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to say, there would be a motor paralysis of the right side, and an anästhesia on the other side of the body, what is called as you know, hemiparaplegia (spinal). In the brain lesions there rarely are troubles of sensibility, and there again the face is always involved; there are also phenomena of contraction after a short time. Well, there is none of all this in our two patients. There is no atrophy in them, and there is a complete loss of sensibility. You can take a piece of ice and rub it well into the paralyzed parts and they will not notice it at all. The abolition of sensibility exists also on the right side of the tongue, with a complete absence of taste. On that side we will rub some sulphate of quinine on his tongue, and you see it does not make any difference to him as long as it is kept to the right side. He tastes nothing, and if one does not taste the bitterness of quinine sulphate they will taste nothing at all. Added to this, if you put your finger down into his pharynx on that side he will not gag; on the other side he will. Finally they can both be thrown into hysterical attacks with the characteristic symptoms of opisthotnosis, etc., that you know so well. By acting on the hystero-genic zones, that exist in both of them, an attack can be brought on.
The second one presents that curious example of muscular contraction, on pressure, seen in hysterics. You notice when I make pressure on one set of muscles of the arm that the corresponding set harden, and unless you make a massage of the part, they will remain so for hours, and give great difficulty to get them back to the normal state. It is rather curious that hysteria in men is much more serious than it is in women. Both these men have now been here nearly two years, but we have not succeeded in curing them yet, which is frequently possible in women in much less time. We will not go into the regular treatment to-day-most of you know it well enough; but we may say a word or two in closing on the treatment by hypnotism. These patients are easy to put into the hypnotic state, and an effort could be made to act on them by suggestion. The psychical and moral element of cure is quite possible here, but you must not expect great success from this new mode of treatment; still it has given good results, and can be tried.
In cases of such an obdurate character as seen in these two men, the influence of the psychical force would not be as great as in the milder types generally found in females. The attempt to produce favorable effects by this method is not flattering.
ANTIPYRINE AS AN ANALGESIC.
The first experiments tried with antipyrine were as to its antithermic action, and we know now that this medicine is counted among our best to lower the temperature of feverpatients. The number of antithermic medicines having been considerably augmented in the last few years, the study of their mode of action has also progressed much. Dujardin-Beaumetz, among others, has called attention to the mode of action of a certain number of these, and remarks that they act, not in diminishing the febrile combustion, but by a direct action on the thermic centers of the spinal cord.
Salicylic acid, acetanilide, salol and antipyrine have been used as analgesics. Antipyrine, which occupies us especially, has been employed as such since 1884, by Alexander, to calm pains of the joints. In 1885, Liroff employed it in the treatment of migraine. In 1886, White and Sprimont employed it with success in migraine. Finally, G. Sée, in a communication to the Académie des Sciences, in April last, threw complete light on analgesic properties of antipyrine.
The results of all this experimentation show that antipyrine is par excellence against pain. Our personal observations confirm this view.
Since the month of December, 1886, we have employed it almost daily in our hospital and private practice, to calm the pains which present themselves in the course of certain maladies of the eyes and ears. The effect that we have obtained seems to us to merit the eulogies of Germain Sée before the Academie des Sciences. Here are the conclusions which we draw from a hundred odd observations we have had on the subject in the last eight months:
(1) Antipyrine calms pains caused by inflammations of the eyes and ears, whatever be the degree of their violence.
(2) It causes the advent of ophthalmic migraine to rapidly disappear.
(3) The dose required in the majority of cases is fifteen grains; it may be carried to thirty grains.
(4) The effect is produced in a space of time varying from twenty minutes to an hour.
(5) Its employment in this dose is exempt from danger and serious inconvenience.
(6) The inconveniences are the following: vertigo often persisting forty-eight hours, perspiration, and passing enervation.
(7) Certain subjects are refractory to its action, in this dose, but we have not carried it farther.
(8) Repetition of the medicine during many consecutive days does not always necessitate an increase of the dose to produce the same effect.
(9) In certain subjects a second or third dose produces no more effect.
(10) In some cases we have observed cutaneous eruptions due to the effect of the remedy.
(11) Antipyrine in doses of fifteen grains is used to calm pain in cases where doses of one-fourth or one-half a grain of morphine were powerless.
(12) In certain cases it not only causes the pain to disappear, but it influences favorably the course of the disease.
(13) It not only causes the pain to disappear, but its calming effect is often prolonged to two or three days, or even more.
(14) Its employment does not call up in the minds of patients the same objection that morphine does.
(15) It does not create, as does morphine, a disposition to habit.
