since copper has been the sheet anchor in suitable cases?

Kalmia IN CARDIAC HEADACHE.-Dr. Pröll (Hom. Monatsblätter) relates the case of a boy of thirteen who suffered from headache and weak memory to such an extent that he was obliged to leave school. The cause was found in an insufficiency of the cardiac valves, and kalmia I was given three times a day. In three days there was slight improvement. The remedy was given twice daily in the 2d dil. The headache then occurred occasionally only. The 3d dil. was now substituted, and continued for seven days, when the headaches had wholly dis appeared. Seven months after the boy was found to have been studying without interruption.

Cinnabaris IN GONORRHEAL SEQUELAOscar Hansen, M. D., Copenhagen Hom. World.-H. J. N., stonecutter, forty-two years old; twenty years ago he had gonorrhea with condylomata, and eleven years ago he was treated by me for, and cured of, mucous papulæ in fauces, at anus, and between the toes, also of maculous syphilides on the chest and back with merc. sol., trit. Ic. Has now, at the commencement of the treatment, October 14, 1890, been sick for three months. On both shoulders and on the chest, below claviculæ, are spread papulous, scaling syphilides, red-brown in color, and without itching. On the scalp the eruption is very close-set, maculous, and peeling off in small, fine scales. On the right side of the neck a gummous tumor as large as a hazel nut. An increasing falling off of hair. Outside of this nothing noteworthy was found, and the general condition was good. Merc. sol. in 1c. trit. as large as a pea, morning and evening, was prescribed. As no sign of improvement showed. itself, I, on January 15, 1891, determined to give him merc. sol., trit. dec. 1, as much as could lie on the point of a penknife, morning and evening. Already, by February 28, the gummous lump had disappeared. The eruption on the body had paled, the peeling off on the scalp having decreased, while the falling off of the hair was but trifling. The medicine was continued with for eight days, then pausing eight days, and so on alternating, until June 3, when only the eruption on the shoulders and the chest

was unchanged. I then gave him cinnabaris Ic. trit., morning and evening. Already, on July 13, I received a letter, stating that he was perfectly well, and that the eruption had completely disappeared. He has since then felt perfectly well.

I must in this case add that in later years, during which skin and venereal diseases have become my specialty, I have always used lower dilutions and triturations. Before we lost our liberty to dispense I often, ten, twelve, fifteen years ago, treated these diseases with higher dilutions, but generally either no improvement occurred, or the improvement was so exceedingly slow that the patients left the treatment. It was first when I constantly used lower dilutions and triturations that I had my eyes opened to how much homeopathy does in these cases, and how much superior it is to allopathy.

Silicea IN ALVEOLAR ABSCESS.-P. C. Majumdar, M. D., in Indian Hom. Review (Calcutta).A young man, aged about thirty-five, had an attack of what is called "gumboil." It was awfully painful, and I was called on July 15, 1889. On examination I found whole of the lower alveolar arch tumefied and of dusky red color. There was also some swelling of the lower maxillary bone in front. There was much salivation of tenacious consistence and fetid odor. fetid odor. I found it to be a distinct case for mercurius, and so I gave him a powder of mercurius sol. 6 every four hours. Next morning the pains much abated and the salivation less.

It has, however, transpired that my patient changed his treatment and an allopathic surgeon was called, who directed him to take away the two lower incisors. That was done, and the patient's complaint instead of being ameliorated was fearfully aggravated. There was a big swelling on the cheek right side lower down. It was poulticed and operated upon, and the poor fellow had been suffering ever since. I was again consulted, after he had been a month under allopathic treatment. The allopathic surgeon suggested the removal of a portion of the lower maxillary bone, which was said to be in a necrosed condition.

On my second visit I found nearly the whole row of lower teeth gone. There were several fistulous ulcers on the gum, oozing out a con

siderable quantity of sanious pus. My patient was much prostrated and emaciated, fever of a hectic type appearing every evening. This fever used to increase to a great extent during the change of moon. I at once had a happy selection in silicea 6, which was given morning and evening, with much improvement, and the patient was completely restored to health in the course of a month.

Nitric Acid IN ULCERS, ETC.-When applied to the skin in crude form, nitric acid burns a hole with a ragged edge and uneven outline; but the burn sinks deep down into the part. A light application to the skin leaves a brownish discoloration. Therefore remember that the nitric acid patient may have brown (liver) spots on the skin, and that the ulcers are deep, but of ragged outline.

