be indicated during the progress of this disease, owing to the variety of symptoms in individual cases, but the five remedies first mentioned are indispensable to this class of patients. We will run over their characteristic symptoms, and see how well they correspond with the symptoms of the disease.

Calc. c. is indicated in early stages of organic diseases when there is lack of assimilation of food to blood and tissues during dentition; open fontanels with profuse sweat (not sour) about the head, when sleeping, in children inclined to fat; vomiting of soured food; green mucous diarrhoea, frothy, watery, sour, painless (not excoriating); distended abdomen and emaciated limbs; urine of strong, pungent odor; all symptoms relieved by warmth and quiet.

Sulph. is indicated in children of dry, flabby skin, with a prematurely old look, after suppressed eruptions; vomiting of milk, sour or unchanged; green, mucous, frothy diarrhoea, profuse, watery, and excoriating, with itching aggravated by warmth; wakefulness, restless sleep, with crying out; aversion to being bathed.

Sil. is indicated later in the disease, when the bone symptoms have appeared. There is tenderness on pressure, and soreness when moved; a desire to be let alone; profuse sour sweat on the head; aversion to animal food; stools sometimes undigested and watery, at others constipated; stitching pains about the joints, aggravated at night; irritableness.

Lycop. is indicated in nausea after cold drinks, not after warm; flatulent colic, with rumbling in the abdomen and bloatedness, relieved by motion.

Also where there is dysuria, with sandy deposit in urine; dyspnoea, with cough after exertion; whizzing breathing, with rattling in the chest; affects oftener the left side; follows well after Calc. c.

Calc. p. is indicated in frequent vomiting of children, sour and with belching; uneasiness and bloating at pit of stomach, with sharp pains; cutting colic with soreness, followed by green or slimy diarrhoea, with flatus; tenderness of muscles and pain in joints; enlargement of condyles; open fontanels; non-union of fractured bones; upper right and lower left side most affected.

XX.

THERAPEUTICS OF RACHITIS.

BY H. C. ALLEN, M D., DETROIT, MICHIGAN.

CLEARLY defined and well-marked cases of rachitis that have been permanently cured by a single remedy, or in fact by any number of remedies, are rarely reported in the periodical literature of our school. This is probably not to be attributed so much to a lack of cases to report, as to the slow, tedious and very unsatisfactory character of the disease in question. A frequent cause may also be found in the fact that, notwithstanding our utmost care, a fatal termination of the case from some intervening acute disease, such as pneumonia, capillary bronchitis, hydrocephalus, measles, scarlatina, etc., often occurs. Owing also to a want of frankness on the part of the physician, or a lack of confidence on that of the patient, a change of treatment by a change of physician occurs, and we lose sight of the case. The therapeutics of rachitis is confined to a very few remedies, and the measure of our success will depend to a great extent upon the care exercised in their selection and the pertinacity with which we follow Hahnemann's instructions in their administration. The wisdom of Hahnemann's instruction as to repetition of the remedy was never better illustrated than in the treatment of rachitis. The efficacy of potentized remedies has never been more clearly demonstrated than in the contrast drawn by their successful exhibition in this disease. The attempt on the chemical theory to correct a functional derangement, by administering the Carbonates and Phosphates of lime and soda in massive doses when the urine is already loaded with

the salts of lime, is now generally abandoned in our school, and soon will be in all schools of medicine. The excretion of the salts of lime is not the cause but the effect of malnutrition, and their exhibition in a crude form and in massive doses can only act injuriously; and the sooner that fact is recognized the sooner will the practice be abandoned.

Bone cannot be made in that way, nor can the lacking chemical constituents be replaced by giving them in their crude form in the massive doses of the other school.

Baryta carbonica.-The child does not grow, is dwarfed and stunted, yet nurses and eats well. Very susceptible to cold and sensitive to change of weather.

Belladonna.-Child is subject to congestions of brain, particularly when teething, with alternate paleness and redness of the face; enlarged pupils; pain and difficulty in swallowing; sleep is restless and disturbed, there are frequent attacks of febrile excitement; pulse full and rapid, notwithstanding which there is no moisture of skin; abdomen thick and protruding; is indicated in all febrile excitements to which the child is subject during the course of the disease; squinting; curvature of vertebræ, particularly of lumbar region.

Fluoric acid.—Where the exciting cause can be traced directly to scarlatina, as one of its sequelæ.

Abies canadensis may prove a valuable remedy in this disease. As yet we have only a meagre proving and few clinical cases to verify its use. I have no special indications to give.

Ruta graveolens.-Tottering gait, as if the thighs were weak; much pain in them on walking; lower limbs heavy and feel so restless that he cannot keep them still; great debility; worse in cold damp weather.

Staphisagria.—If syphilis be suspected, and the teeth have black streaks running through them, edges rough and crumble away readily.

Asafoetida. If disease can be traced to a syphilitic origin.

Oleum jecoris aselli (in trituration). The exact sphere in which this too-often-overlooked remedy is indicated in the treatment of rachitis, is as yet but dimly outlined either in the Materia Medica or clinical experience of our school. When the

patient is old enough to make known his aches and pains, he complains of intolerable pain in the extremities; is easily tired; the teething process is much delayed; the fontanels and cranial sutures are widely open; abdomen distended, and profuse, watery, offensive diarrhoea, with nightsweats, are present.

Phos. acid.-The child has grown too rapidly (Baryta carb., the exact opposite); is listless, apathetic, cares for nothing, wants nothing, is totally indifferent to all external impressions, and if old enough complains of great weakness and exhaustion; the abdomen is much distended; great rumbling in the bowels, with a copious, painless, white, watery diarrhoea, notwithstanding which the child passes large quantities of colorless urine; the extremities are cold and moist. Most useful in the later stages of the disease.