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THE

TON MEDIC

HOMEOPATIC TIMES.

APR 29

MONTHLY JOURNAL

BRARY

ASS'

Of Medicine, Surgery, and the Collateral Sciences.

Vol. VII.

NEW YORK, APRIL, 1879.

No. 1.

Original Articles.

MEDICAL NOTES.

the sick repeatedly and satisfactorily. In other words, "old remedies," like "old friends," have been our main reliances. A few of the new remedies have been used, and in occasional instances with gratifying results. Drugs whose primary effects are largely manifested by their action upon the circulatory apparatus, the heart

ON THE TREATMENT OF MENTAL AND NERVOUS DIS- and its conduits, have most frequently proven them

EASES.

By Selden H. Talcott, A. M., M. D.,

Medical Superintendent, New York State Homœopathic
Asylum for the Insane, Middletown, N. Y.

This paper is designed to embody, in brief, the
ical experiences gained at the asylum under our charge,
during the year 1878. In it we shall seek to "mirror
the vitality of our thought," not alone by recording a se-
ries of successful experiments in medicating the insane,
but also by presenting negative or non-curative results of
treatment in certain varieties of cases.

selves effectual in modifying the symptoms and promoting the recovery of those suffering with mania. Hence we find Aconite and Veratrum viride playing an important part in the early stages of this disease which is marked by such an unnatural and exalted excitement.

The

The distinguishing differences between Aconite and Verat. vir. are these: In Aconite there is great mental clin-anxiety; in Verat, vir, excessive physical unrest. Aconite patient is fearful of the future, and terribly apprehensive of approaching death; the Verat. vir. patient is depressed, but comparatively careless of the future. The Aconite face is flushed bright red, or is pale, with moderate congestion; Verat, vir. has intense cerebral congestion, with a face flushed to a purple hue, and hot, or it is cold, with a pale bluish cast. The Aconite case has great thirst, and gulps water eagerly; the Verat. case has a dry, hot mouth, which feels scalded, but the thirst is moderate. The muscles of the Aconite patient are tense, and the whole mental and physical conditions are like those of an instrument strung to the highest pitch; the Verat. patient is relaxed and restless, has nausea, retches and vomits profusely, has muscular twitchings, and constantly changes his position. In short the Aconite patient has mental. anxiety with physical tension; while the Verat. vir. patient has a lower grade of mental unrest with physical relaxation.

The knowledge that there are forms of mental disease unlikely to recover under the most favorable circumstances, and in which all known methods of treatment have been faithfully tried, with only failures for results, is next in importance, to the honest physician, to those facts which demonstrate our ability to cope successfully with some, at least, of the formidable phases of insanity.

We shall proceed at first with the more pleasant part of our work, that of presenting the favorable effects of medication; and leave the dregs of disappointment and defeat for the closing draught.

In a general way it may be stated that the treatment | of the insane with remedies applied according to the Homœopathic law of cure has been, thus far, a most interesting and fruitful experiment. It has been demonstrated, beyond a doubt, by results gained in the asylum, that the most violent cases of maniacal excitement may be safely cared for, treated, and restored to health, with out resorting to massive doses of somniferous drugs. Indeed, the pathological conditions induced by the latter often form complications, or combinations with the original disease against which the recuperative forces of nature are powerless. Homœopathic treatment conserves the life forces of the patient, and seeks to avoid the aggravation of primary symptoms. Thus, in a long continued and tedious affection like insanity, the curative methods of the Homœopath tend, we believe, to the piloting of a patient through the imminent perils of his disease, with the greatest possible safety and certainty. Brief and imperfect as our experiments have been they have yet been followed by some very interesting developments, and from these a few deductions may now be drawn.

