within the brain, and how anemia is brought about when the supply is deficient and the quality altered. It is computed by Haller, that the brain receives about onefifth of the amount of blood in the human body, a circumstance that irresistably betokens its immense vigor and vitality, and connects it with conciousness, feeling, thought and in fact with all the attributes of man. In the performance of an idea as in the performance of a movement of the body, there is a retrograde metamorphosis of organic elements; the display of energy is at the cost of highly organized matter, which undergoes degeneration, or passes from a higher to a lower grade of being. In no organ of the human body is it more essential that blood should be freely supplied than in the brain, if its functions are to continue energetic and active.

The immense pre-eminence assigned to it as a mental organ seems natural to require an abundant vascular supply; for mental changes and nervous waste are continually going on, and under the influence of strong emotions or excitement, products are removed by the skin and kidneys in excess of what normally occurs. This was shown in one of my cases; when he was subject to any mental or nervous strain; Phosphates would immediately appear in the urine in excess of the normal condition and again diminish after rest and quietude. In the brain the demand for healthy blood is two-fold, in common with all other organs of the body it requires a due supply of nutrient material for the maintenance of its structural integrity, and functional efficiency, but a more urgent demand is for oxygen, which is conveyed by the hemoglobin of the red blood corpuscles; whenever these demands are not complied with we have a cerebral anemia. This may arise from other causes than general anemia; as a weak heart, functional or organic in origin, or organic obstruction of the circulation of the blood.

Let us recall the circulation of the brain and its blood supply and see how freely the vessels are united at their sides and in the median line. I think the pain in the occipital headaches is sometimes caused by an over abundant supply of blood, for the bassilar artery formed by the two vertebral arteries supplies half of the encephalon with blood, viz: The medulla oblongata, the pons, cerebellum and the posterior third of the cerebrum. The anterior portion of the cerebrum is supplied by the internal carotid which divides into the anterior and middle cerebral and posterior communicating artery. Now the difference in the amount of blood supply helps to explain the cause of frontal headache, by the smaller quantity of blood which is received by the anterior portion of the brain, the seat of the intellectual faculties and the fountain head of those functions we call reason, memory, imagination, conception, etc. The headaches of anemia are characteristic in themselves, which will be illustrated by a case that I shall relate: Miss A., aged 19 years. Was called to attend her about five months ago; complained of having had frequent attacks of syncope during the evening, which alarmed the family considerably. History of the case showed that she had been suffering with pains in the head daily for several months, but gradually had been getting worse; pains of a gnawing, boring character, deep in head, worse in forehead after mental exertion. The pains usually began after she had been working about an hour or two in the morning and then gradually got worse till about noon, when she would resort to headache powders for relief. Examination showed marked sallowness of complexion, eyes sunken, listless

look, pulse slow and feeble, cardiac murmur, breathing labored, partial stupor sleepless and what sleep she could get did not seem to refresh her any. Cold extremities, appetite capricous, constipation, headache better when reclining. Prescribed absolute rest in bed for one week and forced milk diet. Kali Phos. 3x gave her prompt relief of her headache and appetite improved, after one week added Ferrum Ars. 2x, 2 grs., four times a day and daily walks lengthened according to her ability, restored her to perfect health in eight weeks' time, having gained 20 lbs. in weight. The anemic headaches following the loss of vital fluids are on top of the head, of a pulsating nature, with a feeling of heat on head; are usually continuous and wearing, although paroxysms may be caused by emotions, fatigue or mental labor.

Hyperaemic headaches may be due to an active or passive congestion of the encephalon, either local or general. Those from hard mental labor are usually frontal and of a throbbing nature. An unusally heavy meal or overindulgence in stimulating food and drinks, frequently are the cause of dull, stupid or bursting pains in the forehead and temples. Exposure to sun's rays or heat rays from a furnace, is often the cause of cerebral hyperaemia, accompanied by intense burning throbbing pains in the head with confusion of the senses. A passive congestion may follow a long continued mental strain during the heated season of the year, more so than at any other time. Will relate a case of this kind: Mrs. W., aged 45 years. Was called to see her in July, 1903. Found her suffering intense throbbing pain and a sense of fullness and heat in head, face bluish red, pupils widely dilated; sclera injected. Expectoration of dark liquid blood which would accumulate in her mouth and throat and continue so for from five to ten minutes; where it came from I could not discover; after an attack of hemorrhage of this kind she would feel better, only to be repeated in the course of an hour or two; vertigo on rising head from pillow to sitting position. Vomiting of mucus and ingesta when attempting to sit up. Pulse full and flowing, 80 per minute, Temp. 98, extremities cold, bowels constipated, urine dark, excess of Ammonia-Magnesia-Phosphate crystals. I made very little impression on the case or afforded her much relief with Glon., Bell., Gels., Passiflora and Ergot. Ferrum phos. gave some relief and sleep, of which she had been having very little; followed this by Irisine and Sanguinarine of each 1/20 grain four times a day. Later NitroMuriatic acid 5 minims in 4 oz. of water and gave her 2 drs. every two hours. This soon made an appreciable impression on the case by way of improvement. In the course of three weeks she was relieved of every distress in her head and appetite improved, then the symptoms seemed to call for Sepia, of which she got the 30th potency. Her condition improved till a complete recovery resulted in five weeks from the date of my first visit.

