of local treatment must call for the respect and earnest attention of us all. A paper like this brings up points for deep thought; points which cannot be hastily set aside or settled by any man's dictum. Even though somewhat at variance with Hahnemann's teachings, it would be difficult to say that Hahneman was right and Dr. Westover wrong, or vice versa. A few of these features I will attempt to point out.

It is an accepted fact that since the microscopists have done such wonders in the diagnostic field of disease, many of the positions of Hahnemann have been modified by facts attained thereby. Hahnemann should not be blamed for not knowing certain things which scientific progress has made plain to us neither should any physician be considered unhomoeopathic for forming ideas on scientific bases which apparently differ from those held by Hahnemann on questions which have been changed by this same scientific progress. This is the position in which the author is placed.

Hahnemann claimed that all diseases were the result of a disturbed vital force. All our scientific progress has not brought out a fact which positively proves the falsity of this proposition. The germtheory of disease, which has attempted to establish the fact that all diseases are of parasitic orgin, has not been able to overthrow Hahnemann's position in the slightest, for all germ theorists admit that there must be a certain peculiar susceptibility on the part of the patient or the germ is inoccuous. This susceptibility, this predisposition, this state of receptivity, is the disturbed vital force of Hahne

mann.

Dr. Westover accepts the correctness of Hahnemann's position, excepting in that he believes a person in perfect health may at the same time have a parasitic skin disease. And his position is a strong one from such ideas as we can gather from what our patients tell us. But at the same time it would be difficult to conceive how a patient with a skin disease could be considered in perfect health. We have all seen notable instances where patients who had chronic adenitis, bronchitis, epilepsy, hæmorrhoids or chronic varicose ulcers, from every other standpoint seemed in perfect health. But none of these patients would pass the inspection of an army surgeon, examining subjects for the recruiting service, as being in perfect health. So it would be with the various forms of skin affections detailed in this paper. It is a fact beyond dispute that Hahnemann did not classify his skin diseases with the fine distinctions of to-day. Therefore all his ideas of the evils of suppressing a skin disease should not be blindly accepted. Also his theory that the suppression of the itch, which might to-day mean various diseases, was the cause of almost every variety of after-affections, must be subjected to careful thought and discrimination. In what does suppression consist? We take it that Hahnemann considered suppression a form of treatment which

But

killed the insect instead of restoring the disturbed vital force. was the evil after-effect due to simply killing the insect, or was it due to either the absorption of the drug used, or to the absorption of what we to-day call the ptomaines in the track of the parasite ? For illustration; suppose in a given case of scabies there are a dozen acari at work. Each one of these is deftly removed with delicate forceps in such a way as to neither harm the surrounding tissues nor introduce into the patient's system any other form of infection. What would be the result? Would this be suppression according to Hahnemann, and if some chronic disease followed to what would it be due? If not suppression, then suppose we change the form of treatment and touch each acari with some chemical, which, according to all known conceptions, is not inimical to health, instead of picking it out with forceps. Would this be suppression? If so, and chronic diseases followed in the track, would they not be due to the absorption of the drug only? Thus it would seem we have yet to settle the question whether the evil results of Hahnemann's so-called suppression arose from absorption of ptomaines or of the drugs used. The principal point in this paper open to Homœopathic controversy is whether it is so much easier and better to cure these cases with local applications than it is to cure them according to the strict method of Hahnemann. Too many cases are on record where these same skin diseases have been promptly cured by the Hahnemann Homœopath when they had resisted every known remedy in the way of local application. This is especially true of ringworm and barber's itch-two varieties of a similar parasitic invasion. But, as Dr. Westover says, the difficulties attending the selection of the curative Homoeopathic remedy and potency is so great at times as to prove discouraging. But it is nevertheless a fact that under the action of the similimum the host rises superior to the tenant, and the interloper has to get out. By what process, other than a complete restoration of the vital forces, it would be difficult to conceive.

To the rational physician it would seem that Dr. Westover's careful instructions should go hand-in-hand with our best Homoeopathic prescribing. Where one has done the best he can in the choice of the similimum and still not met the case, it would be both sensible and justifiable to resort to such other methods as would relieve the patient of his troublesome tenant.

C. B. KINYON, M.D.: I think that this is too good a paper to let go by without discussion. I certainly have no criticisms to make. Dr. Westover substantially stated the case, as I look at it, when he made the statement that we might as well claim that scarlet fever, diphtheria and typhoid fever are due to an impoverished condition of the system as to claim that skin diseases are so produced. The doctor certainly stated the truth, and as regards the treatment he also substantially stated the truth when he said it would be as rea

sonable for us to expect to cure the disease without removing or treating the cause in any of these other conditions mentioned, as in the case of skin diseases. One remedy that the doctor mentioned I wish to speak of in recommendation also, and that is the oil of cade. I have used it in different strengths, sometimes as strong as one part to two of olive oil, and it works admirably, and I have sometimes thought it was actually a parasiticide, if we might so term it. German green soap is admirable in eczema. My experience with peroxide of hydrogen in diphtheria leads me to speak of another remedy in connection with it, and that is the juice of the pineapple. This does not apply to Dr. Westover's paper, but it has served me so admirably that I wish to drop a suggestion in regard to it. It is perfectly harmless, and the children know beforehand that it is not going to hurt them, and they will take a pineapple with very good results, when they will not take anything else.

