tinct. of ergot gtt. x every hour. From this time the patient's condition varied, some improvement following a blister. June 4th, bromide and ergot both being continued. From June 8th to 19th, there was general aggravation, head often bent back, much torpor, restlessness and screaming, mouth and tongue sore, lips and teeth covered with sordes; much thirst; during that time, wine tinct. opii, gtt. vi to x, and chloral, either alone or combined, were used per enema and otherwise, without benefit. On June 14th the patient had slept some during the night, after two or three doses of opium, "and seemed torpid " in the morning; takes no food; skin generally dry and harsh, thirsty, etc. From June 16th to 22d there was some improvement, ending again in an aggravation. On the 22d the patient was removed to the country, the weather being hot and the location in the city unhealthy. The change produced a very beneficial effect, improvement setting in rapidly after July 7th.

The case is reported in a manner allowing the reader to follow and judge of every stage of the disease and its progress under treatment. It appears pretty evident that the attempt at improvement occurred between June 16 and 22, notwithstanding the medicine, which, instead of being persisted in, should have been discontinued; and we are not far from the truth in surmising that the improvement was delayed for several days after removal into the country while the effects of opium and chloral were still present. These drugs cannot be said to have been selected on account of any special relation to the case, for they were used in this, as in any other case accompanied by sleeplessness and pain, to quiet the symptoms most alarming the attendants, but of less importance as indications for curative remedies.

The santonine and calomel, levelled at an imaginary foe, on mere suspicion of his existence, is characteristic of the treatment calmly sanctioned by the dominant school. What a pity

the enemy was not a windmill !

The conditions under which chloral might have been serviceable are as follows: In convulsions of a child during measles; thumb flexed on palm; fingers straight and flexed on hand; hand flexed on forearm, this on the body; thighs flexed on body, legs on the thighs, and toes firmly drawn upward; abdomen rigid as in tetanus; touching the limbs caused pain, especially of haud and arm. Rolling of head, with occasional

Chloral gr. ii in a tea

convulsions and piercing screams. spoonful of water every hour or two. (J. G. Pinkham, Boston Medical and Surgical Journal, Vol. VII, p. 173.) It proved useful, and will be so again, also under the following conditions: Stupor after convulsions (after a fall on the head two weeks ago) with fever and pungent heat all day, with three convulsions at intervals. Chloral gr. xx, in syrup 3 i, a teaspoonful every hour. (W. A. Harvey in the same, Vol. VIII, p. 194.)

The former case shows in what kind of affection chloral is useful; but we know from its physiological effects that the law of similars applies better to the second case. It is to be regretted that the simplicity in the administration of medicines, notwithstanding its success, finds no imitation in that schocl, preferring purely routine prescriptions, ending in sending the patient into the country, astonished at "the remarkable fact that recovery could follow a disease of such great severity.' We are astonished at the recovery after treatment, not only of great severity, but also entirely unadapted to the case.

There are a number of well reported cases (by Hasket Derby, M.D., Boston Medical and Surgical Journal, November 5, 1874), on amaurosis and amblyopia following the abuse of alcohol and tobacco, and cured by the subcutaneous injection of strychnine, as recommended by Hippel and Nagel. Eight per cent of all cases applying for treatment were caused by those narcotics, and three of them yielded to that treatment. A synopsis of one case may serve as example:

"Jan. 9, 1873, Mr. B., generally healthy; for a year his vision had steadily decreased, a mist seeming constantly to surround him, and to thicken; for some time reading and writing had been given up. The patient had for years averaged three drinks of spirits and eight cigars a day. The case presented the usual symptoms of amblyopia ex abusu. The optic nerve had passed the stage of congestion, but showed no marked whitening; the vessels were slightly dimished in calibre. Vision: right, 280; left, 28.

Entire abstinence from stimulants, the use of tonics, abstraction of blood from the temples; then phosphate of iron, quinine, and strychnine were administered; and although "the nerves looked decidedly whiter and the vessels thinner," vision had improved to and 3%, respectively (somewhat paradoxical), by Feb. 20, when improvement became station

20

ary with general decline of health and spirits. A regular course of strychnine injections was now begun. From April 7th to June 26th thirteen injections were made, beginning with of a grain and ending with

At the last date vision was improved of the right eye to 3%, left #8; i. e. a line of print discernible by a normal eye at 30 to 70 feet was seen by the patient at 20 feet; while in the beginning he could not see it at from 3 to 6 feet. The patient was again able to return to business, and to read and write with ease.

