in practise.

Some of the details desired for a full comprehension of malaria cases are: The precise succession of stages: chill, fever, sweat and thirst. Heat with sweat, or without, followed by sweat? Desire to be covered, or uncovered during heat? What other symptoms during the heat? Chill: What precedes? What symptoms are present during? Sweat: General, or limited to special parts? Offensiv or not? Cold or warm? Occasioning relief or aggravation of symptoms, or making no difference? Thirst: For hot or cold; for much or little at a time? Other symptoms: During which stage? What symptoms during intervals of the paroxysms? Circumstances that modify (aggravate or ameliorate) the patient and his particular symptoms. If the case has already had drugs administered, account must also be made of how they have altered the case.

The above is written with no hope of proving anything in reference to the cases stated, but only to indicate how a homeopath individualizes every case of sickness, directing treatment to the patient in the sick state and not to the sickness by name, knowing that other patients with the same sickness (by name) may need other remedies, according to the individual type which they present. Six patients having malaria at the same time may require each a different remedy to cure the case, while in all the manifestation may be supprest by large doses of quinin, to break forth again in chills or some other form. Harrisburg, Pa. JULIA C. Loos, M.D.

Editor MEDICAL WORLD:-In the test case offered by Dr. C. Kendrick in your October number, he has failed (as all men fail who have not made a systematic study of drug symptomatology) to give the finer symptoms in the case. It is plainly seen that the first case is one of intermittent fever, that it is of the quotidian variety, and that it is not a very severe case. But what a homeopathic student would want would be the answers to questions like the following: Is the paroxysm pefectly or imperfectly developt? Does he have vertigo, headache, yawning, stretching and a general sense of discomfort before the chill? Do the chill and heat entermingle? Does he have urgent thirst? and a variety of other questions present themselves to a careful careful

For the first case I would give him the 1x quinin bisulfate in 2 grain doses every 2 hours; and from the experience I have had with this disease, the patient would not have a recurrence of the attack the next day. There is quite a difference in the different preparations of this drug. We live in a river valley here where the fever is prevalent at different times of the year, and I must say the homeopathic lx of quinin bisulfate prepared by Halsey Brothers, Chicago, has not failed me in a single instance.

The second case I would give pulsatilla 3x, from a ruf estimate of the case after reading the Doctor's description. But to take either case for a carefully prepared prescription from the description given by Dr. Kendrick is an utter impossibility from a homeopathic standpoint.

If the wife of either of these male patients he has given us to prescribe for would visit my office and be unable to give me more information than he has given, I would give the first 1x quinin bisulfate, and the second (a case of remittent fever) the pulsatilla. But I wish to say that back of these two remedies I hold eighteen more remedies, any one of which might have been used accurately if the case had been given correctly. Edgerton, O.

C. E. HOOVER, M.D.

Editor MEDICAL WORLD:-The remedy for the two cases cited by Dr. Kendrick is quinin. In the first case smaller doses will suffice than in the second. The cases are malarial and correspond to our provings of china sulfuricum. Potency is not homeopathy by any means.

CHAS. J. POLLARD, M.D.

Princeton, Ky.

Editor MEDICAL WORLD:— Case 2 of Dr. Kendrick's is tolerably well described, so that I think I might venture to prescribe for it, altho it is a dozen years since I have seen any cases of chills worthy the name, and never saw a case of "congestiv" chills. In selecting the remedy it will not help us to consider that it is quotidian, as there are at least 73 remedies for that type, while we need but one; but it is a characteristic of this case that it is anticipating; for which the repertory gives

us thirteen remedies. It is also of the "pernicious" kind-18 remèdies. "Intense heat with delirium," 19 remedies. Now, it is worthy of note that quinin is indicated by each of these symptoms, for it is a "similar," a "homeopathic," remedy, and strongly markt under one of these heads. Yet I do not believe it to be the similium, and consequently would not be likely to cure. It might suppress it and for awhile appear like a satisfactory cure; but it would most likely bob up again. The reason it is not indicated is that quinin does not appear under the heading" restlessness during heat," which is quite characteristic of this case; but we do find 35 remedies in the repertory having that indication in a greater or less degree. "Chill appearing at 2 p. m." is sometimes so prominent a feature as to be a leading indication, but quinin is not indicated by it, but 20 other remedies are.

