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MICHIGAN.

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TABLE C The percentage of deaths to the whole number, treated in 1886 was: Kalamazoo, 4.7; Pontiac, 4.8; Traverse City, 4.0; and Ionia, in 1888, 4.4. The results in Kalamazoo and Pontiac are from biennial reports, and should be divided by two in order to obtain approximate results for one year.

TABLE D-MINNESOTA. The percentage of recoveries to discharges in 1891 was: St. Peter, 32.71; Fergus Falls, 70.; and the percentage of deaths to the whole number treated was : St. Peter, 4.88; Fergus Falls, 2.81.

A FEW QUESTIONS ANSWERED.

BY C. WESSELHOEFT, M.D., BOSTON.

Dear Doctor: While listening to your lectures on materia medica, some years ago, you reported a case which was cured by a "high potency" of a drug where low potencies of the same and other drugs had utterly failed.

The case was that of a young woman who was afflicted with eczema of the scalp. The case was exceedingly aggravated, the head being covered with a thick crust, which so injured her personal appearance that she shunned society almost entirely. She had been treated by other good. physicians, without relief, before she applied to you. Enquiry showed that she had taken about every indicated remedy, and the thought occurred to you that a change of potency might be better than a change of remedy. So you selected calcarea carb. in a "high" potency-somewhere between the 30th and 100,000th- and sent her away. In a reasonable time her symptoms improved, and the case was cured.

To-day, in looking over your article in the GAZETTE for August, you state that it is "simply self-deception" to think that there is any power in the 30th potency. What, then, was the cause of the recovery in the case mentioned? Was it a case of spontaneous recovery; and the time a simple matter of coincidence? Or did her faith play any part in the case?

I am not an enthusiast as regards "high potencies," and rarely prescribe them. Still I have no prejudice against them. Is it not possible that there are forces in drugs which the microscope is powerless to discover?

August 11, 1892.

Respectfully yours,

My Dear Doctor: I well remember the case you mention. It occurred when I had been in practice about six years (twentynine years ago), and impressed me more than it would to-day.

It was an aggravated case of pityriasis, and it got well. It was a case of spontaneous recovery; the medicine (calc. carb., 200 Lehrmann) could by no means have had anything to do with

I was laboring under a deception-call it self-deception if you like-though the fault lay with men under whose influence I then stood, and who denounced every one as a "mongrel" who did not use "high potencies."

You ask, "Was it a coincidence?" The case got well. I know now that many graver cases get well without medicines, under even very careless dietetic management, and I know how difficult a matter it is to distinguish such cases from remedial cures, especially when our dietetic management and nursing are good You ask, "Is it not possible that there are forces in drugs which the microscope is powerless to discover?" The microscope has nothing whatever to do with disclosing medicinal forces, as I have been obliged to declare and explain many times, and in many places. And I repeat here, that the microscope applies only to hard, practically insoluble substances, the limit of whose divisibility it easily demonstrates. The limit of divisibility of solubles is also demonstrable by much more complex physical methods, and is known to be a long way below the thirtieth.

This is acknowledged by Dr. Fincke, and other high dilutionists, who now say that they care not for matter and its divisibility, as they henceforth deal with the "liberated spirit" of the drug.

In that realm they are perfectly safe from the encroachments of the microscope, or those of physical science generally, Nobody will trouble them there in their occultism and spiritism, engrafted on homoeopathy by Jenichen, Korsakoff, Lutze, Jaeger, and their numerous followers, for whose patronage Schuessler made a shrewd bid. All of these stand as representatives of homœopathy, with the result that it has been obscured to such an extent that many who claim to practise it do not know what it is, so that its general acceptance has been indefinitely postponed.

If I have written a few words beyond a simple answer to your questions, excuse me, but believe me always sincerely yours, Boston, Aug. 15, 1892. C. WESSELHOEFT.

THE DANGER OF CELLULOID BUTTONS. - Professor C. Vernon Boys, of England, reports the case of a lady, standing near a bright fire, who suddenly found herself enveloped in smoke. A gentleman who came to her rescue succeeded in crushing the ignited portion of her dress, not, however, without severely burning his hand. On investigation the fire was found to have originated from a spot where a large fancy button had been, but had disappeared. Similar buttons were subsequently examined, and were found to be highly inflammable, being made of celluloid. Med. Record.

THE NERVOUS SYMPTOMS OF COCCULUS INDICUS.

BY E. P. COLBY, M.D., BOSTON.

[Read before the Hughes Medical Club.]

This remedy has acquired some considerable reputation in certain forms of dyspepsia and in sea-sickness, in both of which maladies there are other drugs which would seem to be more frequently indicated. Beyond this there has been but little use made of it by most practitioners. In fact, it is one of our littleused agents. It having been rather a favorite remedy with me for over twenty years, I have thought it not out of place to call your attention to a few of its prominent nervous symptoms, more particularly as the majority of them have been verified by its clinical results. It has been stated by Hughes that its effects must be upon and through the nervous system; to which theory we must at once assent, as there does not appear to present any congruous series of symptoms pointing to organic disease in any other sphere. Let us first consider some of its recorded symptoms.

Effects of motion of carriage or vessel.

Spasms of hysterical females or suppressed menses.
Spasms of the hands, as though one were writing.
Convulsions from wounds.

Traumatic tetanus.
Epilepsy.

Unilateral chorea.

Total and partial spasmodic paralysis occasioned by increase of sensibility and later decrease of motor power.

Paralysis of lower limbs with insensibility of affected parts. Paralysis of tongue.

Fainting of hysterical females.

Vertigo and vomiting.

Alternate going to sleep of alternate hands and feet; difficulty of speech during the attack, and difficulty of reading and thinking after the attack.

Migraine.

Headache in those who indulge in excesses.

Tabes dorsalis and affections of the cord.

Vertigo, with nausea and falling down unconscious.

Vertigo when rising in bed, as if everything turned around, and inclination to vomit.

Stupid feeling, obliged to read over several times what he has previously read to understand it.

Various kinds of headache.
Dimsightedness.

Noise in the ears, noise of rushing waters, with hard hearing (labyrinth ?).

From Hughes we read that poisoning from picrotoxine produces tonic and clonic spasm, with semicircular and backward movements, and rolling over on the axis of the body. This he attributes to the crura-cerebri. (Of this I will speak later.)

"Her hands tremble when eating, the trembling increasing in proportion as she lifts the hand higher up." The nausea and other symptoms, as effects of motion, can only result from action through the sensorium, whether this may be through sense of sight or through the labyrinth, and is undoubtedly reflex.

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The spasmodic symptoms would show it to have a marked action upon the cord and medulla, with a preference for the motor sphere, where its action is more of an excitant than true paralytic ; — i. e., the symptoms in man are more those of spasm than paresis. Its paralysing action when given to fishes cannot be directly applied to the symptomatology of the warm-blooded animals. It would seem to heighten the reflexes, although we have no careful physiological experiments recorded to demonstrate such as a fact. But, in evidence of this, there occurs in the symptomatology convulsions from wounds, and traumatic tetanus. These must necessarily be clinical, and in evidence only as corroborative. The symptoms of unilateral chorea would hardly be important until it can be made clear that it was a symptom produced by the drug, and to what extent. By far the greater portion of the symptoms would indicate the benefit of the remedy in hysteria, as notice, fainting of hysterical females, paralysis of the tongue, numbness of alternate hands and feet, with difficulty of speech during the attack; the various pains in the head, migraine, dimsightedness. You will notice the peculiar symptom, spasm of the hand, as though one were writing, and also trembling of the hand when eating, with increase as the hand approaches the mouth. If these symptoms occurred in the same subject we should have all that is necessary to make out a case of that rare form of paralysis agitans with tremor on voluntary motion. There is no evidence of a condition which could be put down as multiple sclerosis. More regular as an indication, however, is the group of noise in the ears, noise as of rushing water, with hardness of hearing, vertigo, with nausea and falling down unconscious. If this were made to read noise in the ears, and as of rushing waters so that it produced deafness, vertigo, nausea, falling down, etc., we should have all that is necessary, save obliteration of bony transmission, to make out a case of Ménière's disease.

And in this relation we may also properly consider the symptoms referred by Hughes to the crura-cerebri, as the symptoms

apply with much more force to labyrinthian disturbance. In fact, with the cerebral physiology as we now know it, I do not see just how these symptoms could originate in the crura; although they might result from irritation of some of the grey nuclei in the medulla. Fortunately for our patients, Ménière's disease is not common; and I have not had opportunity to make a clinical test of any value in this group of symptoms, but have just now one case under treatment.

One other condition you must all have met occasionally. A patient is taken "deathly sick" with nausea, and on sitting up the vertigo is almost terrifying. The countenance is pale, pulse slow and rather weak, and the skin clammy. All these symptoms gradually disappear after three to five days, never ending fatally in my experience, but still making a very troublesome case. It seems to be a purely functional disturbance, and does not arise from gastric or hepatic disorder.

You find this group under cocculus, and I know of no other remedy which has given so much relief. Clinical experience is in favor of this drug in that form of occipital pain having its origin in a tired spine, and it is one of the most common forms of headache we are called upon to treat. The pain extends from the occiput, down the nape, to the lower cervical region. In such cases picrotoxine seems to be more efficacious than the entire drug.

A word regarding the use of picrotoxine in epilepsy. Dr. Ramskill found that hypodermatic injections of picrotoxine, in doses of 15 to 18 mgr., would produce a fit in 20 to 30 minutes. When more than 5 mgr. were injected a sense of giddiness followed, and at 18 mgr. a fit was always produced. In another patient, giddiness and headache followed 8 mgr., and at 15 mgr. a severe epileptic fit; and in several cases the same result followed from doses of 10 to 24 mgr. In one case 10 mgr. caused giddiness and dazzling before the eyes, and in 30 minutes an aura — a sensation of something creeping up the arm to the top of the head, and numbness and twitching in the right thigh. No fit followed, but the patient was dull and stupid as after a fit.

ANESTHESIA WITH ETHERATED AIR.— A NEW METHOD OF

ETHER ADMINISTRATION.

BY HORACE PACKARD, M.D., BOSTON, MASS.

At the outset I wish to state clearly that the method herein described is that used in the Junker system of chloroform administration, and, while the method cannot be claimed as a new one, it is new so far as its application to ether is concerned.

I have learned, while conducting experiments during the past

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