salt (Merc. sol. Hahnemanni). Of this "formerly," he says, "I was in the habit of using successfully one, two, or three globules of the billion degree "-i.e. 6th centesimal-" for the cure of syphilis. The higher degrees, however, even the decillion degree"-i.e. 30th-"act more thoroughly, more speedily, and more mildly. If more than one dose. should be required, which is seldom the case, the lower degrees may then be employed."

When the chancre has been removed by external means, but the constitution is not psoric, nor injured by mercurials, the same treatment is still curative of the internal disease. The original spot on which the chancre had been developed will in such cases exhibit a morbid-looking red or bluish scar. "If the homœopathic physician has discovered that bluish spot, and by this discovery has become convinced that the internal disease is not yet cured, the patient, provided he is perfectly free from all symptoms of psora, may be perfectly cured by one single dose of the above described mercurial preparation; and, as a proof that the cure is perfect, the bluish scar will completely disappear, and the skin at that spot assume the same healthy appearance as the rest of the body."

Into the treatment recommended by Hahnemann for fully developed constitutional syphilis, which he considers to be always complicated with "psora," we do not enter, referring the curious reader to the Chronic Diseases for further information. But, as regards the treatment of chancre, has Hahnemann's practice been verified or disproved by experiment? and if not, do we not owe it to him to put it to the test?

NOTES ON SOME FORMS OF PARALYSIS OCCURRING IN INFANCY, CHILDHOOD, AND PRINCIPLES OF TREATMENT FOR THE PREVENTION AND CURE OF PARALYTIC DEFORMITIES.

YOUTH, AND ON THE

By Dr. ROTH.

EVERY variety of paralysis which occurs in adults can also occur at an earlier age; to speak of an infantile or juvenile paralysis as distinct from paralysis in adults is only a conventional term.

Conditions under which paralysis arises.

1. The conditions under which the various forms of paralysis arise are very numerous, and the most common and general causes are those which destroy that normal state which is essential either to the conditions of sensitive impressions to the brain, and to their perception by the mind, or to the conveyance of the will, or rather of the stimulus of the will through the nerves of motion. Pressure on the brain by a large effusion of blood or serum, by fracture and depression of the bones, by tumours, or by excessive fulness of the cerebral vessels, disorganisation of structure, in fact whatever prevents the free circulation of the blood through every part of the brain or spinal cord, may produce paralysis which will be either general or local, according to the extent of separate portions or tracts of the brain and spinal cord which are affected.

From this source also originates the difference of the principal varieties of paralysis. If a central part from which a sensitive nerve arises be seriously diseased or destroyed, there will be loss of sensation (anesthesia, paralysis of seusation) in the part supplied by the sensitive nerve in question, but its natural power of motion will remain unaltered;

if a centre of origin for motor-nerve be diseased or destroyed, the part supplied therefrom will lose its motion, but retain its sensibility; if an amount of nervous matter, which is a centre both for sensitive and motor nerves, be diseased, loss of sensation and motion (or complete paralysis), loosening, or relaxing, will take place.

Additional causes of paralysis.

2. A morbid change in the blood, such as may be induced by typhoid fever, scarlatina, measles, diphtheria, or anæmia. Congestion and inflammation of the nervous centres, and of their surrounding membranes, organic changes in the structure of the brain, spinal cord, and the spine itself, convulsions, epilepsy, chorea, metallic and vegetable poisons, functional derangements of various organs which act by reflex action. Brown-Séquard asserts that cerebral paralysis may be reflex by an irritation from a remote morbid part of the brain being transmitted to another part whose function is to control muscular movement. Onanism and masturbation, as well as too premature and too frequent abuse of the sexual functions, exhaustion, mental and bodily overwork, mechanical and traumatic influences, are amongst the most frequent causes of the various species of paralysis.

Paralysis frequently a symptom of other complaints.

3. Paralysis cannot be said to be always an idiopathic disease, and should, therefore, be considered rather as a symptom of some disorder of the nervous system (often seated at a distance from the part where sensation, motion, and nutrition have been lost), or of a disease of any other organ acting by reflex action on the nerves. Congenital paralysis is often caused by deficiency or atrophy of central organs, and arrested intra-uterine development; the various hysterical, rheumatic, arthritic forms of paralysis, and those caused by congestion and inflammation in the brain and spine, and its membranes, are merely symptomatic. VOL. XXVII, NO. CIX.―JULY, 1869.

D D

Division of paralysis with regard to the diseased nervous

organ.

4. For practical purposes relative to the seat of the diseased organ causing the paralysis, we speak of a central (cerebral or spinal) and peripheric paralysis; and with regard to the various functions which are affected, there is paralysis of sensation, motion, and nutrition (this last usually but erroneously called atrophy, because this term expresses only that the nutrition is diminished, but not that the nervous influence providing for the function of nutrition has ceased). Loss of motion and nutrition are often co-existent, or the latter is an effect of the former. Loss of motion and sensation are less frequently combined with loss of nutrition.

The (atrophic localising) infantile paralysis.

5. This disease is frequently called the essential paralysis of infancy, THE infantile paralysis (Laborde); spinal paralysis of children, spinale Kinderlähmung (Heine); fatty atrophic paralysis of infancy, paralysis atrophique graisseuse de l'enfance (Duchenne); paralysis myogenique (Bouchut); torpeur douloureux des jeunes enfants (Chassaignac); atrophic paralysis of children, with fatty degeneration, &c. These are some of the names given to a particular form of infantile paralysis, which has been and is still frequently confounded with a similar disease, caused either by metastasis during the critical stages of the febrile exanthemata of childhood, or by several of the pathogenetic influences mentioned in paragraph No. 2.

Reasons for suggesting the names atrophic and localising.

6. I believe that the words atrophic and localising will by naming two constant characteristics of this form of infantile paralysis prevent the confusion at present caused by the general term of infantile paralysis, because infants suffer just like adults from various forms of paralysis. As

this form of infantile paralysis causes the majority of shrivelled, lame, cold, half-dead limbs, contractions of joints, and all kind of deformities, it might be useful to mention it first, and to give an extract of all what is known about it. The principal sources are Heine's and Laborde's monographies, and I have preferred to consult the original German and French works instead of repeating quotations given by other authors. My own and original contributions refer more to the treatment of this complaint, which is a disease sui generis, and not to be mistaken for other forms of paralysis occurring in infancy.

The characteristics of the atrophic and localising paralysis in infancy are

7. (a) That in the majority of cases it occurs in babies and infants at the age of from four months to five and six years.

From six months to two years Duchenne saw 37 out of 56 cases; West 27 out of 43 cases; Hillier 8 out of 12 cases; Laborde 16 out of 26 cases.

(b) Without premonitory symptoms a violent or slight feverish state precedes the paralysis. This fever lasts sometimes only from twelve to twenty-four hours, rarely more than ten days, and varies in intensity. In more severe cases the little patients are very restless, and the pulse rises to 140, 150; there is no vomiting, a symptom very frequently occurring in other fevers of children, and especially in cerebral affections; a kind of somnolence induces the medical man to believe that a comatose affection proceeding from the brain will be developed, but the short duration of the fever, the complete absence of cerebral symptoms, and the general paralysis of the limbs which at one stroke attacks all the limbs as well as the trunk and neck, shows the difference between this and cerebral paralysis, or other affections of the brain. Laborde has in 50 cases observed the fever 40 times; West in 32 cases 5 times. Often the fever is so slight and short that it is scarcely or not at all observed, and the mother or nurse find an infant paralysed