The remedies most used at the asylum are those whose effects upon the healthy were "proved" many years ago, and the "verification" of whose symptoms, in a curative sphere, has been demonstrated at the bedside of

Treading closely upon the heels of Aconite and Verat. rir. and, in fact, contesting strongly for the palm of supremacy are Belladonna and Hyosciamus. Probably no remedy in the Materia Medica possesses a wider range of action, or greater powers for removing abnormal conditions of the brain than Bell. Its symptoms are clear, well defined, unmistakable; its action sharp, vigorous, and profound. It is the powerful supplementary ally of Aconite in removing the last vestiges of cerebral congestion, and beyond this it subdues, like magic, the subtle processes of inflammation. Its symptoms are so familiar to every student of Materia Medica that it would be unprofitable to repeat them here; so we will only state that a marked and happy effect follows the use of Bell. in cases where, in addition to the flushed face, dilated pupils and throbbing arteries, we have a mental condition which manifests itself by the most positive ebullitions of rage and fury; and where the patient tosses in vague, spasmodic restlessness; attempts to bite, strike, tear clothes, strip herself naked, and make outrageous exhibitions of her person. While in this state Bell. patients are exceedingly fickle and constantly changing; now dancing, singing, laughing, and now violent with intolerable rage. The speedy disappearance of such a

grave and serious train of symptoms after Bell. is administered proclaims its unmistakable power in a manner that needs no eulogy. The magic workings of this protean drug are also manifest in the relief of symptoms directly antipodal to those mentioned above. When you have a patient whose face is flushed to an intense, reddish purple hue, pupils widely dilated, eyes having a fixed stony stare, and utterly insensible to light; heavy, almost sterterous breathing; stupid, dazed condition of the mind, so that he cannot be roused to speak; inclined to remain quiet, but with occasional muttering, incoherent delirium; marked rigidity or stealy tension of all the muscles, then you may give Bell. in the confident expectation of reaping an early harvest of good results.

The excitable Bell. patient requires a minimum dose of the drug, while the stupid one is affected most readily and favorably by oft repeated doses of the 1st cen tesimal or even the 1st decimal dilution.

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The Hyosciamus patient is very excitable, but less frenzied than the Bell. patient; is very talkative, mostly good natured and jolly, but occasionally has savage out-pair of salvation, imbecile taciturnity, and complete prosbursts; is inclined to be destructive of clothing, obscene, with a tendency to expose the person. Hyosciamus is, perhaps, more often indicated as a remedy for female patients than Bell., the latter being frequently called for among the male insane.

State Homœopathic Asylum for the Insane, in this nineteenth century, A. D. we have verified the homeopathicity of Veratrum in "amorous furor" and wandering mania," particularly where these symptoms of peculiar excitement are followed by great mental depression and tendency to physical collapse. In ancient days the drug was given until cathartic effects were produced. In these later times we have found a more acceptable method of use, and, with small doses, secure favorable results without aggravating purgation. The Veratrum patient combines the wildest vagaries of the religious enthusiast, the amorous frenzies of the nymphomaniac, and the execrative passions of the infuriated demon, each of these manifestations struggling for the ascendency, and causing the unfortunate victim to writhe and struggle with his mental and physical agonies, like the dying Laocoon wrestling with the serpents of Minerva. This anguish is short lived. The patient soon passes from this exalted snd frenzied condition into one of deepest melancholia, abject destration both of body and mind. The extremities become cold and blue, the heart's action weak and irregular, the respiration hurried, and all the objective symptoms are those of utter collapse. At the same time the mind passes into a Stygian gloom, from which it very slowly emerges.

Following the remedies already mentioned in the treatment of mania come Cantharis, Lachesis, Nux With such a picture before us we can scarcely hesitate vomica, Rhus tox., Sulphur, Thuya, and Veratrum in the choice of a remedy, and Veratrum is the one sealbum. Cantharis very notably fills a niche apparently lected. To be sure some of these cases are past the unoccupied by either Bell., Hyos. or Verat. alb. The grace of medicine, yet the earnest use of this long tried Cantharis patient has mental exhibitions somewhat sim- drug has frequently repaid us by marked improvement ilar to Bell. and Hyos. i. e, frenzied paroxysms of an following its administration, and in several cases comexalted type; bites, screams, tears, and howls like a dog.plete recovery has resulted. As an invariable accompaniment there is always great We have written somewhat hurriedly of a few remeexcitement of the sexual organs. In the latter respect dies most frequently used in recovering cases from Cantharis resembles Hyos, and Verat. alb., but these mania. We come come now to speak of those successlatter drugs commingle the psychical with the physi- fully applied in the treatment of melancholia, Mania and cal-the Hyos, patient displaying lively fancies in con melancholia, alternating as they frequently do in some nection with erotic desires, and the Veratrum patient patients, often require the same or similar remedies. It uniting religious sentiment with lustful tendencies; but is not the name of the disease, but the array of symptoms the Cantharis case is strictly and solely the victim of that indicates the choice of a drug. Still for purposes lechery for its own sake, a result of intense erethism of of convenience we sometimes group, under the name of the sexual organs, impelling him to seek immediate a disease, certain drugs most often applicable in the cure physical gratification. Such patients are inordinate of that disease. masturbators of an acute type. Proper restraint and the administration of Canth. often affords prompt and happy relief, both from the sexual excitement and from the paroxysin of mania. Very scanty urine, and frequent micturition are characteristic of the Cantharis patient.

