tioners in the State are entitled to membership in them and a full participation of all their legal duties and powers, and this without regard to the schools of medicine to which they may belong or to the theoretical principles upon which they may ostensibly base their methods of practice. Prior to that time a physician might be expelled from membership in any of our medical organizations for the violation of any rule of purely professional ethics. Since that time membership in our medical organizations is controlled by the medical laws of the State before which laws all systems and schools of practice are equally legal and reputable. These far reaching and radical changes in the relations existing between practitioners of medicine and the laws of the State suggest, and even render necessary, a more liberal construction than has heretofore obtained of the established ethical rules in regard to professional consultations. In Alabama there are now two of these rules, viz: (1) The well known rule in the ethics of the American Medical Association; Section 1 of Article 4, which may be found on page 214 of the Book of Rules; and, (2) The special rule of the Medical Association of the State of Alabama, which is numbered five (5) on page 222 of the Book of Rules. The rule of the Code of Ethics of the American Medical Association is in the following words: "A regular medical education furnishes the only presumptive evidence of professional abilities and acquirements, and ought to be the only acknowledged right of an individual to the exercise and hon ors of his profession. Nevertheless, as in consultations the good of the patient is the sole object in view, and as this is often dependent on personal confidence, no intelligent regular practitioner who has a license to practice from some medical board of known and acknowledged respectability, recognized by this Association, and who is in good moral and professional standing in the place in which he resides, should be fastidiously excluded from fellowship, or his aid refused in consultation, when it is requested by the patient. But no one can be considered as a regular practitioner or a fit associate in consultation whose practice is based on an exclusive dogma to the rejection of the accumulated experience of the profession, and of the aids actually furnished by anatomy, physiology, pathology and organic chemistry." On the construction of this rule some question might be raised as to the meaning of such desigations as "a regular medical education," and a "regular practitioner." There may be such a thing as "ethical irregularity;" but no such a thing as "legal irregularity;" and this distinction is nowhere made in the Code of Ethics, and for us in Alabama, it is practically settled by the law of the State that the principle of legal regularity has legal precedence and dominates all issues growing out of irregularities that are purely ethical. We have deliberately invoked the intervention of the State in the regulation of the practice of medicine, and it is incumbent on us to accept in good faith all the necessary consequences of that intervention. In the meantime it is fortunate for us that we can do this without violence to the letter or the spirit of the ethics. As to the additional qualifications of the rule under discussion, that, viz., which relates to "practice based on an exclusive dogma to the rejection of the accumulated experience of the profession, and of the aids actually furnished by anatomy, physsiology, pathology and organic chemistry," we are authorized to assume that it cannot be made a serious issue in Alabama; because with us no person is allowed to engage in the practice of medicine until his knowledge of the branches mentioned has been determined by written examination, and his fitness to practice vouched for by a board of medical examiners appointed by us, and conducting examinations under our supervision. It would present an example of singular inconsistency if we should through one of our medical boards certify to the people of the State that a certain physician was competent to practice medicine, and yet at the same time. take the position that he was not a fit person to be met in consultation. But, as we have said, we find no obstacle in the Code of Ethics of the American Medical Association that stands in the way of the policy in regard to consultations which we have ventured to suggest; and we may add that this is not a new policy in this State. Quite a number of Eclectic physicians have become members of our county societies, and have been for years freely admitted to all the privileges of consultations; and some of them have been members of our boards of medical examiners. Only one Homoeopath has ever applied for membership in any of our county societies, and he was admitted without hesitation. The special rule passed many years ago by the State Medical Association is as follows: "He-that is, a physician-should not. directly or indirectly extend any sort of professional service to patients under the care of Homœopathic or irregular practitioners, no such service or advice being allowable until the Homœopathic or irregular practitioner has been formally and permanently discharged from all further attendance upon the