LETTER FROM ENGLAND.

DEAR NORTH AMERICAN:

The presidential address delivered at this year's British Homœopathic Congress has stimulated discussion upon the modus operandi of our homœopathic medicines.

Quite apropos of Dr. Proctor's suggestion that it is by a kind of inurement-process to the new (morbid) environment of the bioplasm that our small dose acts, is the remarkable address of Professor Leech, of Manchester, delivered to the Pharmacology Section of the British Association at its meeting at Montreal this year. Stated in a condensed form, Professor Leech's theory of the action of some drugs is this: Just as the toxins of the various pathogenic bacteria produce from the protoplasm of the tissues within the body anti-toxins, which antagonize the morbific action set up by the original toxin, so some drugs may form "tox-albumens," which become defensive substances, acting in the opposite direction to that of the drug given in large or toric doses. Ehrlich has proved, for instance, that the tox-albumen ricin derived from castor-oil seed, not only causes immunity (to the usual action of the oil) but also initiates the formation of an anti-toxin in the blood, which protects from the poisonous influence of ricin. Professor Leech suggests that drugs do more than influence molecular conditions; that they, in fact, cause the production of “something which is itself an active agent." He instances the antagonism of mercury to syphilis. "Since, therefore," Dr. H. Bodman remarks, "the defensive substance acts in the opposite direction to the morbific poison, and also in the opposite direction to the drug which causes its formation, it follows that the action of the remedial drug must be in the same direction as that of the morbific poison," whether that of measles, scarlatina, diphtheria, And this is only another way of expressing similia similibus

etc.

curantur.

This remarkable address, coupled with Dr. J. Johnstone's interesting attempt at our congress to prove that the action of the antitoxines was actually an illustration of the law of similia shows a drawing together, in theory at least, of the thinkers and physiologists of both schools of medicine. Thus the year 1897 may be signalized in Great Britain by the Eirenicon of a theory of the mode of action of homœopathic remedies, which has been first given to the medical world by Dr. Proctor, of Birkenhead. Further criticism and investigation, however, is needful, on both allopathic and homoeopathic sides. For we must not confuse that which is identical with that which is similar, very similar, or exactly similar.

The October Journal of the British Homoeopathic Society contains much matter of interest. For the first time a paper on longevity appears in its Transactions.. It is by Dr. J. Murray Moore, of Liverpool, and goes to prove that the average of human life is steadily increasing in Europe; that centenarians are becoming more numerous, and that there are more female than male centenarians now living. Important and very useful papers in this number are

on Tuberculous Meningitis in Children, by Dr. C. E. Wheeler; on two cases of serious lacerations of the vulva from bicycle accidents— one married and the other a single lady, by Drs. Hall and Burford; and on Early Diagnosis of Spinal Caries, by Mr. Gerard Smith. We find that an interesting exhibition of microscopic pathological slides. was held on July 1st.

The British Homoeopathic Society and the Liverpool branch have started the winter session with spirit and plenty of good clinical material.

December 19th, 1897.

SEPTIC FEVER.

M. D.

Realizing with what care and anxiety the physician faces his cases of septic fever, and knowing how utterly useless, in many cases, are the usual modes of treatment, I feel it my duty to report the following case, which is but one of a number of which I am cognizant. Mrs. M., aged twenty-eight years, slight build, primipara, was confined by me, January 15, 1897.

About two months prior to the confinement, her lower extremities and pudendum became cedematous. I examined the urine carefully, and at frequent intervals, and found it free from albumen or

I gave the case close study, and prescribed several remedies, but in spite of all I did the oedema increased, until at the time of confinement her legs and thighs were hard and swollen to such an extent that she could separate them but slightly, and the external parts, especially the labia majora, were enormously distended. The outlook was not pleasing, and it appeared as if it would be impossible to deliver her at all, and at best, I knew laceration would follow.

The labor was long and tedious, although the child lay in the first position. The patient was highly nervous, and, after a safe time, I decided it would be necessary to deliver with instruments. I sent for Dr. Crooks, and, giving chloroform to full extent, delivered her of a bouncing boy weighing twelve pounds.

