of nine o'clock as with some. Lung and nose troubles go together; cleanse with H2 O2. Follow with inhalation of menthol mixture or oil of eucalyptus-my improvement over Robinson's spray inhalants sans the soother afterward. Nitric acid before meals and the popular elixir "diuretic" (buchu, juniper, acetate of potassium) after meals. A small dose of iodid of ammonia two hours after meals with antimony or arsenic.

I would like to ask the Editor if the underlying cause of hysteria should not be sought always in something more definit than vulnerable nerves or disposition. In one case it is the stomach, and a soother like ammonium chlorid is needed.

In

another case it is uric acid, overworkt kidneys apparently suddenly failing, and one can imagin the effect on the nerves. The liver may not elaborate such waste products as it should. The first thing is elimination-grey powder starts both kidneys and liver. G. B.'s case lacks a little of delirium tremens; coca and hydrastis

follow.

Having tried to help others, I want to know whether anyone has detected the enlarged veins in last stage (hemorrhagic) of sclerosed liver by palpation, or mistaken them for cancer. J. P. DICKSON, M.D.

Franklin, Iowa. [Yes, always seek the underlying cause of hysteria, but do not wait till you find it, as it is frequently hard to find. Treat the symptoms until you can find and remove the cause.-ED.]

Obstinate Neuralgia.

Editor MEDICAL WORLD:-For the benefit of Frederick E. Kraft, M.D. (page 392, September WORLD), permit me to state that we had under consideration for a series of years a case similar to his, and in our hands all of the drugs known to us were of no apparent benefit to the sufferer. Our patient becoming desperate, we advised the removal, to a greater or less extent, of the upper and middle turbinated bones on both sides. During last month our patient has informed us that he has had no sickness or pain since the operation, which is more than ten years past. When we take into consideration the anatomy of the parts, it is reasonable to conclude that we must expect to meet with cases where the operation is a sine qua non.

Cincinnati, O. A. W. RINGER, M.D.

Editor MEDICAL WORLD.-If Dr. F. E. Kraft will give his neuralgia patient lac caninum, third potency, two drops every one to four hours, as needed, he may be surprised how quick he will cure his case. Did not the symptom of "changing sides" appear, I would give mezerium, third potency, same as above. Stop remedy as soon as pain ceases. I have had many cases, and his experience and my own tallied until I struck these remedies. Now I never fail. Would like a report from the Doctor. THE WORLD is 0. K. Newark, O. WM. M. BALDWIN, M.D.

Editor MEDICAL WORLD:-For the benefit of Dr. F. E. Kraft, Brownville, Neb., I will give my treatment for neuralgia, which has been very successful in my hands: Morph. gr. and atrop. 1-100th fill syringe. Inject under skin over seat gr., ergotol 10 drops; add enuf water to of pain. Inject one-half in each side, if both sides are affected at same time. Use only when suffering, and repeat, if necessary, until attacks cease. Please report results. Ellzey, Miss. A. B. SMITH, M.D.

Editor MEDICAL WORLD:-Referring to the Obstinate Neuralgia," reported on page 392 of the September WORLD, I suggest 30 grain doses of ammon. chlorid, with grain doses of ext. of belladonna, to be given in a wafer, or kouseal, with water, every four hours during the paroxysms; and, to secure sleep, give crotonchloral, in doses of four grains, in capsules, every two hours, until twelve grains have been given, or until sleep is induced. A copious drink of water should be given after each dose of both prescriptions.

This hint as to drug-treatment presupposes strict attention to promoting elimination, and to improving the nutrition of the patient. The employment of the arsenical preparation, already begun, need not be discontinued.

With my initial appearance among the correspondents of THE WORLD, I will add that its scheme embodies what, from my point of view, are the essential requisits of a practical medical journal. It angles in all Esculapian waters, and what its hook brings to the surface, is, with rare editorial skill, so elaborated as to convey to its readers, each month, an exceedingly valuable miscellany; such as no other

[The Doctor has evidently not read the standing announcement regarding spelling, on the first editorial page, in small print. If he will read it, and the references made therein, he will see that we are not following a "fad," but following the highest scholarship in America and England combined. The reason that other editors and publishers don't do it is the fear of losing a subscriber or two! We have lost a few on this account, but we are going to continue doing our duty, nevertheless. We live for duty rather than subscribers' dollars. However, our subscription list grows, ever and anon; faster during the past year than ever before, and it is going to continue. A steadfast, courageous policy, if it is right, will attract growing support. We feel absolutely sure that we are right.-ED.]

