ally get up-to get up because of the urgency to stool, and there appears a profuse, watery stool, and this is repeated until perhaps ten o'clock in the morning. I have treated cases where the individual could not go about until afternoon on account of this diarrhoea. One case I will refer to has been treated for years by her allopathic physician. It was over fifteen years ago, and she has never employed an allopath since, as I have treated her since that time. The allopathic treatment consisted of Opium until the bowels became constipated, and then he would give a cathartic. With the 30th attenuation of Aloes that patient was cured, and whenever she has had diarrhoea since she has had that remedy. That is the beauty of homeopathic prescribing. Put it down in your book and whenever a patient has a return of her trouble you can look it up and give her the remedy which will surely relieve.

Mercury is more of a dysentery remedy. We occasionally give it in diarrhoea, but not frequently. With this remedy the pain and tenesmus continue after stool.

Nux Vomica has relief immediately after stool. The Mercury patient passes light colored stools and it is perhaps a half-hour before he gets relief after stool. These are positive symptoms of these two remedies. My attention was called to it by Dr. P. P. Wells, of Brooklyn, one of the most careful prescribers and writers we ever had. He in an article, entitled "Diarrhea and Dysentery," advocated this remedy.

Rheum is a remedy that is given every day by allopathic physicians. It has a mucous diarrhoea-more indicated for chronic catarrhal inflammation.

Podophyllum is a remedy which is aggravated in the fore part of the day, with relief in the afternoon, not especially after eating, neither does it drive the patient out of bed. It is a remedy which can be continued for some time. Just one case, and then I am done. A gentleman was in the office yesterday and wanted to get something for his child's diarrhoea. I want to tell you how some of the allopaths treat these cases. The doctor had an idea that there was some certain ingredient which was irritating. He attended the mother in confinement, treating the child afterwards, and for eighteen months-almost without exception every day-the mother or the doctor introduced a long tube and through this tube injected something into the bowel, but the diarrhoea continued. The child could not eat anything and was emaciated and looked like a skeleton. I stopped all this business and looked after the diet carefully. You know how important the diet is in such cases. I gave Croton tig. 6 and secured some relief. I then

found, as in most instances where Podophyllum is indicated, that the stools had become nearly normal, except that they were thin. They had to change the child nearly every hour. Whenever you have a case of that kind think of Podophyllum. I gave that child Podophyllum, 10 grains of the 3rd dissolved in four ounces of water, a teaspoonful every hour and continued that for some weeks and cured the trouble and the child gained in flesh and has continued to improve. Podophyllum was the only remedy which had any marked effect, excepting what little relief I secured from Croton tig. I sent that medicine down south for the child, with absolute faith that the child would again be benefited by it. Caxton Building.

PICRIC ACID AND BRAIN FAG.

By Alvan L. Waltz, M. D., Professor Materia Medica, Cleveland Homeopathic Medical College.

Physicians who are called upon to treat mental workers, such as teachers, bookkeepers, and persons of like occupation, who eventually become afflicted with brain fag and neurasthenia, will find in Pieric acid a very helpful remedy.

Picric acid is an organic compound of Nitric acid and a member of the phenol series. The dilution is made one part, by weight, of the acid to 99 parts of distilled water. This makes the second decimal dilution.

In reference to its physological action upon the brain and nervous system Cowperthwaite says that, "In smaller doses, there is at first slight congestion followed by weariness, which may vary from a slight feeling of fatigue to actual paralysis, associated with this is a mental inactivity, lack of will power, indifference to everything, and a desire to lie down and rest, thus simulating brain fag and neurasthenia, in which conditions is found its chief sphere of usefulness."

At this season of the year when our schools are entering upon a new school year there will be many teachers who return to their work "still tired" mentally and physically. It is this class of mental workers who will require our services more than any other. If we inquire we will find that they closed the last year's work "entirely worn out," or "tired out," the summer vacation not bringing the recuperation they expected, so that in entering upon a new year's work one of two things will have to be done; abandon work in school and take up another occupation, or seek medical aid with the hope of carrying them through another year, when another vacation may right the whole condition.

The medical side of this, naturally, divides itself into two heads, viz. That of palliation and that of cure. The latter is universally

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sought for, but not universally secured by the profession, as is evidenced by the cases who came to me from other physicians. Many doctors advise complete rest, which is a valuable help, but many mental workers cannot do this for financial reasons; then, too, when rest is advised you are not sure that the cure will be permanent, nor are you sure that a cure has been made at all.

The palliative or tonic method is used by many physicians because of their imperfect knowledge of the homeopathic remedy. These remedies if properly applied will cure every time. These cases can be cured and the patient still work, thus showing without doubt the efficacy of remedies.

Picric acid will cure a great majority of these, as the symptomatology will show. We will recognize its applicability more readily if we keep in mind the physiological action of the remedy upon the nervous system and the physiological effect of mental effort. Brain work or brain activity, as you know, causes an increased amount of blood to flow to that organ; if the mental effort is such as to cause a continual or exaggerated flow of blood, there will follow mental fatigue and languor and later on paralysis. Picric acid produces exactly the same symptoms; congestion, fatigue, languor and later on paralysis.

