recommendation, a trial of Chloride of Calcium. Dr. VaughanHughes, who spoke afterwards, referred to some points of treatment in regard to epithelioma of the breast, and Dr. Cooper wished to know if this was a very common affection, to which Dr. Hughes gave an affirmative reply.

Dr. WHEELER, after congratulating Dr. Craig upon the brevity and practical character of the paper, spoke of the unadvisability of delay in resorting to surgical interference, in many cases, where instant action was requisite, and illustrated his remarks by mentioning a case of abscess of the ischio-rectal fossa, which, from delay in operating, had resulted in a most severe fistula in ano, and consequent disgrace to homoeopathy and suffering to the patient. He quite agreed with Dr. Hale in the importance of distinguishing between cases of hæmorrhoids suitable for medical treatment alone and those where surgical interference must be resorted to, and illustrated his remarks by two cases in point,-one of a sailor in Australia, in which the attack was acute, inflammatory, and bleeding, and where hot fomentation and Nux vom. and Aconite alone sufficed for the cure. In another case of more chronic character, the hæmorrhoid was about the size of a large walnut and could not be returned. In this case the clamp and actual cautery was used and the sore dressed with Carbolic oil and wet bandages, and the cure was perfect. In reference to tumours of the breast Dr. W. remarked that there always appears an element of doubt in those cases of reputed scirrhus which are operated on and do not return. There are so many benign tumours of the breast which can be removed by medical means alone. Several cases of apparent cancer of the breast have entirely disappeared under the external and internal use of Hydrastis.

Mr. HARMAR SMITH observed that he had attended two surgical cases lately in which medicine given according to the homoeopathic law had been the instrument of cure. The first case was that of a lady, about forty years of age, married, and having had a family, who had consulted him about a tumour of the breast, which very much disquieted her, as she feared that it was of a malignant nature. It had increased rapidly from the size of a horsebean to that of a small orange. It was hard and lobulated, but scarcely hard enough for scirrhus. The pain was lancinating, severe at times, but bearable. It was increased after the least handling of the tumour, and also was exasperated at the menstrual periods. The rapid growth, the circumstance last mentioned, the limited hardness, the tenderness, and the bearable character of the pain, he thought justified him in assuring the patient that it was not scirrhus, a conclusion which the subsequent history of the case confirmed. It was treated with Hydrastis lotion, and Hydrastis and Phytolacca were given internally. Under this treatment it dwindled and nearly disappeared. After a time, however, it returned and was as hard as before.

It

was then treated with Phytolacca alone (drop doses of the mother tincture), and with a very weak lotion of the same tincture (half a drop to each dressing). This time the tumour disappeared so much more rapidly than before that he was convinced that the cure was entirely due to the Phytolacca. The last time he examined the breast there was no hardness to be felt, and no tenderness on pressure, and the patient had passed her monthly period without any return of the pain. He had also found the therapeutic virtue of Phytolacca in threatened abscess and other affections of the mammary gland. In a second patient, who was still under treatment, a nasal polypus had been in a few weeks greatly reduced in size by Thuja taken internally and applied to the part affected. The polypus had nearly plugged up the nostril, but was now reduced to the size of a pea, and looked like a small wart. He had also visited a patient on his way to the meeting, the credit of whose cure he could scarcely claim for homeopathy unless the beneficial action of Mercury in inflammation of the joints could be so reckoned, which he supposed in strictness, it might be. The patient was a youth who had fallen and hurt his knee, and got effusion under the patella with much tenderness on pressure and pain on movement. He (Mr. S.) had first ordered hot fomentations, then cold lotions with Calendula, but there was no improvement. He then applied the Ceratum Hydrargyri Comp. of the P. B. (Scott's ointment) spread on linen rag, an application which he had often used with advantage in the old practice, on the plan recommended by the late Mr. Scott, of the London Hospital. Over the rag he applied strips of plaster and a bandage, then kept the joint at rest by a pasteboard splint, and was pleased on calling to-day to find the pain and swelling gone, and the patient able to walk without difficulty.

