body perspire freely. Females menstruate too profusely and too often; in women with the above characteristics, if, after abortion or parturition, they flow too much or too long. Also in hemorrhages, pulmonic, from the stomach, from the anus. Feels worse, or really is worse when the limbs hang down, even in bed, wishing to keep them drawn up; from lying on either side; from light; from cold water, whether in washing or drinking; from cold air. Patient feels better in dark rooms; from having the limbs drawn up; from being rubbed; loosening the garments; from warmth and on being covered up warmly. Canth. Hæmaturia; also hemorrhage from any part if attended with cutting and burning pains during micturition.

Carbo. veg. In desperate cases almost in state of collapse. Skin is dry, cold, and bluish; patient wishes to be fanned hard and continually; anguish of heart; blood bright red; rigid fibre; cold breath; pulse weak and irregular.

Cham. The mental symptoms are very prominent and are marked by spiteful irritability; can hardly return a civil answer; snappish and cross. Blood dark and is more or less clotted; desire for air; is thirs ty; restless and distressed; urine pale and profuse. Feels worse, either real or imag ined, in the night; from warmth; from anger; from eructations; when lying on painless side; while perspiring; during sleep; from coffee; from pregnancy; parturition. Feels better while fasting. China. Ringing in the ears as of bells; fainting spells. Pulse irregular, flickering, imperceptible. Skin cold and clammy; unconscious. Worse periodically; in the night; after drinking; whilst talking; after perspiring; from touching the parts softly. Crocus

The blood forms into long black strings as it escapes from inner parts; sensation of rolling and bounding in the abdomen, as of a foetus; worse in the morning; on fasting; in the house; during pregnancy. Better in the open air; after eating. Ferrum. Great erethism of the circulation, red face, and full pulse. Blood partly fluid and partly clotted, black, with labor-like Hæmatemesis ; pains in the abdomen. hæmoptysis; epistaxis; blood from the anus. Feels worse in the night, particularly after midnight; from fat food; from abuse of Peruvian bark. Very weak, though having flushed face and full pulse.

Hyos. A constant flow of bright-red blood

with bluish face; congested eyes; twitching of the muscles; delirium; unconscious, ness. Patients feel worse in the evening; from mental affections; jealousy; unhappy love; from taking cold. Better on stooping over or leaning forward.

Ipecac. Constant flow of bright-red blood; constant nausea; pain about the umbilicus; cold skin; cold, sweat; suffocating spells and dyspnoea. Worse periodically; from vomiting; from coughing; from suppressed eruptions; after eating veal. Hemorrhage may have been produced from taking Peruvian bark at some past time.

Kali carb. One of the best of remedies for post-partum hemorrhages. Chiefly in postpartum hemorrhages; also in threatened abortions between second and third months, accompanied by pain in the back, extending down over the buttocks. Hemorrhages attended with stitching pains. Worse after vexation; after being overheated; from lying on the side. Better from warmth; from eructations.

Lach.

Always when blood can be discerned like black straws as a sediment, whether from the uterus, bowels, nose, stomach, lungs, or at the bottom of an ulcer Often useful in typhus, when hemorrhages occur. At the climacteric period. Paroxysms of pain in the right ovarian region, relieved by gushing of blood from the vagina. Chills coming on at night as an accompaniment to bleeding.

Lycopod. Hemorrhages accompanied with a sensation of fullness up to the throat, and taking food or drink, even in small quantity, increases that feeling of fullness. Borborygmus, and a constant sensation of fermentation in the abdomen; flushes of heat; desire to be fanned continually day and night; desire for more air; has palpitations and dyspnoea. Cutting pains from right to left in the abdomen; can't lie on either side.

Merc. Epistaxis; hemorrhages of old women after the climacteric period is passed. Hæmaturia in typhus, etc. Suitable for light-haired persons with lax skin and muscle. Moist mouth and tongue, with thirst, rarely indicated with the reverse condition. Foot-sweat scentless. Mental symptons are of serious and anxious charter. Blood light. Scorbutic condition of the gums. Nitr. ac.

Bleeding from the uterus, with pain in the back, extending down through the hips into the legs, and pressure as if the uterus would be forced down and out of the vagina. Epistaxis, hæmoptysis, etc.; one of the best remedies for bleeding

from the bowels. Chiefly indicated in darkhaired persons; skin and muscle rigid; no thirst; foot-sweat fetid. Mental condition of distrust. Blood dark.

