"The iodide of arsenic is a remedy which has been used but little, owing to an ignorance of its efficacy; and while it is used with great benefit in the night-sweats of phthisis, as well as in many debilitating diseases, there is nothing that will compare with it in pyæmia. To illustrate this I will give a case where its benefits were well marked.

"Mrs. B., from Pennsylvania, consulted me last October in relation to a large ovarian tumor of a fibro-encysted character. The patient was considably emaciated, but stated that she had been in comparative health for some time, only suffering from a fever in the latter part of the day, which she attributed to the size of the tumor, and the irritation' produced by carrying round such a large weight. On examination the tumor was found to fluctuate, and, owing to its size, it had caused prolapsus, so that the vagina protruded to its fullest extent, presenting the appearance of a large penis, the os taking the place of the meatus.

"An incision was made about three inches in length, through the linea alba, when a sound was introduced to ascertain the extent of any adhesions. There were none apparent, only to the transverse colon. Spencer Wells's trocar was then introduced, but to the surprise of all no fluid escaped. It was then thought best to make an incision into the tumor, and endeavor to break down the cysts in order to reduce the calibre of the tumor. In doing this a large sinus was opened, causing such a loss of blood that it was found impracticable to proceed. The wound was then enlarged in the abdomen to fifteen inches, the tumor enucleated where the adhesion to the colon existed, and an attempt was made to lift the tumor from its bed. It was then discovered that there were adhesions of the posterior wall, which were treated in the same manner as those of the colon. The pedicle was tied with catgut in the usual manner. Two cat-gut ligatures were also used in securing small bleeding vessels, and the wound was closed with fifteen silver-wire sutures and dressed in the usual way. The inflammation was kept down with aconite, gelseminum, and bryonia, and the case went on till the twelfth day quite favorably. A telephone message came to me on the night of the twelfth day, saying that the patient was bleeding profusely. On reaching the bedside, I found the bed saturated with a sanguineous pus, the odor of which was enough to stop one's breath.

"After a careful examination it was found that there was no fluid in the abdominal cavity, and that the discharges seemed to come from under the peritoneum where the adhesions were formed on the back. About six hours thereafter I visited my patient, and found her bathed in a perspiration so profuse that it not only saturated the bed-clothes, but ran through the bed on the floor; pulse small and quick, and she had every indication of sinking from pyæmia. The husband was informed that death would undoubtedly ensue in a short time. The iodide of arsenic was prescribed in the first decimal dilution, twenty drops in a half glass of water, teaspoonful doses every half-hour. In twelve hours after the first dose was given, the sweating had entirely disappeared, and the patient made a good recovery. The tumor weighed fifty-six pounds. Since then I have used the iodide of arsenic in every case where I have operated on these tumors, and have found it to work well where there was any indication of pyæmia or blood-poisoning. The case itself would be interesting if given in detail, but only enough is spoken of to give the reader an idea of the workings of this remedy. The iodide of arsenic has been my constant companion for years, and in almost every case similar to the above I have found it to be all that can be expected. It certainly has been, in my hands, a remedy far superior to all others in pyæmia or blood-poisoning."

[To be continued.]

HOW TO STUDY MATERIA MEDICA

BY C. WESSELHOEFT, M.D.

[Second Lecture.]

METHODICAL Work is reasoning work; I would therefore advise you to continue in this methodical method, by next arranging your material in methodical order. As you find it in your condensed as well as encyclopædic te::t-books, your material is in the most chaotic of alphabetical orders. Creation did not proceed upon the alphabetical plan, bringing order out of chaos. Let us imitate the natural process, according to the best of our feeble human ability, and first take a look at the natural order of our material. Here we find that animals, plants, metals, minerals, and compound chemical preparations are divisible, if not always, like animals and plants, into orders, genera, and tribes, still into kinds the members of which have perceptible relationship through common properties and resemblances.

Let us take first, of the vegetable kingdom, an order, or family of generically related members. In selecting such a group, take any reliable text-book of botany, e.g., Gray's; open the book, and you will soon come upon families of plants and their genera. Take up any family you happen to hit upon, and read over successively the different genera and tribes belonging to it, and you will discover that there is scarcely a family group that does not embrace one or more plants which are also contained in our books on materia medica, be they old or new school.

Now write out all the names of plants which are known to you as officinal, arranging them in groups according to botanical orders. Let us suppose you had singled out the solanaceæ, or nightshade family; now let your eyes glide leisurely down the very conveniently arranged list in "Gray's Botany," and you will at once single out the following plants whose names are familiar to us as those of medicines. There you find solanum dulcamara, or bittersweet; solanum nigrum, or common nightshade; hyoscyamus, or henbane; datura stramonium, or thornapple; nicotiana tabacum, or tobacco; atropa belladonna, or deadly nightshade; and capsicum annuum, or red pepper.

Now, in writing out these individual names, all belonging to one family, this circumstance is most suggestive. We know that members of families resemble each other closely: if this is not quite so readily perceptible in the families of the higher classes of mankind, it becomes much more conspicuous as we

This series of lectures (of which the first appeared in the GAZETTE for April) were delivered at the Boston University School of Medicine, and are now published at the request of graduates, and in the hope of being of assistance to present and future students.

descend in the scale of nature, where we shall find that the resemblance of tribes and species among the lower races of man and animals, as well as in the kingdom of plants, is very striking.

From this you are justified in drawing the inference, that, if plants resemble each other outwardly, they will also bear near relationship in regard to their inner properties as drugs and medicines, as which they are used by man. In this you will not be mistaken. Now take up any reliable description of the effects of atropa belladonna, and you will perceive, on reading the history of its effects, that prominent among them are, for instance, spasmodic affections, with distortion of the eyes, laughing, stretching of limbs, rage, etc.

