cerebral vaso-motor supply-centers, the vessels become turgesced; the sequela is congestion; later, coma. If the establishing of the excretion from the kidneys is brought about early, the vicarious expenditure is arrested before over-stimulation or low vaso-motor paralysis is induced and death is averted. It may generally be noted that any vicarious expenditure of nerve-force is locally destructive, and is followed by general shock to the nerve-centers.

Vicarious menstruation affords most common examples of this unnatural or perverted expenditure. This is most commonly recognized when it is manifested by a metastatic flux. But such is not the only manner of manifestation of this vicarious expenditure. Hysteria, epilepsy, temporary paralysis or paresis (hysterical paralysis), anæsthesias, hyperesthesias, aphonia, cerebral lesions of function too numerous to mention, diarrhæa, diuresis, pustules upon the face and body, exanthemata; all have appeared as manifestations depending on perverted expenditure of nerve-force during amenorrhoea.

The vegetative centers preside over ovulation, and any shock capable of depressing or temporarily suspending their functionary powers; or any improvement of conductivity of the conductors of the ovarian and uterine nerve-supply, will, as a natural consequence, avert the innate currents to the most accessible conductors.

Then, the failure of any female to flow her usual amount, at her regular time, may come to appear a vicarious expenditure of nerve-force, in any locality, organ or tissue.

The citation of a few reported cases may prove instructive, with a few from my own observation :

A case reported by Dunlap, in 1850: His patient bled from her gums six quarts of blood monthly, at the time when her menstrual nisus should have appeared. Treatment, by cup. ping, which was resorted to, for pain in her side undoubtedly caused her death, by establishing uncontrollable hemorrhage from the scarifications.

Mrs. H., under my observation, two years since, had a large tumor of her right mammary gland, which I removed by escharotics. Her menses ceased during the operation and healing,

but before the healing had become complete an exudative discharge of uncoagulable blood appeared not very profuse but lasted four days. I suspected a vicarious monthly flux and simply ignored the occurrence. The next month, the ulcer had granulated and was nearly covered with integument, but the exudition began, though, was scanty; the second day, she had a frothy hemorrhage from the lungs, which she spat up in considerable quantity; it did not coagulate. She menstruated from the lungs at regular monthly intervals, for three times, when her natural menstrual nisus appeared and she has since remained well.

Miss R., while suffering from scanty menstrua, had hemorrhage from the bladder periodically, beginning from four to six days previous to her molimen. She passed blood only while micturating and with urine, non-coagulable, and in considerable quantity, when, by remedial measures, she improved in general health, her inenstrua became abundant, the hemorrhage from the bladder ceased.

Cases closely allied to the above might be enumerated at great length, but the above show the common phenomena quite sufficiently. The fact that plethora is absent in the majority of these cases is ground for the rejection of such a condition

as a cause.

This class of patients is sometimes chlorotic, generally feeble and anæmic, yet such conditions are not essential to the perverted expenditure of nerve-force, as sometimes robust and ordinarily strong physical developments suffer from congestions and shocks produced from such causes, but seldom hemorrhages.

The description given in our common text-books of vicarious fluxes is so meager that little if anything can be had by their perusal.

SELECTED.

Staphisagria.

The palmated larkspur has not been used to the extent that its real value demands. It is a prompt remedy in frontal

nervous headache, also neuralgia of the face and front head. In irritability of the bladder, it may be used with prompt effect. In cases of sexual excitement, with nocturnal emissions, staphisagria is one of our most trustworthy remedies. In spermatorrhoea from sexual abuses, alternated with phosphorus it will often give very prompt relief. In impotency from overtaxing the sexual powers, this is a very valuable remedy, and may be alternated with damiana. Dose, 5 to 8 drops.-Medical Brief.

Remedy in Whooping-Cough.

Ꭱ Ammonii picratis....

Ammonii muriatis....
Pulv. extr. glycyrrh........
Aquæ

.....0.06 (gr. 1).
..1.25 (gr. 20).

....3.75 (3 i).

..q. s. ad 90 (3 f. 3).

