2d, disease of the blood, whereby the gastric juice may become impaired and cause irritation; 3d, sympathetic action from some near or distant organ, which may happen by collateral circulation or impeded function or reflex action, as the uremic and bilious forms the one from mental emotion, teething, etc.; but here I shall especially speak of the one also called the summer complaint. This is epidemic, or, rather, endemic, to the large cities of the United States; here in Chicago, during July, August and September, usually commencing about the 4th of July, for the cholera infantum before then is of a different nature. It becomes especially prevalent when the thermometer rises to and above 90°. It is not the heat alone, but the combined action of heat and impure air, that produces ita peculiar atmospheric condition, or miasma, that only thrives by heat, like the yellow-fever miasma. It attacks the children, mostly, during dentition, and an erroneous diet may often start it. After lasting awhile, the catarrh is liable to become seated, or idiopathic, even ulcerative, the abdominal lymphatic glands affected, and a state of marasmus frequently is devel-· oped. Some cases run a rapid and easily-fatal course; others are protracted for several weeks, and may terminate in death from exhaustion or sequelæ. The specific medication decidedly points to the nervous centers as the place for the basic lesion, where, from these, the vaso-motor nerves excite the gastro-intestinal catarrh; and I have, during my practice with it, observed three different kinds. For when the apparently same disease for awhile most promptly yields to a certain remedy, then entirely ceases and again likewise yields to another, what has changed? The remedy or the nature of the disease? Certainly the last of which I shall speak further in the therapy. Our summer complaint has, therefore, also been designated as brain-cholera, or brain-diarrhoea. The cerebral symptoms have long ago struck other physicians, and some cerebral lesions have been found at the post-mortem examination. Therapy. The summer complaint, I formerly treated in the usual way as a local disease, and according to the best authorities. I considered, however, opium a rather dangerous reme dy, and preferred small doses of podophyllin, ipecac, neutralizing cordial, and even calomel with chalk, or some astringent, and I always paid strict attention to the diet and hygiene. The disease often yielded somewhat, but I found it a very tedious and troublesome work to manage the case through. In the specific medication, I have used three of Rademacher's specific brain remedies; nicotiana, silver and zinc, and seen a wonderful difference, of which I never dreamt before. I am informed of other similar remedies, as gelsemium, ailantus, belladonna, aconite, etc., but I have never, in this disease, employed them myself. I have several times been called to desperate cases, given up by otherwise skillful physicians, and which I also formerly should have pronounced moribund. The little patients were entirely collapsed, with very cold extremities and very hot heads, but they recovered rapidly with the epidemic and charm-like remedy. I have also been called to families who formerly had lost child after child, but by this medication since kept all alive. It may be some trouble to find the right remedy in the first case, which here usually occurs about the 4th of July, but, whenever found, it will be the favorite one for the entire season. The little patient improves instantly, and the next day the intestinal excitement has subsided, the dullness and fever gone, the vanishing health returned; the eyes commence to sparkle with their cheerful and natural brightness, and further visits are seldom necessary. Strict attention must be paid to the diet and hygiene. The child must be dressed very lightly, sponged or bathed several times a day, enjoy as much fresh and pure air as possible, nursed by mother or wet nurse, if possible, or the most suitable feeding obtained. For drink, I like to give toast-water. Sometimes an irritable state of the bowels may continue from teething, which brom. pot. in mist creta usually allays, or form indigestion, where bismuth and pepsin help. Should the disease become more seated in the intestines, then we see the cases where the astringents; as kino, catechu, geranium, blackberry root, have gained reputation; but.here, too, I have seen the epidemic remedy act like magic. In cases of decided anæmia, I have generally prescribed elix. calisaya ferri et bismuth; for the lymphatic troubles I like aqua glandium quercus as a suitable alterative for children. very 1. The nicotiana form, which is the most violent and fatal, having a rapid course, and appears very much like the Asiatic cholera; R carb. soda, 3 ss, plus aqua fontana, 3 iss, plus aqua nicotiana (vide Scudder's Specific Med.) 3 i, plus syr. acacia, 3 iii. Mix. S. One teaspoonful every hour. 2. The silver form. This is more lingering and less acute, and I have met it more frequently than the other kinds. Chloride or oxide of silver may be given in doses of 1-10 gr., triturated with milk-sugar; but I have mostly prescribed R arg. nitras, gr. 4, plus aqua dest., 3 iss, plus syr. acacia, 3 ss. Mix. S. One teaspoonful every hour. 3. The zinc form, which I saw three years ago. The head was remarkably hot; there was often more vomiting than diarrhoea. The zinc is a well-known nerve remedy, and acts very much like the bromides. Williams and Fothergill also recommend