chest, and causing dyspnoea, worse after eating, with a great deal of flatus,'. -A bloated, tight feeling comes after eating and drinking across the upper part of the abdomen, and which is not lessened by loosening her clothing, and is accompanied by a sick feeling. (This symptom came on in a girl, æt. twenty-one years, four days after she had discontinued taking Soda chlorata, which had disagreed with her),'.—In a girl of twenty-one years, an aching pain in her left side at her waist, preventing her from sitting upright,'. After taking the Soda chlorata for a week she got a fearful pain in the lower abdomen, which settled in the right hip-joint, and spread over the whole abdomen, as far as on a line with the umbilicus; it lasted a week, leaving her free from a tenderness of the abdomen that she had had for a year, and free also of pain in the hip-joint (right), and of an inability to flex the hip upon the abdomen from pain; and besides, she ceased to pass "white gravel," which she had been voiding for the last twelve months with great suffering. (On referring to the notes of this previously troublesome case, I can, with present experience, come to no other conclusion than that the primary cause was ovarian; the symptoms had followed upon the cessation of a metrorrhagia. The woman's age was thirty-four years),'.— [40.] (There was an aggravation of the following already existing symptoms; soreness in the lower abdomen, as if bloated, with intense pain on placing her hand there; next day felt the tenderness with distended feeling higher up round the hypochondria, obliging her to unfasten her clothing; trembled all over; her knees felt too weak to support her body; the lower part of her back became excessively tender, and the burning in the vagina, an old symptom, reached an unendurable pitch),'.

Anus. In a woman, aged forty-two years, cutting pain like knives in the anus, which comes on every evening between 6 and 7 o'clock, and goes away during the night, but not at any stated hour,'.

Stool.-Confinement of the bowels for three days, and then passage of a large hard offensive motion,'.

Urinary Organs.—Within twenty four hours he suffered from diffuse nephritis. What little urine he passed was smoke-colored, and afterwards black. It contained a large percentage of albumen, blood, hyalin, and granular casts. Then there was complete suppression. There were vomiting and diarrhoea, headaches, and coma. He died on the fourth day, In a little girl of three years, scalding when urinating, with soreness, itching, and smarting of the vagina,'.-In a female, aged thirty-two years, it brought on excessive action of the kidneys after each dose, the patient was at the time supposed by Priestley to be suffering from cauliflower excrescence of the uterus,'.—În a woman with mitral valve lesion a quantity of red sand was found in the urine for the first two days after taking the Soda chlorata. She never remembers such a symptom before. (The dose being one drop in a wineglassful of water),'.

Sexual Organs.-Almost unconquerable sexual desire after each dose, with priapism,'.-Great sexual excitement comes on after each dose, in a man, aged twenty-five years, of impressionable temperament,'.-She cannot take the Soda chlorata, as it causes a feeling as of “ opening and shutting" in the womb. (In a healthy woman, aged sixty-five years),'.[50.] Uterine bearing down; severe backache, and headache affecting the temples and back of the head, making her feel "light-headed" and sickish, generally worse at night,'.-Violent metrorrhagia,'.-The monthly period comes on at once, a week before its time, in a perfectly healthy woman, after a dose of two drops in water,'.-The monthly illness a week

over time, and during the first day has more than usual aching in the back. (In a fairly healthy girl, aged twenty-one years),'.

Respiratory Organs.-Cough, distressing, with a little phlegm, continual during the day. (In a woman, æt. thirty-five years),'.

Chest. — Tightness on the chest, with dyspnoea, inability to move quickly; a feeling of weight in front of her chest; these usual symptoms become aggravated, and there appears as a new symptom pain under the heart, with catching inspiration; these symptoms ceased on discontinuing the Soda chlorata,'.-(A feeling in front of the chest, as if something were gnawing at the chest, was aggravated),'.-Pain across the upper part of her chest, off and on, and pain with fulness across the hypochondria, with pains extending down from both sides of her waist to the womb, causing a phlegmy discharge,'. Pain under the left axilla and left mamma, aggravated by lying down, with a sickish giddy feeling. When walking about is obliged to keep sitting down,'.

