The hammer is to be used on peripheral nerves, the rhythmic vibrations being transmitted to the centers.

In neuralgia, I percuss over the sensitive points along the nerve; it at first usually causes a decided aggravation of the pain. The hammer should be held steadily until there is a slight amelioration and at once removed. Not infrequently in a very few minutes there will be a fresh aggravation, when the hammer should again be brought into play either on the same or some other sensitive point just as before. This may be repeated three or four times during one sitting. It should be repeated daily for at least two weeks. before giving up. Many times there is almost instant relief for hours or days. I never repeat a treatment unless a pain returns. There are many ordinary backaches and functional disturbances that will respond like magic.

A

AMALGAMATION OF THE SCHOOLS.

BY CHAS. S. MACK, M.D.

La Porte, Indiana.

FEW months ago there appeared upon the sea of medical journalism a ripple of interest in the question of whether amalgamation between the schools is feasible. The question seems to have, for the present, sunk out of sight. When it again "bobs up serenely," as, of course, it will many times, let us be even better than ever before prepared to further the cause of homeopathy. When an old-school society, or an old-school journal, or an old-school physician asks "Why not amalgamate?" then, it would seem, is an opportune time for showing that the particular cure of which similia similibus curantur is the law transcends the possibilities of rational medicine; and that, therefore, no homeopath, whatever may be his attitude toward rational medicine, can seriously consider any proposition which looks to the least blurring of his attitude toward homeopathy.

There is a very large field in medicine that is occupied in common by the old school and by homeopaths-that is the field of rational medicine. The homeopath may be just as enthusiastic over rational medicine as the physician who is not a homeopath. The old-school physician seeing this is apt to ask: "Why do you identify yourself by name with homeopathy?" The most satisfactory answer to that question must, it seems to me, define the particular cure of which similia similibus curantur is the law, and show that this particular cure transcends the possibilities of rational medicine. The particular cure of which similia similibus curantur

is the law, is an immediate transformation from abnormal to normal (or to what is approximately normal) in vital processes. this definition the word immediate does not relate to time; it simply means that the cure is the first effect of the medicine used-that there is no drug effect mediate to it. Now it is perfectly evident that this particular cure transcends the possibilities of rational medicine, for in any given rational practice the immediate end sought must be something knowable in itself, as a specified change in vital processes is not-it can be known only in its effects.

Now when the old-school society, or the old-school journal, or the old-school physician understands the point just made, that society, journal or physician cannot fail to see that the homeopath is perfectly consistent in identifying himself by name with homeopathy, though he cordially accepts rational medicine as well as homeopathy. The old-school society, journal or physician stands (is it not so?) for rational practice as the ne plus ultra in medicine. The homeopath, however much he may approve rational medicine, stands for similia similibus curantur as the law of a cure which transcends the possibilities of rational medicine. Let the old-school society, journal or physician consider this when the possibility of amalgamation is under discussion.

A matter little understood among our old-school friends is, what constitutes the law of similars universal. Many seem to think that if the law is universal, there can be no other law in medicine. If it were the only law in medicine, that would not constitute it universal. Medicine is not the universe. The universe comprehends. the world of feeling and the world of thought no less than the world of flesh and blood; and that the law of similars obtains in the world of feeling and thought, z.e., in the spiritual world, as well as in the world of flesh and blood constitutes its universality. What I am here presenting comports with the general tenor of Henry Drummond's book "Natural Law in the Spiritual World," so much read and talked of a few years ago. Our experiences in the spiritual world, i.e., the world of thought and feeling, evidence the law of similars when we picture to one his mistaken ideas, or his wrong feelings, to the end that he may correct them, the remedy we administer is homeopathic. We picture from without abnormal conditions which we would see corrected from within, and such picturing is what homeopathic treatment essentially is. Note that the particular cure effected in this way, be it from error in head or from error in heart, cannot be effected in any other way-that, indeed, this cure transcends the possibilities of any other method. You may by various means induce one to affect thoughts or feelings

which are not really his: fear of punishment-hope of reward— restraint-various means to correction may be used, but the only means to immediate * correction from within are instruction as to the existence and nature of a fault, and appeal for correction from within. Where would the reformer be-where the preacher-where would home discipline be if it were not that, under the law of similars, picturing (a fault) from without may be a means to correction from within? The best results of satire in literature and the drama evidence the law of similars. Utterly incalculable are the benefits we experience in heart and in mind under that law. These benefits we experience daily-shall I say hourly? Whenever we profit by seeing our own faults pictured in the faults of others, or in spoken or in printed admonition, we profit under the law of similars.

It seems to me of great importance that the real universality of the law of similars be recognized. When this is done, homeopathy in medicine will be seen as merely a part of homeopathy universal. Homeopathy in medicine has been tremendously handicapped by a general feeling, sometimes expressed and sometimes not, that it is queer, unlike anything else—that, if true, it stands unique, alone, unrelated to our other experiences. But the fact is, as we just pointed out, that there really is no principle of correction more familiar to us than that upon which homeopathy is based, viz., that the picturing (of a fault) from without may be a means to correction from within. I say may be. Did we profit by each and every picture of our faults-by each and every corrective admonition, we should be paragons indeed. In the world of feeling and thought, just as in the world of flesh and blood, a homeopathic remedy may fail of accomplishing its end by reason of failure of response from within the patient.

