45.

Mucus and, 169; Myths anent, Dyspepsia, 162.

Basophobia, 25.

Belladonna in Salivation, 47.

Benzosol in Diabetes, 47.

Billroth Dr. (Obit.), 84.

"Birnay s Catarrh Cure," 157.

Bladder. E ysipelas, 15; Foreign Body,
3, 105.

Blod. Temperature, 183; Vessel Paio,

ECTOPIA Lentis Congenital, 33.

Eczema, 77, 88, 192.
Electric Glare and the Eye, 54, 158.
Emissions. Hæmorrhagic, 150.
Empyema, 40.
Endoscope. Electro, 88.

Epilepsy, Cardiac, 21; Colony Treat-
ment, 180; Insanity from, 55: Opium
in, 170; Petit Mal, 69; Stront. Brom.
in, 8.

Epsom Salts in Burns, 121.
Eryngium inCystitis, 4.
Frysipelas, Bladder, 15.

Erythema. Nodular, 43: Opium, 14;
Vaccinal, 3.

Eskimo. Menstruation in, 115; Physiol-
ogy of, 191.

Ether Untoward Effects, 191.

CALCIUM Chlor. in Hæmorrhage, 48. Europhen, 166, 185

Calculi, 3; Heart, 31, 158.
"Canalopathy," 146.

Castration. Sexual Appetite and, 86; in
Sexual Perversion, 114.
Cathartics in Peritonitis, 52.
Chancre, 141; Eyelid, 72; Finger, 69;
Hand; 69.
Chicago Clinical Review, 85; Medicine,
85; Academy of Medicine, 27, 90, 124,
156, 178, -86.

Children, Anal Fissure in, 76; Diagnosis
in, 164; Eczema in, 77. Exfoliative
Dermatitis in, 78; Headache in, 192:
Intussusception in, 166; Masturba-
tion in, 104; Opium Habit in, 111;
Ovariotomy in, 144; Phenoco 1 in, 162;
Phimosis in, 150; Pneumonia in, 115;
Purpura in, 52; Rheumatism in, 184;
Scurvy in, 52, 103, 107; Skull in New-
born, 80; Syphilis in, 77.
Chloralose, 170.

Chloroform and Digitalis, 50.
Cholera, Musk in, 80.

Expert Testimony, 3, 22, 28, 44, 112, 179
Eye. Hygiene, 65; in Diabetes, 54; Lid
Chancre, 72.

FAITH HEALING, 153.

Fallopian Tube Pathology, 15.
Ferment, Vegetable Digestive, 6
Fevers, Exhaustion, 107; Fatigue, 107;
Mutation, 59; Non-Elimination, 107.
Finger, Chancre, 69; Surgi al Value of,

Holmes, Dr. O. W. (Edit.), 83.
Hop-pickers' Conjunctivitis, 15.
Hospitals, 23.

Hydrocele, 106.

Hypnotism, 81, 112.

Hysteria, 40, 51, 52.

IDENTITY, 126.

Impetigo, 46.

Impotence, 137, 170.

Insanity, 9, 22, 24, 26, 54, 55, 81, 90, 145.
Intestine Foreign Body, 105, 152.
Intussusception, 166.
lodoformated Salol, 40.

"KEELEYISM." 138.

Kidneys, Bacteria and, 108; Float-
ing, 174.
Knee Foreign Body, 96.

ACTOPHENIN, 181.

LA

Laryngectomy, 192.

Larynx. Artificial Phonation by, 192.
Lawyers on "Law," 22.
Lead Neur ses, 82.
Leg Ulcers, 172.
Licher, 192.
Lipomatosis, 192.
Loretin," 116.

Lung Collapse, 126; Wound, 32.

In Burns, 121;
MAGNESIA Sulph.
Hypodermically, 117.
Malacin, 15.

Mamma. Ovarian, 118.
Marriage. Early, and Fecundity, 82.
Mas-age, 184.
Masturbation. Children, 3; Female, 3;
in Therapy. 45
Maybrick Case, 83.
MEDICAL COLLEGES: Atlanta, 160; Bal-
timore University, 160; Barnes, 166;
Beaumont, 156; Chattanooga, 128;
Cincinnati Woman's, 192; Georgia
University, 160; Hahnemann (Phila-
delphia), 194; Iowa University, 128;
Keokuk, 160; Louisville University,
156; Long Island, 156; Medico-Chi-
rurgical (Philadelphia), 192; Nebraska

University, 192; New York Eclectic, 189; New York Homoeopathic, 192; New York University, 189; New York Woman's, 192; Niagara University, 192; Northwestern University, 160; Philadelphia Woman's, 192; Rush, 58; St. Louis P. & S., 156; Tokdo, 173. Medical Bills. Responsibility, 147. Medical Charity Abuses, 112, 179. Medical Jurisprudence, 14.

Medical Practice Act Blackmail, 127. "Medical Press and Circular," 83. MEDICAL SOCIETIES, 27, 61, 64, 91, 123, 156, 160, 186, 192.. Menorralgia, 180, 182. Menstruation, 52, 115. Microbophobia, 23.