For loquacity Lach, has been repeatedly verified as a valuable remedy; Nux. com. is useful in cases that are irritable, cross, ugly, obstinate; Rhus tor. and Hyos. relieve suspicions of having been poisoned, the former remedy being particularly adapted to low, typhoid conditions. Sulphur is useful as an intercurrent; and also for fantastic mania, where the patient is inclined to deck himself with gaudy colors, or puts on old rags of bright hues and fancies them the most elegant decorations. Sulphur seldom achieves a cure by itself, but sometimes seconds with vigor the efforts of other drugs.

Digitalis rises to prominence in this connection, not so much by reason of the fame it has acquired in the books," but on account of the excellent effects following its use where homeopathically indicated, and thus administered to the patients in our wards. We use it mostly when the patient is in a dull and lethargic condition; the pupils are dilated to their widest, yet all sensibility to light or touch seems lost; the pulse is full, regular, or but slightly intermittent, and very slow. The slow pulse is the grand characteristic, and upon this indication Digitalis may be given with much assurance that relief will follow speedily, if relief be possible. We notice that the Digitalis patient, when rallying from his melancholic stupor, often moans a good deal, and his eyes are all afloat in tears. Relief, however, speedily follows this bursting of the lachrymal fountains.

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It has long been supposed and advocated that Aurum Veratrum album is a remedy whose sphere of useful was the princely remedy for suicidal melancholia. Our ness comprehends both profound prostration of the experience at the asylum has not sustained this theory. physical forces, and a most shattered condition of the Aurum has often been prescribed, in such cases, but intellectual faculties. The fame of this drug extends usually without good results. Another remedy, which over a period of more than three thousand years. It is we have tried repeatedly, has generally hit the case related that," about the year 1500 before our era, a cer- most happily; and that remedy is Arsenicum. My mind tain Melampus, son of Amithaon, a most celebrated au- has been exercised in solving the mystery of Arsenicum's gur and physician, first at Pylos, then among the Ar-happy effect in cases of suicidal tendencies, while the gives, is said to have cured the daughters of Proetus, king much vaunted Aurum has repeatedly failed to sustain of the Argives, who, in consequence of remaining units whilom reputation. Our conclusion is this. The married, were seized with an amorous furor, and affected by a wandering mania. They were cured chiefly by means of Veratrum album, given in the milk of goats fed upon Veratrum, which Melampus had observed to produce purgative effects upon these animals." In the

patients which Arsenicum has relieved have been those whose physical condition would warrant the adminis tration of that drug. They have been much emaciated; with wretched appetites; a dry, red tongue, shrivelled skin; haggard and anxious in appearance; and evidently

great bodily sufferers. It would seem as if the mental moved altogether for several months. But we are impelled unrest of these patients were due, in the main, to physi- to state that neither this, nor in fact any remedy we have cal disease and consequent exhaustion, and their desire yet tried (and we have tried many) has so far removed to commit suicide is evidently for the purpose of put the symptoms as to enable us to claim a positive, perting an end to their temporal distresses. On the other fect, and permanent cure. The Actea Rac. develops hand the Aurum suicidal patients (that is, the few pa- the best results among those patients who have remarktients has Aurum seemed to benefit,) are usually in fairable heat in the back of the head, and extending down physical health, but who have experienced some unfor- the back, during the convulsions, and who complain of tunate disaster of the affections, who have had trouble great soreness in the muscles of the neck and shoulders with friends, fancy they have been slighted, persecuted, after the convulsions have subsided. Time and experi or wronged, and out of revenge or disgust for the irkence may yet solve the problem, how to cure the epilepsome trials of life seek an untimely end by their own tic insane; but thus far it remains a riddle deep as the hands. Such cases are, with us, more rare than the unfathomed mysteries of Nature. For masturbation we bodily sufferers whose ills are relieved by Arsenicum. have given Agnus Castus, Damiana, Picric acid, Phos. Hence, perhaps, the repeated triumphs of the latter Phos. acid, Nuc comica, but in scarcely an instance drug, and the failure of Aurum. Each drug has its could the relief obtained be considered fully curative. own individual sphere of action, beyond which it be- The Bin-Iodide of Mercury is a remedy said to be efficomes a comparatively inert and useless agent. cacious in such cases, and we are now using it in some apparently suitable cases.

