to the babe, as I understand that the nurse did not believe in them. These conditions were not discovered until after the nurse was discharged, as being very tired at the time of the confinement, and the nurse informing me that she knew well how to care for the baby, I left for home before the child was dressed. After discovering the exciting cause of the convulsions, I telephoned to the Newton College Hospital, requesting them to send me a nurse, who arrived within half an hour, when we immediately made the patient more comfortable, by removing the night clothes and bedding, which greatly needed changing. The baby was also looked after and properly cared for.

One of the near neighbors informed me that in the afternoon, a few hours only after delivery, she was urged to go up and visit the patient, and this when I had enjoined rest and quiet for the tired mother.

The nurse informed my son, and also the husband of the victim, that she would never nurse another confinement case; but I understand that she has withdrawn that decision. When the patient was in a serious condition, the nurse asked: "Do they blame me for this?" I replied: "Most certainly they do. The nurse then said: "But she wanted those things." I replied: "But that is no excuse for you."

Moral: May the physician be mercifully delivered from any nurse who disobeys orders!

A CASE OF ACTUAL AND A CASE OF THREATENED PUERPERAL

ECLAMPSIA.

BY E. A. MURDOCK, M.D., SPENCER, MASS.

[Read before the Worcester County Homœopathic Medical Society.]

May 7th, 1890, early in the morning, I was called to attend Mrs. C in confinement. Patient was about twenty-one years old, very slight in stature and under the average size in every way. She was a primipara. Upon examination I found the os fairly well dilated, and labor progressing in a normal way. Her strength was good; pains not very severe, and yet sufficiently strong to make progress. After I had been there about two hours my patient suddenly called my attention to the fact that she could not hold her hand still; and sure enough it shook like a leaf. Almost instantly she exclaimed that she could see nothing; and then she was in a convulsion. I had no need to

hunt up my text-books to learn that I had on my hands one of the worst complications that can come to the lot of the obstetrician. By some oversight, I had gone to this case (four miles from my office) without any chloroform; but ether I had, and I

quickly placed her under its influence, and proceeded to deliver with my forceps as speedily as possible. This was easily done, and I felt greatly relieved; but when I attempted to deliver the placenta I found I had another child, with a breech presentation. During the delivery of this and the placenta she was allowed to come partially out from the ether, when another convulsion. quickly seized her. But as soon as I had her fully delivered I settled her on the bed as well as possible, took the ether from her and sat down to watch, sincerely hoping my troubles were at an end. I sat by her bedside fully two hours watching, and at times conversing with her. She was perfectly rational and calm all through this time, and I thought that emptying the uterus had done the work; but in about two and a half hours after delivery she suddenly went into another convulsion, and then the convulsions followed each other as often as every half hour. After a while I slipped away long enough to get some chloroform and telephone to Worcester for Dr. Warren. During the afternoon she had frequent convulsions. At 5 P. M. Dr. Warren came. At this time she was at moments rational, but her periods of consciousness were growing less frequent and shorter. At 7 P. M. we left her, but at 10 P. M. I was called back very hurridly-found her wholly unconscious, and unable to swallow. Up to this time I had drawn her urine; it was very scanty, and loaded with albumen. At this time she was extremely restless, rolling from one side of the bed to the other. My patient was in a terrible condition, and it seemed as though she could not live the night out. I went prepared at this time to use pilocarpine subcutaneously; but when they recalled me at IO P. M. they also called an old-school physician, so I thought I would await his arrival before using it. He immedately advised the use of it, so I accordingly injected gr., which was repeated at an interval of two hours. In about one half hour after the first dose of pilocarpine was injected, a grain of morph. was given by injection. The pilocarpine very soon caused a profuse perspiration, and the morph. had a salutary effect in keeping my patient still. The convulsions continued at less frequent intervals, although several times before morning it appeared as though my patient would surely die. But such did not prove to be the case; although she had about twenty-five convulsions in all, she gradually rallied. As soon as she could swallow, I put her back upon the homeopathic remedies that were being given her when she lost consciousness, viz., apis and merc. cor. These remedies were continued more or less during the remainder of her sickness, and at the end of three weeks she was discharged. convalescent. Let me here say that this patient was under my observation more or less during pregnancy; her urine was tested

occasionally and showed no albumen; but the last six weeks of pregnancy I was not successful in seeing her or getting any of her urine, as she was several miles from my office. I afterward learned that during the last six weeks of pregnancy she was bloated, had a frontal headache and pain in the epigastric region. Had I been informed of this at the time, she might have been spared this terrible experience. I will add that her twin boys

are as "rugged" a pair of children as I ever saw.

