permanency. In order to intelligently and successfully treat this difficulty, two distinct classes or forms of the disease must be recognized, as each variety requires treatment peculiar to itself, although occasionally the two forms will be found to be so blended as to require mixed treatment. These two types of spermatorrhoea may be characterized as sthenic and asthenic. In the former, the patient will be found in a plethoric condition, the seminal losses occurring mostly at night, with dreams. and vigorous erections; he is troubled with frequent and persistent desires, which cause the various nervous symptoms growing out of unsatisfied sexual passions. In this class or form of the disease, bromide of potassium is indicated, and will prove to be the remedy. It may be administered alone, or in combination with such other remedies as may be thought advantageous. The following formula will be found useful: Potassii bromide........ Ext. belladonnæ... Ext. gelsemii... Syrp. simple... .... Aquæ menth. P...................... M. Sig. A teaspoonful four times a day. 66 zi. Fl. .Fl. ǎā 3i. Ziss. The asthenic form of the disease is characterized by anemia and general weakness. The sexual organs are much relaxed; the erections feeble, or altogether wanting; the seminal fluid thin and watery, emissions occurring often and generally without any distinct dream or erection, and, in old cases, such a small but constant loss of semen as to constitute what is known as "diurnal loss," or, to more clearly express the symptom, we might say a more or less constant leakage of semen." In this form of the disease, the bromides do harm, as they act by diminishing the blood-supply to the erectile organs, consequently they are contra-indicated in cases characterized by debility and feeble erections. Cases of the asthenic type are frequently very persistent, and require skill and patience on the part of the physician. A debilitated condition. demands a tonic, and, for this purpose, strychnia should be administered in doses of gr. 1.60 from one to three times daily. The remedies most useful in the asthenic form are camphor, ergot, belladonna, conium, lupulin, phosphide of zinc and nux vomica (in pill form) phosphoric acid dilute, and Fl. ex. damiana. For example, a typical case of asthenic spermatorrhoea should be treated about as follows: Half teaspoonful in milk three times daily. Sig. R Ext. belladonnæ............ Ext. conii..... zij. ..gr. xxx. Spts. rect........ M. ft. pil. No. xij. Sig. Two pills at bed time; or, if this should not give satisfaction, continue the damiana in conjunction with the following: R Ergotine (aq. ex.)... Dij. 3i. M. ft. pil. No. xxx. Sig. Two pills at bed time. In some cases it may be advisable to give, in addition to above, a 3 or 4 grain lupulin pill, or to 1 drachm of the fluid extract of lupulin three times a day. Proper attention should be paid to regimen and hygiene; the bowels should be regulated and nervousness and mental depression overcome by appropriate remedies, the most useful of which are dilute phosphoric acid, phosphide of zinc and nux vomica. The introduction of a metallic sound into the bladder once or twice a week will produce a highly beneficial result, and, in some extreme cases, complicated with irritable prostate, the daily application of saturated tincture of iodine to the perineum will be found very useful. BY J. BUNDY, M. D., OAKLAND, CAL. Having suffered for the past eight months from sciatic neuralgia and a host of other nervous manifestations associated with it, of course every means known to medical skill have been brought to bear in my case, nothing being left unturned for my relief until I was relieved. One event occurred which elicits this article. After the sciatica had been arrested, I suffered severely from a nervous manifestation simulating chorea, which would make its appearance every afternoon at about 4 o'clock, lasting two or three hours, or until some means were brought to bear for my relief. I was somewhat emaciated, pale, weak and anæmic, the result of my long suffering, with but little appetite and sleepless nights. My physician was giving me quinine and iron as a tonic, gelseminum and bromide of potass. for the nervous condition which I have related. The paroxysms were not of pain, but an uneasy, restless, fidgety feeling, which would attain to that of actual frenzy, seeming as though I should fly, being unable to keep quiet for a moment. The gelseminum I had taken influenced me but slightly, so far as its physiological action is concerned, and less so so far as my condition went. On one afternoon, as was usual, the paroxysm came on with greater force, and gave my wife so much alarm that she sent for the doctor at once, who hastily made his appearance, and at once gave me five drops of the fluid extract of gelseminum. So terrible were my feelings that I begged him to give me a dose of morphia also, that I might obtain relief at once, if possible. He objected to it, but my supplications were