The "vomiting" is not clearly defined, but apparently points to the remedy that I shall prescribe. Now, there are several remedies formed under several of these heads that have a fine reputation for curing "ague." Which shall it be? There is but one found under all the heads that we have considered, so the choice ought to be easy; and that is arsenicum; and that in a markt degree in almost every one. It also meets the other symptoms not characteristic; "scanty and high colored urin, constipation." If no important indications have been unreported, arsen. 6x or higher will promptly cure, given every two or three hours until better. I am much interested in such cases for the reason that Professor Younghusband told us that when it came to treating ague we would be obliged to give something more than "little pills," and his words ought to have great weight for he weighed 297 pounds. I did not like that dictum, but could not afford to be indiscreet, so for a number of years I treated my intermittents with quinin generally. That was many years ago, and we were not so well supplied with quick firing aids to a diagnosis of the remedy. The case that gave me the most fame was one who had been in bed three weeks under the treatment of an old school doctor. A few doses of my quinin put him upon his feet in a few days, and he sent me numerous cases of shakes. But alack! in spite of faith and quinin he continued to have chills at intervals for eighteen months, and one day came to see me

and in a weak, despairing voice said he had the chills. He lookt as if he had just arisen from his bed from typhoid fever, had constant headache, etc. Meanwhile I had been reading in my journal cases from practise related by the stricter wing of our school in which the superiority of the similar remedy was shown, and I had a copy of Douglas on Intermittents. So I lookt up his case and with some fears for the result I gave him a two dram vial of natrum mur. 6, with directions to take three drops in a teaspoonful of water every three hours. I saw nothing of him for six weeks, when he reported that it acted like magic, curing his headache immediately and the chills likewise. About three weeks after he had a return of the headache, but one dose cured it. This incident did considerable for my backbone, and after I had one patient go into a typhoid condition with the quinin treatment from which he never fully recovered, I procured Bornninghausen's Intermittent Fever and prescribed accordingly. I wish I might say that I invariably cured my cases homeopathically after that. But truth is what we are after-some of us-and so I am compelled to state that I had still to resort to quinin sometimes. I believe, however, that I had the best reputation in the county for curing ague. I certainly studied my cases well, and usually succeeded. I remember that one spring nux. vom. cured the adults, invariably, while the chills affecting young children as invariably were of the ipecac type. Later in the season the type changed,and other remedies were indicated. I remember two cases in one week that were just alike, and when I saw the first one I did not know what to prescribe. She had urticaria, besides ague. So I consulted H. C. Allen's Intermittent Fevers, and found the remedy to be elaterium. This I found in the drug store, made a potency to suit me, and cured both cases promptly. Many years ago I read a report of some experiments of an army surgeon with salt in intermittents. It was this: "It has some antiperiodic powers, but much inferior to quinin." To me this was rank nonsense. When nat. m. is indicated it will make a beautiful cure ; and when it is not indicated of course it will do nothing, and should not be given. Why not prescribe the remedy indicated? Now, it will not be very difficult to find homeopaths who have never given a dose of nat. m.; they can't believe in it.

Why? Because, bless you, they are made of the same kind of clay as other doubters are, allopathic, e. g. But you will find the sharp shooters giving it, and other remedies said to be inert, for the reason, good heavens, that they are indicated, and they produce results. I think somebody in THE WORLD was slandering carbo veg. Well, it is a remedy that I have seldom prescribed; but within a few months I have given it twice in potency with prompt results. Dr. Blank says when he can be convinced that a "part is greater than the whole" he will believe. Well, I have never seen him, and so won't bet, but I can convince some that small doses of quinin will have a better effect than ounce doses.

"Doctor, do you ever give a hypodermic?"

"Certainly; why?"

"Because you are a homeopath." "Well, that is a queer reason," "But you claim that your little pills are sufficient in all csaes. ""

Do we? I must beg to differ; they are efficient only when taken; and sometimes the patient insists on having an opiate, and if there is any reason under the sun why I may not give one I would be pleased to hear it.

"My, my; we have always claimed that it was hypocrisy for you to use anything not homeopathic."

Yes, I know; itis one thing to claim, and another to prove the claim. Being only men, and not possest of infinit knowledge, it must occasionally occur that we cannot do as we like; we find it difficult to select the remedy, or for some other reason we wish to employ means not homeopathic, but generally as a temporary expedient only. The better one knows his materia medica the less need of palliativs. Some of us use them but rarely, altho we have the same right to them that others have; and if you are just and fair you will no longer claim as aforesaid.

A. F. RANDALL, M.D.

Port Huron, Mich.

Homeopathic Reply to Queries. Editor MEDICAL WORLD:-Replying to your invitation to discuss Dr. Young's case of obscure stomach trouble (September, WORLD, page 389), I beg to suggest a remedy from a homeopathic standpoint. A practical demonstration of the efficacy of a drug in a bona fide case of sickness

will of course be far more convincing than any number of prescriptions for a hypothetical case. Seen thru homeopathic spectacles, this case seems to require kali bichromicum; and were I attending same, would unhesitatingly prescribe it and expect a speedy relief of all symptoms described by Dr. Young. Incidentally I wish to remark that Dr. Loope's case (page 394) seems to me to be typical of sanguinaria. Should either or both of these gentlemen desire to put the matter to a test, I will cheerfully forward the remedy in proper potency with directions. LESTER E. WALKER, M.D.

