Nitrate Uranium. Two cases cited of its use. In neither case were results perfectly satisfactory, though great improvement resulted in two very unpromising cases. (A. O., 1876, p. 248.)

Cured with Uranium nitrate 2x, four grains a day for weeks. Diet not restricted to animal food. (P. Dudley, H. M., Jan., 1876.)

Several months after having two furuncles a man complained of great weakness, emaciation, and brittleness of the skin. Appetite, thirst, as well as the quantity of urine, were not increased; the urine contained for the twenty-four hours only four and a half grains of sugar; Uran. nitr. 3; soon after a boring pain in the region of the pylorus disappeared, and he became stronger, but the quantity of sugar had increased after a month despite the careful diet usually observed for diabetic patients; Acid phosph. 4; in six or eight weeks the quantity of sugar slowly decreased and finally disappeared, and the patient was in all other respects well. (Dr. Huber, A. H. Z., 92, p. 197.)

Uranium mur. in. (H. W., vol. XI., p. 83.)

Calcium Sulphide, one-eighth gr., ter die, gave immediate relief in a case. (H. W., vol. XI., p. 84.)

Salicylic acid in ten grain doses, thrice daily, gives great relief. (H. W., vol. XI., p. 84.)

I would recommend a generous diet (excluding only those things which contain an excess of sugar and starch), and Lactic acid as a remedy. (J. K. Warren, Mass. Trans., vol. IV., p. 676.)

The use of Karlsbad water lessens the quantity of sugar in the urine; the hunger, dry tongue, and the nightly urination are also ameliorated, and they slowly disappear; but the improvement only lasts three or four months. (Dr. Porges, A. H. Z., 92, p. 197.) Two severe cases reported cured with Arsenicum. (Dr. Veith, A. H. Z., 92, p. 197.) Carbolic acid and Salicylic acid recommended for. (Dr. Goullon, Jr., A. H. Z., 92, p. 203.)

Insipidus cured within six weeks by Lycopod. (Dr. Müller, A. H. Z., 92, p. 197.) Nephritis vera. Mr. C., laborer, worked in water for three hours, ten days previous to my visit. The next morning awoke with pain in left kidney and could not urinate, but since then has passed a few drops ten or twelve times per day. Urine bloody,

Defective nerve power as a cause of. Dr. Brookhouse, in British Med. Jour. (H. W., vol. XI., p. 223.)

After scarlet fever; oedema of hands, feet, and face; ascites; effusion in the cavity of the chest; rattling; cough, with expectoration of mucus; constriction of chest; short, quick breathing; no appetite; great thirst; pulse 120; urine scanty, reddish, containing much albumen; Arsen. 2 cured, (Dr. Bourgeois, A. H. Z., 68, p. 158, quoted by Dr. Karl Hencke, A. H. Z., 93, p. 85.) A treatise. (II part, Gustav Puhlmann, H. K., vol. XXI., p. 2.)

Albuminuria. Acid benzoicum. Awakens at 2 A. M. with humming in the ears and beating in the temporal arteries, preventing sleep. Sore, hot, and burning pain in left kidney. Frequent desire to urinate. Urine contained mucus and pus, with enlargement of the prostate gland. Urine of a dark color, with unusually strong pungent smell; heavy, hot. Awakens with oppression of breathing, with palpitation of the heart, with heat and hard pulse.

Great

Apis mellifica. Thirstlessness, with dropsy. Urine scanty and high-colored, or profuse and very dark. Strangury. Swellings of face, hands, legs, ankles, and feet. debility, as though he had worked hard. Burning, stinging pains. Hives. Worse at night, and especially in a warm room. Apis, Hellebore, Lachesis, Uranium nitrate, are the most important remedies in this disease.

Arsenicum. Restlessness; anguish, driving him out of bed at night; tosses about the bed in daytime. Great fear of death and of being left alone. Burning swelling of the head and face, with great weakness and coldness. Worse at night. Puffiness of the face, especially around the eyes. Pale, death-like appearance of face. Vomiting of a black substance. Suppressed or difficult urination. Urine bloody, burning. Paralysis of bladder. Involuntary discharge of burning urine during sleep. Oppressed,

labored breathing. Suffocating spells in the evening when lying down. Constriction of chest, with anguish, worse when moving. Stitches with pressure on the sternum. Palpitation of the heart, especi ally at night, with anguish. Left side of heart affected. Drinks but little at a time; has a fear of drinking largely. Aurum foliatum. Melancholic mood, with desire for death. Contradiction excites wrath; bloated, shining face; painful retention of urine, with pressure on the bladder. Passes more urine than corresponds to the quantity drank; turbid urine, like butter-milk, with much sediment of mucus; thick urine, with strong ammoniacal smell; decomposing rapidly; hot, red urine, containing sand.