The proving of Picric acid develops the following symptoms: Is so tired cannot think or study. Does not care to talk or move. Cannot read because it makes the head so tired. The eyes are sore and ache after mental labor. For this symptom glasses are worn by many mental workers and prescribed by opticians, with some relief too, but do not forget Picric acid for a cure. Pain in the occiput and nape of the neck, possibly extending down the spine. Headache and nausea on moving the head, a symptom of Bryonia, but Bryonia does not have the mental fatigue or prostration. A feeling of confusion in the nape of the neck. So very tired; legs are weak and so heavy that it is with the greatest effort that they can be moved. All these symptoms are worse after mental labor.

The symptoms just enumerated present a very good picture of nervous prostration. We will have to differentiate between such remedies as Phosphorus, Phosphoric acid, Nux vomica, etc., as they have many similar symptoms.

All acids have great prostration and in that respect resemble Picric acid, but Phosphoric acid comes the nearer, so that attention will be called to that first.

Phosphoric acid has great prostration due very often to excessive mental labor, but more apt to be due to some great grief or affliction, like that of Ignatia, but this differentiation should be kept in mind,

viz., Ignatia is for acute or recent grief, phosphoric acid for chronic. Phosphoric acid has for its underlying cause, too, a history of sexual abuse.

Phosphorus has brain fag, but not the prostration of Picric acid, but rather has great nervousness. If there is prostration it also has irritableness which is not true of Picric acid.

Nux vomica is often given for this condition, undoubtedly because of the history of a "sedentary occupation." While it is often indicated in such conditions, it does not have the prostration, and besides it would require some gastric symptoms to make its indications complete. Silicea, Zinc and Sulphur should also be studied.

My clinical experience with Picric acid has been very flattering. Two recent cases have been school teachers. One began treatment nearly in the middle of the school year when she had about concluded to abandon her school for the balance of the year, with the hope that the rest would restore her health. She had had the tonic treatment with temporary relief at times but on the whole growing steadily worse. The fatigue was such that the thought of entering upon her school work in the morning was a dread, but by the exercise of her will-power and persistence, the forenoon was passed, with a rest and sleep at noon. The afternoon was passed much in the same way, the evening being spent in rest and sleep, being too tired to go out, or spend the evening in a social way at home. Besides the tired feeling and great sleepiness there was a pain in the nape of the neck; pain in the eyes; legs tired, etc. Picric acid was prescribed in the third tritruation and at once there was improvement, and with the loss of only a few days, she continued until the close of the school year. This was proof that the condition could be cured if the properly indicated remedy was prescribed.

The other case had similar symptoms, but came under treatment at the close of the vacation period. The symptom most complained. of, as in the other case, was that "tired feeling," both mentally and physically. Had no pleasure in going anywhere because she was so tired. Had taken strychnia sulph. and other tonics without improvement. Picric acid was prescribed and the improvement has been continuous from the beginning.

These cases are sufficient to show the efficacy of Picric acid in these affections. It also shows in these cases, that it was medicine they needed more than rest. I am also tempted to make this assertion: that the rest treatment, change of climate, etc., advised by many physicians is an evidence that they have reached the limit of their knowledge of materia medica. 754 Rose Building.

METHODS OF CLINICAL DIAGNOSIS FOR THE GENERAL

PRACTITIONER.

By Josephine M. Danforth, M. D., Pathologist to the Cleveland Homeopathic Hospital.

There is more and more a demand for every aid in diagnosis, and the examination of the excretions and the fluids of the body is becoming of routine practice. The general practitioner, who would stand shoulder to shoulder with the best and most thorough men in the profession, must either do the work himself, or send it to the laboratory.

The feeling that the technique is tedious, and the necessary equip ment expensive, deters many from making a number of examinations which they might undertake with comparative ease, and which would be of material benefit, not only to their patients, but to themselves. This is especially true in cases of pregnancy, interstitial nephritis and tuberculosis, where frequent examinations should be made, but which are often neglected because the patient is too poor to pay the required laboratory fee.

In cases of pregnancy an examination of the urine should be made every month in health, and oftener, if indicated. Every practitioner is prepared to test for albumin and sugar, to determine the specific gravity, re-action and amount of urea eliminated, but I consider these tests only supplementary to the microscopical examination. Often the presence or absence of albumin is considered a sufficient guide to treatment, but in either case, may be misleading, doing the patient a great injustice. If albumin is found, the cause must be determined; is it due to leucorrhoea, to cystitis, or to nephritis? Pus and blood from a leucorrhoeal discharge may be eliminated by catheterization, but the microscope alone, will tell us if the integrity of the kidney is unimpaired. In interstial nephritis, albumin is often absent, or faintly present, and is an unworthy guide in the diagnosis or in determining the progress of the disease. Again, the microscope must be resorted to, thus becoming an instrument of prime importance.

Having the possession of a microscope, a centrifuge and a few stains any practitioner can, with a little study and the use of odd moments, make examinations in the conditions mentioned, and also a few others which would be of decided practical benefit, such as the examination of the discharges for the gonococcus, the secretion from the throat for the diphtheria bacillus, cover slip preparations of the blood, and stomach contents.

The least amount of equipment necessary to make these examinations would cost something under a hundred dollars, and comprise the following: