her very weak and trembling. She had been under treatment with several physicians, with no relief whatever, and had then consulted Dr. Phillips who refused to treat her until she had her eyes examined.

in

She says she has no trouble with her eyes, but admits that they feel some tired after reading for two hours or more. Has no headaches whatever, and does not appear or admit of being at all nervous. Examination showed the vision to be each eye, but improved and lines made correct with +.25D. cyl. axis 90° in each eye. Test of the muscles gave a left hyperphoria of 1° and an exophoria in accommodation of 7°. The following glasses were ordered to be worn constantly. R+.25D. cyl. ax. 90° prism base up O.D.+.25D. cyl. ax. 90° prism base down O.S.

Mrs. L. writes me under date of Sept. 17, 1892, (nine months after the only time she was seen by me), as follows: " I answer your inquiry concerning my dizzy attacks with pleasure, as they seem to be permanently cured by the glasses. I still wear the glasses as my eyes feel much more comfortable with them on. Only twice have I had the dizziness return; the first time was after going away for a day's visit and forgetting to wear them; the second time I had grown careless about putting them on in the morning, would be ten or eleven o'clock before I put them on; after about a week of such carelessness I had another attack, which has cured me of carelessness so far as my glasses are concerned. My health is better than it has been for three or four years, and I do honestly think that Dr. Phillips was right when he told me to have my eyes attended to, and my physical, moral and spiritual being would be benefited."

Remarks. This case received absolutely no treatment excepting the wearing of a .25D. cylinder glass combined with a 1o prism in each eye.

CASE 5. Miss P.; age, 29, a patient of Dr. McMurray's, consulted me Dec. 18, 1891, for a dull, heavy headache, and a tired, strained feeling in the eyes on using them. Is unable to use the eyes for reading more than fifteen or twenty minutes at a time. Has suffered for a long time from nervous dyspepsia.

Examination showed the vision to be in each eye, with no manifest hypermetropia or astigmatism. Test of the muscles revealed an exophoria of 2° at distance and 6° in accommodation. The internal recti could only overcome prisms of 14° in each eye. Systematic exercise of the muscles was followed out until she could overcome prisms of 70° in each eye, when she could use her eyes with perfect comfort for hours, had no headaches, and her dyspepsia was better than it had been before in years.

Remarks. Miss P. received no medicinal treatment, and has been ordered no glasses to wear while under my care. She made no change in her mode of living, but her dyspepsia of years improved with her eyes.

CASE 6. Mr. M.; age, 32; occupation, travelling salesman, also a patient of Dr. Phillips, was sent to me on March 21, 1892, for insomnia, which had troubled him greatly for the past year or more. He says that for three or four nights in succession he will be able to sleep hardly any, then for a few nights he will seem to catch up somewhat, to be followed again by several nights of sleeplessness. He had tried many different things for his trouble with no benefit, before consulting Dr. Phillips who immediately sent him to me. He had not realized that he had any trouble whatever with his eyes, but thought perhaps they did feel tired some at times. Does not have headaches, and could trace no connection between his sleeplessness and any unusual use of his eyes. Vision was found to be with slight difficulty +.50D. cyl. ax. 90° vision was made in each eye and lines correct. Examination of the muscles gave left hyperphoria of 14°, esophoria of 2° at distance and 3° in accommodation. The following glasses were ordered to be worn constantly: +.50D. cyl. ax. 90° prism base up. O.D.+.50D.

cyl. ax. 90° prism base down O.S.

On July 22, I learned from the brother of Mr. M. that he had had no further trouble in sleeping since wearing the glasses. 152 West Thirty-fourth Street.

A FEW CASES OF ASTHMA.

BY FRED'K B. PERCY, M.D., BROOKLINE, MASS.

[Read before the Massachusetts Homœopathic Medical Society.]

Says Sydney Smith, in his work on "Moral Philosophy", "A great deal of talent is lost in the world for the want of a little courage. The fact is that to do anything in this world worth doing, we must not stand back shivering and thinking of the cold and the danger, but jump in and scramble through it as well as we can. It will not do to be perpetually calculating tasks and adjusting nice chances." The man who writes a clinical paper needs just such a mental prop as these wise words give. There are few more difficult tasks than the presentment of a series of clinical cases, with reflections thereon, which alike fulfil the purposes of the writer, and meet the expectations of those who hear it. A clinical paper may be instructive, it should always be suggestive. It may present new truths or rehabilitate old ones. According to the personality or mood of its author, it may dwell upon the pathological or therapeutic

aspect of the subject considered. These few cases then are offered, not as evidence of wonderful recovery through remedial agency, nor because of any marked deviations from the ordinary forms of asthma. They are simple, straightforward cases, which occurred during the recent epidemic of influenza, and emphasize the usefulness of one method of treatment.

Permit me to preface these cases with a very succinct defininition of asthma, which I quote from a recent article :

"Asthma is a paroxysmal dyspnoea followed by inflammation of the bronchial mucous membrane. If the intervals between the attacks are prolonged sufficiently all physical evidence of the disease disappears. It is essentially not a disease of the lungs or of the bronchial tubes, but of the nerves which supply these parts. It is a convulsion confined to the pulmonary branches of the pneumogastric nerves, which produces a spasmodic contraction or narrowing of the bronchial tubes, the shortness of breath and the bronchitis being merely the sequences, at least in a great measure, of the disorder. Asthma is, therefore, a neurosis of the pneumogastric nerves and their centres, and belongs to the domain of nervous rather than to that of chest diseases. In the great majority of cases this disease is inherited."

