ; and they work with vigilance, cunning and restlessness.

It is evident that strict discipline is necessary to protect these people against harming themselves and others. The strong hand of authority must be placed upon them, yet that hand works best and most effectually when clothed with a velvet glove. The exercise of kindness toward the patients in an asylum depends largely upon the heart and 3

596 CAR^ OF* THE INSAN^!.

spirit of the managing power. The ruler of an asylum should have wisdom, firmness, benevolence, and these qual- ities must be made manifest at all times. He should per- sistently inculcate in the minds of subordinates, the doc- trines in which he believes. He must preach a sermon on the text of kindness every day of his life, and hold revival meetings in the evening, if necessary.

He must exercise profounid watchfulness over his wards, to see that his rule of kindness is carried out. This is ac- complished by having, on his staff, assistant physicians who carry his messages in their hearts and on their lips. The supervisors of the wards must also be familiar with the physical wants of every patient, and know of the care be- stowed upon each and every case.

The superintendent must have a grounded faith in the efficiency of kindness, and then he must have written re- ports of the condition and actions of all disturbed patients sent every night and morning from the supervisors to the superintendent. Thus a full knowledge of each critical case is had, and a complete record for reference is kept.

The attendants should be selected with care. The young, the bright, the cheerful, the kind — these alone should be employed. When employed their duties should be clearly pointed out, and a solemn promise exacted, that under every circumstance and provocation, they will refirain from striking or injuring a patient. It should be clearly- understood that the slightest infraction of this promise will be followed by dismissal and disgrace.

When restraint is absolutely necessary, however, let it be applied on a physician's order and in the most careful and judicious manner. Make the restraint as mild and gen- tle as possible. For suicidal and homicidal patients, padded mittens are the best, and usually sufficient. The wearing of these mittens is in reality no more " restraint " than wearing a pair of boxing gloves ; but they prevent patients from killing themselves and others.

If a patient is restless and is wearing out his strength

SHELDON H, TALCOTT. 597

and destroying his chances for recovery, and needs to be placed in bed for treatment and the conservation of the life forces, then a simple canvass bandage around the body, with attachments to the sides of th« bed, will accomplish the purpose. These are the mild and successful means we have employed for the care of disturbed patients, and these means must be used gently and temporarily. All restraint must be kept in reserve and only used as a dernier re- sort.

Moral suasion should be the prime and principal means for quieting the excitable. A few words of quiet petition, requesting the patient to exercise the virtue of self-control for his own personal benefit will often suflSce. The promise of a favor trill often keep an excitable person under good self-control. I have had maniacs keep still for the sake of attending a promised dance. The insane may sometimes be shamed into silence by telling them that they are disturbing others. In fact, the insane must be treated like sick chil- dren. They must be made to feel that they have friends in those who care for them. Their fears must be silenced by kindly words. Their hope and pride must be stimulated by encouraging conversation. Shaking hands and inquiring after their health, their past experiences, their plans and hopes for the future, will please and stimulate many of the cases of abject melancholy*

The insane pine for notice as much as do children and dogs. And they thoroughly appreciate these kindly atten- tions, though they make no sign at the time. It is a pleas- ant surprise to be told by a patient that their improvement dated from a kind word spoken many months before.

Beautifying the wards with pictures, curtains and neat furniture, has an effect on both patients and attendants. Music, pleasant games and entertainments have their refin- ing influences. A pretty dress given to a patient who has lost all pride, will sometimes afibrd marked happiness. One of our most destructive lady patients, who tore her clothing constantly, was furnished a bright red and white dress, and

598 CHRONIC DIARRHCEA,

from that time she was quiet and tore no more clothing. Sleigh riding or carriage riding is most beneficial.

These means must be unremitting, not spasmodic. All discouragements must be forgotten or swallowed up by a swelling enthusiasm for one's work. Attendants must be taught they are missionaries doing God's service as well (or better perhaps), as those who carry Gospel messages to the heathen that sit in African darkness.

When I think of what has been and is being done for the insane, in our American asylums, I feel like saying to the thoughtless and ignorant carper, who snarls and bites at the heels of the workers in these institutions, what the gar- dener, in Thompson's Seasons, said, concerning his toils :

" Ye little know The care, the vigilance, the labor and the skill Which day and night are exercised, and hang Upon the ticklish balance of sospense.''

During the past summer, I visited asylums in England, Scotland, Ireland, France, Switzerland and Italy. Our American asylums compare favorably with them all.

CHRONIC DIARRH(EA.

BY A. M'NEIL^M. D.

Dr. Payton R. Mayo, 328 Fulton Street, Jefferson ville, Ind., a retired allopathic physician, came to me for treatment of a diarrhoea he had contracted in the Mexican war, in which he was a company officer, and afterwards surgeon. The Doctor was wounded in six places. He is 67 years old, and has exhausted the resources of the old school, which in the 37 years of his disease has given him no substantial bene- fit When the discharges exhaust him he takes large quan- tities of extract of logwood, which control them, but do not ameliorate his condition. In a short time the attack returns. He does not eat fruit, or vegetables, but confines himself to cold fat pork and Irish potatoes. Has a great craving for

A. JMTNEIL, M. D. 599

vin^ar, which he uses immoderately. Has great thirst for water, but drinking it causes nausea and vomiting. His bowels are not under his control, but pass off involuntarily so that he is compelled to wear a napkin. He is emaciated to 95 pounds stripped ; when he entered the service he weighed 190. Has taken much calomel, quinine, Fowler^a solution of arseniCy etc. Urination frequent, copious and painful, has to get up three or four times a night. The discharges from his bowels are painless, but are attended by prolapsus ani, which also comes when walking, and is very painful. Always sleeps with his feet outside of the bed clothes summer and winter. The rectum when prolapsed reveals many ulcers red and elevated looking, he says like straw-berries and sur- rounded by a black base. Sometimes has a sensation of a ball starting from rectum and going up to the stomach, and there causes vomiting. Says there is albumen in the urine.

After giving him Arsenicum in higher potencies, with but little benefit, gave him on Sept. 1, 1883, Arsenic 9x, six pellets every two hours.

Sept 21. — Is very much better. Sac. lac.

Oct. 2. — Moved twice a day, natural in character, but a bad attack of colic last night. Arsenic 30, one powder.

Oct 5. — Diarrhoea this morning with frequent copious discharges; gave six powders. Arsenic 12, one every three hours.

Oct. 8. — Five passages to-day; two last night. Arsenic 12, four pellets every three hours.

Oct. 31. — Is better, appetite good. No vomiting or gastric troubles. Arsenic 15, twelve powders, one every three hours.

Nov. 6. — Has three or four painless movements a day. Some prolapsus, ulcers healed, ''eats like a dog." All of these potencies had be^n prepared by myself from B. and T's 6th. Gave him Arsenic 30, twelve powders, one every three hours.

Nov. 20. — Bowels natural, drinks much, but water re-

600 CHRONIC DIARRHGCA.

freshes. Is getting strong. Ran 100 yards without exhaust- ing himself. Arsenic 100, one powder.

Nov. 22. — Prolapsus troubles him. Arsenic 100, six pel- lets every three hours.

Dec. 6. — Night of second, had a violent attack of diar- rhoea. Arsenic 100, in water every three hours for a day and a halfl

December 7. — Feels well, bowels natural, prolapsus with evfery movement of bowels.

January 3, 1884. — Had a bad attack Christmas night, which he attributes to turkey. Thirst, nausea and vomiting. Arsenic 200, one powder.

Jan. 14. — Well, except prolapsus when bowels move. Says he can outrun any man of his age in the county.

Jan. 29. — Had diarrhoea for ten days. Has an ulcer on right great toe, lost the nail, painless. Arsenic 4x, in one dose.

February 2. — Bad attack this morning early. Arsenic 100, in water every two hours.

February 29. — Weighs 120. Says he can eat at any time. Still has prolapsus when his bowels move and when he walks. Still careful in his diet, not for fear of diarrhoea, but of pain in stomach, etc. Bowels natural.

I have given particulars so as to invite investigation for there was a time when it would have been difficult to con- vince me that this report was true. I ask anyone to show that this case is not a cure. Whether the microscope or spectrum analysis would reveal molecules of Arsenic or not is immaterial, but Dr. Mayo was cured, and if there is any- one who thinks he was not let him say so, or forever after hold his peace.

There was nothing in the case demanding any special skill. The indications for Arsenic were such that any prac- titioner calling himself a homoeopath could not mistake. It cured when administered in the minimum dose and was allowed to exhaust its action before another dose was given in mouth, so that each administration proved its efficacy.

UVREX-SEPIA. 601

MUREX-SEPIA.

BY J. T. KElfT» M. D., ST. LOUS, MO.

Editor Medical Advance:

Please ask Dr. Kent, where he got the symptom of Murex p. 478 of Advance, "pains in Murez aggravated while lying down." If he is right I must rectify Murex in my Thera- pet*<t(», p. 792, where it reads, "ameliorated by eating and lying down." According to Dunham, Horn. Review^ — iY, p. 405— the mental symptoms are greater when sitting than when walking; when walking they cease and reappear again when stting down. Page 406, Hering's patient was obliged to go to bed and lie there. The excessive fatigue and debility in the lumbar region lead more to relief from lying down, and still there is that mental symptom. Per- haps Dr. Kent will kindly clear up the point as it seems he copied that symptom from Mnton, p. 227, " all pains come while lying down," and which can only be taken from Her- ring's second case, wher^ she felt no comfort in any position. Another question is whether Sepia has relief from lying down. Minton gives under Sepia^ amelioration on or after rising from bed or from a seat, which may lead to aggrava- tion during sitting and lying. In the study of symptoms we cannot be too critical.

S. LiLIENTHAL.

The "empty, all-gone" feeling in the stomach is relieved by lying down, but that is not in harmony with the general conditions of Murex. In Sepia this symptom is relieved by moving about, and aggravated by the smell of food.

The flushes of heat in Sepia are brought on by motion (Hg). In most remedies we have opposite conditions. In Sepia some complaints disappear during violent exercise, and others are better by rest {AUen Encydop. p. 649. "She felt best when at rest, and while lying.")

In Murex the flushes come on in bed, as well as when moving. The headache of Sepia is made better in the open air if it is pleasant, and by violent motion.

602 MUREX-8EPIA,

Murex. — *' A sensation as of the creeping of a snake over the entire region of the short ribs, upon the left side; great depression of spirits; it seems to her that she was hopelessly ill. She was obliged to go to bed <md lie there^ — Dunham, Science Thcrapts., page 884.

These are not the lUerine pains so fully brought out and cured by Murex, but a myalgia unlike the cutting pains in the uterus that come on when in bed, and are relieved by sitting and walking, until fatigue comes on when she must lie down for relief, and the cutting pains in the uterus come on again, going through and up diagonally, compelling her to get up and walk. I have seen Murex 200, produce this state, and when I find it in practice, I am sure that Murex and Murex only is the remedy.

With the pains there is not the restlessness of Rhus. It is the pain not the restlessness that compels motion by walk- ing. In one of my pro vers: "The cutting pains in my lower belly wakens me in the night and compels me to get up and walk. When walking the bearing^ down comes on which makes we want to hold myself with my hand."

This prover would lie down to get relief from the sensa- tion that her uterua would issue from the vagina, and after lying awhile her pains would begin to come on. This, I have many times verified in practice. But I never saw it expressed until I examined Minton, page 227. In AUcn, VoL VI, Murex. Greneral Symptoms: ^^ Pains worse when sitting than when walking; and those which I cease to feel while stirring about return almost immediately on sitting still." Under Infetior Extremeties. — " Pains in hips and loins * * * ♦ * but that of hips still continues even when not lying down." I interpret that to read, worse when lying down and better from walking, although not entirely relieved by walking.

The aches and pains of Sepia: — The headache is worse from shaking the head, but better from violent exercise. So with many of the pains of the body, but the distressing bear- ing down pains are better from lying in bed. The dragging down of Sepia, which is so much like Murex that I am unable

J. T. KENT, M. D. 603

to distinguish between them, is relieved by lying down; comes on while standing, is relieved by sitting and crossing the limbs and goes off while lying down. Again Sepia has apparently the opposite — page 624, Attends Encydop. near the bottom of page. — "At 9 a. m. the dragging and pressing sensa- tion in the abdomen returned ; pressure as though the content^} would issue through the genital organs. The pelvic distress was noticible the whole night at waking intervals, and relief only momentary by lying on either side with the legs flexed on the thighs and the thighs on the abdomen. I wakej this morning without the distress, but it returned on stirring." *****! cannot but conclude that generally Sepia is better by lying down. Except some of the rheumatic, aching pains which are first made worse (by slow motion) but finally made better by violent walking. Clinically, whenever I have been able to observe. Sepia cures the pro- lapsus that has the horrible bearing down as if parts would come out if it is accompanied by the "all-gone" sensation in the stomach, a lump in the rectum with constipation, the patient wants to hold the vulva with a napkin, and the dragging down is relieved by crossing the limbs, sitting and lying. These are the symptoms as they are found, and Sepia cures not once in awhile, but always, if not given too low.

See Dunham's Science Therapeutics^ page 365. " Whereas on the other hand, the Sepia pains are worse from 9 a. m. to noon, and are relieved by repose; being aggravated by motion and repose." This refers to the prolapsus pains in his (Dun- ham's) contrasting it with Lilium, which grows worse dur- ing repose like Murex, page 319. '*The pains are dull; pain like paralysis is predominant, amelioration from warmth and violent motion. Aggravation by repose and at night." This shows that Dunham fully comprehended the two kinds of pain or distress produced and cured by Sepia. Dunham says that the majority of pains produced by Sepia are aggra- vated by repose, but plainly states that the uterine suffering is ameliorated by repose.

604 MUREX-SEPIA,

THE "all gone sensation" OP SEPLA..

Some readers of the Advance have asked why I gave Sepia for the " all gone feelmg " in the stomach. In reply I have taken the trouble to copy from my MSS. repertory the extended individualization I make in those remedies. It may be of use to somebody. I do not oflfer it because it is better than others, but because it has served me well in the treatment of gastric complaints. It might be much extended, but this is as far as I have verified. This much I know:

Empty, '* all gone feeling," in stomach : Actea, Agar, Alum, Amb., Am. c, Ant. c, Ant. t., Apoc. c, Bap., Bar., Bry., jBu/o., Calad,^ Calc. p., Carb. an., Caust., Con., Croc, Crot. t., Dig., Gels., Glon., Grat., Gamb., Hell., Hipp.. Hydr,, Ign., Ipec, Kalm., Kali, b.. Kali. c„ Kali, iod., Lac. can., Lob., LyCy Mag. m. Meph., Mer. iod., Mur.ac, Murex., Nat. c, Nat.m., Nice, Op. Petr., Phel, PAos., Plb., Pod., Ruta., Sang ., Sen., Sep., Stan. Staph., Sulph., Trill., Teuc. m. v., Verbas., Verat. a.

Empty, with sensation of burning : Actea., Agar., Am^ c . Pho8,j (Bap., Calc. p.)

of sinking, before breakfast: Actea, KaU.

iod.

ol sinking, in uterine troubles : Murex., Sep.

nausea : Actea. Calc. p., Lyc,^ Kali b., Nat. c,

Phel.

pressure : Am. c, Lye. Petr.

trembling : Actea., Agar., Am. c. Lye.

distension of abdomen: Bry., Kali b.. Kali c,

Lye, Petr., Phos., Sep., Sulph.

rumbling in abdomen: Mur. ac.y Crot. t, Phel.,

Verbas.

after eating, coming on ; Carb. v., Olean., Sars.

not relieved by eating : Carb. an.. Kali iod., Lye.

Mur. ac.

and qualmishness : Kali iod., Mag. m.

not relieved by eating: Mag. m.. Sang.

worse after eating : Kali b.. Lye.

nnd coldness not relieved by warmth : Kali iod.

CASE OF HJEMOPTYSIS. 6a5

in the evening : Calc. p., Dig., Op., Pod.

at 7 p. m.: Calc. p.

Emptiness, sensation of in stomach, 2 p. m. with loss of appetite, Grat.

in the morning : Apoc. c, Actea, Hell., Kali b.,

Kal. c, Ign., Nat. m.

at 8 a. m.: Kali. c.

at 11 a. m.: Hydr. Op. Sulph.

at 11 a. m., with a dull pain: Hydr.

at 2 a. m., with tenderness over the

abdomen: Pod.

without hunger, faint feeling: Nice.,

Pho8.

with gnawing : Ign., Murex., Op., Sep.

in uterine troubles : Murex., Sep.

and sighing : Ign.

at pit of stomach, which disappears with rumbling

in left hypochondrium : Verbas.

with gnawing as if life was becoming extinct : Dig.

throbbing in colon : Ant. t., Calad., Kali c, Mag.

m., Nat. c, Nat. m., Sep., Sulph.

before going to sleep : Dig.

extending into abdomen : Mar.

A CASE OF HEMOPTYSIS COMPLICATING VALVU- LAR DISEASE OF THE HEART.

BY J. W. DOWUMO, M. D.,

Professor of Physical Diagnosis fand Diseases of the Heart and Lungs, New York Homoeopathic Medical College.

Miss T. J — a remarkably healthy looking and blooming young woman was sent to me, by her family physician for examination and diagnosis. The history of her case, which is somewhat remarkable, was as follows :

She was born of healthy parents — whose family history on both sides was good and ancestors long lived. As a child

606 CASE OF HjEMOPTYSIS,

she was healthy, passing through the ordinary diseases of childhood nicely. At the age of eleven, she developed a cough, resulting from a cold, which continued, with no ap- parent intermission till she was 18 years of age. Many physicians were consulted and various methods of treat- ment resorted to, but with no relief whatever. During these seven years she was otherwise in good health, aside from a slight dysmenorrhoea for the first 24 hours of each menstrual period; the menstrual nisus first making its appearance at the age of 14.

In May, 1881, she was suddenly startled by her brother who grasped her neck from behind. She involun- tarily threw her head back. She says there was a sensation '* as if something has snapped here," and placed her hand over the lower portion of the sternum. Then commenced a violent paroxysm of coughing lasting about a minute. This was followed by quite a free expectoration of bright red blood. •

Strange as it may seem, the cough which had been con- tinuous for seven years immediately disappeared. Two days later there was another slight hemorrhage. Although much alarmed at the "spitting of blood "she suffered no incon- venience from it, and was quite surprised and delighted at the disappearance of the cough.

A year later there was a return of the cough which lasted for a few days and was accompanied by another haem- optysis, which was followed by a relief to a feeling of chest oppression, from which she had suffered during the contin- uance of the cough as well as by an entire arrest of the cough paroxysms. She has had six of these paroxysms from that time to the present, the last occurring quite recent- ly; and for these haemorrhages I was consulted.

Careful questioning developed the fact that years ago, prior to the onset of the cough, she had a mild attack of articular rheumatism, which was thought but little of, the pains being slight, and supposed to be "growing pains." Several years later she had another attack, more severe in

/. TT. DOWLINQ, M, 2>. 607

character, this occurring about one year prior to the first l^semorrhage.

Although very active and inclined to run up-stairs, she acknowledges a little shortness of breath on extra exer- tion and after such efforts she " can hear her heart beat." She complains of a pain beneath the left shoulder blade which extends around the left side of the thorax to the ster- num. Her appetite is good, bowels and menses regular. She sleeps well, is not troubled by dreams. Has had no cough since the last haemorrhage. She is well nourished, of full weight, and of a cheerful and happy disposition.

PHYSICAL EXAMINATION.

Inspection revealed a beautifully rounded chest, the two sides being perfectly uniform, and a uniformity of the respiratory movements of the two sides. The vital capacity of the lungs, measured with Lowne 's spirometer was about 20 cubic inches below normal, an extreme effort at inspiration and expiration being made. The percussion and breathing soimds over the entire lung area were found to be perfectly normal. Liver and spleen dullness, normal. The superficial area of cardiac dullness was increased laterally about three- fourths of an inch, and the apex of the heart was in the fifth intercostal space, three and a half inches to the left of the middle line of the sternum. Over the left border of the heart was distinctly felt a prsesystolic thrill. The impulse of the heart was somewhat forcible but perfectly regular. The pulse was regular but slightly compressible. Ausculta- tion of the heart revealed quite a loud prsesystolic murmur heard with greatest intensity at the apex, the sound pro- duced by the closure of the mitral valves being loud and sharp, followed by a very feeble second sound. Slightly to the right of the apex was heard a soft systolic blowing mur- mur. Although neither of these murmurs wa^ conveyed to the back, the heart sounds were distinctly heard through the lung at the angle of the scapula. The murmurs were not heard at the base of the heart and were not conveyed to

608 CASE OF HEMOPTYSIS.

the neck. The second sound at the pulmonary orifice was intensified, being very much louder than the second soun^ at aortic orifice.