There are as many causes of Sympathetic Headaches as there are organs in the body. When we recall the arrangement of the Sympathetic Nervous system, and its chain of ganglia along the Spinal Column to the base of the brain, and sending filaments along, to the ramifications of the cerebral vessels, and second, the Pneumogastric nerve communication with the solar plexus of the Sympathetic nervous system. We can understand how readily impulses can be received in the brain, when any of the abdominal or sexual organs are disturbed in their function. The pain in the head of a sympathetic origin may be either anemic, hyperemic or congestive, and some cases where the congestion is continuous, local tissue changes in the en

cephalon may result; pain and functional disturbance may persist even after the primary disturbing cause is removed. A frequent form of sympathetic is the gastric variety. After an unusually heavy meal or unaccustomed food or drink, especially so when the system already fatigued or disturbed by some psychical cause. This form is usually frontal of a bursting fullness in nature, probably more frequent in men. It is also frequently caused by iced drinks or cold food when the system is heated. Gastric headache is often readily relieved by means of an emetic, or laxative, followed by such remedies as Nux vom., Pulsatilla, Ipecac Bry. alb., etc.

The bilious headaches are common and usually affect the occiput, extending to the forehead, are of a heavy, dragging character. Remedies like Podophyllum, Nux vom., Chelidonium, Bryonia alb., Calomel and Carduus mar. are of excellent service. The condition of the Colon and Rectum are often overlooked in the search for a cause of a persistant dull aching pain in the back and sides of the head.

No other organs of the body are so frequently the cause of cephalic pains as the ovaries and uterus. Every physician or Gyneacologist can not fail to note the frequent accompaniment of headache with uterine diseases, especially, endo-metritis, sub-involution and cicatricial tissue in the cervix. For the sake of brevity I shall not go into the description of this variety of headache, but relate a case to explain the symptoms. Mrs. K. aged 28 years mother of two children, complains of a dull beating pain in the occiput to the vertex, relief by pressure and rest, tenderness in the occipital region when walking, soreness when rotating head, flickering of spots before the eyes. Local condition; cervical plug, subinvolution and prolapsus of uterus. Cimicif. rac., 30x gives her relief of pain in head, but it frequently returns. Mrs. E. aged 30, mother of three children, complains of a gnawing boaring pain deep in left side of head, extending from left parietal region to temple and supraorbital arch over left eye, sight of left eye diminished, due to congestion of retina, can only see light, worse during attack of pain, which would continue for days, especially during menstrual period and after fatiguing labors. Local conditions, left ovary indurated, tender on pressure with sharp cutting pains extending to vaginal outlet and region of spleen, remedies seemed to have only palliative effect, so would rest bring partial relief from pain. Resorted to Galvanic current, applied by means of an abdominal pad and intra-uterine electrode, which gave complete relief from all pain and conjestion of retina of left eye, with restoration of sight, so that she can read ordinary print. Menstrual headaches are quite common, usually of a congestive variety but very often of an anemic nature. Remedies of service in the former are chiefly, Cimicifuga, Belladonna, Pulsatilla, Veratrum vir., Sabina, etc. In the latter we must look to the deeper acting remedies as Sepia, Platina, Moschus, Calc. carb. Kali phos. etc.

Headaches due to Prostatic irritation or of the sexual ganglia of the sympathetic nervous system is more common than a casual observer is led to believe. A gnawing, scraping pain in the vertex arising from the occiput, vertigo with nausea, a melancholy disposition, lack of self trust, are symptoms of this form of headache.