so strong he yielded, and gave me one-fourth grain, giving it about ten minutes after I had taken the gelseminum. The gelseminum affected me in twenty minutes, producing pretty thorough relaxation and diplopia, when I became comparatively easy and quiet. At this time the point of my tongue became paralyzed, and within ten minutes more my entire tongue, together with the muscles of my throat, became so paralyzed that I could neither swallow nor articulate audibly; and it soon extended to my face, and lastly to the orbicularis oris muscle. The paralysis was so complete that I had no use whatever of the muscles named, and I became much alarıned, fearing it might extend to the respiratory muscles, and that suffocation would ensue. The doctor himself was much alarmed, and sent for his battery and another physician. He gave me pretty strong doses of tinct. capsicum (or poured it into my mouth) which found its way down, and, in less than ten minutes after, the paralysis was entirely relieved, and I was exceedingly comfortable. The potass. and gelseminum I had been taking were so combined as to give me three grains of the potass. and five drops of gelseminum to each teaspoonful, of which I had taken a teaspoonful four or five times daily. Question.-Was it the combination of the drugs named that produced the paralysis, or was it the gelseminum? Have other practitioners ever experienced such a phenomenon from its use? If so, I would like to have them relate their experirnce. I will also state that I have taken gelseminum many times prior to this, when it relaxed much more thoroughly than at this time, but without any evidence whatever of paralysis, BY S. H. POTTER, M. D. (Continued from August number, page 227.) The undue multiplication of medical colleges, abbreviation of college terms, taking of students without proper qualifications to begin the study of medicine, holding of two graduating terms a year, requiring no graded course as other classes of colleges do, the evident inducements held out to students to quickly and cheaply enter into positions of honor (?) and great responsibility, and the almost general graduation of attendants, have inflicted a serious wound upon our profession, which is not likely to be speedily healed. "What chronic wound did ever heal, but by degrees? This evil seems to have been rapidly growing within a brief period. When I was a student of medicine,' from June, 1833, to September, 1837, the custom of the profession, if not the law, required me to study four years, and recite daily to my preceptor, and take his sworn certificate of my faithful and successful compliance. Armed with such a certificate, I presented myself at college, where six months regular attendance on all the lectures and demonstrations was required for admittance to examinations for graduation. My recollection is very vivid that I then felt that this course of four years and three months was quite too brief for the much I found to learn, even then; although I had to depend wholly on self-earned means through the entire course. For reliable statistics on the subject of medical education, we are indebted mainly to foreign medical journals, which are of a cosmopolite character, which embrace alike the interests of colleges, students, the profession and the people. Unfortunately, our medical journals are not broad enough in their scope to amply elucidate and protect all these important interests. This radical defect in our medical journalism should be remedied at an early day. In proportion to population, we have in the United States the same number of medical colleges as Canada: two to one in Great Britain; three to one in Germany, Belgium, Italy, Sweden and Norway; twelve to one in France, Brazil and Austria. Authentic statistics show that we annually graduate in medicine one new M. D. to every 15,000 of our inhabitants, and this is the ratio in Canada; one to 18,000 in Great Britain (a large number of these are educated for and go to distant service in "the Queen's broad dominions "); one to 48,000 in France; while only one of 68,000 people graduates for this purpose annually in Germany. Notwithstanding this data our United States are prolific of two doctors to one in Canada, and about three to one in England, etc., as before stated; showing that a large per cent of our would-be doctors are not graduates of any school at all, although the facilities for securing such honors (?) are so available, brief and cheap as well. It would seem that our average medical students give a wide berth to a higher and a more thorough medical education, and that competition does not improve the product in this respect. Harvard's classes shrink materially since the new plan has been there adopted of a three-years graded course, and nine-months college year of medical instruction; although she has attained to a venerable age, and has the commanding influence of a large number of cultured Alumni distributed throughout the Union, all especially interested in sustaining |