Grindelia is a remedy from which I have gotten very good results. It is indicated when the patient feels drowsy, but cannot sleep on account of asthmatic breathing. It is a very good remedy to give between the attacks and has been given the credit of curing many

cases.

Arsenicum is indicated in those attacks coming on just after midnight, patient is restless, with fear of suffocation and death. I have had excellent success with it.

Nux vomica where the trouble seemed to arise from gastric irritation through pneumogastric nerve. It is a remedy especially useful in patients subject to asthmatic attacks who are victims of sedentary habits, of a bilious type and victims of coffee or alcoholic habits.

Antimonium tartaricum is a remedy much used by the allopathic school and is homeopathic to some cases. The indications for its use are fine mucous rales, finer and smaller than the rales of Ipecac. Chest is full of mucus, with inability to raise it. Dyspnoea is marked, causing patient to sit up to breathe. One of the characteristics of this remedy is that patient cannot get enough air. It is a remedy adapted to extremes of life.

Lachesis is a remedy that has been used in some of these cases. It has a feeling of constriction about the throat during attack; especially useful if patient is a female at time of climacteric.

Natrum sulphuricum, used in the moist type of asthma with a great deal of rattling in chest, symptoms aggravated by change to damp weather. This drug has looseness of bowels after each attack of asthma. The attack generally comes on about four or five A. M. with cough and raising of glairy slime, the expectoration is greenish and free. One of the characteristics of this remedy is that the patient. must sit up and hold chest with his hands during the attack.

Bryonia has frequent recurrence of the attacks with constant sharp, lancinating pain; excessive thirst and pain in gastric region. are characteristics.

As regards hygiene and prophylactic treatment of asthma, attention should be given to diet, proper exercise, clothing, bathing, regular habits, etc. The excretion of uric acid should be attended to, and the kidneys should be forced to act freely by use of diuretics. The exclusion of meat from the diet is advised by some in view of the uric acid theory which is to allow as little uric acid to enter the system as possible and to stimulate the kidneys to throw off as much as possible, this acid being considered an etiological factor in causation of disease.

I believe the best results to be attained in the treatment of this

disease by the institution of prophylactic measures whenever possible. Raising the general nutrition of the patient will in turn aid in preventing recurrences of paroxysms, or at least make them more mild and shorten their duration. Goodno recommends the use of bisulphide of Quinine in cases of purely neurotic type; when there is associated with the asthma a highly neurotic stomach and emphysema with a weak heart.

Remedies for use during the interparoxysmal period should be selected with great care and their administration persisted in. Among the most important are Nux vomica, Arsenicum, Kali hyd., Sulphur and Iodine. Chloride of Gold and Sodium 2x is useful in cases occurring in highly neurotic individuals who complain of many symptoms. The Arseniate of Copper has been of excellent service in cases of ordinary bronchial asthma, with constant oppression. One foreign observer states that he found swelling of the superior and often the inferior turbinated bodies. For the removal of pressure and irritation he employs Chromic acid, applied with a cotton-tipped probe. Superfluous acid was removed and nose plugged for some hours. Between cauterization, antiseptic sprays were employed. Cures frequently followed upon five or six applications. In some cases "hardening" the skin by means of baths has proved helpful.

Galvanism has also been used as part of an inter-paroxysmal treatment. The current should be used daily for fifteen minutes at a time and as strong a current as patient can stand. One pole should be three or four inches wide and long enough to surround chest and other should be applied to lines of pneumogastric nerve in neck and to the upper spine. The first mentioned pole should be shifted from level of epigastrium upward. To check violent attack a French observer recommends the application of a solution of cocaine 1 to 20 to nasal fossæ at the beginning of an attack. If this is unsuccesful the patient is to breathe freely six to twelve drops of Pyridin from a handkerchief. Thus the treatment of asthma frequently requires us to try many remedies before getting the desired results, but I believe if we are persistent we will succeed in getting results in these cases.

OTORRHEA-SOME REMEDIES.

By O. F. Miller, M. D., Louisville, Ky.

It is not my province, nor is it my intention in the limited space allotted to enter into any prolonged or profound discussion of the causes or course of this affection, nor shall I discuss the surgical treatment sometimes necessary to eliminate bacteric foci, to correct intranasal conditions, adenoids, etc., but I do desire to present to your

notice some of the remedies and their indications which shall guide us to such exploitation of them as is necessary to effect a cure, also that we may recognize the fact, that to-day, as in the days of Hahnemann, his axiom holds-that to the Homeopathic practitioner the totality of symptoms furnishes the only expression necessary to the proper selection and administration of the curative agent.

This does not signify that we may for one moment ignore hygienic influences, and first among these is local cleanliness. This includes the curetting and draining of pus foci, early swabbing of external meatus with dry sterile cotton, etc. Sanitary surroundings. are presupposed to exist and frequent bathing a matter of course. Sea-bathing is beneficial, the precaution being taken to plug the ears, during any full bath.

Diet, too, must not be ignored, particularly if patient is of a tuberculous or strumous diathesis, when cod-liver oil, Bovinine, Petroleum emulsion, and plain, nutritious foods of all kinds must be exhibited. Active exercise in the open air-preferably a country life, in healthful locations is desirable, yet when all these adjuvants are prescribed, the indicated remedy must be relied upon for specific results, and he who shrewdly discerns through the tangling array of symptoms the remedy best suited to the dyscrasia will reap the full reward.

