arations containing prussic acid. In all his autopsies he found the lungs adematous, interspersed with petechiæ, partially emphysematous; the bronchi full of fine vesicular foam, coming out at the mouth; the right heart full of blood. In other cases the whole heart relaxed, containing only a very small quantity of foamy blood. Case 321 showed the lungs pressed to the thorax, lungs very large, bright-red, the alveoli expanded, no petechiæ, auricles and right ventricle contain a quantity of fluid, bright-red blood, the left ventricle empty. Case 330 showed the spots on the skin bright-red, the sinuses of the brain filled with bright-red, fluid blood, the gray substance of a reddish tint, numerous blood-points in the white substance, the plexus full of bright-red blood; lungs of a dark color, large, containing air everywhere, ædematous, full of blood, in sections bright-red; in the right heart some foamy fluid blood, the left heart and large blood-vessels moderately full of blood with loose coagula; spleen large, full of blood; liver soft, discolored by putrefaction, containing much foamy blood; kidneys equally bright-red, putrefying, containing much blood.

Comparing these autopsies with those where death was caused by phosphor-poisoning, we find very little similarity in the condition of the organs found after death; and it is remarkable that persons who committed suicide by taking phosphorpaste or the phosphor contained in matches sometimes lived several days, and were even able to attend to their usual occupation, before morbid symptoms set in. In cases of sudden death the individuals succumb to acute gastritis; but far more interesting to us are those cases where the disease lasted a few days. The cadaver is more or less yellow, especially the conjunctiva and the subcutaneous fatty tissue; the blood dark, tar-like; the heart relaxed, without coagula; ecchymoses or larger suffusions in the serous membranes and in the cellular tissue; the liver enlarged, deep yellow, doughy, soft, anæmic; the hepatic cells are microscopically found large, full of big drops of fat, — and it is this acute, fatty infiltration of the cells which causes the enlarged liver and the sudden and rapid compression of the biliary ducts, which causes the bilious imbi-, bition of the hepatic parenchyma and the icterus. Analogous

changes are also found in the kidneys. The heart, as well as all other muscles, partakes in this fatty degeneration. (Differential points from genuine acute atrophy of the liver: The liver is smaller than normal, the acini small, the cells are broken down to a fine detritus, the urine contains leucin and tyrosis in considerable quantity.)

How does it come that in all autopsies made after death from poisoning with Phosphorus no lesions in the pulmonary organs were detected? How then can we explain its homoeopathic action in diseases of the lungs, a fact of which even the merest tyro in Homœopathy is convinced? Although some physicians give it still in pneumonia simplex and some even at any stage, still experience teaches that it acts far more decisively when pneumonia threatens to deviate from its normal course or when typhoid symptoms appear. May not in such cases, running a tedious course, the blood also become surcharged with carbonic acid, and thus Phosphorus show itself again as the great oxydizer of the circulation, and by its stimulating power aid in the resolution of the hepatized tissue? Kafka (Hom. Therapie I, 204) finds Phosphorus only indicated in croupous pneumonia, when the disease has already lasted some time, the infiltration is still considerable, the fever is more of a remittent character, the patient looks pale and is very weak, the sputa very tenacious and only expectorated after long paroxysms of cough, diarrhoea, or when adynamia threatens, showing itself by a dry tongue, great deliria, and rapid collapse. Similar indications for Phosphorus we find in phthisis: Dry, short cough, so constant as to lead to exhaustion, or moist cough, with greenish fetid expectoration from an abscess on the lungs, great dyspnoea, easily excited diarrhoea or perspiration, pain and soreness in the chest, emaciation, small, quick pulse, etc.

From the cases of poisoning we learned that a spurious, fatty degeneration is characteristic of Phosphorus, and in the resolution of pneumonia microscopic examination reveals the same process. Niemeyer teaches that where resolution takes place during the stage of hepatization the fibrine and the young cells which are embedded in it pass into a fatty metamorphosis and break down, an albuminous serum transudes from the

walls of the alveoli, the contents of the pulmonary cells become fluid, changed into an emulsion, and either absorbed or expectorated. Juergensen (Ziemssen Handbook der speciellen Pathology V, p. 47) speaks thus of the purulent infiltration : The exudation formerly firmly adhering to the alveolar walls becomes loosened; fibrine, blood, and pus-corpuscles form a homogeneous, granular, soft mass, showing only here and there remnants of an organic form; mucine takes the place of fibrine. It passes through a process of fatty degeneration, and thus becomes accessible to resorption, and will be absorbed; a smaller part will be expectorated as mucus; and the structure of the lungs remains intact inasmuch as the pulmonary epithelium regenerates itself quickly and the blood-vessels of the lungs fill again in larger extension with blood. ascribes a considerable part to the fatty degeneration, and believes that a hepatized lung passes through a retrograde metamorphosis solely and alone by resorption of the softened alveolar clots in loco.

