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heard) are arranged, and they are farther subdivided according to the tissues or organs specially affected by them. Dr. Burt considers that this classification "is as much a science as Similia, in fact it is the completion of that great law."

We wish we could endorse his sanguine estimate. But facts compel us to allege that this "physiologico-pathological basis of the Materia Medica" has itself no basis in physiology or pathology, and is welluigh valueless practically.

In the first place, there is no foundation for the sharp distinction here made between the cerebro-spinal and the ganglionic centres, as the nervous system respectively of animal and organic life. In Bichat's time this seemed to be, and perhaps was, a brilliant generalisation, but physiology has since left it far behind. The ganglionic nervous system is now recognised as mainly vaso-motor, and in such additional functions as it subserves its influence is always directed upon muscular fibre, as in the heart, uterus, iris, and so forth. It has no direct influence, so far as is known, upon nutrition and secretion; if there are any" trophic" nerves, they are cerebro-spinal. Moreover, the two systems (if such they be) have so many points of contact that it is impossible to draw a hard and fast line between them. The pupil can be dilated by irritating either the spinal cord or the cervical ganglia; and so with the blood-vessels of various parts, with the heart, and with the intestines. The "great sympathetic" is rather a supplement to the cerebrospinal system than a system by itself; its sphere is not "organic life," which could go on (as it does, in plants) excellently well without it, but involuntary muscular fibre.

It is impossible, therefore, to find a physiological basis for the Materia Medica in the action of drugs on the cerebrospinal or ganglionic centres respectively. As a rule, most medicines which influence the musculo-motor act also on the vaso-motor functions. We ourselves should go farther, and say that the majority of medicines have no neurotic power at all, and act directly on the tissues or organs they influence. But this is only theoretical, and our criticism of Dr. Burt is limited to comparing his hypothesis with the facts of the case.

Its illusory character becomes still more evident when we consider its pathological assumptions. We begin here by eliminating the unfortunate word " sub-acute " introduced by Dr. Burt as a sort of middle ground between acute and chronic disease, which may belong to either. This is surely a misconception. When we speak of "acute" disease as distinct from chronic, we mean by "acute" that it is recent in origin and rapid in course. But when we speak of "sub-acute" we are using the word "acute" in its proper sense of sharp, and we simply mean "mild." However, putting aside this error (which does not touch the essence of the matter), we have before us the theory that all acute disease originates in the cerebro-spinal centres, and all chronic disease in the ganglionic. Now, even were we to admit (which we should be very indisposed to do) that all diseases are primarily neuroses, no such classification of them can be considered tenable. Diabetes is essentially a chronic disease; but if it have a nervous origin, this is found in the floor of the fourth ventricle. Pericarditis is an acute disease; what warrant have we for supposing any cerebro-spinal starting-point for it? It is needless to multiply instances; the theory is entirely without foundation.

So far, then, as Dr. Burt's chart embodies a new and ambitious classification of the Materia Medica, we must pronounce it valueless. But its grouping of the medicines according as they act on the mucous or serous membranes, the glands, bones, skin, &c., is an attempt in an important direction, and may often be helpful in comparison and choice. It is beautifully printed, and, were such errors as "Lachnantes," "Na^a," "CAancalagua," "Eleterium," "Mephitws," and Petelea" corrected, would be externally unexceptionable.

Action des Médicaments Homoeopathiques, ou, Eléments de Pharmacodynamique. Par le Dr. Richard Hughes; traduit de l'Anglais et annoté par le Dr. I. Guekin Meneville, Chevalier de la Légion d'Honneur, &c. Baillière.

We can, of course, only notice the fact of the appearance of this translation; but we may add that it seems excellently done.

165

CLINICAL RECORD.

Treatment of Ulceration, Meningitis, and Conjunctivitis.
By Theodoeb R. Bbotchie, M.B..C.M., of Liverpool.

I Pbopose in this paper to consider three subjects, viz. ulceration, meningitis, and conjunctivitis, and to illustrate these by a series of cases which have come under my observation in practice.

The great resources which homoeopathy affords us in the treatment of these diseases, and the brilliant results which follow the successful application of the indicated medicines, are one of the many triumphs which we may justly claim for the principles we profess, and allow us to bear with equanimity the illiberal attacks of our allopathic brethren. To the eyes of the uninitiated the speedy cure of some of the malignant forms of ulceration appear almost miraculous, and to the practitioner they afford encouragement to persevere in the treatment of what may seem beyond the power of human skill. The first subject to which I will allude is ulceration.

To meet some of the malignant forms of ulceration requires often on the part of the surgeon the nicest discrimination, and the exact differential diagnosis of the remedies, as many medicines may apparently apply, yet be quite unsuitable to the case which he has under treatment.

I think you will also find that in some cases you must resort to certain local applications to assist or bring about the healing process, although I am confident that as we master the exact application of our homoeopathic remedies, we will rarely have to resort to extraneous helps.

The question which naturally occurs is, What is ulceration, and how does it occur? It is a solution of continuity with loss of substance, and is brought about by congestion or inflammation in the part, accompanied by exudation of liquor sanguinis, hence nutrition is suspended, the part becoming weakened and softened, and the substances thrown out likewise producing pressure, molecular death takes place, ulceration ensuing. Ulceration is more common in the cellular and adipose tissue than in muscles, tendons, ligaments, nerves, or blood-vessels, and I would now very briefly allude to some principles which apply to all the varieties of ulceration we may be called on to treat.

Locally, we must endeavour to subdue inflammation, for until this is accomplished no reparative process can go on; again, position and rest of the part is of great benefit, in order that congestion or determination of blood may not take place.

Constitutionally, nourishing diet, especially food easily assimilated, and a certain amount of stimulant in some cases, is of essential benefit.

Having thus briefly alluded to general treatment, I will now proceed to consider one of the most malignant forms we may have to deal with, viz., the phagedenic form of ulceration; and I will show the nature and treatment of this ulcer by cases which have occurred in my own experience.

A girl aet. 12 came to me with an ulcer situated beneath the inferior maxilla of the left side. On examination the ulcer showed first as to the edges. They were ragged, of a dark livid red colour, some parts everted, some inverted; The granulations were dark, livid, red, irregular, elevated, depressed, and painful. Discharge was ichorish, scalding, and very acrid. There was also great irritability of system, and the child was very much emaciated. I prescribed Kali bich. 3, a dose every three hours; beef tea, sherry wine, and plenty of arrowroot, to be continued for five days. I also ordered Camph. 0, morning and evening, to quiet the nervous irritability of the system. On seeing her at the end of this period no improvement had taken place, but the child had better rest at night, owing probably to the Camphor. I next ordered Merc. cor. 3, every three hours, for five days.

At the end of this time she again came to say there was no improvement. The ulcer was apparently spreading, and I was afraid lest it would open into the carotid. As there might probably be a syphilitic congenital cause, although I could get no history of syphilis, I prescribed Nitric acid 1, one drop every three hours. At the end of a week there was a marked improvement, which

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