able to talk and swallow. From February 1 to 5 one-half to one pint of urine was drawn each day. Patient had spasms, during which she bit her tongue. On examination I could find no stone in the bladder, but with two fingers in the vagina, by deep pressure I could feel the stone in the ureter. For three days half a pine of urine was drawn each day, and the spasms continued except when the patient was under the influence of morphia. Patient said she could not remember anything during these three days, although she was apparently in her right mind and talked sensibly a part of the time. At about this time she felt that the stone moved from the position which it had been in for the past two weeks or more. From February 12 to 17 one--half to one pint of urine was drawn daily. From the 17th to the 22d one to four ounces were drawn daily; patient had spasms at times.

On February 23 a very irregular calculus was obtained, and about four ounces of urine drawn. The following day nearly one pint of urine and pus was drawn. Patient's left leg and muscles of the throat were powerless and she would gasp for air. From February 24 to 28 two ounces to a half-pint of urine were drawn daily; patient delirious, often sings. Passage of the catheter causes spasms, unable to swallow at times and rational for only a few minutes at a time. Since March 1st until to-day (9th) there has been from four ounces to a half pint of urine drawn each day. At times there has been a slight discharge from the urethra, which is very offensive and appears like urine mixed with pus. Patient continues about the same, except that she is gradually getting weaker; has to be kept under the influence of morphine. Instead of having the spasms, when the pain comes she goes into a swoon and is conscious for only a few minutes at a time; has very sharp and sudden pain through the head and eyes. A few days ago her menses appeared, which is only the second time in the last eight months, during which time she has been a constant sufferer and has not been able to get about on her feet at all. I examined the bladder again this morning, but did not discover any stone there. With my finger in the vagina I felt on the right side (of patient) a small tube, which was rather hard, giving the feeling of an artery in an atheromatous condition. Whether this was the ureter or an artery I will leave for others to decide. On the left side I did not feel such a distinct tube, but more of a membrane and on following it toward the median line. it became broader and I felt a hard substance, which, upon touching it, immediately made the patient flinch. I could barely touch it, and

as soon as I did so it would seem to move beyond my reach. This is about the position where the patient has located the stone for the past two weeks.

The pain which this patient suffers during the passage of these stones might be compared to very severe labor pains; patient will tear her clothes, bite her fingers, pull her hair, and cloths have had to be put in the palms of her hands to prevent laceration from the finger nails; also between the teeth to prevent them from being broken off (as some have been). She often prays that she might die and had it not been for her trust in the Almighty, she would have taken her own life long ago, I believe, and ended her suffering. While in the spasms she would frequently cross her hands and feet beneath her and with her head and knees resting on the bed, such a curve would be formed by the arching of her body, that an ordinary foot-stool could be placed beneath her. When a stone was in the urethra neither morphia or chloroform would have much effect until the stone was removed. Oftentimes there is a puffiness, if not a distinct swelling, over the kidneys and also in the iliac regions anteriorly, which diminishes somewhat when a stone is passed.

The calculi (if they can be called such) are, as you see, very hard and are of different shapes, sizes and colors. The largest one is rather oval and measures three-fourths of an inch in length, onehalf an inch wide and nearly one-fourth of an inch thick; like all of the others, it looked like a stone picked from a gravel walk.

Sixteen of these stones have been obtained. One has been partially dissolved in dilute nitric acid. After one was passed there would usually be a large amount of pus in the urine. Numerous medicines have been given in both homoeopathic and physiological doses, with the effect of relieving the symptoms to some extent and also, I believe, have assisted in expelling the stones. The following were some of those used: Hyoscyamus, stramonium, berberis, pariera brara, hydrargea, piperazine, cannabis indica, and potassium nitrate with fl. extract of pichi.

I begun by giving one-eighth gr. of morphia by the mouth for the extreme pain and am now giving two and three fourth grs., hypodermically, twice a day. Lithia, cream of tartar, and other waters have been used, but at times causes so much distress that very little can be given, although she has been able to take more lately. 153 Tompkins Avenue.

THE PRACTICAL SIDE OF REFORMING HOMOEOPATHIC MATERIA MEDICA.*

W

By M. W. VANDENBURG, A.M., M.D.,

Ft. Edward, N. Y.

HEN a few months since a young homoeopathic doctor, of some ten years practice, announced that quinine was the proper thing with which to treat malaria, he stirred up a hornet's nest whose proportions he could hardly have foreseen.

Facts are stubborn things. And when so many presumably honest men, living at widely scattered stations, without personal knowledge of each other's experience, and without concerted action, agree that there are other drugs than quinine efficient in curing. malarial fevers and the various sequelæ of malarial poisoning, one is forced to the conclusion that the first statement is incorrect.