Buhl

In relation to emphysema, it is well known that in most cases it has its seat at the apex and at the anterior edges of the lungs, but sometimes it extends over a large part of the surface of the lungs. More rare are the cases where it extends deeply into the lungs. Rainey found fatty infiltration in the tender membrane of the pulmonary vesicles. Hertz considers as cause of emphysema a relaxation or loosening of the pulmonary tissue, dependent on modification in the circulation of the blood. Phosphorus acts well on the apices of the lungs, causes fatty infiltration, and, as a stimulant, aids in restoring the modifications in the circulation, especially of the lesser one, to its former normal state.

It would lead us too far to prove the pathopoetic indication of Phosphorus in pulmonary diseases. Let these few hints suffice. Why does Kali carbonicum possess such a powerful influence over pulmonary diseases? The answer to be continued in our next.

PATHOLOGICAL AND

THERAPEUTIC HINTS ON THE

ACTION OF BROMIDE OF POTASSIUM.

BY O. S. SANDERS, M.D.

BROMIDE of Potassium was first brought into notice in 1852. Its action was soon found to be sedative in character, affecting the cerebro-spinal system.

It has played an important part in the treatment of hysteria, epilepsy, spermatorrhoea, nymphomania, neuralgia, etc.

The provings of this drug show signs of marked depression of the nervous centres.

Ideas become embarrassed and demoralized, with loss of memory and difficulty to select the right word and put it in the right place. For instance, the word emancipation will be used for emaciation, adoption for absorption, contraction for subscription, etc., with fanciful notions and melancholic delusions.

The respiratory passages evince a marked degree of irritation, voice rough and hoarse, dry cough, constriction of the larynx, sometimes loss of voice.

The digestive organs are but slightly disturbed. When deranged, the result is a tendency to diarrhoea.

The urethral passage is often affected, the circulation diminished in frequency.

The muscular system is affected more or less differently with different persons. With some its action is not unlike that of alcoholic stimulants; others become lethargic; some irregular in their gait, while others in trying to walk will stumble.

The skin presents an eruption, like acne, pimples in clusters, boils, erythema, etc.

The urine is increased in quantity and more or less acrid in quality. Micturition is slightly painful.

The phenomena of this salt in the progression of its proving may be put down in the following order: Fetid breath, hypnotism, emaciation, irritation upon the mucous and dermoid tissue in certain localities, cerebral disturbances.

This salt has been favorably employed in psychological disorders. Maniacal subjects have been calmed into repose by its

sedative effect. Delirium tremens, as well as the disastrous effect of tobacco, has been brought under control by it.

The report of hospitals and asylums, far and near, speak of the Bromide of Potassium as a serviceable remedy in a large class of patients occupying their departments.

The therapeutic action of this salt is to lessen the amount of blood to the brain and excite a tranquillizing influence over the mind.

The heart once arrested by its influence does not recover its action by any known agent.

From clinical observation we can speak of Bromide of Potassium as a valuable remedy in mitigating saccharine diabetes and epilepsy, but not curative.

I am of the opinion that from further observation in its proving, in conjunction with the past, it will prove to be a valuable antidote to lead poisoning, Nux vomica, Prussic acid, tobacco, and alcoholic stimulants. A solution of Bromide of Potassium (5 grs. to two ounces of water) has been prolific of great good. Employed in the atomized state in croup, shreds of false membranes have been almost instantly thrown off by this means, so that the breathing has become easier, without stertor.

Irritated and inflammatory sore throats have been acted upon as by a charm with this agent, using it in solution with the atomizer.

It seems that one of the valuable hints or legitimate actions of the Bromide of Potassium is an anesthetic to the nerves of the mucous membranes, as well as a depression of their action, and that its hypnotic effect is secondary.

One noticeable feature of this medicinal agent is that, while the action of the bromide diminishes the vital force of the brain and heart, it increases the action of the kidneys without creating thirst.

While the Bromide of Potassium has its virtue, many of its symptoms are in common with the Chloride of Potassium.

The question might arise whether the beneficial result might be accorded to the Potassium or to the Bromide or Chloride; but I think clinical observation will award credit to the theraVOL. X. NO. V.