longer a theory but a fact. Enough is known to warrant us in saying that what is true in part is true in the whole; but it requires more thought and study on our part to work out the problem yet unsolved.

From my own practice, I will simply recall a few cases which will illustrate all that is necessary for the present. About three years ago, I was called at midnight to a lady, and found she had been suffering severely with facial neuralgia for the past ten hours. Here was a plain case; should I give Dr. Gross' neuralgia pills? Examination showed oppressed pulse, sharp, lancinating pains, oppression of the chest, etc. Gave fl. ext. lobelia sem. gtt. xv, and in fifteen minutes pain ceased and patient soon went to sleep. I left small doses of lobelia and went home. There was no return of neuralgia.

Case No. 2.-Mrs. K., attended by a midwife, was delivered of a fine and healthy child. All went on nicely until the tenth day, when she was taken with a severe chill, and, in my absence, Dr. H. was called, and, as he afterward told me, found her with the most severe chill he had ever seen, followed by fever, and that by sweating. This occurred every other day, in spite of the quinine and cinchonidia that he had given.

After he had treated the patient about a week, and she was growing worse all the time, another severe chill occurred about 12 o'clock at night. Dr. H. and myself were called simultaneously. Arriving first, I diagnosed the case and selected the remedies that I would suggest to her physician. But the doctor was a regular, and hence refused to counsel with an irregular; the upshot of which was, that he was dismissed and I retained. Indications called for aconite, rhus tox. and soda sulphite, which were given, and no more chills occurred. Patient made a complete recovery in four days.

Case No. 3 is your humble servant, who has been for years past subject to attacks of bilious colic, the pains at times being almost unbearable; yet before I practiced medicine, I had some of the best physicians to treat me during these attacks, but it would always take me three or four days for recovery. During my professional life, I have experimented with different drugs-morphine, chloroform, nux vom., and

many others were used in their turn, without any permanent relief. Tilden's fl. ext. of dioscorea was also taken, but proved worthless. I sent to Wm. S. Merrell & Co., Cincinnati, Ohio, for some dioscorea root, made my own tincture, and when I had the next attack of this painful disease, I took a teaspoonful of the tincture in some water, and it seemed as if the medicine went directly to the spot, the cramp gave way, and I went to sleep, got up in the morning with very little soreness in the bowels, and attended to my business as usual. Now a teaspoonful of the medicine is all I need to give relief.

And in conclusion, let me remark that, as we go on in this course of study, the subject becomes plainer step by step; we learn that similar conditions of disease are always treated alike, regardless of the name of the malady or its location, and, as we thus always prescribe for conditions, we find the practice of medicine really simplified. It becomes a pleasure instead of an unpleasant uncertainty.

[XXVIII.]

GONORRHŒA IN THE MALE.

BY ED. F. RUSH, M. D.

In the treatment of this disease, the physician should take into consideration the general condition of the patient, whether he is anæmic and debilitated, or robust and plethoric; he should ascertain, if possible, if he is suffering from any other disease which is likely to have a depressing effect on the system, or if any complication exists which may exert a modifying influence on the proposed plan of treatment; and above all, the treatment should be adapted to the stage of the disease, as 'some plans of treatment would be injurious in all, and very dangerous in some cases if used in another stage than that for which they are recommended. In the great majority of cases applying to the physician for treatment, acute inflammatory symptoms have already set in, thus placing the disease in the second or inflammatory stage, and in this stage it would be highly dangerous and injudicious to apply the so-called "abortive treatment," which is admissible only in the first and last

