Considering the facts that, in this case, had destroyed one eye, and, in the same protracted and persistent manner afflicted the other eye with a steadily increasing impairment of vision, it is only proper to say that "wondrous kind nature" does not deserve a large share of credit in the cure of this case, neither was potassium iodid the only sure thing.

Chicago, Ill. ERNEST CADWELL, M.D.

Dr. E. Erskine, of Rogers City, Mich., in a communication concerning pneumonia, says; "The disease not being a curable one, all we can do is to carefully guide our patient thru the storm of sickness, and assist him to enter the Harbor of Health."

Dr. E. Spencer, of Bel Alton, Md., writes that in his treatment of the "test case" given on page 449, October issue, he had the crisis distinctly in mind; and tho he did not mention it, he thought it was plainly implied. Also, that he wrote thinking that the pleural pain continued to exist on the seventh day, but as it is not given in the condition existing on the seventh day, the local applications recommended by him are not necessary, and the iodid of ammon., intended for the pleura, is not necessary.

Dr. Kendrick's Test Cases.

See October WORLD, page 412, for these test cases. The compositor there misspelled the Doctor's name, making it Kindrick instead of Kendrick.

In Dr. Chapman's case, we gave the homeopathic replies the precedence. Now, for equal "fair play," we give replies from "regulars" the precedence.

Editor MEDICAL WORLD:-The most direct route to arrest those paroxysms in Dr. Kendrick's cases is quinin, not 3x nor 200x, but quinin, preceded by a thoro calomel purge, and promptly pusht to cinchonism regardless of the quantity it takes, whether 15 grs. or 115 grs.

The "keynote" to these cases is the periodic chill, fever and sweat, and the cause is malarial infection; and it has been "proved" on tens of thousands of persons that quinin will arrest these paroxysms promptly if pusht to the limit.

This heroic treatment may not be scientific, for we were taught by our dear old Prof. that a dose of quinin greater than 3 grs. was unscientific; but experience has taught us that if we can produce cinchonism in the patient before the time of expected paroxysm, it will invariably fail

ment.

Wisner, Neb.

Diet: Milk diluted with equal parts of lime water should be allowed after vomiting ceases, and given in small quantities; but milk increast and lime water diminisht. If our patient does not develop typhoid symptoms, he will be convalescent within a week.

I am a young member of the WORLD family, and not much older professionally; and naturally I felt backward in prescribing for Dr. S. C. Chapman's case. However it did not seem a fair test. I left it to my elder brethren, and am somewhat surprised at the irregularity shown in their treatment. It seems to me that I would have given a hypodermic of of strych. sulf. repeating every two hours, and anx

iously watching and waiting (if possible) for the crisis, which is very near at hand as shown by the symptoms.

I enjoy THE WORLD very much, and think it the best and most instructiv medical journal that finds its way to my desk. O. C. HOPPER, M.D.

Scribner, Neb.

Editor MEDICAL WORLD:-On page 412, Dr. Kendrick, of Mississippi, gives us two hypothetical cases to treat. As one of the "allopath persuasion," I venture to prescribe as follows: For case No. 1: As this man is not vomiting, I would prescribe, as the fever subsides a tablet composed of calomel gr., ipecac gr., soda bicarb. 1 gr., also quinin gr. 5, every two hours, until I got the physiological effect of the quinin. I would continue tablet until I gave him 14 if they did not act too freely on bowels before he took them all. In connection with the foregoing, I would make a solution as follows: 24 granules of each of the following kinds: strychnin arseniate gr. 1-134, nitro glycerin (1 drop of one per cent. sol.), atropin sulf, gr. 1-250, aconitin gr. 1-134, dissolved in 24 teaspoonfuls of water. Give a teaspoonful every thirty minutes until the physiological effects of strychnin and atropin is obtained; then give just often enuf to keep up that effect. After two or three days treatment as stated I would put him on a tonic of iron, quinin and strychnin until well.

For case 2: I would give this man morphin sulf. gr. hypodermically; mustard over liver and stomach, keeping surface red for twenty-four hours. After vomiting is arrested, I would give calomel tablets same as in case 1, but give them every hour, until 14 are taken. I would give quinin 5 grs. every two hours, until full effect, then lengthen time of giving. I would give in connection with quinin, the sol. strych, nitro glycerin and atropin as prescribed in case 1. I would have this man's back rubbed with a liniment of chloroform, ammonia, spts. nitre dulc., oil sassafras, etc., and keep it red for twenty-four hours. W. H. NEEL, M.D.

