BY CHARLES STURTEVANT, M. D., HYDE PARK, MASS.

I was called at six o'clock on the morning of Sept. 8, 1879, to see Mrs. A. B., a fleshy lady of about thirty-three years of age, whom I had attended in two previous confinements, the last perhaps a year ago. Labor commenced about four hours before I saw her, and I found upon examination a vertex presentation. The child lay very high, and the pains, though regular and frequent, were not strong or apparently very effective. As labor progressed, the head was forced down with every pain, but owing to the position of the woman, she being on her left side, and the fact that the pelvis was very broad, and the abdomen pendulous, the force of gravitation caused the child to slide down and away from the brim of the pelvis into the loose and flaccid belly, after every pain. In order to counteract this tendency, and to avail myself of the force of gravity, I raised the woman's shoulders and abdomen, and carefully placed beneath them a small crib-mattress, sliding it gently under the larger one upon which she was lying. After one or two pains I made another examination, and to my utter astonishment, discovered the right foot, covered by the membranes still unruptured, well down in the vagina. I am as absolutely certain that before this time the vertex was the pre. senting part, as I am that it was now the right foot.

After the change of position, the pains increased in force and frequency, and there was but one course to pursue, to deliver as a footling, which I did, employing the forceps to release the head ̧ There was but slight pulsation in the cord, and the child gave no

sign of life for a few moments, but after resorting to the ordinary expedients, the babe, a boy weighing eight and a quarter pounds, was soon out of danger. I may state as a part of this record, that the membranes were extremely firm and tough, and the liquor amnii almost as thick and opaque as starch.

NEURALGIA.

WRITTEN FOR THE GAZETTE BY DR. A. CLAUDE, OF PARIS.

[Translated by W. L. Jackson, M. D., of Boston.]

IN a preceding communication I made an allusion to what the English and American homœopathists have called the lateral action of drugs. I reserve the privilege of one day resuming this subject, and of bringing to bear upon it considerations drawn from anatomy and physiology, and intend to demonstrate that upon this point, as upon many others, allopathy furnishes important arguments in favor of our method. But to-day I will limit myself to speaking of the indications which one can draw from such conditions. Even those who are but little familiar with this special part of our belief know the peculiar affinity of Thuya for the left side of the body. I once had occasion to profit by this knowledge to the benefit of a patient, as the following history will show. Madame T-, a young and pretty blonde of twenty-five years, had suffered for several years from fearful and almost constant neuralgia, seated in the left side of the face. I could make out in her case neither a fièvre intermittante larvée* nor the existence of a cerebral tumor (the ophthalmoscopic examination having furnished only negative results).

It was neither the effect of an unsound tooth, of excessive privation or indulgence, nor the sequence of a repressed or constitutional disease. Her physician had tried in turn a tonic treatment, quinine, mercurials, hypodermic injections of various kinds, electricity, etc. The patient continued to suffer, and nothing in her face betrayed the terrible and almost constant pain which she experienced on a level with the left zygomatic process and malar bone. One of her good friends (I do not insist too strongly upon

*Under the name fièvre larvée are comprehended certain neuralgic and rheumatic phenomena which show themselves by a paroxysm, and over which quinia possesses a specific action.

the epithet) counselled her to sacr fice her beautiful hair, but before proceeding to such an extremity she preferred to try either homœopathy or mesmerism. Homœopathy had the preference, and accordingly she consulted me in the spring of 1871. She had employed so many kinds of drugs that I knew not what to give her until I thought of the location of the pain. I prescribed several drops of the third dilution of Thuya, to be taken four times daily. Two days later Madame T was cured, and the affection has never returned.

In the treatment of neuralgia it is necessary to take account of many indications, and I think that to assign to one among them a marked preponderance over the others, or to attempt to classify them too strictly, is a bad practice. Shall we, however, make an exception as regards periodicity? but in those cases where it is profitable to take special notice of this, have you to do with an essential neuralgia or a fièvre larvée? Would it not be better to say that the periodicity is one of the elements which must never be forgotten in seeking our diagnosis?

