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the patient was of a rheumatic temperament, it may have been aggravated by that condition."
In the second case, the most intense neuralgia afflicted the leg and foot, arising from a fall upon the buttocks from a scaffold twenty-five feet from the ground, the patient striking upon a stone pavement. After ten days of insensibility he partially recovered, with difficulty in articulation. From this he gradually recovered, but paralysis of both legs followed. After five months the patient was able to get about on crutches, but without motion or sensation in the left leg. Shortly after this, he had an attack of acute articular rheumatism, which was followed by most excruciating pain on the outside of the foot. For this, Dr. Casselberry, of Hazelton, excised a portion of the plantar nerves, which gave relief for seven years. In 1874 the pains returned, and on June 12, 1877, Dr. Morton stretched the sciatic, in the middle of the posterior surface of the thigh. The limb was lifted twice from the bed by the nerve. The patient returned home on the second day after the operation, but was not relieved. The pains continued so severe that neurectomy was performed on the external popliteal nerve, which gave relief.
From a careful reading of this case, it would appear that perhaps if the anterior tibial and peroneal nerve had been simultaneously stretched both centrifugally and centripetally, a better result might have followed.
From these cases we learn that immediately after severe stretching there may be not only loss of power and sensitiveness, but also excruciating pain and twitchings; that after twenty-four to thirty-six hours, we may reasonably hope the severity of the sufferings will be materially diminished, and that they generally will disappear; that tingling, burning pain, and often swelling, remain for some time, and are especially noticed during motion, and that these symptoms pass gradually away; that when we have reason to believe that the neuralgic pains are returning, from the peculiar character of the sufferings, which are easily recognized by the sufferer and often described as "the old pain," that a thorough manipulation of the parts (if practicable) in all directions, putting the nerve to the utmost stretch of its physiological limits, may assist the cure, in preventing the formation of new adhesions.
How long these patients will remain free from pain is as yet unknown to me. To-day I introduced the patient whose case was recorded first to the class at the hospital. She has gained twenty pounds of flesh, can almost bear her weight on the foot, and walks with one crutch. She is hysterical, however, and complains bitterly when her leg is manipulated. She has not taken any narcotics, and recovers much more rapidly from the effects of the severe manipulations than before.
The second patient is even better than the first; and of the third, her physician, Dr. Blumenthal, thus writes me, in answer to my interrogatories, which I have put to him at the last moment before sending off the manuscript: "Your nerve patient is doing well, very well. She was in my office yesterday, has had no pain, went to the theatre yesterday, for the first time in eleven. years, and enjoyed it. Is still taking Conium at longer intervals."
On April 3 I stretched the ulnar nerve for reflex epilepsy and intense neuralgia of the entire arm, shooting from the point of injury (elbow) to shoulder and down the forearm and hand. To-day, April 16, the neuralgia has disappeared, and there has been no convulsion. Further reports I propose to give to the profession.
RUMEX IN GASTRALGIA.
BY W. K. KNOWLES, M. D., BANGOR, ME.
CASE I. I have lately had a patient who was troubled with repeated attacks of gastralgia, which were quite difficult to subdue. They commenced with an aching pain in the pit of the stomach, which gradually increased in intensity until it was very severe. There were also sharp, stitching pains in the stomach, extending into the chest, and below a sensation of pressure, like a lump in pit of stomach, sometimes rising up under the sternum, greatly aggravated from motion, and somewhat from taking a long breath; generally worse after eating, better when lying perfectly quiet. There was no fever, thirst, nausea, nor aggravation from drinking. Bry. has stitching pains in the stomach and chest, also pressure as from a stone, and aggravation from motion, eating, and taking a deep inspiration. The attacks, however, yielded very reluctantly to Bry., and it had to be used in often
repeated doses. They would also keep recurring. I concluded Bry. was not the similimum, so I instituted a search for it.
Under Rumex crispus I found the following indications: "Shootings from the pit of the stomach into the chest in various directions, aching pain in pit of stomach, and aching and shooting above it in the chest; fulness and pressure in pit of stomach, extending toward the throat pit; it descends toward the stomach with every empty deglutition, but immediately returns. Pressure and distention of stomach after eating, stitching, cutting pain in pit of stomach, worse on movement." This seemed to be a pretty close picture of the trouble, and I gave Rumex, which promptly gave relief. She felt a return of the attacks two or three times afterward, but a dose or two of Rumex would at once banish them, and she has not had one now for a year.
