any had disappointed us that we might with every propriety give Aconite.

It is perhaps worthy of notice that the last two sentences are antagonistic in one of their conditions as to the effect of movement; in the first pain is caused, in the other it is allayed. The last sentence is well worth bearing in mind, as the lameness complained of is by no means rare amongst persons much engaged in literary composition.

Crampy contractive pain in the hand and fingers, sometimes accompanied with stitches. Tearing and paralysing drawing in the wrists. Numbness, icy coldness, and insensibility (deadness) of one hand. Cool sweat of the palms of the hands. Swelling of the hands, with frequent paroxysm of cough, and good appetite. Drawing, jerking pain in the thumbs; pain in the thumbs as if sprained and lame. When bending the fingers, violent stitches dart through the wrist-joint to the elbow-joint. Tingling pain

in the fingers even while writing."

It will not be necessary to make much comment on this quotation because most of the troubles are like those before glanced at, the site and sphere of them only being different. We may conclude for the most part that the same provers who had stitches in the fingers, tingling, tearing, &c., had also like affection in the region of the humerus. "Icy coldness of one hand" is backed by "Icy coldness of both hands" in the Oest. Zeitschrift, but Bönninghausen in the three (only) symptoms he records respecting the upper extremity has "Hot hands with cold feet." Were it not impious and disloyal to say so or think so, the sentence beginning "Swelling of the hands" might be reckoned an incongruous one, the pathological relations being not very evident.

(From the Oest. Zeitschrift.)

"Stinging and pricking in the arms and fingers. Jactitation of the arms. Shooting stitches in the left shoulder. *Drawing, tearing pain in the shoulder-joint. Violent drawing and tearing, with a feeling of lameness in the head

of the left humerus.

Lameness and stiffness of the outer

side of the right upper arm. Frequently recurring pinching as with dull pincers in some parts of the left arm."

It is highly probable that the stinging and stitching sensations have their seat in minute fibres of nerves, not in the larger trunks and main branches, and for the most part are subcutaneous. Jactitation is trembling in a magnified degree. The sentences describing acute pain about the shoulder-joint seem to mark deep-seated lesion, and it would appear from the asterisk and italics have been notably cured by Aconite. With regard to lameness and stiffness of the limb, the cases which most commonly have been treated by me with these features have been those of pseudo-paralysis in women, about the age of fifty, in whom the catamenial periods have become very irregular in their return or have ceased altogether. Aconite and Lachesis help this form of

disease.

Acute pain

*" Drawing, tearing pain in the elbow-joint. in the right forearm along the tendon of the flexor digiti minimi, increased by movement. Drawing, tearing pain in the forearm. Prickings in the joints of the forearm. Insensibility of the palms of the hands. Icy coldness of the hands. Drawing, tearing pain in the wrist-joint and fingers. Hot pricking in the tips of the fingers at night."

With the exception of ordinary rheumatic pains, especially in elderly people who have worked hard for many years whilst exposed to cold and wet, I do not remember many cases of disease which were at all parallel to the above. But of such as I allude to a few might be described were they not so miserably common. The effects produced have been some stiffness and immobility of the shoulder-joint, likewise of the elbow, rarely with deformity. But in the wrist and fingers one often is called upon to prescribe for tendons glued to their sheaths, bursal and other enlargements, lamentable distortion in the joints of the fingers which have become twisted hither and thither; and unhappily the pains which caused or accompanied these lesions have not ceased when the laming effect has been produced. Neither with Aconite nor any other remedy are we able, in

this chronic condition of things, to effect anything better than slight palliation.

It boots little to say that had these patients been at an earlier period subjected to common sense or, as we call it, homœopathic treatment, our blessed drug Aconite would have helped them very much.

Lower Limbs. "After sitting the thighs and legs feel lame and weak. Tensive pressure in the thighs as if a tight bandage were drawn around them, with great weakness when walking. Weakness in the region of the head of the femur and inability to walk, owing to an indescribable intolerable pain as if the head of the femur had been crushed, particularly after lying down and sleeping. Numbness and lameness in the left thigh."