The result was as I feared. Although the instruments were removed before the delivery of the head, the perinæum was torn down to and around the rectum without injury to the rectum itself. Repair was made at once under thoroughly antiseptic precaution, and the patient left in a comfortable condition. She did nicely for three days, when the temperature rose. There was no pain or especial tenderness anywhere, no tympanitis, and the parts looked healthy and were healing. I at once ordered the professional nurse to give vaginal douches every four hours. I gave the intra-uterine (creoline) douch every twelve hours. This was continued for four days. Internal remedies were pyrogenium, 30 every four hours, bryonia 3 and gelsemium as intercurrents.

With a temperature of 105 and no signs of improvement, I decided to test the merits of proto-nuclein.

I discontinued the use of all other medicines, and gave the vaginal douche only (hot water). I ordered proto-nuclein, two tablets, every three hours; after each vaginal douche (four hours) a protonuclein suppository was inserted well up in vagina, the external parts were thoroughly cleansed with dioxide, and the proto-nuclein powder (special) was well dusted on the parts. The improvement was marked; the temperature fell to 102° within twenty-four hours and in three days' time had become normal. The patient made a most excellent recovery. The perineal repair was entirely satisfactory. In two cases of septic fever (occurring in the practice of other physicians) the same treatment was adopted after the fever had continued for three weeks, and the improvement was manifest within three days and continued until both patients made a most satisfactory recovery. After a personal knowledge of this kind-seeing is believing, and one cannot help becoming a devout advocate of this treatment I shall continue the use of proto-nuclein in my practice, and if the future yields as bright results as the past, I shall be highly pleased.

Paterson, N. J.

PORTER KINNE, M.D.

Book Reviews.

Medical and Surgical Diseases of the Kidneys and Uterus. By Bukk G. Carleton, M.D., Genito-Urinary Surgeon and Specialist to the Metropolitan Hospital, N. Y., etc. etc. Illustrated. Boericke, Runyon & Ernesty, New York, 1898. Pp. 253.

The author has already paved the way for the favorable reception of this work by his "Manual on Genito-Urinary and Venereal Diseases," a volume well received by the profession. Dr. Carleton has managed to condense within the limits of two hundred and fifty pages the essential facts pertaining to the diseases of the kidneys. If any fault may be found with the work it is the rare one of too great brevity-a fault so rare as to be a virtue. The various diseases are discussed in a clear and concise manner, and special attention is given to the treatment. The author has not only made use of all new facts, but has made use of his personal experience at the Metropolitan Hospital. It is a work that will be popular, and it deserves to be. It is well printed and bound.

A Text Book of Diseases of Women. By Charles B. Penrose, M.D., Ph.D., Professor of Gynecology of the University of Pennsylvania, etc. Illustrated. W. B. Saunders, 925 Walnut Street, Philadelphia, 1897. Pp. 529. This is a work written primarily for the medical student. The author has kept this point steadily in view, and has treated the subject as simply and plainly as possible. The facts of anatomy, physiology, and pathology which may be found in the general text

books on these subjects are omitted. They are only mentioned in detail when it seemed important to the elucidation of the subject or when there were certain points in the pathology that were peculiar to the diseases under consideration. As a rule, but one plan of treatment is recommended for each disease. By thus sticking determinedly to his text the author has made a volume of great value for students, as he desires.

Dr. H. Cross' Comparative Materia Medica. Edited by Constantine Hering. Second edition. Boericke & Tafel, Philadelphia, 1897. Pp. 520.

This standard work is again presented to the profession in a new dress and in convenient form. The comparisons of drugs given in this volume are the result of many years of painstaking labor. It is a book that may be consulted daily with great advantage, both by the student and the oldest practitioner. But the book is too well known to need any further introduction to the favorable notice of our readers, and we commend the second edition to their consideration.