Kali bichromicum has a deep ulcer, but with a clear-cut edge, as if made with a conductor's punch. Mercurius has a ragged ulcer, but it is superficial, rarely sinking deeply into the tissues.

The ulcers of nitric acid are fetid, exuding a greenish fluid, with urinous odor peculiar to this remedy. The ulcers, boils, and skin troubles generally develop the sensation of a splinter sticking in the part, especially when pressing upon them. You will find this anywhere about the body, nose, throat, chest, rectum, etc. The ulcers bleed upon the lightest touch, even from the application of dressing or the touch of the tamponade. They are made worse from the touch of cold water.

The special affinity of this remedy is for the junctions of the mucous membrane with the skin; hence at the orifices of the body, where it will develop pimples, boils, ulcers, etc. Therefore

has been used, hepar is indicated; but when syphilis and mercury conjoined appear in the system, then nitric acid.—From Private Notes.

Lycopodium IN INFLUENZA.-Villers, Arch. f. Hom.; Jour. Brit. Hom. Soc.-A lady, aged forty-three, had an attack of influenza, after which a dry cough remained, which presented no marked characteristics, and consequently left me free to select from a large number of medicines. I had treated her with various drugs for five or six days, when I ascertained that the cough was most troublesome between 6 and 8 P. M. This led me to prescribe lycopodium, of which she got two doses daily. During the first twenty-four hours the cough became loose, in two days it turned into an ordinary catarrh, and terminated in a short time under the same medicine.

Graphites IN ERUPTION.-Lutze, Allg. h. Ztg.-A young lady had suffered for two years from a white, branlike, rough eruption occupying the whole side of the right forefinger. It exuded a little occasionally, and for the last fourteen days showed a tendency to spread to the thumb. The eruption somewhat resembled that seen by the author in a case of leprosy, though, of course, that disease was out of the question in this case. Graphit. 30, two doses at a week's interval, was the only medicine prescribed, and when seen six weeks later the eruption had completely disappeared.

COLLEGE CULLINGS.

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New York Homeopathic Medical College. PATIENTS will often come to the physician

about the rectum, vagina, eyes, etc.

The urine of this remedy is likened for odor to that of the horse. This peculiar odor is found generally about the nitric acid patient, whether from the sweat, the fluids exuding from the sores, the stool, the menses, or elsewhere.

In nasal diphtheria nitric acid is one of the chief remedies, the discharge from the nose being very watery, offensive, excoriating every part it touches, and having the urinous odor.

Nitric acid has an especial affinity for syphilis that has been mercurialized. When mercury

metritis. Insist upon a digital examination in order to be sure of your diagnosis.—Macy.

THE main factor in a differential diagnosis between hemorrhage from the stomach and from the upper portion of the intestinal tract in which vomiting is absent is that hematemesis is followed by the symptoms of acute gastric catarrh, while hemorrhage of the intestine is not.-Dowling.

IN prescribing anacardium the peculiar mental condition calling for this drug should always Compiled by special representative for the American Homeopathist.

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be kept in mind. A person requiring anacardium has a great loss of memory, is suspicious, and has an irresistible desire for profanity. Allen.

THE aurum patient is melancholy, talks of suicide, but never attempts to take his own life.-Allen.

IN old secondary and tertiary cases of syphilis in which the nasal and lachrymal bones are being destroyed I have never found a drug which has so wide a sphere as aurum. Platinum holds second place.-Allen.

IN breaking up the adhesions of a fibrous anchylosis it is much better to employ flexion instead of extension, as by so doing the adhesions are broken up just as thoroughly, and without the danger of putting the blood vessels and nerves on the stretch.-Wilcox.

In cases in which you have reason to suspect a fever, and the thermometer shows only 98° per mouth, do not be satisfied or misled, as the patient may have taken large draughts of ice water or some other cold substance, which will lower the temperature of the mouth. This is a point worth remembering.-Dowling.

CRACKED ice and brandy is an excellent remedy for severe vomiting, and will often prove effective when other remedies have failed.Dowling.

A DISEASE which ordinarily may have very little effect may prove fatal to the diabetic.Dillon.

SUDDEN disappearance of pain in inflammation without the use of opiates means gangrene. -Wilcox.

PERITONITIS presents an excellent picture for bryonia, and this drug will be indicated in a large per cent. of these cases.-Shelton.

Hering of Chicago.

You will find only a few remedies for headache accompanied by great hunger. I know of but three anac., china sulph., and psorinum. -Sawyer.

