to, for the management of placenta prævia, that if there was no other unnatural complication, I should undertake a case of that kind with scarcely more fear of disaster than in a case of ordinary labor.

OUR SURGICAL REMEDIES.

BY S. L.

(Concluded from May No.)

Every body knows that gout is essentially a time-lasting or chronic disease, and that we have an internal as well as an external gout, and we consider Ledum far more indicated for the symtoms of chronic gout with its deposits and alterations which occur in and around the joints, whereas from time immemorial, Colchicum was the representative to battle with the acute paroxysm. This chronic state is also characterized by general feebleness, sometimes from the very start, which rapidly tends to various organic degenerations; not unlike those usually seen in old age, doubtless due to the constant condition in which the blood is found. Comparing the symtoms of gout with those of Ledum, we find a most valuable correspondence between them: the discontented and morose disposition, the stupefying headache; the vertigo, as as after intoxication, especially when walking in open air, with dullness after eating; offensive breath; pressure in stomach after a small quantity of food; sensation of fulness in upper part of abdomen; ecchymosis in the conjunctiva; purplish spots, like petechiæ, over the whole body; gouty nodosities on the hand and finger joints; drawing pain from hands upwards; gouty nodosities in the feet, fine tearing in the toes; numbness or formication in the limbs. Dunham gives as the characteristic indication the aggravation by

motion and the midnight aggravation by heat shown by throwing off the bed clothes The febrile symptoms indicate that Ledum cannot be applicable in very severe acute cases; it would seem more applicable to such cases as have been brought by the injudicious use of Colchicum to a low asthenic state, and it is in such cases that Dunham found Ledum a most serviceable remedy.

Hence Ledum can neither be a remedy in acute inflammatory rheumatism, and we find therefore paleness, œdema or emaciation of the affected parts, the pains going from the periphery, where circulation is poorest, upwards ; worse from motion and from bed covering.

We greatly doubt whether the hæmopto of Ledum is congestive, for all the symtoms hint to a late stage in this unfortunate affection. Though the discharge may be copius, bright red and foamy, it is only brought up after severe paroxysms of fatiguing, deep cavernous cough, accompanied by tearing, beating pain in the head, and followed by bloody or greenish, fetid expectoration; the night-sweats are also putrid or sour, chiefly on forehead; extreme oppression from the slightest attempt to move about, though the patient makes vain efforts to keep up respiration; brown or red spots on the chest, worse during the hot spells.

Ecchymoses of the conjunctiva, says Norton (1. c. 110), either of traumatic or spontaneous origin, are often quickly absorbed by the use of this remedy, and in many cases more promptly than when our usual remedies (Arnica or Hamamelis) are employed. Ledum has proved chiefly beneficial in contusions or wounds of the eye and lids; especially if accompanied by extravasations of the blood. It is the remedy in asthenopia, if there is dull pain behind the eyeball, as if it would be forced out.

In menorrhagia Guernsey advises it when the menses are too early and too profuse, with a great want of vital warmth, she can hardly keep warm (again that neurasthenia); in uterine displacements with abundant leucorrhoea, pale face,

abundant urination, even at night, great sensation of coldness all through her, she cannot keep warm, and still all her sufferings are greatly aggravated by warmth, as in bed or over a register; in dropsy of the uterus with similar symptoms; in vaginal fistula, in dysmenorrhoea, in constipation or diarrhoea where this great want of vital heat is the cardinal symptom, looming out above all others.

Even Piffard (Mat. Med. of the Skin) mentions Ledum as a remedy for scabies, tinea, and lepra. Conant (Lilienthal's Treatise on Diseases of the Skin, p. 331) gives as subjective symptoms: constant itching; itching-gnawing on the abdomen and arms, with burning in the open air and after scratching; itching-prickling relieved by scratching, but returning soon with more violence; stinging when touched; worse in the evening and before midnight, on moving, while walking, on getting warm in bed; better while reposing. These very symptoms prove it to be parasiticide, and thus prove the value of its application in olden times.

RUTA GRAVEOLENS.

Injuries of fibrous tissues and of the periosteum; mechanical injuries of the tarsal and carpal joints; rheumatic paralysis of the parts.

