yielded to homeopathic treatment, and in a few weeks he returned home restored to perfect health, a result which could not have been attained by medicine alone.

The Rev. J. H-, æt. 49, had perceived a steadily increasing failure of strength. He looked robust, but in spite of a florid complexion a certain pallor and waxiness about the lips became apparent. His breathing on rising even a gentle ascent was laboured and distressing, and he was alarmed by occasional sudden loss of memory and threatened fainting. Several medical friends who were interested in his health carefully examined him, and in succession undertook the treatment of the case. He was sent twice to a hydropathic establishment and took lengthened rest and withdrawal from duty, but without any lasting benefit. The diagnosis of his condition was never satisfactorily determined till in despair I examined the rectum, and found a very large internal hæmorrhoid which bled freely on being touched.. The patient admitted that he had for years occasionally observed blood with the stools, but as he had been led by his allopathic physicians to regard it as salutary, he had never given much attention to the matter. After the removal of the tumour, and under the action of Podophyllum and Sol. Soda Chlorat., a critical diarrhoea set in, with great relief to the portal congestion, followed by the disappearance of all the anxious symptoms.

A condition of congestion and erosion of the mucous lining of the rectum is frequently met with, not amounting to distinct hæmorrhoids, and yet causing many local and sympathetic discomforts. The medicines which I have found of most service are Merc. corr. and Nitric acid, but the cure is greatly expedited by the application of strong Nitric acid to the eroded surface. The distressing pain of spasm of the sphincter associated with fissure in ano is effectually cured by introducing the two index fingers within the tightened ring of muscular fibre, and steadily overcoming the contraction. Ignatia is useful in preventing the return of the spasm, but I have never been able to remove it with medicine alone.

The treatment of scirrhus of the breast by medicines

alone is not encouraging, and the mere surgical removal of the tumour is almost invariably followed by the reappearance of the disease in the cicatrix or in some other part. I have been much gratified by observing the power of a steady course of Sanguinaria Canadensis in preventing the return of the disease. I have notes of six cases, all of whom are at this time alive and well, in which I removed the breast, and followed up the operation with a course of Sanguinaria. Of course the cases were selected as suitable for operation, that is to say, the disease had not extended to the axillary glands nor involved the skin. In every case the entire breast was removed, and adhesion by first intention was almost uniformly secured by the sustained pressure of a large sponge wrung out of Infusion of Marygolds bound over the dressing of the wound.

Mrs. N. N—, æt. 54, had observed a tumour of the left breast slowly increasing for the last three years, There was much shooting pain in the swelling, which was hard and defined; the tumour was not adherent, the breast being moveable. No swelling in axilla and no nodules in the skin. The patient was very stout; nevertheless, under the influence of chloroform, the whole mamma was excised and the wound was mopped out with a solution of Chloride of Zinc, 10 grains to the oz. A dressing of Infusion of Calendula and a large new sponge wrung out of the same lotion was applied. The wound healed by first intention throughout, the slight local inflammation being checked at once by Belladonna. The patient took Tinct. Sanguinariæ Can. 3x for some months, and after three years there is no appearance of any return of the disease. I need not multiply the report of cases so simple and uniformly successful both as to the operation and the prevention of the return of the disease.

I may, however, state that in each case upon which I have operated, examination of the tumour after excision left no doubt as to its being true scirrhus.

I have found Sanguinaria Can. of the greatest service in removing a painful enlargement of the whole breast which frequently occurs at the climacteric period, which often occasions much anxiety and apprehension; but if there is no

defined nucleus in the mass it speedily disappears under the use of the drug. But if a defined tumour exists, neither Sanguinaria nor any other medicine that I know of will benefit the patient, unless the nidus of the disease is removed surgically.

The improved methods of performing ovariotomy and the strikingly improved results of the operation are among the triumphs of modern surgery. Still the operation is most formidable, and patients will not willingly submit to it until they are driven to extremes. Tapping is so readily

performed, and is so free from pain or alarm, that we are frequently urged to resort to it when as yet the patient is not convinced of the necessity of excision. But tapping has fallen into disrepute since it is found to be not absolutely free from danger, and at best it affords but a temporary relief from the dropsical encumbrance. I am satisfied from observation that Apis mel., taken internally after the operation, has considerable power in checking the reaccumulation of the fluid.

I

In 1856, M. N, æt. 24, unmarried, had observed a tumour in the abdomen gradually increasing in size for eighteen months. It was a firm swelling lying towards the left side of the umbilicus, and from its situation and appearance was evidently an ovarian tumour. Various homœopathic remedies were used without any evident result. then tapped and withdrew about eight quarts of strawcoloured fluid, the abdomen was carefully bound, and Apis mel. prescribed to be taken internally three times a day. There was no return of the swelling for two years, when I again tapped and withdrew six quarts of a similar fluid, after which she resumed the Apis mel. After some years she married, and though she has had no children, she is well and free from any signs of the disease.