case; and all physicians under the ban of any local society should be treated in every way as irregulars." This is a rule of our own making, and there can be no question as to our authority to repeal it. We do not stop to discuss the wisdom and expedience of it at the time of its adoption. But it is clearly out of place under the existing conditions of medical law and medical organization in this State; and we respectfully submit for the consideration of all concerned the propriety of repealing it at the next session of the State Medical Association. With the repeal of this special rule of our own making, and with the plain and unstrained interpretation which we have given of the rule in reference to consultations of the American Medical Association the way will be opened for the complete harmony and co-operation of all physicians in this State, surely a consummation most devoutly to be wished. All of which is respectfully submitted. S. D. SEELYE, M. D., Committee. Unanimously adopted by the Medical and Surgical Society of Montgomery County, Ala., at its regular weekly meeting held March 7, 1891. R. J. BALDWIN, M. D., President. R. J. JORDAN, M. D., Secretary. Materia Medica. [Contributed to the SOUTHERN JOURNAL.] KALI CARBONICUM. BY J. T. KENT, M. D., PHILADELPHIA. THE constitutional condition of Kali carb, is so affected that the symptoms of the sickness are aggravated by every change of the weather; he takes cold after every exposure, even the slightest; is usually chilly, keeps about the fire to keep warm, bundles himself up warmly. All the symptoms are brought on or made worse by taking cold. I have often observed that a patient having a weak heart has this susceptibility to cold after, or aggravated by, every change of the weather. The symptoms are the outgrowth of a feeble circulation, or of a fatty heart. I do not know any remedy more likely to ward off heart failure than this one. If a patient recovering from an attack of pneumonia, toward the close has hot flushes, evidences of a weak heart, symptoms of heart failure after the "Grippe" result of vicious and inappropriate the Allopathic treatment, is always taking cold, has prostration, tendency to catarrh of the chest and nose, in such cases Kali carb. has often proved a valuable remedy. Where Nux vomica has been the acute remedy, especially in stomach and bladder difficulties, and has accomplished its mission and no longer helps, Kali carb. may come in as the chronic of Nux to complete the cure, and here it competes with Sulphur. A very striking feature of this medicine is its characteristic stitching, sticking pains, flying about in various parts, especially in the chest and heart like Pulsatilla and Bryonia. The constitution is unlike that of Pulsatilla. The Pulsatilla patient wants to be cool, the Kali carb. to be warm. Most of the Kali carb. symptoms are aggravated by cold. The stitching pains of Bryonia are worse in a warm room, those of Kali carb. are better in a warm room. Pains wandering like Pulsatilla, stitching like Bryonia. Constriction through the chest. Difficult breathing. Stitches through the heart. Many catarrhal symptoms. We have in Kali carb. all that can be found in scrofulous ophthalmia. The very worst forms of catarrh of nose; thick, copious, yellowish green mucous filling up the nose and posterior nares; crusty formations in the nose. Bronchitis, with copious, thick, yellowish green expectoration; continually taking cold keeps up this state of affairs, the catarrhal condition follows down the smaller tubes and capillaries and there is created a predisposition to phthisis. Miliary tubercle may come on. Great pallor, aggravated by the slightest draft and by washing. Washing the skin causes it to become covered all over with blotches, red, mottled purple spots. Ammonium carb. is the remedy generally required for the symptom, "every time he takes a bath his skin is covered all over with spots," Kali carb. has it strongly. The Kali carb. patient says he cannot take a bath without taking cold, no matter how cautious he is, nor how warm the room may be. There is a great deal of anxiety, especially when alone, is afraid something will happen to him; fear of death when alone. It is not a fear of being overpowered, for the presence of a child will allay it. The Arsenic. patient is afraid he will be injured, or that he will do himself harm if left alone; fears he will die. Many remedies have the dread of being alone, without the awful awe of soinething about to happen. Arsenicum, Phosphorus, Mezereum, Stramonium have it, probably the most prominently. The fear of death when alone is the most striking mental feature of Kali carb. Delirium in the night. Very easily frightened; starts when touched; noise is disagreeable; intolerance of the human voice; these show how oversensitive he is. "Alternating mood, at one time good and quiet, at another, excited and angry at a trifle, constantly in antagonism with her self; frequently hopeful, frequently despondent; frets about everything, peevish, impatient, contented with nothing." This is a clinical group containing largely the Kali carb. features. It has a great deal of vertigo. Headache about the eyes and temples. Severest forms of neuralgia, with stitching, tearing