symptoms belonging to a profound typhoid state. Under its use in such a case, the amount of urine becomes markedly increased, the tympanites disappears, the number of stools decreases, the heart beat is strengthened, and the delirium gradually lessens.

During my interneship at the Rochester Homeopathic Hospital I had occasion to use enteroclysis in four cases with seemingly good results.

Case I. This case answered perfectly the demands for enteroclysis. A young man just past his majority had while working in the country contracted the disease. He was of magnificent physique, and previous to his admission to the hospital had gone about his usual work, feeling a "little out of sorts," but not sick enough to stop work. Suddenly symptoms of a profound nature asserted themselves, and he was brought to the hospital in a precarious condition. Delirium was marked; temperature over 105; pulse over 100 and weak; respiration somewhat embarrassed by a marked tympanites. Enteroclysis was immediately instituted, as an adjunct to the other treatment. At first enteroclysis was used every three hours, but as the symptoms abated the interval was lengthened. At one time, owing to a slight hemorrhage, enteroclysis was discontinued, to be resumed after all signs of bleeding had passed away. The man made an uneventful recovery, and the prophecy of the attending physician that the man would surely succumb was proven an incorrect one.

Case II. This case was remarkable for its meteorism, tympanitic to a degree that it seemed impossible for the abdominal muscles to stretch further. Respirations were very frequent, and shallow; dyspnoea marked; temperature high; pulse weak. Enteroclysis was begun soon after patient's admission to

hospital. The tympanites slowly but surely disappeared with improvement of all other symptoms.

Cases III and IV were simply ordinary cases of typhoid running uneventful courses, recovering after four weeks. of sickness. Enteroclysis was resorted. to as a routine measure twice a day, morning and evening. The necessity for enemata and cathartic was thus reduced to a minimum.

It may be argued that three or four cases, or even ten cases are not sufficient to draw conclusions, as to the efficacy of any method of treatment; yet when we see distressing symptoms disappear before our eyes, under a definite form of treatment, we are apt to accord some benefit to it. The statistics for the use of enteroclysis are very meagre, and I am unable to give any tabulation which will to any great degree support my position. In an article in the Medical Record of 1901, Temoine reports thirty-three cases treated by enteroclysis with but one death, or a mortality of 6 per cent. But that proves nothing. for out of thirtyfour cases treated last year in our hospital, under various forms of treatment, there was but one death. Thompson, of New York City, reports a large number of cases treated in Roosevelt Hospital by enteroclysis. Here a check was simultaneously kept of cases without enteroclysis, with the result that those treated with enteroclysis invariably ran milder courses than those treated without. It has not been claimed by advocates of this procedure that the duration of the disease is shortened, but that many of the dreaded symptoms are held in abeyance. I attribute the efficacy of enteroclysis in typhoid (1) to the elimination of toxins by the free diuresis which it occasions; (2), to its reflex stimulating effect upon the circulatory and respiratory centres. in the medulla; (3), to its cleansing

power in the large intestine, preventing auto-infection from absorption; (4), to its aid in emptying the small intestine; (5), to its ability to relieve tympanites, thereby diminishing the liability to hemorrhage and perforation; (6) to its help in making the use of food a possibility in the patients of flatulent tendencies.

Any measure which will in any degree modify the course of such a disease as typhoid should receive our most careful attention and application if it answers the requirements of our medical minds. Statistics and personal experiences, though somewhat limited, seem to accord it a prominent place in the treatment of typhoid, as an adjunct of no mean repute.

ARSENIC AND ITS INDICATIONS IN
NERVOUS DISEASES.

Arranged by J. Richey Horner, A. M., M. D.,
Cleveland, Ohio.

Especially adapted to chronic cases of sciatica, with periodicity. Burning pains and restlessness. A case of a woman of fifty; occasional attacks of sciatica for twenty-five years. Severe burning and aching in sacral region; along the sci- . atic nerve to foot. Relief by motion. Worse at night, often obliging the patient to rise and walk the floor for relief. Seizures last two or three weeks at a time. Arsenic 30 cured.

Gastralgia.-Acute, burning pains, accompanied by restlessness; nervous excitability; coldness of extremities; palpitation of the heart; worse at night.

Delirium Tremens. Cases where there are muscular tremors and exhaustion, with nervous derangement; fear; great anxiety and sweat; dread of ghosts, thieves, death, and especially of vermin crawling about the body, the latter symptom very characteristic.

Cases of Cerebral Anemia.-With vertigo; syncope; chilliness; pale, chloro

tic color of face; tinnitus aurium; cases which have taken a great deal of iron.

