coresin and beta-colchicoresin, some sugar, a fixed oil, starch and gum.

Several of the provings of colchicum were made with the wine, and at least two of those recorded in the Cyclopedia were made with a tincture of the seeds.

Gastro-intestinal inflammation is early produced by the drug. Beginning with failure of appetite and coated tongue, nausea and vomiting soon follow, and almost simultaneously colicky pains in the abdomen and diarrhea. More intense symptoms next appear, such as great thirst and increased nausea, until the very smell of food makes her sick (this is the well-known characteristic symptom of the drug). The vomit, which is of a bilious fluid, increases in severity-is worse upon the slightest movement; there is violent burning pain in the stomach. The intestinal symptoms are also aggravated; distension of the abdomen takes place, with griping pains; tenesmus with pains and spasms of the anal sphincters. These are followed by the passage of a transparent, gelatinous, membranous mucus which affords some relief to the abdominal pains.

The stools may be large, yellowish and watery, or contain a lot of small, white, shreddy particles; or they may be slimy or bloody. The urinary organs share in the inflammation and we have brown-black, scanty or bloody urine with strangury.

Such intense action induces great general weakness and exhaustion with cold extremities, which are marked symptoms of the drug. Severe pains are induced in the loins and urinary passages, cramps in legs and feet, and a violent pain in the arms so that the lightest thing cannot be held firmly.

All the above symptoms are peculiar for the severity of their type and make up pictures of dysentery and true cholera. In many points the proving resembles that of veratrum album; and it is possible that the latter has been used where colchicum would better have been employed.

It is not, however, to elaborate the gastro-intestinal sphere of the drug that this paper was written, but rather to again call attention to its usefulness in the principal manifestations of the uric-acid diathesis.

Gout or the gouty paroxysm and colchicum have become almost synonymous, and yet its mode of action has never been fully appreciated.

Authorities differ in their explanations; some contend that it favors solution and excretion of uric acid and urea, while others deny that it has such action. Some hold that it acts best in gout

when it purges, and others consider its exhibition in purgative doses injurious. On this point H. C. Wood says: "By large purgative doses of colchicum the paroxysm of gout may often be suppressed but experience has shown this use of the drug to be dangerous, the suppression being sometimes followed by serious internal diseases apparently due to a transfer of the gouty irritation."

So late an authority as Sollman says: "It will be seen that the pharmacologic actions of colchicum furnish no guide to its rational therapeutic application. It has been widely used on empirical grounds against gout and rheumatism. There is but little evidence of any superiority over aconite and its uncertain toxicity renders it so dangerous that its use should be unhesitatingly condemned."

It is very gratifying to be able to turn from these conflicting views of the action of this drug and to claim it as another illustration of the law of similia.

The proving of Von Gersdorf on p. 317 vol. ii. Cyclopedia of Drug Pathogenesy gives a pretty full picture of the tearing pains all over the body that make up an attack of atypical gout.

The lamented Richard Hughes in his last work "The Principles and Practice of Homeopathy," points out that in Stoerck's provings "the short, lancinating pains in the joints" and from the poisoning cases that "all joints of the fingers and toes and also wrists and ankles were painfully flexed at times. Pain in shoulder joints succeeded, and later in hips and loins. It also increased in intensity until she thought she should go mad. Ultimately almost all the bones and joints were affected with pains which were of a gnawing character."

Again, where 17 persons drank from a bottle of vinum colchici7 of whom died from the effects (p. 340 Cyc. D. P. vol. ii.)—severe pains were felt in the knee joints by some, and in two cases were very marked in the left shoulder. Rubbing was frequently demanded for relief.

Dr. Hughes also quotes the experiments made with colchicine upon eight men, three dogs and a cat. In the human provers dull pains were felt in the joints, and in the cat which was killed as soon as the effects of the poison were manifest an autopsy showed congestion of some of the articular surfaces. The reporters of these experiments, says Dr. Hughes, were constrained to recognize that colchicum produces its therapeutic effects by an irritant action and that "in gout it produces a substitutive irritation of the articular surfaces."

This evidence goes far to prove that colchicum is homeopathic to the gouty paroxysm. Other medicines are indeed applicable to

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the gouty patient, such as bryonia, pulsatilla, lycopodium, sulphur, nux vomica, arnica and aconite. just as other remedies besides china or quinine are applicable to cases of intermittent fever; but no two remedies are more specific in their action upon these two diseases than colchicum and china.

A few words upon the question of dose. The provings were made with large doses of the extract, wine and tincture, and also with the 15th dilution.

Given a case of profound prostration with nausea and diarrhea, the patient having an appetite for many things but as soon as he sees them, or, still more, smells them, he shudders from nausea and cannot eat anything, and colchicum 3x to 30th will probably relieve the condition.

In an attack of gout, however, while the medicine should be employed in small doses, I agree with Dr. Hughes who says: “I cannot affirm that any dilution, however low, answers the purpose of subduing the local pain and inflammation"; and he uses five-drop doses of the tincture of the British Homeopathic Pharmacopeia repeated every four hours. Dr. Goodno recommends ten-drop doses of a good tincture repeated every two hours, and says that one to three-drop doses often prove successful, and occasionally the IX dilution for typical cases of great-toe gout with heavily coated tongue, nausea, possibly vomiting, colic or diarrhea. He prefers colchicum to the tincture, and gives it in the 3x trituration repeating the dose every one-half to two hours.

