way of postscript to our cases, we have only to say that we propose to edit this department and make the most out of the cases therein recorded. We have the vanity to think this the way in which the thing should be done. And though we shall doubtless often fail in making the best comments possible, we shall continue to do our "level best" in that line, candidly, impartially and fearlessly while we sit in this editorial chair. And now we conclude, as we began, with an earnest appeal to our readers for help in making this department of the Observer what it may and should be, during the coming year.

W. S. SEARLE, Clinical Editor.

Deafness. One of our correspondents writes: "During the many years, in which I have been a subscriber to the Observer, I have in vain looked for any serviceable direction to those who are afficted with deafness. Why the ear should not receive more attention, I cannot conceive. I know several persons who are troubled as I am by constant roaring in the ears: dryness of cerumen; hearing good in the presence of much noise; eustachian tube obstructed on left side; worse after taking cold; deafness gradually increasing; mother and brothers similarly affected."

Our friend's case is evidently chronic catarrhal deafness, and we fear there is little hope for him. Is there no scrofula nor skin disease (repelled) at the bottom of this family complaint? We have very few ear specialists, and the ear symptoms of our Materia Medica are but poorly worked out, and little understood. We would refer our friend to the only M. D. we know who makes this branch a speciality, viz: Dr. H. C. Houghton, Opthalmic Hospital, corner 28th street and 4th avenue, N. Y. City. Will not Dr. H. or some one else give us ear cases occasionally,?

W. S. S.

COCCYODYNIA.

BY W. S. SEARLE, M. D., BROOKLYN, N. y.

Among the minor disorders, of female humanity especially, perhaps none is more harassing than this. Patients frequently appear who complain that while attempting to sit down, rising to stand, making any effort, particularly to defecate, they experience severe pain in the region of the coccyx. Often this is so

severe as almost to prohibit exertion. At this moment, I have a case of spinal hyperesthesia in a young lady who has been nearly bed-ridden for two years, and whose chief complaint is of pain in the coccygeal region which precludes motion in walking, and yet keeps her restless in bed. Generally the most pain is felt in attempting to rise from a low seat, and to accomplish this the sufferer must aid herself by the hands placed upon chairs by her side, or be aided by others.

This condition of affairs often lasts for years, but is generally fugitive and occasional.

It is possible to confound it with only two other complaints -hæmorrhoids and fissure of the anus, and a careful examination will prevent mistake.

This affection was first described by Profs. Simpson and Scanzoni in 1861, and more lately by Thomas, in his work on Diseases of Females.

Its seat is doubtless in the fibrous tissues surrounding the coccyx, and as this bone serves as a point of attachment for several of the ligaments and muscles which are concerned in the movements above referred to, pain is experienced when motion is attempted.

From the character of the pain, its seat, the course of the disease, etc., we infer that the affection is neuralgic or rheumaticoneuralgic in its nature.

Its causes are thus enumerated : parturition; delivery by forceps; falls or blows upon the coccyx; cold; exercise on horseback.

Treatment. The physiological school advise that the part should be blistered and morphia applied. Should this not effect a cure, Simpson proposes that the attachments of the ligaments and muscles to the coccyx should be sub-cutaneously severed by the knife; and if this fail," as it may do," that the bone should be amputated.

Most lame and impotent conclusion for a lame and impotent disease! Methinks there are few but would rather submit their case to the higher "Divinity that shapes our ends," than be curtailed by a Simpson or a Thomas.

But does homoeopathy afford hope or certainty of better results from milder means.

There is nothing in our clinical records, nor in our works on

practice, so far as I can discover, regarding the treatment of this affection. And it is in the hope that cases of cure may be elicited from the profession, that I have written this sketch as well as dug up from our materia medica the means which are likely to afford help from in troublesome complaint.

We will first mention those remedies which manifest the most marked action upon the coccygeal region, and afterward take up those in which the relation is less plainly seen.

Belladonna.-The ischia feel sore, as if there were no flesh on them; yet she feels better when sitting on something hard than on cushions. Intense crampy pain in the small of the back and the os coccygis. He can sit only a short time. Sitting makes him stiff and unable to rise again from pain. Cannot lie down well; wakes often at night, and has to shift his position; unable to lie at all upon the back, and is most relieved by standing or walking slowly.

Causticum.-Dull, drawing pain in the region of the coccyx Darting pain in the coccyx. Pain as from bruises in the coccyx. Every movement of the body gives a pain in the small of the back. Pinching, crampy pain in the lumbar region and buttocks.