At this point, I am reminded of an instance related by a Brooklyn physician some years ago. A young doctor announced at the meeting of a local society, that he had found a new remedy for malaria which cured every time. What was it? Why, gelsemium. The fact was, said the narrator, he had struck a lot of gelsemium cases, or he lived in a gelsemium-malaria district. Probably it was a similar reason that led to the assertion, that quinine was the remedy to cure malaria.

Dr. Clockey's paper has been of the greatest service to homoopathy, in that it has called out such a mass of irrefragable testimony. "The practical side of Materia Medica" has also received a most potent indorsement by the same sign.

"The longest way around is not always the safest way home," but it is often the case nevertheless.

There will always be a large percentage of the race who do not admire labor for labor's sake. Among these there will be many shades and degrees of dissatisfaction, from the downright lazy, to the provisionally lazy. The former group will care for nothing so much as to escape labor; the latter will have respect to results, as well as to the amount of exertion required.

The first class will scorn all difficult roads, and naturally in*Written especially for the NORTH AMERICAN.

cline to "more direct routes" though they involve greater dangers. The second, will seek for practical inventions by which to shorten labor, while securing desirable results. It is among these that we always find reformers.

Reforms are of various classes; some are practical, others unpractical and impossible. Ruskin has said with some show of truth, that "there is no short cut to any place worth going to." But this, too, is subject to modification.

The short cut by way of pathology proposed in a late number of the NORTH AMERICAN, by Dr. Dale, has a practical and an unpractical side. Beyond all doubt, all drugs worth using, have a pathological side. It is equally undeniable that few indeed have been pushed to their final results. The effects of arsenic, mercury, phosphorus, and possibly one or two more drugs used in the arts, have been thoroughly demonstrated from the medico-pathological standpoint. The large majority, at least nine-tenths or more, have never been pushed to their extreme pathological limits. All that we possess, is little more than hints at what they might have accomplished if they had been thoroughly tested.

On this account the application of drugs from the pathological standpoint as a centre, starts off crippled and halting from the first. Nor is it likely to receive much aid from future investigations, at least not while the sentiments and prejudices of men in regard to taking drugs remain the same as at present.

A hundred years ago people were accustomed to take huge doses of powerful drugs, and to be made very sick by them. Now, so great is the fear of the toxic effects of medicine, that ignorant and educated alike, take to the woods on the first appearance of genuine pathological evidences of drug effects. The average prover of today would no more take a half teaspoonful or a teaspoonful of digitalis tincture, than he would commit suicide by shooting or drowning. Yet such was not the case at the beginning of the century, as a study of the provings of digitalis will readily demonstrate.

Hence those who talk of building up a "pathological basis" for the application of all remedies, do not, it seems to me, realize the magnitude of the work they propose. I venture the prediction, that the next hundred years will not see ten drugs proven on this basis, so that they will make a fair showing beside arsenic, or mercury.

The only practical course that seems open to us is to learn how we may best apply our drugs with such intimations as we are able to gain. Herein lies the hope of future reform.

Beyond doubt the pathology of the drug should be studied by the most approved methods of modern physiological research. But when the utmost in this direction has been attained, owing to the sentiments and prejudices of our day against risking drug-effects, but little more than a finger-board will have been erected to point the probable pathological effect of the drug. Who, for example, would be led to suppose that the early salivation and loosening of the teeth from mercury would lead to caries of the jaw-bone? Or, knowing this, would attribute the same pathology to phosphorus? That the burning produced by a moderate dose of arsenic would lead to gastric ulcer? That arsenic would produce acute fatty degeneration of the liver, or of the kidneys?

Who will tell us what pathological changes any of the modern toxic drugs will produce, except in cases of accidental poisoning? And when these are wanting, where is the subject to demonstrate these possible effects to come from? All the truly pathological symptoms of the drugs of to-day, are from ancient records or accidental poisoning, and therefore ill observed and unscientific from the standpoint of present scientific methods. And there is not much hope for future development along this pathological line visible to the unprophetic eye.

This by no means proves that we are without resources; or that the method of cure by similars will have to be abandoned. On the contrary the method is so potent when laboriously and intelligently applied, that it is bound to commend itself more and more to the painstaking and sincere.

The lazy, the shiftless and the fraudulently inclined, are quietly drifting toward the more congenial methods of empiricism, and need not discourage true homoeopaths. With these facts before us, we are forced to use such means as may lead to the application of drugs to disease by the homeopathic method.

Is there any other practical course, than that which considers the symptoms that have been evolved by our drug-provings, as the beginnings of pathological processes? May not the discerning eye see in a mild cough and the sequence of certain apparently inconsequential symptoms, the faint outlines of a pneumonia, or an endocarditis?

Do not these obscure shadowings mean more on the practical side of medicine than many of us are willing to admit?