Mayfield, Kan.

Editor MEDICAL WORLD:-I would treat Dr. Kendrick's first case as follows: One Kenyon hepatic tablet every three hours until liver and bowels are activ: four grains quinin sulf, every four hours:

Editor MEDICAL WORLD:-With pleasure I respond to the challenge of Dr. C. Kendrick. For Case 1 I prescribe chininum sulf. (quinin!) for the following reasons: 1. Chill occurring daily at 10 a. m. 2. Chill succeeded by very high temperature, followed by profuse perspiration.

3. Notwithstanding these severe manifestations of constitutional disturbance, the general health of the patient remains unimpaired, he eats well, goes squirrel hunting, etc.

It is quite probable that a dose of a high potency of chininum will cut these chills off at once, and the cure will be permanent. On the other hand, if repeated doses of the crude drug be administered, the disease frequently is but supprest, and the chills will either recur, or will produce chronic conditions which are absolutely incurable until the malarial miasm be eradicated. This is so much the case that in the treatment of chronic disease, if I find a history of malaria that has been treated by crude doses of quinin, I pre

scribe with reference to that fact-often with most satisfactory results. So much for Case 1.

As to Case 2: "Will you walk into my parlor? said the spider to the fly." The fly was all right until he entered the parlor. Homeopathy is ditto until it enters the guessing field. Case 2 is a dangerously sick man, and will die unless the right thing is done immediately. Dr. Kendrick has not given data upon which to base a scientific prescription from our standpoint. Homeopathy is a science, just as exact as mathematics when the factors of the problem are obtainable. Now Dr. Kendrick propounds about thus:

Homeopaths, how much is twice x ? "Two x," we reply.

"But how much does it represent in dollars and cents? "

"Let us know what x stands for and

we will tell you," is the reply of all homeopaths who know their business. In other words, we cannot prescribe for case 2 without knowing the symptoms, modalities, etc., in minutest detail.

The Editor pronounces Dr. Kendrick's cases much fairer than the one I offered. So they may be from the old school standpoint; but not so from the homeopathic. In my case one essential point has been overlookt by a number of the old school correspondents. They assume that my case might recover without medical aid, or upon purely expectant treatment. Such is not the case. The general condition of the man, and particularly the character of the sputum, makes such hypothesis untenable. The batter-like sputum, gentlemen, indicates disintegration, the scales are strongly tipped toward the side of death, and without potentiated phosphorus his chances to live are nil! I make this ex cathedra statement because I treated many hundreds of cases of pneumonia in the mountains of California' and know what I am talking about.

In conclusion, I do not doubt that Dr. Kendrick will induce many homeopaths to enter his little "parlor," and I only hope that he will detain them so that homeopathy may see and know them more forever. S. E. CHAPMAN, M.D.

3838 Vincennes Avenue, Chicago, Ills.

Editor MEDICAL WORLD:-For Dr. Kendrick's case of chill at 10 a. m.,I would suggest natrum mur. 30 (Boericke's Tafel). Tablet at bed hour, dry. Not to be repeated while improvement continues; stop all other remedies, give this and this only. The symptoms of this case are not as complete as desirable; hence if not successful, give them more minutely.

His second case is somewhat obscure, but I believe he will find ipecac 30. the remedy; same dose and direction.

If a "Doctor's Daughter" will take kali bich. 30, a dose and not repeat while relief lasts, she will find her catarrh benefited or cured. Other remedies may be necessary to follow-as aurum cev. Let's hear from the case again.

THE WORLD is all right. All honor to the man who values truth above faction. The flower's divine where'er it grows: On Christian or on heathen ground. EDWARD T. BALCH, M.D.

Santa Barbara, Cal.

Editor MEDICAL WORLD:-Dr. Kendrick's test case is seriously in need of some one bright enuf to stop his daily trips to the swamp, and removal from infection of plasmodium malariae, which is the probable cause of his trouble. This together with natrum muriaticum 6x would probably terminate what would otherwise be a prolonged case. A homeopath would see many more symptoms than those given, to indicate a remedy.

Richmond, Ind. T. H. DUNHAM, M.D.

