and over-exertion, or strain; the parts af- after vomiting.-Chironian fected feel sore and bruised. Ledum also affects the smaller joints by preference; it usually begins in the extremities and travels upward. The pains. are acute and tearing. Unlike Bryonia, there is not shiny swelling, but a tendancy to the promotion of nodosites. The pains are worse from the warmth of the bed. The patient does not want the covering on. The pains last till midnight, and the affected part becomes cold. In soreness of the feet from cold. Caulopylum also affects the small joints; particularly the phalangeal and metacarpal, and is suited to females. I have cured several cases, in females, of rheumatism of the finger joints, but have never had any result from it in males. It is especially indicated when there are accompanying uterine disorders. Calcarea carb.-For rheumatism caused by working in water, for gouty nodosites about the fingers; it usually has an offensive urine, in persons that are "fat, fair, and flabby." Kalmia is a valuable drug when the rheumatism or gout goes from the joints to the heart, and involves the chest and the shoulders; the pains in the heart are sharp, and take away the breath; like Ledum, the Kalmia rheumatism travels upward. In valvular deposits, Kalmia and Lithium carb, are our foremost drugs. Lithium carb. is indicated in a gouty diathesis, when there are recurring attacks of inflamation of the small joints, or about the heart. Rheumatic soreness about the heart. It affects the mucous membranes; they become dry and hard, and likewise the skin, especially in the region of the joints. There is erythema and itching at this point; the cardiac pains are relieved Practice. A CASE OF DYSENTERY. BY T. MARKS, M. D., SIPE SPRINGS, TEXAS. "STOP, Sam," said Mr. Pickwick, when they had got half across the first field. "What's the matter now?" said Wardle. "I won't suffer this harrow to be moved another step," said Mr. Pickwick, resolutely, "unless Winkle carries that gun of his in a different manner." "How am I to carry it?" said the wretched Winkle, "Carry it with the muzzle down," replied Mr. Pickwick. "It is so unsportsmanlike," reasoned Winkle. "I don't care if it is unsportsmanlike or not," replied Mr. Pickwick, "I am not going to be shot in a wheelbarrow for the sake of appearances to please anybody." It is something after Mr. Pickwick's style of argument that our patients assume when first they place themselves under Homœopathic treatment. A case in point has recently come under my notice which required the utmost tact to overcome. The family had never known any other treatment but the old school, and they looked with suspicion and distrust on any other mode of medication. I was called on the 24th ultimo, to see a child, aged 2 years, the son of Mr. W. His mother informed me that he was having frequent stools of a watery character, with seemingly great pain, with what she called "gobs of brown stuff." That he had been running off at his bowels for a week past, with more or less fever all the time. She said she had treated him with "blackberry brandy and quinine," but in spite of it he got worse. I examined the child and found him very tender. Temperature 103 and pulse 110, very frequent and small; cold skin, collapsed abdomen and a cold, sticky perspiration. My prescription was Arsenicum 3x, 1 glo. after every other action of the bowels. On the 25th I called again and was supprised to find the case no better, if not worse. On inquiry I found that on my departure some lady friend had called in to see the family and advised to give it some turpentine- as it had cured one of her children and the other doctors always prescribed it; they consequently left off Arsenicum and dosed the poor creature to their hearts content, and left it in the state I found it. On remonstrating with the mother she said that she could not think that a little sugar could do any good, and would not I give it some stronger medicine. This was a poser for mebut as I had no idea of giving it up, I told her that although the sugar (as she called it), if let alone, would have done its work, yet I would not stand on any points of dignity in such a case, but would do the best I could to cure it her way. This proposition she agreed to, and I set to work. First of all I made her promise me that she would not interfere with the medicine without first letting me know, and then taking up my case, I requested to be furnished with a glass of rain water, and dropped into it 1 gr. of Permanganale of Potash. This I reduced down to about one third and gave it to the chap to drink. I then