Monsters. Double, 30; Evolution and,

Retina, 54, 146, 168. REVIEWS: American Text-Book Gynæcology, 161; Bouchard's Auto-Intoxication, 123; Brockway's Physics, 154; Burr's Psychiatry, 123; Finger's Gonorrhoea 156; Garrique's Gynecology, 155; Gould's Dictionary. 92 Hamil ton's Jurisprudence, 92; Hektoen's Post Mortem, 29; McEwen's Brain and Cord, 29; McEwen's Head Sections, 29; Mann Jurisprudence, 91; Matthieu Stomach Disease, 93; Moullin's Surgery, 160; Norris' Ophthalmology, 92; Noyes' Ophthalmology, 154; Parant's Insanity, 29; Pepper's Practice, 122; Physician's Wife, 92; Sajous' "Annual," 29; Senn's Syllabus, 29; Sim:n's Chemistry, 160; Starr's Pædiatry, 154; Steven's Therapeutics, 160; Strahan's "Suicide," 61; Sutton's "Tumors," 127; United States Dispensatory, 155; Uniced States Pharmac poeia, 123; Talbot's "Jaw Deformities," 154; Treat's Annual, 155; Wilson's Orthopedics, 160; Witthaus' "Jurisprudence,' 93, 122; Year

Book of Treatment, 128. Rheumatism, 34, 48, 49, 80, 153, 184, 192. Rhinitis, 49, 166, 185

"Right and Wrong" Test, 22.

SALIVATION, 77.

"Salocoil," 27.
Salol, 40.
Salophen, 48.
Salipyrin, 48.

Salumin, 76.

Senn Library, 47.

Serenoa Serrulata, 137.

Serum Therapy, 47.

Sexual Perversion, 12, 114.
Scarification in Ascites, 191.
Scarlatina, 43.

170.

"Orificialism," 90, 195.

Organs. Removal of, 181.

Ovarian Mammæ, 118.

Oxalic Acid in Amenorrhoea, 76.

PAIN. Blood Vessel, 75.

Paraform, 181.

Paranoia, 8, 168.

Scott. Skull of Sir Walter, 147. Scrotum Gangrene, 79; Loss, 87. Scurvy, 103, 107.

Skull Depression, 80.

Somatose, 57.

Spina Bifida, 127.

Spinal Cord Syphilis, 168.

CONTRIBUTORS.

ABBOTT W. C., Ravenswood, Ill., 15-
BAUM W: L., Chicago, 88, 132, 161.
Boisliniere, L C., St. Louis, 109.
Brayton J. B., Indianapolis, 43.
Bremer L., St. Louis, 1, 35, 73.

COLEY W. B., New York, 176.
Coolidge, F. S., Chicago, 101.
Cragin E. B., New York, 142.

DEWEY, G. M., Keytesville, Mo., 89.
Douglas, O. B., New York, 174.
FREE J. E., Billings, Mont., 139.
GOLDMANN F., Berlin, Ger., 39.

New York, 163.

Sprays, 174.

Spruce in Rheumatism, 32.

Paralysis. Pseudo-, 107.

Paretic Dementia, 90, 182.

Phimosis, 150.

Phylctenular Conjunctivitis, 54.
Phthisis, 10, 125, 148, 153.

Phulluah in Hemiplegia, 84.
Physicians' Signs, 85.
Placenta Expression, 118.
Pneumonia, 8, 72, 115, 116, 151.
Pomegranate in Dysentery, 48.
Post Partum Infection, 16.

Pot Bromide in Headache, 16.
Pott's Disease, 102.

Pregnancy, 42, 51, 109.
Prendergast Case, 22, 84.
Priapism, 90.

Prostate, Abscess, 138; Surgery, 4.
Prostitution. Regulation of, 45, 114.
Pruritus, 147, 148, 152.
Pseudo-Hypertrophic Paralysis, 183.
Purpura, 52.
Pyrexia, 76.

QUACKS. Eighteenth Century, 23.

Quinine, Locally, 21; Untoward Effects. 90. Quinsy and Operations, 153.

RAUCH, DR. J. H. (Obit.), 112, 146.
Measles," 191.
Restraint in Insanity, 146.

State Societies (Ed.), 187, 188, 189, 192. Stead, the Nostrum Puffer, 83.

Stillingia Liniment, 34.

Stomach. Uterus and, 8.

Strontium Bromide, 8.

Sulphur in Surgery, 116.
Superfœtation, 42, 144.

Surgery. Petroleum in, 138; Quinine in, 75; Sulphur in, 116.

Surgeon General's Library, 145. Surgeons. European, 114. Syphilis. Children, 77; Copper Sulphate in, 102; Cord, 168; Insontium, 52: Neuroses, 28.

TAILED MEN, 131.

Tannal, 80, Tapeworm, 145. Tetanus, 50. Thrombosis, 55. Thuja, 144.

Tobacco Amblyopia, 25.
Tonsils, 58, 157.
Tracheotomy, 78, 127.
"Trained" Nurses, 85.
Traumatic Neuroses, 8.
Trional, 34, 49.
Triplet. Insanity in, 24.
Trosphoneuroses, 28.
Tumor or Accident, 94.
Twins. Insanity in, 24.
Typhoid Fever, 40, 138, 141, 153, 159.

