garding it-by a fee of thirty francs a month! For this ridiculous sum, a patient expects to be seen every day for a while, then two or three times a week, and, indeed, whenever he thinks he requires the doctor's visit! This is the fee which represents Swiss and German notions of indebtedness to a physician! I trust, however, that English people do not leave without showing that they do not take so low a view of their obligations, or place so indifferent an estimate on the value of the medical services they receive.

A patient, on leaving Davos at the end of March, which is necessary in order to avoid the rapid and heavy thaws which then commence, is usually advised to go either to the Lake of Geneva or to Baden-Baden, before returning to England. Some such stepping-stone homewards is certainly needful. The change is indeed great, greater than anyone who has not experienced it would imagine. The susceptibility to cold would seem to be greatly increased by a long stay in that pure quiet air, while the sources of chill abound in England during April and early May. The weather generally is damp and often cold, while east wind is felt at every corner. bring a convalescent from lung disease home at such a time is almost certain to induce catarrh, and so to ensure a recurrence of disease under very unfavourable circumstances.

To

During the few weeks I have recently spent at Malvern I have been very much struck by the lightness and clearness of the atmosphere, and have thought that, though it would be unwise to go to Malvern direct from Davos, yet the period of expatriation might be shortened by a visit there in the second or third week of April. London or the immediate neighbourhood, and anywhere on the south or east coast, would be decidedly injurious, but Malvern seems to me to be a locality where, with care, a Davos convalescent might spend the first month of his return home with safety, and indeed advantage. The following tables have been kindly placed at my service by Mr. Woods (of Messrs. Burrows, Opticians, Malvern), by whom the observations were taken. They give the averages for each month named. Since 1870 Mr. Woods has ceased to record his observations :

These tables show a low humidity for an English climate, with a temperature well adapted to the wants of the invalid, and a good supply of ozone in the atmosphere. These facts, together with that very important one that, in the matter of drainage, water-supply, and hotel, boarding, and lodging-house accommodation, Malvern is infinitely superior to any continental town, induce me to suggest it as a suitable halting-place for the convalescent from Davos before returning to his usual home.

One more suggestion I would offer to the invalid preparing for Davos, is that he or she should have a compagnon de voyage. The resources of the place in the way of amusement are of the most limited character; and, though great sympathy and kindness are met with by a solitary invalid from all around him, still the attention of a relative or intimate friend is oftentimes a source of the greatest comfort, and tends much to relieve the inevitable tedium of a sojourn in a mountain valley so far removed from ordinary sources of interest. Such companionship too, is, I am certain, largely conducive to recovery, and diminishes the home-sickness which is inseparable from an eight or ten months' expatriation and isolation from the world.

2, Finsbury Circus,

March, 1879.

CASES ILLUSTRATIVE OF IGNATIA.

BY J. MURRAY MOORE, M.D.

1. Mrs. M., of Norton, aged 41, dark-haired, of fresh complexion, and nervous, somewhat anxious temperament, sent for me July 28th, 1878. I found her suffering under sub-acute articular rheumatism, pericarditis of five days' standing, incipient endo-carditis, and mental derangement. Her second child had been born in April, after a rather long labour, terminated by the forceps. The milk-supply had been deficient, but she made a fair convalescence, and the only peculiarity noticeable was unusual irritability and restlessness. About five weeks after her accouchement she most imprudently exposed herself to a wetting in some gardens open only once a year, near Taunton, and almost immediately an intense attack of rheumatic fever supervened, preceded by the weaning of the infant, and the suppression of the milk. This suppression of the milk was stated to have been effected by one or two doses of some powerful medicine (iodide of potassium ?), after which delirium came on, and from that day her mind never regained its balance. When the acute attack of articular rheumatism had subsided, she was sent a few miles away in the country, when this pericarditis came on, and the friends determined to abandon allopathy. Her mental symptoms at once arrested my attention. Her look was vacant, and wandering, yet full of ceaseless anxiety; she was quickly moved to anger, which as quickly subsided; impatient; continually wanting to change her position; fearful of being alone; very timid at night; complaining of noises scarcely audible to others. The memory was gone, and consciousness of time, place, and the people in the house, was much confused. At night there was almost complete insomnia, and this had been combated by her former attendants by giving very strong injections per anum of hydrate of chloral, which had for the previous ten nights not only failed to produce sleep, but had aggravated the mental symptoms. Her face was haggard, with a most distressed expression constantly upon it.

