Miss Doughty is the daughter of Dr. and Mrs. F. E. Doughty, of 512 Madison avenue, New York, and will wed Mr. J. K. L'Hommedieu, also of this city.

DR. DANIEL H. ARTHUR, Superintendent of the Collins State Homœopathic Hospital for the Insane, Gowanda, N. Y., will deliver two lectures to the nurses of the Rochester Homoeopathic Hospital Training School in March.

THE THIRD ANNUAL COMMENCEMENT of the training school for nurses associated with the University Hospital, Homœopathic, University of Michigan, was held at the Homoeopathic College Building, Saturday evening, October 8, 1898.

very

THE DEATH of Dr. J. C. Daily, of Fort Smith, Ark., is announced to have recently taken place at Stamford, Conn. He was a talented young man, amiable and kind. A heat stroke is said to have ended his life. Our sympathies to his family.

THE BUFFALO HOMEOPATHIC HOSPITAL, during the month of September, cared for 47 soldiers, 42 of whom were from the Sixtyfifth Regiment. Typhoid of a peculiar form was the principal disease. A large tent accommodated the convalescents.

THE MATERIA MEDICA SOCIETY of New York held its regular monthly meeting on October 19. An interesting paper was read by Dr. Martin Deschere, entitled "Antitoxin Considered Homœopathically." Considerable interesting discussion was elicited.

THE GERMANTOWN HOMEOPATHIC MEDICAL SOCIETY held its regular monthly meeting on October 17, at the Mosebach Casino. An interesting paper was presented for discussion by Dr. Theodore J. Gramm, entitled "The Preliminary Obstetrical Examination."

DR. F. A. FAUST, of Poughkeepsie, is compelled to leave his practice on account of ill health, a lung trouble having developed which demands a change of climate. Dr. Faust leaves many friends in the East who will hope to hear of his rapid improvement in health.

IMPORTANT TO PHYSICIANS. A fine residence, especially adapted for a physician; excellent location on West End avenue; corner house; recently decorated; all modern improvements; thirteen outside rooms; rent moderate. Owner, C. S. Dobbs, 298 West End avenue.

Dr. Schley and Dr. Vanden BurG beg that their new tele phone number be noted, as it will not appear in the Directory until December. Physicians sending patients for examination will confer a favor if they will write or telephone for an appointment in advance if possible.

DR. SOLOMON C. FULLER, pathologist to the Westborough (Mass.) Insane Hospital, devotes his time exclusively to patholog ical examinations, and will be at his office, 391 Boylston street, from 9 A. M. to 12 M., Wednesdays and Saturdays, to confer with physicians who may wish to consult him.

Third Series

NORTH AMERICAN

JOURNAL OF HOMOEOPATHY.

T

Original Articles in Medicine.

THE TREATMENT OF SCIATICA.*

By A. P. WILLIAMSON, M.D.,

Minneapolis, Minn.

RUE sciatica consists of a perineuritis of the trunk, or some of the branches of the great sciatica nerve.

The predisposing cause of the inflammation is a gouty or rheumatic diathesis. The exciting cause may be one of many, but the commonest is exposure to a draft of cold air.

As a rule, the disease appears suddenly, often following sitting in a strained position or leaning over, which produces tension of the nerve sheath.

The main characteristic is pain, which is described as cramping, stabbing or burning, and it is usually very severe. Its location may vary from the sciatic notch to the dorsum of the foot. Thus it may involve the main trunk, or any, or all of the branches.

Sciatica can be diagnosed by the presence of tender spots, which are invariably found in certain localities. These are termed punta colorosa. Their several localities are just above the hip joint at the sciatic notch, midway of the thigh posteriorly, just above the popliteal space, in the middle of the calf, back of the external malleolus and on the instep.

In addition to the pain and the tender spots we meet as a complication cramps in the muscles about the hip and in the calf, which come in almost unendurable paroxysms.

The pain is aggravated by motion, extension of the leg and

pressure.

*Read before the American Institute of Homœopathy, Omaha, 1898.

It rarely attacks both sides at the same time, but the writer has noted, in several cases, the disease subside in one leg and then attack the other.

It seems to prefer men more frequently than women, and chooses those between thirty and forty years of age, although no age is exempt, except perhaps infancy and old age.

There is a false variety of the disease, which accounts for the readiness with which some practitioners cure it. The pseudosciatica consists of a rheumatism in some muscles near the nerve, such as the glutens medius. Relief from this comparatively mild ailment quickly dissipates the pain. Again constipation sometimes occasions sciatic pain, then a large injection, or the exhibition of a cathartic, by emptying the bowel and removing the pressure, is at once followed by relief.

In justice to the "quick cure" physician it may be acknowledged that the pain has all the agony of the graver disease, and if relief is not afforded it may proceed to a real perineuritis. Having thus taken a comprehensive glance at the enemy, we are in a position to outline the method we pursue in making an attack.