Dr. H. E. Derosiers gives us the following observations on the subject of antipyrine employed as an analgesic.
Observation 1.-J. A. M., aged thirty-six years, has tertiary syphilis; presented himself for consultation the 20th of May, suffering from violent pains in the head. These pains are of a shooting character, dull, and confined almost entirely to the right side of the head. They radiate sometimes to the right side of the neck, and are felt principally at night. The patient had followed a course of iodide of potassium two or three months previously, after which the rupia had healed. They tried iodide of potassium in the same doses as previously, but without success. Mercury, in the form of calomel, and then in the form of inunctions, was afterward substituted for the iodide of potassium, but without any appreciable result. Morphine was poorly supported. Antipyrine was then prescribed in a dose of fifteen grains, to be repeated at the end of two hours, if the first failed of effect. An evident relief followed the first dose of the medicine, and the pains entirely disappeared after the second. The relief did not last more than twenty to twentyfour hours, and it was necessary to repeat the doses on the morrow. During three weeks the antipyrine was administered, and always with the same immediate effect. At the end of three weeks they could gradually diminish the dose, and then stop it altogether, the pain having almost ceased. The mercurial treatment had been continued all the time, and it is undoubtedly due to this that the pains gradually disappeared. As to the antipyrine, it is impossible to doubt its efficiency as an analgesic in
The two doses (fifteen to fifty grains each) caused all trace of pain to disappear in less than two hours.
Observation II.-Mary M., aged thirty years, wife of preceding; non-syphilitic. Had suffered from tic douloreux for two years, the attacks coming, in general, two or three times a month. Antipyrine in a dose of twenty grains, given at the moment of the attack, produced a complete freedom from pain in an hour and a half. It was not necessary to repeat the dose. On the morrow the pain returned, and twenty grains of antipyrine were given with the same satisfactory result. At the end of four days of this treatment the neuralgia disappeared.-A. A. Foucher in L'Union Medicale du Canada.
NEW TREATMENT OF MALIGNANT PUSTULE.
Dr. D. Frederica Ricas, in the Union de las Ciencas Medicas of Carthagena, Spain, gives an account of three cases of malignant pustule treated with success by a dough composed of powdered quinine and oil of turpentine.
The first case was that of a woman who had a pustule at the metatarso-phalangeal joint. It had been treated in many different ways, but as none had the desired effect, they used the dough spoken of; the pain ceased immediately, the cedema of the extremity diminished, and it was reduced to a scab, which was detached on the fourth day, leaving an indelible scar.
The second presented itself, a few days after, on a shepherd in whose flocks this disease had been epidemic. It followed the bite of a fly at the inferior part of the temporal region : two hours after the accident, an intense ædema of the head and neck completely disfigured him. In consequence they applied this dough, and in two hours the cedema had diminished much, and the pain disappeared. At the end of two days a large quantity of bloody pus was discharged, and at the end of four, the scab came away.
The third case was that of a shepherd of the same flock, who, without consulting a physician, applied what remained of his comrade's medicine. The scab formed and detached itself, under the same conditions as those preceding, on the fourth day.
Though the cases observed were few in number, they nevertheless, by their precision and the rapidity of the effect, encourage the trial of this treatment before
other. The quantity of the powder and the oil to employ are such as to form a soft dough. It should be renewed often, on account of the quickness with which it dries.
TREATMENT OF CONSTIPATION BY ABDOMINAL MASSAGE.
A symptom of many diverse causes, constipation is most frequently due either to the relaxation of the muscular tissue of the large intestine, and the diminution of its contractility, or to the lack of secretion of the intestinal juice or of the bile, or yet to a mechanical obstacle impeding the course of the fæcal matter.
Without mentioning all the causes known, we will say that constipation follows frequently in the course of divers affections of the nervous system (hysteria, medullary lesions, etc.). In this order of lesions, the diminution of contractility affects at the same time the abdominal muscles and the muscular coat of the intestine. You know what grave disorders result from habitual constipation : occlusion of the intestine, progressive atony, enormous dilation of the intestine, etc., and among the psychic phenomena, hypochondria and its consequences.
We have had occasion to treat, by abdominal massage, a number of cases of constipation that would not yield to the usual therapeutic measures.
Manner of Proceeding. We have practiced abdominal massage as it is done in Holland and Germany, but have introduced a new feature of our own which will be explained hereafter.
After kneading gently the abdominal integument and then the muscles, one should press gently on the cæcal region with the palmar extremities of the fingers, and then with closed hand should execute a very profound massage of the entire colon. Hostile to all rough practice, we are of the opinion that the massage should be at the same time gentle and very deep. We