DIAGNOSIS.

Stenosis of the mitral orifice with slight insufficiency of the mitral valve, with dilation of the auricles and excentric hypertrophy of the right ventricle.

That I might be sure as to my diagnosis, I had the patient exercise around my office for a few minutes. The result was rapid breathing and an intensification of the thrill and murmurs and great rapidity of the heart's action.

COMMENTS.

The prfiBsystolic thrill was undoubtedly owing to the passage of the blood from the auricle to the ventricle through a constricted mitral orifice.

The prsesystolic murmur arose from the same cause. The systolic blowing murmur was produced by a return blood current through the mitral orifice into the auricle during the systole of the ventricle, owing to incompetence of the mitral valves. The dilatation of the auricle and excentric hypertrophy of the right ventricle were owing to the obstruc- tion to the blood current at the mitral orifice. The dimin- ished vital capacity was owing to capillary and venous engorgement of the lungs, resulting from the mitral obstruc- tion, the size of the air vesicles being necessarily diminished by this overloading of the capillaries and veins.

How shall we account for the valvular disease, the long continued cough, the hsemoptysis, and the sudden subsi- dence of the cough after the bleeding? The patient had a history of rheumatism dating back prior to the onset of the cough. There was undoubtedly an endocarditis as a com- plication. This resulted in chronic valvulitis with deform- ity of the mitral valve. It is an anatomical fact that a large portion of the blood distributed to the mucous membrane lining the bronchioles finds its way into the pulmonary veins [is not discharged through the bronchial veins] and is

MAN'S MICROSCOPIC ENEMIES, 609

carried with the pulmonary blood into the left auricle. If there is imperfect emptying of the left auricle from any cause, in addition to the resulting pulmonary engorgement, there will be hypersemia of the mucous membrane lining the smallest bronchial tubes. This in itself frequently gives rise to sufficient irritation to produce quite an obstinate cough. If in addition there is a catarrh resulting from other causes, the cough is obstinate and continuous. Our patient, contracted a cold which resulted in a cough. This cough continued without evidences of pulmonary trouble for seven years. Suddenly, from a severe nerve shock, she was siezed with a violent paroxysm of coughing, and a sensation in the prsecordial region as if something had given way. This was soon followed by a hsemoptysis. The bronchial vessels were unloaded by the bleeding, the patient being young and vig- orous the vessels contracted and the bronchial hyperaemia which had kept up the cough subsided, and until the occa- sion of another exciting cause the cough disappeared. Each subsequent attack of coughing was relieved the same way. I had no hesitancy in assuring the physician having the case in charge, that in my opinion the haemorrhages, instead of being a cause for alarm, were really salutary in their efTect.

MAN'S MICROSCOPIC ENEMIES.

Man has suffered long from their ravages in person and estate but he has usually attributed his misfortunes to every cause but the real one. Entrenched as these foes of his are, in the citidal of littleness, he has mostly overlooked them, and has only of late years begun to hunt out their significant secrets, which are closely interwoven with famine, pestilence and pain. From his beginning he has struggled on through an unseen mist of organic atoms, wrestling hard all the while with the manifold evils these have wrought, and gen- erally unwitting of the miasma that environed him and that was bringing woe on himself and his household, and work-

«10 HOMCEOPATHY AND ALLOPATHY,

ing sad havoc among his stock, crops and chattels. He can face the lion or the tiger, and may conquer with gun or spear; but how can he dislodge those infinitely more fatal foes from their microscopic lairs; how overcome their count- less multitude.

The largest of the wild beasts fall back before him into the thickest forests and dismal solitudee, or their kind be- comes extinct The mammoth and mastodon, for instance, have vanished from the face of the earth; but the small ver- min of the world defy extirpation. Rats and mice have for thousands of years feasted and sometimes fattened at man's expense, and yet he has all along been busy hunting them down, trapping, poisoning, plotting against them, devising cunning schemes, setting eager dogs after them, encouraging patient cats to watch at holes and crevices. The insect phyl- loxera is eating up the vineyards of sunny Prance in spite of the Academy of Science and its money prizes offered for a remedy. In North America the Colorado beetle gets copious doses of arsenic and other compounds, and yet it survives. Consider then, that these small creatures, which man finds it so much harder to subdue than the great beasts of the field are yet of gigantic size when contrasted with the microscopic plants that are in league with his implacable enemies, famine disease and death.

HOMCEOPATHY AND ALLOPATHY.

Dr. F. W. Stillwell, in the RochesUr Democrat and Chron- icUy of February 29, 1883, says: In the discussion between the different schools of medicine, I see but one champion of Homoeopathy in this city. Dr. Biegler is the only one who has a good word for it. The stamp of quackery is put upon all the teachings of Hahnemann and he is the only one of his followers who dares to deny the charge. A heroic dose of courage administered by a hard shell allopath might prove of benefit to some of them. Counsel or no counsel seems to be the question which stays most of the so-called

HOMCEOPA THY AND A LLOPA THY, 61 1

"old code" gentlemen. Whether it's not better to stick to blisters and plasters and suffers the ills of an empty pocket or recognize those ** little pill fellows" who are revolutioniz- ing the world. Suppose they do, what benefit is Homoeop- athy going to devise? What has brought about this state of brotherly love? What have they ever done for the scholars of Hahnemann that they should ask Homoepathic physi- cians to prop up their tottering gods and fortunes? Never has the new school been so strong and popular as to-day. Never since the birth of small doses, have they done so much good or its workers been more in earnest, and because of this rapid progress, begging allopathy wishes us to counsel with them: They, who for a life time, have scoffed and sneered at the teachings of Homoeopathy. May the ghost of Hahne- mann forever haunt the physician who does. For pnemonia complicated with pericarditis, whiskey and brandy is their favorite remedy. Typhoid fever, bronchitis or measles all require the same prescription. Does Homoeopathy sanction any such treatment? The action of the "new code" gentle- men proves that brandy as an elixir vitse is sadly in need of a pair of new legs. As long as new school physicians keep quiet about the results of their practice, all is well, but let them dare to explain the principle such cures and it is what quackery, humbuggery, or any other pet name which ignor- ance and bigotry choose to construct. It is that which will debar any Homoeopathic physician from a hospital con- trolled by Allopaths and^deny them professional courtesy and society. No man lives, has lived, or ever will live whose teachings have advanced so rapidly and found so many fol- lowers as those of the venerated Samuel Hahnemann. The allopathic boast of a superior knowledge of drugs and diseases is all bosh, and smacks more of the almighty dollar than it does of brains. Judging from an article written by Dr. South- erland in the February number of the Medical Oazette, coward- ice and fear are prominent symptoms among the paralysed ranks of Allopathy. Dr. Southerland writes that a short time ago the managers of St. George's hospital, London, issued a 4

612 CASE OF INTUSSUSCEPTION.

public appeal for aid, stating that many of the beds were unused for the lack of funds for their support. Major Mor- gan on learning this offered the managers nearly five thous- and a year for five years on the modest condition that the occupants of said beds should receive homoeopathic treat- ment. To this honorable proposition the practicians in power returned an unconditional refusal. I think this talk of the "codes" resembles that of those managers. They want homoeopathic physicians to fill their pockets with gold by calling them in counsel, but to the dogs with their little pills.

A CASE OF INTUSSUSCEPTION.

BY J. W. ROCKWELL, M. D., AKBON, OHIO.

By the unanimous vote of the N. E. 0. M. S., I send yon for publication the report of a case of intussusception, which I reported to the society at its session held in this place, April 19th.

Case — March 11th, Charley B., aged seven months, hav- ing just recovered from measles, was taken during the night with vomiting and purging; stools thin and watery. I was called up about 8 a. m., and found the above history of the case with the following condition, much coughing with loose rattling of mucus in the bronchial tubes ; child very peevish with anxious look, refused the nurse but would take a small amount of milk. Was called again at 4 p. m., found the child passing pure blood of a bright color and rather copious, cough less and respiration more free and easy.

March 12th, 9 a. m., haemorrhage very much less, had vomited but once or twice during the night, respiration more difficult, takes but little nourishment, seems very thirsty, and somewhat hoarse. March 13th, 9 a. m., haemorrhage has enurely ceased, stools consist of pinkish mucus, accompanied by slight tenesmus. Great hoarseness could hardly make a loud noise, much couf^h with much rattling in throat and lungs, face pale with anxious look.

/. W. ROCKWELL, M. D. 613

March 18th, 10 a. m., stools of thin fecal matter, no mucus, no vomiting, sleeps better, takes more nourishment and is better every way.

March 19th, 4 p. m., patient very much better. Slept well during the night, stools of fecal matter of a creamy consistancy, respiration free and easy, no cough, takes his rations all right and seems about well. I left with the request that they should let me know if he required any further attention.

March 21st, 1 p. m., was called in great haste, baby taken suddenly worse. Had been all right since the last visit, had had a natrual stool the night before. The cause of the great alarm of the parents was the protrusion of a large tumor from the anus. I found the child with the same old anxious look, great straining, with a tumor about the size of a small walnut, and of a dark red color, covered with mucus, protruding about one and one half inches from the anus. It was very easily replaced and I could pass the finger in and around it on every side, showing that it was not adhered to the lower part of the rectum but had de- scended from higher up.

March 22nd, 8 a. m., the tumor had come down several times during the night, considerable mucus had passed the bowels, but no fecal matter. I gave the tumor a thorough examination: it protuded about two inches, and was of a dark red color with mucus. There ^ere two openings in the tumor one upon each side, with a firm septum divid- ing.

The one at the left side (of the patient,) I could pass the finger to the second joint, at which depth it formed a pouch. Into the other the finger could be passed the full length. I diagnosed intussusception of the ileo-csecal valve which had become prolapsed down through the colon and rectum. The opening to the left being the caecum, the one to the right the ileum.

While the tumor was down the child would worry and cry almost continually, but was quite most of the time

614 THERAPEUTIC DSE OF HOT WATER.

while it was retained within the rectum. 5 p. m., about the same, abdomen somewhat enlarged, slight tympanitis.

March 23d, 10 A. m., Dr. O. D. Childs visited the case with me and coincided in the diagnosis. Great tympanitis with a strong tendency to peritonitis. Refuses all nourish- ment, great thirst for cold water. 5 p. M., no material change since morning, abdomen a little less tympanitic, stools still mucus with a small amount of fecal matter.

March 24th, 9 a. m., tympanitis very much less had several thin watery stools during the night, rested compara- tively well, less thirst. 5 p. m., patient very restless with anxious frightened look, thin watery stool every fifteen or twenty minutes, great prostration.

Patient died at 11 p. m., from prostration, the thin watery stools continuing to the very last. Thirty-six hours after death, I held a post mortem, Drs. Childs, Murdock, Wilcox and Jamison being present, which confirmed the diagnosis. About six or eight inches of the ileum had become invagi- nated into the colon and had been forced down through the whole length of the colon and rectum. The whole of the colon was forced upon the invaginated portion of the ileum, lying in folds which were easily drawn off during the examination, there being no adhesions, and but slight indications of there having been any infiammatory condition, except in the invaginated portion of the ileum.

THE THERAPEUTIC USE OF HOT WATER TAKEN INTERNALLY.

1. The water must be hot — not cold or lukewarm. The reasons for this are principally that cold water depresses, and that lukewarm water excites vomiting. By hot water is meant a temperature of 110° to 150° Fahrenheit, such as is commonly liked in the use of tea and coffee.

2. As to the quantity of water. The commencing amount should not be less than a half a pint, which amount must be gradually increased with the capacity of the patient,

THERAPEUTIC USE OF HOT WATER. 616

until the specific gravity of the urine stands at 1,015 to 1,020, the best standard of health. If on examination of the urine the specific gravity stands at 1 ,030 more hot water should be drunk. On the other hand, should it fall to 1,010, the amount should be decreased.

3. The time for taking hot water is an hour or two before each meal and half an hour before retiring.

4. The water should not be drunk too fast. It should rather be sipped, so that the stomach may not be be so rapidly distended as to make it feel uncomfortable.

5. The length of time during which this hot water treatment should be continued is six months, this time being usually required to thoroughly wash out the liver and the intestines.

6. The amount of liquid to be drunk at a meal should not exceed eight ounces. This amount should not be exceeded in order that the gastric juice may not be unduly diluted, or the contents of the stomach prematurely washed out.

It is claimed that under this treatment the feces became black, the discolorization b^ing due to the washing of the bile down its normal channel. While this blackness may last for more than six months the fetid odor of ordinary feces is abated and the smell approximates that of the feces of healthy sucking infants. The urine became as clear as champagne, free from deposit on cooling and free from odor. The various secreting organs are said to improve as to their functions and a general feeling of well-being takes possession of the hitherto overladen and consequently inact- ive body.

The following is a summary of these general conclusions on the therapeutical drinking of hot water as given by 'Dr. Cutter : He claims it to be the foundation for all treatment of chronic diseases. It excites downward peristalsis. It relieves spasm or colic of the bowels by applying the relax- ing influence of heat inside the alimentary canal, just as heat applied outside the abdomen relieves, it dilutes the ropy secretions of the whole body and renders them less adhe-

616 TOTAL FAILURE OF VACCINATION.

sive, and tenacious. It is an inside bath. It dissolves the abnormal crystallized substances that may be in the blood and urine. It washes down the bile, mucus, yeast and waste and thus leaves the stomach fresh and clean for the function of digestion. It promotes elimination everywhere.

It is necessary in conducting this treatment that the, stomach should be rid of the hot water before meals, and this for reasons which are too obvious to require mention.

While we think it possible that Dr. Cutter has attached undue value to this means of cure, we can not dispute the fact that the number of cases to which it is applicable is great. We should think it peculiarly applicable to the case of those who habitually gorge themselves, and whose systems are always overloaded with matter which the emunctory organs, constantly overtaxed, are unable to eliminate from the system. The thorough washing out which copious draughts of hot water would favor must be very beneficial in cases of this kind. — Therapeutic Oazette.

TOTAL FAILURE OF VACCINATION.

TESTIMONY OF THE REGISTRAR GENERAL OF ENGLAND.

The Registrar General, in his Annual Summary for the year 1880, tabulates the Small Pox Mortality of London for the last thirty years, as follows :

Decades. Estimated Mean Population. Small Pox Deaths.

1851-60 2,570,489 7,150

1861-70 3,018,193 8,347

1871-80 3,466,486 15,551

It is absurd to say in the face of these returns, that

Vaccination has saved thousands of lives, or that the mor

tality would have been greater but for Vaccination, or that

the deaths accrue, as Dr. W. R Carpenter maintains, from

the *' unvaccinated residuum," seeing that in the first decade,

when but few, comparatively, were Vaccinated, the mortality

was not half as great as in the last, when over 90 per cent, of

CORRESPONDENCE. 617

the infant population had received the benefit of the State- endowed prophylactic.

These facts, coupled with the additional one that during the year 1881, 2,371 persons died in London of Small Pox, 615 of whom were under five years of age, show an enormous increase of that disease, are utterly subversive of the claims of Vaccination, and call loudly for a repeal of the despotic law by which it is enforced.

CORRESPONDENCE.

Editor Medical Advance :

I am in receipt of a letter from a young friend of mine who has recently finished his first course in one of our hom- oeopathic Medical Colleges. His previous studies and espe- cially his knowledge of genuine Homoeopathy enabled him to judge of the quality of the teaching he received at the col- lege. The result of his observations is well indicated in the following extract. " I have attended one course of lectures at

College. For God's sake, for the sake of Homoeopathy,

for the sake of all that is good, I implore you to warn young

men against going there. Prof. ^is the only homoeopathist

in the College. Prof. calmly remarked to me the other

day. ' In the future medicine must be practiced in accord- ance with the Principles of Physiology strictly and that

alone.' Prof. is nothing but a beer bloated blackguarding

Allopath. Prof. ^laughs at our using such remedies as

Carbo veg. or Lycopodium, simply because *you can eat them with impunity.' Dunham says the provings of Carbo veg. were made with the third centessimal trituration, yet

this Prof, refuses to credit its symptoms. Prof's and

and take, every opportunity to throw a bad light upon

Homoeopathy. Prof. said to me concerning a patient

'damn your Arsenicum, give her 20 grains of Bromide of Potash and some Morphine.' This College is doing Homoeo- pathy more harm than any Allopathic College in this coun- try. I like all my Professors as men, but as dishonest Horn-

618 CORRESPONDENCE,

OBopaths I despise them." Now Mr. Editor is this a dream or a sad reality ? M. B. '

FIBRIN AND BACTERIA.

Medical Advance :

My article in your February number, on the above named subject, appears to have stirred up a hornet's nest, or, rather, a bacterist's nest But I do not see anything very terrible in results thus far. Well, as Hahnemann so forcibly said : " The agitation of thought is the beginning of truth ; " and that is what I am after. I should like to answer both Drs. Taylor and Ray in full at this time, but previous engagements for papers on this and other subjects, to several scientific and medical societies, render it impossible to tender these critics my full compliments short of two or three months.

To Dr. Taylor I will say now, however, that I ride a suf- ficiently " high horse " to keep my head above the borders of the bacteria ruts, so as to see and know a little something as to what I am about, instead of remaining fioundering therein and learning nothing, as he seems to prefer to do. Also that there must be much larger and more numerous "holes" within his cranium, where there should be brains, than " are common to baker's bread," to allow him to make such foolish remarks as he does on this point. " Holes " consisting of rods and spirals, from an eighth to half an inch or more in length, under a fourth objective, lying sidewise or at all angles towards one, perfectly white in color instead of transparent, and swimming or whirling along at times with the most •rapid motion, then slowing down, but starting on again sopn, violently, is a decidedly rich suggestion, the richest I have heard in a long time, and could only have come from a '* clear gone " bacterist. Don't talk any more to me. Doc- tor, about loose methods," after such an exhibition of your own worse than " loose " ideas. By the way, who told you anything about the " openings " which you assert I see and call rods and spirals ? I said nothing whatever about " open-

CORRESPONDENCE. 619

ings " of any kind, certainly not of '^'openings " in motion, and never saw anything of the kind in my life. Dear Doc- tor, il you do not know more about microscopy than to talk of " holes " in a drop of fluid under a cover glass, that show active motion, I would suggest that you stop " reading up the most common-place experiments relating to bacterian culture," and study something else twice twenty years or more, if that will teach you better than to make such a sug- gestion to any microscopist, or write such stuflF to a reputable medical journal that has many intelligent readers like The Advance. And it might not be out of place to suggest that you resign your official position for the creditof our country, until you do learn better. Nor will it help you out of your ** holes " to again misrepresent me as showing a " ruffled temper." That is a favorite dodge with shallow men to represent an opponent as out of temper, I was in too good humor pointing out your " want of knowledge," to be dis- turbed by other emotions.

To Dr. Ray I will say that I am in no such mortal terror of bacterists and their absurd theory — near relative of the whilom blue grass craze — as he seems to be; and that I *' dare to deny " the teachings of Koch, Pasteur, et al,^^ as bearing upon the *' existence of^ all pathogenetic and non- pathogentic bacteria," in the sense that they teach their existence and efiects. But let me be clearly understood on this point I do not deny the " existence" of the /arm« of so- called bacteria as they have described them ; nor do I dis- pute that they have seen such forms in countless numbers, as they claim they have. Indeed, on more than one occa- sion have I asserted there was no question that they had seen certiiin forms, under the requisite conditions, and had described them accurately. The only dispute I have with them or other bacterists is as to wIuU those forms are, I have asserted a hundred times or more, and now re-assert with more emphasis than ever before, that aU the so-called bac- teria by name are nothing more nor less than granules, rods and spirals, or other combinations of fibrin. And when I

620 CORRESPONDENCE.

get the time to attend to this matter again, I will endeavor to make the facte so plain and clear that a " wayfaring " doc- tor, " though a fool, shall not err therein."

To both Drs. Taylor and Ray I will say that they may just as well dispense, first as last, with their pretentions and high, patronizing airs and nonsense about setting other men right until they set themselves right. This whole question is going to be settled upon a true and far-reaching scientific basiSj wholly difierent from what they believe ; and I have not the slightest fear of the result.

RoLLiN R. Gregg, M. D.

Buffalo, May 5, 1884.

AN INTERVIEW THROUGH THE TELEPHONE WITH DOCTOR G. H. G. JAHR, CHEVA- LIER, ETC., PARIS, PRANCE.

