DESTRUCTION OF THE MEMBRANA TYMPANI.

In cases of ulceration of the ear, it may reach the tympani, and either destroy it or thicken it. By applying an earspeculum, while the patient closes the nose and swallows, the tympanum will be seen, if intact, or absent, if destroyed. And the ossicula auditus may be also discharged where the tympani has been destroyed by ulceration, which can also be discovered by the use of the ear-speculum.

Treatment.-The chloride of gold is one of the best remedies, and it may be alternated with silicia, both in triturations, in small doses, say 1st dec. in doses of 1-5 to 1-8 grain (according to the age of the patient), three times a day.

STRICTURE OF THE EUSTACHIAN TUBE.

This can be ascertained by driving air into the Eustachian tube with the rubber pump made for that purpose, and sold by druggists.

Treatment.-A long course of iodine is indicated, and it may be alternated with medium doses of gelsemium. Or if there is any inflammation, pulsatilla will do good service; it may be given in doses of 1 to 5 drops three times a day, according to the age of the patient. If the child should show signs of struma, then the tincture of sulphur should be given in doses of 2 or 3 drops three times a day, alternated with alnus rubra.

IMPAIRED HEARING-DEAFNESS.

Deafness or impairment of hearing may arise from, 1st, obstruction of the meatus auditorius, by polypi, earwax, inflammation, collection of pus, or from any foreign bodies in the meatus; 2d, inflammation, thickening, degeneration and destruction of the membrana tympani by ulceration; 3d, inflammation of the middle ear and the loss of the ossicula auditus, collection of pus, etc.; 4th, inflammation and stricture of the Eustachian tube, affections of the labyrinth and auditory nerves. It is obvious that cases occurring from destruction of certain vital parts of the ear, as the auditory nerve, are incurable; but those from inflammation or obstruction are generally curable, if properly treated.

Treatment. In cases where an accumulation of hard earwax has obstructed the ear, its removal with glycerine, then the administration of conium in small doses, will often cure the deafness. If the wax is dry and hard, and of a brown-red color, muriatic acid in 5-drop doses, three times a day, will likely be followed by good results. If it follows scarlet fever, nitric acid 3 drops three times a day, alternated with iodine, and the 1st dec. trit. of lycopodium, put in the ear at night, will be apt to relieve the deafness. If it is accompanied with pain, chamomilla will give relief; it may be given in doses of 1 to 2 drops three times per day.

[XXII.]

NATURAL THERAPEUTICS.

BY S. H. POTTER, M. D.

In the treatment of human maladies, the first and most important subjects to investigate are the functions which nature performs in the curative process. The first is rest-physiological and mechanical rest, as essential to be known and kept in mind by the practical physician and surgeon. Growth is the antitype of repair, indicating the physiological capabilities of existing structures to repair themselves. Rest and growth bear the relation of cause and effect. Accurate observation of the animal and vegetable world proves their perpetual coexistence. Growth proceeds pari passu with physiological Calm repose and peaceful sleep are nature's great

rest.

restorers.

The marked tendency of modern practice is to rely more upon the resources of nature and to dispense less drugs. The latter are very useful, of course, when wisely employed, but when given to excess or in depressing doses they are always pernicious. The former are the principal means of permanent relief and indispensable to health.

Rest is one of the chief natural therapeutic agents, often the only one available or required. Warned through weariness of fatigue, exhaustion or pain, all other living beings, and uncivilized men seek rest and are restored from their few mala

dies without other aid. The quiet child who most sleeps most thrives; the restless, wakeful child shows little proof of active nutrition. The healthy infant passes a greater portion of time in sleep and rest. Growth-the normal renewal of some parts and the fresh development of others require rest and sleep. Many well known grave maladies are curable only through absolute rest; in treating all diseases this agent is the most important one. Rest is the fosterer of repair; is necessary for the healthy action of every organ; and the means instituted by nature to secure quiescence and recuperation of the various viscera of the body. True, relaxation and due exercise of mind and body, in alternation, promote and perpetuate health. When the forces are expended in useful pursuits, rest is the one therapeutic agent to restore energy for resuming action in vigorous health.

