DO YOU KNOW THAT PEPTENZYME Contains the emzymes of all the glands, which go to aid digestion, and in the same physiological form and proportion as found in the human body. It is the only preparation that contains the ferments of the spleen and liver. COCA EMPLOYED IN MALARIA. For centuries Coca has been accepted by the Peruvian Indians as a specific for malarial fevers. When the Indians open a grave in search of relics, they chew Coca leaves to propitiate the "evil spirits," and it is a fact that those who do not chew the leaves are attacked with a malignant sore throat. So, too, the Cascarilleros, or cinchona gatherers, in going to the unhealthful forests in search of bark-"regard Coca as a remedy against malaria superior to quinine." [Mortimer's Peru: History of Coca, page 115.] Whether Coca alone will eliminate malarial poisoning in this climate is not fully established, but it is very probable that because of its influence as a depurative of the REED & CARNRICK, 42-44-46 Germania Ave., JERSEY CITY, N. J. blood stream it may do so. Certain it is that Coca can be employed with quinine to advantage. When so used, it wholly prevents that peculiar nervous irritability induced by quinine which is so annoying to many who are obliged to use that specific. Coca is calmative to the cerebral circulation, and in this action is superior to the bromides. In the depression from grippe, a hot grog of Vin Mariani has been advocated by the highest authorities, both here and in Europe, to dispel the nerve-racking malarial pains in the muscles, and it is positive that Coca is not a true specific for malaria, it is the most useful adjuvant that can be employed in the treatment of the aggravating cachexia and blood impoverishment following that disease.-Coca Leaf, April, 1904. ALKALOMETRV: ACTIVE-PRIN CIPLE THERAPEUTICS. WHAT IT IS. 1. The administration of small doses of the most active and potent known remedies (chiefly alkaloids and other active principles representing the majority of all the accepted vegetable remedies) at short intervals until either remedial effect or signs of drug sufficiency, the full physiological effect of the drug are apparent. 2. The exhibition of such doses in the form of tiny soluble granules or tablets each containing a definite amount (usually gr. 1-134, 1-67, 1-6 or 1-3) of the drug. 3. The additional use of such solvents, eliminants, vital incitants and local and systemic antiseptics as have proven by extensive clinical test of considerable remedial value. 4. The freedom to use any and all remedial agents-always in the purest and most concentrated form available--that will produce definite results in a recognized condition. 5, The absolute avoidance of promiscuous formulas, problematical remedies, crude drugs (vegetable) and nauseous, changeable, alcoholic tinctures and fluid extracts when the active (remedial) principle of the drug can be given in its purity in effective well-established dose. WHAT IT DOES. 1. It cures, where it is possible to cure, cito, tuto et jucunde. Its chemistry is done outside the sick body. 2. It gives the maximum obtainable results in the shortest possible time, with absolute safety and with no possibility of overdose, or cumulative effect. 3. It enables the practician to give the most potent medicines to the youngest infant or the most squeamish invalid without the aid of scales, measures or menstrua. 4. It enables the doctor to push a remedy to effect without wondering whether he has poisoned that particular patient in his effort to give enough. 5. It makes it possible for the practician to have always with him an emergency case filled with standard medicaments of unchangeable strength and consistency for acute cases and urgencies, thus enabling him to treat conditions when they most need treatment and whn he can do the most good. 6. It enables the doctor to practise the most certain, safe and efficient method at a nominal cost. 7. It eliminates "chance" and, with perfectness of diagnosis and application, makes medicine "An Exact Science"-or as near that as it is possible to attain. Doctor, you may have seen this before, but it is worth another look. WHAT SHALL IT BE? This question is present in the mind of the busy physician every summer when he confronts the problem of appropriate tonic medication for the weak, poorly nourished, and debilitated. He knows that during no other season of the year is there so marked a tendency to disturbances of the gastro-intes "Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downwright facts at present more than anything else." -RUSKIN. Original Communications. HYSTERIA With Report of Case.* BY O. R. REESOR, M. D. YSTERIA is supposed to be a functional psychoneurosis due to a morbid condition of the cerebral, spinal and sympathetic nerve apparatus, but apparently involving, primarily, the cerebral cortex, and is characterized by mental motor, sensory, vasomotor and visceral disorders. Etiology.-Hysteria is a very common condition, of the female sex more especially. You find it more especially between the ages of puberty and menopause. While you occasionally see it in the young but not frequently, and again after the age of fifty years. Heredity plays an important part; you very often see it in the daughter whose mother was hysterical, or in those who give a family history of being nervous, excitable, etc. Inciting Causes.-Any emotional disturbance may bring on an attack of hysteria, such as over work, grief, chagrin, fright, etc., whieh generally disappears after the removal of the cause. Again it may follow traumatism, and under this head you see it more frequently in the male sex, for the simple reason that males are subject to more accidents than the females. The likelihood of hysteria following trauma depends upon the intensity of the mental shock. You occasionally find this following intoxication, from lead, mercury, sulphid carbon, tobacco, morphine, cocaine and chronic alcoholism, or from a single alcoholic debauch. Acute infectious diseases, such as typhoid, malaria, diphtheria, grippe, pneumonia, scarlatina, etc., may induce hysteria. Where you find a number of persons closely associated, such as Read before the Louisville Medical and Surgical Society, May 15, 1905. schools, prisons, barricks, etc., they may become hysterical, more especially if there are some one in the association who are so affected. You find those who become so affected greatly simulating the case with whom they have been associated. Symptoms.