Nux. vom. One of the most reliable symptoms is a frequent urging to stool, with sensation as if fæces still remained in the rectum which the patient desires to expel. Indicated in persons indulging in rich food; of sedentary habits; constipation; dark hair. Worse at and after four o'clock A. M.; in cold air; after spirituous liquors. Better in warm air; lying on the side; in loose garments; after passing wind. Phos. Suitable for tall, slim persons, with black hair; menses too often; too profuse; lasting too long. Empty feeling in abdomen; costive, stool being very slim and dry, and voided with difficulty. Worse lying on left side or on the back; from warm food and warm drinks. Better lying on right side; from cold food and cold drinks; from being rubbed; after sleep. Small wounds bleed profusely; erectile

tumors.

Plat. Blood flows in black clots and fluid, or in one grumous mass, thick, black, and tarry. Feeling of horror at what may happen; of horror at thought of death,

etc.

Puls. Here the temperament usually decides; mild, gentle, and easily moved to tears; can't bear a close, warm room, but must have plenty of cool air. The flow is intermittent, and is in clots and fluid mixed. Sabina. Pain runs from sacrum to pubis, and the flow is worse at every paroxysm of pain. Clots and fluid, may be dark-red or pale. Often called for during third month of pregnancy; also after parturition. Worse in close, warm room. Better in open air.

Secale corn. Passive hemorrhage, blood dark or red, in feeble cachectic persons, accom. panied by tingling in the limbs and prostration. Desire for air; does not like to be covered; wishes to have the limbs extended; skin cold.

Sepia. Where there is plethora, or congestion to the part, accompanied by a sensation of weight. Pain in the right groin; fine, darting pains in the neck of the uterus from below upward; sensation of weight in the anus; empty feeling in the pit of the stomach. Worse from nursing. Feels better from drawing up the limbs. Disposition to abort from the fifth to the seventh month of pregnancy.

Sul. Sensation of heat in any part, either prior to or as well as during the bleeding;

whether from the lungs, nose, uterus, rectum, etc. Usually feels worse when warm in bed, or when exposed to heat, as of the fire, of the sun, etc. Gets sick soon, and soon gets well again.

The differential diagnosis of the above remedies is very easily made, and if the physician has a good general idea of their pathogeneses, the choice need not occupy much time. I will state the point of difference in each remedy that helps to decide me in my choice, and I very rarely fail to obtain the desired result at once, and without a second selection. Changes in the patient's condition and symptoms, without a continued progress toward a cure, of course sometimes require another selection.

Acon. This remedy differs from every other in its mental symptoms, restless anxiety,

etc.

Arnica. Injuries, fatigue, hot head and cool body.

Arg. nit. Belching of wind affords a marked relief of all the symptoms. Observed particularly in hæmoptysis.

Bell. The hot blood, forcing pains, sensitiveness on being jarred, bounding pulse, congested eyes, throbbing carotids.

Calc. carb. In persons of leucophlegmatic temperament.

Canth. The urinary symptoms.

Carbo veg. Desire to be fanned, hard condition of the skin, rigid fibre.

Cham. Spiteful and irritable temper, blood

dark.

China. The ringing in the ears, condition of the pulse, cold and clammy skin. Crocus. Blood forming into long, dark strings.

Ferrum. Red face, full pulse, very weak. Hyos. Twitching of the muscles, blue skin, delirium.

Ipecac. Constant flow of bright red blood.

There is no other remedy in the materia medica in which the abnormal state of the vital power is so manifested in the desire to throw out every drop of the vital fluid from itself as in Ipecacianha.

Kali c. Hemorrhages, accompanied by sharp, stitching pains. Post-partum hemorrhage with these pains.

Lach. Appearance as of charred straw as a sediment in the blood discharged, or at the base of bleeding ulcers. I recently had a case of supposed hemoptysis, auscultation

and percussion affording no evidence of lung trouble. I looked into the pharynx, and far down I saw an ulcer filled with the above-described sediment. Lach. 100m, one dose, cured the case promptly and entirely.