There is this to be considered, in our treatment of masturbatic insanity, that cases of this sort which reach an asylum are usually so far gone in their terrible ways as to be non-amenable to any treatment. If others, with more recent cases to deal with, have had happier experiences we shall be glad to learn of them their methods and the remedies used.

When we have a patient suffering with melancholia, who is constantly moaning and muttering to herself, walks all the time, looking down, is disinclined to talk and angry if any one speaks to her, tries to get away from her friends if they seek to comfort her, sleepless at night and uneasy during the day, then we have given Chamomilla with most decided and salutary effect. Natrum Muriaticum also affords relief to patients given to much crying, their continual weeping being of the open and-above-board variety; while the grief of the Ignatia patient is more passive and concealed. The Pulsatilla case weeps easily, but smiles through her tears, and is readily pacified for the time being, but as quickly relapses into the depths of sorrow when the words of comfort cease. The Cactus patient is sad and hypochondriacal, and has frequent palpitations of the heart, with a corresponding palpitation, so. to speak, in In general paresis we have observed relief from imthe top of the head. We have found Thuja to benefit mediate and threatening symptoms through the adminpatients who have tenacious fixedness of ideas, are al-istration of alcohol. Veratrum viride, Bel!., Nux com. ways harping on one string, and indulge in the strangest and Phos. have also, temporarily, held the diiease in and most unnatural fancies. Such cases are quarrel- check, but in this grave and singular disease we have some and talkative, or very reticent, won't speak to or wrought no cures, earnest though our endeavors have look at a person, and manifest great disgust if spoken to been. by others.

Our dementia cases have been treated with Calcarea carb., Phosphorus, Anacardium and a few other drugs, An improvement in their general condition has often followed the use of the above remedies; and we look upon such cases as affording a somewhat hopeful field for future experiment and research. Still we are unable to record complete recovery from dementia, through medication, except in a very few instances.

In thus recording our failures we have this for consolation that the forms of disease in which Homeopathio drugs have, thus far, proven unsuccessful, are those already declared incurable by physicians of long and vast experience. We shall never rest, however, nor pause in our labors, until the fountain that holds healIning waters for these unfortunates is discovered. Those who live in the darkness of incurability to-day, may bask in the brilliant sunlight of health a single decade hence. A brief defeat does not discourage us; but we engage in the work of exploring and excavating, and in the application of new discoveries, dug out from the yet but partially explored mine of medicine, with undaunted hearts, and with unwavering expectations. The fruits of medical enterprise, like the fruits of the orange tree, do not all ripen at once. The flavor of those already matured is both pleasing and grateful. We believe that more will ripen on the very branches whence blasted ones have fallen. In conclusion we feel impelled to state that the more earnestly we study its tenets, and the more fully we are brought to understand the delicate intrica cies of the Homœopathic law of cure, and the more fully we apply the precepts of that law in our treatmen of the sick, the more firmly are we convinced of it comprehensive and far-reaching efficacy.

Lilium Tigrinum and Sepia find important place in the treatment of depressed and irritable females. The troubles of such cases originate largely in the mal-performance of duty on the part of the generative organs. Both Lilium and Sepia cases are full of apprehensions, and manifest much anxiety for their own welfare. the Sepia case, however, there is likely to be found more striking and serious organic changes of the uterine organs; while the Lilium case presents either functional disturbance or very recent and comparatively superficial | organic lesions. Lilium is more applicable to acute cases of melancholia where the uterus or ovaries are involved in moderate or subacute inflammation, and where the patient apprehends the presence of a fatal disease which does not in reality exist. The Lilium patient is sensitive, hyperæsthetical, tending often to hysteria. She quite readily and speedily recovers, much to her own surprise, as well as that of her friends, who have been made to feel by the patient that her case was hope less. The Sepia patient is sad, despairing, sometimes suicidal, and greatly averse to work or exercise. There is, however, oftentimes, a good reason for such a patient's depression, for too frequently she is the victim of profound organic lesions which can, at best, be cured only by long, patient, and persistent endeavor.