The Editor's Answers Criticized. Editor MEDICAL WORLD:-I beg leave to criticize a few points in the Editor's reply to Dr.'s Kinzer's and Cooley's queries. In your reply to Dr. Wm. M. Cooley's question in September WORLD, page 390, you said: "Your patient has aspermatism. If it is organic, i. e., caused by some obstruction to the spermatic ducts, he is incurable. Organic obstruction is a sequence of gonorrhea, but may result from traumatism; or orchitis; or epididimitis of non-specific origin." Our kind Our kind Editor will remember that the bulk of seminal fluid is secreted by the prostate gland, and not by the testicle. The testicle only secrets the impregnating element (the spermatozoa). Besides, there is an operation which, if you can locate the obstruction in the vas, you can cut out the obliterated portion and reunite the vas with success.

Again, in the Editor's answer to Dr. Kinzer's query, on page 399, he said: "However, on second looking at the Doctor's query, this is not the question. Closing the vas deferens would make the

escape of semen impossible. It would be pent up, and the functional activity of the testicles would be destroyed."

It is a fact that the function of the testicles would be destroyed, but I reiterthe that the semen is not secreted by the testicles. So obstructing the vas would have nothing to do with the flow of semen.

Now my observation with a case in view, is this: I did the operation on a man 6 years ago. He was then about 37 years old. I operated by the injection method, heretofore explained in WORLD, and closed the vas. The man has enjoyed perfect health ever since. His sexual appetite is as good as before. His sensations in coitus are as voluptuous, his ejaculations are as great as ever. testicles have not softened nor atrophied. The seminal fluid is unchanged in quality or quantity, but the microscope shows the absence of spermatozoa since the operation.

The

Dr. Collins' case is psychic, unless there is some organic or spasmodic obstruction of the urethra or ejaculatory ducts. Beda, Ky. R. L. FORD.

[You are both right and wrong. If a man has no spermatozoa in the fluid he ejaculates in coitus, he has aspermatism, and is generally hopelessly impotent. No matter how much of the prostatic fluid he expels, if no spermatozoa accompany the flow, the man is impotent. Prostatic fluid is not semen. We confess that we would not like to attempt cutting and reuniting the vas in any but the most hopeless case. The simple operation for varicocele caused the death of one doctor. He had operated for varicocele on a young man about to be married; had included the vas in the ligatures thru mistake; when on the eve of his marriage the young man found himself impotent, in his rage and despair he shot the doctor and killed him. A man may enjoy coitus and have satisfactory orgasm, without even the ejaculation of prostatic fluid. We think you have slightly misunderstood us, as we use the term spermatic fluid in its literal sense, i. e., as that fluid only which passes from the spermatic ducts to unite with the prostatic and urethral secretions. We admit that your use of the term may also be considered correct. We are glad to know that our comments are so closely scanned. Men who write as you do should give THE WORLD Some valuable original articles once or twice a year. We await to edit them, and they will be well digested by a

Dosage of Fowler's Solution. Editor MEDICAL WORLD:-In your September issue you criticize sharply A. C. L's dosage of Fowler's solution. I have used it very largely in certain stomach troubles and rarely find a patient who can take more than one or two minims before meals without marked disturbance of the digestion. When used for gastritis, etc., I think you will find that small doses before meals are generally advised. Fowler's solution was perhaps not of much use in this case, but larger doses would have aggravated it. GEORGE H. RHOADS. Tobyhanna, Pa.

[We have seldom advocated the routine use of arsenic in gastritis or any other disease. Of all drugs, it is one that requires a nicety in discriminativ diagnosis as to therapeutic requirements. When actually indicated no other drug will meet the requirements; but if given when not indicated, one or two minims would be far too much. When it is given, the best effect is secured only by thoro saturation after tolerance is establisht. We would not often institute dosage with a ten minim dose, but we have frequently used much larger initial doses with benefit. We prefer to follow the old rut of a one minim dose in water before meals, and increase the dose one minim each day until we get the physiological effect, or ten minims are given; then we drop back to half the dosage and again ascend. We have never had an over-effect. We have always had good effects when our diagnosis was correct. It has never disturbed digestion when indicated. We have never seen a case which indicated arsenic, aggravated by our customary plan of dosage with Fowler's solution. Dear doctor, please study your arsenical indications over again with care, and then "roast" us till THE WORLD office smokes, if you then feel like it; this is the kind of communications that make THE WORLD unique. When you can furnish us with a condenst list of undoubtedly correctly diagnosed cases in which arsenic was indicated and failed in the dosage we commend, we will gladly publish it, with a full column apology to you. In the meantime THE WORLD needs men like you. Get to work on something original from your experience, and send it While we write editorials from

to us.