Norwich, Conn.

[We wish to say a word of commendation for this practical way of presenting homeopathic treatment. We have had about enuf theory and argument on both sides. Now is the time for practical work. We wish to emphasize the fact that our Quiz department is as freely open to our brethren of the homeopathic and other "irregular" schools, as to our own regular" brethren. Neither homeopaths nor "regulars" can be injured by earnest and honest efforts to help each other; and the same is true of eclectics, etc. We want with us those in all "schools" who are not afraid of inter-sectarian help. This may lead to a non séctarianism which will include the best in all sects. A practical way to get at this is for brethren of all sects to present their puzzling cases to this department, and brethren of all sects to offer help.-ED.]

Editor MEDICAL WORLD:-I would suggest that Dr. Cushman (on page 391) look out for heart lesions in his case of regurgitation of food. Would advise Dr. A. C. L., of Kentucky (page 393) to try aqua creasote in ounce doses just after meals. Be sure that it be prepared from best beechwood after U. S. P. Persist not for weeks, but months, and he will likely get good results. J. T. KIMSEY, M.D.

Bloomington, Mo.

Peculiar Form of "Vertigo." Editor MEDICAL WORLD:-Your mailing list will show that I have been for many years a reader of THE WORLD. I desire to present a few symptoms, asking for a diagnosis. I can't give many symptoms because very few are present. Patient: American, male, minister for forty years. Two years on retired list. Age 67 years,

9 months. Has always enjoyed good health; sick but little; always good appetite; digestion especially good. Could eat anything at all times and never suffer any ill effects therefrom. Bowels and kidneys very regular, and very responsiv to medication. Complexion clear and good always. Used to activ outdoor life. Ever a good sleeper. Twenty-five years since he had an attack which the present recalls. That was simply a sensation of falling while standing, such as caused him to ask a bystander to catch him. It past off in a few moments and was almost forgotten, and called vertigo. In 1889 he had a succession of attacks while lying down, which lasted for about a week. These attacks These attacks were more severe at first, and gradually grew less pronounced till in about a week they ceast. No further trouble till September 14, about one a. m., after having slept and rested well previous portion of night. Two days previously had suffered from an acute attack of dysentery, which was relieved and he was at work the day previous to attack. These first attacks never presented except while lying down and on turning from right to left. Never present while standing, nor sitting; nor upon lying down nor rising from recumbent position. Could not lie on right side. No effect on vision; none on mental faculties. As far as patient knows, he was well in other respects; appetite not diminisht. Sleep was good without an attempt to turn

over.

No difference in pupils; no numbness, no premonition. Some nausea at time of first attack, but only with more severe ones. Free use of bromids thought to give some relief. Recovery was prompt and complete without a return for twelve years. These attacks consisted of a sensation, or feeling, or impression that the bed was rapidly turning upside down, on top of him, nothing more nor less. Was so markt that patient would grasp the bed railing or mattress and hold on to it for some time. This sensation past off in a few moments and did not return unless he attempted to turn from right to left. He would involuntarily grasp the bed and could not release his grasp till sensation had past away. The sensation accompany. ing attacks on September 14, 1901, presented as said after a day's work as life insurance canvasser. He retired tolerably early and rested and slept well until one a. m., when he awoke and attempted to turn from right to left, when he felt as tho

the bed was suddenly turned bottomsideup, on top of him. Now it was twelve years since last attack. This was more severe, and was just as often repeated, as any attempt was made to turn or to rise, or if standing, to lie down again. It was frightful and very unpleasant, creating a sensation of impending dissolution, a constant anxiety and a foreboding of evil. These attacks are continuous till to day, twenty one days. They are lighter, and never present while sitting, standing or walking, but come on when lying down, or turning from right to left or on rising from recumbent position. Can't lie on right side. After he gets down on left side; sleeps well. They are very much lighter than at first, and somewhat changed. On rising the sensation of "just flopping over" is not so markt, but one of turning round; and any stationary object the eyes may rest upon waves up and down till he gets straight, then all is over till he lies down again. The sensation of everything turning upside down is now more markt on lying down than on arising.

No difference in pupils. Tongue I think pushes a little to right. Nothing else discoverable by me to aid in diagnosis. One to look at him would call him a well man and a hale and hearty one for his age-very grey. Arcus senilus not markt at all. Only other condition which gives any concern is weakness-easily fatigued. Would like to have pathology and diagnosis, and some suggestion as to what and where to read to enlighten one's self on group of symptoms.

