which overshadowed all else in his mind was the drowsi

ness.

I gave him Sepia 200 (Carroll Dunham). He was markedly better the next day, and reported that he was quite himself again on the 12th inst.

This gentleman had been ailing for several months and had taken mercury, Rochelle salts, and other purgative medicaments. He had also had Nux mosch., from a student of mine,-his nephew-which had helped him some, but its effects were only temporary. He has remained well down to this date (June 23th) although pursuing the even tenor of a rather confining employment.

There are some interesting addenda to this case. I have said that the man was a mechanical engineer. When told sometime subsequently by his nephew that he had been cured by Sepia, he said, "Why that's curious; do you know whenever I used Sepia to draw with and get it on my hands, I always noticed that I was worse." The question now is, was it a case of Sepia poisoning? And, if so, did the dynamized Sepia not only antidote the effects of the ink, but provide a prophylactic against subsequent exposure to its influence?

Being called suddenly to take charge of a person in a comatose state is not a pleasant experience, and as usually it is impossible to get the "history" of the case, a prescription becomes largely a matter of guess-work. A case of this sort was that of a young married woman which I saw in 1879. I was called as a Dispensary physician, late one night, to see a woman whose family I had known for a couple of years, and whom I had treated several months previously, for a uterine catarrh and general anæmia. I found her lying on the bed surrounded by her weeping relatives who were expectant of her immediate demise; she already looked quite corpse-like. Unconsciousness, was complete; respiration was slow and shallow, and the pulse radial imperceptible; the eye did not respond to bright, light, nor did pricking with a needle elicit any evidence of sensation. The extremities were cold and, the features

shrunken, and the whole appearance as of one who was quietly slipping out of life,-one who had known little of quietness here-into the Great Beyond. The only additional facts obtainable beyond those obvious to the eye, were that she had been slowly sinking for several days, and had gradually fallen into the state in which I saw her. I did not consider it would be of any use to give medicines. I knew, that whatever might be the more immediate causes of her present condition, she was simply succumbing to that hard fate which has carried down many a gentle and romantic woman--a drunkard's wife; and that a constitution never over-robust had been weakened probably beyond repair by continuous semi-starvation. Yet it would seem heartless not to attempt to do something, and urged on by her sisters, and guided by a peculiar enlargement of the pupil of the eye-an enlargement which displaces the entire iris-I put some pellets of Belladonna 200 (Carroll Dunham) on her tongue. Singular and even improbable as it may seem, in about a quarter of an hour, the eye-lids, which had been closed, twitched slightly and soon after opened slowly; respiration gradually became deeper and seemed more frequent; the pulse could again be felt faintly at the wrist. And although there was little change in the death-like appearance of the countenance, and no evidence. of returning consciousness, surely and slowly, little by little, the thread of life was being taken up again, and I felt justified in saying to the gathered friends, that morning would see her "clothed in her right mind;" and so it proved, for when I called about noon day she was sitting on the edge of the bed eating some gruel.

Another case quite different in all its surroundings gave much more anxiety. A gentleman residing on Fifteenth street near Eighth Avenue, engaged in the electric light business was so unfortunate in February, 1832, as to take the measles. The case progressed fairly well for several days; although the bodily temperature was rather high, the patient slightly delirious and the rash not sufficiently out to please me, however, I felt no alarm about the case. The

*

man's wife was an impulsive, vivacious creature who, unfortunately for my peace of mind and the success of the treatment, became possessed with an insane idea that if her husband did not eat he would die, and not knowing anything better for sick people than beef tea she busied herself making it and pouring it down him. She said nothing of this to me, and in fact she spoke English so indifferently that I doubt if either of us was much the wiser for our attempts at conversation. She deluged that poor man with beef tea, coaxing it down his unwilling throat with all manner of pretexts till I verily believe he was full of tea from his rectum to the top of his oesophagus. The result was that one morning about three o'clock I was called to see him, the messenger urging the greatest haste, as the patient was thought to be dying.

