other times the trachea is so involved as to conduct the poison into the small bronchia. The meatus auditorius estarnus, the anus, the vulva and prepuce have been known to be affected; in short, the broken skin or abrasion thereof may manifest the presence of diphtheria. Some one or more of these may be involved, and not affect the fauces, or any one of these are liable to be involved during the progress of the disease. Diphtheric formations or growths must be discriminated from follicular secretion, which is quite common on the tonsils. This is a non membranous pultaceous accumulation, and is not removable in strips, or patches, as true diphtheria. This is pharyngitis, but often incorrectly called diphtheria, and during the prevalence of epidemic diphtheria laryngitis often prevails, and is incorrectly called diphtheria.

The symptomology of diphtheria is briefly as follows: A marked diversity relates to the development of the disease. Sometimes it is marked by acuteness, commences with a chill or rigor, which is soon succeeded by a high fever; at other times it is gradual and insidious, made up with undefined ailments, and the disease is only known by careful inspection, and even then the characteristic evidences may be few and indistinct. The fauces are sore, accompanied with notable pain. The sensibility of some of the parts may seem somewhat diminished; swallowing is sometimes painful, at other times unattended with pain; again partial paralysis of the tonsils and the parts concerned in deglutition prevails; the extension of the pseudo membrane, more or less over the buccal surfaces, may cause pain and ptyalism, and regurgitation through the nose of substances swallowed; the breath is often notably fetid; the pulse in some cases becomes very much accelerated, in others moderate and even slight, falling below the average in health, indicating diminished cardiac force; epistasis, bleeding from the mouth and throat are not infrequent symptoms. The disease has no characteristic eruption other than rose spots and erythema, which may be considered accidental. Albuminuria is not an infrequent symptom; at times it is quite abundant, particularly where the exudation is large and the oedema of the glands of the neck great; fibrinous casts are not often found in the urine; blood has been found as an accompaniment; the urine contains a greater quantity of urea than in a state of health, showing a destruction and corre

sponding waste of tissue. From the facts set forth in this paper, I conclude, with others, that diphtheria is a constitutional disease.

After a careful investigation of the causes of diphtheria (I have, in this, taken account of the great diversity and frequently totally opposite conditions and circumstances under which this disease has prevailed), my humble opinion is, the cause does not lie in the accidents of heat, cold; dry, warm weather; elevations or valleys, nor in sanitary conditions. The hypothesis that I suggest I trust will, at least, possess the merit of calling attention, in a somewhat new direction, for a cause of this affection-I mean in the meteorological field. I do not, in this hypothesis, predicate anything on what are called specific poisons, as entities or independent bodies, nor to infusoria, but upon the property which one body may possess, when brought in proximity or contact with another, of exciting the atoms of the latter to a readjustment of their relations. In such phenomena the exciting body suffers no change in its own particles or composition, but, by an inherent force or attraction, has caused the combining elements of a more complex body to break up their affinities, and, by new attractions among themselves, seek readjustment and then form new bodies; and these new bodies, possessing toxical properties, contaminate the blood and cause the phenomena of diphtheria. This phenomena to which I refer-sometimes called catalysis-may be witnessed in compounds, the elements of which are held together only by a feeble affinity; that change in temperature, electricity, or even simple mechanical friction or motion, will cause in them a breaking up and readjustment of combining elements. Thus, chloride of nitrogen explodes by contact with many bodies which combine neither with chlorine nor nitrogen at common temperatures. The contact with any solid substance is sufficient to cause the explosion of the iodide of nitrogen. My theory supposes that some meteorological force or element, by a catalytic influence, produces chemical change in structure of cells, and these act the part of the virus, causing decomposition and destruction of tissue. Animal tissue, like all highly organized bodies, is exceedingly complex in structure, and is very sensible to any impression or influence, and the blood-the fluid body-wonderfully so, so that the slightest force or agency may disannul normal affinities, and set up abnormal ones instead in that body.

Therapeutic agencies that are usually serviceable in the treatment of diphtheria, are such as might be inferred upon theoretic grounds, when we take into account and recognize the constitutional lesions and local manifestations of the disease, to wit: antiseptic and stimulant. My experience in the treatment of this affection may not have been as extensive as some others, yet it has been considerable, and has been uniformly successful. Among the antiseptics of value in the treatment of this disease, are carbolic acid, chlorate of potassa, nitrate of silver, muriate of ammonia, tincture iron chloride, acetic acid, permanganate of potassa, sulphur, alum, compound solution of iodine. For topical treatment I sometimes use Monsell's solution, tincture of iodine or nitrate of silver, as may be indicated from the local manifestations of the disease. The following can often be employed to advantage: Tincture of aconite, aconite ointment, baptisia, fluid hydrastis, tincture yeratrum veridi, compound syrup of squills, syrup of ipecacuanha. As for stimulant treatment, I rely on sulphate of quinia or carbonate of ammonia; sometimes I have found a poultice of hops and corn meal of great service. The following I have found quite reliable in average cases of diphtheria :

Misce. Sig Gargle the throat well every thirty minutes, and, in conjunction, give muriatic tincture of iron, fifteen drops in one tablespoonful of water, every four hours, and sulphate of quinia three grs. every two hours.

