this work you have witnessed from time to time. Nothing has been concealed or kept back from you. We have studied together, and let this summary put a meaning to the work-let it give a "method to the madness" that otherwise might seem eccentric.

In conclusion, let me sum up the entire subject in a single sentence. Bring me an individual with clean lips and nostrils; a palate of proper length and unobtruding tonsils; a rectum that presents neither piles, prolapsus, fissure, ulcer, pockets nor papilla-an individual whose sexual orifices are smooth and free from all irritation; if it be a man, his foreskin shall be free, the frenum of sufficient length, the urethral passage smooth and normal in size, especially in its prostatic portion; if a woman, her hymen must be pale and atrophied, her urethra devoid of caruncles and ulcerations, her internal and external os uteri reasonably patulous, and without undue sensitiveness; bring such an individual, and I will point to the same person and show you a human being whose digestion is good, whose sleep is sweet and

WOMEN IN MEDICINE.

(NINTH PAPER.)

MARY F. THOMAS, M. D.

We subjoin the following sketch of this truly noble pioneer, written by Dr. J. R. Wiest, in the comparatively recent publication of the history of Wayne County, Ind.

She was born in Maryland, near Washington City, in 1816. She studied medicine with her husband, Owen Thomas, M. D., then living in Wabash County, Ind., attended a course of lectures in Penn Medical College for Women in Philadelphia in 1851-52, graduated in the same college in 1854; she also attended a course of lectures in Indiana Medical College at Indianapolis in 1869. After practicing medicine two years in Fort Wayne, she removed to Richmond in 1856, where she has since resided. She was elected a member of the Wayne County Medical Society in 1875, after having been twice rejected because she was a woman.

After having passed an examination and been recommended by its censors, she also became a member of the State Medical So

to membership in that body.

On the other hand, introduce to me a mortal suffering with passive congestion in various parts, whose blood finds its lazy way back to the heart by slow stages because the peristatic action of the arteries is tired outa person whose vitality is low, and whose poor, enfeebled body begins to be the prey of inherited or acquired tendencies-consumption, scrofula, syphilis, organic derangements, or whatever form they may take show me such an individual, and they are as numerous as withered leaves in autumn, and I will stake the reputation of this idea that I shall be able, without straining a point, to find legitimate fault with the condition of some one or more of the various orifices of the body.

I SHOULD say that under danger of infection, re-vaccination should be performed, even if a few months only had passed from the date of the previous inoculation.--Hardaway.

In 1877 she was a delegate from the State Medical Society to the American Medical Association, and was the second woman physician admitted to membership in that association. During the war, under the direction of Gov. Morton, she spent considerable time in the special hospital for Indiana soldiers at Nashville, Washington City, and other places on the Mississippi River (as well as constant sanitary work when at home, giving all the profits of her profession, as well as personal labors to her country, for two years). She spent also nearly a year in similar service in Nashville, Tenn., under the direction of the Christian Commission.

She has been Physician to the Home of Friendless Women twelve years and one of the city physicians eight years. She was one of the prime movers in establishing the Woman's Prison and Girls' Reformatory, at Indianapolis, and has been resident of the Woman's Suffrage Association of the State of Indiana for eight years, and has several times represented the interests of the woman suf fragists before the Legislature of the State. Since 1880, when she began the movement in the State Medical Society, she has made active efforts to secure a modification of existing laws governing hospitals for insane, in

order that women physicians be appointed for the wards of insane women in the hospitals under the control of the State. Partial success has already attended her borsla in that direction.

In the various county and State temperance organizations she has been for many years an active worker. When she began the study of medicine her husband was ill, and upon herself devolved, to a great extent, the care of their three little children, and there is something almost sublime about the courage she displayed at this period. An unconscious pathos pervades her description of this part of her life. In a letter to a friend she says: "I found the most rigorous discipline of my mind and systematic arrangement of time indispensable. Having the needful preparations made, when my youngest daughter was three months old I began in earnest to make the most of my opportunities by strict application to reading and domestic duties, alternating so that my husband and children should not suffer for any comforts a wife and mother owed them. At the end of four years, having done all my household work without the aid of sewing-machine or hired help; having comfortably clothed my family for six months in advance, and provided for the comfort of my children, I entered the Penn Medical College of Philadelphia as a student."