aid of a competent staff, we are not a windmill. THE WORLD belongs more to our subscribers than it does to us; you get all you can get out of us for a dollar a year, and we are spending our lives in trying to get all we can out of medical laziness for the benefit of humanity. Help us do good rather than tersely criticize.-ED.]

"Obscure Stomach Trouble."

Editor MEDICAL WORLD:-In re the case cited in September WORLD by Dr. O. R. Young on page 389, I would like to say his history is extremely vague, since he says nothing of patient's habits as to drink and smoking, whether jaundiced, condition of urine, and if any nervous symptoms. From vague history given. it would lead one to look for hepatic congestion, or chronic intestinal dyspepsia.

As for treatment, I think it will prove evident to the Doctor that dieting will be his best stronghold, avoiding the following: Strong soups, hot bread or biscuits, any kind of rich made dishes, fats, eggs, butter, tea, coffee, fish, cheese, pies, pastry, malt liquors and sweet wines. This may seem that patient would not be allowed anything, but once tried always tried.

Medicinal treatment: Fairchild's pepsin, spt. chloroform, cascara (P., D. & Co.) or calomel for the bowels. Cup of hot water with teaspoonful sodii bicarbonate

hour before breakfast. General tonics, with a combined preparation of Gray's glycerin tonic and Gude's pepto mangan. I make use of the following for such cases:

chance for all schools to show their differences. FRED P. LOWENSTEIN.

Westfield, Mass.

[The Editor wishes to heartily endorse the last paragraph of the above. He will gladly leave the answering of queries to the members of the profession, if they will grasp this opportunity to serve their brethren. Practitioners of different schools are always invited to reply to queries. Do not think that the Editor's reply is the " 'last word." Feel free to reply, whether he replies or not.—ED.]

[In continuing the homeopathic discussion, we have endeavored to select from the contributions offered, and cut down those selected, in order to avoid repetition as much as possible. The homeopaths are earnest and prolific; and it is not strange that many have offered the same facts and arguments. In each of the following articles admitted will be found something not offered before, with repetitions eliminated as far as possible. As we said last month, we do not expect to continue this discussion (nor any discussion) permanently, but we will do so as long as contributions are offered which contain any facts or arguments of value not previously presented in these pages. It is supposed that when a man subscribes for THE

MEDICAL WORLD, he does so with the hope of learning what he did not previously know. In order to learn, there must first be a willingness to learn from any source. Hence we admit whatever may seem of sufficient importance for consideration, not only from our own "school," but from any source whatever. We should strive to be as broad as truth, that "the truth may make us free "-ED.]

How to Easily Try Homeopathy. Editor MEDICAL WORLD:-In regard to the test case of pneumonia in the August number, my prescription is phosphorus. Why? Because phosphorus has produced, when given to healthy persons, great dyspnea, tightness across the chest, a dry, tight, hacking cough, and an expectoration similar to that described in this case, and experience has shown that it will remove these symptoms and restore

ease.

the patient to health, when they arise in the course of pneumonia or any other disIf this patient had received in the beginning a few doses of aconite, followed, perhaps, by bryonia alba, the disease would have been cut short; but at the stage given, phosphorus is the remedy. After it has done its work and produced resolution, sulfur will probably be needed to cause absorption of any remaining deposit. If it is needed, it will be indicated by the symptoms.

The potency question, which seems to be such a stumbling block to the investigation of homeopathy, to some members. of the profession, should be regarded as a secondary one. The homeopathic law on which the treatment is based, is that similars are cured by similars-it says nothing about potencies. The law is capable of being tested by the use of the lower potencies, from the third to the sixth, in which the presence of the drug is easily demonstrated. A safe potency to use is the third, in which the proportion of drug to menstruum is as 1:1000. This could hardly be caviled at in these days when every medical man acknowledges the antiseptic potency of solutions. bearing the ratio of 1: 2000 and even of 1:10,000.