W. H. LANCASTER, M.D.

Lockhart, Texas.

[Despite the fact that your patient does not complain of indigestion, we are certain that he has it at times of attacks. The diagnosis of vertigo is plain, but the treatment and pathology must necessarily, in the dearth of symptomatology, be more difficult. Vertigo being only a symptom and not a disease, is treated empirically or only successfull after learning they true cause, or by chance. It is often found in its severer forms in connection with vaso-motor disturbances or angio-neurosis. It is occasionally found in plethora and universal vascular engorgement conditional upon cardiac hypertrophy or endarteritis. It is occasionally noted in anemia and after hemorrhage, and idiopathically in debility from any cause. may be an aura of epilepsy, or occur from

It

disease or injury to the ear. It is a pretty constant symptom of intra-cranial disease, especially the inter-cerebellar aneurism. It is often found in combination with various gastric and intestinal functional disorders. It is treated empirically by bromids and nitro-glycerin. The possibility The possibility is that your patient may have been mistaken in regard to his former attacks being identical with this. It does not It does not appear that any definit information is given on this point. Better go over the patient again. We hope that we have suggested something. The gradual amelioration of the symptoms would be against the probability of any advancing organic disease.ED.]

Peculiar Condition Following Grip. Editor MEDICAL WORLD:-D. A., aged 49, 5 feet 7 inches in height, weight from 105 to 115 lbs. (family all lean), teacher by profession, has been always of weak, nervous organization, with weak and irregular heart action, but with no apparent organic trouble. Has always been unable to bear any great exertion. Had typhoid fever 45 years ago; has had no serious illness since. Has suffered from constipation for the past 10 years.

Last January had an attack of grip, brought on by letting his back become chilled thru. Had characteristic fever for seven days, then slowly recovered his usual health. Four weeks after the first attack, he let his back become chilled again and the grip came back. Recovered in three weeks, but a few days after he had, from the same cause, a second relapse. This was followed by marked debility; had night sweats for two months, and for the past three or four months he cannot bear to have the least breath of air blow upon his back, as it brings on a "spell." The sensitiv place on his back appears to be in the spine just above the lower points of the shoulder blades. The first symptom of his back being chilled is that his ears begin to ring louder and louder, until finally (unless the back is quickly warmed) it throws him into a fever; also this chilling of the back will cause a fermentation in stomach and bowels, causing them to become painful by the distention of the gas formed. These spells take place every night when he goes to bed. Sometimes it causes his head to burn so that he has to lie propt up in a chair for a couple of hours, when it will

pass off, and he will rest comfortably until the next night. He has the worst spells if he allows himself to perspire, then chill afterward; but he evades this by drying his person and changing his undershirt sometimes three or four times in a night. He has his back vigorously rubbed with a ruf towel while changing his undershirt, for he feels that a thoro chilling would produce very dangerous results.

The remedies that have been tried and proved worthless are as follows:-static electricity applied locally; and the following drugs: mercury, arsenic, strychnin, opiates, quinin, hyoscyamin and duboisin. The only thing that appeared to benefit was to use onions freely as an article of diet.

The spells are worse when the bowels are constipated. Beer appeared to relieve for awhile, but soon lost all its virtue. The curious part is that so slight a chill to the cord will cause the ears to ring so hard, and the stomach and bowels to swell up. There is no particular pain or feeling in the cord, only that the one spot is so sensitiv to cold.

The dozen doctors who have examined him give a dozen different kinds of diagnoses, tho all think it is thru the great sympathetic nerve the trouble comes, while I think the trouble lies directly in the sensitiv spot I have described.

Howard, Kan., R. V. PEARCE, M.D.

[Recovery of normal health and strength after grip is frequently very slow and tedious, with frequent "ups and downs" in spite of vigorous and various medication. The thing to do is to court nature, and give her plenty of time. Rest, both mental and physical, with proper hygienic environment, is essential. A generous dietary, with proper attention to the digestiv organs, is important. Sunshine and fresh air should be courted. With this as a basis, carefullly prescribed exercise and occasional medicins of the chalybeate and reconstructiv class, will perhaps help. For the above mentioned case, we would suggest a pad consisting of several thicknesses of flannel, to be worn constantly, day and night, over the sensitiv part of the back, and a similar one to be worn over the solar plexus. Vigorous rubbing of both these parts morning and evening, is also suggested-indeed dry rubbing of the entire body would be beneficial. And don't forget the advantage of the ingestion of plenty of pure water. Even under the