From our Special Correspondent, P. P.

While perusing the brief yet interesting note by Dr. Wm. Jefferson Guernsey, on prescribing we were prompted to have a little talk, and if possible more light on the subject of prescribing, through some of our departed trans-atlantic brothers who had given more years to the practice of medi- cine than we had. Remembering that Jahr commenced the practice of Homoeopathy in 1827, and having had an unusu- ally successful career we concluded to " call him up " for an interview and directed the central oflSce to connect us with the ground wire.

In response to our call we soon received a " letter " from the Doctor, when we asked, if he had read Dr. Guernsey's article on prescribing, in the December Advance.

His reply was that he had not, but being acquainted with the Doctor he could believe, knowing of the author's experience and success, that their opinions would harmonize.

" Will you please give to the readers [of The Advance some of your views regarding the proper manner of prescrib- ing homceopathic remedies ? "

CORRESPONDENCE. 621

" This is indeed a difficult matter. You cannot expect to dispose of such an extensive subject in this manner when it requires volumes, and even then proves unsatisfactory? "

"Well, can you give us a few rules on prescribing?"

*' I would much prefer your consulting my kliniachen anweimngen (clinical instructions) for advice."

" Thanks, but we desire something more brief for this occasion. Will you tell us what remedy you found most useful in the cholera epidemic in 1849? "

'*I was in the habit of treating the well-known precur- sory diarrhoea with the globules of Veratrum album 12, dis- solved in a cup full of water, of which solution a tea-spoon full was to be taken after every evacuation."

" Can you give us from your clinical record a report of some cases ? "

" Yes, one case I remember well was one who was toler- ably familiar with homoeopathy, (this expression is applicable to a great many of the so-called homeopathic physicians, ed.) a vial full of globules saturated with Veratrum album 12, with instruction to use it for himself and his family if occa- sion demanded, this gentleman was the first to make use of this remedy ; for one morning, while attending to his busi- ness in the city, he was violently attacked by the premoni- tory diarrhoea. Not having his vial with him and being two far from his home, he obtained Veratrum 12, from the nearest homoeopathic pharmacy, and immediately took two globules dry on the tongue, with the intention of repeating the dose if another attack should take place. The globules had scarcely melted on his tongue when the urging which he still felt, abated, so that when evening set in, he had not only had no discharge from his bowels, but not even an intimation that his bowels would be moved. This gentleman witnessed the same result in similar cases not only in his own family, but likewise among his friends, to whom, if he chanced to hear of their being attacked by this ominous diarrhoea, he gave two globules of Veratrum dry on the tongue, and after- wards learned from them that to their amazement the diar-

622 CORRESPONDENCE.

rhoea was soon controlled. Another case which Ulustrates the action of the proper remedy when given, was a poor woman who had consulted me on account of this diarrhoea and had it arrested at once by a few globules of Veratrum 12, but two days afterwards committed the indiscretion of eating a quantity of cucumber salad, after which she was not only attacked with a violent diarrhoea, but likewise with even vomiting. Residing at some distance from my office she sent for one of my colleagues, who gave her first Cuprum and afterwards Arsenicum, a few dropB of the lower attenuations, without effecting the least change for the better. For this reason she again sent for me in the greatest hurry. On my arrival I found her attacked with true cholera ; she had rice- water evacuations by the rectum and mouth, the puLse was collapsed and she was tormented by an inconceivable nervous excitement which according to her statement, set in after she took the last medicine {Arsenicum,) After examining all her symytoms I made up my mind that Veratrum was still indi- cated as the most appropriate remedy. I intended to give her Veratrum in solution, but not being able to obtain any pure water in the house, which was a wretched dwelling, I placed two globules of this medicine dry upon her tongue, leaving at the same time a prescription of Veratrum 12, to be dissolved in water by the apothecary, of which solution she was to take a teaspoonful every half hour. On my second visit, four hours later, the prescription had not yet been sent to the apothecary; but nevertheless, a remarkable improve- ment had taken place in her condition, the pulse had re- turned, the countenance had resumed a more natural expres- sion, the vomiting had ceased, the skin was warmer and the rice-water discharges had changed to a brown, watery diarr- hoea. Having the prescription filled, I ordered a teaspoonful every two hours. Next morning her health was fully restored."

^^ I suppose you could relate many such cases during that fearful scourge in Paris?"

Yes, thanks to that opportunity, however dreadful, Hom- eopathy gained its first foot-hold among the people and en-

CORRESPONDENCE. 623

listed in its ranks men worthy to be called homeopathic practitioners, not pretenders, but honest laborers.

"Will you give us some of your methods of selecting the appropriate remedy?"

"This comes from long experience and hard study. Even in cases where practitioners, who are the most conver- sant with our Materia Medica, sometimes hesitate between two or three remedies. The method of prescribing the single dose has the advantage in cases where the remedy had been improperly chosen, but administered in a single dose, of enabling the physician to give another remedy with much less loss of time and with more certainty of success, than in cases when the former medicine having been given in re- peated doses, must necessarily mingle its eflTects with the action of the new medicine, whose influence is thus greatly interfered with. From my long practice I might relate more than a hundred of such cases where one dose of a single remedy achieved a final result in the space of two months that twenty impatiently administered drugs could not Have done in two or three years. Observation, however, has shown to a certainty that in chronic diseases, where one remedy alone is capable of achieving the whole cure, slight symptoms of an incipient improvement will, according to my observations, show themselves in the first week or in the first fortnight, and if these preliminary symptoms do set in, the physician cannot watch subsequent aggravations with too much care, unless he means to spoil everything by the premature exhibition of another remedy. On the other hand it is likewise an established fact that, where even the discriminating eye of the most careful observer does not even perceive the slightest signs of a begin- ning improvement in fifteen or twenty days after the exhibi- tion of a remedy in chronic diseases, nothing better can be expected of this drug, and some other remedy will have to be chosen."

"Why do not the homeopathic physicians of to-day meet with the same results in practice ? They at least pretend to follow the above rules."

624 CORRESPONDENCE.

"I can only answer that question by stating that their observations are not made with sufficient correctness, hence the poor results. It is much better to adopt the advice Hahnemann gave in the commencement of his practice, and which his first disciples followed without an exception for upwards of twenty years, until the advent of the specificists in the homeopathic school, namely, to administer the remedy in one dose, or, in chronic diseases at most in three doses, which, being given in rapid succession, at intervals of two or four days, were intended to represent one dose, and then to watch the result of this treatment; I say it is much better to follow this course than to order several doses at once to be taken in water. The best cures which I ever performed, were achieved with such doses, which I prefered to any other method of exhibiting remedies in chronic diseases as well as in acute, non-febrile afiectionfi. Even in febrile inflamma- tions of internal organs, after having subdued the fever and the intensity of the inflammation by means of a watery solu- tion of Aconite or of some other suitable remedy, of which so- lution I never gave more than a teaspoonful at a dose, which sufficed in my hands to cure the worst kind of inflamma- tions. I prescribed for the remaining morbid symptoms, a single dose dry on the tongue."

"Are not many of our physicians now following this same practice?"

" No I I am sorry to say they are not, and this is the stumbling-block to their success. Our art is and always will remain an art of observation^ which has for its object, not only to investigate the efiects of drugs upon persons in health, but likewise to examine every individual case in all its aspects, and, after administering the proper remedy, to exiamme him again, in order to find out what further course the disease will take. For if a physician is ever so well acquainted with the remedies at his command, all he can do in spite of his patient's case, and of the most careful selection of the remedy, is to h^e that the right remedy has been found; he cannot posi- tively know this till he sees what effect the remedy produces."

COKRJESPONDENCE. 625

'*How are we to know that we have selected the proper remedy?'

"There is no more certain way, than to give only one dose of the remedy by way of trial and afterwards to observe and watch the patient, in order to satisfy ourselves whether we have entered upon a road that we can pursue further without hesitation and with perfect confidence."

"Yes, but Doctor how do you account for the good re- sults which follow the alternation of drugs ?"

" It is true. I too have seen excellent results obtained by my colleagues, when I was in practice, by this method, but I have always asked myself whether they would not have reached their object more speedily by giving first the most suitable remedy by itself and after this remedy had exhausted its good efiects, administering the other remedy for the re- maining symptoms."

" How did you treat cases of typhoid fever ?"

"After having subdued the fever and the intensity of the inflammation by means of Aconite or some other drug, I then prescribed for the remaining morbid symptoms, one dose dry on the tongue of Mercurius 30, or some other remedy."

" Did you not believe in alternating in malignant diph- theria?"

"No sir. And in corroboration of this statement, I wish to give you the experience of my friend, Dr. Kallenbach, who gave his diphtheritic patients when the first severe epi- demic broke out at the Hague, Apis and Lachesis in alterna- tion, but who afterwards when he wished to find out which of these two remedies really afiected the cure, saw those of his patients to whom he gave Apis alone, recover in three or four days instead of six or eight under the former prescrip- tion, whereas those who had received Lachesis alone, did not improve at all. I could give you any number of instances if they were needed, to convince homeopathic practitioners who really desire to make progress in the difficult art of always selecting the right remedy."

"Why is it that our beginners in Homoeopathy do not

626 BOOK NOTICES.

appreciate the importance of the study of Materia Medica as they did in your time?"

" I can only explain that upon one theory, and that is with the present flood of homoeopathic literature that is forced upon the profession from year to year, makes the careful study of our pure Materia Medica almost impossible to the younger members. Overwhelmed as they are by the accum- ulated mass of drugs and clinical observations they scarely know which way to turn for at least one ray of light in the chaos spread out before them and instead of singling out a few remedies from Hahnemann's Materia Medica Pura for their particular study, they prefer having recourse to some clinical guide or repertory where they can pick out what they require for the time being. To the experienced prescriber to whom these repertories are like sign-posts in the field of prac- tice, to the beginner they never fail to confound simply be- cause he does not know how to distinguish the truly charac- teristic and essential from the accidental and non-essential.

At this juncture the Central oflSce interrupted our con- versation by stating that Dr. E. M. Hale had been waiting some time to hold a controversy with Dr. JaLr, over his (Hale's) work on "New Remedies," and therefore we were obliged to discontinue this interesting interview.

BOOK NOTICES.

TRANSACTIONS OF THE NEW.YORK CHIRURGICAL SOCIETY, 1888. VoL IIL

The present number comes to us well freighted. A matter worthy of imitation is the printing of abstracts of papers and full report of discussions. The science and art of surgery makes very substantial progress in the energetic and skillful hands of our New York friends. Their enterprize in the production of this volume is every way commendable.

ANNALS OF THE BRITISH HOMCEOPATHIC SOCIETY AND THE LONDON HOMCEOPATHIC HOSPITAL. February, 188i.

The present number is full of valuable contributions. They treat respectively of Koumiss, of some special cases of Enteric Fever, of comparisons in the treatment of Diphtheria. Report of cases of

BOOK NOTICES, 627

Skin Diseases, some additional cases of Typhoid Fever and a case of Aneurism of tiie Abdominal Aorta. These papers are some of them followed by brief discussions which leave us to wish they had been reported more fully.

AMERICAN DRUGS AND MEDICINES. Quarterly, devoted to the Medical, Phar- maceutical and Botanical History of American Drugs, and the Plants yielding them : By J. U. <& C. G. Lloyd, ISO Elm street, Cincinnati, O.

This is an illustrated 32 page quarterly. The engravings are on wood, and although very good, lack the beauty of the colored life-like engravings of Millspaugh (American Medical Plants), now running through the press of Boericke & Tafel. The list of con- tributors promises well, and represents all schools of medical prac- tice—Hale, Bartholow and Scudder — ^being an earnest of the some- what cosmopolitan character of the journal. The first number con- tains engravings of ''Clematis vir.," ''Phalictrum dio.," "Anemone patens/' the Pulsatilla Nuttallania, or American Pulsatilla, and others. It is well printed, and the low price of $1.00 a year should ensure many subscribers. We wish the publishers success in their new enterprise. H. C. A.

COUGH AND EXPECTORATION. A Repertorial Index of Their Symptoms. Edl- ted by E. Jennings Lkb, M. D., assisted by Geo. H. Claxk, M. D. New York : A. 8. Chatterton Publishing Co., 1884.

This work consists of Part I, which treats of cough symptoms ; of Part II, which treats of expectoration and a supplement contain- ing remedies omitted in the body of the work, etc. That the task of arranging this has been great is seen at a glance and that the work has been well done we can well believe. There need be no ques- tion as to the value of such a work. It is almost indispensible to the busy doctor, for peculiarities can at once be found in prescrib- ing for coughs, that might otherwise baffle a long search or not used because not readily found. Too much cannot be said of the thor- oughly practical character of such a repertory. Give it a place on your table and the result will justify the cost a thousand fold.

BACTERIA AND THE GERSC THEORY OF DISEASE. By Db. H. G&iLDLE. W. T. Keener, Chicago.

If one desires to become thoroughly posted on all the latest facts and theories relating to micro-organisms he cannot find any- thing so well fitted for study as this little book. It is truly multum in parvo. In a clear and condensed manner the field of modem re^ search is gone over and all the most recent facts are carefully noted.

628 BOOK NOTICES.

Since so much is being said and written upon this topic at present, Dr. Gradle's work is most opportune, and we would urge upon oar readers its great value for it is a reliable resum^ and condensation of every thing that has appeared up to date, concerning the micro- germs and their relation to disease. While we have taken great pleasure in reading this book it has by no means convinced us of the truth of the theory, which makes Bacteria disease producing: agents. Upon that point we claim to be medical agnostics.

A TRBAllSB ox SYPHILIS IN NEW BORN CHILDRBN AND INFANTS AT THX BREAST. ByP.Diday. Wm. Wood i^ Ck>., New York.

The importance of the subject treated in this book is best known by those who have had much to do with hereditary syphilis in children. There are few general practitioners however, who do not have to often deal with this form of disease. It would be diffi- cult, no doubt to find any who have not seen cases of thi^ kind and to all such Diday 's work cannot fail of being of permanent interest The author discusses every possible phase of the question or rather questions, but in no dogmatic spirit; but yet, with a clear conviction of his own opinions. The proofs and limitations of diagnosis are worthy of careful study. The conditions of transmissibility are faithfully marked out and practical illustrations are crowded in on almost every page. When, however, we come as inevitably we must to the question of all questions the treatment of this disease, we ob- serve at once that Diday has nothing new to offer us. It is the old, old story: Mercury and Iodide of Potassium. There are the same worn out theories and the usual illustrations which are supposed to prove the value of this ancient "anti -syphilitic treatment.'' How long will it be before these learned gentlemen, who like M. Diday, are wise enough in some things, will learn the simple truths of therapeutics? How vastly might they improve their work if only they would.

A TREATISE ON UTERINE DISPLACEMENTS: By 8. J. Donaldson, M.D., Now York. Publiflhed by Otia Clapp <& Son. Boston, Maes.

This work is a small monograph of 80 pages, intended, we should judge, from the author's preface, as an offset for the " hastily written and consequently betraying crudity and incompleteness " of a previous effort of Dr. Donaldson's, CkmiribuHofu to PracHeal Gynecology.

After a careful examination of the work we came to the conclu- sion that this book, like the former, was " hastily written, and con-

BOOK NOTICES. 629

seqnently betraying crudity and incompleteness," and that the author was in a transitory state of either giving up the use of pes- saries altogether in the treatment of uterine displacements, or an advocate of the one pessary only, shown on page 74. We trust the good Doctor will not inflict upon suffering women this kind of an instrument very long.

Although the title of the work would lead us to expect some therapeutical treatment in addition to the mechanical, such is not the case. The anatomy and etiology of the subject is simply a com- pilation up to date. The author's criticism of Dr. T. Gillard Thomas is quite severe, and yet proper, but we were amazed when we came to the treatment of his subject to find he had likewise dropped into the same error. From the Doctor's language and manner of hand- ling hissubjeci, w6 cannot but think he will soon publish another work, stating in the preface, as in this book. *' the work had scarcely left the press before I resetted Its publication." P. P.

A MATERIA MEDICA OF DIFFERENTIAL POTENCY: B. F. Underwood, Ph. D.. M. D., New York. A. L. Ohatterton Pabllshing Co., 1881.

In this volume of 215 pages the author attempts to settle the vexed question of dose, and like many other writers on the same subject, his attempt ends in signal failure. He says that *' among the authors consulted are Periera, Wood, Ringer, Bartholow, Phillips, Bering, Hempel, Hale, Hughes, Ruddock, Lilienthal, Jahr, as well as many others of all shades of opinions." How a writer on homoeopathic Materia Medica could find anything to aid him in the ''selection of the appropriate remedy, and attenuation " from Pereira, Wood, Ringer, Phillips, etc., is incomprehensible. And what, we we would like to know, have Hering, Hale, Jahr or Lilienthal done that in such a search they should be classed in such company? The author makes the somewhat startling assertion, and quotes Meyer and Periera in proof of it, that Aconite is not homoeopathic to fever. He also says that Aconite, for instance, should be used ''in the early stages of simple inflammatory fevers, imflammation of serous mem- branes,pleuritis, pneumonia, tonsilitis, acute rheumatism, erysipelas, etc., in the low or lower attenuations, and in the higher attenuations it is a nervous stimulant and is adapted to the disturbance of the brain and nervous system, dry cough, etc." He asserts that "clinical and empirical symptoms agree or harmonize with the generic force of a drug, hence for them low potencies should be used." This is the only attempt to formulate a law of dose or deduce a rule for the administration of high or low attenuations. His ipse dixit, drawn

630 EDITOR'S TABLE,

from his experience! is all he gives us. To arbitrarily say that such a drug should be given in certain diseases in highy and in others in low attenuations, is a very easy and simple method of settling a vexed question.

Dr. Underwood evidently bases his classification of drugs as to dose on their peculiar action on the nervous system. This asser- tion is not more absurd than that Aconite is not homoeopathic to fever, because some allopathic writers have been unable to find the products of inflammation in cases of death from poisoning with Aconite. We have no recorded cases of albuminuria from poison- ings with Apis, and yet it has cured many cases of albuminuria. Spigelia has not developed organic valvular diseases, but it has notwithstanding cured many cases of organic disease of the valves. We do not think the classification here ofiered a practical one. We would not like to be confined to the "low or lower'' attenuations of Aconite and Bryonia in pleuritis, croup or pneumonia, because the author thinks it is the rule to follow. The author appears to be earnest and honest in his opinions, but like many others on this same question we think he is honestly mistaken. It is doubtful if this book will aid much in the settlement of the question of attenu- tions. The publishers have done their work well. H. C. A.

EDITOR'S TABLE.

Dr. W. W. Walker has removed to Port Sarnia.

Dr. E. F. Beckwith has taken Dr. Walker's practice at Muir, Mich.

McGregor, la., is reported in want of a first class physician. Address Rev. A. S. Church.

Married.— Mr. Theodore Engelbach and Miss Emily Maier of New Orleans. March 27, 1884.

It has been suggested that beef tea was invented about the time Henry VIII. dissolved the Papal bull.

The Cincinnati Homoeopathic Medical Society passed appre* ciative resolutions upon the death of Dr. J. H. Pulte.

T. Engblbach who has been connected with Boericke & Tafel's pharmaicies for the last 15 years, now succeds them as proprietor. We wish him success.

W. E. Vananda, M. D.. (U. of M.) has recently enjoyed the pleasure of a trial for mal practice, and what is still better he com- pletely defeated his enemies. Congratulations, doctor.

EDITOR'S TABLE, 631

Rbmovbd : C. C. Pillsbury, M. D., locates at Ypsilanti instead of Mt Clemens. Dr. Folsom, formerly of Minneapolis, takes Dr. Pillsbnry's place at Mt. Clemens.

Dr. Thomas Young to Columbus, Ohio.

The Twentieth Annual Session of the Homoeopathic Medical Society of Ohio will be held in Cleveland, May 13th and 14th, 1884. We would like to see every Homoeopathic Physician in the State at this meeting. H. E. Bbbbe, Secretary.

Hahnemann Medical Association of Iowa, will hold its 15th Annual Session in Des Moines on May 28, 29, 30. R. F. Baker, M. D., of Davenport, President; S. E. Nixon, M. D., of Burlington, Sec'y. A big rally is looked for.

The Minnesota State Homoeopathic Institute will hold its 18th Annual Session in Minneapolis, May 20, 21. President, Henry Hutchinson, M. D.; Secretary, Arthur A. Camp, M. D. The bill of fare is aopetizing. Our Minnesota doctors turn out well.

