plied early in the disease the length of the attack would be materially lessened.

The management of the convalescent period after an acute attack requires careful attention. Recovery is hastened by judicious. massage; not rubbing or kneading, but gentle manipulation of the small fibres which make up the muscles.

It frequently happens that after the enemy has been vanquished there will be left a soreness, or an uncomfortable feeling in the region of the hip; this can be speedily and permanently relieved with the sinusoidal current, the most useful and generally applicable form of electricity yet discovered.

Relapses are unfortunately common, they are readily induced by draughts, by dampness and by indiscretions in eating. Again they may be brought on by giving the limb too great care.

After the symptoms of the disease have passed away the patient should be encouraged to use the limb just as if nothing had been the matter with it. Patients are often inclined to do what they term "favor" the recently painful limb. This should be forbidden; there is no surer way of inducing a relapse than by thinking of the wretched pain and entertaining a fear of its return. Crutches and canes are a constant reminder of the late agony, and are more helps to it than to the patient. Another reason for prohibiting the favoring of the limb and the use of crutches, etc., is that they prevent the return of healthy nutrition in the leg. The use of the muscles is necessary for the proper nourishment of the parts, and should be encouraged.

B

SOME REMEDIES FOR DIM VISION.*

By JOHN L. MOFFAT, M.D.,

Brooklyn, N. Y.

Y "the totality of the symptoms" Hahnemann meant all that can be learned about the patient's condition, about his deviation from health; hence a clear understanding of the pathological condition underlying or accompanying each symptom is essential to scientific homœopathy.

Perhaps no other symptom can better illustrate this than "dim vision." What did prover No. I mean by this expression? What *Read before the Kings County Society, June 14, 1898.

No. 2? etc. We do not know (in most of the provings) just what the pathology of this symptom was. Now, granting that the prover was critical of his language, and that the word "dim" best expressed his condition, at least ninety out of every hundred patients are inexact in their choice of terms, too uneducated, or too sick or hurried to discriminate, and express the same condition by the words "obscure," "blurred," "impaired," "hazy," "misty," "like a cloud" or "veil," etc.

In selecting our remedy, it is not so necessary to weigh the differences between these words as it is to understand what makes the vision dim, and (if it be a therapeutic case) choose the remedy which covers the pathological condition as well as the subjective symptom.

A moment's thought shows us that the cause of indistinct vision may be one or more of several quite distinct tissue changes in the eye. Inflammation of different parts of the eye may be accompanied by impaired transparency of the refractive media, by functional or organic disturbance of the optic nerve or its expansion, the retina, and by muscular disturbances; or these conditions may be the result of a past inflammation.

Muscular weakness of the recti may blur the sight by double images close together (senega, natr. mur., alum, physos.), paresis (gels., caust., duboisia, cocaine, atropia), or irritable spasm of the ciliary muscle (jab., lil. tig., arg. n., physos., eserin., agar.).

The intimate association of the iris with the muscle of accommodation heightens the blurring effect of these remedies; mydriasis (atropia, etc.) dazzles the eye by admitting too much light, while the myotics (eserin., etc.) lessen the illumination. It is thus that opium obscures the sight when it contracts the pupil without blunting the sense perception.

Cataract used to be considered incurable, except by operation; but caust., naphthalin, phos., nux., and lyc. have arrested the progress and even cured cases.

"Blurred vision relieved by winking" (euphr., puls.), suggest at once the explanation: tears, mucus or pus, which the lids wipe from the corneal surface.

Blurred vision accompanied by winking is a condition where the lids participate with the ciliary muscle in a spasmodic action (agar., hyos., physos.)

Astigma, regular or irregular, prevents accurate focusing; in a few rare cases lil. tig. and arg. nitr. are reported to have cured spasmodic astigma (unsymmetrical contractions of the ciliary body) and calc. fl. has relieved a corneal facet-irregular astigma.

Inflammation of the cornea in any of its varied forms naturally impairs its transparency. The principal remedies are aur. (mur. in low, met. the high potency), mercury, kali bichr. and mur., rhus, hepar and other lime salts, chinin. mur. and ipec. For the opacity, diffuse or local, following corneal inflammation benefit is obtained by sulphur, kali mur. or calc. fl.

When I began to study the eye eighteen years ago we were. taught that these opacities were incurable, except in young children. I have recently treated two ladies about sixty years old for impaired vision due to diffuse corneal opacity. The first has now a perfectly clear cornea. The other, who was practically blind in that eye, is still under treatment, but the cornea has cleared up so astonishingly that expectation of a complete cure seems amply warranted.

In iritis the dimness of vision may be due to cloudiness of the aqueous humor, to exudation into the pupil, or to concomitant congestion of the optic nerve, retina or choroid. The principal remedies here suggested are acon., bell., bry., spig., mercury, asaf., aur., kali iod. or bichr., and gels.