Belladonna. Urine deep-red, with a light sediment; blood-colored urine. The urine becomes turbid, like yeast, with a reddish sediment; whitish, pale urine; retention of urine, with later dysuria; spasms; back of the head hot, twitching of limbs while asleep.

Bryonia. Urine almost dark-brown; more scanty and darker than usual. In cases of effusion of the chest: A dry, hacking cough, with sticking pain under the sternum; frequent catching for breath immediately before a paroxysm of coughing; suffocative attacks, especially after midnight; asthmatic breathing, worse upon the least motion; dyspnoea so great he cannot utter a word; breathing, hurried, quick, anxious, from stitches in the sternum, compelling him to sit up.

Colchicum. Brown-black urine; also whitish sediment in the urine; cedematous swelling of the face, with great paleness; lancinating pain or cutting, as with a knife, in the right side of the chest; oppression of the chest, with anxiety, relieved by bending forward; frequent pressure and oppression in the region of the heart, as if an attack of apoplexy was coming on; disgust for food, especially if he smells it cooking. Cantharis. Burning, stinging, and tearing

in the kidneys, extending along the ureters into bladder; constant desire to urinate, passing only a few drops at a time; useful in some cases in the early part of the dis

ease.

Copaiva. Urine foams, and smells like violets; greenish, turbid urine.

Cuprum m. Convulsions of the head; it is drawn to one side; purplish-red swelling of the face; twitching of the limbs, and biting of the tongue; especially to be thought of in epileptic patients; dropsy from hypertrophy of the heart.

Digitalis. Blueness of the eyelids and lips; bluish hue of the skin; excessive emission of urine; hydrothorax, with slowness of the pulse; dyspnoea.

Dulcamara. Oppression of breathing from a cold; aggravation from change from warm weather to cold; or when fire gets low in the room.

Helonias. Lowness of spirits; restlessness; burning, aching in lumbar spine; frequent profuse sweat; urine pale-yellow; sp. gr., 1013, acid; gets up two or three times in the night to urinate; debility; palpitation when going up stairs; appetite poor; sleep difficult, and not refreshing.

Helleborus niger. Indifferent, sad, silent; diminished power of the mind over the body; giddiness; cedematous pale swelling of the face; pale-yellowish color of the face; staring eyes; eyes seem to start from their sockets with every breath; old, anxious look; forehead is full of horizontal wrinkles; dry tongue, and coated white; distention of bowels, ascites; frequent desire to urinate, emitting a large quantity, almost as black as ink, with blood in bottom of the vessel, black sand or sediment like coffee-grounds; suffocative attacks; effusion in pericardium, or pleura; lies in a stupor, with eyes half open, and pupils turned up. Sopor. Convulsive twitching of the muscles during sleep; raises one arm and one limb, and keeps them going verti cally to and fro; pulse small, almost imperceptible. If fever occurs, face remains pale. No desire to eat or drink. At times cold, clammy sweat; sudden dropsical swellings. Aggravation at 4 P. M., in the cold air, in the evening, and from exertion. Wants to be quiet and let alone. Better in warm air, especially for bad cases. Hepar sulph. Urine dark and hot. Bloody urine after abuse of Mercury. Dry, hoarse cough, from evening till midnight. Cough caused by limbs becoming cold or uncovering at night. Bronchitis. Violent palpitation of the heart, with stitches in heart and left half of the chest.

Kali carb. Sacculated swelling of upper eyelid. Face yellow, bloated. Difficult wheezing breathing. Spasmodic asthma in the morning, relieved by sitting up and bending head on knees; worse 3 to 4 A. M. Stitches in sternum and right side of chest, extending through to back. Stiffness in the back and shoulders.

Kali hydriodicum. Bloated eyelids; acrid coryza, with cold in head. Increased secretion of urine, with unquenchable thirst. Urine red as blood. Frequent and copious emission of pale, watery urine.

Kalmia latifolia. Diseases of heart, alternating with rheumatism. Emits large quantities of yellow urine.