ULCERS, 172; Buccal, 107; Foot, 111.
Umbilical Hæmorrhage, 50.
Untoward Effects, 161; Chloralose, 170;
Ether, 191; Opium, 147, 148; Quinine, 60.
Ureter Stricture, 149.
Urethra, Foreign Body, 150,

INGALLS E. F., Chicago, 58.

JACOBI A., New York, 26.

Jacobi Mary Putnam, New York, 171.

KIERNAN J. G., Chicago, 1,32%

Koplik H. W., New York, 76. LLOYD S., New York, 111.

Lydston G. F., Chicago, 4.

MCGOWAN J. P., New York, 77.

120

McLin J. H., Huntington, Ind.,

Matthews J. M., Louisville, 78.
Millard P. H, St. Paul, Minn.. 37.
Monroe G. J., Louisville, 58, 88, 119.
Mumaugh S., Lima, O., 134.

NORRIS R. C., Philadelphia, 16.

Northrup W. P., New York, 103. PAGE R. C. M., New York, 162. Phelps A. M., New York, 167. Pinckard C. P., Chicago, 33.

RUSHMORE J. D., Brooklyn, 130.

SCATES D. W, Green eld, Tenn., 64.
Senn N.. Chicago, 97.
Slayter J. Howard, Chicago, 132.

TAYLOR H. L., New York, 17.

Taylor J. J., Streator, Ill., 185.
Tuttle J. P., New York, 70.

VANCE A. M., Louisville, 105.
Verity W. P., Chicago, 165.
Vogel C. R., Columbus, O., 43.
WILDER W. H., Chicago, 65.
Wilmarth J., New Orleans, 89.

I should prefer to designate the disease under consideration "Beard's Disease," the French designation for neurasthenia, in honor of the man who evolved a clear cut clinical picture from a mass of neurological rubbish. Since then two opposite tendencies are noticeable in discussions of the subject. One tends to enlarge the clinical picture and crowd into its frame a vast variety of neuroses. The other tends still more to simplify, circumscribe, and restrict it. The trend to enlarge, and, therefore, to weaken and render diffuse the picture of neurasthenia, as Beard conceived and drew it, is a special feature of some works written by German authors, notably Arndt, who composed his book at the green table, who theorized and schematized on the matter like one who is at home in the medical library, but not in the consulting room or the hospital ward.

The other extreme, that of narrowing the frame and hardening the lines of the picture, was essayed by the French, whether successfully or not, is still an open question. The French school being under the all-powerful influence of Charcot, has tried with great emphasis to disengage Beard's disease from hystery, with which, it is claimed, it has nothing whatsoever in common. A mixture of the two distinct diseases, hysteria and neurasthenia, may exist according to Charcot, i. e., neurasthenic may become hysteric, and a hysteric, neurasthenic, presenting the combination known as hystero-neurasthenia, but a hybrid form of the disease, being neither the one nor the other, but partaking of some essential features of both of them is out of the 'question and cannot be demonstrated according to Charcot's teaching. I have not made up my mind as to the correctness of either one or the other view. Löwenfeld of Munich, one of the best posted men on the subject of Beard's disease, claims that there is such a hybrid. In my opinion there are cases which it is next to impossible to classify, which it would not do to call hystero-neurasthenia.

*St. Louis Med. Scc. Trans. Cond.

Notwithstanding the copious and exhaustive literature on the subject, neurasthenia is little or not at all understood by the vast majority of the physicians. Like hysteria, it is generally considered as something indefinite and floating. Its kaleidoscopic aspect leads too often to the erroneous aspect that disease, if existent, is a mental product. This has led physicians to diagnose unfamiliar neuroses as neurasthenia, as unfamiliar dermatoses were diagnosed as luetic by dermatologically untrained physicians. Sixteen years ago Beard's treatise surprised the neurological world with its accuracy, yet to-day neurasthenia is still a neurological waste-basket to which all diagnosable neuroses are consigned. It is claimed that hysteria in women and neurasthenia in men are equivalent. As a result, the average practitioner is horror-stricken at having to treat neurasthenia, especially if it be of longstanding. In reality, if not congenital or dating back to infancy, it is one of the neuroses most amenable to treatment. The bad prognostic reputation of the disorder is due to the fact that inveterate cases only are designated neurasthenia while the milder types are generally diagnosed as "chronic malaria," "dyspepsia," "biliousness," etc.

The great variety, the quick changes, and the inexplicability of many neurasthenic symptoms on ordinary physiological or physiological or pathological grounds, have led to the belief, as remarked before, that neurasthenia is not a nosological entity. This is the most prevalent of current mistakes about the disease. For, in reality, it is as well defined as typhoid fever; but, just as in this affection the atypical cases are the rule, at least in our part of the country, so the type of neurasthenia, i. e., the co-existence of all the characteristic symptoms, is not the rule in actual practice.

What is typical neurasthenia? After Beard had given us an accurate description of the disease-a masterpiece, by the way, of observation and delineation—it remained for the skillful hand of Charcot to retouch this picture and bring it. out in bolder relief.