This was certainly a gratifying improvement, and though accurately reported, these cases, like those of Dr. Chambers, confirm the unintentional and unconscious application of the homoeopathic law of cure, and especially what has been known since the earliest days of Homœopathy, the beneficial effects of strychnine (and nux vomica respectively) in cases of abuse of alcohol and tobacco- provided the result in above instances was not to be ascribed to the abstinence from these stimulants, so clearly the cause of the disease; and again, had strychnine, administered internally, been allowed to act undisturbed by iron and quinine, possibly the subcutaneous injections would have been unnecessary.

The observation here forces itself upon the mind of the reader that every cured case published by the old school, is by its adherents considered as authoritative proof of the efficacy of treatment, while volumes of excellent reports on the part of our school are not considered worthy of the slightest attention

in front of the curtain, before the public, though things are very different behind the scenes. Such is partisan spirit. We have to rejoice at the absence of such narrowness on our part, preferring to read daily the reports of both sides, thus being enabled to observe and to judge with greater impartiality. In its exercise, we arrive at the conclusion that, if the cures of the old school are entitled to credence, those of our school, if equally well reported, are also to be believed.

Therefore, by way of comparison with the preceding cases, and to show that homoeopathic cures should also be accepted as due to the means employed, and in order to afford the reader some practical material, with the hope that others may meet with similar success, the following cases are offered for perusal.

PRURIGO.

I. July 3, 1873, there appeared in my office Mr. E., an old German laborer. His face was haggard and expressive of great distress; being questioned as to his case, he threw off his vest and shirt by way of reply, and, unfastening his belt, stood before me a picture of misery. His old and emaciated body was covered with what originally was a papular inflammation of the skin, now in a state of irritation, causing it to appear as red as a boiled lobster. In many places the skin was hypertrophied and raised over back and thighs into hard welts, as if produced by blows with a heavy lash, the result of scratching to obtain relief from the intolerable itching; this was so troublesome at night in bed that sleep had been almost impossible for months. Scratching invariably aggravated the itching atmost to madness, so that the patient inclined to tear his skin with his nails, such efforts always ending in violent burning.

There were no vesicles nor scabs, but many nodular elevations and some exfoliation of cuticle; also numerous abrasions from scratching. In other places the surface was smooth and shining, as if polished, in appearance. The disease began a year ago, and was severe for the last six months, probably the result of poor food and damp dwelling, all circumstances aggravated by poverty, owing to inability to work.

It is worthy of remark that authors like Neumann, following Hebra, consider prurigo of adults as absolutely incurable.

The italicized symptoms point very closely to Rhus tox.; but the itching, aggravated by scratching and followed by burning, is so characteristic of that medicine that it deserves to be considered as one of its leading indications. The reader is herewith referred to a proving of the variety of Rhus tox. called venenata, by G. Ehme, M.D. (Gazette, I, 121 and 149.) The dilution used in these cases was prepared from the tincture furnished me by the prover. The prescription was one drop of 5th Cent. dil. in one half goblet of water; a tablespoonful to be taken every fourth hour; the solution to be renewed every day for five days.

On July 15, the medicine having been repeated as before,

the patient reported decided improvement; he had been able to sleep some hours every night; the itching, redness, and elevated stripes had diminished very much. July 25 the improvement was so marked that only little redness could be seen, and the itching was insignificant, so that the old man could sleep and follow his occupation again.

II. April 27, 1873. Mrs., aged 55, living in affluent circumstances; mother of several children, and past the climacteric period, was afflicted with prurigo vulvæ for more than six months. She had previously always enjoyed very good health; it was only disturbed by a severe concussion caused by a fall from her carriage, soon after which the prurigo appeared; at first for short, then for longer periods, and now almost constant. It is present mostly at night while undressing, but also at other times, setting in with such violence that the patient must yield to the desire to scratch or become desperate. When she once submits to the irresistible inclination to relieve the terrible irritation, she is then unable to cease, but must continue till violent soreness and smarting begin to take the place of the itching. There had been boils on the labia at times; walking aggravated the itching. Examination reveals swelling of the parts; the skin is red; hard and smooth in some places; in others rough, cracked and torn by the finger-nails. The patient is much emaciated, easily fatigued, and appears worn from loss of sleep, as well as from the constant irritation in the daytime, though her appetite and general health is good, no uterine or vesical disease being discoverable.

A prominent dermatologist had exhausted every remedy known to him, including black wash, corrosive sublimate, Pond's extract of hamamelis, sulphur and lard, leadwater, petroleum, as well as laxatives every morning, all without other effect than steadily increasing aggravation.

Mezereum, which had relieved a similar condition, having proved useless in this case, the redness, swelling, and especially the intense itching, aggravated by scratching, and followed by soreness and smarting, led to the use of Rhus tox. This was given on May 1st, in the fifth cent. dil., one drop in one half goblet of water; the solution to be renewed daily for three days.