Points the consideration of which is opportune whenever the subject of amalgamation is discussed are:

Ist. The universality of the law of similars.

2nd. The peculiarity of the cure of which it is the law.

3rd. The impossibility of attempting in rational practice this particular cure-this cure transcending the possibilities of that practice.

Due consideration of these points brings out clearly the difference between the homeopath who believes in rational medicine ast well as in homeopathy, and the physician who regards rational practice as the ne plus ultra in medicine.

* See above what is said of the word immediate in definition of the particular cure of which similia similibus curantur is the law.

CONDUCTED BY

WILLIAM TOD HELMUTH, M.D.,

GEORGE W. ROBERTS, PH.B, M D

ENLARGEMENTS OF THE PROSTATE GLAND.*

THE

BY JAMES KRAUSS, M.D.

Boston, Mass.

HE prostate gland undergoes enlargement from disease, senile changes, and congenital products. Situated in the male pelvis so as to enclose the first part of the urethra, the larger portion lying behind and the smaller portion in front of the urethra, the base directed into a close proximity with the bladder and the apex reaching the membranous portion of the urethra, the prostate gland, when enlarged, sooner or later encroaches upon the posterior urethra, the bladder, or both, and thus brings on a series of urinary disturbances which have been the despair of suffering men and a reproach to the medical profession.

It has been stated over and over again that an enlarged prostate is a hypertrophied prostate, yet there is numerous testimony of surgeons and pathologists that the enlargements of the prostate gland are manifold, that they represent, in the words of Gouley, "Neither a morbid nor a morphic entity." Since Tschikanofsky has proved that cases of hypertrophied prostate rest upon a basis of previous inflammatory disease, doubt has crept into the minds of medical investigators as to the actual existence of genuine prostatic hypertrophy, a condition characterized by an increased volume of the normal tissue elements of the gland in consequence of over-nourishment and not of disease. Following the lead of Tschikanofsky, Green and Brooks have declared that prostatic hypertrophy in the aged is the result of chronic prostatitis, which again arises most frequently from chronic posterior urethritis. In eighty-nine cases of hypertrophied prostate which have come under my observation, there were only three that did not give a history of previous gonorrhea, and it is almost impossible to have a gonorrhea without a resulting prostatitis. It is well, therefore, that we pause to consider the various pathological conditions contributory to enlargement of the prostate gland, in order that we may obtain the foundations for an intelligent and appropriate treatment.

* Read before the American Institute of Homeopathy.

I. INFLAMMATORY ENLARGEMENTS.

These may be prostatic or periprostatic, or both; tuberculous.. septic, gonococcic, traumatic.

Tuberculous enlargement of the prostate gland is not so rare as it is supposed to be. The prostate is enlarged not so much from endoprostatic development of tuberculous nodules as from swelling of the periprostatic tissues. The entire prostate may undergo caseation or abscess formation, and perineal, urethral, or anal fistulæ result. The surface of the gland, in the absence of periprostatic swelling, is uneven, irregular; with periprostatitis it is smooth and tense. A case in point is that of K., a clerk, age twenty-six, who weighs eighty-nine pounds and who on the 20th of September, 1902, consulted me on account of extreme frequency and smarting in micturition, occasional "matter" coming from the urethra as well as occasional hematuria. He is the bearer of an old spondylitic kyphosis. and lordosis. He says his acute sufferings date from the 1st of the previous May. His urine is turbid, full of pus. He passes twoquarts in twenty-four hours, by fifty-two distinct acts of urination; i.e., he urinates once every twenty-five minutes. Rectal palpation. discloses a prostate as large as a goose egg, extremely sensitive. The urethra is extremely sensitive and no bougie-à-boule can be passed even after thorough cocainization. Two days afterwards by a prerectal incision I opened the periprostatic abscess, enucleated the prostate gland, and established drainage of the bladder, which was so contracted that it could hardly hold over two ounces. The patient made a rapid recovery, the relief given having been instantaneous with the operation, though up to last February he retained. a perineal fistula, no doubt owing to the state of his bladder. In. another case of tuberculous enlargement of the prostate I removed the prostate with the left seminal vesicle, which was also enlarged.. The patient, a man of thirty-eight, left the hospital in eighteen. days; the healing was complete without any fistula.

In enlargement from periprostatic phlegmon, the prerectal tissueis infiltrated, the anterior rectal wall is fixed on the gland underneath and cannot be moved over it. The infiltration may extend beyond the prostate, upward and laterally, and the contours of the gland are not palpable. This is always a grave condition, which may lead to general septicemia or pyemia, or rupturing into the rectum, perineum, urethra, or even peritoneum, leave fistula that are very hard to heal.

The Plexus Prostaticus, situated between the capsula propria of the gland and the outer fibrous capsule, the latter continuous with