Lachesis. General oedema. Face pale, puffed, yellow. Urine foaming, feels as if a ball rolled about in bladder. Advanced cases; shortness of breath and suffocative attacks by touching larynx, or by clothing, and aggravated by moving the arms. Wheezing breathing; must sit up. With dyspnoea, eructations of wind, which relieve. Head thrown back; grasps throat, or clothing near it and tears it away. Greatest anguish.

Lycopodium. Loss of appetite; when he feels hungry and food is brought him, a few mouthfuls suffice. A little eaten aggravates the dyspnoea and causes rumbling of wind in bowels, probably eructations. Foamy and dark urine.

Merc. cor. sub. Dyspnoea almost paralyzes the heart.

Nitric acid. In syphilitic cases, or after abuse of Mercury, dullness of first sound of the heart; worse at night. Heart intermits every third beat. Muddy and foul-smelling urine, like that of horses. Dry, hot skin, fever, headache. Edema pedum.

Nux vom.

Pains in the small of the back, as if bruised, so violent he cannot move. Lameness in back. Heaviness and stiffness in the neck. Cough from exertion. Dyspnoea. Constipation. Bad breath. Deranged stomach. Sour taste. Sleepless fore part of night, with great drowsiness in the morning and during the day. Drawing in the arms, as if they were asleep. Loss of motion of arm. .

Petroleum. Fistula recti. Deposits of gonorrhea produced in old people ascending fistula, and after awhile albumen appears in the urine. Difficult micturition. Red sand in urine, with slimy pellicle on surface. A dark cloud in urine. Brown, extremely fetid urine, of strong, ammoniacal smell. Discharge of prostatic fluid. Phytolacca dec. Albuminous urine.

Dark

red urine, leaving a deep red stain in the vessel. In post-diptheritic cases the patient is of a rheumatic diathesis, and is frequently afflicted with rheumatism of the periosteal and fibrous tissue, or is suffering from the bad effects of syphilis. Phosphorus. Right side of heart affected. Double beats of heart. Urine whitish, like curdled milk; soon becoming turbid, with brickdust sediment, with a variegated cuticle on surface. Great nervous debility; trembling in all the limbs from the least exertion. Hæmorrhage from the kidneys.

Phosphoric acid. Disinclined to talk or to answer a question. Indifference. Hot tension of the skin of the face, as if the white of an egg had dried on it. Urine like milk, with bloody, jelly-like lumps. Prof se emission of urine. Loss of fluids does not weaken the patient as much as one would suppose.

Pulsatilla. Scanty, red-brown urine. Dyspnoea and cough as soon as he gets warm. Must have more fresh air and less covering than usual.

Sepia Must rise at night and urinate frequently. Urine turbid, with sediment of red sand, which adheres so firmly it must be scraped off the chamber. Urine bloodred, with white sediment and cuticle on the surface. Urine so offensive the patient asks to have it put in another room. Stramonium. Attacks of rage; strikes persons who come near him. Desire for light; has all the burners in the room lighted. Very changeable, laughs loudly, becomes proud and haughty in his delirium. Faints away, with paleness of the face. Bloated turgid face. Total loss of consciousness. Raises the head frequently from the pillow, or bends it backward. Anxiety and fear is expressed in the countenance. Is afraid of some particular person. Paralysis of the tongue, making speech indistinct. Periodicallv returning attacks of painless, barking, spasmodic cough, in fine, shrieking tone, from constriction of the larynx and chest, without expectoration. Emprosthotonos. Opisthotonos. Convulsions. Deep, stupified sleep, with snoring. Frightful visions; wakens and starts out of bed to run. Eclampsia. Tingling and trembling in the limbs.

Tart. em. acts best in sycotic cases. Dark-red urine. Brown urine. Dyspnoea, compelling him to sit up. Painful urging to urinate. Rattling, hollow cough. Accumulation and rattling of mucus in the trachea and chest.

Terebinth. Difficult micturition; the urine smells of violets; deposits of mucus, or thick muddy deposit. Suppression of urine. Strangury. Pressure in the kidneys when sitting, going off during motion. Sensation of pain and heaviness in region of the kidneys.. Hæmaturia.