Inflammation of the choroid, associated with iritis and cyclitis, or only with retinitis, affects vision by diffuse clouding of the vitreous, exudation upon or into the choraid, atrophy or detachment of the retina, or even suppurative destruction of the contents of the globe. Here a careful selection of the remedy is necessary, based upon examination of the eye and the totality of the symptoms; we turn first to study aur., bry., gels., kali iod., mercury, nux, prunus, rhus, sil., sulph.

Of course, inflammation will impair the function and structure of the optic nerve and retina. Without attempting to consider separately the various forms we will call attention in this connection to ferr. phos., duboisia, bell., merc. corr., gels., arn., crotal., lach., kali iod., aur., ars. and nux.

Quinine has caused-and cured-loss of vision from anemia of the optic nerve and retina.

Atrophy of the optic nerve, if curable at all, responds best to nux., strych., strych. phos., zinc phos., plumb., or arg. nitr. But such cases, if relieved, are, in all probability, amblyopia and not true atrophy. Galvanism has been used, and static electricity, in skilful hands, may prove valuable.

It can readily be seen that an attempt to differentiate the above remedies would enlarge this paper beyond proper bounds. The writer has only tried to suggest in a general way pathological conditions accompanying the symptom, "dim vision," under the various drugs

mentioned. It is hoped that the necessity has been made clear of a thorough and skillful examination of the eyes whenever vision is at all impaired.

A CASE OF ANEURISM OF THE ABDOMINAL AORTA.*

IN

By W. S. GARNSEY, M,D.,

Gloversville, N. Y.

IN 1894 L. J., then 46 years of age, had a fall and struck on the end of a ladder. He was a contractor and builder by occupation. Active and industrious, of good general habits, although he at one time suffered from syphilis. Not long after his fall he began to have epigastric pain and distress, which was variously treated as dyspepsia. Early in 1897 a pulsating, expansile tumor was discovered in the epigastric region, which was examined by several doctors and pronounced an aneurism. In October, 1897, he first came under my care, having moved from Troy to Gloversville. He was so weak that he had to be helped in and out of the carriage, and carried into the house. His former physician, Dr. S. F. Rogers, of Troy, had kindly sent me a letter giving the diagnosis of the case, and some thing of his history and treatment. I found a large epigastric, pulsating tumor, somewhat expansile, very sensitive to pressure and much disturbed by any accumulation of gas or food in stomach. He had been taking powders of codeia, antikamnia and bismuth with so much frequency as to give his lips a bluish look. I put him on a fluid diet, and succeeded in reducing the number of powders taken to one or two a day. With the aid of various remedies to improve digestion and allay the irritation of the gastric nerves and solar plexus, he became able to tolerate some solid food. Emaciation, however, was progressing, and what improvement there was seemed mainly in the line of mitigation of suffering. Constipation gave us decided trouble. It was necessary to keep the bowels well unloaded to avoid pressure, but the efforts in this direction were very exhausting.

Toward the latter part of December his sufferings became more intense, and he seemed to be weakening quite fast. Although warned by his former physician against the use of morphine, I decided

* Read before the New York State Homœopathic Medical Society, September, 1898.

January 1st to try it subcutaneously, and gave him a quarter grain combined with atropine. These remedies in varying proportions were given once a day, about 9 A. M., and the morphine was increased until he took a grain and a quarter at a dose. His appetite and digestion were greatly improved. Soon after the injection he would call for and take a good breakfast, and another good meal later in the day. His bowels would act frequently of themselves, or with less aid than formerly. He gradually gained upwards of twenty pounds of flesh, and increased in strength, so that in May he did various little tinkering jobs, and made frames for some screen doors and windows. In June he went out riding a few times, and his morphine was gradually reduced to one-quarter grain. July 5 he complained of decidedly more pain and less ability and inclination to take food. The hypodermics were increased, but even a grain and a quarter twice a day failed to relieve him. I failed to detect any changes in pulse or tumor until the morning of the 15th. Then the pulse was more rapid and less forcible. In the evening the pulse was so rapid and feeble that I saw that dissolution was approaching, and I remained with him all night. At midnight the pulse could not be counted and scarcely detected, and the pulsation of tumor had ceased, yet he lived until 9 A. M. of the following day. The only points I wish to make on the treatment are that in incurable cases, where our homœopathic remedies fail to relieve, real, genuine improvement may result from the use of anodynes if discreetly managed and controlled by the physician. Also that in this. case the morphine appeared to have a distinct remedial action, for the pulse became slower, and the pulse over the tumor less marked under its use; and digestion, assimilation and excretion were greatly improved. It is, indeed, a grave question whether or not I made a mistake in reducing the doses of morphine and trying to do away with its daily use.

Sunday morning, July 17 last, in accordance with a promise he made some months previous, I had the privilege, in company with five of my colleagues, to examine his body. On opening the peritoneal cavity no fluid blood was found, and only two or three small, free clots, and nothing could be seen of the tumor. I then began at the upper end of the thoracic cavity, and from above downwards stripped this and the abdominal cavity completely, turning all their contents into a large pan. It was then easily shown that there was a rupture of the aneurism, and that this had taken place behind the peritoneum. The hemorrhage had been extensive, but not sudden. It had peeled up the peritoneal covering of some organs and en