For a wonder we have here a drug which has not been quite discarded by the old school, notwithstanding that the taint of agedness clings to it, for Hippocrates mentions rue already. According to their Materia Medicas, the essential oil has long been reputed as antispasmodic, stimulant, emmenagouge and anthelminthic, and their teachers still recommend it in infantile flatulence,colic and convulsions and among the class of true emmenagogues. Phillips considers it trustworthy, and it seems likely that the cases in which it is most useful are those examples of amenorrhoea and dysmenorrhoea in which muriate of ammonia does good service.

M. Elgajakis says that the excessive use of the rue produces dimness of vision, but he also alleges that by taking

it in moderate doses the eyesight becomes improved, and good effect follows the continued use of minimum doses, night and morning, in dimness of vision dependent, apparently, upon a functional amaurotic condition.

Murray and others have claimed for it the power of curing epilepsy, but only in cases where the malady is wholly or partially dependent on seminal weakness; small doses of rue, by their action on the sexual organs, may limit the amount of nocturnal discharge, and thus mitigate the nervous prostration so favorable to a continuance of the fits.

Vice versa we find this drug rather neglected in our school, and Franklin and Helmuth mentioned it without much endorsement. Ostrom even publishes a case of periostitis which he cured with Silicea and Calendula, finding no indication for Rue Mezerum.-Homœopathic Physician, I.

of

Ranney (Surgical Diagnosis, p. 103) divides periostitis into simple, suppurative and chronic. The diffuse or suppurative type is usually of traumatic origin, but as a rule is associated with some impairment of constitution or hereditary taint. It is characterized by great pain, marked constitutional disturbances; diffuse inflammation of the soft tissues, fluctuation after pus forms and by being confined between two joints. It is most common at about the age puberty, and usually affects the long bones. The chronic form is most frequently present in syphilis, and it most commonly affects the anterior surface of the tibia (nodes). It is associated with severe pain in the region of the seat of the disease, with tumefaction dependent on swelling of the periosteum, with extreme tenderness on pressure and with exacerbations at night and during damp weather.

It seems to us that Ruta is more indicated in traumatic periostitis or ostitis where the patient's condition is impaired and a dyscrasia needs treatment simultaneously with the trauma, and I think the pathogenesis of the drug will bear us out in our surmise. Thus Hering gives us : large painful swelling of scalp, as if originating in periosteum, sore to

touch and preceded by rending pain; head extremely painful as if bruised and beaten; and in Hahnemann's Materia Medica Pura, English edition, we read: a shooting drawing pain from the frontal to the temporal bone; from the temporal bone to the occiput, in the periosteum, pain as if from a fall; pain from the coccyx to the os sacrum as from a fall or blow; pain in the lumbar vertebræ, as if bruised; he cannot bend his body, all the joints and hip bones are painful as if bruised, worse on touching the painful parts; the whole anterior surface of the thighs is as if bruised and painful to the touch; he has difficulty in going up and down stairs; the legs bend under him; the bones of the wrist and back of the hand are painful as if bruised, when at rest and when moving; mental dejection, his thoughts are melancholic and he is tired of life.

Guernsey recommends Ruta in corrosive leucorrhoea in consequence of suppressed menstruation; the labor pains are weak and feeble, with lameness and soreness all over; constipation from either inactivity of. the bowels or from impaction of fœces, with large protrusion of rectum immediately on attempting to go to stool; involuntary emission of urine, whether at rest or in motion; at every step after micturition, she feels as if the bladder were full and moved up and down; she feels as if she could not retain the urine, so urgent is the desire, although she can only pass but a very small quantity.

The indications for employment among the sick, as given by Heinigke and Hughes, we fail to find in the pathogenesis as given by Hahnemann or by Allen, and we would request these authors to give up their clinical verifications.

DAPHNE MEZEREUM AND SYMPHYTUM OFFICINALE.

Mezereum and Symphytum enjoy the reputation of aiding nature in forming a callus after fractured limbs. The former, like ruta shows also in its pathogenesis, pain in the periosteum (of long bones, especially the tibia), worse at