A SMALL chin generally indicates a weak heart; advise such patients not to use tobacco. If the patient be hollow and thin through the cheeks, you may expect to find stomach dis

order; and if the face is narrow through the cheek bones, you will find defective lung power. Roberts.

In cases of persistent diarrhea after vaccination thuja will generally give relief.-H. C.

Allen.

COUGH ameliorated by warm drinks spongia. What other remedy has this?-H. C. Allen.

In cases of poor recovery from la grippe, or where that disease is followed by brain or lung trouble, I have frequently found lac. can. to be the indicated remedy.-H. C. Allen.

THE object of a drainage tube is to drain; it is to be kept in a wound from three hours to three months, if necessary.-Crutcher.

IN photophobia without apparent cause conium is the first remedy to be thought of.-L. A. L. Day.

WITH measles you may often find a complication of capillary bronchitis. Now, if you remember that chelidonium covers these conditions in a vast majority of these cases, you will have but little trouble in their treatment.Hoyne.

PROFESSOR HOWARD CRUTCHER: I present some rules for general guidance that I think will prove reliable in the treatment of appendicitis :

1. The pulse and temperature are not safe guides as to the local condition.

2. Cessation of pain may indicate either approaching recovery or impending death.

3. Where acute pain is aroused by digital pressure over the cæcal point, operate at once. 4. "Early operation" means before pus has formed.

5. When pus has formed, do not invade the peritoneal cavity unless such a course is imperatively demanded.

6. Medical cases are relieved promptly by the appropriate remedies; surgical cases ought to be relieved as promptly by surgery.

7. To allow a gangrenous appendix to butcher a patient is worse than any abuse charged against surgery.

8. One attack of appendicitis invariably predisposes to a second attack.

9. Succeeding attacks are increasingly danger

ous.

10. A mistake on the side of non-interference gives the patient seven chances out of eight; a mistake on the side of interference, if mistake is ever made on that side, gives the sufferer fortynine chances out of fifty.

11. When in doubt, operate.

Southern Homeopathic Medical College, Baltimore. PROFESSOR JANNEY: Sprains are sometimes taken for rheumatism. Always get the history.

In a sprain the ligaments or synovia are injured, and a good way to diagnose which is by forcing together or pressing apart the bones of the joint. If it is ligamentous injury, the latter gives pain, and if of the synovial membrane, the former does. Besides, there are heat, swelling, and pain attending injury to the synovial membrane, and only pain prominently when the ligaments are injured.

Flannel makes best bandage for such cases, as its resiliency makes it the best for even pressure. Sponges also, bound about joint and then water poured on them, are a good procedure and give good results.

MATERIA MEDICA AND THERAPEUTICS.

PROFESSOR PRICE: We may sum up all we need to say of the allopathic divisions of the materia medica as such in a few words.

The astringents are good sometimes for local use. I have found, in diarrhea, when used to stop discharges that after the few days of their action a worse condition always ensues.

Expectorants we do not need, nor emmenagogues. Ergot acts well when an active uterine motor stimulant is needed.

Antacids, absorbents, and solvents might be called for in a mechanical sense.

The best anthelmintics, cina, or its principle santonin, and spigelia, we use, but homeopathically.

For teniæ I prefer the following: chloroform, I dram; castor oil, 2 ounces; croton oil, 2 drops; and peppermint, I ounce to be taken at one dose on an empty stomach.

But in the alteratives we see much of interest. Their unknown action-to the allopath-is but homeopathy, and one day it may be accepted as such.

VAGINAL HYSTERECTOMY FOR PROCIDENTIA. Service of Professor J. S. BARNARD. ĮCONSECUTIVE report of a vaginal hysterectomy for procidentia by Pratt's improved method in Professor J. S. Barnard's gynecological clinic Parts are shaved and cleansed, urine drawn, and proper diet given. Peroxide of hydrogen is used in vagina and rectum, and resulting debris washed away with sterilized water. Then bovinine is injected in vagina and rubbed about pudenda as a stimulant to tissue Sims' retracting speculum is inserted in vagina, which well dilates lower part of vagina. Cervix is now drawn down, and the anterior and posterior lips are run through with a needle threaded

Stimulants are orthodox treatment in typhoid and many diseases, but should only be used when threatened collapse.

Among the prominent sedatives are some of our best remedies, and they act better under our manner of prescribing.

Emetics are good when poison is taken, but dangerous results, as apoplexy and hernia, have been known to follow their administration.

