Vol. VIII.

Practice.

Influenza.

BY WM. H. HOLCOMBE, M. D., NEW ORLEANS.

THIS epidemic catarrh is prevailing con

siderably throughout the country, and it is a good time for the Homœopaths to review our means which we have of meeting it.

Camphor, which is always favorably mentioned in the books, seems to have really no power of preventing the disease, or of arresting it when developed. Its triumphs are theoretical, practically verified to no great extent. Its inhalation or insufflation may mitigate the catarrhal flow, and that is all.

The profuse discharge from the eyes and nose which often characterizes the first stage, is greatly relieved by three remedies, Aconite, Euphrasia and the Iodide of Arsenic.

The insufflation of warm water, medicated with minute quantities of Pond's Extract of Hamamelis, or Hartshorn, or Cardamom is very comforting.

If the sneezing and lachrymation are not speedily relieved by the above mentioned means, we have excellent resources in Euphorbia, Sabadilla and Cyclamen.

Sometimes, however, the coryza of influenza is trifling, and the force of the disease falls upon the general system before

No. I

it invades the respiratory tract. There is high fever, intense headache, pains all over the body, and an array of symptoms very much like our dengue fever.

Gelsemium is here a remedy of supreme value: superior to Aconite or Belladonna, although these last polychrests may be called for by strongly characterestic symptoms.

Bryonia, Rhus tox. and Eupatorium exert great curative power in these cases. Bryonia, when the joints are very painful, Rhus tox, when the muscular tissue is most affected, and Eupatorium when the pains are said to penetrate to the very

bones.

When the myalgic sufferings are confined to the chest and simulate pleurisy, Asclepias and Ranunculus display their spe

cific value.

It is well in this and as in all other fevers to open the bowels on the second day at least, and this is best effected by a few grains of Mercurius dulc. 1x administered at bed time.

The throat symptoms are sometimes troublesome, amounting to pharyngitis or tonsillitis. The Iodides of Mercury and the Kali bichromicum here display their usual power. Gargles of hot milk are very soothing, and gargles of solutions of Salicylate of Soda, or of Boracic Acid, or the Sulpho-Carbolate of Soda are decidedly beneficial.

The laryngeal and tracheal symptoms

are especially distressing; harrassing, tickling, croupy cough is admirably met by Spongia, Drosera, Rumex, Hepar sulph and Lachesis according to their special indications or key notes.

The bronchial irritation sometimes ending in inflammation, is a principal feature of the disease. If the first stages of influenza are neglected or badly treated, especially in young children, or very old people, or greatly debilitated subjects, the pulmonary trouble may develop rapidly into capillary bronchitis or pleuro-pneu

monia.

Tarlar. emetic. and Arsenicum album are the typical remedies for this bronchial catarrh. They may be reinforced by Kali hydrojodicum, Kali bichromicum, Ammonium carbonicum and in special cases by Ipecac., Scilla and Senega

pleuro-pneumonia,

For threatened Bryonia and Phosphorus; for capillary bronchitis, Phosphorus and Tartar, emetic. are the standard remedies.

If unfortunately the prostration increases and typhoid phenomena begin to appear, we have invaluable resources in Baptisia, Lachesis, Arsenicum and Carbo veg.

I always avail myself of the remissions and even intermissions which sometimes occur in this disease to administer Quinine in small but appreciable doses. The tasteless Quinine Lozenge, which is the Tannate of Quinine in chocolate, rubbed up in a little Syrup of Tolu, is a precious invention for small children and their mothers. The professor who teaches that the Tannate of Quinine is insoluble and inert, has surely never made a trial of this excellent preparation.

Believing that it is a part of the duty of the physician to quiet nervous irritation, relieve pain and promote sleep, inde

pendently of his specific treatment of a given case, I have found Codeine, onetenth of a grain, given at bed time, to be an invaluable adjuvant in this and many other diseases. When that dose is administered, suspend all other medication until the next morning, unless some special symptom imperatively calls for treatment. A nice little cup of coffee in the early morning will dissipate any unpleasant symptoms the Codeine may have produced. When opiates are inadmissable, on account of idiosyncrasy, ten grains of Sulfonal will give the patient a very pleasant sleep.