A Handbook of Therapeutics. By Sydney Ringer, M.D., F. R. S. Holme Professor of Clinical Medicine University College, etc., and Harrington Sainsbury, M.D., F. R. C. P., Physician to the Royal Free Hospital, etc. Thirteenth edition. William Wood & Company, New York, 1897. Pp. 746. Ringer's "Therapeutics" has long been known to the profession. The appearance of the thirteenth edition demonstrates pretty conclusively its popularity. In this edition the endeavor has been made to select the tried from the untried drugs, and every portion of the work has been carefully revised. On the new departure, "Serum Therapeutics," a separate chapter has been introduced, and in connection with the Invalid Dietary a short section upon the use of the digestive ferments. In the earlier part of the work a brief reference is made to the Nauheim (Schott) treatment. The physiological action of drugs is not dwelt upon as much as the indications for the use of drugs. It is one of the best of the clinical hand-books of the old school, and contains much valuable information.

Pathological Technique. A practical manual for the Pathological Laboratory. By Frank Burr Mallory, A. M., M.D., Assistant Professor of Pathology Harvard Medical School, etc., and James Homer Wright, A. M., M.D., Director of the Laboratory of the Massachusetts General Hospital, etc. With 105 Illustrations. W. B. Saunders, 925 Walnut Street, Philadelphia, 1897. Pp. 397.

This admirable volume is the result of years of labor and experience. It is intended especially for use in pathological laboratories as a guide to beginners and as a source of reference to those advanced. It gives instruction in port-mortem bacteriological and histological technique and adds the special methods employed in clinical bacteriology and pathology. The method employed in presenting the subject well serves to bring the student to a realization that the mechanical performance of a post-mortem examination and the inspection of the gross lesions constitute usually only the beginning

of the solution of the problem, which should be investigated bacteriologically and chemically as well as histologically. The work is divided into three parts. Part one treats of post-mortem examinations, including both the external and internal examination of the body. Part second takes up bacteriological examinations, discusses bacteriological apparatus, culture-media, bacteriological examinations at autopsies, methods of studying bacteria in cultures, bacteriological diagnosis and clinical bacteriology. Part third treats of histological methods in detail. It is a work well worth study, and is confidently commended to the profession.

Skin Diseases of Children. By George Henry Fox, A.M., M.D., Clinical Professor of Diseases of the Skin, College of Physicians and Surgeons, New York, etc., etc. William Wood & Company, New York, 1897. Pp. 166. This modest volume is intended by the author to serve as a concise and practical sketch of the symptomatology and treatment of those eruptions which are most likely to affect the juvenile patients of every family physician. The majority of the articles in the book appeared in the American Journal of Obstetrics and Diseases of Women and Children about a year ago and are now republished, with some additions, in this form. The book is illustrated with twelve photogravure and chromographic plates and has sixty illustrations in the

text.

Practical Diagnosis. The use of Symptoms in the Diagnosis of Disease. By Hobart Amory Hare, M.D., B. Sc. Professor of Therapeutics in the Jefferson Medical College of Philadelphia, etc., etc. Illustrated with 201 engravings and 13 colored plates. Lea Brothers and Company, Philadelphia & New York, 1897. Pp. 605.

The appearance of a second edition of this book within a year is evidence that its value has been promptly recognized by the profession.

The plan of Dr. Hare's diagnosis is natural and logical. He has presented his subject as a case always presents itself to the physician, namely, symptoms first. The book consists essentially of two parts; first, "The Manifestation of Disease in Organs," and, second, "The Manifestation of Disease by Symptoms." The physician discovering a symptom in any organ can at once find its clinical significance in the first part, and in the second he can equally ascertain the special indications of the more general symptoms such as fever, headache, vomiting, cough, pain, etc., etc. Obviously two or more symptoms lead to a diagnosis, as the botanist easily identifies a plant by means of its characteristics arranged according to a similar natural system in the well-known botanical key. Hare's "Diagnosis" is, however, much more than a key, for it is fully descriptive. The "Index" is equally novel and helpful. Under each symptom is a list of the diseases in which it occurs and under each disease are indexed its symptoms. The physician finding a symptom accordingly has at hand a suggestive list of possible diseases and on comparison of the lists following two or more symptoms he has a prompt method