it for night sweats, like the atropia. In the diarrhoea it may at the same time act locally. Of all the zinc preparations, the acetate is undoubtedly the best for internal use. R Acet. zinc, gr. ii or iv, plus aqua mentha pip., 3 iss, plus syr. acacia, 3 ss, M. S., one teaspoonful every hour. I may further state, that with this medication, I never found it necessary to send a child into the country, nor to the lakeshore, nor upon boats, as I formerly did. The prominent success with these and similar brain remedies in small doses, in comparison with all other treatment, speaks decidedly in favor of locating the basic lesion of our "summer complaint" in the nerve-centers, and I heartily invite other physicians to try it, but they must always bear in mind that our remedies usually act by spell or epidemically. [XVII.] THE NATURE AND TREATMENT OF NASAL CATARRH. BY PROF. EDGAR READING. It is remarkable to see with what facility the attention of the public is drawn in certain directions, and how susceptible the masses are to fall in with the views of others, without hesitating for a moment to exercise any reason. The result is that "what everybody says must be so," is not always so by any means. Public opinion is frequently manufactured rapidly and very erroneously. Certain movements become extremely popular for the reason that they have had illustrious leaders. Different causes or motives goad us on to follow them. The more educated or refined a community, the greater slave it is to fashion. This phase of human nature is frequently manifested in certain popular diseases and the remedies offered for them. There is no doubt that a large proportion of the socalled invalids are afflicted with imaginary diseases. And imagination will frequently cause a disease in reality. We see such cases occur frequently during the prevalence of an epidemic. The foregoing remarks are made to explain why it is that we have so many cases of catarrh at the present time, and how it is that so many catarrhal remedies become so popular. There is no disease so common, judging from the expression of the people, as catarrh, and there is certainly no disease which is so frequently an imaginary one. The mental distress which it causes is certainly of no small consideration. The epithelial membrane lining the nasal cavity is peculiarly and admirably arranged to fulfill the objects for which it was intended. It is very delicate and thin, so as not to obstruct the periphery of the olfactory nerve, which is so minutely distributed over its surface. This is necessary to enable the nerve to perform the function of olfaction. When this nerve becomes thickened, it prevents the odoriferous particles from coming in contact with the nerve and the sense of smelling is obstructed in proportion to the degree of turgescence, thickening and abnormal condition. In those animals in which the sense of smell is very acute, a thickening of this membrane, produced by either natural or artificial causes, will impair the sense of smell in proportion to the abnormal condition of the membrane. It is evident in such cases that the high degree of development of the nerve is not changed, but the communication is partially or wholly cut off. Hence, then, the necessity for the delicate organization of this membrane. It is so much exposed to the vicissitudes of the atmosphere, and the various irritating particles which it contains, that some provision is necessary to protect it, otherwise it would be kept in a constant state of irritation. This lubrication is provided for in the form of mucus. It is so constituted that its protecting properties are very great, while at the same time it will allow the odoriferous particles to pass readily through it. In a healthy condition of the parts it performs its work faithfully, but often to the great consternation of the individual. If this secretion is sufficient to be noticed, which is very liable to be the case at times, they imagine that they are afflicted with that loathsome, offensive disease called catarrh. They infer that the stream of air which is constantly passing over it becomes impregnated with foul matter, which is constantly being taken into the system, producing disease, putrefaction and death. In It is very difficult, if not impossible, to convince them of the importance of this secretion to protect these parts. It naturally follows that such persons lose no time in making a selection from the scores of remedies offered to the public for the radical cure of catarrh. The mischief which this false impression is doing, is extensive and greatly to be lamented. addition to the anxiety and suspense, it induces them to make free use of such application as will change the healthy membrane into a diseased one. How often we meet with patients who have used so many remedies without any benefit, but, on the contrary, they gradually grew worse and despaired of ever being any better. They have lost all faith in everything, and with them it is only a question of time when they will be deaf, blind, insane, or fill a consumptive's grave. Physicians are frequently to be censured for not explaining the nature of things to their patients, instead of approving of their opinion and encouraging them in the continuance of such application as must necessarily be injurious, by irritating the membrane and ultimately producing a diseased condition of what might otherwise be considered a healthy condition of the nasal cavities and fauces. The pain and distress which the |