State Societies.— A State Society for Texas was organized in Austin, May 1 and 2. The bill of fare was excellent.

Michigan State Society in Detroit, May 20 and 21.

Wisconsin State Society, in Milwaukee June 4 and 5. Owing to continued ill health Dr. S. S. Lungren, of Toledo, Ohio, has been compelled to give up his practice and will visit Europe for a period of two or three months, sailing on the '^Amamie" of the Cnnard line April 30th. We wish the Doctor and Mrs. Lungren hon-wyage,

Hahnemann's Birthday. It appears that our brethren of Minneapolis and St. Paul, also kept in due remembrance the 129th birthday of the founder of Homoeopathy. Judging from the card, they had a big, big time. Dr. W. E. Leonard is our informant and he can be relied on.

A good well established practice in a live city of 5,000 inhabi- tants, in fine farming country well settled, together with a fine home, also office furniture, fixtures, and medicines, can be had for $3,000, $2,200 cash, balance on long time. For particulars address, J. M. Larbabee, M. D., Maryville, Nodaway Co. Mo.

The compliments of Prof. A. C. Cowperthwaite and wife to the members of the American Institute and their families Deer Park, Monday evening, June 16, 1884. Assisted by the following officers of the B. & O. R. R. Co. : J. G. Pangborn and wife ; G. H. Dearborn and wife, and W. J. Walker and wife.

The First Annual Announcement of the Hahnemann Medical College of San Francisco, session 1884-85. This looks like business.

632 EDITORS TABLE.

If the early bird catches the worm the early announcement like this should catch some students and we sincerely hope the new College may catch it full of them, and that there may never, never, never be a row in the faculty.

Thb Irving Libraky.— Mr. John B. Alden, of New York, is pub- lishing a large amount of the choicest literature at a price that is the wonder of the age. History, poetry, romance, science and relig- ion are included, and all of the first quality, most of it in fact stand- ard works. What is often paid for single books, will here purchase a considerable library. Send Mr. Alden, (18 Vesey street. New York) your name and see what he can offer you.

At the 33d Annual Meeting of the Homoeopathic Medical So- ciety of the State of New York. Feb. 12 and 13 last, the following oflScers were elected : President, Edward S. Coburn, M. D., 91 Fourth St., Troy ; Vice Presidents, Henry C. Houghton, M. D.. 12 W. 39th St., New York; H. M. Day fort, M. D., Rochester; A. P. HoUett, M. D., Havana; Secretary, John L. Moffat, M. D., 17 Schermerhorn St., Brooklyn ; Treasurer, H. L. Waldo, M. D., West Troy. The next semi-annual meeting will be held at Binghamton, Sept. 9 and 10, 1884, and the Annual Meeting at Albany on the second Tuesday and Wednesday of February next. T. p. WiiAON, M. D., Dean of the HomcBopftthlo Dept. Michigan Univenity. :

Dbab Sir — ^At their annual meeting, the Faculty of the New York Homoeopathic Medical College carefully considered their posi- tion in regard to endorsing the diplomas of other colleges, which, you remember, was discussed in the Intercollegiate Committee at the last meeting of the Institute, and unanimously resolved— that, hereafter the Dean of the New York Homoeopathic Medical College will endorse, without examination of the applicants, the diplomas of all Colleges represented in the American Institute of Homoeo- pathy. Edgab V. MoppAT, Secretary.

M. Malhbrbe, in a recent Thise de Paris, remarks that the fre- quency of the pulse in this disease is not always in proportion with the elevation of temperature. The temperature often becomes very high without a corresponding change in the pulse and inversely, the pulse may become very much accelerated without any extra elevation of temperature. In any febrile affection where, with a high temperature, the pulse remains almost normal in frequency, typhoid fever should be thought of. The prognosis is not generally bad when the pulse remains at 80 or 90 beats per minute, even when the temperature amounts to 104** or 105®. But when the pulse is very frequent in conjunction with this high temperature, then the

EDITOR'S TABLE, 633

prognosis is grave. When, on the other hand, the temperature suddenly falls, while the pulse remains very frequent, the prognosis is equally grave. P. P.

Canadian medical schools maintain a higher standard of edu- cation than those of this country. — Medical Era. The high standard above referred to belongs almost exclusively to the Province of Ontario. It is provincial not national, applies only to Ontario as the Board of Health laws apply only to Illinois. The matriculation examination is the highest of any on the continent, but in atten- dance on lectures the requirements are not so high as at the Uni- versity of Michigan. The Ontario law requires attendance upon four courses of six months each — 24 months— while the University of Michigan requires three courses of nine months each — 27 months. The amount of practical work demanded of the student is much greater in the University of Michigan than in the Ontario colleges.

One hundred and fifty -eight students graduated from the two Chicajico colleges this spring. — Medical Era, Query: How many would have graduated under the requirements of Ontario or Univer- sity of Michigan?

Sbc^y op Board of U. S. Examining Surgeons, \ Coventry, Vt., Jan. 7, 1884. j J. A. McArthur, M. D. :

Having used your valuable combination of Hypophosphites of Lime and Soda for more than a year, I would like to report to you one case in particular and then ask a question.

In June last I was called to see a young man aged 18, whose mother and one brother had died of phthisis. I found him suffer- ing from severe pleuritic pain, night sweats, sevtre, distressing cough and profuse expectoration, characteristic of first stage in phthisis. Tongue coated, pulse 128 to 130, temperature 105 deg. at night. Profuse crepitus in lower half of left lung, dullness on per- cussion over almost entire left side. Intercostal depression marked on left mammary, extending backward into left axillary region. No appetite, and general facial expression of rapid emaciation, etc. I begari the use of your Syrup Hypophos. Comp., and contin^ied it four months, using some other means for night sweats and such other conditions as seemed to require special attention. To-day the young man is about the farm doing light work. Appetite excellent; no cough; no night sweats; the wasting of lung sub- stance is arrested, leaving dullness in left lower lung ; vesicular murmur gone. The disease is arrested at least, and he has increased in weight 43 pounds. I have used the Syrup in five other cases during 1883, with the moat gratifying results.

634 EDITOR'S TABLE.

HO ! FOR DEER PARK.

It must be clearly apparent that the Baltimore & Ohio Railroad Company is determined to leave nothing undone to render the Annual Institute of Homoeopathy at Deer Park, in June, the most memorable in the history of the organization. Not only has the week to be spent in the mountains been planned to insure the greatest enjoyment, but in the journey to this lovely resort every detail has been carefully looked to. At no extra expense whatever to those participating, advantages have been vouchsafed which cannot but meet with the heartiest endorsement. A special train of magnificent new cars, and with every facility for the fullest enjoyment, will be run from Chicago to Deer Park for the exclusive use of the members and their families. The train will leave the new Baltimore and Ohio Depot, on the Lake Front, foot of Madison street, at four o'clock, June 15, and will run through on special time, arriving at Grafton in good season the following morning for break- fast, thence on to Deer Park. Stops for brief inspection will be made at the most noted centres of picturesque interest in the Alle- ghanies, and arrival at destination will be before noon. It is par- ticularly important that it be known at the earliest possible date the number to be provided for on the special train. To this end it is urgently requested that notification be sent to Prof. A. C. Cow- perthwaite, Iowa city, la., of intention to go upon the Special, and the sleeping car accommodation desired. First in will be first recorded on the sleeping car charts. The Railroad Company will do all within its power to add to the pleasure and convenience of the Association, amd only requests in return that co-operation which will leave not the slightest question as to a successful result. A general officer of the Company will visit Chicago for the express purpose of accompanying the party to vhe mountains, and through- out the entire journey officials of the road will pay every attention to details, looking to the fullest satisfaction of all. The programme for the entertainment, especially of the ladies, during the session of the Institute at Deer Park, will be announced hereafter; and if, in its entirety, the week in the mountains is not voted beyond all comparison the most attractive and enjoyable known of any meet- ing, it will be by no means the fault of the Railroad Company and managament of Deer Park. Those who cannot arrange to go upon the special train can leave Chicago on the regular trains of the B. & 0., leaving Chicago as follows : 8:10 a. m., daily, except Sunday ; 5:10 and 11:10 p. m. daily. The rates are exceedingly low, one half the regular fare or one usual fare for the round trip.

F. H. ORME, M. D., ATLANTA, GA.

WILflM^M, M. D.,

Editor.

PHIL PORTER, M. D.,

Gyneoological Editor.

Vol. XIV.

Ann Arbor, June, 1884.

Xo. 12.

All subsorlptiqns and business oonununications should be addressed to MEDIOAL ADVANOB PUBLISHING OO., Ann Arbor, Mioh. Subscription, $2.00 per annum.

H. O. ATiTiBN, M. D., Business Manager.

Principles of Medicine, No. 2. — That Medicine is a science and not simply an art has been again and again denied by those who were high in authority. But to give it place in the list of modem sciences it is necessary only to show that Medicine in all its departments rests upon scientific principles — that is upon natural laws. By the slow but sure processes of evolution, Anatomy, Physiology and Pathology have come to a development that entitles them to be called sciences. They have simply come out of a condi- tion of chaos into a condition of orderly arranged facts. They are sciences because we no longer guess them ; we know them. They each follow well-known laws in their develop- ment. If now we can demonstrate that therapeutics rests upon law, we shall succeed in placing Medicine on a plane common to all the accepted natural sciences. The desira- bility of this cannot be questioned by any one. From Hip- pocrates down, this has been the dream of medical men. By

636 EDITORIAL,

finding and applying such a law we give exactness and consequent success to therapeutics it could not otherwise have. But no natural law can be said to be self-evident. Every such law is built out of an aggregation of facts, and these facts must first be fully understood. A blind faith may accept an alleged law upon some irresponsible ipsi dixit^ and indeed, this is the general attitude assumed by most minds, but the genuine student of Medicine demands knowl- edge before he is willing to give his belief. If, then, Medicine is a science, its facts are capable of demonstration; and for its enforcement it can have no higher authority than Nature. For over two thousand years medical art proved of little avail because it was hopelessly entangled in the meshes of elaborately woven theories, any one of which being broken, only gave place to other and more intricate theories out of which the physician could find no means of escape. It is not diflScult to see, however, in the past history of Medicine a steady process of evolution in which more and more med- ical art was working toward that state of freedom, which could be obtained only by abandoning the false teachings of false philosophies and allying itself to science. Anatomy and Physiology broke the shackles of ignorance and super- stition with which they were bound so many centuries and became realities when they went to the dissecting room and laboratories and proved the facts upon which they are built. It was reserved to Hahnemann to lift Materia Medica out of the quagmire of superstition and to give it a solid foundation. In the track of these must follow a scientific Therapeutics. Empericism, the legitimate precursor of all the sciences must here, as elsewhere, give way to the reign of law. It is the province of the Principles of Medicine to discuss and elucidate the laws which we obtain in the cure of disease.

University of Michigan, Hom(bopathio Department. — The tenth annual announcement of our school is out. It will repay those who are interested in medical education to compare the opportunities here olBFered with those of other

EDITORIAL. 637

schools. No doubt each of our medical colleges has its strong points. There must be something worthy of the attention and patronage of the profession in every school that hopes to obtain permanency and success among our ed- ucational institutions. Of the Ann Arbor school — for by this title is our school most widely known— it is enough to say that it offers and can secure a higher medical education for men AND WOMEN. That "higher medical education " includes far more than we have room to even specify in this brief article. The University of Michigan undertook at an early date to practically solve the problem of co-education. It is years since its doors were first fully opened to women. And now, as our worthy President remarked, they blossom like June roses in all our halls and recitation rooms. In every depart- ment of the University they hold place and power. In our medical school they have full rights and privileges, and we can truthfully say, that their presence and co-operation in no sense detracts from, but in all respects enhances the rights and privileges of others. This much is settled: Whatever doors are closed against women, this University will keep its doors opeA to all without regard to sex, color or nationality, or any other false standard of requirements. It does, how- ever, demand qwdijkcUion, Every student must possess a fit- ness in moral character and in educational acquirements. If English is his mother tongue, he must master it before matriculation. Once admitted, the student finds a compre- hensive curriculum spread out before him and he will be invited to enter upon nine months of earnest labor. This may seem a heavy task, but it is not so. The brief vacations scattered here and there give needed rest and tend to sharpen the zest for subsequent study. The collegiate year is divided into semesters, each having its own work, and at the end of which the student makes his final examination of that half of the year. Of the ability of the faculty it would not become us to speak. As teachers of long experience in other schools before coming to this University, the professors of the Homoe- opathic Department may justly claim the confidence of the

638 F, H. ORME, M, i>., OF A TLANTA, QA,

profession and respect of the students. Of the clinical work of this school something demands to be said. Because Ann Arbor is a city of only 10,000 population it is asserted that we cannot give adequate clinical instruction — that we have not the material in patients, etc., such as may be found in our larger cities. To all this we need only reply that our clinical hours are always more than full. If we had more patients we could not utilize them. Our Hospital adjacent to and opening directly into our amphitheatre, together with our out patients, give us an abundance of diseases and oper- ations. It cannot truthfully be said of our school that it lacks in clinical advantages. We have repeatedly been urged to set forth more fully than is done in the annual announce- ment the status of our school. For years the medical pro- fession has loudly demanded a higher standard of medical education. We desire to have it known that as part of the University of Michigan, and amply endowed by the State, our school offers what is so earnestly desired, and we tender in good faith, with an ability to make our tender good, a

HIGHER MEDICAL EDUCATION FOR MEN AND WOMEN.

F. H. ORME, M. D., OF ATLANTA, GA.

The professional life of Dr. Orme commenced with his entrance as a student into the office of Dr. J. B. Gilbert, of Savannah, Ga., in April, 1850. (Dr. Gilbert had been a student with the late Dr. John F. Gray, of New York, who was one of the first to learn of homoeopathy from Dr. Gram, the first to prescribe upon the homoBopathic method in America. Dr. Gilbert had been graduated from the Univer- sity Medical College of New York, and settled in Savannah in 1842 — being the pioneer of homoeopathy in Georgia).

Receiving his diploma from the University Medical Col- lege of New York in the spring of 1864, Dr. Orme at once formed a partnership with his preceptor's successor. Dr. Wm. H. Banks, a physician of large practice in Savannah.

F. H. ORME, M, />., OF A TLANTA, QA. 639

Hifl first year was one of severe trial, being the year in which the most violent epidemic of yellow fever ever known to the city occurred. Eight physicians and two medical students, engaged in assisting their preceptors, lost their lives with the fever during that season. This was a fearful mortality among physicians in a city of about twenty thous- and people. But two physicians escaped the fever — ^both men of advanced years. Of course Dr. Orme suffered from it, having a very severe attack, from which, with careful attention, he recovered. (He also had it again during the epidemic of 1858).

He was, during two weeks of the worst of the plague, the only one of five homoeopathic physicians in the city who was able to attend to patients. This threw upon him more than he was able to attend to— but he did nobly, with the result of being well established in practice by the end of the season — Homoeopathy having made a good record in its grapple with the disease.

From considerations of health and family, he moved to Atlanta in 1861, at which point he has continued in his pro- fession, to which he is strongly attached, doing much for the spread of Homoeopathy in the south.

He was a member of the Homoeopathic Yellow Fever Commission, composed of eleven prominent physicians (four of whom are ex-presidents of the American Institute of Homoeopathy) which met at New Orleans in .1878.

His membership of the American Institute of Homoe- opathy having commenced in 1869, he will class with the "seniors" from June, 1884 Since his connection with the Institute, he has furnished many valuable papers to different bureaus, and held positions of honor. He takes much interest in this national organization, of which he is one of the Board of Censors, and considers it a labor of love to do any committee or bureau work assigned to him.

Being located at the capital of his state, he has been instrumental in defeating many bills introduced into the Legislature, which were unjust and unfavorable to homoeopa-

640 MICHIGAN HOMOSOPATAIC MEDICAL SOCIETY.

thy; at the same time influential in the passage of our pres- ent laws.

He was the first president of the Atlanta Medical Glab, and in sundry ways has contributed largely to the spread and respectability of Homoeopathy in Georgia. Although his practice is such as to occupy the most of his time, his contributions to medical literature are by no means few. This is but a brief sketch of a very able, influential man, who by his examplary character, exceptionally clear and forcible writings, and devotion to his work, to his family and to his friends, is a worthy representative of a noble profession.

Dr. Orme's family consists of his wife (who was Miss Ellen V. Woodward, of Beaufort Dist., S. C, whom he mar- ried in 1867), a daughter of sixteen, (Lillie), and a son (Prank) of thirteen.

MICHIGAN HOMEOPATHIC MEDICAL SOCIETY,

SYNOPSIS OF PROCEEDINGS.

Tuesday morning. May 20, the fifteenth annual session of this Society began in the Royal Templar hall, Detroit. There were about forty members present when the society was called to order by the president. Dr. R. B. House, of Tecumseh. Dr. Phil. Porter, president of the College of Physicians and Surgeons of Michigan, in behalf of the pro- fession of Detroit, extended a hearty welcome to the society. He noticed the significant fact that on this, the fifteenth annual session, the homoeopathic profession in the State were fifteen times stronger in number and influence than when this society was organized : and, with pardonable pride, pointed to the rapid extension of the system of practice in the State, and especially to the position it had obtained in the University. He thought much of .this progress was to be attributed to its medical societies, which should be en- couraged and maintained, not alone from a scientific stand-^

MICHIOAN HOMCEOPATHIC MEDICAL SOCIETY. 641

point, bat for the purpose of cementing together the mem- bers of the profession. He concluded a short and practical address by warmly thanking the members present for attend- ance, and wishing them a pleasant and profitable session.

Dr. House, in replying to the address of welcome, re- ferred to the many new faces that had been added to the ' society since the last session in Detroit, five years ago. He was sure that the hospitality of their Detroit brethren would be thoroughly enjoyed as doctors only knew how.

After the roll call, the secretary read the minutes of previous session, made up, he said, through the courtesy of The Advance and Oounsdar^ as he had never been able to obtain any minutes firom the former secretary.

Dr. Porter moved that a committee of two be appointed to examine the minutes as prepared by the secretary. The Chair appointed Drs. McGuire and Wilson.

The report of the secretary showed an expenditure dur- ing the year of, 114.51 ; while that of the corresponding secretary was 111.25. On motion, the reports were accepted and referred to the Auditing Committee. On account of ab- sence, on motion, the report of treasurer was deferred until afternoon. The president appointed Drs. A. R. Wheeler, of St. Louis, B. H. Lawson, of Brighton, and L. M. Jones, of Brooklyn, as auditing committee.

Report of reception of delegates to this society being in order : Dr. E. P. Gaylord, delegate from College of Physi- cians and Surgeons, made a' brief verbal report of prosperity, and much interest taken in the weekly meetings of their so« ciety. Dr. J. G. Gilchrist made a verbal report as delegate fipom Iowa State University. Dr. W. A. Phillips represented the Cleveland Hospital College, and Dr. T. P. Wilson, the Uni- versity of Michigan. The committe to examine the secretary's minutes, reported them correct, except such as referred to Dr. Morley, as it does not appear that he was a member, and, on motion, his name was stricken from the minutes wherever it appears, after which, the report of the committee was adopted.

642 MICHIQAN HOMCEOPA THIC MEDICAL SOCIETY.

On reports of delegates to other societies, Dr. Gilchrist and Dr. Bailey reported as delegates to Ohio State Society, and Dr. Gilchrist as delegate to the Legislature to secure the passage of asylum bill.

On motion of Dr. Wilson, the reading of papers was limited to fifteen minutes, and the discussion thereon to five minute speeches.

BUREAU OF SURGERY.

Dr. Gilchrist read a paper on " Resection vs. Amputa^ tion," in which he claimed many advantages for the former over the latter. In all cases in which there was any doubt as to which operation should be performed, the benefit of the doubt should be given the patient. The paper was briefly discussed by Dr. Bailey. A member asked for Dr. Gilchrist's method of dressing in resection of shoulder or hip, to which he replied that he was not a believer in or advocate of the use antiseptics. He dressed with Hypericum at first, and later with Calendula, which was our great vulnerary. These had given him good results, and, under our law of cure, he thought we should use them instead of the fashion* able antiseptics of the other school.

This closed the Bureau of Surgery, and the Bureau of Ophthalmology was taken up by a paper by Dr. T. P. Wil- son, on " The Relation of the Specialist to the General Prac- titioner in Eye Diseases," in which he contended that, although this department was now so generally given up to the specialists, it was one to which the general practi- tioner not only could but should successfully apply him- self. Especially was this true in all the diseases— the ma- jority of all the affections of the eye — of the external struc- tures, such as inflammations of the conjunctiva, cornea, iris, etc., while the diseases of the deeper tissues and the errors of refraction would still be left, and very properly left, to the specialist. The study and successful treatment of the latter required special preparation.