Back.-Much pain across the small of her back, worse on getting up in the morning, existing along with a want of appetite for breakfast, but a fair appetite for supper,'.

Extremities.-60.] An aching in all her limbs, and a feeling as if bereft of all power, and as though she would faint upon the slightest movement,'.

Superior Extremities.-Both hands are swollen every morning. (Observed in about three cases),'. NOTE.-This morning swelling of the hands appears to be a very characteristic symptom

Inferior Extremities.-Pain in both hip-joints, and in the calves of her legs, with tingling extending to her toes,.-Extreme weakness in her ankles and knees,'.

Generalities.-Rapid emaciation (in a girl of twenty-one years),'.She becomes quite overpowered (from of a drop three times a day, in a woman, æt. sixty-five years),'.-In a delicate, highly nervous woman, suffering from uterine weakness that followed two months after her confinement, the Soda chlorata, after removing most of the symptoms within the first fortnight of treatment, began to tell on the patient. She became very weak, with shooting pains all over the body, and in the limbs, especially between her shoulders, and at the points of her shoulders (the inferior angles of the scapula), worse in the morning before getting up; these shooting pains are worst in the arms, and very bad in different parts of her head; day and night, but principally by day, she has much headache, worse, if anything, on the very top of her forehead, an aching pain without throbbing,'. In a delicate anæmic woman, suffering from uterine weakness, the Soda chlorata caused a pain to appear in the left infra-mammary region, which affected the left side of the chest, the shoulders, and top of the head; the shoulders became stiff and painful, and the top of her head and side felt tender to touch and ached, an unbearable pain; felt drowsiness after meals, the left hand, and left alone, was swollen one morning after waking, and next morning the right only was similarly affected. The bowels became confined and less urine was voided,'.—In a decidedly consumptive girl, æet. sixteen years, it improved her cough, and made her feel stronger; its continued use made her feel drowsy and lazy, as if she could lie in her bed all day, and her skin became covered with pimples, that smart after washing, and upon going into the open air; the slightest drop of cold water as a drink irritates these pimples,'.—In a delicate consumptive girl, subject to convulsive seizures and bearing down in the lower abdomen, the first dose caused a strange lifeless feeling, which

made her apprehensive of fainting, followed in about an hour by sickness; this was succeeded some three days afterwards hy vertigo caduca; the bearing down temporarily improved,'.-[70.] Great exhaustion, as if about to die before the bowels act; sudden and forcible expulsion, with consequent complete relief,'.-Aggravation of symptoms before each monthly period. (Observed in many cases,.-Pulsatilla is antidotal to many of the aggravations from Soda chlorata; Guaiacum seems to lessen the rheumatic and myalgic pains. The Pulsatilla influence I have several times observed, that of Guaiacum only twice. Strychnine overcomes the powerless feeling produced by it,'.—* Its nervous symptoms come on very irregularly,'.

Skin. Pimples are thrown out on her skin, which smart when washed or when going into the open air; the slightest drop of cold water as a drink irritates these pimples,.-Pimply rash appears on her face and irritates a great deal, especially at night,'.—In a woman of thirty-one years, from three-quarters of a drop, diluted: Red smarting rash on the face and neck, worse after meals or after warm drinks; a uniform redness, with tendency to blister, "as if from a mustard-plaster,".-Sores, angry-looking and moist, break out about the mouth,'.-Small gatherings form on the fingers of both her hands,'.

Sleep.-* Drowsiness after meals,'.-[80.] Drowsy during the daytime, wakeful at night,'.-She is unable to sit down without falling asleep; her appetite falls off, but bowels are regular and tongue clean,'.-Heavy sleep, with much disinclination to get out of bed, in the morning,'.-The child, when asleep, has a ghastly look, as if dead. His sleep is quiet,'.

