anasarca was quite reduced; during that time she complained occasionally of much pain in the upper part of one leg, and on examination distinct varicosis was found (none existing about the ankles): this swelling of the principal cutaneous vein at the back of the right leg had only existed for a short time (two or three weeks), and Hamamelis 3 reduced it in about three weeks :-All this time it was unknown to me that there was anything wrong in the water of the house, and I think it shows the strength of Arsen., in a therapeutic point of view, that it should reduce distinct anasarca, owing, I have no doubt, to the lead in the water, though the water was still taken. The anasarca returned in about six weeks, and was again subdued by Arsenicum 6 in about a month. Soon after that the discovery of the presence of lead in the water of the well was made (the house is a semi-detached one, a common well supplying it and the adjoining house, where the case of lead jaundice occurred). Four days after the use of the water had been stopped she was suddenly seized with a loss of power in her hands, one morning, while attending to her household duties (she had awoke in the night with a feeling of numbness in them). I was sent for in great haste, the lady of the house thinking that her servant had been seized with a paralytic stroke (the symptoms would have made me uneasy too had I not then known of the existence of lead in the water, which they had been drinking for three years). I told the lady that I did not expect her servant would become much worse (the use of the poisoned water having been stopped), and this proved to be the case. Lachesis 6 was given, and on the following day there was some improvement in the arms, but she complained of a numbness in the legs as well. She continued the Lachesis for three or four days, and then took Phos. 6, for a few days, improving gradually, and in about a fortnight ceased to be under treatment, slight neuralgia only being at times felt in the legs (it was for this that Phos. was given).

CASE 5. Chronic enteritis.-Mrs. B-, the mistress of the last patient, consulted me frequently (from the middle of February, when I commenced to attend the family) on

account of troublesome and constant diarrhoea, at times accompanied with a good deal of abdominal pain, aud sometimes with very much tenesmus. She had lived in India for about twelve years, and had there had dysentery, which seemed to account for the ailment. Various medicines were given, without permanent benefit, except that Merc. corr. 6 stopped the tenesmus, and Ars. 6 kept the diarrhoea in check. Puls. 3 also gave relief several times, but still the bowels generally acted three or four times a day, the stools being quite liquid; no blood was passed, but mucus sometimes. About the time that the discovery of the presence of lead in the water was made, she had begun to suffer more continuous abdominal pain. Improvement commenced as soon as the use of the poisoned water was stopped; Puls. 3 had to be given for about three weeks, else the looseness returned, but with that, in small doses, the bowels began to act naturally (once a day) and continued to do so except when, either from fatigue or a chill, a slight return of the old malady came on.

CASE 6. Tabes saturnina.-Master H. B-, æt. 12, the youngest son of Mrs. B-, was put under my care in the middle of February this year on account of the remains of a severe bronchial catarrh (for which he had been treated by a physician from town). I found a tall boy, very thin,

in fact so emaciated that I feared I had to do with a case of confirmed tuberculosis. On examining his chest I found that there was evidence of consolidation in the left apex, but as no breaking up of lung tissue had occurred, I hoped that he might still be brought round, though appearances were very much against a favorable issue of the case. There was some loose cough, but not much expectoration; Hepar sulph. 6 checked this, and the boy improved gradually, but being very weak, Quinine 1 was the medicine chiefly used after the cough had ceased; constipation was a troublesome symptom and Nux vom. 3 had to be frequently given; meat three times a day and wine were also found necessary. The constipation increased to such an extent notwithstanding the medicine, and careful dietetic

management (brown bread, fruit, &c.), that fissure of the anus took place, although the bowels acted nearly every day. I need not dwell long on this case, but will only say that as soon as the use of the poisoned water was stopped, the improvement was so rapid that in a month he looked almost as if nothing had ever been amiss. The peculiarity of the state of his chest was that although there was distinct consolidation in one apex, and the appearance of its commencing in the other, there was no râle, moist or dry, and very little cough. When I first attended him, and while the poisoned water was being used, there was scarcely any rising of the upper left chest on inspiration (the respiration being very harsh, almost bronchial), but soon after pure water had been used in the house, the chest began again to expand, and the respiration became puerile. I have no doubt that with care the lung will quite recover itself. The family has left Wimbledon, so that I cannot report the final issue of this case. It seems to me that this was a case of pathogenetic consolidation of lung tissue from the continued use of lead in the drinking water.