Of course, these directions are only general; each individual case has marked peculiarities, frequently necessitating a variation in treatment, and these peculiarities must be carefully studied, if we wish to be successful.

Session of 1880-81, of the Eclectic Medical College of New York, will commence October 1, 1880, and continue five months. The next number of this Journal will contain the catalogue in full. Very few changes in the organization have been made from last year. For advertisements in full, see another page. The prospects for a very large class are good, and it is hoped the friends of the school will interest themselves in its behalf.

SEXUAL ABUSES AND DISEASES ARISING

THEREFROM.

BY I. J. M. GOSS, A. M., M. D., Marietta, Ga.

The diseases arising from sexual abuses or excess are numerous and very destructive to mind and body. Not only is there a physiological sympathy and connection between the generative organs and the physical system, but also with the mental system. Abuse of the sexual instinct is sooner or later followed by sexual neurasthenia-sexual exhaustion-which is then followed by a very long train of pathological conditions. Among the prominent effects of sexual excess, may be mentioned impotence and spermatorrhoea. The extreme stages of either of these morbid conditions are so well marked, that a minute description is needless in this place. But the more mild degrees of these affections may elude the observation of the inexperienced practitioner. Impotence may begin with premature emission merely, or with less pleasure in sexual embrace, and, finally, end in that graver form, of ejaculation before complete intromission. It may begin with deficient power and desire, and progress to complete want of both. Spermatorrhoea may commence with occasional involuntary emissions, then progress until they take place several times during the night. At first they may not be complicated with spermatorrhoea, which is flowing away of semen in the urine, or at stool, or from sexual excitement from contact with the opposite sex. There may be frequent involuntary emissions by night or day, yet no true spermatorrhoea. And there may be frequent emissions and no true spermatozoa in the urine, or any discharges at stool. And again, involuntary emissions may take place only once or twice a month, yet there exist active spermatorrhoea. The microscope alone can detect the spermatozoa in the fluid passed from the urethra, and should always be used in all cases of doubt. I have found spermatorrhoea far more common than medical authority admits. It is stated by some writers that the discharges that take place at stool are all from the prostate gland, but the microscope has proved to the contrary; if there is erotic excitement, they will be found to contain spermatozoa, hence from the testes, and veritable semen. Physicians are often very careless in their examination of these

cases, and very few go to the expense of procuring a good microscope, without which no man can possibly determine these sexual diseases. Itching of the scrotum, penis and perineum, are one of the symptoms characteristic of sexual exhaustion. It is a form of pruritus, which is generally worse at night, and not to be relieved until the sexual trouble is removed by proper remedies. Another marked symptom is pain on coition, or pain in urination, extending sometimes to the perineum, as a form of neuralgia. Another well marked symptom is a heavy, dull pain at the perineum at the prostatic gland. In some cases that have come under my notice, there was congestion of the lips of the meatus, leading the patient to suspect gonorrhoea. And there is generally an irritable state of the prostate gland, attended with a sense of weight and heaviness in that region, and coition will either be prolonged, and in bad cases without emission, or it will be premature and scanty. And in such cases the scrotum will present a relaxed appearance, resembling varicocele. And in most cases I have found occasional attacks of retention of urine, or difficult and frequent urination, with pain. Another symptom is unusual erectile excitability— diurnal orgasms, the erection taking place from the simple rubbing of the clothing against the glans penis.

Treatment. For impotence, we have damiana, in doses of from thirty to sixty gtts.; doses, three times a day. I have removed this trouble in several cases. For diminished sexual desire, agnus castus is a remedy introduced by homoeopathic physicians, and does material service, and may be alternated with preparations of phosphorus and nux vomica. If digestion is feeble, and there is nervous prostration, feeble brain force, hypochondriasis, dullness or sullenness of mind, then anacardium will be the remedy indicated; and the chloride of gold, in doses of the one hundredth of a grain three times a day, is a valuable remedy in such cases. Where the sexual desire is suppressed, or where coition is unattended with the usual thrill, the ejection premature, then berberis vulgaris is the remedy indicated; dose, twenty to thirty drops of the tincture. If the nocturnal emissions are frequent, and there is spermatorrhoea, then tincture of cantharides, in drop doses, is indicated. Where the spermatorrhoea and nocturnal emissions have produced great debility, then the fluid extract of Peruvian bark will aid in restoring