I went. Then the whole story of the beef tea came out, but, unfortunately, much of the beef tea was bottled up inside of the patient who was comatose, and who certainly looked as if he was about at his journey's end. I gave Nux vomica at frequent intervals and in varying potencies, applied mustard drafts to the soles of his feet, nape of the neck and over the solar plexus, but after three hours work saw no change in the condition of the patient. Thoroughly alarmed I had sent for several physicians in counsel, but the messenger came back each time with word that they were out, or too used up by other calls to go out again.

At 7 A. M. the condition of the patient was practically the same as when I first arrived. The skin was cold and clammy, the face distorted, the pupils strongly contracted, respiration very labored, the pulse weak and irregular, and he gave vent at frequent intervals to quantities of offensive flatus. I now bethought me of Arsenicum which I gave in the 12,000th potency. No very remarkable change took place, but gradually the pulse became stronger, the respiration less labored, the face assumed a natural expression and was no longer bathed in cold sweat, and by night-fall he sank into a quiet slumber without regaining consciousness, in which state he remained until late in the afternoon

of the next day when he awoke and expressed himself as feeling quite comfortable, but astonished at having lost two days out of his calendar.

I never saw a case of lucid lethargy and never expect to, but I did see some dozen years ago a case of poisoning that was very like it. This happened in 1875 when I was fresh out of college and knew even less than I do now. The patient was a prosperous middle-aged man, and the worst sufferer from trigeminal neuralgia that I have ever seen. He had made his own way up in the world and was a rugged and courageous nature, but in the paroxysms of pain would literally roll on the floor in uncontrollable anguish. He had suffered for many years and had had many physicians, and was none the better for any of them. He had just given himself into the care of Dr. Meredith Clymer, a distinguished member of the "old school" and who made the prescription which is the occasion of these remarks. The powder was taken about 10 o'clock in the morning and sometime subsequently in attempting to go from his chair across the room he fell prone upon the floor. Dr. Clymer was sent for and came in no listless mood. Those who are familiar with the huge bulk of this genial gentlemen of the "old school" in its best sense, can imagine the effects of the haste upon him, as he sat puffing and panting in a chair as absolutely speechless as the poor patient before him.

Mr. X. lay bound hand and foot, under the influence of the medicine, as inert as a dead man; if he took cognizance of anything that took place and was going on he gave no sign; he apparently ceased to breathe, the pulse stopped and life seemed to have gone out. Various restoratives were applied, and at last when the man was able to speak he declared that he had been conscious all the time; had heard every word that was uttered, and had suffered no pain only a sense of the utter helplessness from which he had not even an inclination to arouse himself. He recovered completely and had his attacks of facial neuralgia all the same. The drug was Curare.

PROLAPSUS RECTI: WHAT IS THE REMEDY?

C. S. DURAND, M. D, Sedalia, Mo.

A CASE. Freddy O, four years old; well formed, chubby, with light hair and blue eyes. Mother died of consumption of the bowels soon after he was born. Had catari hal symptoms from birth; nostrils always stuffed up. The least cold gives him cough and symptoms of croup. Coughs worse at night and early in the morning. Is easily thrown into fever and is then subject to spasms. So much for general description.

I was called to see him March 26, when he presented the following symptoms:

Prolapsus of rectum with every stool; also sometimes when sitting. Often bleeds a large quantity when prolapsed and occasionally at other times. Constipated; bowels move every other day. Dark crusts and much yellow, purulent matter in nose all the time. Sulphur 55m., two doses.

April 1. A little better. Sac. lac.

April 19. Still improving. Sac. lac.

April 26. Is in bed with measles, but seems better. Nux vom. 2m., one dose. [Why give Nux without giving the reader any symptoms for which it was given? Could it have been given for measles? Why change from Sulphur when patient was improving? Another dose of Sulphur either higher or lower would probably have been a better choice.-ED.]

May 20. Not so well. Bowels regular. Always tired. Can't stand much play. Mucous membrane exfoliates from prolapsed rectum; is of greenish color. This leaves the rectum very sore. Cough worse when lying on back. Legs ache; left worse. Calcarea 30, one dose.

May 24. No operation of bowels yesterday-better. Sac. lac.

May 23. Better. Calcarea 13m., one dose.

June 4. No prolapse till yesterday for a week. Does not take cold as formerly. Much better. Sac lac.