and its relation to all the morbid states of the patient must be considered. In short, it is the patient always and his totality of symptoms that must form the basis of the prescriber's art. Practical application of our therapeutic method has long ago taught us that every complete prescription has as its elements consideration of symptoms pertaining:

I.

2.

To the locality involved.

To the kind of sensory disturbances; i. e., character of pain or altered sensation.

3.

To the modalities, or accompanying modifying factors, i. e., conditions of weather, times of day, rest and exercise, warmth and cold, etc.

Every complete symptom is made up of these three elements. and whenever possible ought to be so analyzed in order to utilize it for a homœopathic prescription. In the treatment of pain another factor is of importance in determining the curative remedy and that is the immediate etiological factor, if known. Whenever we can cover with our medicine these conditions, a speedy curative response is certain; quicker perhaps with the higher attenuationshigher in proportion to the great similarity, although this is not an absolute rule. But even if only one condition is well marked experience teaches that often the remedy so indicated is capable of helpful curative service of a high order.

The Materia Medica is full of valuable suggestions, but my object is to call to mind such as I have personally verified in practice or seen so verified by others.

Taking the first division, locality. Our Materia Medica furnishes us with many well-tried and frequently verified remedies, adapted to and acting especially upon certain parts of the body. In certain cases this is so pronounced and the elective affinity of certain drugs for certain organs so plainly evident from the provings and from ultimate lesions as testified by pathological anatomy as to be truly wonderful.

While the seat of pain may have comparatively little relation to the true location of the disease excepting gastric pain which usually locates it, yet for homopathic therapeutic purposes the seat of pain as experienced by the patient is always important and often leads to the right remedy. The reason, of course, is evident. Our provings are simply records of symptoms produced independent of their pathological interpretation, and in passing, we see how wisely the builders of the homoeopathic Materia Medica worked by keep

ing the record pure of all pathological speculation and making the outward expression of the morbid condition produced, namely the subjective and objective symptoms, the only legitimate basis for recording drug action and for guidance in drug selection.

What homoeopath does not associate cactus with the heart, podophyllum with the duodenum, argentum with the joints, oxalic acid with the spine, belladonna with the brain, aloes with the rectum, ceanothus with the spleen, etc.? But aside from this general organopathy, our remedies seek certain parts of organs and tissues by preference and the careful prescriber will seek to utilize this more minute affinity. Thus we all think of chelidon. for pain under right shoulder-blade and cedron for supra-orbital pain; gelsem. and picric acid for occipital pain; spigelia, when pain centers around left eye; coffea, pain in the parietal bone as if a nail were driven in; bellisper for pain in coccyx; mezereum, when it seats itself especially in the malar bones, etc. Every practitioner soon gains from his own observations knowledge of some of these localities, which become always suggestive, and offer certain guides to curative remedies. So myrtus became associated with the upper left chest about the third rib, and illicum with the corresponding place on the right side. Kalmia for all sorts of flying pain in region of the heart; ulmus for pains in the wrists; zinc, aching in the last lumbar vertebra; china for sensitiveness of scalp; mel cum sale, hypogastric pain, and so on indefinitely. In this category belong sensory hyperæsthesias, which are characteristic of certain drugs: for instance, the olfactory hyperæsthesia of carbolic acid and of phosphorus; the acoustic hyperæsthesia of belladonna and acid salicylic; the ophthalmic of oxalic acid and conium; the cutaneous of ergot, etc. In the treatment of pain such changes in the functional integrity of the senses, whether increased or decreased or perverted, become helpful indications.

In regard to the second leg of our therapeutic stool, upon which our prescription must stand, the kind of pain, this, also furnishes decisive aid. My own experience corroborates that of the whole homoeopathic school as to the value of, for instance, the burning pains of phos., arsen., and cabro., and we know that burning pains. are usually associated with morbid condition of the mucous membranes and skin and these tissues determine the form of pain more certainly than does the character of the morbid process, although as a rule burning pains are effects of passive states or incipent decom

position. So pain in bones, is of a gnawing, boring character, is worse at night and influenced by changes in the weather.

Remedies presenting similar conditions will be found to act on bones, as is known of aurum, mercury, etc. Serous membranes give us the sharp, sticking pain, as is also produced by bryonia and kali carb., which experience teaches, have a direct relationship to serous membranes. Throbbing, beating, hammering, point to movements of the vascular walls, congestion and inflammation, and aconite, belladonna, glonoin and verat. vir. are of course the pathological similars.

Drawing and tearing and sore pain occurs in muscles, tendons, and fibres and is usually rheumatoid in character, with remedies. like arnica, rhus, and cimicifuga as types. So the stinging pains. or herpes call to mind the corresponding sensation and remedies -apis, theridion, natrum mur. To this category belong the erratic shifting pains of pulsat. and kali-the plug-like sensations of anacardium, the hot needle sensation of arsenic, the corresponding icy needle sensation of agaricus, the general coldness of veratrum and absolute refrigeration of heleoderma.