CASE II. Mrs. B. complained for a week or more of distress. in the stomach, which finally became so severe that she could not sit up, and I was called in to see her. Found symptoms as follows severe aching pain in pit of stomach and above it, occasional spells of sharp, shooting pains in chests, sides, and abdomen; some headache and nausea after eating, aggravation of all symptoms from motion and after eating. Arsen., Nux vom., and Bry. failed to relieve her. On closer examination, I ascertained that she felt a sensation as of a lump or pressure which was sometimes in throat, and sometimes behind sternum, not being constant in position. I gave Rumex, and all her symptoms disappeared after a few doses.
CASE III.-Mrs. C. had complained for several weeks of distress in pit of stomach, worse after eating anything, particularly apples. Once after eating an apple, she was taken with such distress that she became cold and unconscious, and her family thought she was dying. She also had at times sharp pains in chest and abdomen. At times she felt a sensation as of a bunch, either in throat or behind sternum, which was very distressing. She was quite emaciated, for she could find scarcely anything she could eat without causing distress. I gave her a vial of pellets medicated with Rumex, with directions to take a dose three times a day until better, and then discontinue. Soon after her return home (she lived about twenty-five miles away), she wrote that she had taken the medicine but a few times before she got relief, and did not
have to take the whole of it; that she was now able to eat apples or anything she liked without inconvenience, and that she had not felt so well for months.
I do not report these cases as brilliant cures, but to verify certain symptoms of Rumex, which I believe we shall find a valuable remedy in some cases of gastralgia and gastritis.
NITRITE OF AMYL IN ORBITAL NEURALGIA.
BY A. H. ALLEN, M. D., NEW LONDON, CONN.
A GENTLEMAN about middle age, full habit and vigorous, applied to me for relief from excessive pain in and over the right eye, which comes on periodically, or when he is prostrated to a certain extent by overwork. I prescribed Ars. 3, to be taken during the evening and night if awake. I called the next morning and found my patient no better. He was using hot water and bags of hops as external applications.
I determined to try Nitrite of Amyl; putting ten drops upon a cloth I directed him to inhale it. In less than five minutes he said, "Doctor, I feel better." I let him have it until it evaporated; then, after waiting for a short time, I gave him the same quantity in the same manner again, which still further increased the relief. When I left half an hour afterwards, I put ten drops of the remedy in half a tumbler of cold water, and requested him to take a teaspoonful once every half-hour for two hours, if the pain returned. It did not return until about the same time the next morning, from five to seven o'clock, when he took the remedy as ordered. After the second teaspoonful the pain left him, and there was no recurrence from Friday up to the following Monday, when he left town on business. So much pleased was he with its action that he took with him enough to last until his return. The only effect other than the relief of the pain was a slight decrease in the heart's action.
The patient has had this trouble for a number of years, and never has had any relief before, although he has been treated by eminent physicians of both schools.
VOL. XIV. NO. V.
THE NEW ENGLAND MEDICAL GAZETTE.
BOSTON, MAY, 1879.
WE must have in Massachusetts a LAW TO REGULATE THE PRACTICE OF MEDICINE Similar to that now in force in Illinois. Not only Massachusetts, but also every other State in the Union needs it. It will be a burning shame to the intelligence and boasted civilization of this great country, if the people delay much longer the enactment of such a law. It is an imperative necessity, not only for the protection of the lives and health of the community from the reckless and dangerous experiments of ignorant impostors, but also for the protection of the medical profession. To be sure, New York and some other States have passed laws having the same object in view, but they have practically been failures, so far as we can learn; while the Illinois law, which has now been in operation for almost two years, has been a great success in the opinion of allopaths, homoeopaths, eclectics, the non-professional public, in fact, of everybody except the ignorant quacks themselves, who are the only sufferers.
In July, 1877, the State Board of Health of Illinois, appointed by the governor with the advice and consent of the Senate, met for organization under the law, and drew by lot their respective terms of service. The board contains seven members, and the term of office of one of them expires every year. The allopathic, homoeopathic, and eclectic schools are represented in this board. Dr. R. Ludlam, who represents our school, and whose term of office expired by limitation not long ago, has since been reappointed, this time of course for seven years. In addition to the performance, of the customary duties in relation to the preservation of the public health, which is expected of all State Boards of Health, the Illinois board is authorized to require every person who wishes to practise medicine to obtain a license from it; in order to do which, he must either show a diploma from a medical college in good standing, or must pass an examination before the board.
The board has made its first report to the governor, covering the year and a half ending Jan. 1, 1879. From the printed copy before us (for which we are indebted to Dr. Ludlam), we intend to cull a few facts illustrating the glorious work so well begun.
About 3,600 non-graduates were practising medicine in the State