Sodium lactate.

NATRUM LACTICUM.

Authorities. 1, Preger, Centrabl. F. Med. Wiss., 35, 1875 (Amer. Obs., 1876, p. 307), effects of Natrum lacticum when subcutaneously injected, or given internally in large doses; the same from fresh, and especially sour milk, whey, and very concentrated sugar water; 2, Botticher, Berlin Klin. Woch., 1877, p. 538, effects of large doses.

Unusual hunger and thirst (in some cases),2.-Vomiting (effects of very large doses),.-Great weakness of the lower extremities, analogous to the anxietas tibiarum noticed after great physical exertion,2.-Rheumatoid pains have been noticed (Senator, Berlin Med. Woch., July, 1876),— Hypnotic effects occur in about one-third of the cases, sometimes simply making the normal sleep more prolonged and sounder; in other cases it causes an abnormal sensation of fatigue, yawning, and sleepiness,.-Sleep,'.

NATRUM SALICYLICUM.

Authorities. 2, Brit. Med. Journ., quoted by the Review, p. 376 (Hahn. Month., vol. xiii, 1877, p. 56); 3, A. D. L. Napier, M.B., Practitioner, vol. xviii, 1877, p. 411, an old gentleman, for rheumatic affections of the wrists and ankles, took 20 grains every three hours for more than a week; 4, John A. Erskine Stuart, ibid., p. 425, effects of a 15-grain dose; 5, Weckerling, Deutsche Archiv für Klin. Med., vol. xix, 1877, p. 319, a woman, who had formerly suffered from hæmoptysis and pleuritis with effusion, and now continued to have fever, took several evenings 5 grams at a dose, but this day took 15 grams, at 1 P.M.; 6, Hemlein, Erz. Intell. Blatt., April, 1878 (Lond. Med. Rec., May, 1878, p. 211).

Urine passed after three hours kept fresh and free from ammoniacal

odor, and perfectly clear when exposed to the air for ten days,'.-The patient was a woman, aged forty years, whose hearing was supposed to be impaired. She was not subject to giddiness. It was her first attack of acute rheumatism, and there was no cardiac affection. On January 26th, Salicylate of soda was commenced in doses of 25 grains every three hours. On the 28th she complained of noises in her ears, deafness, and giddiness, which the next day had increased so much that the drug was omitted. The following day the giddiness was much less, and by the 31st had almost gone. On February 6th the same dose was resumed; on the 7th the same symptoms were complained of. The noises in the ears were constant; a watch was heard only at two inches distant from each ear, and was not heard at all on either side when in firm contact with either zygoma or mastoid process. A tuning-fork on the vertex was heard fairly well, but the sound was not increased by closing the ears. The giddiness was slight and indeterminate as long as she lay still, but was very considerable and definite when she raised her head or sat up. Objects before her all seemed moving to the right. On the 8th these symptoms continued, and the Salicylate was discontinued. On the 10th the giddiness was gone, and she could hear the watch at a distance of six inches from each ear, and could hear it, although faintly, in contact with the zygoma or mastoid process, but not when in contact with the parietal eminence. On the 23d the Salicylate was resumed, and eighteen hours after its resumption deafness and giddiness had returned, which again ceased a day or two after discontinuance of the drug. When the patient was convalescent, a careful examination of the state of hearing revealed very little abnormality, the only difference being that the watch in contact with the skull was not quite so distinct on the right side as on the left. In another case I have seen similar symptoms of deafness and definite vertigo produced by Salicylic acid,.-Vomiting; unconsciousness, with at times wild delirium, from which she recovered with loud cries; great heat; dyspnoea; difficult hearing (after two hours); pulse 120 (the previous day it had been 92). The most remarkable symptom was the respiration; it was somewhat slower than it had been before, being now 28, while the day previous it was 32; respiration was so noisy, that it could be heard in the street; when the dyspnoea was most violent she had to be supported in a half sitting posture, gasped for air; respiration was exceedingly forcible; there were no objective signs of dyspnoea, like retraction of the chest, of the clavicular fosse, or of the hypochondria; the respiration continued so difficult that it was surprising that a patient so weak could breathe with such force. Diarrhoea; great thirst; difficult hearing (second day); no sweat (first and second days),.-C. K., a house painter, aged forty five years, had rheumatic inflammation of the elbow and knee-joints. The pulse was intermittent throughout the course of the case, raising the suspicion of a fatty heart, which was further indicated by the pasty appearance of the patient, and by his acknowledged addiction to alcoholic liquors. During the first ten days, Salicylate of soda was given in hourly doses of 7.7 grains (0.5 gram) without any effect. Thereupon the dose was increased to 60 grains (4 grams), with the following result. Soon after this first dose was given, there came on intense tingling and itching of the skin. The left side of the face, the lower extremities, and the right side of the chest were diffusely reddened, while both eyelids, the upper lip, and a great part of the legs were slightly edematous. The pulse stood at 90, temperature at 101.8° F., and the urine was slightly albuminous. At the same time all pain in the affected joints had vanished,