Constricting pains are met with. A feeling of constriction of the trunk, as if the clothes were too tight or as if a cord were compressing it, is often present in spinal affections. Plumbum produces a similar sensation. Local constrictive sensations are certain indications when present. Such are the constriction around the heart of the cactus, around sphincters of apis, etc.

The opposite sensation of expansion points to cannabis indica, if in the head; to medorrhinum if located in eyes, these feel as if staring; and to argentum if in other parts of the body.

Thoracic pain is marked in cases of pleurisy and pericarditis during the stage of friction; a similar respiratory distress is met with in pleurodynia, but the friction sounds over the heart easily differentiate, the former calling for remedies of the type of bryonia, the latter being easily vanquished by ranun. bulb. and borax. I meet member that intercostal pain is often caused by ovaritis. I meet with much thoracic pain of severe type due to poor digestion with loads of flatulence that becomes incarcerated. Here I cannot be too enthusiastic about the efficient service of argent. nit., and in women of nux moschata.

The pain of angina pectoris is intense. It is not always centered in the cardiac region, but it always tends to the left side of the chest. A mortal terror accompanies it, with pain shooting down the left

arm or darting from heart to elbow. I can conceive but one humane treatment during the attack-palliation. Amyl nitrite is the only drug I have any experience with in this dreadful pain. Spigelia, oxalic acid have in their pathogeneses very similar symptoms.

Epigastric pain coming on suddenly points to appendicitis. It is reflex and associated with moderate bloating and muscular tension of the right side of the abdomen. The rapid pulse and rise of temperature here are very important, but both are apt to be erratic in this disease. Belladonna, with its rapid onset of pain, colocynthis and lachesis certainly correspond to the symptoms in great part at least.

Abdominal pain, with tenderness to deep pressure, points to enteritis and peritonitis, colic being rather relieved thereby, and the temperature, usually, normal.

Persistent colic with constipation looks like lead colic. If vomiting is added always examine the hernial region.

Pain associated with defecation, aside from the tenesmus of dysentery, ought to lead to examination-probably inflamed piles, fissures, ulceration, etc., will be found to exist. Homoeopathy possesses two remedies of extraordinary value in rectal pain-ratanhia and sanguin. nit.

Pain on urinating is often a symptom in fever, due to a highly acid and concentrated urine. It may be due to anal fissure and other rectal disease. In pelvic peritonitis acute pain on urinating is frequent, but there is other pain as well. Pain during and some time after, points to the bladder and urethra. I wish to sing the praises of berberis as a general remedy for pains centering in region of the kidneys, radiating thence in every direction, especially down the ureters. In males, pelvic pains is usually vesical in nature.

Another important aid in selecting the remedy is the side of the body affected. There is no question of the predominant left-sidedness of lachesis and spigelia; of the right-sidedness of belladonna and chelidon.

The method of invasion of pain is important also. Remember the sudden violent onset of aconite; the equally sudden coming and going of belladonna; the absolutely certain gradual decrease of pains of stannum; the gradual increase to unbearable height with a sudden snap of release characteristic of pulsat., eac.

And even greater certainty in the choice of a remedy is obtained from the third factor-the modalitics. Given these clearly cut, you are enabled to decide the curative remedy often even if the special pain is not found in its pathogenesis. First in importance in the

treatment of pain, I consider the aggravations, according to time. Here belong the early morning aggravation of the kalis and of nux, remembering that many nervous affections are worse in the morning; the forenoon aggravation of natrum mur. and stannum: the afternoon aggravation of pulsatilla; the early evening aggravation of lycopodium, remembering here that many congestive and vascular affections are worse in the evening; the night aggravations of many remedies, aconite, mercurius and syphilinum; the after midnight aggravation of arsenic than which nothing is more characteristic. These can be utilized in every form of disease and so can the remarkable aggravation of lachesis after sleep and the equally remarkable temporary improvement after a nap of nux. The aggravation from dry cold air of aconite, the amelioration from fresh air of pulsat.-the aggravation from exposure to cold damp surroundings of nat. sulph.-the California winter storm antidotal powers of dulc. and rhus. Each one of us could from his own experience multiply examples of unquestionable modalities that he has learned to class amongst the certainties of medicine.

There is nothing more satisfactory than to see the wonderful restorative and quieting effect of a well-chosen homoeopathic remedy in cases that have passed through the gamut of all sorts of treatment and palliative measures with the disease more firmly es'tablished and fastened upon the patient, plus discouragement if not despair. But it can be done but in one way, not in any hap-hazard fashion, but only by following out the principles of our art faithfully and patiently. I think it is not an exaggerated statement to make that Homœopathy can take the incurable cases of the old school, the victims of mere palliation, the candidates for narcomania and cure a good percentage. How? Just in this way. Make our diagnosis according to the most approved methods of the up-to-date physician; bring in all our pathological theories and lore, apply all hygienic and dietetic aids. But then for purposes of homeopathic prescribing, forget for the time being most of this interesting knowledge, take the patient as a morbid symptomatic being-take account of his stock of symptoms subjective and objective-arrange this totality according to location, sensation and modality, fit the remedy to this organized morbid human form, and the curative response will come just as sure and as long as there is reactive vitality left.