I shall not attempt any classification as to acute or chronic conditions, but confine myself solely to indications as given by some of the best authorities, beginning with:

Arsenicum, which may be given where there is a profuse, ichorous discharge, cadaveric odor, or in a typhoid condition, with suppression of an old discharge; red, burning pustules in the canal and on the auricle.

Asafoetida, when, especially after abuse of Mercury, there is a purulent discharge, with great hyperæsthesia of the parts.

Aurum met. is useful in advanced cases with fistulous openings in the mastoid, perforations of the tympanic membrane, necrosis following syphilis, or abuse of Mercury; the well-known mental depression is present, desire to commit suicide; fœtid discharge, bruised pain,, worse at night.

Baryta mur., where the trouble is complicated by enlarged tonsils; there is a clacking sound on swallowing or on sneezing, caused by forcible dilatation of the Eustachian tubes.

Calcarea carb., where the typical Calcarea lymphatic temperament is present; in strumous children with blonde hair, and flabby

muscles; irritation of eyes, nasal discharges, singing and roaring in the ears.

Chenopodium has a serous or bloody discharge; deafness to the voice, but great sensitiveness to the sounds of passing vehicles, or to musical tones; bone conduction diminished; hears shrill, high-pitched tones better than low deep ones. There is also a roaring tinnitus synchronous with the heart-beat; sometimes there is staggering and nausea, with vertigo.

Capsicum is often the remedy in implications of the mastoid cells; the mastoid process is swollen, painful and tender to touch; the canal may contain much thick, yellow pus; ears are very hot; there is a deep, itching pain, extremely annoying; acute conditions occurring in chronic cases-mostly in adults.

Conium mac., when there is more or less hard swelling of the parotid glands and cervical lymphatics; hearing is painfully sensitive; strumous conditions.

Elaps. is a very valuable remedy when with an offensive, greenish, yellow discharge, we find headaches, both frontal and occipital, worse from motion and stooping. The nasal and pharyngeal membranes may be involved, dry, fissured and scabby; more or less cruption about the nose and face.

Graphites is useful in conditions showing thin, watery, offensive, excoriating discharge, with cracks behind the ears; cracking in ear when swallowing or sneezing; hears better when riding in a carriage.

Fluoric acid is useful in hereditary syphilitic taints; earache nightly; intolerable itching, scratching followed by burning; facial bones feel numb.

Hepar sulphur is the remedy when with discharge of yellow pus there is exquisite sensitiveness to touch; the discharge may be occasionally suppressed, with a return of inflammatory symptoms, and a disposition to boils or styes.

Kali bich. has a stringy, yellow, thick discharge; nightly pains, stitches in left ear running into the roof of the mouth, or down the neck.

Mercury, if there is offensive discharge; a pulsation of pus at inner end of the meatus; polypoid growths; earache nightly, with flow of thick, creamy, acrid pus; syphilitics.

Kali mur. is a valuable remedy for a thick, whitish discharge, stuffy sensation in the ear, naso-pharyngeal obstruction and deafness. (If discharges are yellow, Kali sulph.)

Nitric acid after syphilis or abuse of Mercury; caries of ossicular

and mastoid processes, nightly pains in the bones; discharge is terribly offensive; one's speech echoes in the ears. (Similar to Phos.)

Psorinum has a watery, offensive flow, more or less pain, pustules on or behind the concha; vesicular eruption about the meatus or cheeks; the skin is dirty; all discharges from the body are exceedingly offensive; much itching about the ear, so that children dig at it beyond control. Dose should be given infrequently and high for best results.

Pulsatilla may be useful when pus is profuse, bland, thick yellow or yellowish green. Eustachian catarrh. If chronic case Kali sulph. will act better.

Plantago maj., with throbbing pain and discharge of sanguineous serum; will cure if Belladonna seems indicated, but fails.

Silicia in deafness worse from washing and changing linen; caries of bone; discharge is thin, watery, curdy, of foul odor, not so profuse, but persists tenaciously.

Sulphur in purulent, offensive discharge, worse in damp weather or from bathing; stinging pains, mostly in left ear. It may manifest a periodicity, occurring every eighth day. The auricles are very red. This remedy is useful to clear up a case after repeated trials of seemingly well-indicated remedies, cases which follow recession of eruptions often will prove amenable to this drug only.

Thuja should be given when the watery discharge has a cadaverous odor, constitutional dyscrasias, the so-called sycosis is present; the skin of face is greasy and the veins show in capillary net-work upon the cheeks. Condyloma, polypi.

Tellurium has a characteristic discharge, smelling like fish-brine. The Tellurium case usually begins with a formation of phlyctenules upon the tympanic membrane; these burst and the resultant ulcer goes on to perforation; the discharge is ichorous and causes formation of phlyctenules also along the external canal. These vesicles contain a watery pus of the characteristic odor; there is also a constant, dull, throbbing pain day and night, while the concha has a bluish-red appearance.

Skillful selection and persistent administration of some one of the foregoing remedies will cure almost any case of otorrhea presenting itself to our observation.

There is nothing that so promptly cuts short congestion of the lungs, sore throat or rheumatism as hot water when applied promptly and thoroughly.

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