tion of all the mucous membranes of the air-passages, nares, pharynx and larynx; it also excites on the mucous membranes a vesicular exudation of an acrid, excoriating nature.

"Few diseases require more prompt and vigorous treatment than diphtheria, in its more severe forms. If Hahnemann were alive to prescribe for it, he would be as likely to advise the lowest dilutions, in substantial doses, frequently repeated, as when he advised the strongest solution of camphor in cholera.

Muriatic Acid, next to Iodine, of importance, according to Dr. Kidd. Arsenic indicated in the last stage. Mercury. Ammon. Causticum.

"Muriatic Acid comes next to Iodine in the closeness of its pathogenesis to the symptoms of diphtheria, but it wants the peculiar, sudden, constitutional depression, and sudden irritation of the glandular system, which Iodine presents. The most decided action of Muriatic Acid is on the mucous membrane of the throat, which it causes to swell and become painful. It also produces a suffocating tightness of the chest with cough, but it does not excite coryza and profuse mucous exudation, as Iodine. In the last stage of the disease, Arsenicum is indicated, more especially when the swelling of the neck and throat is oedematous, as it often is; also when the odor is putrid, more from the throat and air-passages, not so much from putrid salivation. When this latter clearly exists, Mercury is the most closely indicated, but the practitioner must carefully distinguish this from the putrid exhalation of the air-passages from typhoid exhaustion, where Arsenicum is priceless and Mercurius worthless, worse than that, positively injurious. Ammon. causticum deserves most careful trial in the latter stages of diphtheria, from the singular homopathicity of its provings to the disorganization of blood in the latter stages of the disease.

Nitrate of Silver in the Pharyngeal Variety as a Gargle.

"When diphtheria is altogether confined to the pharyngeal mucous membrane, it seems to me that gargling with a solution of Nitrate of Silver is called for most urgently, and called for also, strictly in accordance with the law of "similia similibus curantur," in its practical application.

"The appearance of the throat, in many cases of diphtheria, is singularly like that of a healthy throat after the application of a strong solution of Nitrate of Silver. Where diphtheria extends to the larynx, gargles seem quite uncalled for, and superseded by inhalation of the specific medicine, be it Iodine or Muriatic Acid.”1

Stimulating Diet an absolute necessity. In Children, Nutritive Injections are best.

(Dr. Kidd prescribes in all cases of diphtheria a stimulating diet,―e. g., port wine, claret, champagne, he considers but as stimulants. Occasionally, stout or pale ale, eggs beaten up with brandy, hot water and sugar; strong beef-tea mixed with port wine, according to the constitutional idiosyncrasies, are administered. I can, from my own experience, speak in the highest terms of the superior advantages of a stimulating diet; in fact no very severe case can get well without it. In the cases of children, who positively refuse to swallow, nutritive injections should be had recourse to from the outset. To use them effectually, they should be thrown above the sphincter, and only about one ounce at a time. The best injections are the yolk of an egg beaten up with a tablespoonful of new milk, and two tablespoonfuls of essence of rennet, or ounce of extract of beef, with a scruple of Boudautt's pepsine.)

1 Why Iodine and Muriatic Acid should be more specific in a blood disease pervading the whole body, when attacking the larynx than when only affecting the pharynx, it is not easy to perceive.

Bromine. Unsuccessful Treatment.

"A case of diphtheritic croup, in a child aged twelve months, was unsuccessfully treated with pure Bromine, internally administered, as well as by inhalation. The symptoms were, for four days gradually increasing hoarseness of voice, constant efforts to vomit, general prostration and tight suffocative cough. The structures behind the uvula formed one dense pultaceous mass of yellowish-white exudation, completely blocking up the top of the pharynx. Before the Bromine, the 1st decimal trituration of Tartar Emetic was given so as to increase the vomiting." (I have been consulted in four or five cases of diphtheritic croup where Bromine was freely administered, in large and small doses, without any effect. They all died. In one or two of my own cases, it was also administered without benefit. It would seem that Bromine has not much effect in diphtheritic croup, nor in diphtheria generally.)

Nitric Acid. Successful Treatment.

Dr. Kidd mentions several cases of superficial diphtheria as having been successfully treated with Nitric Acid.