Simple Acute Meningitis.- Especially in the last stage, where the pulse is rapid, feeble, intermitting; delirium; tonic spasms followed by paralysis; also in epidemic form, with symptoms which are similar. Great paleness of the face, almost death-like. Tetanic rigidity of the muscles; spasmodic grinding of the teeth; comatose state.

Chronic Hydrocephalus. - Where the head and face are particularly swollen; vomiting on being raised up in bed; emaciation; muscular weakness a peculiar symptom is that the child strikes his head as though for temporary relief; nervous.

Headache. Periodical, semi-lateral, with nausea; buzzing in ears; vomiting; restlessness; anxiety; aggravated by eating and motion, rising up in bed, light and noise. Slightly better by warmth; wrapping up the head warmly. Peculiar condition which might be called a sympathetic headache, where it is due to catarrhal, gastric or malarial conditions; intermittent character; periodical, with symptoms similar as last quoted.

Vertigo. Gastric nervous or epileptic. Periodical; with coldness followed by fever, with loss of appetite and vomiting.

In a case of hemiplegia produced by Arsenic, where there was emaciation, aphonia, the laryngoscope detecting paralysis of the vocal cord on the affected side.

In the Arsenicum anesthesia there is sometimes manifested an acute sensibility to cold, by which also the neuralgia is aggravated. It has actually caused epileptiform and choreiform convulsions. It certainly has a direct action on the nervous system, not only of pure depression, like that of curare, but loss

of pure excitation, like that of strychnia. Paralysis is accompanied by

cramps.

Anesthesia with neuralgia. This we find in chronic poisoning. It has a direct action upon the ideation and emotional centres. There is a mingling of irritation and depression. There is melancholia, with restlessness, irritability, anxiety.

On the sympathetic, or what is more properly termed the ganglionic system, it has a decided effect. Hahnemann says that "it is capable of producing spasms in the blood vessels," -as he expresses it in the language of his time. In other words, it affects the vaso-motor

nerves.

Resistive Melancholia, with restlessness.-Suicidal-inclined to mutilate his own body. Hallucinations of smell.Smells pitch and sulphur and anticipates consignment to sheol.

Sleepless-restless anxious.

Affections in the insane characterized by periodicity.

Acute delirious mania, which is very exhaustive.

HOW THE BLOOD IS AFFECTED BY A
SPELL OF VERY COLD WEATHER.
By Dr. B. F. Gamber, Lecturer on Haematology, Cleve-
land Homeopathic Medical College.

I wish, to-day, to call your attention to the condition of the blood in the living subject as I found it in several persons during the late cold snap.

It was the rapid solution of the red corpuscles and the appearance of their red coloring matter in the serum of the blood.

This condition of the blood has been traced to this cause by a number of investigators and my attention was attracted to it by the condition of the blood of several persons who had been suffering from acute and chronic disease previous to this cold snap.

In various conditions a predisposition to such an atack has been observed. It is readily recognized by a spectroscopic examination of the serum of the blood.

I detected it in dry specimens which had been smeared upon glass and stained. Then I mounted it and examined the specimen with the micro

scope.

Under normal conditions this degree of the disintegration of the red blood corpuscles is never observed.

Our knowledge in the ultimate cause of this excessive disintegration of the red corpuscles is as yet very limited.

A view entertained by eminent authority is that it is liable to occur in the course of many infectious diseases.

The coloring matter frequently occurs in the urine, but the formed elements of the blood are absent.

This rapid solution of the red corpuscles may be the result of poisoning by certain varieties of mushrooms. Sunstrokes, burns, and, excessive, exposure to cold are capable of giving rise to this excessive solubility of the red corpuscles. It frequently is the result of transfusion of blood in the living.

It is probable that some underlying predisposing cause tends towards this condition and that the paralytic dilatation of the veins on the surface of the body, containing such blood may offer special opportunity for its occurrence.

Ehrlich supposes that in the predisposed subjects exposure to extreme cold causes the development of a "ferment," which dissolves the red corpuscles.

These specimens which I examined lately, showed very marked evidence of this morbid destructibility of the red corpuscles and the serum was deeply stained in two of these specimens.

The microscope clearly demonstrated the matter resulting from the dissolu

tion of so many red corpuscles of the blood.

I likewise found the remaining red corpuscles greatly reduced in their resisting power to destructive influences and many artifacts were evidently the result of the necessary manipulation.

It has been shown that in uncomplicated cases, the regeneration of the red corpuscles may be very prompt.

However, in invalids and in subjects who were very greatly exposed at a time when their resistance was reduced, there may develop irreparable destruction and serious results may develop.

One of these cases coming under my observation manifested subjective symptomes of a general soreness of all the tissues and the roots of the hairs when extracted caused great pain.