and they could be moved freely about. By the next morning the redness had disappeared, and the pulse and temperature had fallen respectively to 80 and 100° F. In order to ascertain how far these symptoms were the result of the treatment, it was determined to repeat the dose at the next opportunity. The patient continued free from pain for the next three days, but on the fourth day the articular pains returned with such severity that the patient himself begged for "the large powder." 60 grains were given; after fifteen minutes severe burning pain in the frontal integument supervened, and five minutes later strong itching on the back of the right hand. In half an hour a marked eruption of urticaria was established over the greater part of the body, especially the legs and abdomen, with some œdematous swelling of the arms, eyelids, etc. This disturbance moderated in the course of two or three hours, and had completely subsided the next day. Subsequently, several smaller doses were administered without producing any of the above effects, and the patient recovered. After his recovery the patient consented once more to take the larger dose, and the result was precisely the same as before,.-Became very deaf, had ringing noise in the ears; severe headache; thirst; loss of appetite; felt dull and heavy,'.

NATRUM SULFURICUM.

Authority. 6, Dr. W. Roe, Practitioner, vol. ii, 1869, p. 239, ordered 10 grains of the bisulphite in distilled water with tincture of orange-peel, three times daily, for a girl troubled with ascarides.

[900.] Suffering greatly from headache (second day),.-Flushed face (second day),.-Furred tongue (second day),.-Pain all over the abdomen (second day),.-The bowels had not been moved for three days (second day),.-Passed very little urine,.-Very feverish (second day),.

NITRI DULCIS SPIRITUS.

Authorities. 9, T. W. Hill, Lancet, 1878 (2), p. 766, a child, aged nearly three years, swallowed about 3 or 4 ounces; 10, H. C. Lawrence, ibid., 1879 (1), p. 9, a lad, aged eighteen years, took almost daily, for three weeks, an ounce.

Delirious and incoherent in his manner, drowsy as if he had been taking alcohol. When he was roused he could answer questions, complained of headache, and said he found it difficult to walk straight of late. He could see clearly, the irides being somewhat dilated, acting feebly. Skin and tongue dry, breath smelling strongly of ether. Pulse 60, small and hard. Constipation well marked. Urine had not passed since early morning, and had been scanty of late. Bladder empty on pressure above pubes,1o.—In a comple state of collapse, cold and almost pulseless, insensible, both pupils fixed and widely dilated, breathing hardly perceptible. Later, vomiting and purging set in, with stertorous breathing, and death occurred in twelve hours,9.

NITRO-MURIATIC ACID.

Authority. 5, H. Scott, M.D., Amer. Med. Recorder, vol. i, 1818, p. 84; the acid used was formed by mixing three parts of the Nitrous acid with one of Muriatic acid.

Bombay, April 27th, 1798. I bathed in a bath which was merely acid