stairs; dull, pressive pain in forehead and vertex; hemicrania; stitch-like pains in supra-orbital region; pressive and boring pain in temples; pressive pain at vertex; pul- < sating pain at occiput; feeling of pressing asunder at occiput; congestion of the head; throbbing in the middle of the brain. Accordingly, we find aloes recommended for headache by Dioscorides; and specially prescribed in severe and prolonged cases of headache, accompanied with vertigo, by Schroeder and Trousseau. The head symptoms are relieved by cold, thus manifesting their congestive nature. We also find numbness and heat of the scalp, with dryness of the hair; and this drug has been recommended by Schroeder and others to prevent loss of hair. Again, we find pressive pain in the eyes with conjunctivitis, and find it given by Dioscorides for suppuration from the eyes. We find ear-ache, increased by clenching the teeth, tinnitus, and other aural symptoms. Its efficacy in some cases of deafness is well known. Lastly, we have drawing toothache.

For cerebral symptoms compare with aconite, lycopodium, colocynth, pulsatilla, nux vomica, conium, bryonia, plumbum, belladonna, arsenicum, platinum, aurum, assafætida, clematis, agaricus, graphites, phosphorus.

Now, every one of these symptoms occurs with aconite and phosphorus; agaricus presents fewer points of resemblance than under the previous head; assafoetida still fewer; arsenicum a good many more; aurum and platinum have much in common with them, especially the eyesymptoms as regards the former, and the pressive nature of the headache in the case of the latter; the cerebral symptoms of belladonna, though far more marked, are not dissimilar in kind; those of nux vomica, conium, and bryonia approximate still more closely; but in the last case the symptoms seem more of a nervous than a congestive character; plumbum has much in common, and, what is very striking, produces frequent and sudden attacks of deafness; pulsatilla offers a very strong resemblance; graphites less so; clematis rather more than graphites; while the likeness presented by lycopodium and colocynth almost equals that of aconite. Ipecacuanha, the morale of which is a good deal similar to that of aloes, here presents few points of resemblance. The order of likeness seems to me as follows: Aconite, lycopodium, phosphorus, colocynth, pulsatilla, nux vomica, conium, bryonia, plum

bum, belladonna, arsenicum, platinum, aurum, assafœtida, clematis, agaricus, and graphites.

We find the following symptoms recorded under the digestive system. Hot, red, and dry lips; dryness of mouth with thirst; tongue red and dry-sometimes coated yellow-tongue and gums sometimes ulcerated (for which it was given by Dioscorides); constriction, hoarseness, and rawness in throat; persistent nauseous taste; eructations, sometimes bitter, at other times tasteless; appetite sometimes increased, at others diminished; nausea and vomiting, for the cure of which it has been successfully employed by Schroeder; hæmatemesis, for which it was prescribed by Dioscorides; pressive pain and warmth at epigastrium; colic; acute abdominal pains at various parts; pain and distension in hypochondria; pain in spleen (the drug is much used by the Hindoos for enlarged spleen); heat, pressure, and pain in liver; great, general distension and flatulence; inflammation and ulceration of rectum; dragging sensation in rectum; hæmorrhoidal pains; crawling, pricking, and burning in anus, which is morbidly sensitive to the passage of the faces; dysentery; hæmorrhoids; stricture of the rectum; stools generally very yellow; said to act as a purgative when constipation arises from insufficient flow of bile, or atonic state of intestinal walls.

For digestive system compare with aconite, lycopodium, pulsatilla, colocynth, arsenicum, bryonia, belladonna, ipecacuanha, nux vomica, mercurius.

The above symptoms are nearly identical with those of aconite and lycopodium, while they strongly resemble those of pulsatilla, colocynth, phosphorus, arsenicum, and bryonia. They also bear some likeness to the corresponding symptoms under belladonna, ipecacuanha, nux vomica, and mercurius. But we no longer can trace any noteworthy resemblance to the symptoms of graphites, agaricus, conium, plumbum, platinum, or aurum.

The provings of the chest symptoms, alike respiratory and circulatory, are in a very unsatisfactory state, so far as I have been able to discover. We find epistaxis mentioned, which, according to Schroeder, it will also arrest; but, considering the tendency of aloes to produce cerebral congestion, it may be questioned whether in the present case this ought not rather to be considered a head symptom. Then we have sneezing and coryza, a general feeling of

oppression and anxiety, along with acceleration of the pulse; hoarseness, and occasional inclination to cough. Congestion of blood to the chest is also mentioned by some provers, together with flushes of heat over the entire body. It is obvious that with such meagre provings any comparison which we may institute in this respect between the action of aloes and that of any other drug must be very imperfect, but it is equally clear that so far as they go the above symptoms closely resemble those of aconite, lycopodium, arsenicum, phosphorus, and ipecacuanha.

The action of aloes on the urinary system is variable, as at times the urine has been hot and scanty, while again on other occasions the urinary secretion has been large in amount and yellow and turbid, or, again, mixed with blood. Scalding during micturition has also been noticed in some cases. All these symptoms also occur under aconite, pulsatilla, lycopodium, arsenicum, and phosphorus.

