meets with strong opposition from the patient's friends, who beg or insist that he may be left to die in peace. The patient himself very often begins to breathe more deeply, to groan, mumble, gesticulate, etc.; but the cold water must still be poured over him till at last he energetically resists any further application, and perhaps even swears at his tormentors.' Another good application of the cold is the wet pack, the sheet being previously dipped in iced water."

"Professor Hirsch of Berlin, the leading epidemiologist of Germany, who has been appointed first German representative on the International Plague Commission, has, before leaving, addressed a communication to the Medical Society of Berlin on the subject. After tracing the historical lines of the pest, he expressed his agreement in the view that on this occasion it has been brought to Russia from the Persian town of Rescht, on the Caspian, which has considerable intercourse with Astrachan. He pointed out that the characteristic and dangerous symptom of the present disease, which he calls the Indian plague,' is an inflammatory affection of the lungs. It is the same form of bubonic plague which was observed in the beginning of our century in some parts of the East Indies, and which in the fourteenth century swept over the whole of civilised Europe and disappeared afterwards. From the descriptions of this fearful calamity which were compiled at the time and still exist, we gather that the principal symptoms of this affection were the same which are observed in the present epidemic, viz., affection of the lungs and buboes. He thinks that the real cause of the disease in the plague is a blood-poisoning, which produces not only very serious general typhoid symptoms, but also localised ones, especially in the lymphatic glands, either externally as buboes or internally in the retroperitoneal glands and the spleen. The follicles of the intestines, however, are never affected as in typhoid fever; the carbuncles develop in a way similar to noma. The illness lasts for three to five days, but may also end with death in twenty-four hours.

"The speaker then went on to discuss the important point of the diffusion of the disease. He has come to the conclusion that it does not belong to the group of contagious affections in the full sense of the word-i.e., where the virus is reproduced in the affected organism-but to the zymotic group, where the virus may be propagated either through some object or an individual, but can only be developed if it fall on a certain soil."

REVIEWS.

Clinical Lectures upon Inflammation and other Diseases of the Ear: being a Course of Lectures delivered to the Students attending the Class of the London School of Homeopathy during the Winter Session of 1877-78. By ROBERT T. COOPER, A.B., M.D., Trin. Coll. Dublin, Physician, Diseases of the Ear, London Homœopathic Hospital. London: The Homœopathic Publishing Company. 1878.

WE have much pleasure in noticing this work. A treatise on the homœopathic treatment of diseases of the ear was certainly a desideratum, as no such work had hitherto been published, and in fact the ear had been very much neglected from a homœopathic point of view. Dr. Cooper has succeeded in giving us a really excellent treatise on the subject, which, though not intended to embrace all ear diseases, embraces the most important of them, viz., inflammations of the middle ear, with its concomitants and

consequences.

Dr. Cooper makes his work thoroughly practical, and we are sure that all those to whom the homoeopathic treatment of ear-diseases is a new study, will benefit much by its perusal. Our author describes clearly and most interestingly the anatomy and physiology of the parts of the organ of hearing which are the ones chiefly involved in inflammations, a knowledge of which is essential to the thorough understanding of these diseases and their treatment. He does not confine himself to mere drug treatment, but recognises the necessity for occasional surgical interference. All this part of the work is well done, though not pretending to originality, but when we come to the drugtreatment, Dr. Cooper displays his usual acumen in observation of the effects of drugs, and in deducing their therapeutical import and sphere. We find several points brought out which are to be found in no other work. The first of these we find noticed is his use of glycerine as an application to the membrana tympani. We quote a passage on this point, which explains what we refer to, and gives a good sample of Dr. Cooper's writing :—

"Connected with the discussion of the dryness of the membrana tympani will come in the way in which it is influenced by glycerine, and as this bears closely upon the treatment of accumulations within the middle ear, it will be well for us to deal with it on the present occasion.

"One of the physical laws to which a membrane placed as is the membrana tympani is subject, is this: that if two liquids of different density are placed on either side of it, they will by virtue, as Draper has it, of simple capillary attraction, interchange, and, as it is generally though not quite correctly stated, the lighter

fluid will move towards the denser and vice versa, the movement of the one being termed by its discoverer, Dutrochet, endosmosis, and that of the other exosmosis, names quite unnecessary and even misleading.

"You can perform this simple operation for yourselves. Take two ordinary clinical test-tubes, place on both a tampon of cotton-wool moistened with water, then tie across the mouth a piece of ordinary parchment; against the one place a pledget of cotton-wool moistened with glycerine, and against the other one moistened with water only. If you watch them closely you will soon observe active movement taking place between the glycerine and the water through the parchment, while the fluid in the other remains quiescent.

"I think we may reasonably hope to put to practical account such simple experiments in the removal of serous or hæmorrhagic accumulations within the tympanic cavity, and that in effecting an interchange between the fluid on the outside and that upon the inner surface of the membrana tympani, we may set up such stimulation as will lead to its entire dispersion. This would quite accord with the ordinary physical laws by which the transposition of fluids in the process of absorption is effected in the human body. It is a point to which attention ought to be more earnestly directed.