Discussed by Drs. McGuire, Phillips, Gilchrist, Bailey and Wilson.

MICHIGAN HOMCEOPATHIC MEDICAL SOCIETY, 643

The President called the society to order promptly at 2 p. M., with a report of the Board of Censors, and Drs. Famsworth, Cleveland, Cooper, and Kasselman were elected members.

The Bureau of 0. and 0. continued its report with a paper by Dr. McGuire on " Jequirity in Granular Lids."

Dr. Wilson asked the author what he meant by applying it in a slovenly manner?

Dr. McGuire replied, "applications by means of rags, etc."

Dr. Wilson — But De Wecker recommends it to be ap- plied with a linen rag.

Dr. Phillips had only tried it in four cases, successful in three, but failed in one. In reply to a .question, Dr. Philips said he had never succeeded in a single case in curing granular lids with internal remedies alone. Had treated some cases that he could control for a year or a year and a half, and was then compelled to resort to topical applica- tions. Bureau closed.

Bureau of Pathology had a single paper, by Dr. T. P. Wilson, " What of The Baccillus Tuberculosis," which was read and referred.

The committee reported the following names as chair- men of the respective bureaus for next session. Pathology, B. L. Cleveland, East Saginaw ; Surgery, H. L. Obetz, Ann Arbor; Ophthalmology and Otology, T. P. Wilson, Ann Ar- bor; Mental and Nervous Diseases, A. A. Allen, St. Johns; Paedology, R. C. Olin, Detroit; Materia Medica, C. C. Miller, Detroit; Theory and Practice, W. E. Clark. Three Rivers; Gynaecology, Newton Baldwin, Ann Arbor; Microscopy, J. G. Gilchrist, Deftroit; Registration and Statistics, A. R. Wheeler, St. Louis; Necrologist, F. WoodrulBF, Detroit.

A committee was appointed to memorialize the next leg- islature to secure the passage of a law providing for the better payment by the courts of law for suitable expert medical witnesses, their payment being at present left to the discre- tion of the judges.

644 MTCHIOAN HOMCEOPATHIC MEDICAL SOCIETY. THE president's ADDRESS.

The president, Dr. House, then delivered the annual ad- dress, in which he stated the conviction that Homeopathy had made considerable progress during the past year, not only in the State of Michigan, but all over the world, and that the present outlook was most gratifying. A brief glance back over the present century, at the commencement of which Samuel Hahnemann introduced his new system that was to revolutionize the world of medicine, showed results of the most encouraging nature. Hahnemann, in common with other reformers, had endured insult, misrepresentation and persecution, but the fruition t)f his labor was now to be seen in the twenty thousand practitioners and their twenty million patrons, who. had endorsed his method. " The com- pounding of forty or fifty drugs for a solitary prescription/^ said the speaker, "is no longer tolerated as a scientific pro- cedure even by the old school. Their heroic doses are being discarded and the divided dose is being recommended by the leading minds of that school." The cordiality of the medical profession at large toward Homoeopathy at the pres- ent time was referred to as an indication of the gradual sub- stitution of that system for the old one of hap-hazard admix- ture of drugs. Forty-one years ago

HOMCEOPATHY WAS INTRODUCED

into Michigan by the Rev. J. D. Perry, through whose instru- mentality Drs. Thomas Blackwood, of Washtenaw county, and S. S. Hall, of this city, were converted to its feith and practice. During these forty-one years the single lay prac- titioner with his book of domestic practice and a few reme- dies had grown into a respectable array of 500 physicians,, many of whose patients belong to the wealthy and cultured classes. The state university with its world wide reputation supported a first-class homoeopathic department. The hom- oeopathic hospital upon the campus afforded clinical privi- leges to students in surgery, ophthalmology, otology, gynaecol- ogy and therapeutics; the legislature has at its last sessiou placed the new asylum for the insane being built at Traverse

UICHIQAN HOMCEOPATHIC MEDICAL SOCIETY. 645

City, under Homceopntliic control, and successful medical societies had been organized and were doing their legitimate work in the onward march, notably the College of Physicians and Surgeons of Michigan, of this city, with its frequent meetings for discussion and interchange of thought and ex- perience upon the various medical and scientific topics of the day. An epitome of the history of the State Society was given showing steady progress and development during the past fifteen years, and a plea for its future harmony and success concluded an interesting address, which was listened to with marked attention.

On motion, Drs. Lawson, Wilson and Olin were appoint- ed a Committee on the Prenident's Address.

Dr. Gilchrist moved that the corresponding secretary, Dr. Van Horn, act as treasurer pro. tern.

In the evening a very interesting and instructive micro- scopic exhibition was given at Dr. J. D. McGuire's residence by the Bureau of Microscopy, assisted by a large staflF of volun- teers, which brought together between the hours of seven and eleven o'clock most of the members and their friends. Some ten or a dozen powerful microscopes were available, in which were exhibited multitudes of choice mounts, mostly pathological specimens. Dr. Younghusband exhibited a fine colored specimen of the dreaded bacteria, which looked quite harmless under a one-sixteenth objective. One instru- ment was lighted by electricity from a small battery stand- ing alongside upon the table, while each was superintended by its owner or some other person competent to explain the examples shown.

WEDNESDAY MORNING.

The session opened at 9 a. m. : Bureau of Theory and Practice with a paper on ** Diabetes," by Dr. Clark, of Three Rivers. It was discussed by Dr. Rejmolds, of Grand Haven, who took some exceptions to the treatment as given by the author.

Dr. J. C. Wood had had some experience in the treat- ment of this afiection, and thought we should use opium as

646 MICHIGAN HOMCEOPA THIC MEDICAL SOCIETY.

a palliative for the troublesome cough, which often occurs in the later stages. The Allopaths use it successfully as a palliative, and succeed in prolonging life in some cases.

Dr. Chase, of Caro, asked in what strength the author used Phos. Acid ?

Dr. Clark replied, ten drops of tincture in water.

Dr. Nottingham objected to the use of opium or mor- phine in any form as a palliative. It was bad treatment and would do more harm than good. We had much better palliatives in our homoeopathic remedies. Coccus cacti had relieved these coughs for him in a number of cases.

A motion was made to appoint a committee to nomi- nate the oflScers of the society, which was lost.

The Treasurer's report was read, and on motion referred to the Auditing Committee.

Bureau of Pathology was now called. A paper by Dr. Warren was read by title and referred. Dr. Amdt read a paper on " Chemical Thermometry," and another on " Padal expression in infants, as a symptom of disease." In the discussion of the former paper, Dr. Gilchrist called attention to. the importance of the clinical thermometer as an aid in diagnosis, and illustrated on the board the differential diag- nosis of pyaemia, septiceemia and erysipelas as given by the thermometer. The papers were then referred. Dr. Amdt reported as delegate to the Western Academy, and gave as the reason why the Academy could not accept the invitation to hold its next session in Detroit, in connection with the State Society, was that there were so few members from this State.

The Board ol Censors reported favorably on the appli- cation of Dr. Sprang, of Buchanan, who was elected.

The Bureau of Nervous Diseases reported with a single paper on " Hysteria," which was read by the author, Dr. E. A. Bagley. Among the remedies recommended by the author, for this hydra-headed affection, no mention was made of the animal poisons, especially TarainMa and The- ridioTij two of the most frequently indicated in the worst

MICHIGAN HOMCEOPATHIC MEDICAL SOCIETY. 647

forms of the disease. The paper was referred to Publishing Committee.

The Bureau of Materia Medica, presented a proving of ^^ Secede Oojmutum^^ by H. C. Allen, assisted by the students of the University, which will be published in the form of a monograph. The provings were made from the attenuations of Boericke and Tafel— 2," 6," 12," 30," 100," 200,"— and ver- ified many of the toxicological and clinical symptoms, of which our present symptomatology is entirely composed. This is the first attempt to prove Secede on the healthy, and although fragmentary, is a very fair beginning. Dr. Clay- pool took exceptions to provings made with the higher atten- uations, thought that the attenuations would cure symptoms similar to those produced by the crude drug, but they were not capable of producing reliable symptoms on the healthy.

Dr. McGuire thought the symptoms were wholly subjec- tive. In our provings we wanted more objective indications, as our Materia Medica was already too cumbersome for prac- tical use. We have too many subjective, too few objective and tangible symptoms in our Materia Medica at present.

Dr. Nottingham had made some of his best cures with the higher attenuations of Secale, smd was much pleased with the proving.

Dr. Gilchrist thought many attached a different mean- ing to objective symptoms than he did. He was always very suspicious of subjective symptoms either in a proving or a patient. He knew that patients suffering firom subjective symptoms, as in hysteria, frequently exaggerated or even fabricated symptoms, hence he considered the objective symptoms, when they could be obtained, as much more reliable.

Dr. Phillips had no confidence in provings made with the attenuations. Had given five provers Gelsemium lOx and five others Placebo, and those taking the Placebo had about as many and as reliable symptoms as those taking Gelsemium. In one prover he had seen the characteristic action of Gelsemium on the eyelids in a very few minutes.

W8 MICHIGAN HOMOEOPATHIC MEDICAL SOCIETY, AFTERNOON SESSION.

Began with a report of the Board of Censors, recom- mending Dr. Snell, who was elected.

Bureau of Gysencology. Paper on ** Pelvic cellulitis," by W. £. Clark, who recommended the indicated remedy and external application of hot poultices. He also advocated the use of stimulants in certain cases.

Dr. Baily asked where he would apply the poultices?

Dr. Clark replied, not to the chest or shoulders; would apply on abdomen.

Dr. Baily also objected to the use of stimulants as both unnecessary and un-homceopathic. In his experience they were injurious, and always retarded convalescence. Dr. Baily read a paper on "The relation existing between dis- eases of uterus and rectum."

Dr. Porter presented a paper on "Ovariotomy," and exhibited a dried specimen of a multilocular cyst which, when first removed weighed 42 lbs. He entered very fully into the etiology^ histology, and differential diagnosis of ovarian cysts, and from its histology argued that it was not beyond the pale of possibility to remove them by internal medication, and asked for an expression of opinion on the subject. Dr. Allen said that well authenticated cases were on record cured by internal treatment. The late Dr. Gal- lupe cured one case with Podophyllum; Dr. Dunham one with Colocynth; Dr. Gilchrist one with Colocynth; Dr. Guernsey one with Apis, after Dr. Atlee had pronounced it incurable by operative measures, and had. actually made the abdominal incision, but irom the extensive adhesions was compelled to desist

Dr. Porter said that he had tried internal treatment in a number of cases, but had never seen any beneficial results. Perhaps he did not know how to select the appropriate remedy.

Dr. Obetz considered the disease entirely beyond the reach of internal treatment He had carefully looked through the various authors, Bilroth, Kieth, Wells, Atlee, etc., etc.

MICHIGAN HOMCEOPA THIC MEDICAL SOCIETY 649

and they all were unanimous in pronouncing it incurable by internal medication.

Dr. Nottingham, objected to the authorities quoted by Dr. Obetz. They belonged entirely to the other school, and we should not expect to find any cures by internal treat- ment recorded by their authorities. If the doctor expected to find cures made by constituional remedies he must look for them in the records of our own school of practice. The other school did not attempt to treat them remedially ; they turned them all over to the knife.

Dr. Obetz had seen a number of cases, and he had searched in vain for a single case cured by the internal rem- edy. He declared emphatically that you might as well pour your medicine into the gutter as give it to such patients. It was totally useless. All such reported cures were simply mistaken diagnoses.

Dr. Woodruff" objected strongly to the sentiment ex- pressed by Dr. Obetz. He did not think the doctor under- stood, or at least did not practice, the law of cure he professed to follow. The case cited by Dr. Allen as cured by Dr. Dun- bam had been diagnosed by some of the best known gyne- cologists in the old world as well as in New York. Besides, very few men were presumptuous enough to dispute the diag- nosis of Carroll Dunham. It was very evident to him that the doctor did not know how to select his remedy, or he would not make such a sweeping statement. The following is the case reported by Dr. Dunham:

'*0n October 10, 1864, 1 was requested to visit Mrs. C. E. H., aged about thirty-eight years. She gave the following history : She had been always in good health, married ten years, but never pregnant. While traveling in France in 1854, she was attacked with what was then called acute per- itonitis. She wa6 confined to her bed several years. Par- tially recovering, she consulted Trousseau, who discovered the right ovary inflamed and somewhat enlarged. From this time she was more or less unable to walk, and suffered much from a tumor, which gradually developed in the pel-

650 MICHIGAN HOMCEOPA THIC MEDICAL SOCIETY.

vis, between the uterus and the rectum, and which wa& pronounced by Trousseau to be an enlarged and prolapsed ovary.

In 1863 she came to New York, and placed herself under one of our most experienced gynecologists, who ^confirmed Trousseau's diagnosis, pronounced the case incurable, and advised a sparing report to anodynes to mitigate severe suf- fering. I found Mrs. H. confined to her sofa; she had not left her room for a year. A firm, elastic tumor occupied the space between the uterus and vagina anteriorly, and the rectum posteriorly, completely occluding the vagina, and rendering defecation very diflScult. It seemed not to be adherent to the walls of either passage. Attempts at walk- ing induced paroxysms of acute pain across the hypogas- trium, in the sacral region, and around the hip-joint; from here the pains extended down the groin and along the femoral nerve. The pain was relieved by flexing the thigh upon the pelvis; and always induced or aggravated by extending the thigh. Even without the provocation of motion there were frequent and severe paroxysms of pain as above described. The appetite was not good, and diges- tion feeble ; but the general condition of the patient was good. Nervous sensibility was very great. The pains had been ascribed to the pressure of the tumor upon the sacral nerves.

The patient had a dread of taking opiates, and had used them sparingly. I was requested to mitigate the pains, if possible,— no hope being entertained of a cure. With no definite expectations of accomplishing a radical cure, I pre- scribed Colocynth ; a few pellets to be taken whenever a paroxysm of pain came on, and to be repeated every hour during the paroxysm. This prescription was based on the result of the Austrian proving of Colocynth, which confirm and amplify the provings of Hahnemann.

November 1. I learned that the paroxysms had been less frequent, much shorter, and milder; the remedy appear- ing to control them.

MICHIQA N HOMCEOPA THIC MEDIC A L SOCIETY. 651

March 1, 1865. The patient walked half a mile to my office and reported that she had had no pain for a month. She could walk half a mile daily without fatigue or pain, and had resumed the charge of her household after an inter- val of nine years. She thought the tumor had become somewhat smaller. Being about to sail for Europe, she de- sired some more Colocynth, that she might be provided in case pain should return.

June 9, 1869. Mrs. H. has just arrived from Europe. I find her perfectly well. There has been no return of pain since 1865. The tumor disappeared from its position be- tween the vagina and rectum in the autumn of 1865, and was plainly perceptible in the abdomen, about as large as a Sicily orange. It has since disappeared entirely, and noth- ing of the kind can now be discovered. Was this really an ovarian tumor? No doubt appeared to be entertained by the eminent physicians who preceded me in the case. Did the Colocynth cause its absorption? The patient has no doubt on this point. Why should it not have done so? Because we have no record of any action of Colocynth, ex- cept on the intestinal mucous membrane, and on certain plexus of nerves? Fortunately, the action of remedies is not restricted^to the measure of our imperfect a priori knowledge of them.

A reviewer in the British Journal takes exception to a statement of mine, that a remedy, when indicated by a well- marked group of symptoms, will often remove, not merely those, but also other groups apparently unconnected, — in fiEkct, the whole disease. This case is in point. And yet I can hardly doubt that, in such cases, a complete proving, were it possible, would show that the remedy does produce likewise these seemingly unconnected symptoms, — in &ct, a picture of the whole disease. Indeed, on examining the Austrian proving, we find Prelich reports two brief provings on women, both of which show the action of Colocynth on the ovaries. Had we well-instructed women-provers, how much more we should know of the action of drugs!"

652 HOMCEOPA TEIC HOSPITA L.

The papers were referred to the Publishing (Committee and the bureau closed.

East Saginaw was selected as the next place of meeting.

OflScers elected for the ensuing year were: President, Phil Porter, M. D., Detroit; V. P., B. H. Lawson, M. D., Brighton; second V. P., L. M. Jones, M. D., Brooklyn; Sec- retary, J. G. Gilchrist, M. D., Detroit; Cor. Sec., L. T. Van Horn, M. D., Homer; Treasurer, G. A. Robertson, M. D., Battle Creek. Censors: Drs. D. J. McGuire; W.E. Qark; A. R. Wheeler; B. L. Cleveland; J. N. Reynolds.

This closed one of the most successful meetings in the history of the society. There were no " axes to grind," no "wires to pull," no injured members to be ** vindicated." There were many able papers presented and the discussions were interesting and practical. The future of the society is certainly encouraging.

HOMCEOPATHIC HOSPITAL.

The annual meeting of the corporation of the Massachu- setts Homoeopathic Hospital was held yesterday afternoon in the hospital building in East Concord street. The annual reports of the treasurer, executive committee and board of trustees were submitted. The last mentioned summarizes the work of the year : The following oflBcers were elected for the ensuing year: President, Charles R. Codman; vice- presidents, Rufus S. Frost, Henry S. Russell, Liverus Hull, Otis Clapp; trustees (in addition to those of last year), John R. Hall, David B. Flint, Edward Whitney, Mrs. Edward Whitney, Mrs. A. W. Taggard, Geo. H. Quincey, Asa P. Pot- ter ; secretary, Ellen Frothingham ; treasurer, Isaac Penno ; assistant treasurer, Miss Hellen CoUamore.

In their annual report the trustees express the hope that within a few months there may be ready for use a much needed addition to the surgical wing of the hospital. The original $5,000 appropriated for a building fund has been increased to $61,153.56, of which sum $50,000 is the gift of

CLINICAL, 653

a donor who declines to make his name public. To fully carry out the contemplated improvements the building fund should be raised to $76,000. Ground was broken for the addition in July last, and the work is proceeding rapidly. The remaining $15,000 necessary to complete the work will undoubtedly be soon subscribed. The current expenses of the hospital for the past year were $11,718.42 — $400 less than the previous year. The income of the hospital has been $9,629.29, leaving a deficiency of $2,089.13. The number of patients treated during the year was 277, of whom 10 died. During the seven years the hospital has been established 1,399 cases have been treated, with a death rate of only five per cent.

CLINICAL CASES.

BY BENJAMIN A. BRADLEY, M. D., CINCINNATI, OHIO.

Case I. — Mrs. M., aged 36 years. Married, has five chil- dren, no miscarriages. Came to me, complaining of pain in the small of the back with a sense of weakness when walking or on her feet, has cramps in the calves of her legs at night, bowels inclined to be constipated, has had prolapsus uteri since last baby was born, slight acid leucorrhoea, which is worse after coition for a day or two, menses regular, has a small nodule in left breast, the size of a bean. Prescribed Sepia 3x, a powder twice a day for a week, and then report, at the end of that time she came in and reported that she felt much better, prescribed Sepia and placebo in alternation for one month, at the end of that time she came in, mid she was once more well again.

Case II. — Mr. T. P., aged 23 years, single. Came to me saying that he had a thin, milky discharge from his penis during the day, and in the morning the lips were stuck to- gether; there was no unusual sensation on micturating. On examination could not find any stricture, discharge more pro- fuse after drinking beer. Advised him to abstain from drink-

654 CLINICAL.

ing beer for awhile, and prescribed Kali bicb 3x, a powder three times a day, for ten days, until he came into the city. He then reported that he was nearly all right again, and so I prescribed placebo, a powder night and morning for a week, at the end of that time he reported that after the tak- ing the fifth powder he found himself cured.

BY BENJAMIN EHRMANN, M. D., CINCINNATI, OHIO.

In compliance with the request for interesting or unus- ual clinical cases, I offer the following :

Case I. — A maiden lady aged 60, suffering from a cold and painful hemorrhoids, sent for me, for which Nux vom. Sulphur and Sac. lac. were successively prescribed with benefit. Now I learned that she was continually annoyed by a "6ad smdV^ from her body and clothes, that followed her wherever she went, in spite of daily washing and bathing, to her great mortificatioi.. This symptom had existed for years as well as an inveterate constipation, for which she received no benefit from any treatment. Psori- num **, was prescribed, one dose every six hours for two days, followed by placebo, until I saw her again on the fifth or sixth day, when I learned that the *'bad smell" had entirely disappeared, and that the bowels acted without an injection every day since, a thing which had not occurred for many years.