In all periods of life, from infancy to decadence, intellectual vigor, moral courage and physical endurance render regular rest and refreshing sleep indispensable. Conspicuous among natural therapuetics are pure air and water, wholesome, nourishing food, proper protection and favorable surroundings. Without these, other therapeutic means are useless. This should be kept in mind. In early practice the average physician seeks new and vaunted remedies, and puts those in requisition in abundance. Later experience and observation dispel this delusion. Eminent and experienced physicians usually settle upon comparatively few therapeutic agents, to them well known to be efficient in their action, to fulfill the various indications in treating disease. The cardinal rule is: Never severely impress the system, nor employ remedies which can injure it. Support the vital forces through natural therapeutics, rendering whatever auxiliary aid may be afforded by the use of drugs, employing few and simple remedies-only those whose nature and known action give good results. Investigation for new remedies and new uses of old ones are commendable and should be encouraged.

SELECTED.

Diseases of the Organs of Respiration.

THE TREATMENT OF EARLY PHTHISIS.

By Dr. J. MILNER FOTHERGILL, Assistant Physician to the Victoria Park Hospital for
Diseases of the Chest.

The leading characteristics of early phthisis are cough,
emaciation, loss of flesh, night sweats and pyrexia, with more
or less hæmoptysis; each symptom indicating an appropriate
line of treatment. For here it is essential to treat symptoms
while doing our best to influence favorably the pathological
process on which they casually depend. If asked the question,
"What do you think the most important matter to attend to in
the treatment of early phthisis?" my answer would be, "To
arrest the night sweats." "The next most important?"
"To
keep the stomach and intestines in good order and attend
to the assimilative processes." If these are not attended to, all
treatment is futile, or nearly so. If the sweats are not
checked the blood-salts drain out as fast as supplied; if the
digestive powers are not cared for, the food taken is not assim-
ilated, and so the patient is no nearer more perfect nutrition
and effective tissue repair.

To arrest night sweats we must have recourse to some anhidrotic, as oxide of zinc, sulphate of copper, or one of the solanaceæ, as hyoscyamus, and still more, belladonna. The first two act as astringents, generally affecting any part where there is an abnormally excessive flux; how, we do not know. Belladonna acts directly upon the secreting nerves of the sudoriparous glands, whether applied locally or administered by the mouth. Probably hyoscyamus acts in allied manner. Taken altogether, there is no anhidrotic to be compared with belladonna, though in the few cases where it fails the other agents may be tried. But in order to get out the good effects of belladonna, it is necessary to give it in sufficient dose. The ordinary dose of sulphate of atropia-for it is much better to use a solution of atropia of known strength than to give the tincture of belladonna, which may, and probably usually does, vary in strength-is in many cases quite insufficient. The

variations of toleration of belladonna in individuals is as pronounced as is the case with Epsom salts; what is sufficient of the latter for one, exercises no influence over another person, while the dose some require to produce even a gentle action of the bowels would produce well-marked, nay, serious, diarrhoea in others. I use atropia in doses varying from the seventy-fifth (75th) to the fiftieth (50th), and up to the twenty-fifth (25th) of a grain. A considerable proportion of patients are unaffected until the last dose is reached, and even then do not complain of much dryness of throat, or indistinctness of vision (effect upon the pupil as a guide to the administration of belladonna is utterly worthless). With many patients, the seventyfifth of a grain of atropia will arrest the night sweats, and in a certain number will affect the throat and eye-sight; while others require the fiftieth to influence the night sweats; and again a small proportion are uninfluenced till the twenty-fifth is reached. Thus we see the toleration of belladonna varies very much with different individuals. An impression exists in my mind that these large doses of belladonna are more frequently required in the case of Jews than of other patients. The practitioner then must not go away with the impression that belladonna had failed in any case until he has pushed the dose to decided dryness of the throat and distinct impairment of vision; flinging aside any effect upon the pupil as a fallacious test not to be trusted; for in my experience the pupil is rarely much affected, and yet in other cases a marked effect is occasionally produced on the pupil by placing a small belladonna plaster over the heart. To some other effects of belladonna reference will be made shortly.

The profuse night sweats of phthisis, and, at times, of other maladies, are very exhausting. Sweat is a secretion which contains chlorides, phosphates, and sulphates of the alkalies, as well as urea, uric acid, traces of iron, and of fat or of fatty acid. Consequently, when the sweat is profuse in a person who is debilitated, it drains the body of its salts, and, in doing so, cripples the assimilative powers. Usually the first consequence of arresting the night sweats of the phthisical is the return of the appetite-food is both relished and digested. So