Review, Jan. 1, 1879.

called to see him, I found him struggling furiously, and the efforts of four men were necessary to restrain him. After three or four days had passed I perceived that the attacks were gradually merging into tetanus, until at last the symptoms of tetanus were unmistakable; there was frequently complete opisthotonos. The attacks came on quite suddenly; he would be talking rationally and quite quietly, when suddenly he would appear drowsy, and for a few moments fall off to sleep; that was always a signal for preparation, as in less than two minutes the convulsions would commence.

I prescribed at first gelseminum 4, which appeared beneficial in the first few doses, but soon failed; then bell. ign. aurum met. but with no success. On August 24th I prescribed acid hydrocyan. 3x gttij 2nd horis; on the 25th he had a very slight attack, and was totally free from fits afterwards.

The superiority of the appropriate homœopathic remedy over the nauseating compound of medicines I have just mentioned as having been prescribed in this case, is signally shown.

I must not omit to mention that I found Chapman's spinal ice-bag of great service, as it evidently had the effect of blighting several attacks of convulsions, which might, as I judged from the symptoms, have been violent.

I have nothing to add, except that he steadily improved in health, with the exception of a little dyspepsia, which caused a few attacks of palpitation, but it soon yielded to treatment. As he was evidently anæmic, I completed the cure by prescribing syr. ferri. phos. comp.

The second case was that of a young woman residing at Guestling, who had suffered very severely from epilepsy for three or four weeks, and had been more or less subject to epileptic fits for some years. Before I was called in she had been under the care of an allopathic practitioner at Hastings, who had prescribed steel, and she had evidently become worse under his treatment. On the day before my visit to her she had had as many as eighteen fits in the twenty-four hours, and most of them of a very severe character. She was frequently insensible the whole night. The menses had been absent for three months previously. I prescribed acid hydrocyan. 3x gttij 3 tis horis, and there

has been no return of the fits since I was consulted on the only occasion that I saw her, which was June last.

It will be noted that in this case the epilepsy was not of recent origin, nevertheless the homeopathicity of acid hydrocyan. to the symptoms cannot be doubted, although some of our first authorities are, I believe, of opinion that this remedy is only applicable to cases of recent origin.

The uterine troubles have been relieved by puls. 3x gttij ter die, and puls. 30, gttj omni nocte.

October, 1878.

CASE OF LOSS OF SPEECH AND PARALYSIS OF THE LOWER EXTREMITIES-CURED.

BY. J. C. BURNETT, M.D.

ON August 15, 1877, Joseph, æt. eleven, was brought to me to be treated for neuralgia and rhachalgia.

Previous history: Nine months ago he was observed to wince when being rubbed with the towel after his bath. At first he was scolded, as it was ascribed to naughtiness, arising from a desire to shirk his bath, but it was soon noticed that the wincing occurred only when his spine was touched, and that the nape was the tenderest part. He was placed under the care of the late Dr. Macdougall, of Liverpool, who blistered the nape, and told the mother that there was something wrong with the brain and spine. Very severe ear-ache next supervened, and the patient was taken to the Liverpool Eye and Ear Hospital, where wax was discovered in his ear, and dislodged by means of the syringe and warm water; oil was ordered to be dropped into the ear. Soon after this a pain in his head of a really terrible nature supervened; starting from the ears, going up the temples, over the eyes, and across the forehead; the pain was also very severe behind the ears. For this iodine was prescribed to be painted behind the ears. The pains were of a neuralgic nature, coming on in paroxysms every few minutes by day, but not by night. This state of things continued for about two months, and then to the pain on pressure all up the spine, to the otalgia and cephalalgia, was added loss of power of speech at intervals. This latter was such that there was physical but not psychical paresis ; he could read mentally, and write and communicate with

his friends freely in writing. These attacks of dumbness lasted two or three days (and nights), and he had five or six of them in about as many weeks. Then he became nearly well for three or four months, excepting the spinal tenderness, having only slight attacks, and being able to go to school.

Three days ago, August 12th, 1877, these attacks of pain began again after his rolling on the grass. He is very fond of turning cart-wheels," and "standing on his head," and as for climbing walls, trees, and water-pipes, he has no equal in these parts. Hence he has had a great number of falls in his life, some of them completely stunning him, and his mother stands in constant dread of his being brought home dead from some such fall; she says, "if we do not know where he is, and we want to find him, we look for him at the top of the tallest tree." This acrobatic skill causes his mother to fear that if he escape an untimely end from accident, he will "go on the stage.'

