one indubitable cure, though I have certainly only tried it in cases where the lower dilutions had produced no effect, and yet Rhus seemed perfectly suitable.

Sambucus, 1 and 2, has several times done undeniable good for affections of the larynx and trachea.

Secale cornutum, 1 and 2, I have sometimes seen clearly efficacious in hæmorrhages and choleraic conditions. 3 and 6 hitherto ineffectual.

Senega belongs to the class which, notwithstanding frequent trials, have never given a definite result.

Sepia I give in 6 and 30. The sixth I choose especially in the appropriate liver complaints with the peculiar colouring of the skin. I prefer 30 in chronic costiveness and consequent plethora abdominalis.

Silicea.-I believe I have seen from this medicine, in trituration 3 and in dilutions 6 and 30, evident effects in individual cases. Which grade is to be preferred I am not able to decide, and so much the less because the nature of most diseases corresponding with Silicea renders a striking effect and cure not very often admissible, but often highly improbable or even impossible. In the case of such failure of effect, it is extremely difficult to decide whether it proceeds from the inaccessible nature of the malady, a wrong choice of medicine, or an unsuitable dose. I have observed curative results beyond all doubt and repeatedly from dilution 6 in hygroma patellare.

Spigelia I prescribe in dilution 6 or 3, and that not unfrequently with good result for heart disease and indigestion.

Spongia, 1st and 2nd decimal dilution, has so often rendered good service in croup, that in this rapidly progressing disease I have not yet ventured to give the dilution which is on many hands prescribed with éclat, viz. 30. From 3 and 6, too, I have repeatedly seen good effects in ring

worm.

Stannum has shown visible effects, in trituration 3 and in dilution 6, for certain forms of bronchial catarrh and mucous phthisis.

Staphysagria I have employed mostly in 6, seldomer in 30, especially for ringworm, but in no dilution have I seen results worth speaking of.

Stramonium 6 and also 3 has often produced very decided effects and cure, especially in St. Vitus' dance (chorea). I have also used 18 and 30, sometimes with good effect, for spasms of the oesophagus and cramps in general in children.

Strontian I used some years ago pretty frequently, but never with any visible effect, so that ever since I have quite

given it up.

Sulphur.-With this medicine, in mother tincture, I have effected a great number of glorious cures, especially many cases of impetigo, eczema, ulcers of the legs, hepatized lungs, &c., so that the excellent effect of this tincture has long stood apart from all question, and I have but very seldom been induced to give Sulphur in a trituration. There are, however, cases where for years I regularly gave 30, and believe I ought to prefer it to the mother tincture; in particular in all those cases where no objective morbid symptoms are present, or where, at least, they are of little account (with the patient), thus the itching and the like in exanthemata. Accordingly, not unfrequently, after the cure of eczema, prurigo, &c., when probably Sulphur in the mother tincture has been given, and has acted with full result, I prescribe a few doses of 30, if excessive excitability of the cutaneous nerves and burning of the skin without any physical cause remain or commence. This, not unfrequently, occurs in itch, after its cure, i. e. after the destruction of the acari. Besides, I select 30 when in acute and chronic diseases of a serious character, after the employment of many medicines, all power of reaction against them seems wanting to the constitution in general and a fatal issue seems to threaten from this cause, as e. g., in typhous pneumonia, inflammation of the brain, &c., and, in fact, I believe I have sometimes seen decided amendment in such desperate cases soon after the administration of Sulphur 30. Finally, in certain cases of chronic constipation, I have observed, occasionally, good

effects from Sulphur 30, also in weekly alternation with Calc. carb. 30, in cases of general scrofulosis.

On the contrary, I give Acid sulph. in strong doses only, from first decimal to sixth centesimal dilution; and from dilution 1 and 2 I have almost always had well-marked results in suitable cases of gastric disease, acidity of the stomach, &c., and from spitting or vomiting of blood, congestions, &c. Nor were good effects much less frequent from dilutions 3 and 6, in scorbutus, purpura hæmorrhagica, and palpitation of the heart.