Carbo animalis.—Pain in the coccyx, which becomes a burning pain when the parts are touched. Pressing, bearing down pain in the coccyx as if the part were bruised. Pain as from sub-cutaneous ulceration in this region, mostly when sitting or lying down. Pressing, drawing or stiffness in the lumbar region, as if the back were brcken.

Thuja.-Painful drawing in the sacrum and coccyx and in the thighs when sitting. After having been seated awhile, the drawing hinders standing erect. Sudden cramp-like pain in the lumbar region after long standing, and then attempting to walk. It seems as if he would fall.

These four remedies seem to affect this region more powerfully than any others. Of less characteristic remedies, we find the following:

Cannabis sat.-Pressure, as if with a sharp point on the coccyx. Pain in the middle of the back as if it were being pinched, the pain gradually extending toward the abdomen.

Cantharis.-Lancinations and tearings in the coccyx, causing

him to start.

Cicuta.-Tearing, jerking in the coccyx.

Cistus canadensis.-A burning, bruised pain in the coccyx. Drosera.-Itching stitch in the coccyx when sitting.

Graphites.-Dull drawing in the coccyx in the evening. Violent itching of the coccygeal region, the part being moist with scurfy formations.

Gummi gutti.-Repeated gnawing in the coccyx.

Kali c.-Violent gnawing in the coccyx both when at rest and in motion.

This remedy has many back symptoms, and may be frequently indicated, but the above is the only symptom recorded including the coccyx.

Kali hydriod.-Pain in the coccyx as from a fall.

Kreasote.-Drawing pains along the the coccyx down to the rectum and vagina, where a spasmodic, contractive pain is felt. Better when rising from her seat. Subsequent milky leucorrhea.

Lachesis.-Continual pain in the sacrum and coccyx. Drawing pain, or as if sprained, in the small of the back, hindering motion.

Lactuca.-Pain, as if in the spinal marrow extending through the coccyx.

Magnesia. Sudden, piercing pain in the coccyx; sudden, violent, concussive, tearing, stitching pain in this region as if the spine were bent back.

Mercurius-Tearing pain in the coccyx relieved by pressing the hand against the abdomen. Pain in the sacrum, as if one had been lying on too hard a couch. Pricking, itching in the sacrum when walking.

Muriatic ac.-Drawing burning along the back, beginning at the coccyx, as if under the skin. Burning stitch in the sacrum, causing one to start.

Paris quad.-Tearing in the coccyx when sitting. Pulsative stitches in the coccyx.

Petroleum.-Pain in coccyx while sitting. Great uneasiness and stiffness in the small of the back and coccyx in the evening. Phosphorus.--Pain in the coccyx as if ulcerated, hindering motion, and followed by painful stiffness in the nape of the neck.

Phos. ac.-Itching stitch in the coccyx. Fine stitches in the coccyx and sternum.

Platina.-Numb feeling in the coccyx as from a blow. Ruta.-Pain extending from the coccyx to the sacrum, as if caused by a bruise.

Valeriana.-Bubbling pressure above the anus in the region of the coccyx.

Zincum.-Pain in the coccyx, sometimes a pushing-aching and sometimes pinching. Lancination in the sacrum, pressure, tension and weakness in the lumbar and sacral region, cracking in the back when walking.

Tuberculosis and Cancer.-The correlation of these diseases has been for some time past the object of anxious thought on the part of medical men. Facts have so distinctly obtruded themselves on the attention of observers that the mere collection of cases will go far to establish a relationship between tuberculosis and cancer. Among the most intelligent physicians who have clinically studied the subject is Dr. Burdel, of Vierzon in France. On the 17th of May last he read a paper before the Academy of Medicine of Paris, in which he stated that the diseases have been observed in more than one hundred families, both by the author and his father, to whose practice he has succeeded. It was found that parents effected with cancer had children who presented the tubercular diathesis. Dr. Burdel's memoir is remarkable, not only for the care with the statistics which were collected, but also for the sober manner in which theorizing is attempted. The facts speak so forcibly that the profession cannot fail to be struck by them. It would be well if one of our societies would next winter appoint a committee to receive reports from medical men all over the country, respecting their experience on this important subject.-Lancet.

Cholera in Southern India.-Medical Record says: The year 1866 was one of the very general distribution of cholera throughout the Madras Presidency. Out of a total of 586,228 deaths in the civil population, 197,955 were due to cholera, giving a proportion of cholera mortality of rather more that 35 per cent. of the whole.

The proportion of cholera mortality in the European army was a little more than 12 per cent. of the whole; of the native army, 27 per cent of the whole deaths.