In all exhausting diseases with tendency to increasing prostration, it is necessary to feed the patient often and a little at a time. Milk and milk punches are advisable. Hot beef tea is a temporary stimulant, but as generally prepared, beef tea is almost worthless as a nutrient. Reed and Carnrick's Liquid Beef Peptonoids will best realize your hope of finding a pleasant, concentrated and digestible food.

China officinalis is the standard Homœopathic remedy for convalescence from exhausting diseases; but you will find the Arseniate of Strychnine 3x a rejuvenating tonic of great value.

The Homœopathic physician who knows his Materia Medica and reviews the above mentioned remedies, will feel confident and strong in his faith when he meets the Russian grippe.

Diphtheria.

THE following letter is the substance of the discussion on diphtheria at the meeting of the Cincinnati Homœopathic Lyceum on Nov. 11th 1889.

In reporting the discussion, it has been thought best to group remarks of

the same general nature into one paragraph; and make instead of the usual disjointed phrases a readable article which shall present the clinical experience of physicians here.

Primary attacks of diphtheria are not constitutional; many cases are suppressed and will return with constitutional symptoms at the first cold.

When the deposit is seen, with some fever and glandular symptoms, and before the epithelium is broken, the outlook is generally good.

No solid foods should be given, as they are liable to tear or break the epithelium, and give increased opportunity for absorption with the consequent production of constitutional symptoms.

When the membrane is gray and dark the micrococci have entered the blood. The point in reference to intact membrane, should be held in view, and no strong caustics or other means should be used to remove it.

The indication for treatment in diphtheria, is to establish a suppurative process beneath the membrane, which at all times should be gently handled. The use of alcohol is not to be recommended on account of its disposition to harden the membrane and cause it to curl up, leaving a raw surface.

Insufflation of flowers of sulphur, acts much in the same way as the alcohol, and at the same time sulphur has the property of prolonging the suppurative process.

Chlorate of potassium makes a good application to the throat on account of its germicidal effect, and its properties of dissolving the albuminous material of the membrane and arresting any putrefactive changes.

If croupous symptoms appear, inhala

tions of lime water steam by enveloping the heads of patient and nurse in a blanket and conducting the steam under it, are useful. When the dyspnea returns, repeat the inhalations.

Dyspnea with a membrane, and dyspnea without a membrane should be differentiated. With the former there is impeded inspiration and expiration; with the latter, which is due to edema of the vocal cords, there is impeded inspiration only. In either case if dyspnea is excessive, intubation should be practiced.

Lime inhalations do not go far enough. Early intubation must be practiced to admit more oxygen, the tube also affords a means for expectoration of membrane. However, many bad results of intubation are due to relying too much upon the tube and relaxing other methods.

A good method of treating the throat, is to wash it out with some aseptic fluid, using an ordinary household syringe minus the nozzle. Protecting the patient with a rubber blanket, while using the syringe.

Attention should also be given to the nasal passages, and never allow membrane to form there without your knowledge. Early in the disease it is well to wash out the nasal passages with some aseptic fluid, using for the purpose a bulbous pointed ear syringe, exercising great care not to abrade the mucous surfaces.

If a plug has formed in the nares, gently probe a hole through the centre of it, and pass the fluid up through it.

CINCINNATI, Dec. 4, 1889.

T. M. S.

Denver has a Homoeopathic Free Dispensary that is doing good work for the poor and for Homœopathy in that city. Good for Denver.

Materia Medica.

Poisoning by Kalmia latifolia.

BY A. E. MEADOW, M. D., BLOCTON, ALA.

MY subject is one with which, no doubt, some of you are familiar.

In the latter part of winter and early spring cattle desiring something green, eat this shrub, which is very poisonous, and in the majority of cases eat too much and death is the result.

For description I refer you to the pharmacopeia. The first symptom of its poison is intense thirst, the animal drinking all it can bear, which is followed by trembling, weakness, staggering and jerking, abdomen full of wind. If the animal gets into a creck it often falls down and drowns before it can get out. If not, this is soon followed by spasms at intervals of fifteen or twenty minutes, which increase in severity and rapidity till they assume the most violent form of clonic spasms.

During the intervals the animal appears rational and will try to get up and walk about, but in the effort falls into another spasm.

The eyes become fixed, pupils turned upward, the head drawn backward, limbs rigid, abdomen bloated and bowels loose. If the animal recovers, it is apt to be in a state of prostration for a week or more and seldom recovers from the effect under three or four months, during which time it is weak and nervous, walks as if intoxicated, tottering as if unable to control the use of its limbs.

