the negative pole up and down the spine, and the positive over the epigastrium. She seemed to get great relief by this treatment, and improved steadily for about three months longer, when she began to go out, using the crutches first, but gradually commenced to dispense with them until she was able to walk without them.

Kali phosphoricum and Kali muriaticum, at different intervals, helped the case greatly.

Six months from the time I commenced to treat her, she seemed perfectly well, and was able to go about as she had not done for four years. A pessary had to be worn constantly to keep the uterus in position. Every time it was taken out there was an increase of all of her symptoms, but as soon as it was replaced, the symptoms would

pass away.

This case is of exceedingly great interest, because it shows the wondrous effects of reflex action upon the system at large. The moment the reflexed uterus was replaced the symptoms passed away, and remained away as long as the uterus was kept in the proper position.

As stated before, the reflex symptoms were due, first, to the irritation of the nerves supplying the uterus; second to the irritation of the sexual centres within the spinal cord; and third, to the irritation of the nerves from the spinal cord to the head and limbs and various organs of the body.

As the result of this reflex action, the system became depleted on account of the inability of the organs to properly perform their functions, which prevented the assimilation of food, and thus deprived the patient of proper nourishment, which resulted in a true neurasthenia.

The second case was a young lady, 19 years of age, who had many of the same symptoms which the first patient had, but they were caused principally by shock produced by the violent death of her father, who was thrown from his buggy and so severely injured that he died within a few hours. There were no hysterical manifestations at any time in the case; simply, a giving out of all of the vital forces.

After a few months' illness, I discovered that there was great enlargement of the uterus, due evidently to menstrual subinvolution.

As the patient would not tolerate local interference, I attempted to treat the case wholly by Homoeopathic remedies; but, after two

years of such treatment, during which time the patient was confined wholly to her bed, often suffering intense agony, I concluded that something else must be done. I determined to use electricity to reduce the enlargement of the uterus. I passed an intra-uterine electrode, connected with the negative pole of the battery, within the uterus, and the positive over the abdomen. She was able to stand from thirty to fifty milliampères for ten or fifteen minutes at a treatment, without any serious inconvenience.

At the end of six months of this kind of treatment, aided by my Homœopathic remedies, I found that there was some decrease in the size of the uterus. I then discontinued the electrical treatment for about six months, at the end of which time I recommenced it and continued constantly for another six months, when I was able to introduce a pessary, and then my patient could sit up a little and after awhile began to walk some. Improvement continued more or less rapidly until she finally recovered, and to-day, four years after her recovery, she seems perfectly well.

I have not detailed all the symptoms in the last case, because they were so similar to those of the first case. Both cases were undoubtedly cases of true neurasthenia produced by shock and uterine displacements.

Whenever these cases of neurasthenia are encountered the first thing the physician has to do is to find the cause of the trouble.

To do that he will have to interrogate every organ of the body, and he will usually somewhere find the cause. If it be an external One, as it usually is in the case of males, it, too, should be removed, if possible, before anything can be done. When the nervous exaustion is due to overwork rest is the all-important remedy.

Change of scene and complete giving up of business should be inSisted upon. The individual symptoms which I have enumerated En this article cannot be treated singly, but the whole must be treated at once. Any remedies which tend to tone up the whole system will relieve the individual symptoms.

Kali phosphoricum, China, Phosphoric acid, Anacardium, Argentum nitricum, Phosphorus, Strychnia and Belladonna will be the Homœopathic remedies most generally indicated.

The condition is purely a functional one, and the moment we determine that fact that moment may we feel assured, no matter how serious the condition, that under the proper treatment our patients

will recover.

It is of the utmost importance that the physician should thoroughly understand his case and that he must instil this fact into the patient's mind, thus giving him confidence in his physician's skill and understanding of the case.

There will be many ups and downs which will be greatly discour aging to both the physician and patient; but patience, on the part of the physician particularly, is an all-important factor and should not for a moment be lost.

A CASE OF RHUS POISONING AND A REMEDY.

BY J. W. DowLING, M.D., NEW YORK, N. Y.

THE case of Rhus poisoning I am about to describe was under my observation from beginning to end and came about in the following manner. The patient, a middle-aged man suffering from Bright's disease, but not seriously incapacitated for business, consulted me with regard to an inflammation of one of his toes, which had resulted from a slight scratch with the blade of a knife. Several days after this trivial injury I found a small abscess at the root of the nail, which was opened, and after being cleansed was packed with a small piece of gauze and carefully dressed. For a day or two it seemed to improve, but suddenly, after the patient had attempted to attend to his usual business duties, with a considerable amount of walking as an accompaniment, the inflammation began to spread, and in forty-eight hours involved the adjoining toes and spread to the sole and instep. There was considerable oozing of serum with formation of bullæ and maceration of the epidermis, with great and constant pain. It so happened that the appearance of the skin, the character of the pains and the general constitutional symptoms seemed to indicate Rhus toxicodendron as a remedy. It was, therefore, prescribed, 3 drops of the tincture in two-thirds of a glass of water, teaspoonful every two hours. I gave the drug thus low with considerable confidence, having in ten years seen most of my best results with Rhus after its administration in this manner without a single case of aggravation of symptoms.

The following day word came from the patient that the foot was very much worse, and on calling I so found it. The whole foot was swollen greatly; it was intensely hot; the skin of the toes and instep was elevated into huge blisters, some of which were discharging a thin ichorous fluid, and the patient complained greatly of drawing and tearing pains, which made sleep impossible and often caused him to cry out in agony. Discontinuing the Rhus and ordering cooling applications with some appropriate remedy I awaited developments. The next day the foot was worse. It had taken on a pale bluish

color, and the fluid in the blisters had become sanguineous. There had appeared in addition a vesicular eruption, which rapidly spread over the whole body, with the most agonizing and constant itching. This made the condition clear and relieved the fear of a possibly gangrenous foot, which had begun to cause me uneasiness. The object now was to relieve the terrible itching and the terrific pains in the foot. For several days internal remedies and external applications with and without cocaine and laudanum were of no avail. The foot was looking better, but the pain continued, and, above all, the itching. Itching everywhere and all the time; the patient could get no sleep because of the uncontrollable desire to scratch.

At this time, quite by accident, I obtained a remedy, the effects of which were so magical that I was prompted to give them for the benefit of other sufferers. In conversation with a student while. speaking of ivy poisoning, he described how in the country when the boys developed the poison ivy eruption, as was often the case, it was their custom to gather the so-called "Blood Root," Sanguinaria Canadensis, and rub it on the affected parts with the result of invariably relieving the itching and burning.

Entirely skeptical as to its efficacy in my case, but willing to try it in response to the patient's demands for something, anything, to stop the itching, I took some of the tincture and painted the foot and other regions where there was the most distress. On calling the next day, I was greeted with the remark, "Well, doctor, you have hit it this time," and was informed that the application had indeed acted like magic. It had relieved the itching and burning for hours, and several applications had made possible a restful night.

I ordered its continuance and as long as the eruption remained, some two weeks or more, the itching could invariably be controlled by the application of the Sanguinaria. Not once after its first use, was the itching so severe as during the three days previons.

The provings of this drug show little in connection with the skin. Allen's Handbook gives us "Ulcers around the nails and renewed itching of old eruptions."

Whether, exhibited internally, it would prove as efficacious, remains to be seen.

I shall certainly prescribe it in the next case of ivy poisoning I see, and failing improvement, shall paint it on freely, feeling confident that it will give relief.