left six pow ders of Mercurius cor. 3, to be taken every three hours, and called again on 27th, when I found the child almost well; another lot of the Mercurins cor. powders finishing the cure. Now, what I want to know is, did I do right in exhibiting Permanganate of Potash? I can find no provings of it in my materia medica, but knowing its chemical effects, or rather medical effects, I used it as an accessory measure to purify the intestines previous to my exhibiting the Mercurius cor. 3. There is one thing certain, it gave confidence to the mother, and she has ever since, when I have talked to her about it, given the credit of the cure to the K, Mn, Og. VERIFICATIONS. LYCOPODIUM 1400, SILICEA 73,000, FERRUM 1400... BY M. A. A. WOLFF, M. D., GAINESVILLE, TEXAS. OCTOBER 9, 1890. Mr. E. H. (in the beer business) had come home from Dallas where he keeps office on account of his ailment. Symptoms given and observed: Griping in abdomen; yellowish diarrhea; no appetite; loathing of his main drink. coffee; headache in vertex; dirty tongue; foul breath; dejection of spirits; cannot sleep; feverish; abdomen sensitive to touch. He was too stubborn to give more particular symptoms, and called the blank I gave him to study in his home and answer a "humbug." I prescribed as well as I knew. On October 9th, 10th and 11th, he returned feeling very little better, but "getting weaker all the time." As it was raining hard on the 12th he could not come, but sent his son for medicine, stating that it was all the same with him. On the 14th I was called to his house and found him in bed, worse only as far as his weakness. He had till then received Gelsemium, Nux vomica, Ferrum phos., Sulphur, Magnesium phos., in potencies. between CM and 200. I now gave Kali phos. in water, but as everything went but slowly, but without aggravation, I decided to study the case up, taking as foundation the only symptom which seemed to be most on his mind, i. e. aversion to coffee. Lippe has seventeen remedies for this symptom, and after having marked them out on my analysis sheet I looked each up in the materia medica for the rest of known and observed symptoms. Lycopodium took the highest vote. On the 16th, at morning, I gave him one dose of the 1400th on the tongue and placebo in water. Next day he was up; "I am now all right." Nevertheless I called again on the 18th, but he was getting along finely, so this ended the treatment so far. On December 18th I met him in the street and he wanted me to give him something for emergency as he was going to leave January 1st. He was now very communicative and stated that he bad on waking up in the morning a sensation in soles of feet as if they were swollen. Stool: usually two soft ones a day, one before breakfast and one at 2, 3 or 4 p. m. Has then a griping pain in lower abdomen, which drives him to hurry, sometimes the same symptoms before urination. Immediate relief after satisfying nature's craving. When sitting awhile, reading or writing, legs go "to sleep." Breath very offensive in morning till he has washed off the slime covering his teeth. In hot weather he has what he calls prickly heat, but which he describes as an excoriation of the skin or lower part of the body. When crossed has to restrain himself from doing violence: "I could grab the fellow by the throat and strangle him." Silicea 73,000 cured. FERRUM PHOS. 1400. Mrs. C. D. J., whose very complicated case was reported in the Homœopathic Physician of January and March, 1890, has since then had but three prescriptions. She always gives a very elaborate statement of her case when suffering, and consequently one dose of the indicated remedy, high, cures her. Some time ago she came to get some Vaccininum for her children, when she stated confidentially that she should like to have something to make her have "some feelings" when cohabiting. Her second husband is a fine built man in every respect, and is "always very nice" the way he treats her, but she has "to pretend to pleasure" or else he might not satisfy himself. Gave Ferrum 1400, a few powders, one a week. Yesterday I received the statement that it did what was wanted. times he had been treated by dilatation and each time supposed to have been cured; that he had recently been under treatment, his physician having passed a No. 12 English catheter into the bladder. Upon attempting to introduce a catheter, I found that the smallest instrument could not be passed; I tried for half an hour to insinuate a fiiliform bougie through the constriction, thinking that if I could do so, to use it as a guide for the passage of a tunneled