Miss E. J—, æt. 72, had an ovarian tumour on her left side. Her physician, a skilful homœopath, had failed to make any impression upon the disease with medicine, and requested me to tap. About five quarts of fluid were withdrawn and the abdomen carefully supported with a bandage, and she took Apis mel, for a length of time. She died six

years afterwards of bronchitis. A post-mortem examination was permitted, when we found the cyst shrivelled to the size of a walnut and attached by a pedicle to the ovary.

In cases therefore where the patient cannot reasonably be expected to bear ovariotomy, or declines to run the risk, I would recommend tapping in conjunction with the use of Apis mellifica.

In conclusion, whilst I readily admit the power of the antipsorics to influence peripheral morbid lesions, yet I submit that it is safe and often desirable to supplement the curative action with surgical assistance.

Discussion on Dr. W. S. Craig's paper.

Dr. WYLD did not see how tapping could be of use in any ovarian tumour unless it were hydrous and unilocular. He had at present under treatment an abnormal tumour diagnosed by the first authority in London to be multilocular ovarian tumour, and a good case for the operation for removal. Under the use of Silicea 6 twice a day and other remedies, together with daily medical rubbing with Olive oil, the health of the patient has much improved, and the tumour, which was gradually increasing, has decidedly decreased under six weeks' treatment. Twenty years ago, while treating a woman for large ovarian tumour, it most fortunately burst and discharged itself by the vagina. The case made a perfect recovery and is well up to the present day, there being no recurrence of the tumour.

Dr. HALE doubted whether Dr. Craig had sufficiently discriminated between the cases of hæmorrhoids requiring operation and those which were curable by medicine alone. In the great majority of cases Dr. Hale had succeeded in curing hæmorrhoids by medicine alone, and in the few cases in which he had advised an operation there was either prolapsus of the hæmorrhoidal tumour during the exercise of walking, riding on horseback, or standing (prolapsus during defecation only he did not consider demanded operation), or there was hæmorrhage which medicines failed to control, and which was reducing the strength of the patient. Under those two conditions Dr. H. had seen the most happy results following operation either by ligature, the écraseur, or the clamp and the actual cautery, according to the nature, shape, or situation of the hæmorrhoid. Dr. Hale mentioned the case of a gentleman who had become anæmic to an

alarming extent from very slight but daily recurring hæmorrhage during defæcation, going on for many months, caused by a small vascular polypiform tumour, which was removed by the clamp and cautery with arrest of the hæmorrhage and complete restoratiom of health. In cases of fissure of the anus he thought operation with the knife the quickest and most effectual mode of treatment, but he had at present a case under his care of superficial fissure external to the sphincter, which he was treating by dilatation by means of a large bougie well smeared with Calendula ointment, and with every prospect of cure. Dr. Hale had been often consulted about non-malignant irritable tumours of thebreast; in such cases he had invariably found they yielded to Conium. He related a case of fibrous tumours of the uterus at present under treatment, the characteristic feature of which is that, although there are frequently recurring attacks of a secretion, which is partly coagulated blood and partly serum deeply tinged with blood, the general health and strength of the patient are very slightly affected, the most distressing symptom being a fearful dread of fatal flooding. There are two tumours attached to the fundus, the left very mobile, and neither of them fortunately pressing to any extent upon the rectum or bladder. Has given several medicines, amongst the rest the Vinca major, suggested by Dr. Meadows, but without any very satisfactory result. A suspicion of polypi in utero was dispelled, for upon two examinations no polypus was found.

Dr. COOPER stated that it was very desirable that we should, as homoeopathic physicians, cultivate the art of surgery as much as possible, but unfortunately the means at our disposal were far too limited to accomplish this satisfactorily. Dr. Cooper did not think Dr. Craig's inference as to the prophylactic properties of Sanguinaria over cancer of the breast after removal could be justified upon such insufficient data. Cancerous tumours of the breast frequently do not return after operation, and, except the evidence of a large number of cases be taken, the non-recurrence of these tumours could not be accepted as exemplifying the beneficial effects of the medical treatment. As to piles, save in very exceptional cases, we OUGHT to be able to cure them with medicines alone. Those who are worse educated than we find no difficulty in treating an ordinary case of piles-he referred to the herbalists, a class from whom we might derive many a wrinkle. If operation must be resorted to there is none he had seen comparable to that of the actual cautery applied by catching up the piles with Henry Smith's protected clamp, and applying a good, large, red-hot iron, which, when applied to the mucous surface only, never causes any pain. Dr. Cooper was surprised at no reference having been made to Rhatania, a remedy of established repute in homœopathy for fissure of the rectum. In reply to Dr. Hale, asking for a remedy to arrest the hæmorrhage from a fibrous tumour of the uterus, Dr. Cooper advised, on Dr. McClintock's