Dose. For a child up to six months, 1 teaspoonful every hour4gr. ammonium picrate; from 1 to 2 years: 2 teaspoonfuls every hour gr.; from 2 to 5 years: 3 teaspoonfuls every hour = } gr.

=

This mixture was devised by Dr. Dellenbaugh, and the reports of its efficacy have been very favorable. The attacks diminish in severity already after two or three doses, and after a few days the malady had been reduced to symptoms of a simple laryngo-bronchal catarrh.-Translation in New Remedies.

Ethylate of Sodium.

Dr. Purdon, of Belfast, finds ethylate of sodium quite specific as remedy for nævus, a case in which he employed it having been cured after four applications. He has also removed by its aid a small patch of epithelial cancer of the lower lip; and three cases of lupus, and one of warty growth affecting the back of the hand were reported to be progressing favorably. The effects as noted in the case of nævus were, 1, removal or absorption of water from the tissus into the ethylate; 2, destructive action as a caustie from the caustic soda

which is formed; 3, coagulation from the alcohol that is produced; 4, prevention of decomposition of the dead organic ubstances.-Cincinnati Lancet and Clinic.

Lactopeptine.

From a private letter from Dr. M. G. Salley, of South Carolina, we extract the following: "I have occasion to test the remedial effects of Lactopeptine almost daily. I find large doses of subnitrate of bismuth, combined with lactopeptine, the best and surest remedy in the summer diarrhoeas of children. They are safe remedies, and may be used in conjunction with many others, but I prefer to use them alone or, occasionally, with opium."-Maryland Medical Journal.

The Cure of Hydrocele.

The contents of the sac are first to be evacuated in the usual way, after which the scrotum should be placed on any hard smooth surface, such as the corner of the table, and the opposite surfaces of the tunica vaginalis rubbed together until a sufficient amount of inflammation is caused to stimulate absorption adequately in that membrane. By judiciously varying the amount of force with which the friction is applied, and the time it is continued, any desirable degree of irritation can be produced in the diseased membrane, from the slightest tenderness to its total disorganization, and that by a few minutes' work. No amount of experience will enable the surgeon to predict just how much irritation should be caused to effect a cure in any given case. In this, as in the treatment by injection, a very slight inflammation of the tunica vaginalis will sometimes effect a cure. In other cases, a much greater degree of consecutive irritation fails. The patient should be closely observed, and, if any fluid is detected accumulating in the sac, it is a signal that more vigorous friction should be at once applied. The advantages accruing to the sufferer from the mode here advocated over any other with which I am acquainted, are worthy of a moment's notice.

The pain is trifling, being confined almost exclusively to that occasioned by piercing the scrotum with the trocar. Treatment can be successfully carried out while patients are attending to their usual employments.

When an emptied hydrocle has been injected with iodine, the fluid rapidly re-accumulates, and several weeks are required even in favorable cases, before it is absorbed and the cure completed. Under the mode here advocated, the fluid recurs only to a very limited extent, if at all. The results of the treatment, whatever they may be, are therefore, promptly apparent.

The encysted variety of hydrocele is made up either of one large cyst, or more frequently of a number of small cysts, filled with clear fluid, developed under the tunica vaginalis, and pushing that membrane before it as the cysts increase in size. When the scrotal tumor is multilocular, it is obviously impossible to evacuate it completely by tapping, and successful treatment by stimulating injections is equally difficult. The method commonly adopted in such cases, is to lay open the tumor and cause it to granulate from the bottom. The cure by friction is specially applicable to this variety of hydrocele, because, by this means, all the cysts can be ruptured at once, and their contents extravasated into the contiguous tissues, from which its absorption readily occurs, resulting in a cure complete, painless and safe.-David Wark, M. D., in The Medical Tribune.

I

Rhus Glabrum.

BY. H. C. BARNARD, M. D.

propose, with your permission, to give my experience in the new uses to which I have put this old remedy-new, at least so far as my information extends. I will only mention some of the various diseases in which I have successfully employed it, before I report the cases that more immediately are the cause of this communication. I am constantly in the habit of using it in leucorrhoea, gonorrhoea, infantile diarrhoea, nasal catarrh, etc., while I know of no remedy superior to it in colliquative sweats, or a cold inactive skin, with or without rigors.