Dr. Smith. Ammon. Causticum. Successful Treatment.

Dr. Smith, of Oldham, (British Journ. of Hom., vol. xviii., p. 160) treated, very successfully, several severe cases of diphtheria with Ammon. caustic. 1, after Iodide of Mercury, Chlorate of Potash, and Nitric Acid, had been fruitlessly exhibited. In the North American Journal, in "Elements of a New Materia Medica," the following post-mortem appearances, from the effects of Ammon. causticum, were given: "The nostrils were blocked up with an albuminous false membrane; the whole mucous coat of the larynx, trachea, bronchi, and even some of the bronchial ramifications, were mottled with patches of lymph. Hence it seems to produce a true croupous inflammation. The gullet and stomach showed red streaks here and

there, and there was a black eschar on the tongue, and another on the lower lip."

Of its general effects on the system we know very little. Cantharides, Bryonia, Iodine, Hepar sulph., etc., also produce false membranes, and still are not so similar in all their manifestations as e. g. Lachesis, Crotalus, Kali bichrom., and particularly Chloride of Lime.

Since writing the above we have met with Dr. Bayes' practical remarks on the use of Carbolic Acid and Phytolacca decandra in diphtheria. He comes to the following conclusion: "That Carbolic Acid lotion is the best means for removing false membranes from those parts which can be reached by it. That Phytolacca decand. gargle possesses the same power, but I have not yet treated a sufficient number of cases to be able to give an opinion on their comparative power. Phytolacca is pleasant, and every patient who used it said it soothed. the throat, and was comforting to it, while all disliked Carbolic Acid. I think that Phytolacca will prove a most useful addition to our remedies for diphtheria, and hope that my own small experience of its value will induce others to test its powers."

SECTION II.-FRENCH PHYSICIANS.

Discussions of the Société Médicale Homœopathique de France.

Dr. Curie on Bryonia.-The French Homoeopathic physicians, as appears from the discussions of the "Société Médicale Homœopathique de France," held January 16th, 1860, have employed only to a very limited extent the mercurial preparations, and the Iodide of Mercury not at all. They relied chiefly upon Lachesis, Bellad., Bromine, Iodine, Hepar sul., etc.

Dr. Cretin. Unsuccessful Treatment by Belladonna, Lachesis, Hepar Sulphuris, etc.

Dr. Cretin (in the Bulletin de la Société Médicale Homœopathique de France, vol. i.) publishes some severe cases

which proved fatal. They were treated with Bellad., Lachesis, Hepar sul., Nux vom., China, Arsenic., and Corrosive Sublimate, Dr. Cretin ascribed death in all these cases to the same cause, viz., to a poison infecting the general system, and not to the local disorder. He protested, from sad experience, against cauterization, and quoted Mr. Marshal to the same effect. He recommended Homœopathic treatment exclusively.

Dr. Curie claims for Bryonia the merit of being a Specific for Diphtheria, "par excellence."

Dr. Curie was disposed, if there must be a "specific" admitted for diphtheritic affections, to claim the merit for Bryonia, having only lost one case out of twenty-five, in the winters of 1857-58 and 1858-59. For the dose, he gave a child six years old, six drops of the mother tincture, in eau sucrée, during twenty-four hours, in fractional doses every hour, averring that throughout the treatment generally the malady is arrested in twelve hours, i. e., false membranes cease to form, respiration is freer, and the mucous surfaces less dry. Thenceforward, all that is not yet organized gradually separates, and generally in forty-eight hours, at the latest, the false membranes, which have any consistence, begin to detach themselves, and this goes on perhaps for a fortnight, whilst others disappear completely in from forty-eight to seventy-two hours. He objected to tracheotomy, except where death from suffocation is imminent. In the absence of M. Teste, he acknowledged our obligations to him for having, some years ago, made known the value of Bryonia alternated with Ipecac., though he (Dr. Curie) gave all the credit to Bryonia.

M. Cretin succeeds with Bryonia. M. Raymond finds Belladonna efficacious. M. Molin protests against Generalization.

Dr. Curie claims on behalf of Bryonia "a real specific power over diphtheritic affections in general, on the ground of its pathogenetic property of forming false membranes, which the other medicines do not, (though he had something