You will doubtless ask me for some instance in actual practice of glycerine having had any such effect; it is difficult to adduce positive proof. This is unquestionable, that the local application of glycerine has long been a popular remedy for deafness. In 1851, Mr. Wakley, backed up by a Mr. Tindal Robertson, brought out a work upon 'the use of glycerine in the treatment of certain forms of deafness.' The critique of this work in Wilde's Aural Surgery is painfully adverse; still I suppose they had seen some cases cured with it, and our colleague, Mr. Tate, of Blackheath, the other day told me that his wife had been completely cured a short time since of a catarrhal deafness by means of its local application to the meatus. Patients, too, have often told me they invariably cure their catarrhal deafnesses by the instillation of glycerine to the meatus. The idea we would moot is, that these occasional cures of deafness with glycerine are instances of an impervious state of the Eustachian tube, with possibly catarrhal accumulations in the middle ear, and that the glycerine, as it were, sets up a certain amount of capillary activity, a discharge of fluid taking place all along the mucous surface of the tympanal cavity and tube, which in this way frees, or, in fact, washes out the passages.

"This would be, in my mind, a thoroughly allowable scientific exercise of the imagination.

"That glycerine acts in this way we have no other proof than that referred to; but in regard to the other extremity of the middle ear, if I may so term the faucial orifice of the Eustachian tube, we can understand that this effect would more readily be induced if we but bear in mind that the mucous membrane can constitute an endosmosing surface."

Again, when speaking of the diathetic conditions of children, which influence their liability to inflammations of the ear, we have some interesting and original remarks on a medicine little known in this connection, terebinthina. Of this medicine Dr. Cooper says:

"Then there is that familiar old remedy terebinthina, to which I have already referred, and which, as I have said, I believe to be much too neglected by us in the treatment of children's diseases. I am one of those who regret that as homoeopaths we have devoted so much attention to the investigation of the actions of substances that were unfamiliar to the profession at large, to the exclusion of our old and standard drugs.

"Turpentine is known not alone to exercise a very decided irritating effect upon the intestinal mucous membrane, but to have as well a very pronounced cerebro-spinal action. Thus symptoms of intoxication, vertigo, mania, and other well-developed cerebral effects belong to it. Extreme restlessness at night is amongst its symptoms. Now, if you look to the article on Terebinthina in Hull's Jahr, you will find amongst the curative effects, a burning soreness and interstitial distension of the gums. From whence this symptom is taken I am unable to say; but this I can confidently assert, that there is no remedy which in cases of difficult dentition has given me such uniformly happy results as terebinthina, used in purely infinitesimal doses. Where dentition is accompanied by suppression of urine and convulsions, or where the child is wakeful at night, screaming as if frightened, has a staring look, clenches her fingers, twitchings in different parts of the body being prevalent, where she picks her nose and is troubled with cough, whether or not worms are present, in these instances I have found terebinthina positively curative. The little girl is cross and irritable, her temper is very changeable, she has a dry short cough, complains of aching in her limbs and her head, and is very often feverish; these are indicative symptoms.

"As to its special relation to otitis, I can only say that I have often found it curative in the otalgia of children old enough to express their sufferings, and conclude from this its utility in the otitis of those too young to pronounce upon it; and even amongst the allopaths its internal use is sometimes resorted to for the purpose of preventing the onset of inflammation after paracentesis

Review, Mar. 1, 1879.

of the membrana tympani and catheterisation of the Eustachian tube. (Weber, Monatschr. für Ohrenheilkundli, 1871.)

"In one case of obstinate eczema in a child, situated in front of the left ear, and tending to affect the eyelids as well, I was unable to effect a cure until terebinthina was prescribed. These eczemates of children that border upon the ear often alternate with otitis.

"This remedy seems to be peculiarly appropriate to the affections of children, its intestinal irritations are accompanied by symptoms like in every respect to those we meet with in association with the diseases of child-life; and more than this, in presence of its symptoms, it never disappoints-an assertion that, while it certainly holds good of all remedies, is yet more obviously true of some than of others."

Dr. Cooper's remarks on the value of calcar. phosph. in cases of chronically enlarged tonsils (pp. 96, 97) are well worth attentive observation, and also those on the use of soda chlorata. The value of hydrastis in the treatment of chronic catarrhal otitis with otorrhoea and deafness, is an important point, unknown till brought into notice by Dr. Cooper. We can best illustrate his views and practice by quoting the following case with the remarks upon it.

"Case III.-Catarrhal Otitis with Deafness succeeding Scarlatina. "Barnard Dyer, a boy of seven years of age, admitted to the London Homœopathic Hospital, May 24th, 1877, being deaf in both ears, worse on the right side, the cause of which is traceable to scarlatina which he had two and a half years ago, and which was followed by an otorrhoea that continued for three months, since when he has been invariably deaf, though worse at some times than at others. Before scarlatina he had had very large tonsils, but these subsided in consequence, apparently, of the severe inflammation attendant upon it.

"He takes cold easily, and in winter is troubled with a hollow cough; otherwise his general health is very good.

"The left membrana tympani is dark and shiny, as if polished, while the right-the worst-is red and inflamed-looking along the handle and neck of the malleus.

"Treatment.-Air-bag inflation of the tubes, once performed; and for medicine :-Hydrastis canadensis 2nd dec., 7 drops to 3 oz. of water, and a teaspoonful three times a day.

"June 23. Certainly better. Medicine continued; no inflation this time.

"June 30.-Has gradually and decidedly improved. Watch can be heard at all distances. Inflamed look has disappeaaed from

the right membrane.

"July 21.-Is quite well. Cold does not affect him nearly so No. 3, Vol. 23.

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