Case No. 2.- March 4th, 1891, was called to see Mrs. E ———. She was six months pregnant, and I found her in the following condition-high fever, severe pain in the epigastric region, with vomiting, headache, urine loaded with albumen. I will not detail minutely her symptoms from day to day. Suffice it to say that it was evident that I had a case of albumenuria to deal with. Her fever many days ran as high as 104. All through the month of March she could keep hardly anything on her stomach, and at times would drop into almost a comatose condition. My perplexity was great. Should I produce abortion or not? If eclampsia should suddenly seize my patient and should prove fatal, I should feel that I had not done my duty. Counsel advised waiting; meanwhile to watch closely and be ready to act at a moment's notice. The husband said, " 'Save the child if you can, but don't sacrifice the mother." The meddlesome neighbor said, "Change doctors." I watched and waited. At the end of one week I could see no improvement, neither could I call her worse. Before another week had passed I could see a slight improvement, and yet the albumen was not on the decrease, perceptibly; but by patiently exhibiting the homœopathic remedies as nearly as I could select them I saw my patient slowly improving, and at the end of six weeks I was able to discharge her, with her urine free from albumen, her nausea gone, appetite good, strength returning and foetal movements perceptible. June 17th my patient was delivered of a boy, alive and fully developed, but with a decidedly old, wrinkled and pinched appearance. However, time and Horlick's food have put new life into the lad, and now he is as frisky and bright as many infants who had a better start. My patient made a good recovery. The remedies I used during her attack of albumenuria were, mainly, merc. cor., apis and ars.

Case No. 1 has taught me to watch carefully my cases of pregnancy, bearing in mind the three prominent symptoms which generally are the forerunners of eclampsia, viz., frontal headache, epigastric pain and disturbance of vision. If these are present, either with or without albumenuria, I am likely to prescribe apocynum, putting my patient upon a milk diet.

Case No. 2 has taught me to give the remedies a fair trial

before interfering with nature, and then I think that my experience will be repeated in a large per cent. of such cases.

MENSTRUAL HEADACHE.

BY F. P. Glazier, m.D., HUDSON, MASS.

[Read before the Worcester County Homeopathic Medical Society.]

As it sometimes happens that this variety of headache is overlooked or improperly diagnosticated, and in consequence poorly treated, I have thought it proper to bring the subject before this meeting, not with the hope of offering anything new, but simply to bring up in review the etiology, diagnosis, prognosis and treatment, that a knowledge of these may be more fully impressed upon our minds.

With few exceptions, this form of cephalalgia is of reflex origin, dependent largely on ovarian irritation or inflammation, and coming regularly each month, either anticipating, accompanying or following the discharge.

This regularity of attack assists in the diagnosis, which is further confirmed by the complete exemption from the headache during gestation and lactation, or when the function of menstruation is arrested from any cause.

In differentiating this headache from sick headache, which affects males as well as females, we are aided by the fact that the latter headache is not regularly paroxysmal, nor dependent on the menstrual cycle, but is caused mostly by worry, fret, improper food and a relaxed condition of the system, and shows itself principally during gastric derangements.

A neuralgiac headache will be indicated by the absence of relationship to the menstrual flow, and its connection with prolonged mental strain, exposure to wet and cold weather, nervous exhaustion and an existing rheumatic diathesis.

Another affection, evidently closely related to the menstrual headache, is the hysterical form.

This may be distinguished by the emotional condition of the patient, her fitful temper; and, further, this hysterical headache is limited in its location, and is of a sharply defined, burning and gnawing character.

Thus, in the menstrual headache, Ludlam gives to us a line of symptoms peculiar to itself: "The headache returns every time the woman menstruates. If its habit has been to come on at the beginning of the monthly crisis this habit will be persevered in. If it has been accustomed to return at the last of the month, just as the flow has almost entirely ceased, you may expect it again at the same season."

Our prognosis should be governed by the condition and surroundings of our patient; more favorable in recent cases, where the associations of life are pleasant, and less favorable in chronic cases, and where there has been frequent child-bearing, and where domestic infelicity exists.

In the treatment, we should look to the hygienic, first removing and regulating, as far as possible, all unfavorable conditions, as improper food, too tight-fitting clothing, with, as additional measures, the correcting of malpositions of the uterus and the enforcement of rest.

Especially should the patient avoid, as far as possible, excess of care, confinement and toil for a few days before, during and immediately after the catamenia.

Electricity may in some cases give relief.

For internal remedies we must refer to our materia medica, where we shall find the more important medicines to be puls., sepia, nux vomica, bell., ign., lach., calc. carb., and apis.

OTORRHEA IN CHILDREN.

BY AUGUST A. KLEIN, M.D., BOSTON, MASS.

[Read before the Massachusetts Homeopathic Medical Society.] Otorrhoea means a discharge from the ear. It is not a disease by itself, but is a symptom of various diseases of the meatus, tympanum or mastoid cells. It varies according to the place and the nature of the disease. It may be serous as in eczema, sero-mucus in affections of ceruminous glands, mucopurulent in diseases of the tympanum and saneous in affections of the inner ear. The majority of ear diseases are accompanied by otorrhoea, in fact otorrhoea often leads to the discovery of serious affections of the ear. The seat of the disease is often very difficult to find on account of the narrow and swollen meatus.

The causes which induce diseases of the ear with otrorrhoea are various. The most frequent in young children are foreign substances as water, soap, etc. Inherited diseases: scrofula, tuberculosis, rhachitis, syphilis.

Exanthematic fevers: scarlet fever, measles, typhoid fever, small pox, diphtheria.

Diseases of the nose, pharynx, larynx, bronchi.

Reflex irritations: dentition, whooping cough.

Foreign substances in the meati of new-born children consist mostly of water, which gets into the meatus during bathing. You will often see very small children placed in a bath with ears immersed. The meatus in a new-born child, if narrow, will retain part of the water. This acts as a foreign substance