We have spoken thus far of remedies which are applicable to those forms of insanity which are in a measure curable. We now approach the more discouraging portion of our essay, that of recording the vanity of our attempts in treating cases of epileptic and masturbatic insanity, of dementia and general paresis.

It has often been our good fortune to relieve the immediate and distressing symptoms of the epileptic with sensible doses of the Actea Racemosa. Under its action the fits have been lessened in frequency, and sometimes re

INFANTILE PARALYSIS AND DEFORMITIES
DEPENDANT THEREON-TALIPES.

BY GEO. H. TAYLOR, M.D., NEW YORK.

The tender period of infancy and childhood is peculiarly liable to accidents to the health, which result in permanently depriving one or more extremities of voluntary power. Muscular power is developed only under the influence of nerve stimulus. When nerve-cen

tres of the spinal cord are disabled, muscle nutrition is method usually employed.
diminished in proportion to the diminution of muscular thus summarized:
action; development ceases, and the sound extremities
begin to outgrow those whose nutritive supply is thus
cut off. The suffering extremities become cold, blood-
less, soft, doughy and non-resisting; they deteriorate in
development as in functional activity.

Examination of the muscular fibre shows that one of two things usually happens. Either the contents of the muscle-cell, the sarcode, is absorbed, leaving only the collapsed cell-walls and connective tissue and membranes in place of muscle; or the absorbed matter is replaced by fat. In the one case the muscle is diminished in length, as well as size, causing contraction, shortening and drawing; in the other, the parts may continue plump, but quite limp and soft, and destitute of the active features of vitality.

This form of disability of locomotion generally dates from some sudden and short disturbance of health, to which all children are liable. It may be a result of some exanthematous attack, of an acute indigestion, or other not well understood or even recognized cause.

It is probable that in most cases of this kind the actual affection localized in nerve-centres is quite inconsiderable. This is inferred from the ease and certainty with which recovery follows the direct remedy; also from considerations relating to its essential nature.

Many instances of infantile paralysis, probably a considerable proportion, are chargeable to ignorance and neglect in nursing, during the primary attack to which the infirmity is referred. Change of place, exercise, or some equivalent, is a necessity for children. It is not merely that the exuberant nature of children compels great activity, but that change of place, motion, is an absolute requirement for the perfection of function. The effect of carelessly allowing prolonged lying flat upon the back, which sick children are compelled to endure, through the weary days and nights of febrile attacks, is injurious in the extreme. It causes great local excess of heat, dilatation of capillaries, weakening of the spinal cord, and gravitation of fluids into the distended and unresisting vessels is certain to occur. Serous effusion and compression of the delicate nerve-elements, if it does not destroy the integrity of the cord by the plasticity of the effused matter, at least so suspends the nerve-function as to prelude its spontaneous resumption. The result is paralysis, for which ordinary remedies are nearly impotent. They do not completely meet the needs of the

case.

In most of these cases, life-long consequences might have been averted, by using the simplest, common-sense precaution that of frequently turning the little invalid from side to side, and in all directions that appear to be agreeable. Both replete and collapsed vessels imply blood stasis, and are incompatible with nutrition. Every change of posture in these cases is followed by change of contents of vessels-xactly what occurs in health, and without which health is impossible.

Whatever be the nature of the acute or original attack, it is probable that in most cases it is shortly resolved into simple inertia of nutritive processes. Materials adapted to sustain muscular power are not so employed when muscles do not act; equally inactive are the spinal centres from which the normal incentive through the will is received. The conditions for renewal of substance are deficient. Evidently the direct remedy consists simply in supplying initial conditions for vital acts. These are physical and mechanical. These cases furnish beautiful illustrations of the necessity of function to the integrity of vital organs; and of the adaptedness of the vital system to receive and transform power for its own uses from sources exterior to itself. This, in fact, is the end and aim of the organism-a consideration always helpful in therapeutics.

The above pathological review is given for the purpose of enforcing the real and direct therapeutic indications, in distinction from the palliative and temporizing

These indications may be

1. To incite nutritive activity (and consequently power).in the muscles of the affected extremities. 2. By reflex impressions at the extremities as well as over the spine, to increase nutritive activity in spinal

centres.