When she began practice additional demands were made on her courage, as prejudice was strong against woman's work in the line of scientific advancement. "Without being aggressive, she pursued a modest, straightforward method of meeting all difficulties, and she has won the victory over ignorance, narrow-mindedness and prejudice."

In all the relations of life Mrs. Thomas is a womanly woman. She possesses easy manners and a varied fund of conversation. She is capable, as her life shows, of great selfdenial and heroism. She is an extemporaneous speaker, a talker rather than an orator, and never fails to hold her audience. She is by nature kind and benevolent, freely giving to those poorer than herself, her gifts of charity often exceeding the present allowance of her income.

Among her patients she combines the firmness of her nature with a gentle motherly tenderness that inspires gratitude; and being herself a Christian woman, when opportunity offers brings the sustaining power of love and

faith to soothe the sufferings medicine fails to heal.

Her daily life is a true illustration that a "good woman is woman's best friend." The poverty-stricken and the outcast from society never had a truer friend than Mrs. Thomas, and the grandest monument that can be constructed she has built for herself in grateful hearts.

It is a significant proof of her worth that one of her home papers pays this unsolicited tribute to her as a woman and a physician:

"Her patient, modest manner, kind and sympathetic nature, together with her thorough ability in her profession, have won for her such universal esteem as is not often given to woman or man. She came to this city years ago when prejudice was strong against woman's work in the line of scientific advancement. Without being aggressive, she pursued a modest and straightforward method of meeting all difficulties, and she has won the victory of triumphing over ignorance, narrow-mindedness and prejudice. She is today known and loved by hundreds who have known her kindly ministrations. She is acknowledged by the faculty as entirely worthy to sit in council, and her opinions are valued, as they deserve to be. It is a pleasure to make this acknowledgment while she can appreciate it, and not wait to give it in a notice of her departure from works to rewards. Her life has been a grand success, and the best exemplification of the truth of the saying: "The Lord helps those who help themselves." " -Mrs. Mattie Berg, Anderson, Ind.

WHAT THEY HAVE PRESCRIBED.

In the last number of the MEDICAL ERA two cases were given, and prescriptions were called for. We are glad to know that the physicians who take the ERA are so busily engaged in prescribing for cases in actual practice that they cannot find time to prescribe for a hypothetical case found in the columns of their journal Only twenty answers have been received. We did hope that about one in twenty-five of our subscribers would send cards, so as to make out one hundred; but for the reason above given, no doubt a far less number responded.

The remedies prescribed for CASE I, are: 1, Arsenicum; 1, Cuprum ars.; 1, Rad. granatum; 1, Phosphorus; 1, Merc. sol.; 1, Merc. bin.; 1, Natrum mur.; 2, Sulphur; 2, Podophyllum; 2, Iodum; 3, Calcarea phos.;

1, Chamomilla; 1, Silica; 2, Calcarea carb. As will be seen by what follows, these two cases were taken in a slightly altered condition from Carroll Dunham's work, "Homoopathy the Science of Therapeutics."

We are sure that the slight changes made in presenting the cases could not have been sufficient to alter their nature, since one acute correspondent, in sending his prescription, cited us to the original.

A useful lesson in prescribing may be learned by those who have given attention to these cases. The lesson is conveyed in Carroll Dunham's own words:

"It is evident that, to assign the chief place in our scheme of symptoms to the diarrhoea, would be to prescribe for symptoms (and secondary ones at that) rather than for the whole morbid state of the patient."

Bell, in "Diarrhoea and Dysentery," says: "In selecting Calcarea carb., the stool is of less importance than the concomitant symp. toms.❞

