there is much mucous expectoration, and considerable dyspnoea.

"Ipecacuanha, 12th, 6th, and 3rd dilutions, in succession, of each a drop three times a day, for two days.

"22nd. There is much less retching. Repeat, in the third decimal dilution, for six days.

"29th.-Continues better, but has an attack of lumbago. Rhus 3, four times a day.

"December 6th.-The lumbago well, and the cough with its accompanying symptoms nearly gone."

Ipecacuanha has a high allopathic reputation in the treatment of dysentery. Hahnemann, as is well known, objects to its being considered a remedy for this disease, since its pathogenetic action is limited to the production of simple diarrhoea. But it is impossible to suppose that the "radix anti-dysenterica" has obtained its reputation upon no ground whatever, while its mode of action, when curative, can hardly be chemical or physical, or other than dynamic. And when we consider what dysentery is, we find that one of its most characteristic symptoms is identical with that for which in other parts of the body Ipecacuanha has been seen to be the remedy. I speak of the tenesmus. This is a violent and recurring expulsive action, not necessarily proportionate to the amount of irritation present on the mucous surface. When such muscular actions are known as cough or vomiting, the indication for Ipecacuanha is plain. It is no less so, even in the absence of pathogenetic analogy, when it is called tenesmus and takes place at the lower bowel. Only here, as in croup, the amount of mucous irritation is generally too great to be overcome by Ipecacuanha alone. As there Teste alternates it with Bryonia, so here it usually requires to be supplemented by Mercurius corrosivus.

There is another element in dysentery which Hahnemann himself admits may be overcome by Ipecacuanha-" It is capable," he says, "of diminishing the quantity of blood." The power of Ipecacuanha over hæmorrhage is very curious, but undoubted. In intestinal hemorrhage I have hardly ever known it fail; and in hæmoptysis, menorrhagia, and

hæmatemesis, it holds a high rank as a remedy. I know of nothing in the pathogenesis of the drug which shows it to be homœopathic to these maladies; nor does the curative action seem to bear any relation to that already described as characteristic of the drug. So that while the practical fact remains for our edification, the theoretical explanation is at present impossible.

I have found most benefit from Ipecacuanha in the dilutions from the first to the third (decimal). In doses of one or two drops of the mother tincture it is an excellent and harmless way of restoring an absent appetite.

CLINICAL OBSERVATIONS.

Some kinds of Paralysis, Chorea, and Epilepsy.
By Dr. TH. RUECKERT.*

CASE I.-S. M—, a girl, æt. 22, came on the 2nd July, 1863, to ask my advice. She was bent forward, and walked with short and trailing steps. She is of feeble constitution, earthy, pale countenance, and complains of the following symptoms-Since her 14th year she had suffered from frequent attacks of water-brash and vomiting of food. She generally vomited most of what she ate, but she could, soon after doing so, eat again. For the last six or seven weeks the vomiting has ceased, but in place of it she now complains of her back and legs. She has no particular pain in the back or sacrum, nor is any vertebra painful, she has only a paralytic weakness from the back into the legs. When she goes out to walk, she can get on for a little while, but then her strength fails her, the legs refuse to do their duty, and she must stop to rest. In this way she had with great difficulty crawled about three miles to see me. I made her walk about the room, which she did bent quite forward, she could not step out properly, it seemed as if her legs were

*Allg. Hom. Ztg., vol. lxix.

quite stiff. She complains of no particular pains, nor is there any emaciation. It is always dim before her eyes, she cannot read more than a line. There is nothing abnormal visible in the eyes. For some time back she has every week had urinary tenesmus, the water comes away in drops. She has never been regularly menstruated, it only came on scantily; for a year she had none. She has often leucorrhoea of a bland description. Her digestion is better, the bowels regular. Prescription. 1 dose of Thuja, 30.

20th July. The urinary complaints were better the first week, the second they quite disappeared; the leucorrhœa is less. In back, sacrum, and legs, no alteration; the same stiffness when walking.

4th August. The catamenia have returned and kept on for three days; no urinary symptoms. In the back and sacrum there was occasional burning, less latterly. She has less difficulty in moving about the house, not much improvement in walking about the street. The skin of hands and arms is much chapped, the neck and arms are desquamating, and feel very rough. No prescription.