3. To restore the conducting power of nerves, both as instruments of the will and as bearers of reflex impressions.

4. To secure displacement and local absorption of matters invading the area of spinal defect; also of fat deposited in muscle cells.

The suitableness of transmitted motion to secure these ends is best illustrated by reference to cases.

1. Maud M., at three years of age, had never shown the least disposition or ability to walk. Her helplessness became suddenly apparent when a year and half old, following an obscure and very short attack of some acute sickness. The affection was confined to the left side, and included both the arm and the leg. The leg was cold, very soft, though plump, skin pale and nearly devoid of sensation, and it had not the least power of motion below the knee; the thigh, though smaller than the opposite one, retained some muscular power. The arm was somewhat less feeble.

When such cases are left to themselves, experience shows that one or more of the following changes are liable to occur in the progress of time:

1. Arrest of growth. Normal development continues in the unstricken portions of the body, causing progressively increasing difference in the size and length of corresponding limbs.

2. Arrest of development of part of the muscles of the limbs. The same differences occur in parts of the same limb, and for the same reason; one portion is nourished, the other is not. In this case the strong muscles usually so overpower the weak as to produce deformity of the joints. A segment of the limb is drawn to one side, causing unequal pressure of articulating surfaces.

3. Contractions. Enforced sitting allows muscles to remain contracted, while the cell-contents are absorbed and adhesions of connective tissue fix the limb in a permanent flexed position. If there be spinal or meningeal irritation, this effect is the more certain and ́obstinate. Sometimes the plumpness, but seldom the size of the limb is retained, by a substitution of fat in place of muscle.

The case now referred to belonged to the first in the above classification. The treatment consisted exclusively in the transmission of motion on the principles and in the manner before indicated. No child is too young or too weak to be a proper subject for this treatment; children are also invariably pleased with the application of treatment. Rapid motion (800 to 1,200 per minute), under very moderate pressure controlled by the child herself, was applied to all parts of the body, always in limited areas and in succession. Intermingled with these applications are very slow motions, that is, slower than the natural or usual motions; also applied to segments of the body and limbs in succession. Between each application is a period of ten or more minutes of absolute quiet in a recumbent position. These intervals are positively necessary; it is then that the effects sought for are secured. Three hours of every week day are devoted to the treatment. In the present case the little patient had so far recovered in four months as to begin to walk. From this time I lost sight of her.

Last Winter, just ten years having elapsed, the same case appeared at my office again. I found a well developed young lady of thirteen, healthy, active, proficient, giving no appearance of backwardness due to the early disease. The occasion of the call was the recent discovery, in learning to play on some musical instrument, that she was unable to raise the arm directly upwards. The defect was easily seen to be arrested development of the deltoid: the shoulder was very bare of

few weeks before, and was treated with external applications; but he died suddenly from the effects of applying some one of the salts of potash.

Was my language too strong in calling such practice murder; or in saying that a medical organization, that would take up such facts and push them to their legitimate conclusion, would soon show itself to the world, "as the leading progressive medical institution of our country and age"?

flesh-hence the awkward circuitous route made necessary by substituting the action of other muscles. The deltoid muscle had no efficient contractile power, and but very little substance. In view of the time the diffi culty had existed, I was doubtful as to the capacity of the muscles to acquire fresh development and power; and expected that improvement, if possible, would be slow and unsatisfactory. Great satisfaction was felt at the end of three weeks' vigorous application of the treatment, in seeing her raise her arm to the perpendicular, Two or three weeks after the occurrence of the last through the lateral transverse plane of the body, without case but one given in my preceding report, I was conundue effort. The top of the shoulder had gained in sulted in another, where diarrhoea had been suppressed appearance, and the presence of acting muscles was evi- by strong stimulants, and which was very similar to that dent to the touch. In about two months the newly gained case, in nearly all of its features. A man was attacked motion was natural and easy. Friends of children af with diarrhoea. He called upon a bartender to prepare flicted with infantile paralysis need not despair of re- him a sling, of which he drank freely. It arrested the covery, if treatment be applied during the period of ac-diarrhoea at once, but his kidneys became severely contive growth.