Cathartics may possibly be of use to rid bowels of some acute condition and in dropsical effusions.

Diuretics may be used in dropsy, also diaphoretics, and the latter, too, in congestion of the kidney, both as a last resort only.

four inches long, are used as guy ropes. Grad. ual dilatation of both internal and external os up to 23 American scale next is done. (But little resistance.) Then sterilized wicking is packed in for the purpose of absorbing all moisture, withdrawn, and new, dry sterilized wicking again inserted. This is allowed to remain with. the object of furnishing body to the relaxed uterine tissue. A line is cut around the cervix with curved scissors about one-eighth of an inch deepthrough mucous membrane-and about one-half inch from tip of cervix. The membrane is now dissected off and back, traction being made on the guy ropes. Dissection is done clear up to the situation of the internal os, when the attached tense fibers of the uterine ligatures are come in

contact with anteriorly. Entrance is now made into the abdominal cavity by cutting through the peritoneal wall. The slippery feeling of the peritoneum makes it unmistakable. Instead of, as in the usual operation, enlarging this opening and turning the fundus out of the vagina being done now, the dissection was continued on up to show how easily it could be executed, as in Langenbach's operation. Posteriorily an opening is made into the cul-de-sac of Douglas. The fundus is drawn out, and a line of incision made along the attachment of the broad ligaments, meeting at the upper part like a V. With the hysterectomy knife, made especially for such work, the ligaments are separated from the uterus, and as the fingers are beneath and around them on each side, bleeding is easily controlled. Forceps are used for bleeding points, and some are ligated. Dissection is continued until the uterus is liberated. Several points of adhesions are noted during operation, and in this case are so bad that they would have made suprapubic hysterectomy a very grave procedure. The ends of the fallopian tubes had been caught with T-forceps for location purposes, and these were now found and the tubes and ovaries brought out into view, making examination complete, easy, and thorough. Though the patient is in a dorsal position, the intestines and omentum give no trouble. Ovaries are found somewhat bound down, but normal. The suturing is now commenced. This is done from both the tubes toward the center, a continued overstitch being used, drawing the anterior and posterior margins of broad ligaments together and pushing back what is between. The center is used to finish up with, as it can be better done. Two needles are used, one on each side, threaded with catgut. After sewing the parts are pushed back in place, and they recede nicely.

Notes.-The peritoneum is easily recognized by its glistening, whitish appearance and its slippery feeling beneath the fingers.

Laxness of tissue, as in this operation, makes the danger of going into rectum and the bladder quite grave. These and the arteries are for the most part escaped by keeping close to the uter ine tissue.

As to the inflammatory condition noted, by this operation no raw tissue is made by which

sepsis might arise. And should any arise access is very easily gained for draining or cleansing. Up to several days no trouble has arisen in this

case.

The dressing is to be noted. A piece of raw silk, about five inches long and tied with long silk strings at both ends, was dusted externally with quinine, having inside a small piece of iodoform gauze, and passed into the cavity left by the removed uterus. Then iodoform was sprinkled on parts, and vagina packed with gauze in such manner as would be drawn out by length, and not in lump. Dressings are to be removed in six days.

The instruments for this operation were all steamed. No water touches the tissues after the operation begins, sterilized gauze being used for what cleansing is necessary.

UNDESCENDED TESTICLE: IDIOCY; EXPLORA-
TORY LAPAROTOMY; FAILURE.
By HOWARD CRUTCHER, M. D., Chicago.

IT again becomes my duty to put on record an

A boy of eight years, who has been idiotic since his second year, was referred to me by Professor J. A. Tomhagen, who had exhausted the resources of therapeutics for the relief of the patient without benefit. The little fellow was remarkably bright in some respects, his parents were highly intelligent people, and as the boy clutched continually at his genitals, it was thought that a retained left testicle was producing reflex symptoms. Careful investigation failed to reveal the slightest external traces of that gland. The right testicle was apparently perfectly normal in all respects.

I explained to the parents the dangers of the operation, the likelihood of failure to find the gland, and the small prospects for improvement in any event. They were in a desperate frame of mind concerning the present hopelessness of their only child, and left the case entirely in my hands. After consultation with Dr. Bayard Holmes, who is in many respects the foremost surgical authority in this city, I concluded to do an exploratory operation.

Assisted by Drs. W. W. Stafford, E. E. Tracey, W. E. Warren, F. H. Lockwood, Charles J.