Lycopod. Sensation of fullness up to the throat. Desire for constant fanning and for more air. Flushes of heat; can't lie on either side; borborygmus and sensation of fermentation in the abdomen. Not long since I had a case of uterine hemorrhage, with the following symptoms: The blood flowed in paroxysms; each paroxysm was preceded by a gurgling in the left hypochondrium. This gurgling soon seemed to descend into the abdomen, producing a great fermentation, which in turn would soon be followed by a hemorrhage from the vulva, and would last for hours. Lyc., 100, one dose, produced marked and immediate relief, and in thirty-six hours she was well.

Merc. Hemorrhage of females after the climacteric period. Epistaxis in light-haired persons, with lax skin and muscle.

Nitr. ac. The peculiar bleeding from uterus. Epistaxis, or hemorrhage from the bowels in dark-haired persons, with tight fibre and muscle.

Nux vom. Symptoms of the rectum. Phos. Small wounds or orifices bleed profusely; tall, slim persons, with black hair. Weak, empty feeling in abdomen. Platina. The flow appears in a grumous, black mass. Patient feels horrified at what may happen.

Puls. Flow intermits; tearful and gentle disposition.

Sabina. Pain is felt running through from pubis to sacrum in uterine hemorrhage. Blood is discharged in liquid and clots. Secale c. Passive hemorrhage in feeble and cachectic women. Does not want covering.

Sepia. Sensation of weight in the part from which the blood flows.

Sulphur. Sensation of heat in the part from which the blood flows.

Uterine Fibroids. One of the size of a child's head, the other one half that size; allopathic treatment without result.

Calcarea carb. had no effect; Hydr. auratum softened the tumors; at last Calc. sulph. stibiata made both fibroids disappear entirely. Treatment took almost two years. (Deventer, H. K., vol. XXI, p. 19.) -Interstitial and subperitoneal, diagnosis and

treatment of Continuation from A. H. Z.,
91, No. 25. (Ad. Mayländer, A. H. Z., 92,
p. 11.)

Calc. carb., 30 trit., is very useful. (Dr.
McClelland, M. I., vol. IV, p. 193, 1876.)
Sub-mucous. A report on, with a case
operated on. (W. Danforth, M. I., vol.
IV, p. 361, 1876.)

Sub-mucous of the Cervix Cteri, causing
profuse leucorrhoea and menorrhagia enu-
cleation. Cure. (G. O. Spence, O. M. and
S. R., 1876, p. 208.)

Polypus. Removal by galvano-cautery (H. F. Biggar, O. M. and S. R., 1876, p. 154.)

Accidental division of the pedicle in tightening the ligature. No hemorrhage, and good recovery. Weight thirteen ounces. (A. O., 1876, p. 293.)

Case of, removed by ligature. (Dr. May länder, A. H. Z., 92, p. 171.)

Myo Fibromata. When tumor is rich in muscular elements, or when its seat is submucous where the contractility of uterus is intact, the conditions for success of subcutaneous injection of ergotine are most favorable. (A. O., 1876, p. 290.)

Tumors and their treatment by Ergot. (Wm. H. Byford before Am. Med. Ass'n, quoted in N. E. M. G., vol. XI, p. 287.) Dysmenorrhea and Sterility. Cured by opening up the inner mouth of the womb. Impregnation following. (H. F. Biggar, O. M. and S. R., 1876, p. 148.) Menses preceded by pain in small of the back; great aching and general soreness of lower limbs; bad breath, bitter taste, vertigo, chilliness. This continues for a day, when a very scanty discharge of bright red blood begins, accompanied by intense nausea and vomiting of yellowish, bitter matter; pain unremitting for six to twelve hours. Cau lophyllin, 34, cured. (J. Martine, Kershaw, M. I., vol. IV, p. 377, 1876.)

