some food is explicable in the same way. The blood in this case is depraved during assimilation instead of during aëration, and the balance is struck in some similar way to those already pointed out.

3. The case of bad habits, such as indolence and the like, also fall into the same category of adaptation, commencing at the point of nutritive depuration of the blood. To realise this we have only to recall another very important physiological fact, first pointed out by F. Wolff and Treviranus, and particularly insisted on by Mr. Paget, viz., that "each single part of the body, in respect of its nutrition, stands to the whole body in the relation of an excreted substance." From whence it follows as a corollary, that the disease of any part or the cessation of any function will directly interfere with the normal constitution of the blood. We must never forget that blood consists of the relics of the past, the food of the present, and the supply for the future; in other words, effete material from dead and used-up tissues, fully formed nutriment for present use, and partially formed blood from the most recently digested food; and it must also be remembered that a just proportion must be maintained between these three series of ingredients if morbid accumulation is to be avoided. For example, in the case under consideration, indolence involves disuse of muscle; hence diminished tissue-change-hence diminished nutrition -hence less demand for new material, and thus present supply accumulates in the blood. On the other hand, the dwellers in impure air have their blood loaded with the effete matters of the past, which cannot be oxydized or thrown off, while the imperfectly nourished suffer from a defective supply for the future. In each case, however, an adaptation can be effected, provided some function or functions are as much increased as others are diminished. It will be interesting to inquire how it happens that dyspepsia is by far the most common ailment among the three classes of patients to which I am now referring, and a careful consideration of this point will prove instructive.

Healthy digestion requires a healthy stomach; but this

organ will suffer in its nutrition whenever it is deprived of normal blood, or of sufficient nervous influence (8). If, then, the stomach be weakened, some form of dyspepsia must result. But how does it happen that the stomach should more frequently suffer than any other organ in the adaptation which so frequently takes place? Why should not other organs suffer at the cost of which the stomach might remain healthy? That this actually does sometimes happen, I feel sure; but experience proves, that dyspepsia is on the whole the most common chronic disorder, and that many, very many persons who are compelled to lead a physiologically vicious life are unconscious of any other source of suffering. To understand this, we must first recall to mind that the stomach and its allies stand at the entrance, and are the direct recipients of all supplies from without. Associate with this the fact that in all the cases we are considering there is accumulation of some kind going on within, and we at one perceive that the law of balance between supply and demand will operately directly in reducing the functions of assimilation. The activity of every organ is adapted, through the agency of the nervous system, to the amount of work required of it, and we can well understand that a nervous system already suffering from a supply of loaded blood will telegraph to the entrance that the amount of imports must be reduced. But why does not appetite diminish, and thus level the stomach's work to its reduced power? Unfortunately, our appetites are no longer in their state of primitive simplicity, and hence it very frequently happens that the general sense of lowered vitality consequent upon certain functions being depressed induces a craving for something which will strengthen and brace us, and this craving manifests itself in a desire for strong food and drink; thus creating an increased demand for work at the very time when the digestive powers are lowered. The exact form of dyspepsia will be determined by circumstances too complicated for illustration in this place; but the important practical fact to be borne in mind is, that in all these cases the dyspepsia acts to a certain extent as a compensation, and can only be cured by a re

adjustment of the balance of the functions. Our next point for consideration should be how this desirable end is to be attained. The first and most obvious step in the process will be to disturb the existing equilibrium, and this will be found on examination to be at the root of all successful methods of treatment. Every process of cure which has yet been tried will be found to consist primarily and essentially of a disturbing of the balance. They almost all exalt some function abnormally. Of course, they effect this exaltation in very different and often in very questionable ways; but still the fact remains-they exalt some function-and, as a consequence, the vicious equilibrium is disturbed, and at once nature's power of adaptation to altered circumstances is called into play. Aperients do this by exalting intestinal secretion; sudorifics do this by exciting the sudiparous glands; stimulants, by acting on the nervous system; hydropathy and the Turkish bath, by acting upon various systems, but pre-eminently on the skin; gymnastics, by acting on the muscles; alteratives, by modifying the nutrition of certain parts; the thirst-cure, grape-cure, wheycure, &c, by disturbing the process of assimilation, and often by compelling the system to feed upon itself in consequence of the insufficiency of the supply ab extra. The treatment by specifics which we follow differs in no wise from the others, in as far as a disturbance of the pre-existing balance is concerned; but here all resemblance ceases, and we find in Homœopathy a new elemeut which raises it, as a system of cure, infinitely above all other methods of treating disease, and it is this. Homœopathic specific remedies not only evoke the natural powers of adaptation by disturbing the equilibrium of the functions, but they direct the new adaptation along the exact line by which the vicious balance was reached, and hence in the way towards perfect health. This is evident when we remember the important part which the previous history of a case plays in the selection of our remedies. In every chronic disease we carefully inquire into the history of the ailment; and having thus ascertained the road which the powers of adaptation took to effect the vicious