If that seems too much attenuated, put five or ten drops of a good tincture in four ounces of water, shake well, and give teaspoonful doses. Results will be apparent if the remedy is selected according to the homeopathic indications. In practise, many good homeopaths confine themselves to potencies below the sixth or seventh; so it is entirely unnecessary for the brethren of the dominant school to tackle the thirtieth potency when they think of investigating homeopathy. It reminds one of a student attempting a proposition in higher mathematics before he has mastered the multiplication table.

To an honest, unprejudiced mind, no amount of ridicule will weigh against one positiv demonstration of curativ power at the bedside; and it was to this test that Hahnemann invited the medical profession. "Prove all things and hold fast that which is good."

Portland, Ore. W. I. HOWARD, M.D.

Dr. C. N. Dunn, of Centralia, Ill., wishes to recommend Farrington's Clinical Materia Medica for beginners in homeopathy. It can be gotten from Boericke & Tafel, Philadelphia.

A Homeopath Gives Hints as to "How They

do it."

Editor MEDICAL WORLD: When a physician of any other practise beholds our materia medica he is confused by its perusal, simply because he has not learned how to go about it. Many of our prominent remedies have from two thousand to forty-five hundred symptoms. The beginner will say, "how am I to know which remedy is indicated where the same symptoms occur under so many different remedies? We answer by showing that only a limited number of symptoms of each remedy go to to make up what we call the "picture of the remedy."

The most important symptoms are those affecting the whole being; these we designate "generals;" and they include mental conditions. When we find a patient made ill by changes in temperature, storms, eating some article of food, etc., we class such symptoms as "generals," giving them precedence over the symptoms that affect only one part of the body. Should a patient present a fair, fat and jolly appearance, yet easy to cry about the veriest trifles, suffocating in a hot, close room, thirstless, gastric conditions intolerant of rich or greasy food, pains flying from one part of the body to another, symptoms changeable, all troubles worse after 4 p. m., and all made more comfortable by walking slowly in the open air. I would give pulsatilla regardless of how I named the complaint.

The next case may be one of chills and fever. Internal heat with external chill, drinking cold water during the chill causes vomiting, while thirst is for little and often during fever; extreme restlessness but no relief from motion; much prostration, yet wants to go from one bed to another arsenicum will cure.

Another case of chills: Trouble developt by getting wet while overheated. This patient has quotidian chill; wants large quantities of water during chill; during fever continual motion, which relieves aching; but as soon as quiet, pains return; triangular red tip to a coated tongue. Rhus tox. will speedily restore to health.

There are countless other valuable symptoms to be considered under these remedies, but this illustrates how we make rapid prescriptions if we know our remedies. A good prescriber can keep this work up all day and give the proper remedy every time, provided the patients all

give true answers to his questions. When results are not what we expected we may ascribe it to failure in getting the patient's whole and true condition. Here is where tact must accompany knowledge.

I suggest that all who desire to investigate our methods of practise place themselves in correspondence with some of the contributors to THE WORLD who believe in the law, and in potencies. Then they will not be stranded on middle ground. Austin, Texas. W. D. GORTON, M.D.

Explanation of "Potency."

Editor MEDICAL WORLD:-In the last number of THE MEDICAL WORLD there are several articles by correspondents, also editorial comments, discussing the socalled homeopathic dilutions. After reading them I cannot but express my astonishment at the unpardonable error, for any homeopathic physician at least, to fall into. into. By so thoughtlessly making use of the words dilution and potency as if they were one and the same thing, or as if they were interchangeable terms, or simply a difference without a distinction. By so using them it is exceedingly misleading, and has a tendency to keep our branch of the school of medicin in a false light. Webster defines the word potency to mean power, energy, efficacy, which, when applied to our medicins, is superlatively correct. Therefor it will be seen that potency is something more than dilution, which, according to the same authority, is weak, thin, reduced in strength, etc. Now what homeopathic physician ever thinks of using a potency in that sense in his practise? I trow none. Why, then, use a term that must of necessity prove so misleading, particularly to those who have not given the subject a logical consideration? and give to those "whose ignorance is bliss" an opportunity to shoot their darts of ridicule? But the question will naturally arise in the minds of the uninitiated, how convert a dilution into a potency? Are not all potencies prepared by diluting certain quantities of what is known as mother tinctures with certain quantities of alcohol, either pure or diluted? True, we answer in the affirmativ. That is the starting point in the preparation of the remedies, and then the potentization and the developing of the latent dynamics, or the liberating of the medicinal force from the crude material, is accomplisht by vigorous succussion; or if