You will find that hyocyamus also produces spasms, diarrhoea, coldness, flexion of the limbs.

Stramonium exhibits among its prominent effects convulsions. with violent motion; also rage.

Dulcamara produces one-sided convulsions, which begin in the face. Diarrhoea and mucous discharges are there noted. Capsicum offers nothing severer than drawing in the limbs, sprained pain.

Tobacco produces spasms of a tetanic kind; also trembling and nausea.

This list is long enough to illustrate my meaning. These vegetable substances have close resemblances by virtue of their family relation. They are not identical, but similar to each other, as indicated by the broad rough outlines I have given. They are much alike in general character, but differ in minor details. By more careful comparison of other groups of effects as produced on the various organs, you will readily perceive the same conspicuous analogies. In noting these, remember always that the differences, which are often slight, are differences nevertheless, and that those differences in their effects, even in the rough outlines, are of equal importance with those external differences in form upon which the distinction into tribes and species is founded.

We make use of their differences therapeutically; they point out to us why one and not another member of the family is to be used. But let us leave this out for the present, and consider only the points of close resemblance. On this is based my plan as to the readiest reasonable way of impressing your memory with drug effects; expressed in the most concise manner, I mean to say that if you have carefully studied one prominent member of such a family of plants, you will already have learned much concerning all the others. If you have got hold of the essential features of the effects of belladonna, you may surmise, with

dominant chances of being correct, many of the distinguishing features of many, if not all, of the other members of the group. They agree in important generalities, but differ in details; still, let me remind you that details even are related in each group.

Do not take alarm at this long description; the whole process of mastering one member of a family of plants, that is, of becoming acquainted with its drug action, will not be the task of hours, but of minutes, even for a mind of average capacity, provided it has some notion of methodical study. The list is soon written out. Without consulting any alphabetical list of remedies, you will recognize the medicinal members of a botanical group. The reading twice or thrice of some reliably recorded proving of the one member selected is also done in a short time. The mind readily retains the important features of a proving, and now being aware that the proving of the other members of a group is in large measure an analogue of the first, the recognition and remembering of the others is less difficult than the first. The preliminary study of materia medica, then, is not a task of years, but can be absolved to a practical extent in a few weeks.

The principle of studying materia medica by analogies of family members is very noticeably illustrated by the study of the Ranunculus group, the Strychnos or nux vomica group, etc.

It is true that this method of study is best applicable to drugs. derived from the vegetable kingdom; but when we have mastered a reasonable number of these, we have acquired a large share of materia medica. Still it remains for us to delve into the animal kingdom. Here we find mollusks, radiates, insects, it is true, but only isolated members of separate groups, rarely allowing us room for generic comparison. This, however, can be compensated for by other steps in our methodical studies, to be described later on.

The metals and their chemical compounds offer a better opportunity than animals for study by the method of analogies. I will not tire you by repeating the description of my method, but will confine my remarks to the statement that metals and their chemical combinations form groups which you will find. conveniently arranged in any good chemical text-book. Thus you will find the iron group, comprising iron, alumina, zinc, manganese, nickel, cobalt, chromium. There is the arsenic group, containing antimony, tin, platina, silver, bismuth, copper. The gold group, with lead, quicksilver, cadmium, etc.

Chemical compounds form groups like those of the salts, such as potassic nitrate, sulphate, bichromate, carbonate, etc. The sodic and calcic salts are nearly related groups; while the haloids such as chlorine, fluorine, bromine, iodine, cyanogen, form closely allied family groups, with clearly marked analogous medicinal

properties; for the study of which, the bromides constitute a familiar example, illustrating the suggestion of study by prominent analogies first, with the addition of differences later, just as we propose to study plant-substances.

Some may raise objections to these proposed methods. fancy I hear them say that Hahnemann said that each drug was different and distinct from the other, and that members of family groups, in Hahnemann's sense, must be considered quite as different as if they were not related at all, botanically or chemically. To that I would reply, that, if such objectors had ever resorted to methodical study of any thing, especially of materia medica, there would have been little need of certain kinds of repertories, like, for instance, Boenninghausen's, jumbling the most heterogeneous things together, according to wholly arbitrary groups of "symptoms" having no foundation in fact or nature, and derived from sources which are not mentioned anywhere.

The physician should have the essence of his materia medica fresh and ready in his mind, prepared by some form of methodical study, which will save him the trouble of laboriously picking out his remedies for each case from repertories. These have their uses; they are as indispensable to us as dictionaries are even to literary men of renown; but a literary man would not establish a reputation if he had to look up every word in a dictionary, as 'some doctors, who did not study properly when young, have to look up each symptom.

Having now obtained a preliminary knowledge, which, however, may serve as a solid practical foundation, we come to the study of extended symptom-lists. As already stated, reliable narratives of provings should be preferred. If these are read after personal experiments in proving of drugs, the symptomlists arranged according to parts of the body, like Hahnemann's Materia Medica (translated by Dr. Dudgeon), or Allen's Encyclopedia, or even Hering's Condensed Materia Medica, may be used profitably; still I would prefer the narrative arrangement of Hughes's Cyclopædia to the others, for study especially. For practical purposes, a combination of both arrangements is desirable, and would be accessible if it were not for the great cost of printing such voluminous records.

The question now arises, of how to master such narratives or other compilations. If you endeavored to do so without preparation and proper method, you would soon be hopelessly discouraged, and I have no doubt that many of the deplorable departures from homœopathy, pure and simple, are due to disappointments arising from fruitless, because unmethodical, study. It is to this that backsliding is due, but not, as some zealous men have it, to