Status praesens.-While making these notes in my casebook, patient has had two attacks of the neuralgia here in my consulting-room; it is very distressing to behold, and moreover very characteristic; he burrowed with his head in the soft arm-chair, and screamed and sobbed notwithstanding that be was unable to speak. He is said to be rather obtuse and bad at his lessons, and generally backward intellectually, but his looks do not bear this out. His nose is very flat at the bridge, as if it had been knocked in by a fall small pieces of bone have at times passed from his nostrils, and he has ozæna, but his parents take no account of it. There does not appear to be any history of hereditary taint, neither does he strike one as scrofulous. Pressure on the spine and hairy scalp pains him, and causes him to cry out. Eyes brown, pupils equal, lazy; pulse 60; bowels costive; urine normal.

Progress and treatment.―The pathological conception trauma stands out boldly in this most interesting case, and hence I take advantage of our grand master's genial generalisation with regard to the panacea lapsorum (arnica), and give one drop of it in the first dilution every three hours.

22nd. He was ill the whole of the day of his first visit to me, but the following day the pain left his head entirely at 11 a.m.; he was unable to speak the whole day,

1

but began to utter words at 7.30 p.m., and ever since (six days) he is quite well, both of the neuralgia and of the loss of speech.

Had the arnica anything to do with this cessation? Probably, for these reasons. The mode of the cessation of this attack differed from that of all former attacks. On all former occasions, the pain lasted as long as the loss of speech, but on this occasion the neuralgia ceased at 11 a.m. (he having taken three powders, on each of which was one drop of the medicine), but the speechlessness continued till evening. Besides, the attacks generally lasted longer. Rsac lac.

Sept. 5, 1877. Excepting the spinal tenderness, and a little aching in the left ear, he continues well. Rarnica 1. One drop of the tincture daily.

17th. The ear-ache disappeared, and he continued well until to day, and now he has suddenly become paralysed in the lower extremities, with great pain in the cervical and lumbar portions of the spine.

Parents, of course, in dire distress. Sensation in his lower extremities is complete, he feels the slightest touch in them, and he has complete power over his sphincters. Otherwise nothing abnormal beyond his usual obtuseness and the ozæna.

We read in the pathogenesis of gelseminum sempervirens (Allen) symptom 459. "Loss of voluntary motion of the lower extremities," and symptom 492, "complete relaxation of the whole muscular system with entire motor paralysis.” Therefore gelsem. semp. 1, two drops of the tincture in water was administered every hour.

18th. No amelioration, but less pain; slept well, appetite good; he has the same good spirits as ever, and now that he is paralysed in his lower extremities he still evinces acrobatic proclivities by making the maid-servant carry him on her back while he seizes hold of, and tries to hang on to rails and pegs; moreover, he has already discovered a peculiar mode of locomotion that amply suffices for his ordinary wants, and consists in working himself along the ground with arms and trunk. His mother cannot keep him in bed, is greatly distressed, and presses me for a prognosis.

19th. No amelioration; continue medicine. 21st.

Same.

22nd. No amelioration; the parents are getting very uneasy, and consider it a hopeless case. I accordingly suggest another opinion.

23rd. No amelioration. Continue the gelseminum.

24th. Has had a good deal of pain in the spine, and the parents want something else done at once; in vain I plead that Dr. Drysdale has promised to come in the afternoonsomething must be done instantly, so I prescribe nux romica, 2, every hour.

24th, p.m. Dr. Drysdale kindly came over and fully entered into the case; he agreed with me in giving a rather unfavourable prognosis. The parents expected no better, but the lad was thereby a little disconcerted, and consented to remain quietly in bed.

Dr. Drysdale and I then discussed various remedies, notably secale cornutum and lathyrus sativus, which he suggested, but before proceeding to one of these we agreed to give arnica a somewhat fuller trial than it had had.

R. Arnica montana A. two drops in water every 3 hours; nothing else except rest in bed, and making the patient promise to remain six weeks in bed as a start.

26th. No amelioration. Continue the arnica.

Oct. 1. No amelioration. All through the case I could not divest myself of the traumatic idea, and it was particularly strong upon me at this time; so before giving the secale or the lathyrus, I thought I would give hypericum perfoliatum, as being to injured nerve what arnica is to muscle. I cannot say that I expected much from its use, and I fully anticipated that I should not only have to give secale and lathyrus, but also many more paralysers, and fail at last.

R. Tc. hypericum perfoliatum 2, four drops in water 4 times a day; otherwise nothing but to continue in bed. 4th. Better, can move his legs a very little; they tingle a good deal. Continue the hypericum.

8th. Still better; begs to be allowed to get up, but I refuse. To continue the hypericum.

12th. I find him up and dressed, but sitting on the floor; on enquiring if he has complete use of his legs, he jumps up and walks round the room. Sadly wants permission to go out, but I only allow him to go in an easy perambulator. Continue the hypericum.

17th. Perfectly well. My ordering him about in a perambulator had a tragic end, for Joseph got his brother No. 1, Vol. 23.

C