Dr. VAUGHAN-HUGHES remarked that it was well known the fissured anus was kept from healing by the passage of fæces over the denuded and ulcerated surface, and he had resorted to the plan of washing out the rectum daily, and then injecting an ounce of Carbolic oil (1 to 10) and leaving it in the bowel, where it was retained with great comfort, so that at the next evacuation no fæculent matter came into contact with the fissure. As a supplement to this proceeding he would scrape the surface of the ulcer with his nail, and thus get a raw healthy basis, and this he would sometimes paint over with a solution of Nitrate of Silver (1 to 20). He had not resorted to the use of the knife for a long time. He once cured in three months a very bad case of fistula in ano (in which the lady said she would die rather than that a knife should touch her). The rectum was perseveringly washed out daily, and the fæces were thus cut off from entering the internal aperture of the abscess, and through the external skin opening a solution of Chloride of Zinc was injected by means of a stopcock syringe attached to a small elastic catheter. Thus

the cavity was cleansed daily, and it gradually healed up from the fundus. Merc. cor. and Arsenic 3× are the remedies usually employed internally by him. Within the last twenty-five years Dr. V. H. had removed a goodly number of scirrhous growths, but he could not venture to say, even under the most favourable circumstances, that they did not, one and all, return sooner or later. Still it was of the utmost importance sometimes that life should be prolonged for a year or two, and he did not hesitate to use the knife. When a tumour did not return he felt sure that it was not really malignant, but of a fibroid or at the worst of an epitheliomic character.

Mr. POPE said, that while he believed it was true that he was the best surgeon who was the least indebted for his success to the use of the knife, he thought that it was equally true that in the early history of homoeopathy evil had been done by too often relying on medicine when the knife had been really required. It was, no doubt, a fact that many cases, where surgical interference would otherwise have been demanded, were curable by medicine alone, when that medicine was homoeopathically indicated. But still there were only too many where this was not the case. Of late years this fact had become more generally recognised, and their business now was to establish clearly the line of demarcation between those cases which could be treated medicinally and those which required the surgeon's knife. Cases of piles, of fissure in ano, and of cancer of the breast were among those which they required to consider carefully from such a point of view. With regard to piles there were many instances of this troublesome disorder of a purely functional character that yielded well to medicine. On the other hand, there were cases of chronic enlargement of the veins which gave an immense amount of discomfort to the patient that no medicine could do more than imperfectly palliate, while the pain and suffering could only be entirely removed by one or other of the methods Dr. Craig had alluded to. While, again, in those cases of bleeding piles where a great drain was going on and undermining the health of the patient, he could see no advantage to be derived from waiting for the specific action of a medicine when other means of remedying them at once were at hand. Tumours of the breast afforded another illustration. In one class where there was a hard and may be suspicious growth in the mamma, Conium was undoubtedly curative. These, however, were not cases of true cancer. Their nature had been described, and their remedy pointed out many years ago, by Sir Astley Cooper, who invariably gave the Extract of Conium in a pill with the, at that time, invariable Blue pill in combination. He (Mr. Pope) had frequently read in homœopathic journals of cases of cancer of the breast cured by Conium. In all such instances he believed the diagnosis had been at fault. Small as had been his confidence in the remedial power of medicine over scirrhus of the breast, he would never again advise the

removal of the disease by operation until a fair trial had been made of the Hydrastis Canadensis. In one such case, which bore all the marks of true scirrhus, he had seen recovery take place. He had felt so confident of the scirrhous nature of the tumour in this instance as to have recommended its removal by the knife. While the patient was endeavouring to reconcile herself to an operation he gave her the Hydrastis, and the result was that the pain left, the retracted nipple again appeared, and the hard swelling became imperceptible. He had been much impressed by the result of treatment in this instance, the more so, perhaps, as it was entirely unexpected. That the cases Dr. Craig had related were true specimens of scirrhus, had been verified by the microscope; and the non-reproduction of the disease, which usually occurred within eighteen months of operation, might, he thought, be fairly attributed to the Sanguinaria used by Dr. Craig. At all events, it was of great importance to know that they bad medicinal measures worthy of some degree of confidence in these very anxious cases.