She

She presented herself again on the 9th November. now complained of nothing except a slight want of sensibility of the skin of the legs, she walked with ease about the room, and she had been dancing all night.

CASE II.-A tailor, æt. 40, tall, of strongly marked phlegmatic temperament, hitherto always healthy, had about Christmas suffered from erysipelas of the head, which was improperly treated, and left behind it the following horrible symptoms, from which he had been suffering for six weeks, all the time treated with the greatest care by an allopath; but all in vain, so that the patient dismissed his doctor.

The morbid picture we observed on the 25th February, 1863, was the following:-I went to see the patient, who lived at some distance, and found him in a small, narrow room, in which he could scarcely turn, lying naked in a miserable bed, emaciated to the last degree; the countenancé expressive of pain and despair; the head, arms, and legs in con

stant movement; the hands constantly wringing, and he constantly groaning and crying, "Oh my God! what will become of me!" He then, with a loud distinct voice, repeated the Lord's prayer, some verses of hymns, and the introductory prayer to the communion. In this state he passed day and night, he had no sleep, indeed his uneasiness grew worse at night, he wanted to get out, in fact he leaped out of bed several times, and required people to watch him. When I spoke to him he recognised me, and reached out to me; he answered all questions properly, and begged me to relieve him of his painful anxiety. When I took hold of his hand to feel his pulse and observe the play of the tendons, he drew it hastily away from me, because his anxiety increased when he was held. He had little appetite, and had to be fed, because he could not hold the spoon, and carry it to his mouth. His bowels were rather costive, urine normal. Prescription. Cupr. 6 in solution, for twenty-four hours. I did not see the patient again for several months, but received reports from the parish officer, under whose care I had left him.

1st March. He has been better and worse, at night he has always most restlessness, but the movements of the limbs are not so violent, there is less anxiety, more appetite, bowels more regular. Cupr. as above.

3rd March. On the 1st, at 3 p.m., he was bad again, he would not allow the bed clothes on him, wished to jump out of bed, complained of internal heat, and had much thirst. His bowels were opened by a simple clyster. He continued the Cupr.

11th March. No material improvement, the patient complains chiefly of internal heat, his bowels are confined, and he says he feels as if the limbs were twisted. He has often burning in the soles of the feet. He has little sleep and after sleeping is more restless, but not so much so as formerly, he speaks quite rationally. In consequence of the peculiar sensation in the belly, the constipation and the burning of the soles, I now (as nothing more was to be expected from Cupr.) gave him Nux Vom. 6 and 30, a dose to be given every other evening.

16th March. The day before the medicine arrived he was quite quiet, had appetite, sleep, and only one hour of restlessness at night. After the first dose of Nux he had more excitement, two hours of nocturnal restlessness, and mental disturbance, but the following day he was better; the bowels are still costive.

On the 18th March, I sent Argent nitr. 12, 1 dose to be taken in solution.

27th March. The patient slept for some hours at night, had appetite for his food, regular bowels, the anxiety has gone off, he often sits up in bed and reads, and only now and then he has twitchings in the muscles. He complains of great weakness, but starts at every little noise. I sent him now 3 doses of Ignat. 12, one daily.

9th April.—The improvement advances, digestion good, he lies quietly with his clothes on, can also go to the watercloset, does not sleep by day, but at night for hours at a time, still complains of great weakness and tearing in the legs. To complete the cure I sent one dose of Sulph. 30, to be mixed with three spoonfuls of water, half a spoonful twice daily.

Up to the 19th July, when I was able to visit him, I heard that he kept well, and then I found him sitting up in his room at the spinning wheel, looking stout and pleased. He had nothing more to complain of, except some bodily weakness, and I found oedema of the legs, for which I prescribed Lycop. 30, after which the oedema rapidly went off, and the patient could again earn his living as a day labourer.

July, 1864. The patient remains quite well.

CASE III.-Miss. P-, æt. 25, strong, full-blooded, short, healthy-looking, has, as she says, always enjoyed good health up to three years ago, when, after a distressing dream, as she alleges, she had an attack of rigor, followed by fits of alternate laughing and weeping. These attacks have since been periodical; only latterly the weeping has given place entirely to laughing. They are worst just before menstruation, which is regular every four weeks, but sometimes more, sometimes