The two first sentences of the above quotation are not very suggestive of clinical comment, the tight-bandage sensation being one of rare occurrence, albeit well deserving to be kept in mind. For the rest, although the passages do not point clearly and unmistakeably to what we understand by the expression hip-joint disease, I shall take this opportunity of subjoining a few remarks on that subject, and though when one sees in every town of any importance strumous children in whom one of the lower extremities has been dislocated at the hip-joint by the slow process of scrofulous inflammation and suppuration, the question naturally arises, Are there no means hitherto discovered, in allopathic or homoeopathic modes of treatment, whereby such a direful calamity might be more frequently averted than it hitherto has been? And there is also another interesting question connected with it, viz. By what strange cause does it befal that double hip-joint disease is unknown? It might have been reasonably presupposed that, when one joint has been destroyed, and the limb of which it formed a part has become suspended, and doomed to be a mere pendulous crippled extremity, the other limb, having to bear the whole weight of the body almost constantly, and at a great disadvantage, would soon become hors de combat also. For whoever has noticed a case of this sort with single crutch, or crutch and stick, may well

be astonished at the rapid and nimble rate at which the child will get over the ground, and at each step, if so it may be called (for the motion is more like vaulting with a pole), coming down to the ground with a shock and jerk of a very pronounced kind.

we

If hip-joint disease were always treated very early and according to reasonable indications, the success should meet with would be far greater than it ever yet has been. As an illustration of what I mean the following sad case may be recorded:

Many years since a poor man brought to me his daughter, æt. 10, and stated that she was suffering from an inflammation of the right knee, but it was very evident that there was disease of the hip-joint of the same side. I mentioned the nature of the disease, and prescribed for the child, and requested the father to come to me again in a week, and directed that the limb should be kept in a state of entire rest. I saw nothing further of the man for several months, when he came again, bringing the little girl with him, and expressed his extreme sorrow that he should have listened to other advisers, who confirmed him in his first opinion, that the knee was the principal part affected, if not the only one; there had been suppuration of the joint, and the child was lamed for life.

Soon after this event, another patient, in an early stage of this disease, a boy of nine years, came under treatment in good season, and the parents being intelligent and trustful, the disease entirely subsided in six weeks, Aconite and Belladonna being administered internally, and Belladonna lotion assiduously applied to the joint.

"Unsteadiness of the knees, they totter and give way in walking; tearing of the knees, as with a jerk in the inner side; drawing in the right leg, and the region of the tendo Achillis extending as far as the heel; the legs feel heavy; the legs and feet feel numb, and go to sleep; pain in the tarsal joints, accompanied with despairing thoughts and the dread of death."

Bönninghausen gives "want of power in the hip and knee-joints." The first condition given in the text of our

Materia Medica I have never had to treat, except in a man, æt. 26, who had suffered some degree of paralysis of the lower extremities when a child. The attack was believed to be due to severe convulsions when teething was going on in a painful manner; there was also some distortion of the ankle-joints. The poor fellow on one occasion slipped and fell, at the same time the extensor muscles of the thigh contracted so violently that both ligaments of the patellæ snapped asunder; nor was there ever after any good repair of these structures. The man was sadly crippled, and could only walk by aid of crutches.

The other symptoms enumerated are met with commonly enough in practice, with the exception of the last, in which, strangely enough, there is found extreme mental depression, with affection of the tarsal joints. There can be little doubt that this combination must have been an accidental one.

"Coldness of the feet, extending as far as the malleoli, with sweat of the toes and soles of the feet. Coldness of the feet, particularly the toes. Sensation in the malleoli as if a bandage were drawn tightly around them early in the morning. Excessive pain in the malleolus, diminished by pressing upon the part."

This passage scarcely demands any remark. The diaphoretic property of Aconite is felt, no doubt, in the extremities. It would seem that the malleoli are especially subject to the influence of our drug. The pathogenesy does not suggest to my mind any clinical experience.

(From the Oest. Zeitschrift.)

"Trembling of the lower extremities. The lower extre mities totter. They are in constant motion. Drawing pains in the hip-joint during movement. Drawing pains in the lower extremities, especially in the joints. Drawing in the aponeurosis of the lower extremities. Drawing, tearing pain in the thigh." Trembling and tottering correspond with and confirm the original observation in the Materia Medica, viz. "unsteadiness and tottering of the