- Borax, according to Hahnemann, makes conception easy. Six cases reported by C. S. Middleton, in which dysmenorrhoea, even membranous, was greatly relieved or cured, and conception followed in some. In sterility be also used successfully Borax in one-grain doses of the crude article. Gossypium, is also a remedy for sterility, and also for painful menstruation. Korndoerfer referred to the slaves using a glass of Salt water just before coition, to increase the susceptibility to impregnation. B.W. James uses often Cimicifuga 1* in dysmenorrhoea, with nausea, retching and vom

Dr

iting, pain in head, flushed face, giddiness, and great restlessness, tremor, fainting, sinking feeling, and pains in extremities. It is also useful in rigid os uteri, dry vagina, etc. R. J. McClatchey added Viburnum opulus to the remedies for dysmenorrhoea; mammæ enlarged and hard; aching in the hips. Also as a preventive of miscarriage where there is an unusual susceptibility thereto. Reported failure in sterility from Borax. (H. M., 1876.) -Translation by S. Lilienthal of paper by Prof. Gusseron. (A. O., 1876, p. 297.) Use Baptisia when the tongue is dry, rough, and coated; diarrhoea and debility. Caulophyl. 1 to 30 to bring on uterine contractions; also in menstrual colic. Cimi

cifuga, as a nervine; hysteria; best remedy in hysterical headaches; prosopalgia and rheumatic pains in nervous females; chorea, 3 cases. Gave it in a case of typhoid; lady nervous, excited, headache, flying nervous pains, tremor, with partial convulsions. (H. M., 1876.)

A domestic servant, æt. 28, inclined to anæmia, complained for two weeks of a dead pain in the lower part of the chest, upon the left side, coming on after eating; during the pain the stomach becomes swellen. This pain begins soon after taking food, and continues so long as the food remains down; vomiting, which occurs about an hour after taking food, results. She is unable to sleep upon her right side, from its bringing on palpitation of the heart, and this palpitation obliges her for relief to press her hand hard against her side. The pain extends from the pit of the sternum to round along under the heart, in fact, corresponding to the situation of the stomach. Always feels faint toward evening. Bowels are regular, stools occasionnally black-looking; appetite, as we might expect, is dulled by the pain. Monthly period is regular, but attended with a great deal of pain; this pain comes a day before each period, and makes her feel horribly faint; fainted three times at her last catamenial period. Her monthly period lasts one day only, the dysmenorrhoea ceasing with the free discharge. Complains very much of pain at the lower back coming on after breakfast, sometimes remaining all day, sometimes going away soon after breakfast, but generally much increased during the monthly illness.

Here we deal with a clear case of incipient ulceration of the pyloric extremity of the stomach; we have it, as is almost always the case in this form of gastric ulcer, in association with anæmia, and an insufficient and painful menstrual flow. Amen

orrhoea is usual with the anæmia ulcers of girls; here the menstrual irregularity took the form of dysmenorrhoea, the one-day monthly period being normal. This affection is seldom met with without some form of menstrual irregularity, showing, as it appears to me, an intimate connection between it and an inactive state of the ovario-uterine sphere. And when we remember how often a left side pain, a subcardiac stitch, exists along with menstrual irregu larity, the conclusion is a natural one that the nerves supplying the coats of the stomach are particularly liable to sympathise with those of the ovaries, and that this inorganic and palpable stitch is, in its origin, intimately allied to this very apparent and tangible ulcer of the stomach. And you will find, too, that the great majority of patients who suffer from this submammary stitch are of ages varying from fourteen to thirty-five, pretty nearly the time of life at which this particular form of gastric ulceration occurs.

The heart sympathises with the gastric mischief; for, when lying on her right side, and thus causing the contents of the stomach to shift over to the seat of the ulcer, palpitation is induced; vomiting, too, is occasioned by the food acting as an excitant when in the stomach; it is a really painful, a true vomit, in contradistinction to a gulping up of food, which would characterise a simple gastric irritability, and would be met by a preparation of iron; and the black appearance of the stools shows that, in all probability, bleeding has begun from the abraded mucous membrane of the stomach.

The remedy selected was Argentum Nitricum, in the third decimal potency, ten drops to three ounces of water, a teaspoonful three times a day in water.

After taking the Argentum for a week, the gastric symptoms-a sufficient interval had not elapsed to observe as to the dysmenorrhoea-were much improved; the pain in the side and sickness had left, and the pain had ceased in her back.

The prevailing condition of system in association with this gastric ulcer is one of anæmia; and we may take it that the pre-existing condition of the walls of the stomach is one due to local mal-nutrition, leading to enfeeblement of digestive power and a tendency to ulceration in, as is usually observed, the posterior wall and pyloric extremity of the stomach. But there is found, along with and preceding its occurrence, ovario-uterine as well as gastric weakness. It will therefore be opportune to ask ourselves, what is the pathological condition of the uterus most likely