catheter. All my efforts were ineffectual and I was forced to temporizing measures for the night. The accumulated urine, about six ounces, was withdrawn by means of the aspirator. The next morning, assisted by Drs. Neal, Hughes and Burns, I anesthetized the patient, and placed him upon the table in the lithotomy posture; after a prolonged effort I succeeded in introducing a filiform bougie into the bladder. Using this as a guide, I passed a grooved sound through the first stricture at the perineo-scrotal angle; half an inch further down its beak encountered another, through which I could not force it, the instrument finally making a false passage to the right, doubling the bougie upon itself and dragging it out of the urethral track. I was now practically without a guide, but I cut down upon the first obstruction, at the inferior scrotal junction and then proceeded to pick my way by aid of a small director along the callous tract. The task was a tedious one, but patience was finally rewarded by a gush of urine announcing the fact that the bladder had been reached. A mass of cicatricial tissue, through which passed a small tortuous opening, replaced the natural channel from the perineoscrotal junction to the membranous urethra. With forceps and scissors I dissected this away, leaving only soft healthy structures. I now dilated the membranous urethra, which was much contracted, into the bladder. No prostatic obstruction or stone being found I next directed my attention to the anterior urethra; the meatus was incised and a stricture two inches deep divided up to 34 F. I could now easily pass a 32 F. sound in to the viscus. The upper portion of the wound was closed with catgut sutures, leaving an opening at the lower angle one and one-quarter inches in length. The patient rallied promptly, but required the fourth of a grain of Morphia hypodermically to allay the vesical irritation. He slept well that night and did not experience discomfort. The passage was kept patulous by use of the sound, which was passed every two days for the first two weeks then every third or fourth day. The patient rapidly gained in flesh and strength and is now feeling quite well, and can readily pass a 32 F. sound into the bladder. This was the most extensive stricture it has ever been my lot to treat. Almost the entire urethral structure was replaced by an indurated mass, much of which was dissected away. There evidently had been no instrument passed into the bladder for months; his physicians were either ignorant or had been playing a hocus pocus game upon him. frequent and the act accompanied by smarting and burning sensations. Examination with the urethro-meter showed the normal urethral calibre to be 36 F., with a slightly strictured condition just back of the fossa. With the meatotome I divided the contraction and incised the meatus, bringing it up to the normal urethral calibre. All medication and washes were discontinued and the passage kept open by the daily use of a No. 36 Weiss's straight sound, care being used not to introduce it beyond the seat of the traumatic lesion. Within three weeks the parts had entirely healed and the discharge ceased and did not return. A narrowed meatus and the use of injections are frequently the cause of the continuance of sub-acute and chronic gonorrhea, and it only requires the removal of the one and the discontinuance of the other to insure a speedy recovery. CASE IV. February 4, Mr. P-, aet. 25, consulted me on account of stricture of the urethra. He had been twice operated upon but failed to get the desired relief. Upon examination with the urethrometer I found the normal urethral calibre to be 38 F. Three inches back was a stricture of large calibre, measuring 30 F., the size of the meatus. I injected half a drachm of four per cent. solution of Cocaine, which I allowed to remain for six minutes, then with the meatotome, I incised the meatus bringing it up to the normal standard. I then introduced an Otis urethrometer until the knife pointing upward rested well beyond the stricture, I then turned the screw until it registered 38, putting the stricture well upon the stretch, firmly holding the instrument in position; the blade was withdrawn so as to cut through the entire length of the stricture, dividing every constricting fibre, The blades were then slightly approximated by a reversed action of the screw and the instrument withdrawn. It is not best to let the blades entirely down as they are liable to catch and tear the mucous membrane, thus increasing the tendency to contraction. A 38 Weiss's straight sound now passed smoothly along |