-The symptoms may be divided into two classes, the Stigmata, those which are persistent, and the Accident, those which are transitory or intermittent. The Stigmata are necessarily single or in combination, but when once developed tends to persist so long as the affection lasts. The Stigmata may be divided into sensory, motor and psychic. Sensory may be divided into negative varieties, such as anesthesis, positive, the hyperesthesias. You may find them both in a given case but the anesthesis are the most important symptomatically. Hysterical anesthesia may affect sensation in all its modes and tenses, including the special senses. Special Senses.-Taste and smell may be perverted, diminished or abolished. The loss of taste is usually limited to a portion of the tongue and mouth. Hearing is often greatly diminished, but complete hysterical deafness is very uncommon. Vision is very frequently modified, but complete blindness is very rare; when it does occur, it is of sudden onset, of few days duration and sudden recovery. Vision in one eye is often reduced to counting fingers or less. You will most often find first a reduction of the field; second, troubles of color perception; third, errors of accommodation. These conditions of the sense of sight, I leave to the eye specialist for discussion. Cutaneous anesthesia may be absolute. Pricking, pinching, hot and cold bodies, produce no response. You may find one side of the body or limb anesthetic. Again, you may be able to locate certain spots on the body anesthetic. The mucous membrane may show the same anesthetic modifications of sensibility. The deeper parts are frequently anesthetic. You may take the bones, muscles, ligaments, or the cord, and give a severe wrench, twist or pierce them without any sensation whatever. Motor Stigmata.-You find the movements in hysteria retarded; you therefore find the retardation closely allied to the anesthesias. It may be increased by diverting the patient's attention, or diminished by concentrating his attention upon the given act. These patients are often capable of performing several acts simultaneously, as they are unequal to the division of attention thereby necessitated. In many, there is a tendency to rigidity or contractures and may be demonstrated in weakened or anesthetic limbs and often indicated by exalted reflexes. Mental stigmata or hysteria consists in a belittlement of memory and will power. The amnesia is sometimes due to lack of mental concentration, and the loss of will power is frequently manifested in the impulsive acts and general want of self-control. Accidents of Hysteria.-The accidents of hysteria are considered to be more or less transitory features of hysteria, which chief among these, are the hysterical attacks. These often take the form of severe, intense and prolonged convulsions. The complete grand attack as studied and described by Charcot are infrequent, but in some irregular or fractional form, they occur in a majority of all cases. When one has this attack, they may assume most any posture, having most generally always a prodromal stage, characterized by some to be depressed, moody, etc. Others exhilarated, restless, quarrelsome, and talkative. The Aura follows, and this ordinarily consists of a painful feeling arising in the lower part of the abdomen and develops into a lump in the throat, giving a feeling of strangulation and suffocation: "the globus hystericus" face flushed, throbbing in the temples, objects turn black before the eyes, vertigo occurs and the patient sinks down or may fall suddenly unconscious, which is the beginning of the convulsion. Motor Accidents.-Paralysis and contractures may both be combined in a given patient and given limb. They may follow convulsive attacks, mental impression or shocks, traumatism or morbid states. Paralysis are commonly marked by sudden emotional onset, or may gradually develop after some such moral strain. They very rarely ever abolish every movement of the limb. Contractures present loss of power with persistent voluntary rigidity without modification of the electrical or tendon responses. The affected limb is more or less rigid, muscles tense and firm. The contractures persist during sleep but yield completely under a general anesthesia. Prognosis is not so good, for under the actions of inciting causes you very often find its recurrence. Many consider themselves well, but upon careful examination you will be able to find traces of it. It is exceptional to see a well developed case of hysteria gain absolute health. Children make better recovery than elder persons. Diagnosis. You have less difficulty if you can distinguish it from neurasthenia, emotional disturbances, etc. No disease when well developed is so distinctly marked and stigmatized. Treatment.-Recognizing in hysteria a mental disturbance principally your treatment must be mainly psychic. Methods are usually successful in proportion as they are novel to the patient, strike the fancy and stimulate the imagination. You may divide the treatment into general which is applicable to all the manifestations of the disease. Special regarding the manifestations of individual cases. General. First, try to do away with the fixed idea that dominates the patient; after this you have easy sailing. To find out just how this idea arose, is sometimes difficult; may have arisen in a dream and in many it is a subconcious idea. Best to remove person from place where disease first originated. If possible a trip across the country, sea voyage, etc. Limit their associates and avoid everything which causes |