From Thuja I can, unfortunately, report no such favorable result. I have but seldom seen good after the employment of this medicine (and, even then, could never be sure of the fact), though I have used it often enough in the strong tincture (internally and externally) in 3, 6, 30, nay in 200; I frankly confess that I have entirely lost courage and confidence in the employment of this medicine, so highly esteemed by others, and for years seldom use it, though I most earnestly wish to be better informed.

Veratrum, 1 and 2, I have all the oftener employed with very decided effect for diarrhoea, cholerine, and choleraic sufferings; nay, sometimes the effect was almost instantaneous with quite strong doses. On the contrary, I usually employ 6 for palpitation of the heart, angina, cramp in the legs, gastric affections, mental disorders, &c. For the latter, even higher dilutions (12 and 18) have been of service.

Zincum, in fine, has unhappily done but little for me. either in the third trituration, or in the sixth and thirtieth dilution, though I have not unfrequently prescribed it, and particularly for hydrocephalus and actual inflammation of the brain.

376

THE VALE OF CONWAY SPA.

By JOHN W. HAYWARD, M.D., M.R.C.S., L.S.A.

So many chalybeate springs have been brought under the notice of the profession that it may appear to some almost superfluous to call attention to any more. And this consideration would have deterred me from calling the attention of my professional brethren to the Vale of Conway Spa were I not convinced that it possesses peculiarities of its own, and is superior to any chalybeate water yet described in Great Britain.

It is a strong solution of protosulphate of iron and sulphate of alumina with some sulphate of magnesia and soda, and a little chloride of magnesia, calcium, and nickel. It is very similar to the celebrated spa at Sandrock, in the Isle of Wight, so highly spoken of by Drs. Lempriere, Saunders, Latham senior, Young, Calvert, and Sir Charles Scudamore. And it has already gained great celebrity for the cure of diseases of the nervous system, as paralysis, fits, neuralgias; diseases of the stomach, as dyspepsia, in most of its forms; diseases of women, as chlorosis, menorrhagia, and amenorrhoea; worms; and chronic skin diseases, rheumatism and erysipelas. At times there are not fewer than one hundred patients drinking the water in a day.

The water of the sulphur mine near the summit of Allt Cae Coch, not far from Trefriw, in the Vale of Conway, has been used externally from time immemorial for the cure of skin diseases, and with great success; but for the last thirty years, the water of the old mine-cutting near the base of the same mountain has quite superseded it, and become recognised as

THE VALE OF CONWAY SPA ;

and is used internally as well as externally.

IRON is a time-honoured medicine, and has been eulogised by physicians of all ages and every shade of opinion; and it

well deserves much of the praise bestowed upon it, for it is a very valuable medicine, as its pathogenesy will show. I need not here relate the many symptoms producible and curable by this potent drug, for they may be found in their proper place, and scattered throughout our literature. It will be sufficient here for me to remark that its two sets of symptoms, primary and secondary, are very marked, and that the diseases corresponding with its secondary action are those for which it is generally prescribed even by homœopathists, and that it is to these the following observations will apply.

Iron expends its influence especially on the digestive and blood-forming processes. Its operation is primarily excitant and secondarily relaxant. Hence, at first, and when given in small doses, it promotes and increases the formation of blood from the food, especially the red corpuscles; it increases the appetite and digestion, and stimulates the vital operations; it induces a fulness of blood and quickens the circulation, causing congestive feeling about the brain, with flushing of the face, amounting to a kind of feverishness, with perhaps active hæmorrhages; and it dries up the secretions, inducing constipation and general plethora. But, if continued long, or given in large doses, its secondary action supervenes, and it checks and obstructs the digestion and sanguification, producing loss of appetite, indigestion, dyspepsia with distension and flatulence, fetid eructations, spasmodic pain in the stomach and bowels, nausea, vomiting of food, languor, muscular weakness, and general debility; perspiration, palpitation, want of breath on exertion, chilliness, diarrhoea, and anæmia; and it checks the action of the spleen and diminishes its size (and the spleen being one of the organs that assist in the process of sanguification, this may, as Dr. Hempel says, account for its beneficial effects in chlorosis, vide 'Mat. Med.,' p. 478).

Such may be taken as the general operation of iron, but as there are many preparations or combinations of this metal, so there are many shades of this action. Of all the preparations of iron, the sulphate of the protoxide is the most