The microscopic examination of the blood showed evidence of extensive destruction of the formed elements of the blood, and the serum was highly tinged by a dissolution of the coloring matter of the red corpuscles.

Numerous morphological changes in the red cells were in evidence.

toms of a general soreness of all the increased destructive tension of the serum all showed a marked change in the blood.

It is believed by eminent authority that this change may result from simple exposure to cold in subjects who have acquired the predisposition through previous malarial infection.

One of these subjects in whom I found this condition during the late cold snap, had been suffering from malarial infection while he was in military service in the late war in Cuba.

Bristowe and Copeman endeavored to prove by this condition that very cold. climates might cause depreciation of the blood so as to favor disease, and they found in confirmed cases that it pro

duced a marked chronic anemia sometimes associated with enlargement of the spleen.

There seems to be a close relationship between the intensity of the attack and the intensity of the anæmia.

I examined the blood of a subject who left her seal skin cloak at home and was exposed to extreme cold following a great fall in the temperature. You can readily imagine the subjective symptoms.

The blood was greatly affected, showing a marked destruction of corpuscles and the serum was deeply tinged by the liberated coloring matter.

Such a weakened condition of the red corpuscles has been experimentally produced in animals by heating them in an oven and putting them into a refrigerator. It has been demonstrated to increase the susceptibility of infectious diseases.

Following the destruction of red corpuscles I found a marked reduction in the alkalinity of the blood. Kobert believes this to be due to setting free of phosphoric and glycerin - phosphoric acids during the separation of the elements of red corpuscles.

There is no doubt of the capacity of these attacks to intensify and prolong other diseases.

The reduced amount of hemoglobin in the blood and the reduced alkalinity of this fluid results in imperfect oxidation and an accumulation of carbonic acid in the tissues leading to this low resistance and possibly to the accumulation of bacterial toxins in chronic diseases. It has been observed that hydremia often results.

The passing of the coloring matter from cells to the solution in the plasma has been observed in so many toxic conditions, that this transformation has largely increased our knowledge of these

Diminished capacity to carry oxygen may lead to dyspnea and nervous symptoms.

The destruction of corpuscles occasions coagulability to a morbid degree as to form thrombi and develop ferment intoxication, and fever with its results may be the outcome. 634 Rose Building.

NEURASTHENIA AND SEXUAL WEAKNESS IN THE MALE.

By F. M. Evans, M. D., Bellaire, Ohio.

This is one of the most difficult class of cases the physician of to-day is called upon to treat. The two conditions are usually associated. The one is often dependent on the other. The management of these cases requires much time and patience, on the part of both physician and patient, and as a rule the case soon becomes discouraged and tries "the other fellow," and keeps on "trying" until he finally lands in the hands of the advertising specialist, where of course he is assured of a speedy cure. (1) There are three important factors to consider in taking these cases. (1) Get the confidence of your patient; (2) Remove the obstacles to recovery; (3) Adapt the remedy to the patient (not the disease). Probably nine-tenths of the physicians of all schools, when a case of this kind comes into the office, will grab for a favorite remedy for neurasthenia and overlook the patient. The other "one-tenth" may look a little farther into the case, discover and correct some mechanical irritations, give his favorite remedy for the disease and forget the patient.

The first thing to do, is to get the confidence of the patient. Have a little. "confidential" talk with him; disabuse his mind of the fears engendered by "quack" literature on the subject; get

him that the sole object in life is not the performance of the sexual act; that "the sun does not rise and set" in his sexual organs, but will still continue to shine, even if his emissions are not checked at once. Let him realize that "there are others" in worse shape than himself, and that his cure is only a matter of time and patience, and faithful following of advice. Insist that he must refrain from sexual intercourse entirely, for a time, in order to get his mind away from such subjects, for the mere thought of the sexual act will often cause an emission, especially in highly nervous subjects. The quicker the patient realizes that there is something higher than the sexual act in this life, the quicker will improvement commence.

Having treated the mind and won his confidence, the second factor is to remove the obstacles to recovery. This will often be found in the genital organs,

-an adherent or long prepuce, or urethral stricture is often the exciting cause of the whole trouble, which will quickly disappear under surgical treatment. Tight sphincters should be thoroughly dilated and old hemorrhoids removed surgically. "Orificial irritation, as a cause of disease, is too often overlooked by the busy members of the profession.

Another obstacle is mental worry. The patient should have absolute rest from business cares and domestic irritations, for as great a period of time as possible; this is best obtained by a long trip to the mountains, or the southern health resorts.

Excluding surgical conditions, the basic cause of neurasthenia, and one of the greatest obstacles to recovery, lies in one (or more) of the three great miasmsPsora, Sycosis and Syphilis. According to Hahnemann, Psora is the chief underlying cause. The hereditary influence