CASE 1. Bronchitis. Mrs. C.; age, 48; neurotic temperament, brunette, physical health good, but one year ago had severe attack of herpes zoster, in which the neuralgia was most intense and persistent. Present illness is attributed to long ride after being overheated. First visit was made on the evening of Feb. 5th, when I found her suffering from severe paroxysmal hollow cough, dyspnoea, and slight elevation of temperature. Physical examination showed no dullness, but marked mucous and sibilant râles over both lungs. B. Sambucus gtts. x. in 3iij. aq.,

two teaspoonfuls every half hour.

Feb. 6. Patient reports more comfortable night, less cough, and some expectoration which was characteristic. R. Repeat medicine each hour.

Feb. 7. Another comfortable night, râles less, some improvement in cough.

Feb. 8. Râles have disappeared, cough practically gone, and case was discharged.

CASE 2. E. A., boy; age, 14 months; fat, robust baby, has been fed on artificial food, (sterilized milk.) Parents in good. health; father, strong, vigorous man, mother had as child severe catarrhal trouble with cough, which was finally cured by a homoopathic physician. From her father she inherits a tendency to asthma, and, during pregnancy, and for some months after confinement, she suffered intolerably from asthma. The

baby, when a few months old, had convulsions, which were attributed to dilatation of the stomach, and during the preceding summer had his first attack of asthma with bronchitis. I attended him for the first time in January, when he had a moderately severe attack of influenza.

On Feb. 26, he was taken with what seemed an ordinary cold, but by evening he was so much worse, I was summoned. The above history was given, and the cough, dyspnoea, inability to lie down, aggravated very much by the nasal catarrh obstructing nasal respiration, led me to prescribe ipèc. 2x.

Feb. 27. Child no better, nurse reports absolutely sleepless night, child only comfortable when held in erect position. Physical examination showed characteristic râles. Temperature normal. R. Samb.

Feb. 28. A comfortable night, child slept in broken snatches much of the night, cough not so severe. R. Repeat.

Feb. 29.

Improvement.

Feb. 30. Child so much better case was discharged, and sulph. 12x. given for hereditary tendency. There has been no recurrence up to date.

CASE 3. Mrs. R.; age, 60; very fleshy and polyamic. Was thrown down when alighting from horse-car, and had umbilical rupture which has given her much trouble; she now has a belt, made by Mrs. Merrill, which affords her great relief and firm support. There was a previous history of occasional attacks of spasmodic croup, laryngismus stridulus, and asthma, so that the lady was not disturbed by this illness, and had, up to my coming, used remedies heretofore useful. My first visit was on the fourth of December, when I found that for three nights she had slept little, if any, because of great shortness of breath, panting respiration at times, severe cough, with little or no expectoraration, and that tinged with blood. Temperature was 100°; pulse, 96, and in the morning at time of visit felt comparatively well. Physical examination revealed nothing but characteristic râles notably on left side of chest. R. Antim. arsen. 2x.

Dec. 5. Another night of unrest, was forced out of bed, no easy matter for à person of her weight, and general symptoms unchanged. B. Continue arsen., with ipec. 2x. in alternation. Dec. 6. Slight improvement. Continue.

Dec. 7. A bad night, rattling in chest greater, breathing audible to those in room, cough persistent with scanty expectoration. R. Samb.

Dec. 8. Marked improvement, no paroxysm during night, expectoration more free and dyspnoea lessened. Continue. Dec. 9. Progress, most satisfactory. Continue.

Dec. 10.

Patient discharged, and, at her request, she was

provided with sambucus, which she said had afforded her greater relief than any previous remedy.

CASE 4. Feb. 1, 1892. I was called to the house of previous patient to see a friend, who, while visiting, was taken ill much as Mrs. R. had been. Patient was a lady over 60 years of age, and of lax fibre mentally and physically, in other words, easily overcome by slight ailments. Mrs. R. had suggested the usefulness of samb., but, convinced that pneumonia was threatened, I was sent for. The absence of chill, slight fever, temperature being 100.2, the lack of all physical signs of any lung mischief, were evidence enough of the neurotic character of the disease. Sambuc. was prescribed, and in forty-eight hours, improvement was sufficiently great to permit of her riding to her house, a distance of two miles, and I learned from her friends that the asthmatic paroxysms did not return.

CASE 5. Baby C., age, 11 months. This case is by far the most interesting of the series. It is so for three reasons; in the first place, because illustrating so clearly hereditary influence; in the second place, because catarrhal disturbances of the respiratory tract had so recently been present, and lastly, because of its great severity. The family history develops the following facts of interest: The father though now a typical specimen of fine physical development had in the early months. of life severe asthmatic attacks, and the syrup of lobelia was the unfailing remedy. His eldest son, when only three months of age, was attacked with similar seizures, and after a persistent use of antimonium tart. and arsenicum, the trouble was conquered, and tendency thereto overcome. The second son, during the first two years of life, had frequent attacks of catarrhal croup and bronchitis, but since that time has been singularly well and strong. This little girl-baby has been unfortunate from the beginning of life. The mother's milk absolutely failed to nourish her, and no efforts to improve its quality proved of any use, so that in two weeks artificial feeding was instituted, and only after a protracted series of experiments did improvement begin. In fact, for four weeks oil baths were used morning and evening, the temperature of the room most carefully watched, and any possibility of cold avoided. Finally, the lowered vitality of the baby succumbed to lacta preparata, and for some weeks her life was uneventful. Thus fed, however, the family tendency cropped out, in brief attacks of bronchitis, and these yielding speedily to antim. tart., I left with the mother a supply of powders to be used immediately upon the onset of such attacks. In November, baby had a severe attack of capillary bronchitis, and made tedious convalescence, but remained. fairly well until January, when influenza developed. At this