Editor MEDICAL WORLD:-I have enjoyed reading the treatment of Dr. Chapman's test case very much indeed; but I shall enjoy more reading the treatment of Dr. Kendrick's cases. Like you, I think this test a much fairer one. Give Dr. Kendrick's case No. 1. natrum muriaticum, 6x, 3 tablets every hour until relieved. The chill will fail to appear on the second day. Have recently had two very similar cases in which this treatment was used with marvelous results.

Give case. No. 2. arsenicum alb., 3x, 4 tablets every hour until better, then every two hours. C. E. SMOOт, M.D. Richmond, Ky.

Editor MEDICAL WORLD:-For Dr. Kendrick's test case No. 1 I should refuse to prescribe if it were possible to see the case and learn more of the symptoms. If I could not learn more, I should explain the liability to err on account of meager report, but do the best I could by sending him natrum muriaticum. As to dose, I have heard of certain Colonists in a malarial district curing themselves with spoonful doses of scorcht salt. I do not doubt its action, but would prefer a potency, say the 200th.

Now what's the matter with this report? Here are symptoms enuf for a diagnosis; perhaps that's all a "regular" wants; but we homeopaths can't take life so easy. Chill, fever, sweat, coated tongue; I trow they mostly all have these, but what is there distinctiv about this case? The hour 10 a. m., the regularity of stages, and some of the tongue symptoms are good as far as they go, but we want more; and, Mr. Editor, we wouldn't even be satisfied with some single "key-note" symptom as you suggest. We want notes enuf to sound a chord, if not to play a tune. the report stands, you might change the key by the addition of two or three notes

As

in relation to thirst, the effect of drinking, or of heat or cold, or other aggravation or amelioration. In each stage he either has thirst or he hasn't; and either fact might be a chord note, depending of course upon the other notes which must chord with it. Look at Dr. H. C. Allen's work on intermittent fever. Notice how carefully the symptoms are delineated under each heading: Prodome, chill, heat, sweat apyrexia; also type, time, aggravation and amelioration. Here you get an idea of what a symptom picture we require; and surely, if we can use all these symptoms, we have a right to know them even tho they may be meaningless to a "regular."

And believe me, a remedy thus carefully selected will cure either case the Doctor gives (the latter case demands careful bedside study), and cure in the smallest doses. The only cases that won't yield promptly to the right remedy are those which by the assistance or teaching of you other fellows," are full of quinin, blue mass, Fowler's solution, etc., etc., which may have supprest the shake, but in no sense cured the disease. Here you have spoiled the symptom picture and added drug diseases to the natural. Pardon me, but it is true.

66

Union, Ore. A. W. VINCENT, M.D.

Editor MEDICAL WORLD:-A clearer description of these cases would enable much more accurate prescribing. No doubt there are symptoms in each patient not given. Case No. 1 "has had good health for a year past." What was his condition previous to that? Is he one of the chronic recurrent ague cases? Has he headache with the attack? and does it increase in intensity with the fever and sweat? Would like also to know something about the thirst. However, as it is not possible always to obtain all we want in regard to symptoms, we must do the best we know how with symptoms given. For case No. 1, I suggest natrum muriaticum, 30x potency, 10 drops in glass of water. After fever has abated, give a teaspoonful of this every hour. Or, if he is "going squirrel hunting," medicate a two drachm vial of disks No. 6; that is, pour into the vial filled with disks enuf of the 30x dilution to thoroly saturate the disks, and instruct patient to take two disks every hour; chew them up, not swallow whole. Case No. 2: Give arsenicum alb.,

(An

Editor MEDICAL WORLD :- On page 412 of October WORLD, Dr. C. Kendrick asks treatment for another "test case." You think it is a much fairer test than Dr. Chapman's. I beg to differ from you, so much so that for the present I hesitate to prescribe for it. Dr. C. gave us sufficient symptoms to enable us to select a remedy, even should he have left off the characteristic sputum spatters when ejected" -even should he distinctly say that the patient has not that kind of sputa. swer to the Editor's query September WORLD page 384 and October WORLD 412.) Dr. K. does not give enuf. Suppose A. should ask me to tell him which two figures he has in his mind, of which the sum amounts to 25. I could tell him it is 1+24, or 2+23, or 3+22, etc., (12 different combinations, no more); but I could not tell him just which pair he has in his mind. Should I make a guess and hit the right answer, that would be by accident. I could not repeat the experiment. Just so with a homeopathic prescription. If we have not sufficient symptoms, we may prescribe or try one of several indicated remedies, but are not sure of the right one, until we have obtained additional symptoms (compare October WORLD page 432). So, in Dr. Kendrick's case we would ask for the following information : Where does the chill commence? head, feet, extremities, etc.; progressing downward or upward? Is thirst present or absent in each of the stages? If present, does patient drink little at a time and often, or large quantities? Is there any headache? If so, describe it. Are there

