over the surface of which the hair is either absent or broken off in various lengths, and from which, through various openings and around the hairs, there exudes a sticky mucoid, or purulent fluid. The hairs over the patch are generally loose in their follicles, and the disease is liable to be followed by permanent baldness over the patch. If the inflammatory process has not been too acute the nycelia and speres of the trycophytose will be found on microscopic examination of the hairs. The tumor has a "boggy" feel to the touch, and slight pressure will cause increase in the flow of the exudate, especially around the orifices of the hair follicles. It may be mistaken for abscess, which it much resembles; but such a mistake is not for the advantage of the patient, as a free opening, such as would be demanded in abscess, is always contraindicated in Kerion where the pus is not contained in any one cavity, but is infiltrated throughout the tissues involved. This condition was first described by Celsus, and by him given its present name, from Xypiov, a honeycomb. Silbury Fox, however, in 1866, was the first to discover its parasitic nature and identify it as one of the trycophytoses. The notes of the following will illustrate a typical case of kerion L. J. N., girl, age 6, plump habit, light complexion, fair hair, was brought to me on May 13th for examination and treatment. She showed on the right vertex a tumor, size of a hen's egg, partially devoid of hair, what hair there was remaining showing the characteristic "gnawed off" appearance, covered with a dirty yellowish crust, beneath which, from a reddened, inflamed, sore surface, there exuded abundantly a sticky, nasty muco-purulent fluid. There were also two small scaly spots on face, and one on the face of the mother, who brought the child. Following history was given: During the winter and spring child had had whooping cough and measles. It was during the attack of measles, in January, that this lesion of the scalp appeared. It was diagnosed as an eczema, and had been treated, among other things, with cutacura. Microscopical examination of hairs showed abundant parasites, and a diagnosis of kerion with tryeophytosis cicinata was made. Treatment consisted first in the internal administration of hepar sulph., and locally a flaxseed poultice until the acute inflammation had subsided. This was followed by epilation and the daily application of murc. bichl. 2 grs. to 3 in alcohol, followed immediately by nug. ag. rosar, and later by sodac hyposulphite 3i to loanolin i. By July 24th the disease was apparently cured, and the hair growing nicely over the afflicted area. Six months later the child reported as having had no further trouble. - PHYSICIANS of all schools now bleed their patients. — Med. Era. CEPHALALGIA. BY F. W. PATCH, M. D., SOUTH FRAMINGHAM, MASS. [Read before the Worcester County Homeopathic Medical Society.] The subject of this paper is so well worn and familiar to all, that perhaps it may be thought great presumption to attempt anything further in the way of elucidation or interest. It may be understood at the outset that we do not expect to bring out any new points in diagnosis or treatment, and at best can only reiterate old and well-tried methods. The subject of headaches has been particularly brought to my mind for several reasons; among them the frequency with which we are called to treat many trying cases in our every-day work, and the perusal of a recent monograph on the subject, by an eminent authority of the opposite school, and a comparison of the methods of treatment recommended by this authority with our own far more simple and efficacious modes of procedure; simple in that they are guided by a well-known law, though requiring persistence and care in the exercise. In the above-mentioned treatise we are, as usual, first introduced to a learned division of the subject into the several heads of "Congestive," "Anæmic," "Organic," "Toxic," "Neuralgiac," and "Neurasthenic" headaches, followed by a labored diagnoses and explanation of each, with many subdivisions of the several classes. Then follows the most important part, treatment, consisting of a long list of variously compounded drugs to be prescribed, according to the idiosyncrasies of the physicians who may use them, rather than on account of any peculiarity that may be exhibited by the patient. Then there are many ingenious "systems" of treatment that have been devised by men with minds for novelty and desire for change, so often exhibited by these professors of the rational in medicine; such as pricking the cavernous bodies for the relief of constriction, the use of an alkaline spray, bleeding, leeching, douching, etc., etc., a delightfully arranged needle-bath whereby a spray may be directed toward almost any spot on the body and the temperature regulated to suit, various forms of electrical and magnetic appliances, and, finally, that most barbarous of all procedures - nerve stretching. Append to this a list of the so-called "tonics," and the recent additions of new drugs of chemical manufacture, as long as the "moral law," and you have the present status of the treatment of cephalalgia in all its "scientific" aspects, as practised by members of that school. Happily we, as homoeopathists, have no need of considering such heterogeneous and bungling methods, the result of which, at best, can be but palliation. Homœopathy seeks higher ends,. and in order to fulfil its promise must work toward the entire eradication, or at least permanent modification, of disease; and, provided the case is an uncomplicated one, may proceed directly to the heart of the matter, which is the selection of the correct remedy. How shall we do it? Just here, at the outset, is where we must exercise the greatest care, as our success or failure depends greatly on the manner in which we have "taken the case." The rules for the examination of the patient, as carefully formulated by Dr. P. P. Wells in an elaborate essay written in 1888, should be familiar to every prescriber, and put into practice with every case. Then, with the requisite study of repertory and materia medica, we need have few failures, and will be sure to make many brilliant cures. If possible, we should endeavor to visit the patient during an attack at least once, that we may the better judge of the objec tive symptoms about which patients often unintentionally deceive us. Then, too, they can better describe the character and location of the pains while experiencing them than at a time of comfort. We must note the various positions assumed, and ascertain the reason for those positions, the conditions and times of aggravation and amelioration and the concomitants; but above all we must search most carefully in our examination for any peculiar symptom or condition that shall aid us in individualizing this case among others. This is where the