balance, we administer a remedy whose tendency is to effect the very same series of changes, or, figuratively, we supply a guide well acquainted with the road leading back to health through all the labyrinthine steps which have been passed on the way to chronic disease. Most other modes of treatment simply disturb the balance, and leave to chance its readjustment in some more pleasant or healthful way; or, what is worse, many of them establish a new morbid adaptation, requiring a perpetual continuance of the treatment to secure the so-called benefit. For instance, the relief effected by aperients as depurators of the blood is often so marked, that many persons are induced to follow this pernicious habit, regardless of the fact that the ultimate effect of all purgatives is most injurious to health.

It would extend this paper beyond all due bounds, if I attempted to develop the many points of practical importance which branch out from this physiological law; but I trust that having directed attention to this balance of the functions, I may have led my colleagues to some interesting and practical reflections.

ON SOME REMEDIES FOR CLIMACTERIC SUFFERINGS. By Dr. RICHARD Hughes.

THERE are very few women to whom the menopausia is not a time of considerable distress. They cannot call themselves, or be treated as, invalids; yet they rarely feel at ease. It is in the belief that we have some remedies capable of affording much relief to these sufferers, that, being unaware of any existing literature on the subject, I jot down these few notes from practice.

1. One of the most common and not the least distressing of these climacteric troubles is known as "flushes." Their subjects "come over," as they express it, in sudden heats, sometimes dry, more commonly accompanied with perspiration, but rarely if ever preceded by chill. The attacks last

but for a few minutes, but recur frequently, and cause indescribable discomfort. The pathological condition appears to be a hyperesthesia of the vaso-motor nerves, analogous to that of the cerebro-spinal system which obtains in hysteria. There is no arterial tension, and Aconite does not help. I do not know whether Quinine is found useful for it in oldschool practice. But we have a most valuable remedy against it in Lachesis. Administered in the 6th or 12th dilution, it will rarely fail to reduce the trouble to a minimum, and to gain us the grateful thanks of our patient. I owe the original suggestion of this medicine to my friend Dr. Madden.

Dr. Gray, of New York, has recommended Sanguinaria, and Dr. Trinks Sulphuric Acid, for these flushes. I gave the former (1st dec. dil.) in one case with decided benefit.

2. There are two forms of distress in the head complained of by menopausic patients. The one appears to be a special local manifestation of that general hyperesthesia of the vascular nerves which I have already described. There is little or no pain; but the patients complain of great giddiness, with rush of blood, throbbing, beating, and roaring, sometimes with noises in the ears. Lachesis helps this, but not very decidedly. On the other hand, it finds in Glonoine a most efficient remedy. I believe that Dr. Kidd was the first to suggest this medicine for the malady in question (Annals of the Brit. Hom. Society, Sept. 1864); although the pathogenetic indications for it are so strong as to make it wonderful that no one had pointed out its applicability before. I have always used it, as recommended by Dr. Kidd, in the 3rd dec. dilution.

The other head-affection of this period of life is a true ache, a burning pressure upon the vertex. Sometimes it is here, as elsewhere, a symptom of debility from loss of fluids; as when the shifting menses occasionally stream forth profusely. In these cases the patient often complains of a feeling as if the head were opening and shutting. The medicines are obviously China and Ferrum. Quite as often, however, there is no such cause present to account for it,