Here is a case to exemplify this fact, which occurs to me even after the lapse of several years. Mademoiselle M, aged twenty, was taken a week before coming to me with a double facial neuralgia, which made its appearance every day at noon. At the commencement there were slight chills, then violent, sudden congestion of the face, then the regular paroxysm, continuing two hours and gradually diminishing, leaving the patient quite prostrate. I gave her a powder of Quinia Sulph. gr. iii. at five o'clock. Notwithstanding the paroxysm was totally relieved and the patient relatively well, I gave another powder the following day, twelve hours before the presumed appearance of the pain, but it did not come as expected, and has never shown itself since. I know that a purist might have proposed Cedron on account of the daily regularity of the paroxysm, but I should remark that at the time of which I speak, I had but commenced the study of homoeopathy, and after all, the homœopathicity of quinine in this case was unquestionable.

Madame X-, age thirty-five, dressmaker, nervous temperament and quite delicate, consulted me in December, 1877, at the dispensary. She complained of quite an abundant and creamy leucorrhoea, of a fixed pain seated in the neighborhood of the left

ovary, which was increased at time of catamenia, of a neuralgia in left sciatic nerve, which often caused lameness. The left ovary was swollen and easily to be detected on palpation; the examination by the speculum showed a slight excoriation of the anterior lip of the os; the neck was not congested, and in short everything appeared normal except the exit of the leucorrhoeal flow. Madame X's intelligence was but slightly developed, and she furnished with difficulty this incomplete history. I diagnosticated a chronic ovaritis (of about ten years' duration), which played the principal part, and as a consequence of this, the leucorrhoea and sciatica. The rachitic appearance of the patient induced me to try a treatment based upon her morbid constitution, and I prescribed a powder of Calc. Carb. 3d trituration, to be taken morning and night for one week. The following Thursday I was informed that the discharge had slightly diminished, but there was no amelioration of the other symptoms. I recalled the lateral action of Thuya, and I prescribed the 6th of this medicine. One week later I was obliged to acknowledge a fresh and complete failure, and consequently was compelled to recommence my investigations, and then I learnt that fifteen years before Madame X— lived in the country. Her occupation at that time might furnish an indication. I made fresh inquiries, and learned that she was a milkmaid, but that she had left this occupation on account of a blow received on the left side from a cow's horn. You can readily conceive the conclusion which I drew from the fact. The lateral action was deposed by traumatism, and Arnica replaced Thuya. I began with the 3d, and passed week by week to the 6th, 12th, 30th, but stopped medication during the menstrual period. The flow stopped little by little, and had entirely disappeared in March, 1878, as well as the ulceration and ovarian tumefaction. As for the sciatica, it disappeared during the first fortnight. I have several times since had an opportunity of seeing Madame X, and her disease has never returned.

NORTHEAST GEORGIA AS A HEALTH RESORT.

BY H. P. GATCHELL, M. D., ATLANTA, GA.

WHILE engaged more than twenty years ago in analyzing the vital statistics of the census of 1850, I was impressed with the

salubrity of Northern Georgia, especially with the small mortality from consumption, these characteristics being most marked in Northeast Georgia. This region rises from the Chattahooche Ridge, with a general altitude of about 1,200 feet, to the base of the Blue Ridge at an altitude of 2,000 or 3,000 feet. The soil is, in general, a sandy, gravelly clay, resulting from the disintegration of the granitic rocks of the Blue Ridge, with enough of sand and gravel to render it, in most places, readily absorbent of water. The air is neither excessively dry nor excessively humid, the Signal Service Office in Atlanta reporting for the first four months of this year a mean humidity of 56.4.

A Californian, writing for the New York "Times" a just criticism on the article in "Harper" which I have alluded to, mentions two points, Atlas Peak and Blake's, on the East Napa Ridge, in California, as particularly desirable on account of the dryness of the air, the former with an annual mean of 40, and the latter of 57, a singular difference between two points not far apart, and neither of them at a great altitude.

To enable the reader to judge better of the atmosphere of Northeast Georgia, I will give the mean annual humidity of several places, taken in part from the communication to the "Times," and in part from Prof. Kerr's "Geology of North Carolina," and will assume 56 as the annual mean of Atlanta.

It is at least questionable whether a degree of humidity below 50 is, under ordinary conditions, desirable. Excessive dryness is irritating to both mucous membranes and nervous system, to the latter especially, where, from an almost cloudless sky, a perpetual glare of sunshine prevails throughout the day; to which cause the large proportion of insanities and other diseases of the nervous system in California is probably, in a great measure, due.

From the scanty growth of moss and other indications, I judge that the humidity diminishes somewhat as we approach the Blue Ridge. But where this mighty wall uprears itself against the