specific nature of homœopathy comes to the front; each remedy is the specific against its own peculiar conditions, and those only, and one distinguishing symptom, like the "aggravation from cold drinks" of sabadilla, or the photophobia of belladonna, will prove of more aid in finding the correct remedy than a whole page of general symptoms, which are peculiar to nothing, and exhibited by more than half our sick and ailing patients. Now, having proceeded to elicit their symptoms from the patient in question, the next thing to do is to write them down on the spot as we take them, while they are fresh and vivid. It is impossible to properly study a case without this aid. The next step, providing the remedy is not already apparent, is the study of repertory and materia medica. With the intelligent use of the former it seems to me almost impossible to dispense, if we expect to make a correct prescription, and while it takes considerable time at the outset it is a saving in the end. The repertory seemingly best adapted to this use is the "Therapeutic Pocket Book," of Boenninghausen, of which we now have a new edition by Dr. Allen. While incomplete in many ways, its arrangement is still such as to make it of great value in this form of case analysis. My method of use is very similar to that detailed by Dr. Holmes, in the January Advance, differing only in some minor points. First, I have a sheet on which are printed the names of nearly three hundred remedies, with a blank space following each. Then, after arranging the symptoms of the case in as concise a manner as possible, we may proceed to check the remedies on the printed blanks. For instance, we will suppose that our first symptom is headache at the vertex. Now in the Boenninghausen four styles of type are used, signyfying different degrees of importance, which, in checking, we may indicate as 1, 2, 3, 4; therefore, under "vertex" we check the most important remedies, placing a figure 3 or 4, as the case may be, opposite the name of that remedy on the blank. Then proceed to the next symptom in the same manner, usually the character of the pain at the vertex, if it is "bursting;" we then look for that rubric. in the repertory under the general head of "sensations," and place the value of every remedy found to be indicated in troubles at the vertex opposite what we have already placed in the blank space, and so on through the list of symptoms. At the end, by adding these values, our attention will be directed to a certain few of the remedies for study, and while the highest is not always found to be the similimum, the correct remedy will nearly always be found among the half dozen at the top of the list; while, if by some mischance we do not get it the first time the analysis of the case is made, a moment's consultation will usually give us what we desire in the way of further knowledge. A few cases briefly noted will, while exhibiting nothing of unusual prominence, serve to show the results that may always be expected under like circumstances. Case 1. Woman, 49 years of age, slender, dark complexion, had suffered, more or less, for the major part of her life with periodical attacks of migraine. About a year previous to my attendance a friend (?) had introduced her to the wonderful action of the Pheno-Caffeine pill in such conditions. She consulted her family physician, a prominent member of the opposition school in town, about these pills, and he characterized them as a "happy combination," advising her to use "anything that would relieve those terrible headaches. Of course she took them, and they relieved the condition for the time being; but the headaches recurred oftener and oftener till, at the time of my first visit, she was in a half prostrated condition, with not enough energy to perform her usual household duties, which were light; a grumbling headache most of the time with frequent severe attacks, which now the pills had failed to relieve. The symptoms were as follows: Headache preceded by hunger and extreme sleepiness, aching of face, upper jaw, teeth and front part of head, of the eyes on turning them; the attacks usually begin in the night and last through the next day, often with delirium; sensation of dryness at vertex; sensation that the scalp was drawn over head; sensation that the bones of head were grinding together; pains through root of nose, worse from noise, better from pressure; perspiration of head during attack; backache; thirstless; nausea from walking, relief from vomiting bile; great restlessness; cold feet. Concomitant symptoms were headache after eating fruit; craving for sweets; constipation, stool large and hard; frequent nose-bleed from both nostrils, blood bright red; can hear heartbeat like a hammer after eating. Silica was prescribed, and the improvement during the first week was gradual and marked, and has since continued. This was in November last, and there have been but one or two slight attacks since, which were readily controlled by a dose of the remedy. Case 2. Woman of about 50, tall, spare, dark complexion, subject for many years to frequent headaches of great severity, obliging her to relinquish her household duties and remain in bed for a day or so at a time. The symtoms were as follows: Drawing pain in nape and occiput, she must take down her hair; dizziness; nausea on rising in the morning; pain, better when quiet and in a dark room, worse from light and noise cannot bear it; thirstless; better from binding head, from cold water application, when sitting up, after sunset; grating sensation in nape; feet and hands cold; rush of blood to the head; headache preceded by craving for food; pillow seems as hard as a rock, cannot lie on it; profuse flowing of dark blood every two weeks. Although much resembling a belladonna case, this woman's remedy was found to be arnica, which speedily brought relief; one new symptom, however, developing meanwhile waking every morning with a cold spot in forehead. After searching through the materia medica it was found that this symptom was given under no remedy except arnica; hence it was again administered, this time in a higher potency, and the symptom disappeared. For the past two years this woman has had very few headaches, and none that have not been speedily controlled by one or two doses of the same remedy taken early. Case 3. Is of a young women, about 22 or 23 years of age, who, for six or seven years, had suffered from severe periodical headaches at intervals, of varying frequency, lasting several days at a time, and unfitting her for any occupation. During these long attacks the headache was present, in some degree, constantly, but was greatly aggravated from about 4 P. M. through the early part of the night, so that she could not go to bed or lie down. The pain was much worse at the vertex and nape; stiffness of nape; dullness of senses; better out of doors. Lycopo |