cerebellum inflamed, and present (especially the latter) a certain degree of softening. Serous effusion in the cellular tissue beneath the arachnoid, the ventricles, and at the base of the brain. The sinuses of the dura mater are distended with blood. Spinal cord. The integuments strongly injected; the vertebral sinuses filled with blood, soft and fluid. Medullary substance red and congested.

Circulating system.-Heart.-Bulk normal, sometimes serous effusion, due to pericarditis. Heart always gorged with black blood, containing fibrinous clots; left side generally bloodless, there exist also brown spots on the parietes of both sides of the heart; the large vessels contain black blood, quite fluid. Respiratory system.Larynx, epiglottis.-More or less deep colouring of the mucous lining, with more or less injection of the venous network which covers it. It contains a frothy, whitish fluid. Trachea. Injection; bronchial glands gorged. Lungs. Bulk normal, generally crepitant, presenting some petechia and nuclei of pulmonary apoplexy; bronchi sometimes gorged with thick mucosities. The vessels are filled with black blood, liquid and ropy; some obstruction was also ascertained at the back; but this, we think, was the result of incipient decomposition.

In short, the symptoms produced by poisoning with Enanthe crocata are as follows, according to authors in general and Dr. Bloc in particular. The attack presents two forms: first, sudden; second, consecutive.

1. Some minutes after swallowing it the subject utters a cry and falls a prey to convulsions. 2. These symptoms do not appear again for about an hour. Local symptoms.— Some time after ingestion, spots appear on the hands, face, and limbs, at first rose-coloured, then becoming deep red like the stings of Urtica urens. This eruption may extend over the whole body; it is preceded and accompanied by a sharp itching. In about two days the redness abates, the eruption decreases, leaving a scurfy desquamation. But the progress of this eruption is not always so gentle. The dermis is inflamed, the glands are gorged, and there appear shortly signs of a phlegmon which runs its usual

course, ending either by resolution or suppuration. Observe that this eruption sometimes shows itself in subjects who are poisoned, but especially from the application of the juice on the hands.

General symptoms.-1. Regarding the nervous system: shivering at the outset and horripilation; loss of consciousness and of memory; agitation brisk, shaking, and intermittent or rather with remission; acute cries; delirium more or less prolonged; stupor, vertigo; convulsive movements of the muscles of the face, jaws, and limbs ; sometimes opisthotonos. Well-marked trismus proceeding from mere cramp to impossibility of opening the jaws, or having them opened by force. Dilated pupils, contraction of the muscles. of the eyelids, spasms of the muscles of inspiration, fainting fits, sometimes horrible convulsions followed by general insensibility and death. We rarely observe hallucinations.

2. As to the alimentary canal, an acrid sensation, biting and burning on the tongue, mouth, and fauces; sensation of constriction of the pharynx. Appearance of red and brown spots on the parts directly in contact with the poison. Bloody froth at the nose and mouth. Tongue projecting and almost always bitten. Acute burning pain of the œsophagus, stomach, and intestines; pressive pain in the epigastric and abdominal region. Nausea, efforts to vomit with or without effect. Virulent smell of fried celery. Loss of appetite. Obstinate constipation, or frequent stools.

3. As to the circulatory and respiratory symptoms: irrregular beating of the heart; small pulse, and thread like; respiration short, with long intervals, and sometimes appearing to cease entirely. Brisk expirations are made from time to time to expel masses of bloody mucus.

4. As to secretions; at first, cold clammy sweats; then dryness of skin. Excretion of urine: In general, there is retention, and very little is passed each time.

Of all maladies, epilepsy has most resemblance to this poisoning; but epileptic attacks last on the average ten to twenty minutes, whereas the sufferings produced by the poison are of long duration, extending beyond eight hours and even

for days and weeks. In epilepsy the trismus never lasts longer than the fit, and is not always present. In poisoning cases it not only appears during the general attack but lasts very long, even so as to prevent emetic treatment from impossibility of introducing liquid into the mouth, and they haye to inject it by the nostrils with the œsophagean catheter. Out of 124 poisoning cases whose phenomena have been recorded in this work there were fifty-five deaths.