Under the head of generative system we find aphrodisiac symptoms strongly marked in both sexes, and menorrhagia in the female, as well as uterine congestion and miscarriage-very much, in fact, the symptoms of platina, which here approximates more closely to aloes than any other drug with which I am acquainted; but it deserves to be compared likewise with lycopodium, phosphorus, arsenic, aconite, and pulsatilla. In some respects it ought rather to be contrasted with the last named. Colocynth here presents an absolute contrast.

With regard to morbid anatomy, the chief appearances which have been noted are those of congestion of the bowels, particularly of the large intestine, and of the pelvic viscera generally, but congestion of the lungs and brain have been recorded in some cases. Clinically it has been found especially useful in cases of dysentery, piles, menorrhagia, and some forms of hepatic disease that is to say, just in the very diseases which, according to former works on Materia Medica, contra-indicate its exhibition, and in some cases of rheumatism, headache, falling out of the hair, and deafness.

Having thus briefly summarized a few of the leading actions of aloes, and seen with what drugs it admits of comparison under each system, as well as taken a short view of its clinical action and post-mortem effects, we must endeavour to apply the knowledge thus gained, so far as it goes, to discovering the organopathy of the drug, and

further ascertaining for what regions, as well as for what tissues and organs, it has a special affinity.

The post-mortem appearances, so far as recorded, point to little more than congestion of the alimentary canal, especially at the lower extremity, but to this clinical observation and provings have enabled us to add congestion of all the pelvic viscera, and occasionally of the lungs, and meninges of the brain.

I am not aware that any rash has been observed as the result of the administration of aloes, but that the drug exerts some influence upon the skin seems certain, since it clearly arrests the falling out of hair in many cases. We might also have been led to expect some action on the cutaneous system, by noticing its similarity to graphites in some respects.

While we started with a comparatively large number of companion drugs with which to institute comparisons, we have seen that, as we passed hastily from system to system, they have for the most part, like earthly friends in the fable, dropped off one by one at each successive stage of our progress, so that of the 17 with which we started at its commencement, 6 only have accompanied us to its close. These are named in order of resemblance, lycopodium, aconite, arsenic, phosphorus, platina, and pulsatilla.

Now, of these we may note

1. Lycopodium specially acts upon mucous membranes, and also exhibits an elective affinity for the liver and chylopoietic viscera.

2. Arsenic acts specially on the gastro-intestinal mucous membranes. Here we have one region of the action of aloes clearly indicated by comparison no less than by observation. Again,

3. While phosphorus certainly has an action very similar to that of arsenic on the gastro-intestinal mucous membrane, it has also a distinct aphrodisiac action of its own.

4. Platina is chiefly remarkable for its action on the pelvic organs, especially those of generation in the female. Here we find the analogues of aloes in reference to another sphere of action, viz., emmenagogue and aphrodisiac, and also to its most characteristic seat, namely, the pelvis.

5. The action of pulsatilla is over the mucous membranes generally, likewise on the organs of generation; hence the great resemblance we have noticed to aloes, though it is right to observe that as regards the genera

tive system the action of pulsatilla is very frequently, if not most commonly, in an opposite direction to that of aloes. The relations between aloes and aconite appear to me to require a little more careful consideration.

The control which aconite exercises over the circulation must be ascribed to the direct or indirect action of the drug upon the heart. Besides this, it appears to act upon the system of involuntary muscle generally, as shown by its power in dilating the pupil, which it does, though to a less extent than belladonna. Now, the action of aconite is very much more rapid than that of aloes, and its cerebral action is far more marked, both of which facts lead to the conclusion that the former acts through the medium of the nervous system-an inference which derives greater probability from the well-known anodyne properties of aconite.

The drug we are now considering (aloes) possessing no anodyne properties, and exhibiting a less distinct cerebral action, while, at the same time, it seems to affect the circulation, probably does so by its direct action on the involuntary muscular tissue contained in the coats of the vessels, and as its action on the circulation is so very much less distinct than that of aconite, it seems worth while to inquire whether it exerts any direct influence on the heart itself at all. No doubt, the heart is an involuntary muscle, but it possesses the striated instead of the non-striated structure, which may possibly make some difference as to the drug influences to which it is amenable.

We may, I think, sum up the organopathy of aloes thus: The structures upon which it acts are

1. Mucous membranes generally, and in particular those of the pelvic viscera.

2. Involuntary muscle, especially that of the pelvic and cranial blood-vessels.

The sympathy so well known to exist between the brain and its neighbouring structures and the pelvic organs of generation, may help us to understand the influence of the drug on two such distant sets of vessels. Its action in arresting falling out of the hair may admit of explanation by its influence upon the small involuntary arrectores pilorum muscles at the root of each hair.

I should describe its primary action as tonic, its secondary action, or the action of a poisonous dose, as relaxant, and to this relaxant action on the muscular walls of the

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