The tincture of colchicum prepared according to the Homeopathic Pharmacopeia of the United States, is an active preparation and may be used in the same dosage as that recommended by Drs. Yeldham and Hughes for the British tincture, viz., 5 drops every four hours. In this dose it has given me good results. The tincture of the U. S. Pharmacopeia is not so satisfactory, being made from plants collected at different seasons of the year and varying very much in the percentages of alkaloid contained. The alkaloid colchicine has consequently been preferred unless an assayed tincture was available.

I have employed Merck's colchicine 2x tablets made by Otis Clapp & Son. I prefer tablets containing 1-100 gr. to the 3x because they are more exact in the quantity of drug contained. Colchicine is soluble in water, alcohol and chloroform. I dissolve one tablet of the 2x in from five to ten teaspoonsful of water; of this a teaspoonful (which thus approximates 1-500 or 1-1000 of a gr.) is given every one, two or four hours as required. Solution in water seems to be more active than in alcohol. It is well to direct

thorough stirring before taking each dose. In two of my cases where the patients seemed to be specially susceptible to the drug, active emesis occurred which subsided on withholding the medicine. In these cases the subsidence of the swelling and inflammation in the joints was very rapid.

In the case of the feeble or aged, a tablet of the 2x of colchicine should be dissolved in not less than ten teaspoonsful of water and a teaspoonful of the mixture (after thorough stirring) given every two to four hours.

The similarity of colchicum to the joint pains of gout suggests its use also in acute articular rheumatism; and experience proves its value in this disease.

Dr. Colby (quoted by Hughes) claims that it acts equally well in sub-acute rheumatism, especially in gouty subjects; but apart from this, he says it is well indicated when the inflammation attacks chiefly the hands and feet, shows central tenderness on palpation, moderate swelling and a pink blush, causes constant pain which is increased during the prevalence of damp east winds, and especially before a storm, and gives the affected members a sense of paralytic weakness. He prefers to administer the vinum of the British Pharmacopeia.

Dr. Goodno in his work under Rheumatism recommends colchicum I gr. dissolved in an ounce of alcohol, and gives 5 to 10 drops of this as a dose. Allowing two drops to a minim this dose is about equivalent to 1-200 to 1-100 of a grain.

In rheumatism colchicum is to be compared with bryonia, pulsatilla, mercurius, caulophyllum, lycopodium, viola odorata, and other remedies.

To sum up the action of colchicum, we have in it a remedy of limited usefulness, yet very valuable when indicated in such gastrointestinal disorders as cholera and dysentery and which is homeopathic to the joint pains of gout and rheumatism when given in doses which are insufficient to cause its physiological effects.

The Treatment of Leprosy.-Dr. Razlag, an American physician resident in South China, reports through U. S. Consul McWade excellent results in the treatment of four severe cases of leprosy. Dr. Razlag's methods are in line with the modern idea of the supreme value of good hygiene. Open air, cleanliness, and baths may be said to be the main factors. The doctor brings about the slow healing of skin lesions, attacks the anesthetic areas with oil frictions, and reduces edema by the use of leeches. Then he is ready for the internal treatment, in which arsenic is used routinely in combination with strychnine and icthyol.

THE INFLUENCE OF THE CLIMATE OF SOUTHWESTERN TEXAS UPON RESPIRATORY

DISEASES.*

BY M. J. BLIEM, M. D.

San Antonio, Texas.

N this paper I propose to tell the truth, the whole truth, and

writing about climates; some for advertising purposes and some from ignorance or unbalanced enthusiasm. Be that as it may, the importance of climate in the successful treatment of tuberculosis, especially, is rated much lower by the profession to-day than it was ten years ago. Two factors undoubtedly account for this change of view. First: the vast number of patients who have left home for distant climates only to come back for burial or to die has convinced us that climates do not by any means bring about the infallible cures they were supposed to. Second: the remarkable results achieved in the sanatoria, amid indifferent climates both in Germany and in this country, have demonstrated the fact that the influence of climate has been greatly overestimated.

In consequence of this change of opinion many doctors are now advising their patients to go to sanatoria near home or to live a sanitarium life, so to speak, right at home. Proper and abundant food, life in constant fresh air, perfect regularity in all habits of life, perfect hygiene- these have been found to be far more important factors in cure than change of climate. There is no question but that thousands of hopelessly incurable victims have been allowed, or encouraged to leave home, only to die among strangers, in loneliness and sorrow. The mortality records of San Antonio, Texas, show that 60 per cent. of all deaths from tuberculosis occur within the first year of their residence there. This shows the advanced stage in which many of these cases leave home. Then, forsooth, the "climate is no good!"

But, after all, let us be just. If such splendid results can be attained by proper methods in notoriously poor climates, it stands to reason that much better results can, by the same methods, be obtained in a good climate.

Among good climates that of southwest Texas holds a deservedly high place. It is sui generis-has qualities peculiar to itself which must be understood in order to appreciate what influence it may

* Read before the American Institute of Homeopathy.