I treated the pericarditis, &c., with the various medicines homoeopathic to the symptoms, from day to day, commencing with aconite and bryonia. But the insomnia and the other brain symptoms remained quite unrelieved, until I ordered ignatia 1x, five drops at bedtime, repeated

once only during the night. This remedy acted like a charm. The first night she obtained two hours' refreshing sleep, and so on, until the state of the mind became each day less cloudy and anxious; and I had the satisfaction of seeing her become not only sane, but sufficiently well of her heart disease and rheumatism, at the end of three weeks, to be moved away to her own home. She made so rapid and complete a recovery, that many of her friends have become in consequence adherents of our system.

2. Mr. D., aged 46, a stout, florid man, had the misfortune to slip on the ice, December 23rd, 1878, and fracture, transversely, his left patella. He called me in the next day; I set it, secundum artem, and adjusted the leg with a straight splint behind the ham, so as to dispense with the use of Malgaigne's somewhat painful (though very efficient) hooks. All promised well for osseous union, when, four days after, I found the splint loosened, and ascertained that Mr. D. had been subject for five years past to involuntary twitchings and jerkings of the legs in bed, on, or shortly after falling asleep. These were quite involuntary, and affected either leg or both legs indifferently if he stretched the leg out stiffly to stop it, the foot quivered. Compare symptoms 604, 646, 647, 714, and 715 of ignatia, in Allen, vol. v. Ignatia 1, two drops at bedtime, arrested these spasms, and they have not returned since. The fracture united well by true osseous callus in five weeks.

3. Mrs. T., aged 56, a thin, nervous, loquacious woman, somewhat fond of beer, and sometimes indulging in gin, subject to a chronic morning diarrhoea in consequence, consulted me October 1st, 1878, for involuntary twitchings of her hands and arms, and sometimes of the muscles of the thigh, after anything that caused her grief or anxiety. She had been subject to this trouble for twenty years, and was too ready to take brandy and water to "steady her nerves," by way of stopping these movements.

Ignatia 3x, in one drop doses, in three days cured this complaint permanently. It is in the hope of calling attention to this valuable power of ignatia in controlling reflex abnormal muscular movements that I have submitted cases 2 and 3 to my colleagues.

Taunton,

Feb. 13th, 1879.

Review, April 1, 1879.

REVIEW.

On the Neglect of Physical Education and Hygiene by Parlia ment and the Educational Department. By Dr. ROTH. London: Baillière & Co.

1879.

ALL who know Dr. Roth are perfectly well aware that whatever cause he advocates, he advocates with a degree of energy not often equalled and never surpassed. For thirty years has Dr. Roth pressed upon the Government and people of this country the importance of the scientific training of the body in children and young people. For fully as long a time also has he endeavoured to make all having the direction of education alive to the necessity of imparting knowledge on the principles of hygiene. That his success so far has been slight, very slight indeed, is discreditable to the intelligence and discernment of those who are entrusted with providing for the education of the country. While other European nations have, long years gone by, seen the value of physical education, of a really scientific physical education, nothing whatever has been done to promote it here. Nothing daunted by the deafness of those he has addressed so often, Dr. Roth again comes forward and shows, in the pamphlet before us, that the physique of our population is degenerating for lack of training and information; that abroad physical education is (especially in Belgium, France and Germany) carefully studied and regularly enforced with the greatest advantage to the youth of those countries, while in England little or nothing is being done in this direction, either in public or private schools, and that little is for the most part done badly, unscientifically, and carelessly.

The consideration of such questions as those here discussed is of vital importance to the health of our nation, and, indeed, to the maintenance of our position as the first and most powerful country in the world. Feeling it to be so, we shall quote more largely from Dr. Roth's brochure than is ordinarily necessary in a review. That physical education which may be defined as "The inculcation of some sound, though elementary, principles of hygiene, combined with the practice of simple though scientifically devised exercises, founded on sound physiological and anatomical principles " (Mr. Butler-Johnstone, M.P.), has never attracted any official, and but a very limited amount of non-official attention amongst us, will, we think, be allowed by every one. Dr. Roth traces this want of consideration in some measure to the non-existence of an Educational Minister in the Cabinet, and to the fact that the Vice-President of the Committee of Council on Education is already overweighted with official duties; as well as to the lack of appreciation of the scientific requirements of physical education on the part of such bodies as the British