Cases in which only a portion of the muscles is paralyzed, in consequence of the increasing difference of development of parts, tend directly to deformity of some kind and degree. If the stronger muscles receive a morbid stimulus to contraction from irritation of reflex spinal centres, this tendency is the more pronounced. Club Foot, whether congenital or otherwise, furnishes the highest degree of this morbid process and deformity; and I introduce a short account of a case, to show that even this is amenable to treatment on the principles here explained.

C. S. was born with the right foot turned inward, talipes varus. At one and a half years old he suffered the usual operation of cutting tendons, with the subsequent treatment by some modification of Scarpa's Shoe. The treatment was unsuccessful. At two and a half years old he walked only on the side of that foot. At this time he was brought to me. The child was small, pale, thin and weakly in appearance; the deformed foot was poorly developed, and had very little sensation. He was subjected to the methods before de scribed; special attention being given to the distorted limb, without, however, applying any instrument, pulling or stretching of any kind. In about a month he be gan to walk like other children, on the bottom, instead of the side of the foot. The child has since done perfectly well.

The effect of treatment was to remove the paralysis, produced by pre natal causes in certain muscles. Common sensation gradually returned, and with it the power of the weak muscles to antagonize successfully their opponents; this being effected, no force or mechanical apparatus was needed; the foot was restored to its natural shape because it became possessed of its natural

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BY R. R. GREGG, M.D. BUFFALO.

Since my last report, two more cases of sudden death, from suppressed rheumatism, have come to my knowledge. A man had acute rheumatism, and not improving as he thought he ought, dismissed his physician and called another, who made some external application that suppressed the disease in two or three days; and the patient died suddenly, in consequence of the rheumatism being driven to his heart, and in less than a week from the time he was so grandly cured!

Another equally marked case, was that of a man who had been suffering from chronic rheumatism only a

gested the next day; the secretion of urine was almost
wholly suspended for several days; great pain in the
back arose; a terribly fetid breath also resulted, and he
continued in this condition, barely able to travel, and
without the slightest evacuation from his bowels for
several days, when he called upon me. An evacuation
was obtained under the action of Nux Vomica in very
high potency. I have not heard the final result; but fear
Bright's disease or something as serious may follow.
I am now treating a little girl for goitre, the history of
whose case is as follows: At the age of a few weeks the
usual chafing, or intertrigo of infants manifested itself
but in her case it spread as an eruption until all parts of
the body where there were folds in the skin, became
more or less ulcerated. Various washes, ointments, etc.,
were applied without effect, until the pollen of Lycopo
dium was sprinkled upon the parts, which speedily sup-
pressed the eruption. The child was then three months
old, and at once upon the disappearance of the skin dis-
ease, and in the month of February, when there was no
epidemic of any form of bowel disease prevailing, she
was seized with a most violent attack of dysentery, from
which she barely escaped with her life. The dysentery
must in turn have also been in part, or wholly sup
pressed, for before the child had regained anything like
full strength from that, she was taken down with one of
the very worst attacks of acute bronchitis I have ever
seen, and I was then called. Her pulse ran up to 160, or
over, her respirations were eighty per minute for two or
three days, and suffocation appeared inevitable, many
times, from the extent and violence of the congestion
and inflammation. Arsenicum 8000 however, soon ar-
rested all violent symptoms, and the child got out in a
few weeks; but her constitution was so shattered by it
all, that she has been a markedly scrofulous subject ever
since, the upper part of her forehead projecting very
much, and she had a goitre develop two or three years
ago, which is now nearly as large as a man's fist.

I will now give a single case only of a type of which I have seen many dozens, in the course of my practice; and which it is important that every physician should fully understand in its connection with metastasis. Nov., 1862, I was called to a lady in this city of medium height, but of very stout build, who had been considerably reduced by a violent and obstinate cough of several weeks duration, that had resisted all the usual domestic remedies, and also several prescriptions made by a phy sician. The cough was hoarse and somewhat hollow and violent, and occurring as it did in a lady of stout build, it called unmistakably for Belladonna, which was given her in the 200th potency. In two or three days the relief given by it was very great, and the case went on improving rapidly a few days longer, until the cough was scarcely at all troublesome, when further improvement ceased; indeed, the cough soon returned in as great violence as at first. I attributed its recurrence to a severe cold the patient must have have taken, but there had been no exposure, and upon inquiring into the matter more carefully, she told me that after the cough had been so nearly cured, a severe frontal headache

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