Uranium nitrate. Cross and disagreeable. Ill-tempered. Pain over left eye. Desire to urinate immediately after voiding urine. Micturates twelve to twenty-four times in twenty-four hours. Diabetes with albuminuria. Bright's disease. A constant sensation of faintness at stomach even after a hearty meal. (Hale.) (M. M. Walker, H. M., p. 343. 1876.)

BLADDER. Renal colic. Passage from time to time of gravel, with dull pain in the right renal region; pains went into the ureter; there was tickling in the urethra, and difficult urination. Arsen. 1 cured. (Dr. Bourgeois, A. H. Z., 68,p. 158, quoted by Dr. Karl Hencke, A. H. Z., 93, p. 85.)

-

Left-sided, pains lancinating or dull, radiating into the ureter, could not work or be long in an upright position; attacks worse from getting tired; profuse urination, with sediment and uric acid; emaciated. gastralgia; alternating diarrhoea and constipation. Arsen. 3 cured. (Dr. Bourgeois, A. H. Z., 68, p. 158, quoted by Dr. Karl Hencke, A. H. Z., 93, p. 85.)

With passage of two small oxalate of lime stones; after this the pains in the kidneys increased, were stitching, extending into the ureters, or dull, increased by pressure, bending of the trunk walking or riding, at the same time itching and burning in the penis; burning in the urethra when urinating; great pressure to urinate; difficult micturition; urine alkaline, dark yellow in color, with deposit of mucus and urate of lime crystals. Arsen. 3 cured. (Dr. Schodler, A. H. Z., 68, p. 151, quoted by Dr. Kari Hencke, A. H. Z., 93, p. 77.)

Calculus, one said to contain seventy-five per cent. of peroxide of iron. (Reported by M. Laborde to the oc. de Biologie, Exchange Gaz. de Hos., H. W, vol. XI., p. 491.)

Dios. relieved the writhing, twisting, crampy pain. (E. M. Hale, M. I., vol. III., p. 417, 1876.)

Urinary Infiltration. Etiology, diag nosis, and surgical treatment, with statistics of eighty-two cases of rupture of the bladder.

By urinary infiltration we understand the escape of urine from the bladder and its extravasation into the adjacent tissues. It is caused either by rupture of the urethra or bladder. The early symptoms of rupture of the bladder are, sensation as of something giving away within, sudden relief of extreme distension of the bladder, great prostration, collapse, and death in a few hours. It is important to know whether the effusion has taken place into the peritoneal cavity or into the connective tissues. The main indications for treatment are: (1.) To remove the escaped urine. (2.) To prevent its reaccumulation in and further escape from the bladder into adjacent tissues. (3.) To relieve pain and combat inflammation. (4.) To sup

port the system. As soon as the accident is diagnosed place your patient in the lithotomy position, introduce a staff with a broad groove into the bladder, and upon it make an incision in the median line of the perineum, opening the urethra to the neck of the bladder, dividing any stricture that exists. You then remove the staff, introduce a silver catheter into bladder perineal wound and explore for rupture, through which, when found, you introduce the. catheter in order to evacuate the effused fluid from the peritoneal cavity or cellular tissues as the case may be. After you have drawn off as much urine as possible, inject warm water with carbolic acid till the cavity is thoroughly washed out, then withdraw the catheter and introduce a flexible one through the urethra and retain it there in order to prevent the accumulation in the bladder and its overflow through the rupture. As this mode of treatment has never been tried or advised that I know of, and as every other method has proved unsatisfactory, I think every physician should feel called upon to investigate and give this method a trial if he have an accident of this kind to treat. (Henry G. Preston, Trans. N. Y. S., 1876-7, p. 255.)

Bladder, Inflammation of the. (J: C. Burgher, H. M., Oct. 1876.)

Treatment of. This should be both local and general. The bladder should be kept as free as possible from inorganic deposits. The urine, if of an irritating quality, should not be allowed to remain in constant contact with the mucous membrane. Catheterism should be performed, to insure the complete evacuation and contraction of the bladder, where the powers of nature are unable to accomplish these objects. Morbid deposits should be removed by irrigating or washing out the bladder with pure water at a temperature of 98° or 100°. The operation is easily performed with an ordinary India-rubber bottle syringe and gum catheter. A fountain syringe and double catheter are sometimes employed, affording an opportunity for the fluid to escape as it is injected. The safer plan is to slowly inject two or three ounces of water, allow it to remain for two or three minutes, and flow out. In washing out the bladder only a small quantity of fluid should be injected. Two or three ounces may prove highly useful, while the employment of double that quantity would result in mischief. Warm water, to which salt has been added sufficient to impart a brackish taste, injected into the bladder, sometimes has a very soothing effect. An infusion of linseed, used in the same way, has been used with

