vessels I should ascribe the pelvic and cerebral congestion which have been recorded.

To its tonic action on the same tissue I ascribe its value in medicinal doses in the treatment of piles and menorrhagia, and it is noteworthy that it is in those cases of the last-named ailment which are accompanied by determination of blood to the head that this drug has been found especially useful.

In dysentery, with well-marked inflammatory symptoms, and much flatulence, aloes have been found useful, and these two conditions would seem to be especially amenable to this tonic action of aloes on the non-striated muscular system of the coats of the vessels and intestines, while a similar action on the mucous membrane of the alimentary canal lessens the undue secretion of mucous slime passed with the discharges.

Lastly, the forms of simple diarrhea and dyspepsia to which aloes have been found most appropriate, are those accompanied with flatulence and other indications of an atonic state of the gastro-intestinal walls. Its influence on the liver may, perhaps, be further explained by the sympathy known to exist between that viscus and the

rectum.

Such are the observations I have been able to collect upon this drug. I cannot but regret, that, meagre and brief as they are, they should so far have trespassed upon the time due to other more valuable and more original communications.

HOMEOPATHY IN THE TREATMENT OF MALARIOUS FEVERS.

By MAHENDRA LAL SIRCAR.

MR. PRESIDENT AND GENTLEMEN-HONOURED COLLEAGUES,—I can scarcely thank you sufficiently for the honour you have done me in inviting me to contribute my mite in the shape of a paper on some subject relating to homœopathy at this your annual gathering for 1874. When I recall to mind the history of these congresses, which I have watched with intense interest, when I recall to mind the great men who had presided and the great men who had contributed papers at these congresses in times past, and when I realise in my mind's eye (which alone I can do at present, being prevented by a variety of reasons from accepting your president's kind invitation), when I realise in my mind's eye the meeting of the present congress-presided over by a gentleman of rare accomplishments, to whose noble translations the Englishspeaking world is indebted for its acquaintance with the thoughts, experiences and reasonings of our illustrious Master, thoughts, experiences and reasonings which have removed for ever the landmarks of mystic, and laid the foundation of positive medicine; and to whose valuable "Lectures" the world is indebted for one of the soundest expositions of homoeopathy extant:-When I realise in my mind's eye the other gentlemen present, some of whom, like the worthy president, have, by their writings and researches, acquired names which are heard of in every part of the civilised world, and others—the younger band of workers-nobly striving to add to the stock of knowledge and to advance the cause of the greatest truth yet discovered in the domain of medicine:-When I realise in my mind's eye all this, I am humbled in the dust to think that you did not forget to invite an obscure man in an obscure corner of the far East, and to invite

such a man to contribute to your intellectual enjoyment. Not for my own sake, nor even for yours, honourable colleagues, but for the sake of the truth which we all worship and the system which enshrines it, do I hasten to comply with your kind request. Yes, Gentlemen, it is simply to bear witness to the truth and to show that truth when understood has charms for even the meanest intellect, that I have ventured to lay before you this humble contribution of mine, which otherwise would be ridiculous in comparison with the contributions of the other gentlemen.

I have selected for my subject "Homœopathy in the Treatment of Malarious Fevers," for the reason that we have at present in Bengal a deadly epidemic of malarious fever which has been devastating the country for some time past, and does not as yet show any signs of diminution of its virulence, and that this, in common with epidemics in general, has been instrumental in demonstrating, not indeed the utter futility of the old system, but the vast superiority of the new over the old. The limits of this paper will not allow me to dwell at any length on the causation or even on the nature of the disease. The causation is, in spite of the efforts of Government and of private individuals to discover it, still shrouded in the densest obscurity; but the nature of the disease, though mistaken by a few eccentric medical men, is patent to every one who has eyes to see and a modicum of common sense in their heads. Whatever malaria may be, whether a material poison, or a mere influence, whatever its immediate and remote causes, in all which matters there may be and has been the widest divergence of opinion, there is perfect unanimity about its effects on the human system. The fevers, the cachexia, the concomitants, and the sequelae, which come on in its train, are all so marked and characteristic, that even laymen do not fail to recognise their peculiar features, and refer them to their true origin, though the origin of that origin itself may not be easy to trace.