As a result of all that we have related (almost verbatim) it is the opinion of other authors, and of Dr. Bloc himself, that Enanthe crocata, and especially the root, gives rise in man to all the symptoms of epilepsy. According to experiments on animals with the fresh juice, or aqueous or alcoholic extract, or even with the tincture in small doses, it provokes in them also symptoms analogous to those of epilepsy. The lesions of the dead body ascertained by post-mortem examination present in each case precisely the same alterations. From this similitude of symptoms ascertained during life, and of the organic lesions found after death, may we not hope that this plant can be administered beneficially to epileptic subjects? This is what we wished to try in the case of one of our dispensary patients. This young man, about 22, presented frequent epileptic vertigo, and sometimes biting of the tongue and involuntary urine during the fit, with total oblivion of all that had happened during the crisis. We prescribed, for four months, Enanthe from the 6th dilution to the "mother tincture" in drops. Sometimes we observed retardation of the attacks, which, from fortnightly, became monthly, and retardation and diminution of the vertigo. But at other times the vertigo and fits reappeared as often and as intense as ever, though we could not positively prove that the strong doses produced aggravation. This patient left off coming. I ought to add that, having taken his medicine from a druggist's shop, where I was not quite sure that they had the Mother Tincture of Enanthe crocata, and not from Messrs. Catalan, where I had verified its presence, I cannot feel certain as to this experiment.

475

NOTE TO "EXAMINATION OF HAHNEMANN'S

PATHOGENESIS OF BELLADONNA.'

By Dr. RICHARD HUGHES.

In the account I have given (vol. xxxi, p. 669) of the symptoms cited from Greding, I have said that SS. 262, 507, 648, 703, 704, 968, 1255, 1283 of Hahnemann's pathogenesis are referred to a paper of this author's on Stramonium, and have nothing to do with Belladonna. I made this statement upon the following data. The first symptom cited from Greding (S. 12) is authenticated thus: "Greding, in Ludwig's Adversaria medica Practica, vol. i, page 670."

Subsequent symptoms are cited as from "Greding, a. a. O." (2. e. loc. cit.) with the page of each. When we come to S. 262, we find "Greding, a. a. O., p. 324." This should mean p. 324 of the same book; and my supposition was strengthened when I found that Greding was there also the contributor. S. 507 was similarly characterised, only as at p. 321; and I came to the conclusion that Hahnemann had through negligence incorporated into the pathogenesis of Belladonna symptoms he had excerpted for that of Stramonium. Under this (I think justifiable) impression, I classed the remaining symptoms of Greding's whose pagination seemed to refer them to his article on Stramonium with these two, and expunged them all.

But, some time after, I noticed in S. 648 an addition which had escaped my eye. It is credited to "Greding, a. a. O., vol. ii, part 2, p. 323." On referring, accordingly, to the second volume of Ludwig's Adversaria, I found a paper of Greding's on the treatment of jaundice by Belladonna, in which all the eight symptoms occur. I have, therefore, to shift to my own shoulders part of the burden of negligence, but must submit that I was led into the error by the incorrect reference given in SS. 262 and 507. (I may add that SS. 703, 704, 968 have also no distinguishing mark; but SS. 1255 and 1283 have II. 2 inserted.)

These symptoms have accordingly to be examined on their own merits.

They occurred, in three patients suffering from jaundice -not very favourable subjects, one would suppose, for a pure proving. The first, a woman of 32, presented SS. 704 and 1255. Of these, S. 704 ("green stool, with diuresis, and thereafter sweat") is quite inadmissible; for the green stools (which continued several days, with continuous decrease of the icteric tint of the surface) were simply the evidence of the reappearance of bile in the evacuations. S. 1255, however, seems a genuine effect of the drug; but it should have read "pulsations of the arteries, especially in the temporal region."

The second patient, a girl of 17, was the subject of SS. 507, 703, 968, and 1283. Of these, S. 703 must be rejected on the same grounds as S. 704. S. 968, moreover, is merely an aggravation of a symptom she had before beginning the Belladonna, and cannot be reckoned a certain drug-effect. The other two symptoms have nothing to forbid their retention, and S. 507 is of some importance. To the third patient, a youth of 17, belong SS. 262 and 648. The first is, of course, a Belladonna symptom; but the second is very doubtful. On October 29th he complained of pain in the hypochondrium, back and loins; and then began the remedy, gr. j of the powdered leaves being taken twice a day. On the 31st "he felt a sense of considerable weight pressing in the lower belly, in place of the pains which had occupied the hypochondrium, back and loins." On November 1st this sensation was much less troublesome.

My conclusion is that SS. 648, 703, 704, and 968 are to be rejected; but the rest retained. As I was unable to make this investigation in time to incorporate its results in my arrangement of Belladonna for the Hahnemann Materia Medica, I will ask those of my readers who possess it to write in the following:

750 a. Inflammation of the tonsils, which after four days suppurate; during the time she cannot swallow a drop (Greding, in Hahn.).