Case II. — A peculiar sick headache came incidentally under my observation. While on my way up stairs to see a patient, I was hailed by the mother of the patient who was sitting in the parlor in a distressed condition and exclaim- ing: "Oh doctor! I have my sick headache, my brain feels bruised-like all over and as if it were drawn down to the root of my tongue." Recollecting this to be a symptom of Ipecac, and without questioning her I put a lew pellets . of the thirtieth potency on her tongue, and then went up stairs to attend to the patient I came to see. When coming down in about ten minutes, the mother met me with a cheerful countenance and said she was entirely relieved.

BENJAMIN EHRMANN, M. 2>. 655

Whenever I met this lady at any time afterward for yeans, she did not fail to tell me that she has had no headache, einoe I put those pellets upon her tongue.

Case III, — Several months ago I was consulted by a merchant from Burlington, Iowa. Advised to do so by his wife, who many years ago lived near Chilicothe, 0., and knew of me, when I practiced there about 36 years ago. This patient had been under the treatment of several allo- pathic doctors for months, and was getting worse all the time, until I sent him medicine in accordance with his description of the case. Two months afterward I received a letter from my patient's brother-in-law, and as this is the case I herewith wish to present, I will simply copy the letter. " Dear Sir : My brother-in-law, Mr. S., has derived flo much benefit from your treatment, that I thought I would also consult you in my case. I am now 57 years of age ; have been engaged in active business since a boy. The last few years I have worked harder than ever, at selling goods, keeping books and making out bills, etc., and I presume I have over-taxed my powers. About three months ago I took a dislike to my business and with the greatest difficulty could force myself to my daily task. I am all the time thinking that iomething dreadful is going to Jiappen to me; can't sleep, have no appetite, can't read, and, in fact, life has almost become a burden to me, and I fear, if I do not get relief / shall lose my mind. When the spell of despon- dency comes upon me my feet are icy cold, and my head aches. I have frequent desire to urinate, and weakness afterward, etc." (The italics are mine.) I prescribed Calc. and administered it according to Hahnemann's direction for one month. When this was all taken I received the gratifying report, that th^ medicine acted like a charm and that he was entirely restored.

Case IV. — More than 40 years ago a middle aged, stout built man called on me for relief of a periodic asthma, that had troubled him about 17 years, and for which many doc- tors. Allopathic and Thompsonic, were called in vain. The

656 CLINICAL,

attacks came about every four or five weeks. He felt as if the blood from the extremities was flowing to the chest causing a pressure, as from a great load, and compelling him to walk as fast as he could for fear of suflFocation. He often walked eight or nine miles before he was relieved. For the last three years he was under Thompsonic treatment, where he received teaspoonful doses of the tincture of Lobelia, with only palliative effect. I mention this fact especially because Lobelia, the fifteenth potency, cured the patient permanently in about five or six weeks. A few doses given according to Hahnemann's advice was all that was neces- sary to cure this obstinate case.

BY EDWARD MAHONEY, M. D., LIVERPOOL, ENGIAND.

February 9, 1880. Mrs. H., aged about 50. Had pleu- risy six and a half years. Previously to that considered herself in good health, but has been subject to sick head- aches when menstruating, ever since menses appeared, with depression of spirits before and during their flow, and since menstruation ceased has been subject to headaches on wak- ing during the winter. Irritable temper.

Systolic murmur at heart, loudest at apex. Bronchitic rAles over both lungs posteriorly; ascites, with extensive oedema of both legs and thighs, and red inflammatory blush over greater part of right thigh. Great emaciation of chest and upper limbs. Tenderness in renal region with sediment in urine. Nat mur.^y one dose.

February 20. Took the Nat. mur. on the 10th, and felt very ill for two or three days ; headaches disappeared for four days, but there was some return of them two days since ; none this morning, and she feels much better in her- self. Has a sensation from the back up to the head, sudden before micturition, and accompanied by dread; cutting pains after micturition. One day during the past week she passed black urine after suppression for twenty-four hours (took some gin). Has involuntary micturition when cough- ing. Is constipated, and has taken one or two Gr^ory^

ED WA RD MAHONEY, M. D. 657

powders. The ascites is less and the inflammation has dis- appeared from the right thigh.

March 17. Steady improvement until now, when head- ache returning, and ascites not fdiminishing, I gave another, and the second dose of Nat, m.**.

March 31. Able to get out of bed, though she can't walk on account of the distension of the abdomen. Appetite improved; sleeps better; cough gone; breathing much im- proved. The skin has lost its unnatural hue. Sac, lac,

April 30. Troubled much with flatulence, as above stated great emaciation of chest and upper limbs'; lower limbs swollen; ascites. Lyc.\

June 26. Ascites gone; anasarca gone; able to walk out, and in fact, up to date continues well.

Remarks. — This case appeared to me about as simple, and at the same time profound an illustration of the deep wisdom and practical bedside utility of the genius and teaching of Dr. Samuel Hahnemann as one could well wish to see. Truth, I believe, is always profound and at the same time simple, and unless that which is presented to us has these two marks, we may well question if it be the truth. These two marks (characteristics) of truth, are, I believe, well brought out in this case. I may say first of all as to the circum- stances, not referred to in the detailed report, they were in every sense discouraging, disappointing and disheartening. The woman was a dispensary patient, living in the locality and after the style of such persons; an acknowledged drinker ; the reverse of obedient ; in the pauh post, of life, when therefore, according to pathological teachings and especially after such a life, material changes in the tissues would be commencing. The peculiarity of feminine sexual life, menstration, was already past, yet the symptoms which had been connected with that function, gave the key note to the simillimum of the case. She had also had abundant treatment or maltreatment, during the previous six and a half years, allopathic and pseudo-homoeopathic, external and internal applications, moral arguments, and had finally

658 CLINICAL.

pretty well reached the conclusion, that for her, at least, there was no remedy.

The pathological condition actually present, namely: systolic cardiac murmur, bronchitic rdles over both lungs posteriorly ; ascites with extensive oedema of both legs and thighs and red inflammatory blush over right thigh ; great emaciation of chest and upper limbs, was, I hope, sufficient to satisfy the hungriest materialist, yet, if we look at the treatment, one dose of the 30th potency (an entirely imma- terial attenuation) of a substance taken in its crude form by most civilized (?) persons many times a day, reaches the root of a complicated, mental and physical condition, which had for years defied the combined assaults of both friends and physicians.

What, however, constituted the real essence of the case and made it so good an illustration of the truth and power of the Hahnemanninn doctrine of psora, was that the remedy was selected on account of subjective symptoms existing some thirty years beiore she was supposed to have any disease whatever, namely, at the commencement of men- strual life, and what confirmed me in the opinion that Nat. mur. was the remedy to begin with, was the fact that the headaches incidental to that function, had continued since the function itself had ceased. Here, then, I argued is a case of untreated psoric miasm of over thirty years' duration (for she was now fifty), and whatever else may have been done, this ^has clearly been left undone. It is the longest of her diseases; it is there; it is constitutional in the sex- ual sense as well as the antipsoric; therefore, it must be treated first ; and the immediate result again confirmed the truth of Hahnemann's teachings, for we find aft«r the one dose, "felt very ill for two or three days, and headaches dis- appeared for four days," but there was some return of them eight days later, then two days later again ; we have "none this morning and she feels much better in herself." Hahne- mann's words in the English translation read: "But when the remedies whose action lasts for a long time, have to com-

H. N. O UERN8EY, M. D. 659

bat a disease of some duration, or one of very long standing, and consequently the dose ought to continue its action several days successively, then we may see during the first six, eight or ten days, from time to time, some of those apparent aggravations of the original malady which last during one or several hours, while the general amendment develops itself sensibly in the intervals. When these few days are once passed, the amelioration produced by the primitive effects of the remedy continue, without interrup- tion, for some days longer."

The sensation in the back, upwards, the dread and cut- ting pains after micturition, may safely be attributed to the Nat. mur. which has: ''Drawing pain in the back firom below upwards." ** Afraid of becoming mad ; imagines he will die; apprehensive about the future," and ** cutting in the urethra shortly after urinating." This one dose, too, produced steady improvement for more than a month, and one more dose of the same power was all that was required for that combination of symptoms which was traceable to the psoric symptoms which had just manifested themselves at the commencement of menstrual life, and a few doses of Lyc^j cured all else except the valvular affection of the heart, which I cannot say was entirely gone when she passed from under observation, though she was to all intents and purposes well, and continued so for twelve months, after which, circumstances necessitated her going into the country.

BY H. N. GUERNSEY, M. D., PHILADELPHIA.

Case I. — Last winter I was called in consultation to a case of diphtheria. Its history ran thus: Doctor was called about six days previous to my first visit, and thought he had a case of croup to deal with. Could discover nothing wrong excepting a croupy cough, high fever, restlessness, and much rattling in the larynx, until the face and neck began to swell, left nostril began to bleed, and on examination of the fauces again, found deposits of diphtheritic membrane involv-

660 CLINICAL.

ing the tonsils, back part of the uvula and all the visible portions of the throat. On ray first visit I found the left side of the face and neck considerably swollen, of an ashy gray color, left nostril discharging, dark blood running down the cheek, though completely obstructing the nose on that side ; child very weak ; small, faint pulse ; croupy cough. We at once decidad to administer Bromine*" in water every three hours. Next day bleeding of nose had ceased and a general improvement of the child manifest. The next day swelling of the face and neck better, and the child seemed to be in a safe condition. After a few days the croupy cough not im- proving any more and the membrane in the throat remain- ing stationary, Lac. can.*^ was given, which seemed to make a clean sweep of what remained in twenty-four hours and the child convalesced rapidly. No adjuvants were used in any form whatever, the child subsisting on ice and ice water until it had suflSciently recovered to take food.

From the above case a hint is thrown out that besides Bromine for diphtheria beginning in the larynx and coining upwards^ Lac. can. may be thought of. I seldom have any trouble with this formidable malady when no interference is interposed to the practice of pure and simple Homoeopathy.

Case II. — Not long since I was called in consultation to a case of typhus, and found the following conditions : Cere- bellum, the most suffering organ, giving her severe aching pain day and night; very little sleep, and of a disturbed character. Great sensibility of this organ so that the slight- est noise increased her suffering greatly. Eyes inflamed and running water, causing an itching sensation. Extreme pho- tophobia, the least ray of light causing great pain in the eyes, and also increasing the pain in the cerebellum. Great thirst, dry mouth and dry lips. Urine seldom, usually once per day and with very great difl5culty. Repugnance to all kinds of nourishment except water. Pulse very small and weak, great prostration, face sunken and pale, and life was despaired of by all observers, among whom were old and experienced nurses. We agreed, after much study, and com-

H. N. O UERNSEY, M. D. 661

paring of remedies, to give Nux v.^ in water every three hours until next morning, when we found she had had a lit- tle better night in some respects. No more medicine was given for seven days, the improvement continued gradually and on the eighth day the critical urine and perspiration was fully established; a suitable diet partaken of, quite sufficient for the time. A grand recovery resulted in good time.

Case III. — Was called to visit a gentleman with one of his periodical headaches which he has had every few weeks since a child. Symptoms : The pain all through the head is excessively severe, and every pulsation of the arteries aggra- vates this suflFeriAg almost beyond endurance. The only partial relief he can get is to seize the neck with both hands and compress the carotid arteries almost to suflFocation. He took one dose of Bell*^. Soon went to sleep and has had no trouble since. Experience proves to me that he will soon lose the paroxyms altogether, and it is doubtful if he ever has another.

Case IV. — Last winter a gentleman called on me with a diseased eye. Symptoms: Almost constant pain over the left eye, of a bruised, sore nature, and an appearance as if he had cataract fully developed. Of course he was blind in that eye. History: Had a terrible blow over that eye some six yesirs since, and it has never been well since. I at once gave him Am.*^, and he has had one dose per week ever since. To-day the pain is all gone, his head and eye are in a nat- ural state as to sensation, he can see to read with that eye, and there is only a thin veil over the pupil instead of that thick, heavy cataract appearance as at first.

But why take the time and the paper for the purpose of multiplying clinical cases? Has not the time come to push on in the teaching and application of our principles as a law of cure? It seems to me we are more at fault, in these days, with the application of the Materia Medica, than we are in its knowledge. A perfect knowledge of the latter would be of no avail without a proper knowledge of the former. By those of us who practice the true scientific art of healing, the

662 CLINICAL.

blind are made to see, the deaf to hear, the lame to walk, the insane to become rational again. We dissipate tumors of all kinds, open occluded passages and remove all morbid and material growths and accretions that result from disordered vital forces. It remains for us to remove the bounds of incurable diseases and to declare the possibilities to all, because we are following on in that true stream of science which flows from the infinite to the finite.

BY AD. LIPPB, Iff. D., PHILADELPHIA.

It was on a hot August morning, on one of those hot summer days, so very enjoyable in the City of Brotherly Love, in 1853, that a gentleman summoned me to go with him and see his very sick wife. While we were walking to the hotel where she was, the husband informed me that they had left New York in the night, had intended to go to Wash- ington, that his wife sickened as they approached Philadel- phia, that he had to take her to the hotel, but that he had to take the next train for Washington, as he had to go there unavoidably on very important business; that he was, much against his wish, compelled to ask me to attend his wife and do everything I found necessary to be done. When I reached the sick-room I found the lady in spasms, such as I had never read of, or seen before or since. When she heard water poured out, or when water was offered her, or if a looking-glass was presented to her she suddenly jumped to her feet, the muscles of the body were rigid, the spine was rigid and stiff, but her arms, hands and facial muscles were convulsed, she groaned and upon being approached she attempted to scratch and bite the person coming near her; the eyes were wide open, her look was savage. The attacks lasted from two to five minutes, then she gradually relaxed all the muscles and assumed a horizontal position. Upon close interrogation I learned that her spasms were preceded by an ineffectual and extremely painful desire to pass urine (strangury). This information made the choice of the rem- edy very easy. Gave her a dose of Cantharides^^j (Jenichen)

AD. LIPPE, M. D. ' 66S

on her tongue. The spasm became less frequent and less severe all day, but in the night she became worse again; she had not passed any urine all day. A second dose of Oanr tharide^ had the desired eflfect, she passed urine freely and gradually fully recovered under careful nursing. She received no more medicine. During her convalescence I learned the cause of her malady. Preparations was made by her and her husband to go to Washington and she had walked that day much more than she was in the habit of doing, her feet were swollen and intensely sore in the evening. By advice of a friend she applied oil of turpentine to her feet with the results here stated.

Comments. — Upon first seeing the patient it seemed pos- sible that she suffered from hydrophobia, but her husband declared positively that she had never been bitten by any dog or by any other animal, certainly never by a mad dog. It was only after a patient and rigid examination that the fact was discovered, that strangury preceded these strange spasms. If guided by the materialistic pathological school, the first step to be taken would have been the hasty intro- duction of the catheter to empty the bladder and attempt thereby to obviate the possible return of the strangury. After obtaining a full picture of the disorder, which is the first and most difficult task of the healer, the second task of selecting the truly homceopathic (similar) remedy was a comparatively easy one. There could be not the slightest doubt, but that Cantharides covered the totality of the symp- toms. It was also evident that after the first dose of Can- tharides had exhausted its effects another dose had to be given, and the final disclosure that turpentine was the cause of the disorder, accounted for the necessity of repeating the dose, as no doubt some turpentine was still retained in the feet. And finally, as to the dose administered. The dose dispute has again become a burning question. In 1846 we took the liberty to call the attention of the profession to the superior healing powers of the higher potencies in a letter dated, Carlisle, Pa., April 7th, 1846, and published in the

664 CULTIVATION OF BACTERIA AND FIBRINE.

Homoeopathic Examiner, page 417. Although the successful experiments with these then considered high potencies, as well as by much higher potencies, later made, were confirmed by such members of the profession as were versed in the tenets and practices of our healing art, we find ourselves at this date confronted by men who boldly demand with the late president of the American Institute of Homoeopathy that a "Kmii" should be fixed by statute as to the possible curative powers remaining active in a certain potency — says the late president— the 12th. Whether anyone is fit to decide in this burning question, who is capable and willing to strike out all the accumulative testimony deposited in our journals by an increasing number of experts from 1846 till 1883, has to be left to the better judgment of just and honest men. We lay this case before our professional brethren as one more ot the many proofs that the only possible hope of "a cure^^ is in following out explicitly the laws and methods of that healing art given to the world by that immortal phil- osopher, Samuel Hahnemann.

THE CULTIVATION OF BACTERIA AND FIBRIN.

BT BOLLUf R. OBBQO, M . D., BUFFALO, NEW YORK.

About "cultivating" fibrin, or its rods and granules, as they claim to have done with the various forms of bacteria, I have not yet tried it to any great extent And for the very good reason, that since I commenced my investigations in treating both blood and fibrin in numerous other ways in which errors could be avoided, to see what could be thus learned, I have been so greatly taxed with that and my professional duties, that I have not dared to undertake more.

Besides, all the assumed "cultivation" of bacteria are wholly vitiated and nothing is to be learned by imitating errors. To illustrate, the so-called bacteria are nowhere de- veloped, either naturally or artificially, excepting in putrid-

ROLLIN R. QREQO, M. D. 665

ity, or by rotting. Very well, putridity or rotting does not go on excepting in organic matter; and all organic matters contain fibrin, which, by rotting, is disintegrated into every form of assumed bacteria. Pasteur uses chicken soup, Koch and others use beef or other animal broths for their "culti- vations," all of which, of course, contain fibrin; and from which no other forms showing life or motion can be ob- tained under rotting, excepting such as are obtained in the same length of time from rotting pure fibrin in distilled water. Fibrin, then, being in all animal broths, and ** culti- vating" the so-called bacteria in them under warmth being a rotting process, the fibrin therein is disintegrated precisely as it is in a clot of blood, or pure fibrin, in distilled water; and precisely the same forms are obtained in the one case as the other.

Thus, you will see that all " cultivations," carried on in any kind of organic matter, are vitiated from the very begin- ing. You can get the same identical forms, I repeat, and all of them, from disintegrating the purest fibrin in the purest water, and even many of such forms can be obtained irom fibrin in chemically pure acids, like nitric acid, etc., as I have repeatedly done. And ,here let me tell you, that noth- ing in all my scientific reading and research so astonishes me as the fact, that scientific men, the world over, have, with- out exception, overlooked all these facts and wholly neglected to consider the forms of fibrin that are everywhere and inevitably present in every instance where decay is car- ried on.

I see by one of the newspapers sent me, that one of your members exhibited " some micrococci from a solution of common turnip." Well, he had the granules of fibrin to deal with even there. Kirkes and Paget say, fibrin exists in the juices of all vegetables, and I have confirmed this assertion to a considerable extent. I found quite an abund- ance of fibrin in the juices of the leaver of the common plantain, in geranium leaves, etc., etc. So you see all vege- table infusions, in which bacteria are said to have been

666 CLINICAL REFLECTIONS,

"cultivated," contain fibrin to be broken up by rotting, pre- cisely as is the case with the fibrin from the blood ; and yield the so-called bacteria in broken pieces of fibrin. You know that infusions of ha}' have been used for the purpose, and here it is the broken fibrin from the hay that has been perverted into proof that bacteria are vegetable. In a scien- tific work published only last year, the title of which now escapes me, it is asserted that "eighty per cent, of crude gluten is fibrin;" and that there are no longer any grounds to regard animal and vegetable fibrin as different, or words to that effect. Lehrmann says : " The blood of herbivorous animals contains more fibrin than that of the carnivorous,^' which must come wholly, of course, from their vegetable food. You will, therefore, understand that I do not rely upon guess-work as a basis for any of my positions. And you will also see that the whole question of " cultivation of bacteria," as hitherto carried on, is a very uncertain matter and of no scientific value whatever, because nothing has been done to eliminate the precisely similar forms of fibrin, in a single instance, where bacteria have been " cultivated " in either animal or vegetable solutions.

From all this and much more I know that fibrin can be cultivated or grown ; that is, made to take many different forms under different conditions. And I am entirely confi- dent that the assumed cultivation of bacteria in mineral solutions, that is, in sea-water, in solutions of salt with am- monia, etc., etc., is or will be fully explained by such growth or changes of form in fibrin.

But what is even more than that, I have little fear in pre- dicting that one of the greatest fields for science to work in in the future, is going to be in this very direction, of furnish- ing, or feeding, fibrin in solution, and then watch the vari- ous other matter in solution, and watch the various growths that will thus be produced. Unless I am greatly mistaken, much of the organic world that is now all mystery to us, is thus going to be opened up in a way that we have hitherto little dreamed of.

