regulate temperature. I have no wish to undervalue the power of aconite in the treatment of the febrile state, especially at the commencement of illness; but I wish to protest against its being considered the sole remedy for feverishness.

In my experience I have found aconite of no value in the form of acute rheumatism accompanied by hyperpyrexia, and it has failed in the hands of others who have used it in heroic doses.

The medicine for this state has still to be found; and since I have looked up the physiological actions, I have not had an opportunity of trying in hyperpyrexia any of the drugs that produce high temperature.

During the course of acute rheumatism, with moderately-elevated temperature, and inflammation of the spinal membranes, atropia 2x, was of marked benefit in one case.

In chronic elevation of temperature, increasing towards evening, and accompanied by tuberculosis of the lung, I have used calc. carb. 3x, and continued it for several weeks, apparently with decidedly good results. The evening temperature reached 103° Fahr. in one case. But I need hardly state that this fails in many cases to bring down the temperature.*

I have already far exceeded the limits allowed to readers of papers, so that I must postpone the consideration of several drugs, such as bryonia and baptisia. Some temperature charts, which I have prepared, give the main points of the cases; and I will conclude with a few remarks on the use of cold water and galvanism.

Water.

Up to the present time the only treatment that is of service in the management of a case of hyperpyrexia is hydropathic. If a physician is called to a case in which the temperature of the axilla is more than 108° Fahr., no medicine hitherto tried is of any service-the patient is comatose, breathing rapidly, with mucus rattling in the throat, and apparently dying; and death will inevitably result in a few hours, unless the temperature be reduced. If the patient is found at this step, the temperature must be reduced

* Some charts of cases treated in the Mason Orphanage show the action of calcarea in diarrhoea and debility with high temperature, kindly supplied by Dr. Wynne Thomas.

quickly; and the best way to do this is to place the whole body into a bath of 90° F., and reduce the temperature of the bath with cold water and ice. In this way the bodily temperature may be reduced to 98°, and if the coma has not lasted long, the patient may recover consciousness in the bath. But if the temperature is 106° or 107° in the axilla, the "pack" with towel may be sufficient, but if that does not quickly reduce the temperature, the whole body must be packed in a wet sheet. By these means the excessive temperature can be reduced, whilst the general symptoms are treated by medicines.

Galvanism

May be required in the treatment of hyperpyrexia. During the comatose state the breathing may be arrested, whilst the heart goes on beating regularly; at first the reflex actions caused by splashing the face with cold water are sufficient to arouse the action of respiration, as in the new-born child; but after awhile this stimulus ceases to have any effect, and the application of the induced current to the trapezius and sterno-cleido-mastoid on the right side will cause the act of respiration to be resumed. The left side should not be galvanised, lest the action of the heart be affected injuriously.

ON THE THERAPEUTIC PART OF THE BRITISH REPERTORY.

By P. PROCTOR, Esq.

THE object of the remarks I have to make is to introduce to the Congress the very practical and important subject of the proposed therapeutic part of the Hahnemann Publishing Society's Repertory; and as many present may not be well acquainted with the scheme in its present condition, I propose glancing at some of the points, in the hope that they may then be discussed with advantage and a definite plan agreed upon, with a working organisation, without further loss of time.

The educational requirements of homeopathy are, in the first place, the statutes at large, viz., the full records of medicinal provings, without a single comment to bias the judgment; 2ndly, a repertory or classified list of the symptoms, for the sake of easy reference; and 3rdly, a handbook for assisting in the application of our resources to cases of disease. These requirements seem very simple and easily to be met, yet where can we point to anything like a full and uniform publication of our original records upon which practical homœopathy is built? Then as to the classified catalogue of symptoms, there is no complete repertory that commands more than a very partial confidence; and as to handbooks, though we have many, even in English, it must be confessed that we have to hunt through book after book to find that aggregate of practical information that might easily be contained in one volume. The originators of the Hahnemann Publishing Society conceived the idea of supplying all these wants, but the re-provings go on most tardily, the Repertory is incomplete, and the therapeutic part has yet to be begun. It was at first intended that a therapeutic chapter of clinical information should be added to each part of the Repertory as it appeared; but as that is far from completion, it is felt that the urgent demands of homoeopathy call for an early publication of the clinical chapters in a

mous.