From the information I have been able to get, the therapeutic range appears to be very limited, but, in my opinion, it is Read before The Southern Homœopathic Medical Association, Memphis, 1889.

destined to be a wonderful remedy in the treatment of nervous diseases, more especially in epilepsy and chorea, yet I have not had an opportunity of giving it a fair trial, having used it only in one case, with what I considered fair result, but not sufficient to warrant any positive conclu

sion.

From the effect noticed on suffering animals, and the marked similarity to a person suffering from epilepsy, I am led to believe it is a remedy that should be studied in that connection. The symptoms are violent spasms of the whole body, limbs extended and rigid, eyes turned upward, jaws clenched and foam at the mouth, with jerking and twitching all

over.

I also find symptoms that lead me to suggest it in chorea, such as involuntary jerking and twitching motions of different parts of the body or the whole, staggers in walking, head drawn to one side, walks sideways, dragging the feet of one side. Appetite usually very weak, has no desire to eat, but eats and drinks at will.

Indigestion may find a foe in its virtues. We have largely distended abdomen, eructations of wind, flatus with stool, &c.; diarrhea, profuse and watery, with much flatus during spasms. Antidotes: Green coffee, tea and vinegar.

As for the pathological changes produced I have not studied them and do not feel competent to undertake the comparison, but hope this may be the foundation for an investigation of its merits.

"Gem Vegum" is a popular remedy among the natives of Central America for impotency. The fresh plant is macerated in whiskey, and a drink taken occasionally.-Dr. Giroud.

Surgery,

Dont's In Urethral Surgery.

BY W. E. GREEN, M. D., LITTLE ROCK, Ark.

DON'T-use injections during the acute inflammatory stage of gonorrhea; depend upon internal remedies.

Don't use strong injections at any time. If the injection produces a momentary smarting, reduce its strength. If, during the treatment by injections, the discharge suddenly stops and the urethra irritation and vesical tenesmus increase, discontinue the injection and give Gelsemium, tr., one or two drops every two hours, until the discharge is re-established and the irritation subsides.

Don't use polypharmacy in formulating injections; simple prescriptions answer better. Sulphate of Zinc, one half to two grains, or Nitrate of Silver, one-fourth to two grains to the ounce of water, is the very best.

Don't-repeat the injection too frequently, two or three times daily is sufficient.

Don't-promise a speedy cure in gonorrhea. In well managed cases, from four to six weeks is the allotted time.

Don't-neglect to inform your patients, so afflicted, of the contagiousness of the disease and the liability of infecting the eyes; strict cleanliness should be enjoined.

Don't fail to examine for stricture in all intractable cases of gonorrhea or gleet. Gleet is the symptomatic manifestation of stricture.

Don't forget that a narrowed meatus may be the means of protracting a gonorrheal attack; and, also, that it may be the cause of urethral or vesical irritation. A small meatus should always be incised

and brought up to the calbre of the urethra when diseases of the genito-urinary tract exist.

Don't-operate on the meatus with a dilating urethrotome. It is liable to tear the tissue and give a ragged opening. Use an ordinary bistoury or a bistouri caché, and make the cut downwards.

Don't forget that a contraction of one or two m-m-, may do incalculable injury. Don't operate for stricture during an acute attack of urethritis.

Don't forget that the average calibre of the urethra is about 33 F. It is seldom below 30 F., but often measures 40 F.

Don't forget that there is usually more than one stricture present. The number varies, from one to six or seven, and the location is always in the anterior urethra, that portion lying anterior to the bulbomembranous junction.

Don't-cut downwards when performing urethrotomy, when the stricture is situated back of the first inch. There is less liability to hemorrhage when the incision is made in the roof of the urethra.

Don't fail to divide every constricting fiber; the success of the operation depends upon it.

Don't forget that in after treatment there is less liability to hemorrhage, and you will produce less pain, by passing an instrument every day than when it is passed every two or three days after the parts have become glued together. After the tendency to hemorrhage has ceased. the time may be lengthened to every second or third day.

Don't attempt to prevent recontraction in imperfectly divided strictures by the use of the sound; you will inflict unnecessary pain and accomplish nothing. Allow the wound to heal, then make a second and a deeper incision.