CASE 7. Hæmoptysis and epistaxis.-Mr. N. B—, æt. 22, an elder brother of the last patient, came to me in the middle of February, informing me that he had coughed up blood for three days, having lost altogether about half a pint. I was anxious about his having come to me, having walked a distance of two miles, but he said that he was accustomed to walking, and it did not fatigue him. I examined his chest and nothing very distinct could be detected, except that the respiration was very feeble in both apices; he had no cough.

I gave him Arnica, but he did not continue under my care, not having any confidence in homœopathy; he consulted Dr. Sieveking, who put him on Iron and Quinine, and he improved quickly, in fact there was nothing amiss with his health to all appearance beyond a weak action of the lungs, especially the left. He continued under Dr. Sieveking's care for about six weeks, and after the first fortnight was allowed to walk four miles a day, showing that it was

not an ordinary case of incipient phthisis; he could have walked twelve miles with pleasure, he told me. He was very fond of rowing, and being out a whole day with a friend about a month after having left off treatment, got a fresh attack of spitting of blood, again without cough. I did not see any of the expectoration, but he told me that his nose bled at the same time. This was evidently from the exertion, but he had no pain in his chest, and no cough; there was a distinct shade of dulness in the right apex (the left being the first affected). I gave him Arnica, and after keeping quiet for a fortnight he was allowed to walk as usual, Soon after this the state of the drinking water was discovered. He looked pale and rather emaciated until the poisoned water was stopped, but after that improved so rapidly that, in about six weeks, one would scarcely have known him to be the same young man. I examined his chest then, and there was still feeble respiration in the left apex, but otherwise no appearance of phthisis.

I have related these two cases, as they seem to me to be purely pathogenetic in nature, and singular in the gradual production, in both cases, of an organic lesion, such as was capable of being detected by the ordinary means of physical diagnosis. I ought to add that phthisis exists in the family on the father's side, but remotely. There are two other sons one, the eldest, had consolidation of one apex about ten years ago, while at a military college, but is now robust and well; another brother, younger than my patient with hæmoptysis, is an officer in the army and in good health. The family tendency seems to be only sufficient to have determined the action of the lead chiefly to the lungs.

Remarks. I am not aware that Lachesis has ever before been used as a remedy for incipient lead paralysis. I have found it to be most effectual in the cases in which I have tried it. I first used it about twelve years ago, in the case of a dispensary patient, a painter, who came to me with "wrist-drop," which had existed for a few days, and he had been obliged to give up work in consequence of it; it was

my first case. I gave him Lachesis 6, from my general recollection of the fatal effects of snake-poison, viz. that death in snake-bite takes place from asphyxia, caused by paralysis of the muscles of respiration. It was an experiment, but it proved to be a crucial one; the man returned in a week so much improved that I was quite astonished, expecting after my experience of the tediousness of this complaint in hospital patients under the best ordinary treatment, that it would be weeks before he would be able to work again; he returned to work in the following week, and did not come to me again, which I have no doubt he would have done if he had had occasion to do so.

In the case of commencing lead paralysis which I have now related (Case 4) the improvement was equally rapid. The same might be said of the relief afforded to the asthmatic suffering of Case 3. These different facts, taken together, seem to point to Lachesis as a valuable medicine in some of the conditions produced by lead poisoning, i. e., paralysis and asthmatic suffering, with palpitation of the heart. The lead jaundice was also distinctly benefited by it, and would have been still more so, I have no doubt, had the patient not been taking the solution of lead at the same time. None of our books mention lead paralysis, except Hempel in his Lectures on the Homœopathic Materia Medica; he says there, under Oleander, that Hahnemann recommends it in lead palsy. This is not definitely stated in the French translation (1834) which I have by me, though it might be implied from the following statement, "dans certaines paralysies sans douleurs . . . . le laurier rose est si-non un moyen propre à procurer la guérison complète, du moins un remède intercurrent indispensable ;" this is certainly not very encouraging! If I should have another case of lead paralysis, and Lachesis (or Crotalus) failed me, I should be inclined to try Apis, an allied remedy and a natural analogue of the serpent poisons. I say this on the strength of the record of a fatal case of bee-sting related by Dr. Strong, of Ross, in the September number of the Monthly Hom. Review for this year (1873*). A woman

* Monthly Homœopathic Review, vol. xvii, p. 569.