The first and most important step in the line of treatment is to place the patient in bed and enjoin absolute quiet-rest of the body and peace of mind. In order to insure freedom from motion for the affected part, a long splint may be used, one that will extend from below the foot to the axilla, or, as we prefer, two sand bags of suitable size, one placed from the foot to the axilla and the other from the foot to the perineum; pressure on tender spots may be avoided by using small pillows, six inches by four in size, which can be tucked under the leg so as to prevent resting on the inflamed nerve.

The patient should be encouraged to view the difficulty in as hopeful a light as possible, being assured that cheerfulness is as necessary for his rapid recovery as any part of his treatment. Visitors should be prohibited; sympathetic friends are very much out of place near the sufferer from sciatica. Kindness should always be shown, but exaggerated sympathy and evident solicitude should never be displayed.

Heat is generally agreeable and frequently gives great relief. A large flaxseed poultice, to which some powdered ginger or mustard has been added, is the best method of applying heat. The everpresent, generally leaky hot water-bag occasionally will act as a substitute, but usually it is applied best where it is not needed, and its use is more gratifying to the friends than to the patient.

Galvanism is of great assistance, too. It should be applied twice

a day, for ten or fifteen minutes each time. The negative pole being applied to a neutral spot, such as the lumbar spine, the positive pole is gently moved along the course of the nerve, stopping a few moments at the painful places. The strength of the current should be governed by the feelings of the patient and the effect desired by the physician, say from three to ten milliamperes. Galvanism is usually preferable to faradism, but still the secondary current certainly has sedative action, and in some cases seems to be more agreeable to the patient than the continuous current.

The diet is a matter which does not always receive the attention its importance demands. Care in this direction is always fully repaid by the good effect produced. The food should be liquid, and, of course, very nourishing. It is best to give it in small quantities. and at frequent intervals.

Pain has said to be the cry of the tissues for nourishment, and if its severity is a criterion of the quantity of the food needed, there can be but little danger of over-feeding.

Milk, with salt, to aid its digestibility, especially when given hot, is the very best food to be found. Home-made broths come next in value and the preparations of blood, such as bovinine, hæmaboloids, and Murdock's food, are also very useful. Other foods have their place, and, therefore, the palate of the patient may be consulted, but beef and uric acid forming foods, in general, should be carefully avoided.

In this connection it may be well to add a thoroughly recognized fact, but one which cannot be too frequently repeated, that in all diseases of a rheumatic or gouty diathesis, large quantities of hot water should always be given the patient, say from two to four quarts every twenty-four hours. The rectum should likewise be flushed out every day, or every other day with large injections, thrown well up, of as hot water as can be borne.

Drugs are, of course, useful, but they are certainly secondary to the foregoing. If immediate relief does not follow a prescription one must not be surprised or disappointed. Care should be taken in selecting the remedy, and it should be administered faithfully.

We intend to simply discuss some of the drugs which have been most useful to us, and do not presume to name all those which may be indicated.

The most frequently called-for remedy, in our experience, is aconite, particularly in recent cases. It quiets the patient's anxiety, subdues the restlessness and occasionally relieves the pain.

In looking over our case-book we find the next most used

remedy is cimicifuga. In cases where the whole leg is involved, and every part is tender to touch and aches, this remedy will help very much. In several instances it was the only drug given. Improvement began at once on its administration, and continued until cure resulted. The very lowest potencies should be used.

Colocynth is a favorite remedy, according to some of our writers on materia medica. It is certainly frequently indicated by the shooting pains, or the paroxysmal cramping of muscles, with relief from relaxing the affected muscles, but in our experience it has rarely shown itself worthy of its indorsements. We have found, however, that dioscorea, with the same indications, will act at once, and give the patient ease. Another most useful symptom pointing to dioscorea is a pain which has a point of greatest intensity, with pain of lesser degree surrounding it, or elsewhere in the body. This is a much neglected remedy in painful diseases, and is worthy of trial in cramping pains, or those with a central point of intensity, whether in the muscular apparatus or elsewhere.

Ledum has done good service, especially when the disease seems to begin down the leg, and either progresses upward or the pain shoots upward. It will also help those cases which have a point of greatest intensity near the heel.

Rhus. tox. is often highly recommended, but it has disappointed us, especially in acute cases. In old sciatica of a mild type it will moderate the pain, and perhaps enable the patient to endure it. Ruta is another which we have found helpful. It has not received the attention it deserves. It is particularly indicated when the pain is deep-seated and the limb is very sensitive to hard pressure, such as the edge of a chair when sitting. It helps sub-acute cases, when they are made worse by sudden changes in the weather, and the patient is so nervous that he cannot sit still, but finds relief by walking.

Sub-acute cases likewise receive help from ferr. phos., gels. and ignatia.

In chronic cases, when remedies have failed, such as rhus tox., bryonia and plumbum, and nearly every known mechanical device has proved useless, the static spark applied to the whole length of the nerve has been of permanent service. This may seem heroic treatment, but the writer has seen it perform marvels.

The static current is a great source of comfort in nearly every painful affection. Its greatest disadvantage is that it requires a bulky instrument, which cannot be taken to the bedside of the patient. Doubtless in many cases of sciatica if the roller could be ap