benefit. The tincture of Hydrastis (five drops to the ounce of warm water) may prove a valuable adjuvant, used in the above manner. Great care and gentleness should be observed in these manipulations, or the harm resulting from the manual interference will more than counterbalance the good. Should these means afford no relief after a trial, or should they cause aggravation of the symptoms, they must be discontinued. Ice introduced into the rectum is a valuable palliative in painful urination. When nausea and vomiting are present, small pieces of ice, slowly dissolved in the mouth, will sometimes relieve these symptoms. Hot fomentations and poultices applied over the supra-pubic region are often very useful in relieving the congestion of the organs. The same may be said of the warm hip bath. Demulcents are useful in two ways-they 'dilute the renal secretion and furnish some nutriment to the body. Possibly in some instances they may exert a special therapeutic influence. Among those most usually employed are infusions of Irish moss, linseed, slippery elm bark, gum arabic, and barleywater. Pure water may be used ad libitum. As proper hygienic and dietetic regulations are important, they should be rigidly inforced. Walking, riding, in short, all physical exertion should be prohibited, and rest in the recumbent posture enjoined. Special care should be taken to protect the patient from cold. The diet should be light and nutritious, and great care taken to maintain the digestive system in good condition.

Atony and Paralysis. (J. H. Buffum,
H. M., Oct. 1876.)

Treatment of. Among the remedies which
will be found useful in atony the following
are prominent: Arnica, Rhus tox., Opium,
Phosphorus, Arsenicum alb., Strychnia,
Stannum met., Hyoscyamus, Causticum,
Opium, and Stramonium. The special in-
dications for the remedies will be found in
an appendix to the paper. In addition to
internal medication strict attention must
be paid to general hygiene, and toward a
removal of the cause. In the attempt to
restore the contractile power to the over-
stretched muscle, the first indication is to
keep the muscle from further violence by
the use of the catheter three or four times
daily, and the electricity passed directly
through its walls to the other electrode,
either in the rectum or upon
the hypogas-

trium.

The treatment of vesical paralysis must necessarily be mainly constitutional, as it is often merely symptomatic of serious af

fections of the central nervous system. Cold water here, as in the atonic conditions, is useful, unless cystitis has supervened, and may be employed as an injection, a wet pack or a sitz-bath. An important procedure, which must receive the attention of the surgeon immediately upon his introduction to a patient who is wholly or partially paraplegic, is the use of the catheter and the prevention of distension of the bladder. The catheter should be used three or four times daily, great care being exercised in its introduction, owing to the insensibility of the parts. It is well to wash out the bladder with warm water after using the catheter, thus preventing cystitis by removing any urine, mucus, etc., which would otherwise be liable to decomposition. When stagnation and overflow have occurred before the surgeon is called, it will be found difficult to prevent the consequent cystitis, but the sooner it is attempted the better is the chance of success. Even after catarrh of the bladder has been established, careful attention to the washing of the bladder with warm water will improve the condition and add to the comfort of the patient. The paralysis of the bladder being most commonly a symptom of some deeper-seated and more grave constitutional trouble, the prescription of the homœopathic remedy must be made only after a careful study of the totality of symptoms; the treatment being directed more to the cure of the more serious affection than to the vesical trouble. The remedies most likely to be indicated are Belladonna, Opium, Hyoscyamus, Dul camara, Gelsemium, Arnica, Cantharis, Plumbum, Cannabis Ind., Causticum, Anantherum, Lycopodium, Pulsatilla, Natrum mur., Nux vomica, Arsenicum, Phosph., Uva ursi, and Aconite; these remedies applying more particularly to the symptoms presented by the vesical trouble. The precise indications are omitted in this part of the paper, as the selection of the remedy will depend upon the special symptoms of the case and the pathogenesis of the remedies presenting symptoms which render them applicable to other affections of the bladder.

Spasm of the. (R. E. Caruthers, H. M., Oct., 1876.)

The treatment in this, as in other spasmodic affections, must be such as to give immediate relief. This can be done more promptly, in most instances, by external applications, especially by heat, which may be applied by means of flannel cloths wrung out of hot water and applied to the region of the bladder, or the use of the