Nervous headache. This variety of headache is not confined to any particular class of society, but is of most frequent occurance in persons of a nervous temperament and delicate organization. No temperament can however claim exemption from it and no habit of body is proof against it. Throughout a long life it period

ically attacks those who are susceptible to it and they surrender to the irresistable evil without murmur or comment. They feel it approaching as a certainty, from which there is no escape and placidly resign themselves to its torture. It is to a certain extent the headache of anemia, and yet not entirely so, for some persons are afflicted with it whose blood is neither diminished nor impoverished and whose muscular development and robust appearance indicates the soundest of health. Amongst its victims it selects persons of high social culture and vivid imagination, and if at the same time they are deprived of their just portion of sleep it all the more readily seizes them. When the brain is highly developed and the physical organization delicate, it is all the more likely to occur.

It is in the want of balance between the mental and physical state that a nervous headaches originates, for when the circulation is energetic and the digestive organs perfect the mind may be exerted to its utmost without incuring it. Results of investigation of this form inclines towards the nervous origin, to a morbid change in the nervous centres; clothe our arguments as we may choose, the observation of cases and urianalysis lead me to the conclusion of a faulty metamorphosis in the tissues, through the influence of the trophic centres, disturbed by psychic causes, as mental worry, stress of responsibilities, expectations be they pleasant or otherwise, is the prime disturbing element. Sometimes it seems a perfect "nerve storm", a certain amount of nerve energy being stored in the cells of the brain, will break loose and cause a disturbance of all functions of the body and highly unpleasant sensations in the head. In other classes of cases it seems to be of a chemical origin or improper elimination on the part of the liver and kidneys. Should like to dilate some more on this subject as it has been of marked interest to me ever since I entered the practice of medicine; but suffice by mentioning some remedies that have been of invaluable service to me in the treatment of these cases: Arg. nit., Aurum brom., Aurum mur., Sepia, Silicea, Natrum mur., and the hepatic tonics like Iresin, Euonymin, Podophyllum, Bry alb., Leptandrin and the uric acid solvents.

Toxic headaches are usually caused by some systemic affection as fevers, etc. Uremic headaches may be classed under this head. I would especially urge that in all cases of severe cephalalgia of sudden onset, that an examination of the urine be made to discover some possible disease of the kidneys, especially in the middle aged and those who have been living well. Headaches due to malarial infection are characteristic for their periodicity and following exposure to malarial infection.

Syphilitic, rheumatic and headaches from organic causes, will be dismissed by their mention and leave for your meditation.

The doctor who does not attend the meeting of his local and state medical societies may justly expect what he will get-oblivion.

Apropos of the recent epidemics of pneumonia we found that the degree of prostration and gravity of the disease was largely out of proportion to the amount of living tissue involved.

D. M. GIBSON, M. D.

EDITORIAL COMMITTEE
WILLIS YOUNG, M. D.

J. H. MCCAUGHAN, M.D.

THE MISSOURI COLLEGE.

The Homoeopathic Medical College of Missouri is now nearing its half century mile post. Within a few years it will celebrate its fiftieth birthday. In the retrospect a study of its career as an institution of medical education would be very interesting. A land mark of homœopathic medicine in the West, its influence in shaping the policies of medical education throughout this section has been very great-always a pioneer in everything tending toward the betterment of the medical course it has consistently held to, and developed in its classes that high standard of homœopathy that is the sole basis on which our system may perpetuate. Interest may flag at times; enthusiasm cannot, will not be continuous, but through all these years there has been a steadfastness of purpose whose central idea has been, the desire to build up and maintain an institution which will typify the solidarity of our rank and file.

The very evident benefits to be derived from a course in homoeopathy are now unquestioned. That the prospective students are beginning to see this more clearly, is evidenced by the larger enrollment in the ranks of Homœopathy. Its distinctiveness which perhaps at one time may have militated against it, is now a factor in drawing to its ranks a very representative class of students. Of the many calls for physicians that are being sent into the medical centres annually from all parts of the country, it is gratifying indeed to note the frequency with which the Homeopath is specified. This is a hand-writing on the wall whose meaning is too apparent to need any explanation. They are the advance ripples of an incoming tide.

In the face of this homoeopathic colleges must not be caught napping. The medical course of to-day is vastly different from that of fifteen or even ten years ago. The collateral sciences are pre-eminently necessary in making up the modern curriculum. Their omission in any slight degree, will tell against homœopathy.

A complete, comprehensive course in the allied sciences and real homeopathy should be the policy of the homoepathic college.

The homepathic graduate who is well grounded in the departments of knowledge on which the schools meet in common, and has besides a thorough conception of homeopathy, is armored and mounted for the stern battles of competition, which he must fight successfully to secure and maintain any degree of prestige.

In general the exclusiveness with which the homeopath is accredited, subjects him and his methods to more critical scrutiny at the hands of the regular, and any lapse of whatever nature is the occasion of more or less use of the hammer.

However let it be said for the comfort of the beginner, mayhap