ringing or noises in the ears? Is patient drowsy? sleepy? or restless and moving all the time? Any trouble in breathing? During the heat, does the patient desire to be well covered (notwithstanding the heat)? or does he throw the covering off? Is the sweat general? only on some parts of the body? Are there any particular pains in any part of the body before the fever comes on? Are the lips or nails blue during the chill? Is the face red? or pale? Are the teeth chattering? etc. Besides, we want to know what is the condition during the anorexia. No complaint whatsoever? or else, what? Has the patient had a previous attack? If so, when? and what remedies were given? The answers to these questions can easily be obtained. Trivial as they may appear to the (socalled) "regular" physician, they are of great importance to the homeopathic prescriber.

Another difficulty in the case is this: The Doctor wants his case cured in twentyfour or forty-eight hours. We doubt that anybody, of any school or mode of treatment, can accomplish this. We can suppress the fever within that time, by giving large doses of quinin, but not cure it. If supprest, the fever will return within two to four weeks, more violent than ever before, and then it is much harder to manage. (The writer has had a sad experience in this regard.) Suppressing or arresting the fever is, however, no cure. A well selected homeopathic remedy may cure it within forty-eight hours, but this happens only in exceptional cases. In most cases homeopathic treatment will not stop the paroxysms at once; they will become gradually less violent, until they disappear altogether. Meanwhile, the patient's system will have been brought into a healthy condition, and, when the paroxysms stop, there will be less fear of a return. This is another reason why the test is not a fair one. We are called upon to do the impossible, which Dr. K. himself could not do. Arrest of the fever is no cure, and homeopathic treatment is never meant to suppress any disease or discharge. In regard to the second case, we fail to see the great danger, should a third paroxysm come on. The man was previously in good health, has a slight attack, eats a hearty meal at night; and at 10 a. m. next morning has a severe chill, etc. He is delirious; (that happens often when patients have weak brains, so that the poison attacks

that weak point). Perhaps this is the cause of the vomiting, too, for his stomach was previously in good condition. Might not his hearty meal of the preceding evening, soon after the fever, have something to do with it? Might not indigestion have hastened the second paroxysm? At any rate, there is not a single symptom of pernicious fever. It is a simple intermittent with some concomitant symptoms, and is to be treated on the plan as the first case after a thoro examination. To prevent within a few hours the coming of another paroxysm cannot be done, unless by giving large doses of quinin to suppress the fever.

Dr. Chapman did not ask how to cure his patient within twenty-four hours; he only askt what to prescribe under these conditions to see if we were uniform in our opinions. If Dr. Kendrick would give an answer upon the questions mentioned above, and then ask what would be our prescription to start with in such a case, we would be enabled and willing to answer. J. LOPES CARDOZA, M.D.

Brooklyn, N. Y.

Editor MEDICAL WORLD:-Probably you will find no homeopath to agree that the cases cited by Dr. Kendrick in October MEDICAL WORLD are fairer than those offered by Dr. Chapman as a test case. If the latter was insufficiently reported to give a fair image of the patient, those in the October WORLD are ten times more inadequate in symptoms. Probably most homeopaths would decline to prescribe for either of the malaria cases unless a fuller report of symptoms were available. first case, according to symptoms stated, might need carbo veg., chin., eup. perf., gels. nat. mur., phos., puls., rhus or sepia. From the statement that the patient goes out after a few hours (probably about 4 p. m.), one might hazard natrum mur. to be the remedy; but would seek first for further coroboration in symptoms before prescribing.

The

One would scarcely dare even hazard for the second case, with no further knowledge than what is stated. All the more because the patient is desperately ill must the physician be sure to administer the right remedy, for he may not have a chance to correct mistakes. There are other symptoms present which have been unnoticed, or at least unnoted. It is precisely such details of differentiation that makes it impossible or difficult for the