COLLEGE PHYSICIANS AND SUROSONS. 667

PROCEEDINGS OP COLLEGE OF PHYSICIANS AND SURGEONS.

Detboit, February 18, 1884.

College met at appointed hour, President, Dr. Phil. Por- ter in the chair.

Dr. McGuire, the lecturer for the month,^ read an inter- esting paper on " Ephiphora aa Symptom" It was stated that Lachrymation, Epiphora, or watering of the eye is mislead- ing to the general practitioner, often leading to fatal delays in the treatment of serious diseases ; and for this reason the subject was chosen. Attention was called to the diseases of this class not frequently met with by the general practitioner. The Dr. referred to the Lactrymal apparatus as being simply a hydraulic system^ and that it was necessary in order to maintain the perfect working of the system, that each part should remain in a physiological condition; hence the importance of recognizing anything abnormal. The lecturer objects to slitting open the canaliculus, thereby converting it into an open channel, on the ground that the physiologi- cal and philosophical function is destroyed. Dacrocys- titis often results from the early symptoms not being recog- nized. Reference was made to different intra-ocular condi- tions, which give rise to this symptom and which have a tendency to destroy vision.

Diacusmn : — Dr. Gilchrist thinks the paper one of gen- eral interest to us as physicians. Mentioned case of Dacro- cystitis that he treated, in which the swelling was enormous. SUicea seemed to be the remedy indicated, gave it in<^ and speedy relief was obtained by the patient, which, at ihat time of his life in practice, twenty years ago, sur- prised him very much. This was the first high potency he ever gave.

Dr. McGuire objected to accepting this cure, as due to the remedy, for often this disease would make a spontane- ous recovery. He thought we should always make great allowances for diseases of this nature when they make a 3

668 COLLEGE PHYSICIANS AND SURGEONS,

rapid change, either one way or the other, and not attribute the cause to the remedy, he bad seen them alter in appear- ance in twenty-four hours when nothing had been given.

Dr. Gilchrist simply desired to state, that had he not often had similar results since that time, he would not have mentioned this case. No further discussion followed.

February 25, 1884.

Dr. Gilchrist appearing for Dr. D. J. McGuire, read a paper on " Venerecd OontcLgion " confining himself to a con- sideration of the two forms chancroid and syphUU. It was stated that contagion was dependent on three facts : 1st, Exposure. 2nd, The poison must be brought in contact with an absorbent surface. 8d, A lack of protection on the part of the person exposed.

A peculiar and interesting property of the poison is its potency, for the smallest quantity often being mixed with, say an ounce of water, is capable of producing the charac- teristic sore.

The doctor spoke of there being two parties amon^ pathologists, one believing in the dualistic theory, that is that there are two different poisons ; the other claiming that there is but one. The first, in his opinion, is right Many seem to think the term syphilis applies to the initial sore, when it should be used only to express the morbid condi- tion producing the sore.

> Some time was given to a consideration of the diagnostic differences between the two diseases. In this connection the lecturer emphasized the fact that the multiple ulcers come on successively in chancroid and simtdtaneousiy in syph- ilis.

The discharge from a chancroidal sore differs micro- scopically from that of a syphilitic, the former showing debris or waste material, while the latter is shown to contain build* ing up material. The first property of contagion of syphilis was said to be bioplastic.

As to the prognosis of syphilis, the Doctor claimed that it is, as a rule, incurable. No case can be pronounced abso-

COLLEGE PHYSICIANS AND SVROEONS. 669

lutely cured until the grandchildren have been examined and no traces of the disease found in them.

But little was said concerning the treatment. In chan- croid the first thing to be done is to counteract or neutralise the poison by heoL

Discussion : — Dr. Basse, Mt Clemens, Mich., thinks the best treatment for syphilis is by means of the cold water bath. That is, water at about 65^ F. He does not hesi- tate to pronounce the case cured if the patient can stand a severe water course. Also thinks it may be cured by nature^ the patient taking no medicine. The water treatment is supposed to set free the syphilitic germ, and not only it, but the mercury as well, provided that drug has been given. Has never been able to decide as to whether there are two poisons or only one.

Dr. Gaylord. When we see a child with enlarged glands are we to suppose there has been syphilis in the family ?

Dr. Gilchrist Either that or struma, which also may result from syphilis.

Dr. Gaylord. Knew a man, who, while in the army, was vaccinated; soon after syphilis, or what was thought to be it, developed. Another gentleman was vaccinated on the same day, the same virus being used, and died from syph- ilis in a few weeks. Now the first person is in doubt as to whether he has the disease at present, for all symptoms dis- appeared long ago. How is he to know? Can he marry with safety?

Dr. Sasse. If he can stand a severe course of water treatment as now practiced in Germany, you may say he is welL

Dr. D. J. McGuire. Seldom sees it in its early stages. The cases that come to him are usually tertiary involving the eye. Uses Iodide of Merc.

Dr. Bailey. Believes in the dualistic theory. In treat- ing chancroid uses severe measures. If indurations appear he endeavors to induce suppuration.

B?0 C'OLLBOE PHYSICIANS ANb StlkQt!OM

Dr. Porter. Bumstead claims to cure syphilis by what he calls the '* continued treatment" Sims also claims that it can be cured. When he (Porter) was in the Marine hos- pital service, he obtained good results &om Iodide of Potaa- sivm. Thinks Mercury is the specific. Qaestion. Does Dr. Gilchrist know of any remedy that has any effect upon the copper colored spots?

Dr. Gilchrist. Nitric Acid has been used, but does not know of anything that will remove them. Does not believe in syphilinvm at all.

Adjourned.

March 19, 1884.

Dr. Gaylord was elected lecturer for June, 1884.

Dr. 8. A. Jones of Ann Arbor appearing for Dr. Mc- Laren, the lecturer for the month, read a paper entitled *' A Criticism on the Proving of Opium," in which he stated that many symptoms given under that drug in our text books were unreliable and unworthy of consideration. Quite a gen- eral discussion followed, the members all taking a part in it.

Dr. McLaren thinks the lecturer should have gone a little farther and given us the reliable symptoms.

Dr. Bailey would also like to hear from Dr. Jones, as to the symptoms that he knows are reliable. Thinks the sim- ple fact of symptoms having been given by Hahnemann, or any other man, does not prove that they are true.

Dr. Gilchrist looks upon medicine as a progressive science, many things that were accepted as true years ago have since been rejected as false. No one man has the abil- ity to take up a drug and say that a certain set of symptoms are true and another false. Many symptoms of illegitimate origin have, by clinical experience, been proven tniey and others that were properly developed are found to have no clinical value.

Dr. D. J. McGuire does not presume to discuss the paper because, 1st, " he has not the ability," and 2nd, "we all feel doubtful as to the value of the provings of our reme- dies." What we want is a way out of the trouble.

COLLEGE PHYSICIANS AND SURGEONS. 671

Dr. Jones has been disappointed in many cases where he relied on the symptoms as given in our books. No man can tell what to trust and what not, in our Materia Medica. Will only arrive at the truth after years of labor. Does not want anything that he has said to-night to detract from Hahnemann.

Dr. Sasse. Perhaps to the many &llacious symptoms revered under opium, is due the number of failures to cure with that drug.

Dr. Jones. Hahnemann says that of all the remedies in our Materia Medica it is the one least called for. With reference to dose^ he thinks it is just as Intimate for a homeo- path to give teaspoonful doses of the mother tincture in certain conditions as to give the highest potencies. Has given Morph. sviph. in certain cases, particularly in Renal Lithiasis. This last remark led to quite a discussion as to the best remedies in these cases.

Dr. Uaylord uses Santonine in one grain doses, with best results.

Dr. Bailey has been pleased with the action of GUna * *

Dr. Gilchrist has tried Laudinum in a number of cases, but with poor success. Thinks more of Ars. Apia. Chinas and Lycop. Does not use Opium in these cases because it stops the peristaltic action of the ureters.

Dr. Avery thinks it is a mechanical trouble, and poten- cies useUsB. Would use morphine.

Dr. Porter, from the chair, endorses what Dr. Avery says with regard to its being a mechanical trouble, which, when relieved by remedies, such as ApiSj Santonine, etc., is brought about by the mechanical action of an abundant flow of urine, produced by these drugs. He does not ap- prove of Dr. Jones' treatment. Adjourned.

March 24, 1884.

Dr. McLaren, the lecturer for the month, read two short papers. The first treating of the value of instruments in diagnosing lung troubles. The second being a description of two cases of persistent and long standing cough.

672 COLLEGE PHYSICIANS AND SURGEONS.

In the discussion Dr. Younghusband stated that while he believes in many cases the stethoscope may help us in our diagnosis, he does not think it is always to be relied upon as he has known of its misleading many physicians in a number of cases. He thinks the microscope is a more certain means of diagnosis.

Dr. D. J. McGuire is glad to know of a certain means of diagnosis in these cases, for certainly many serious mis- takes are made by those supposed to have special skill in auscultation and percussion.

Dr. Gilchrist thinks there is a fine appreciation of sound to which the ear must be educated, in H>rder to detect any little abnormalities that may exist in the lungs. As for him he makes no pretentions in that line.

Dr. McLaren referred to a case reported by one of the

members, who had claimed a cure of a chronic disease by

one dose of the 200 of Suiph,, when the patient had, for years,

resided in a sulphur district. Thought the imagination of

both the doctor and patient had to be largely drawn upon

to believe in the diagnosis. The physician who had

reported the case not being present, no attention was given

the remarks by Dr. McLaren, and a motion to adjourn was

made and carried.

J. M. Griffin, Recorder.

A doctor dressed a boy's injured elbow, and gave his mother directions for after-treatment. The mother n^lected the directions, and a deformed elbow was the result The mother brought a suit for damages; and, notwithstanding the &ct that the doctor could prove the mother's negligence, he was advised by his lawyer to "settle." The ground for this advice was, that in Ohio "A child of tender years, injured by the fault of another, is not deprived of a right of action by reason of contributory negligence on the part of the parent or guardian." The surgeon must not only give the necessary directions, but see personally that they are carried out.

0 VARIOTOMY—RECO VER Y, 673

OVARIOTOMY— RECOVERY.

BT PHIL POBTKB, M. D., DETBOIT.

In the fall of 1883, Dr. R. C. Olin, of thig city, brought Mrs. K , age 37, to consult me in regard to an enlarge- ment of the abdomen, the Doctor having suspected an ovar- ian tumor. Placing the patient on the table, under an anses- thetic, with considerable difficulty — as the lady was very fleshy, weighing over two hundred pounds. — I succeeded in diagnosing a cyst of the right ovary.

After repeated efibrts for relief, from internal remedies, an operation was advised, but listening to the suggestions of so-called friends(?) she visited a quack, known here as the "spit doctor," who supplied her with powders composed of lobelia, capsicum and hydrastis, which caused an excessive flow of saliva, which the said "doctor" informed her, was "parts of the tumor being spit up through the mouth." After several months' trial of this disgusting treatment, she con- sulted Dr. Olin again to see how much the tumor had di- minished in size, but to her astonishment and chagrin, on comparing her present measurement with the former, which I had given her, she found she had rapidly increased in size Realizing the discomforts of the increased growth, and the foolishness of delaying the operation she presented herself for relief by surgical measures.

Preparing her in the usual manner for all laparotomies and examining her with reference to adhesions, I proceeded in the usual manner for an ovariotomy.

With the assistance of Drs. R. C. Olin, C. C. Miller and H. H. Crippen, I removed a large unilocular ovarian cyst, meet- ing with no obstruction until the pedicle was reached; here to my utter amazement I found a very short and broad ped- icle, in width, nearly five inches, and very vascular, as well as oedematous. In treating the pedicle I departed from my usual method. Seizing the pedicle at the base of the cyst at right angles to the vertical axis of the pedicle, with a pair of

674 0 VARIOTOMY-RECO VER Y.

long handled, lock clamps, which included half of the width, then on the opposite side, I applied another pair, so that the points met, which included the entire pedicle. Immediately below these clamps, with well cleaned silk ligatures, I ligated the pedicle in five diflferent sections. Then depressing the abdomen I applied Billroth 's large pedicle clamp, crowding the mass of pedicle in between the jaws of the clamp, and with a wet sponge placed on the left hand side of the pedicle, I divided the tissue with cautery below the first clamp, but above the ligatures, which delivered the cyst Then loosen- ing the handles of the clamp and observing no haemorrhage, I again drew the tissues of the pedicle within the jaws of the clamp and again tightened the blades. With the cautery iron at a dull red heat I slowly cooked all that portion of the pedicle above the large clamp. With the second iron I then burnt away that portion of the pedicle already cooked, and with the third iron I completed the cautery, down to the margins of the clamp. By this method, that portion of the pedicle between the blades of the clamp was converted into a glue like substance which will never slough. Loosening the clamp, but still retaining a hold upon the pedicle, no bleed- ing was observed.

With this method no foreign bodies are left in the abdo- minal cavity, the ligatures having been removed with the first portion that was divided by the cautery.

Then cauterizing the divided ends of some large bands of adhesions, which were quite vascular, I proceeded to per- form the toilette of the peritoneum.

Inasmuch as the pedicle was of unusual width, and very vascular, I was especially well pleased with the result of the cautery treatment.

The closing of the abdominal incision was in the usual manner of ovariotomy, and one of Keith's drainage tubes was left in the lower angle of the wound.

Recovery was complete with no interruption ; the tem- perature never going above 99i^.

The antiseptic treatment was abaoliUe deanlinees.

8UB-CELLUL1TIS. 676

The after treatment consisted of the administration of first, Hypericum^ followed several days later, by Nv/x. v. 30th.

The drainage tube was removed on the fifth day. The tumor weighed forty-two pounds.

SUB-CELLULITIS.

READ BEFORE THE WAYNE COUNTY H0M(E0PATHIC MEDICAL

SOCIETY.

BT O. P. BAEB, M. D., RXGHMOXO). DID.

Permit me to oflfer for your deliberate consideration an interesting case of sub-abdominal abscess, known by the many names of sub-cellulitis, peri-proctitis, para-metritis, pelvic-cellulitis, peri-uterine-cellulitis, peri-rectal-cellulitis, or, in other words, an inflammation of the intermediate cellular or areolar tissue, lying between the uterus and rec- tum, which suppurated, and discharged through the rectum, to the extent, of at least, one-half gallon, of greenish-yellow, ofiensive pus. This case came under my immediate treat- ment, from one of our city allopathic physicians, who had been treating her for a week or more. The doctor did not define the case, for prudential reasons. The disease is not a common one, and often-times presents very different aspects, and uncertain characteristics, so much so, that the profound- est medical expert may be mistaken.

The cellular or areolar tissue is the most common of all the tissues of the human body. It fills all the interstices between the various organs, vessels and muscles; gives form to different parts, and by its elasticity, contractility, and in- herent fluid contents of its areolae, amply facilitates organic motion. Pathological, or morphological changes, such as fllling up with &t, serum or adipose tissue, or morbid strowths, gatherings etc., may deprive the parts of all motion. This tissue is subject to every variety of both external and internal injuries, such as contusions, frictions of one section upon another, falls, direct blows and continued pressures.

676 SUR-CELLULITIS.

in consequence of the universality of its position; hence its frequent liability to irritation, congestion, inflammation and consequent suppuration. It is the great, if not the only lubricator of the human organism; hence the great nobility of its office. It allows of no intrusion without resentment. The suffering it induces, is always commensurate with the physical value of the parts involved. Oftentimes, gatherings in this tissue, are very obscure and insidious ; burrowing between, or below some important internal hidden muscles or organs, or even, the aponeuroses; and in consequence of the ambiguity and indirectness of symptoms, may easily mislead the physician.

The case I am now about to describe to you, was of this uncertain character. During its inception and early devel- opment it was under the care of an allopathic physician, as stated above.

On my introduction to the case, I made inquiry as to ' the history of the attack, and found that the patient, a lady of good constitution and well-to-do in life, disposed to be corpulent, particularly over the abdomen, had been house- cleaning, and wound up with an all night dance. Soon found herself stiff and sore, which rapidly increased, fol- lowed by pains over the entire body, fever, chills, thirst, loss of appetite, general debility, nausea, retching, vomiting, con- stipation. Urine hot, scanty, cloudy and sedimentary ; while the whole region immediately over both ovaries and uterus was intolerably sensitive and considerably tumefied.

On making a digital examination per-vaginum, I found the parts dry, hot, and exceedingly painful, (vaginismus) very much shortened and narrowed. Uterus tightly pressed down against the symphysis pubis, and both ante-verted and ante-flexed, discharging a thick, heated, greenish-yellow leucorrhoea. The bladder' was apparently full and pressed upward, while the rectum was pressed both forward and downward. I then introduced my second finger into the rectum, which was very much contracted, painful and throb- bing.

0. P, BAER, M. D. 677

Finally I placed mj thumb in the vagina and brought finger and thumb together, revealing unmistakable evidences of fluctuation. I now explored the rectum as high up as it was possible with my finger, and became satisfied that the preponderance of weight, as well as weakness, was towards the walls of the rectum, and that the great probability was, the abscess would soon open into the rectum, about three inches up. From this examination, I had not the least hesitancy in saying that I had a formidable, pure case of sub-cellulitis, involving both vagina and rectum.

I prescribed Phosphorus 3rd, every hour, to be aided by hot water injections, and fomentations over hypogas- trium. I visited the case twice every day, and sometimes oftener, until it broke, which occurred on the fourth day. The break resulted as was anticipated, not more than three inches up the anterior wall of the rectum. The discharge amounted to fully one-half gallon of greenish-yellow, oflTen- sive pus.

The pain, which had been of the most aggravating and persisting character, both day and night, caused transient spells of despondency, hysteria, and delirium. This now all suddenly disappeared, and my patient became as joyous and happy, as though she was the recipient of a princely gift. I now .gave her Hepar. sulph., with an occasional intercurrent remedy, to subdue stray symptoms, until the discharge of pus had entirely ceased.

Since that time she has been taking such appropriate remedies as were indicated by different symptoms as they presented themselves.

For more than a week after the abscess broke, she was almost free from pain; but as the abnormal pressure was removed, and the parts began to assume their normal posi- tions, more or less nervous irritability came, only involving the left ovary and thigh, for which I have given her China, Colocynthis, Pulsatilla and Conium as they were demanded. She is now convalescing rapidly, rides out each day, eats, sleeps and enjoys herself. Will soon be well.

678 CORRESPONDENCE.

CORRESPONDENCE

Editor Medical Advcmce :

For once in my life I have spent some time in attending medical conventions. Already this summer I have taken in several such and to say that I am tired is to put it mildly. It has made me well nigh sick listening to the papers which have been reported by the members of the several bureaus. Now and then I have heard a bright and original paper but the most of the papers reported have been taken bodily out of our text-books. I wish I could specify a few of these papers that were filled with this second-hand material and not hurt the feelings of the men who wrote them. If you will look at the proceedings of these societies you will easily distinguish them. But what I want to know is, if this fool- ish waste of time cannot be stopped. Will it be so next year and forever, that in order to have a paper for the con- vention a man must give us such stale stuff? Do these gentlemen imagine their hearers are ignorant of first princi- ples, and need to be taught their a b c's? Is it a fact, that they are incapable of writing an original paper? If so, then Mr. Editor for the Lord's sake, ask them to write nothing. Please gentiemen don't insult our intelligence and waste our time after this fashion. Quit this text-book busi- ness or quit the business altogether. Friday.

Editor Medical Advance : — In your editorial, " Principles of Medicine," April number, you threaten to " endeavor to so outline the subject, (Principles of Medicine) and so sug- gest how it might be amplified, as to place the art of healing en rapport with modem thoughts." Now Doctor, please donH do it. If there is any one thing that more than another has hindered the progress of Homoeopathy, and over which friend and foe alike have stumbled, it is the attempts, by outlines and amplifications, to explain the unexplainable. Such efforts in the past have covered the great truth with such a mass of rubbish as to completely hide it from all

ooniiEsPot^i)t!Nc£. m

but the diiligent. If I had the power and could do the cause of medical science the greatest possible good, I would wipe out of medical literature every word that was ever written, by Hahnemann or his followers, to explain the principles of the law of similars. It is a great, simple, natural law. So great and so simple that efforts to explain it only confuse.

What would be the effect of writing article upon article, and book after book, to explain the principles of the law of gravitation? Time is better spent inventing perpetual motion. You have only to let go the apple under proper conditions and it falls toward the center of the earth, that is all there is known about it, and the more you try to explain the principles the more you mystify the whole thing.