The grand characteristic of malarious fevers is their periodicity-their recurrence after definite or indefinite periods of lull as it were, of apparent health, at least, of apparent apyrexia. A typical paroxysm of fever consists of three distinct stages, the cold, the hot, and the sweating, which are followed by a period of apyrexia of a few hours

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or of a day or two, which again is succeeded by another paroxysm of the same character, and so on, for a number of paroxysms constituting an attack, after which there is a longer lull of a few days or even months, to be followed by another series of paroxysms or another attack. In this way attack after attack follows, either gradually diminishing in intensity and duration, which is a rare thing, especially when the patient continues to reside in the malarious locality, or gradually increasing in severity, till the intermissions are mere remissions, and the paroxysms, though less in violence, become more obstinate and more exhausting, in other words, till the intermittent gives way to the remittent type. Sometimes the order of things is reversed, the disease at first appearing as remittent, and afterwards becoming converted into an intermittent form. This is certainly the more favourable course of the two. general rule, it is the degree of virulence or concentration of the malarious poison or influence which determines the type of the fever; the more virulent and concentrated the malaria, the greater being the tendency to the remittent variety of the disease. We say as a general rule only, because we have seen cases of the strictly intermittent type in which life has been compromised sometimes in the pre-febrile, sometimes in the post-febrile stage, and this in the course of one or two days only. In these cases the malaria must certainly have been of the most concentrated and virulent form, notwithstanding that the fever was of the intermittent character. These acute cases are of the gravest description. They occur when the epidemic is at its height. In their acuteness, severity, and mortality they resemble cholera.

The varieties of these types of malarious fever are endless, and it is needless in this paper to recount them. I shall just touch upon the concomitants and the sequelæ. It is difficult to say whether the primary action of malaria is upon the blood, and through the blood upon the ganglionic nervous system, or upon the ganglionic nervous system and through it upon the blood-forming organs. Whether the one or the other, the result is the same— destruction of the red corpuscles of the blood and the arrest of their genesis. I have seen healthy, robust men, with no lack of red blood in their system, blanched after a few days' residence in a malarious district, before even the symptoms of the fever had been quite developed, and long

before either the liver or the spleen had become enlarged. Simultaneously almost symptoms indicative of derangement of the ganglionic nervous system, especially of that part presiding over the primæ viæ, make their appearance, such as loss of appetite, defective secretion, costive bowels, nausea with or without vomiting, &c. Next in order of sequence is the implication of the animal nervous system, as manifested by extreme nervous and muscular debility: this is probably through the ganglionic nerves controlling the vessels supplying the cerebro-spinal centres. The symptoms of implication of the nervous system, ganglionic and cerebro-spinal, indicate not congestion but exhaustion and defective nutrition from an improperly oxygenated and spanæmic blood. I maintain that primarily there is no congestion of any of the viscera, cephalic, thoracic, or abdominal. I maintain also that congestion of the abdominal viscera much more frequently ensues than congestion of the thoracic, which again is much more frequent than congestion of the cephalic.

It is difficult to say, however, which of the abdominal viscera it is which suffers the earliest. If we trust to physical signs alone, apart from vital symptoms, the spleen would appear to suffer first. But attention to the vital symptoms, a right interpretation of all the phenomena of these fevers, leads to a different conclusion. It would thence appear that the mucous membrane of the digestive tract suffers earliest in the order of sequence; the liver next, or simultaneously; and last of all the spleen. The spleen, in fact, appears to me to act as a safety-valve to the disturbed functions of the alimentary mucous membrane and of the liver. I have accordingly always looked upon the early enlargement of the spleen as a salutary sign. And I have almost invariably seen that in these fevers the gastric and the hepatic derangements continue obstinate, so long as there is no perceptible enlargement of the spleen. The first effects, therefore, of the enlargement of the spleen are to divert the morbid action from the stomach and the liver, and to avert the tendency to vomiting, diarrhoea, and dysentery. Again, the assumption by these fevers of the remittent type seems to me to depend upon the want of an adequate safety-valve action of the spleen. And it is a notorious fact that it is in the intermittent variety of the disease, that this organ is found early and the most frequently enlarged. All that is said