separate form, constituting a manual of the practice of homœopathy brought up to the level of the present time. But we are met at the very outset by difficulties and objections. It is said that no work of the kind is properly required in homœopathy, as it leads to a contravention of its principles in attempting to prescribe for nosological entities instead of symptoms, whose proper place for reference is the Repertory; and practically having the vast array of symptoms of the Mat. Med. Pura before us, it looks like an attempt to compress the ocean into a gallon jar. As Clotar Müller says: "A homœopathic therapeutic manual, in the first place, can never include all the diseases met with in the daily practice of a medical man, even were it as perfect as possible, and contained all the diseases susceptible of being classed under any pathological system. The number of apparently unimportant cases which cannot be reduced to any diagnostic nomenclature is great, and their variety enorBut even granted that we could get a therapeutic manual which comprised all diseases in easily found general titles, still, in the second place--and this is the chief thing-it could not contain more than a mere small selection compared with the inexhaustible varieties of each disease, and always only a circumscribed list of those medicines which might in reality be suitable." This is but a fair statement of the objections to such a work. But we are met, on the other hand, by the exigencies of practice, which call for an abridgment of the labour of consulting our repertories in every case. We are, therefore, obliged to trust largely to our memories, and would gladly turn to a book that might supply at a glance such useful hints as experience has stamped with its approval. We have but to look at our practice to see that experience counts for more than Hahnemann was willing to allow. It verifies pathogenetic indications, which is a great deal, and it gradually supplies the true interpretation of hosts of pure symptoms otherwise of doubtful meaning. The work under consideration is intended to garner the harvest of experience, and will thus become, as Dr. Bayes has happily expressed it, "the general practitioner," while the Repertory and Symptomatology must ever remain "the consulting physician.

The unsatisfactory nature of existing therapeutic manuals is due partly to the plan and partly to the

manner in which they are worked out. We hope in the present attempt to improve upon both.

With a view to arrive at the best plan of the work, Dr. Bayes, Dr. Hughes, and Dr. Gibbs Blake published single specimen chapters in the Monthly Review, in order to elicit opinion, and as a result, at the Congress at York last year, Dr. Drysdale and Dr. Gibbs Blake were appointed to draw out a plan embodying the principles suggested in the above specimen chapters, viz., that it should consist of a therapeutical list of practical directions for the treatment of disease; 2ndly, that pathology, ætiology, diagnosis, and prognosis should be omitted, as information on these subjects is easily to be obtained in any good text-book on medicine; and 3rdly, that each chapter should consist of four sections.

Accordingly, a chapter on acute rheumatism was prepared and published in the Monthly Review for this month, and upon it we have a few remarks to make.

The first section gives the name and definition as suggested by the College of Physicians, London, in their recently published nomenclature, along with a list of medicines, arranged in three classes, the first class containing those medicines which have been discovered by the homœopathic law and tested in actual practice; in the second class are those medicines which are specific in their action, but only empirically known to be such, and which will probably be shown to be homœopathic; in the third class, those which, from their pathogenesis, would presumably be effective, but have not yet been tested by experience. The second section gives practical directions in treatment. The third section gives general treatment, diet, regimen, miscellaneous hints and bibliography; and the fourth section is an alphabetical summary of the medicines, accompanied with the clinical indications for each.

Now, as regards the first section, I think there can be no doubt of the advisability of eliminating the general information about diagnosis, prognosis, &c., as we do not want to consult such a book on these points, which besides rendering the book ponderous diffuses the knowledge we seek over a large space, instead of gathering it under our eyes, so as to be quickly glanced over.

As regards the classification of the medicines, I would very respectfully suggest that the three divisions should