It is the same with the so-called homoeopathic law of cure, You give the pellet, according to that law, under proper conditions, and the patient is relieved, and recovers; you don't know how, nor why, and your efforts to explain, or outline or suggest explanation, will not satisfy you nor benefit your readers, and may result, as many another effort, with the best intention, and from the purest motive, has done before, viz.: hide truth, divide friends, and confirm enemies.

I firmly believe, were it not for the thick cloud of mys- ticism which has been thrown around this great law by efforts to explain it, the law itself would no more be con- tradicted to-day than is Harvey's great discovery of the arterial circulation.

I would urge every one to investigate, observe, record, and give the profession the benefit of all the facts and every condition which modifies them, but let every physician do his own guessing and theorising.

Now next in importance to wiping out what has been written is to oppose any more; I therefore close by repeat- ing, what I b^an by saying, Dont.

Chas. a. Church, M. D.

Passaic, N. J., May 1, 1884.

680 CORRESPONDENCE.

[Note. — Our likes and dislikes primarily depend upon the shape of our heads. They are decided before hand by our phrenological development. The higher reasoning facul- ties are located in the upper portion of the forehead. One may have fine intellectual development without having any taste for philosophy, but such a liking is possible only with a fair development of the region of reflection. Bearing these facts in mind, we have the key which unlocks the troubles of our correspondent. If his ideas are any index of his cranium his head lacks relatively in the antero-supe- rior portion. This by no means discounts his intelligence, but it explains his horror of philosophy. If Sir Isaac Newton had been of like mind with our correspondent he would have made sorry work with his falling apple. He did just what Dr. Church protests against : he reasoned and wrote, and so placed the law of gravitation upon an endur- ing base. "The proper conditions" are the things we are after and they cost thought We must break the shell if we would get at the meat ; we must crack the nut if we would find the kernel. It will not do to turn aside these vital questions, though they be knotty, as the boy did who being asked how digestion was accomplished, said, "01 put the puddin in my mouth an it tslips down down ath eathy." It is to clear away the "mysticism" that we labor. If similia is a "natural law" it can be investigated and under- stood. It is demonstrated as a fact, but what is its philoso- phy ? That is the question. — Ed.]

Editor Medical Advance :

The Indiana Institute of Homoeopathy has just closed its last annual session in this city. The attendance was not near as large as on many former occasions. Upon the whole it might be said, however, that the deliberations were both interesting and instructive. But to particularize, it might also be claimed that many of the papers read, including the President's address, were entirely too lengthy. The busy and enterprising practitioner cannot patiently listen very long to

CORRESPONDENCE. 681

the reading of a paper that deals with dead issues and vis- ionary theories that are unprofitable alike to himself and to his patients. He must have diet that furnishes mental nour- ishment and useful information, or else he gets nervous and goes home before adjournment, perhaps never to return again.

As instances, I will give you the outlines of a few of the uninteresting and unprofitable papers read. In a paper on ninay the author started out with a prolix preface, claiming that this valuable agent had been entombed, but he came to ressurrect it, by pointing out its many uses. He then pro- ceeded to describe every pathological condition and every natural movement that has ever been observed in a child, and for all these things, Cina, with hida, like Aconit with Hem- pel, is generally indicated. But its special indications are convulsions, resulting from an engorgement of the alimentary canal of undigested food, cherry seeds, buttons, etc., etc. A few doses of the 200th is all that is needed to allay such spasms. To the credit of the society be it said, that after brief discussion the paper was wisely rejected, with the opin- ion preponderating that a dose of castor oil would be more efficacious in such cases.

In another paper read on the " Mortality of Children," the author put forth a laborious effort to present a long array of hospital statistics, supported by the observations of emi- nent practitioners, that mothers' milk is by far the best food for babies, and that the milk of grass-fed cows and goats is the next best diet for them. While this paper did not con- tain anything that was ridiculous, it nevertheless presented nothing but universally admitted facts; its reading was therefore a total loss of time to the society, and it should have shared the same fate with the foregoing one, instead of being referred to the committee on printing.

So long as State medical societies are measured by the length and number of papers presented at their meetings, instead of the merit of such papers, so long will true progress in medicine move slowly, and grand and great objects be de- ferred. Nothing can be accomplished by presenting papers

682 CORkESPONDElfCE.

before a State society composed chiefly of extracts from text and other books commonly read, filled in with meaningless or unsupported assertions, exploded theories, weak-minded chaff and bad grammar. But such papers should always be brief and to the point, without any effort at display, and should be the result of our best efforts after an exhaustive research of the subject in hand, and a deliberate and mature reflection of all its claims and bearings. And right here it might just as well be admitted that not every practitioner, although perhaps as successful as many others, is capable of preparing a paper of merit All such should attend the meetings as listeners and not presume to instruct others who possess special ability in this direction. This course has been pursued by your correspondent for five successive years, and as an attentive listener only he has no regrets.

There is another very discourteous practice indulged in at our society meetings that deserves a more severe stricture than it has ever yet received, and that is whenever a new idea or method is presented by any of the progressive mem- bers, the fossils come at once out of their shells and tell you, " if you would only study Hahnemann's Organon thoroughly you need not resort to any new methods." And this they say with an air of superiority which implies that no one, ex- cept the antideluvians, had ever read that valuable book. If we were to admit that Hahnemann was the omega as well as the alpha of Homoeopathy then this attempt at restriction and uncalled for tyranny might be admissable, and we might then just as well as not come to a "dead halt" at once. Further progress and development in our science would not only be unnecessary but impossible. But as our school of medicine is one of progress, it would perhaps not be out of place here to tell the aforesaid fossils, by way of a little wholesome retaliation, that they too bJuaM ready not only a book, but the history of all the ages, and there learn that all the discoveries of new laws and new truths have only seen the banning of a work that succeeding generations have carried on into fuller development. And thus must it be

BOW TO LIVE LONG. (583

with Homoeopathy, if it is to survive and prosper. The Alopathic medical society of Indiana has a committee of enquiry, or some such a name, to whom all papers are referred before they can be read in open meeting, and by this means a vast mass of ignorance can be hidden. Some such a plan should be suggested to certain of our own medical societies.

D. Haggart, M. D. Indianapolis, Ind., May 2d, 1884.

HOW TO LIVE LONG.

Old age is of two varieties— premature, and that caused by the lapse of time. Premature age, as engendered by various mental and physical excesses, comes not within our present notice. The principal characteristics of old age, as demonstrated by anatomical research, are a deposition of fibrinous, gelatinous, and earthly deposits in the system. Every organ in the body during old age is especially prone to these ossific depositions. These earthly deposits have been found to consist principally of phosphate and carbon- ate of lime, combined with other calcareous salts, accord- ing to the research of Dr. Williams. "That man b^ns in a gelatinous and terminates in an osseous (or bony) condition," has been truly observed by a French physician. Prom the cradle to the grave a gradual process of ossification is un- doubtedly present ; but, after passing middle life, the ossific tendency becomes more markedly developed, until it finally ushers in senile decrepitude. These earthly deposits in the various organs during old age materially interfere with the due performance of their respective functions.

Hence we find imperfect circulation in the aged, owing to the heart becoming partially ossified, and the arteries blocked with calcaerous matter, interferring with that free passage of blood upon which nutrition depends, so the repair of the body naturally becomes impared thereby.

Both Bichet and Baillie considered that the great num- ber of persons over 60 sufier more or less from arterial 4

684 m>W TO LlVJS LONO.

ossification. When the heart's valves become cartilaginous they consequently fail to propel the blood to its destinations — this fluid being further obstructed by the ossified and con- tracted condition of the arteries themselves.

In youth, on the other hand, nutrition is perfectly carried out, there being no blockades to impede the circulat- ing system upon the due perlormance of which physical reparation depends.

Bearing the above facts in mind, we plainly perceive that the real change which produces old age is, in truth, nothing more or less than a slow but steady accumulation of calcareous matter throughout the system.

Having arrived at the piredisposing causes of senile de- cay, it yet remains for us to go still further, and seek out their origin. The two principal sources of old age are fibrinous and gelatinous substances; secondly, calcareous depositions. According to the recent researches of Mr. de Lacy Evans, the origin of the former may undoubtedly be traced to the destructive action of atmospheric oxygen. Fibrine has been said to contain 1-5 per cent, more oxygen than albumen. Now, oxidation converts albumen into fib- rine, fibrine itself being but an oxide of albumen.

Although unquestionably fibrine nourishes the organs of our bodies by repairing the waste, yet a great deal of this substance accumulates in course of time, lessening the cali- bre of the blood-vessels, and thereby causing their indura- tion.

It therefore follows that, as time goes on (old age), fibrinous and gelatinous depositions become noticeable. Con- sequently, as fibrine is an oxide of albumen, so also is gelatine an oxide of fibrine, due to the action of oxygen on the fibrine deposited by the blood. A further effect of oxi- dation causes part of these substances to be decomposed, and subsequently eliminated through the kidneys as compounds of ammonia and urea. There is always a continual struggle progressing in our systems between accumulation and elim- ination. Thus it is that the fibrinous and gelatinous accumu-

PASTEUR CURES HYDROPHOBIA. 686

laiions of old age are chiefly traceable to the chemical action of atmospheric oxygen.

The calcareous deposits next claim oar attention, being proved by anatomical investigation to be peculiarly a char- acteristic of old age.

PASTEUR CURES HYDROPHOBIA.

For some time past, Loais Pasteur was known to be at work on the microbes of the rabies virus, with the expressed hope of curing the terrible malady. He now announces that he has been successful in his researches, and invites any one bitten by a mad dog to present himself at the laboratory of the Ecole Normal for treatment The patient, Pasteur prom- ises, will not only be protected against the effects of the previ- ous bite, but rendered proof against hydrophobia in the future.

Pasteur's method closely resembles that followed in his previous investigations or virus microbes, notably the anthrax or charbon microbe. Briefly stated, his researches show that the rabies virus is chiefly localized in the brain of the ani- mal dying from acute hydrophobia, and increases or decreas- es in power according to the kind of animal inoculated with it. Starting from a rabid dog, for instance, the virus on be- ing transmitted to monkeys loses its strength. The first monkey dies, but if a second be inoculated from the first, a third from the second, and so on, the virus becomes so weak as to be almost harmless. If, on the contrary, rabbits are experimented with, the virus increases in power; so that starting from the almost inert virus from the last monkey, and inoculating rabbit after rabbit, the virus regains its max- imum power. In this way Pasteur obtains virus of various degrees of attenuation, as a Homoeopathist would say, and his treatment simply consists in inoculating the patient suc- cessively with three different attenuations of the rabbit virus, beginning with the weakest, and ending with the strongest. After the operation the patient is cured and becomes com- pletely insusceptible to hydrophobia.

)6 CONTAGIOUS DISEASES.

REASON WHY CONTAGIOUS DISEASES ATTACK ONLY ONCE.

Professor Tyndall, viewing the question from the mod- em standpoint, thus explains the immanity obtained against a second attack of a contagions disease : One of the most extraordinary and unaccountable experiences in medi- cine was the immunity secured by a single attack of a com- municable disease against future attacks of the same malady. Small-pox, typhoid, or scarletina, for example, was found as a general rule to occur only once in a lifetime of the individual, the successful passage through the dis- order apparently rendering the body invulnerable. Reason- ing from analogy, I have ventured to express the opinion that the rarity of second attacks of communicable disease was due to the removal from the system, by the first para- sitic crop, of some ingredient necessary to the growth and propogation of the parasite.

The cultivation of micro-organisms which is now every- where carried on, enables us to realize the smallness of the change which in many cases suffices to convert a highly nutritive liquid into one capable of supporting microscopic life. Various important essays bearing upon this subject have been recentiy published in the Remie Scientifique. M. Boulsy there draws attention to the results obtained by M. Raulin in the cultivation of the microscopic plant named Aspergillus niger. The omission of potash from Raulin's liquid suffices to make the produce fall to one twenty-fifth of the amount collected when Potash is present. The addi- tion of an infinitesimal amount of a substance inimical to the life of a plant is attended with still more striking results. For example, one part in sixteen hundred thousand of nitrate of silver added to the liquid entirely stops the growth of the plant And now we come to the important applica- tion of this fact, which has been indicated by M. Duclaux. Supposing the Aspergillus to be a human parasite — a living contagium — capable of self-multiplication in the human

BOOK NOTICES. 687

blood, and of so altering the constitution of that liquid as to produce death, then the introduction into the blood of a man weighing sixty kilogrammes of five milligrammes of the nitrate of silver would insure, if not the total effacement of the contagium, at all events the neutralization of its power to destroy life. An index finger here points out to us the direction which physiological experiment is likely to take in the future. In anticipation of the assault of infec- tive organisms, the experimenter will try to introduce into the body substances which, though small in amount, shall so affect the blood and tissues as to render them unfit for the developement of the contagium. And subsequent to the assault of the parasite he will seek to introduce substances which shall effectually stop its multiplication. There are the strongest grounds for hope that in the case of infective dis- eases generally such protective substance will be found.

BOOK NOTICES.

OBSTETRIC MENTOR. By CLARENCE M. CoHANT, M. D., A. L. ChatTerton, Pub- lishing Co. New York.

This is jnst what it purports to be, an obstetric mentor for pocket use and ready reference at the bedside It is well arranged, well printed, on good paper; a credit to both author and publisher^ and every homoeopathic prescriber should have it. It will save him much time and trouble in looking up a case.

HAND BOOK OF ELECTRO THERAPEUTICS. By Da. Wn^UAM Erb, proftssor in the University of Leipzig. With thlity-nine wood cuts. Wm. Wood A Co. New York.

We find in this work beyond question a most admirable pre- sentation of the subject of Electro Therapeutics. It is well adapted to the wants of the student who desires the fullest and latest infor- mation on the uses of electricity in the treatment of disease. The directions are simple and well illustrated, and the clinical reports of cases add a practical value that no mere desertation however learned can equal. It will not do to say that electricity is a cure-all, but its importance to the physician even the general practitioner cannot be well over estimated. Erb's work may properly be placed in the front rank of text books, and is one of the best of the series of Standard Medical Authors.

688 BOOK NOTICES,

SOME OF THS DISEASES OF THE RECTUM AND THEIR HOMCBOPATHIC AND SURGICAL TREATMENT. By Mobtimer Atebs, M. D. Chictgo:

' Duncan Brot., 1884.

We are pleased to find in this little work much of importance. It is truly a valuable addition to our growing literature and every one who reads or rather studies it, with care, will feel in common with us a sincere gratitude toward the author. There is no doubt that just this sort of a book is wanted by thousands of practitioners and they cannot better supply their want or better show their ap- preciation of the book than by obtaining a copy. Our only criti- cism would concern the quantity and not the quality of the work, we should be glad to see the anatomy and physiology of the rectum more fully discussed by the author.

VETERINARY MEDICINE AND SURGERY. AND DISEASES AND INJURIES OF THE HORSE. By F. O. Kirby compiler and'editor. Wm. Wood it Co., New York.

The editor and more especially the publishers have done

excellent work in producing this book. All lovers of the horse

will be pleased to read it with care. A knowledge of the diseases

of the horse is so often called into requisition that a reliable guide

like this is of no small importance. It would give us pleasure to

commend Mr. Kirby's book without reservation but our knowledge

of sick horses is such from practical experience that we must dissent

from the medical treatment the editor reccommends. It is without

warrant and as needless as the heroic treatment the human race too

often get at the hands of doctors. In horses no less than in man

it is the will power that cures. For our part such drugging and

drenching as is here followed looks like sheer cruelty to animals.

THE JUNE CENTURY.

Though there are four profusely illustrated papers in the June Century, and four full-page pictures, this number of the magazine is perhaps even more notable fof its literary features than for its pictures. Of special interest is Miss Fanny Stone's "Diary of an American Girl in Cairo during the War of 1882.'' It is a vivid and remarkable narrative of the life of General C- P. Stone's family dar- ing the month that mother and daughters were exposed in Cairo to the greatest uncertainties and dangers, while General Stone was at his post with the Khedive, and aiding in the English operations against Arabi. General Stone, in a prefatory letter, severely criti- cises the English attack upon Alexandria. President Eliot, of Harvard, discusses the question, "What is a Liberal Education?" in which he claims that the sciences and English should be givea leading places in the school and also in the college course.

JEDITOR'S "TABLE, 689

The North American Review for June opens with an article on "Harboring Conepiracy," by Prof. Henry Wade Rogers, who exam- ines, in the light of international law, the diplomatic history of the United States and the national constitution, the question as to how far our government may and must go in suppressing plots against governments with which we are at peace. Henry D. Lloyd, in the same number of the Review^ shows how every branch of production is coming under the control of " Lords of Industry." corporations and monopolies. Elizabeth Stuart Phelps has an article marked by rare philosophic force upon the "Struggle for Immortality.'' Other articles of not less importance are: "Sociological Fallacies," by Prof. W. G. Sumner; "The Rise and Fall of Authority," by President J. C. Welling; "Walt Whitman," by Walker Kennedy ; and symposium on "Expert Testimony," by Rossiter Johnson, Dr. W. W. GK)dding, T. O'Connor Sloane and Charles L. Dana.

Vol. XIV ends with the current number. Vol. XV begins with July. We do not like to send out billo. It looks like a dunn ; and many men do not like to be dunned. We would if possible avoid the necessity; and have printed on the mailing address the date to which subscriptions are paid. Subscriptions are due in advance ; and when paid in advance to the Advance, the publishers are enabled to make better terms and the printers do better work. Small items are easiest paid, and if our subscribers will note the date and remit promptly, it will enable us to increase the quantity of reading matter without increasing the price, and save us the necessity of sending a bill.

EDITOR'S TABLE.

C. B. Pillsbury has removed to Ypsilanti, Mich.

G. A. Hall, M. D., has removed to 2400 Prairie Ave., Chi- cago.

B. A. Bradley, M. D., has removed to 55 Everett St, Cincin- nati, Ohio.

Hahnemann College, San Francisco, opened its first session June 3, with a class of " about 20."

Wallace McGeorge, M. D., has removed from Woodbury, N. J. to 1921 Chestnut St, Philadelphia.

We are pleased to learn that Drs. Famsworth, of East Saginaw, are about to issue a Directory of Michigan. Let some one in each county send a list of physicians at once, that we may have a relia- ble work when printed.

m lEDltOlda TABLE,

A recent committee appointed to report suitable resolutions on the death of a brother member speak of him in feeling terms as "our diseased associate.**

DrSi Breyfogle & Pierce have dissolved and Dr. Chester A. Mayer has formed a partnership with Dr. Breyfogle. Dr. Pierce has opened an office on his own account.

Business pressure has compelled Dr. Gilchrist to resign the Dosition of secretary of the state society to which he was recently unanimously elected, and the executive committee has appointed Dr. Grant, the late efficient secretary to the position.

We regret that we were unable to accept the following invita- tion of Dr. and Mrs. Talbot: "Dr. and Mrs. I. T. Talbot request your presence at the marriage of their daughter Edith, to William Leavitt Jackson, Wednesday evening May 21, at eight o'clock, First Church, Marlborough and Berkely sts., Boston Mass.''

Prof. W. A. Edmonds M. D.,has been selected to fill the chair of Practice in the St. Louis college, left vacant by the illness of Prof. Valentine ; and H. H. Schott, M. D., takes (he chair of Psedology. These are both good appointments and will materially strengthen the teaching force.

Elbctric LiGriT.— Doctors are to be furnished with an appa- ratus to be attached to their carriages which will give them mate- rial assistance in their nightly journeys through the country. The Svoan light is best adapted to this purpose. Quacks will, however, be expected to use the Duch light.

I have used Churchill's preparation as made by J. A. McAr- thur with the most decided benefit, and am satisfied that a fair trial is all that is required to establish it's therapeutic value, I have at this writing^several cases in which the syrup is going beyond my expectation. Phiup Leidz, M. D.

Philladelphia, Pa., February 6, 1884.

The 30th annual meeting of the New Jersey State Homeo- pathic Medical Society which was held in the parlors of the Park Hoi el, Newark, May 6tb, was largely attended and particularly in- teresting and profitable. Distinguished medical gentlemen and ladies from abroad wer69 present and took part in tl^e discussion. Many valuable papers were read, among others one by the vener- able P. P. Wells, of Brooklyn, is deserving of special mention. The usual officers were elected for the ensuing year. Dr. Church, of Newark, was chosen president, and S. W. Clark, M. D., of Jersey City, secretary.

'' nii:v

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