pains, associated with congested hot head, mostly from catarrhal conditions. Has no power to ward off the tendency to take cold. Pressure in forehead with photophobia. Stitches in forehead and temples, worse stooping, moving head, eyes or jaw; better raising head and from heat. Stitches into eyes and root of nose, with catarrh. Congestive and catarrhal headache, with dry, hard cough. Liability of head to take cold from a draught, after being heated, causing headache or toothache. Like Baryta carb. and Graphites, it has cured wens on the scalp. Hair falls out. Perspiration on head and forehead. If Kali carb. was only known for its eye symptoms, it would be a very valuable remedy. The vision often reflects its nervous condition. Eyes weak, dimness of vision, connected with symptoms of the genital organs; weak, dull after emissions, cannot see or use his ordinary glasses. Photophobia, following excitement of genital organs; under such circumstances there seems to be a gauze or fog before the eyes. Blood vessels of conjunctiva are engorged and the mucous membrane tumid, swollen; ulcers in spots, bleeding. Milk-white spots about the cornea. Little whitish, milk-white growths on the conjunctiva. Lids swollen, edges and canthi red. Caruncula red and swollen. The catarrh of the eyes is associated with catarrh of nose, There is a peculiar state common to a few remedies, but striking in Kali carb.; it is the extension of the catarrhal condition to the ears causing deafness. Pharynx fills up with tenacious, foul mucous, hawks it up and gags, coughs and gags. When the mucous is raised to pharynx it produces gagging. Another general feature running through this remedy is its time of aggravation. Mental symptoms, chest symptoms, stomach symptoms, cough, all worse between 2 and 3 a. m.; 3 a. m., aggravation; wakes at 3 a.m. with the symptoms. Puffy swelling between eyebrows and lids. Upper lip swollen. Swelling of lower jaw, with looseness of teeth and enlarged submaxillary glands. These It swellings are in keeping with its general state, it produces much cardiac weakness with edema of the extremities. Swelling of the feet with pitting on pressure. has the constriction of Cactus about the heart. You will notice in such low, debilitated constitutions a tendency to enlargement of glands. Parotids, especially the right, inflamed, swollen, hard. You will find under each region that has susceptibility to pain, the stitching, sticking pains. Headache with noises in ear after a cold drink, shows the aggravation from cold. Nose obstructed making breathing through nostrils impossible; better in open air, returns in warm room. Dry coryza. Coryza; thick yellowish discharge with great lassitude; purulent, fetid discharge from one nostril; yellow green or bloody mucus; sore crusty nostrils; complete closure of nostrils. This group corresponds to a bad case of catarrh. You will notice as a striking feature of a few remedies that have general aggrayation from cold air, amelioration of their coryzas in the open air. Kali carb. Nux vomica and Cyclamen are all cold patients. Cyclamen is furiously averse to open air, except when coryza comes on, which is relieved in open air. You will not find this in the books, it is purely clinical, but has been very often verified. The Allium Cepa coryza is always worse in a warm room, and better in open air. but so far as we know, it has not that freezing feeling in the open air in other conditions. The Kali carb. patient is always chilly at best, but the coryza is better in the open air. Swelling of face, especially over the eyes. It doesn't always follow that, because the Kali carb. patient is worse from sudden changes, or from cold air, he would be better from hot things. Some remedies have aggravation from cold and amelioration from warmth, but it is not so with Kali carb. Hot things, hot drinks, hot applications often make the pains worse and make the patient worse. Many pains are worse from either heat or cold. Toothache, stitching, tearing, aggravated by both heat and cold. Toothache, worse from chewing. Drawing toothache as soon as she gets into bed in the evening, not during the day. This shows aggravation from heat of bed and from lying down. Many of the symptoms are aggravated after lying down, many of its pains come on at night from lying. Dyspnea, cannot possibly lie down. It is somewhat whimsical in its modalities. The destructive process about the teeth goes on until they loosen and fall out. (Carbo vegetabilis.) ' With feeble circulation beginning in very early life, white patches form on the mucous membrane of the mouth breaking down into thrush. Sticking pain in pharynx, as if a fish bone was sticking in it, if he becomes cold. In old chronic catarrh, or in pharyngitis when riding in a cold wind, the cold air feels like a burning flame in phranyx, there is sticking like sticks, likely to be followed by headache, then neuralgia of face, eyes, scalp and head. Difficult swallowing, from partial paralysis of esophagus, food goes down slowly, spasmodic stricture, holds food for awhile, then allows it to go down; a drink of water sometimes helps. There are only two remedies that I can recall that "cannot swallow a single mouthful without a swallow of water." They are |