The reg

stages, and in many cases, is not admissible at all. ulation of the diet, exercise and mode of life of the patient is of the highest importance in the treatment of gonorrhoea in any and all of its stages; the advantages to be gained by absolute repose and quiet in the commencement of the disease cannot be overestimated, and the great advantages thus to be gained should be explained to the patient, and if possible, he should be induced to follow the physician's advice in this respect, for if he will but keep to his bed for a few days the battle is half won; but, in practice it is very difficult to induce a patient to submit to this restraint; the calls of business or the necessity of secresy often render the observance of such stringent directions impossible, during an attack of some disease dangerous to life men will stay at home, but hardly ever for an attack of gonorrhoea. At home and at the office, store, or wherever he may be, the patient should assume the recumbent posture as much as possible, and at all times the scrotum should be well supported by a good, snug-fitting suspensory bandage. All kinds of exercise should be avoided as much as possible, walking, riding, dancing, are all injurious and often make a gonorrhoea much worse, or cause a relapse even when, to all appearances, it is cured; rest, absolute rest, is what is required, and the closer the patient observes this rule the more speedy will be the cure. While the acute symptoms continue the diet should be very light, meat, stimulants, asparagus, cheese, coffee and acids should be strictly forbidden. The reading of all books calculated to excite the sexual passion, and the society of females, even if no improprieties be committed, should be prohibited. Should the patient be an habitual drinker, he must not be cut off entirely and suddenly from his accustomed stimulus, for fear of complete nervous prostration; rather limit him to the least possible quantity, and let that be gin or brandy rather than beer or wine, or better than either, one drachm doses of Tr. Cinchona rub. four or five times daily. As before stated, the disease is usually met with in the second, or acute inflammatory stage, and in all such cases, it will be well to commence the treatment with an active saline purge, a full dose of sulphate of

magnesia answering the purpose. In bad cases, characterized by swelling, extreme inflammation and scalding pain in passing urine the following mixture should be used for a few days before commencing active treatment:

Ꭱ Potas. Bicarb.....

Tr. Hyoscyami..

Muc. Acaciæ

.....

..3ij.

.3i.

..3v. M. Sig.

Tablespoonful every three hours. At the same time, to allay the inflammation and pain, and to reduce the swelling, the penis should be frequently and persistently immersed in water as hot as can be borne. After the severity of the symptoms have been modified by the use of the foregoing measures active treatment may be commenced.

The most reliable internal medicines are copaiba, cubebs and oil of yellow sandal-wood. Copaiba and cubebs should be given together, as they are more efficacious in combination. The following formula will be found very useful:

Some stomachs will not tolerate copaiba in any form, and it often causes a very irritating eruption. In such cases, the oil of sandal will be found to be an elegant and valuable remedy; the only objection to its use is the cost and frequency of adulteration. It can be given in doses of from 15 to 30 drops three times a day on sugar, or in water, or in a mixture, as follows:

In connection with this internal treatment, the patient should use either of the following injections.

R* Hydrastis pulv..............

Zinci. Sulph....

Morphiæ Sulph.....

Aquæ dist.......

..3vj.

..gr. xij.
.gr. viij.

Zvj. M. Sig.

Shake well, and inject 2 or 3 drachms after each passage of

urine.

Ꭱ Ext. Hydrastis fl..............

Morph. Sulph......

Muc. Acaciæ.......
Aquæ dist. ad......

....3vj.
..gr. v.
zij.

iv. M. Sig.

Inject 2 or 3 drachms after each passage of urine. In using injections, care should be taken not to throw the injection any further back than is necessary, which can be prevented by pressing on the urethra in front of the scrotum. Care should be taken in the selection and use of the syringe; a hard rubber or glass piston instrument with a rather blunt point should be used, and the physician should administer the injections himself until he is satisfied the patient is competent to do so. Each injection should be retained at least three minutes.

In some persistent cases a very good effect results from the passage of a full-sized bougie once daily, which dilates the urethra and allows the injections to reach every portion of the inflamed mucous membrane. In some cases, it would be well to smear the bougie with some astringent ointment or lotion, such as tannin and glycerine. Treatment should not be stopped. suddenly, but gradually discontinued during a period of about ten days.

[XXIX.]

TREATMENT OF HYSTERIA.

BY DR. JOHN A. HENNING, RED KEY, IND.

The young physician must be careful in his diagnosis, and not pronounce the patient pregnant when there is only hysteric distension of the intestines by flatus. He must not mistake hysteric colic for peritonitis, hysteric cough for asthma or limpid urine for diabetes or nephritis.

When called to a paroxysm, the first indication is to remove any tight clothing about the patient, and to administer anti

* See Clark on "Diseases of Women."