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have seen some cases where new Misters constantly broke out, developing with extreme rapidity into raw exuding spots the size of the hand. What with the constant screaming, the refusal of food, fever, and complete suppression of the urinary secretion, the little patients were so reduced that death seemed imminent. I gave several remedies, such as Apis, Urtica, Cantharis, Lycopodium, the disease at length took a favorable turn, but I am unable to say whether any one of the remedies, far less which of them, contributed to the favorable result. Probably warm baths, and alleviation of the burning pain by supplementing the loss of the epidermis by the artificial aid of cotton-wool, dusting with starch-flour or the like, did most to promote the cure.

Urticaria.

In the case of dispensary patients, whose visits are almost invariably very irregular, it is very difficult to determine what effect the prescribed remedies have on the temporary or radical disappearance of the exanthema. The nettlerash appears on one spot of the skin and perhaps vanishes soon to reappear after a short time on the same or another spot. It is only in the case of chronic urticaria that it would be possible to establish the action of remedies with certainty were it not that the patients are too apt to cease attendance when they have obtained some alleviation, for they do not think the malady important enough to subject themselves to a lengthened treatment in order to obtain a radical cure. Moreover, the cure of nettlerash is to a great extent dependent on the avoidance of various local and general exciting causes, which is a matter of great difficulty with dispensary patients. In the chronic form that is liable to burst out after any dietetic error or after any overheating or mental excitement I have generally employed Apis, Clematis, Dulcamara, Copaiba, and Urtica, but without any marked result; in acute cases Aconite sometimes seemed to have a favorable effect, at all events on the troublesome itching.

Acne, Impetigo, and Lupus.

In that most obstinate affection acne, which in the form of acne punctata faciei so frequently attacks young girls and boys, I have for many years tried various remedies. I have sometimes seen decided good effects from high dilutions of Belladonna and Pulsatilla, but very often no effect at all. Latterly I have generally employed Sulphur, and direct the affected parts of the face to be washed at night with the undiluted tincture. When large pustules appear here and there I prescribe Antimonium tartaricum or crudum. Of all remedies Tartar emetic is most decidedly and markedly specific to impetiginous and erythematous eruptions. I may refer here not only to its well-known property of causing a pock-like exanthema when rubbed on the skin, but also to the various pustular eruptions caused by its internal administration which are recorded in our Materia Medica. Antimonium crudum alone displays a similar marked resemblance in its skin symptoms, and doubtless it would do this in a still greater degree were not its proving so imperfect and incomplete. This may also be the reason of its rare administration and neglect by us, which I regret much, as latterly I have frequently witnessed its extraordinary efficacy in affections of the skin and respiratory tubes. I have reason to think that Antimonium crudum is an invaluable remedy in all cutaneous affections where pustules, pocks or furuncular excrescences, or pimples and boils, arise primarily or secondarily, especially when at the same time there is severe, continued pricking itching of the skin, and after rubbing tenderness and soreness. These indications for Antim. crud. may occur in the most various forms of exanthema, in eczema, prurigo, scabies, acne, impetigo, ecthyma, &c., and in my opinion always furnish a particular indication. They may appear on any portion of the skin, but specially call for Antim. when they occur on the face or genitals. I may particularly mention an impetiginous eruption on the scrotum that is by no means uncommon and is very tiresome and obstinate.

VOL. XXXII, NO. CXXVIII. APRIL, 1874. Q

Moreover, some of the symptoms of Antimony lead me to infer that it may be of use in certain cases of lupus, namely, when the suppurative destruction and loss of substance is not far advanced; at least, prominent among the symptoms of Antimony we find the obstinate lumps, boils, and pimples so characteristic of lupus, and not less so the disposition to discoloured gangrenous suppuration of the upper connective tissue. I have not at the present moment any clinical experience of the efficacy of Antimony in such affections, but I shall employ it whenever an opportuuity presents itself.

As regards the treatment of lupus it is not altogether without favourable results. Arsenic and Mercurius are sometimes strikingly efficacious, sometimes, however, not at all. I have given Kali bichrom. and Condurango too seldom to be justified in forming conclusions respecting them. For about seven months I have had under treatment a girl of seventeen who has had this horrible disease for ten years, and in whom it has already produced the most cruel devastation. The left eye, the nose, and the upper lip are completely destroyed; the lower lip is so far destroyed that the incisor teeth are laid bare to their roots and are quite loose. Since the employment of Mercury the destructive process in the orbit and the root of the nose has come to a stand and become almost dry, and the pains in the lower lip have almost ceased.

In order to show how numerous are the cases of exanthematous disease in our dispensary I subjoin a- tabular resume of the cases treated in 1872 and the results of the treatment.

[graphic][table]

I should mention that in the third column (" improved ") all those cases which did not present themselves in the dispensary after their complete cure must he included; and in like manner under the head of "discontinued" there must always be a considerable proportion of cured, as, indeed, we are often made aware when they subsequently present themselves for other affections.

The case of elephantiasis occurred in a man of sixty, in whom, in consequence of chronic ulcers of the legs of many years' standing (originating in eczema), there was developed immense infiltration of the whole surrounding skin with considerable thickening and desquamation, so that the whole leg and foot formed a thick shapeless mass, which certainly justified the above diagnosis. Under the use of Sulphur and Arsenic marked improvement took place; unfortunately the patient ceased attendance after some time.

THE CYPHER REPERTORY.
By Dr. Richard Hughes.

The appearance of a fresh instalment of the Repertory of the Hahnemann Publishing Society,* for which we are indebted to the industry of Dr. Herbert Nankivell, induces me to say a few words on the subject of repertories in general, and of this one in particular.

It must be obvious to any one who considers the subject, that there are two conceivable modes of working the homoeopathic method, of following the rule "Let likes be treated by likes." The one may be called the a priori mode, the other the a posteriori. The former infers from the pathogenetic action of any substance what will be the morbid conditions in which it should prove curative. It tests the inference by practice, and gains therefrom additional indications for the distinctive choice of the remedy. It finally obtains a specific, i. e. a medicine definitely related to a certain form or stage of a known malady, which when it encounters it will certainly modify or extinguish. The a posteriori mode, on the other hand, begins with disease instead of drugs. It is that which we adopt when, having examined a case, we consult our pathogenetic records to see what medicine has caused similar symptoms in the healthy. Our future progress here may be as in the former way of proceeding; but, more commonly, the fre

* A Repertory; or, Systematic Arrangement and Analysis of the Homoeopathic Materia Medica. Part VI, containing Stools and Rectum. By Dr. Herbert Nankivell. London: Turner. New York: Boericke and Tafel.

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