Dr. YELDHAM urged the absolute necessity of examining the anus and rectum in reputed cases of piles. He had seen many sad mistakes occur from the omission of this simple procedure: cancer of the rectum, attended with the protrusion of granular growth, treated as cases of piles. He had seen several cases of itching eczema ani treated for piles, on the ipse dixit of the patient. He made it a rule never to treat a case of piles, if he could possibly avoid it, without ocular and, if necessary, manual examination. The advantage of this was immense. Some time since he saw a gentleman from the country who had been attended two years for bleeding piles. He had never been examined. On examination a bleeding point on an internal pile was instantly detected. Two applications of Nitric acid stopped the bleeding, and, with proper medicines, cured the pile. In recent piles, medicines, as a rule, were alone necessary, and in some chronic cases too. In all cases they did good. Those on which he relied were the mother tinctures of Sulphur, Nux vomica, and Hydrastis, chiefly. Some cases demanded the addition of other measures. Of these he found the application of Nitric acid the most frequently available. He applied it with a glass rod. When confined to the mucous membrane it was nearly, in some cases quite, painless. It not only stopped bleeding, but under its action the pile shrunk and ultimately disappeared. He agreed with Dr. Hughes that it was rarely necessary to incise fissure in the anus. The object to be had in view in the treatment was to protect the ulcer from the contact of fæces, which irritated the nerves and caused the agonising spasm for hours after. He effected this by the introduction of the finger, immediately before and after evacuating, well charged with lard. As regarded affections of the breast, he knew that cases of fibrous tumour were sometimes removed as cancerous

disease. A lady friend of his once had undergone such an operation. He knew her to have several hard fibrous lumps, feeling like so many small eggs, moveable under the skin of the breast, for many years. A surgeon removed them; they had, of course, not recurred, but she had been in weak health ever since the operation, now some years. The chief diagnostic signs of true cancer were its irregular nodulated condition, and intense hardness. Fibrous tumours were smoother, more uniform in shape, and somewhat elastic. The constitutional condition of the two diseases was also generally different. As to the treatment of wounds, whilst he fully admitted the great value of Calendula as a topical application, and employed it where wet dressings were necessary, as in open ulcers and the like, he, on the other hand, greatly preferred dry dressings in all cases where they were admissible, such as cases of fresh and incised wounds, and the like. Warmth and moisture, conditions unavoidable when lotions were applied to a limb and enveloped in bandages, inevitably favoured decomposition of discharges from wounds, and prevented healthy granulation and union. Dry dressings of cotton-wool and lint had no such effect, but, on the contrary, by excluding the access of air, and water moisture, and infecting germs, they tended to prevent decomposition and to promote healthy action; under these dressings, pus even was benign and unirritating. In incised wounds, whether from accident, or from amputations of limbs, the breast, &c., the plan was to bring the cut edges together with silver sutures (never with thread), wash the blood away around the wound, wipe it thoroughly dry, apply a layer of cotton-wool or lint, and a roller, and let these remain undisturbed as long as possible. He would give an example. A few days ago a gentleman, occupying offices over his consulting rooms, in attempting to draw the cork of a bottle of wine in the old-fashioned way, burst the bottle between his knees and cut his hand and thigh fearfully. The end of the forefinger of the left hand was nearly severed; a large piece of flesh was scooped out between the forefinger and thumb, and hung by a piece of skin only; and a deep wound of three inches long was inflicted diagonally in the thigh, immediately across the femoral artery. Had there not been a considerable layer of fat this vessel would inevitably have been wounded. Keeping the arm in an elevated position for a few minutes till bleeding ceased, and having ascertained that there were not pieces of glass in the wounds, he (Dr. Y.), without washing the blood away, for blood was the best of all lotions, replaced the piece of detached flesh, applied pledgets of dry lint to it and the cut finger, and kept them in position by light rollers of lint. Three silver sutures were inserted in the lips of the femoral wound, and it was covered and bandaged in like manner. This was on Monday afternoon. The dressings were allowed to remain undisturbed till Saturday afternoon. On removing them the union was perfect in every place. The sutures