T. G. COMSTOCK, M.D.: Regarding Dr. Kinyon's mention of pineapple, I wish to add that I have for three years past often prescribed pineapple juice in diphtheria. I let the patient gargle with it, or swallow it, ad libitum. This is a therapeutic resort well worth remembering. Children as well as adults like it, and it does not interfere with any indicated Homoeopathic remedy. Without doubt it seems to exert some favorable action in this infectious disease. The paper under discussion is scientific, a well written essay, and the result of the practical experience of the writer. The important question is one that the Bureau of Clinical Medicine should decide, First, how can we best cure eczema? Second, can we cure those chronic skin diseases by internal treatment alone? Third, are we not necessitated sometimes to resort to local applications, and when they apparently do good to the local manifestation of the affection, are they followed by any bad after-consequences? These are important questions, and they can be replied to, not theoretically, but only by the results of actual experiments, and practical experience at the sick bed. I mean, of course, clinical experience. I have had a pretty large experience in the treatment of cutaneous diseases, and I confess that I have not been able to cure them by internal treatment alone, but I have treated them very much after the same fashion that Dr. Westover has so well described. I will here mention

case where a patient came to me for advice regarding an eczema upon his right index finger. It may, perhaps, be interesting to state that the patient was an Homoeopathic physician of large experience and of prominence, known as a strict Hahnemannian. He told me that this eczema had troubled him for a year and a half, and, moreover, his patients often asked him, "what was the matter," and expressed surprise that a "physician did not cure himself," and as he had a first-class practice, or in other words, a "stylish clientele," he now wished to resort to any remedy that would cure him.

I told him that quite recently I had treated a similar case, and had applied the following locally: R. Chrysarobin, one drachm; Salicylic acid, one drachm; Ether, one and a half drachms: Flexible collodion, seven drachms. Mix. Apply this with a camel's hair brush once daily. The only thing unpleasant about this is that the chrysarobin colors the skin. To cover up this, apply a small piece of isinglass plaster.

This physician's finger was cured in one month by the above application, and he has told me since that not the least unpleasant consequences have resulted. Whether it is possible to cure all skin diseases, by internal treatment alone and without the use of local applications, I shall not decide; with my own large experience, I have not been able to cure scabies or the itch, without local treatment. Recently I was called to the family of a minister, where his wife and three children had an eruptive disease. They had been treated by a physician of high standing, who had given them only internal treatment (it was strictly Hahnemannian) for some months but without success. Upon a careful examination I found they all had the good old-fashioned psora, that is the itch. I treated the three cases with storax balsam (liquid storax), one ounce, to vaseline, With this ointment I had them rubbed once daily, and they were effectually cured in a short time. Now I want to say here, that I have been familiar with this treatment for years, and I have never seen the least harm to follow it. Storax balsam is harmless, but it kills the living insect that constantly irritates the patient.

two ounces.

SCARLET FEVER.

BY W. H. HANCHETT, M.D., OMAHA, NEB.

IT is a kind provision of nature that the tendency of all acute disease is toward recovery. But while Nature usually is benign, and assists in recovery, she sometimes seemingly assumes a malevolent spirit, and the disease, which in most instances seems to be only a mild disturbance in the system, assumes a malignant form, without an apparent cause-the zephyr becomes a tornado.

Among the long list of diseases peculiar to childhood, scarlet fever is one which often varies from its mild form and tendency to recovery, assuming a malignant character, and seems to come in epidemic form, certain periods being marked by the virulence of the disease.

Perhaps in all the long catalogue of ills to which children are exposed, this disease is most to be dreaded, and if, in running the gauntlet of diseases, the child may escape scarlet fever, both parent and child are to be congratulated. Asylums are everywhere filled with its dire results. No doubt, if accurate statistics could be obtained, we would be surprised at the large percentage of children who are left deaf, blind and dumb as a sequel of this fever. The sequelæ are so numerous, long-lasting, deep-seated, and attended with so grave consequence, that we do all in our power to prevent the disease which may blight a whole life, if not cause an untimely death; for it is a well-known fact that although the case may seemingly run a mild course, there are many dire results in the sequelæ that appear. No wonder, then, that we view scarlet fever with apprehension. However, it is fortunate, as above stated, that the acute disease of scarlet fever usually runs a quick and quiet course. It is not highly contagious when compared with measles and other epidemic diseases peculiar to youth; in truth, we often see one member of a family attacked and others escape. If reasonable precaution is taken, and the affected child is isolated, there is slight