CASE I. CHRONIC DIARRHEA. Charles Caged ten years, has had diarrhoea ever since he was four years old; has been subjected to various modes of treatment, including the homoeopathic, but without any material benefit. He is of good height for his age, but is emaciated to an extraordinary degree not only are his tissues utterly devoid of fat, but the muscles are wonderfully attenuated my thumb and finger meet with ease around the middle of his arm. Nevertheless, he is active and full of fun. His appetite is prodigious; thirst very great; he complains of distress in the epigastric region, which is much greater just before a stool, compelling him to press his hand upon that region and bend forward; this is relieved to some extent by a movement of the bowels. The epigastrium is sensitive when touched. The abdomen is greatly distended: this is habitual; it is hard and tympanitic; by forcible manipulation, one can detect hard ovoid bodies, deep in the abdomen, as large as a pigeon's egg. The number of stools in twenty-four hours varies from five to twenty. They are copious, pappy, of a dark greenish-brown color, quite offensive. They occur chiefly during a period from 4 a. m. to noon-seldom after noon or before midnight. Though so copious, they do not produce faintness or a sense of weakness, nor does the boy complain of debility, although aware that he is not so strong as other boys

are

And, indeed, on a hasty review of the symptoms, it might seem extraordinary that Arsenicum should have failed to cure the case. The dark, pappy, offensive stools, preceded by tolerably acute pain in the abdomen, with great and excessive emaciation, comprehend, to speak with the pathologists of our school, the essential features of this present disease of the alimentary canal, and, moreover, present a fair simile to the arsenicum disease. A careful examination, however, will show that some even of these symptoms vary in important aspects from the corresponding of symptoms other Arsenicum, while which diathesis symptoms betray the of the patient quite at variance with those of Arsenicum. For example, in the first place, the thirst, although very great, is not satisfied by a small quantity of water, as in the arsenicum disease; the stool, though similar in color, consistency and odor to that of Arsenicum, is copious, that of Arsenicum being, like all the secretions under that drug, scanty. It is not attended by as great a sense of exhaustion as one would expect to find. Indeed, the debility and muscular weakness are much less than one would suppose must result from a diarrhoea so copious and of so long duration, whereas in the arsenicum disease, the general prostration is much greater than can be accounted for by the actual drain upon the system. In the second place, the aggravations occur in the mornings, while in the arsenicum disease they occur almost exclusively in the evenings. The abdomen is distended and hard, making the child quite pot-bellied, whereas Arsenicum produces retraction of the abdominal walls and concavity of the abdomen. The appetite is very great, a symptom which is not characteristic of Arsenicum.

Newburgh, N. Y.

Then it appears, although the symptom to which my attention was first called, as being the symptom of chief importance, seemed to point to Arsenicum as its remedy, yet the conditions and concomitants of that symptom and the general symptoms of the patient did not at all demand, but decidedly contra-indicated, that remedy.

But with what propriety can the diarrhoea, the frequent liquid stool, be regarded as the symptom of chief importance, the primary symptom, so to speak? It is that symptom which would first strike the observation of the patient's friends, because so decidedly objective in its character; but it is obviously a secondary phenomenon, depending on the diseased state of the alimentary canal and of the mesenteric glands; and this diseased state depended unquestionably upon a general depressed state of the vascular and nervous systems, or upon a modified vital action, which is manifested in those general symptoms, upon which we predicate distinctions of dyscrasia and diathesis. Taking this view of the case, it is evident that to assign the chief place in our scheme of symptoms to the diarrhoea, would be to prescribe for symptoms (and secondary ones at that) rather than for the whole morbid state of the patient. But if, in accordance with the view I have indicated, we give but a secondary place to the diarrhoea, it becomes easy to find a remedy for our case. The distended, prominent abdomen, the indurated and enlarged glands, the excessive appetite, the great thirst, demanding large draughts of water, the pain in the upper part of the abdomen just before the stool, the tender epigastrium, the copious and long-continued diarrhoea, without corresponding exhaustion all these symptoms combine to exhibit a condition which finds its exact simile in Calcarea carbonica. Moreover, although Calcarea does not produce stools of the color met with in this case, yet the conditions of stool produced by Calcarea correspond to those of the case in hand. The aggravations of Calcarea are frequently in the morning, and the pain in the abdomen is relieved by warmth as in this case. Calcarea carbonica, therefore, was selected as the appropriate remedy, and the propriety of giving it being so obvious that I could not suppose it had been overlooked by the physicians who had previously attended the lad, and there being every probability that, if they gave it at all, they gave it in low potencies, I concluded to

give the two hundredth. Two globules were accordingly dissolved in four ounces of water, and a teaspoonful of the solution ordered to be given every four hours. For the week preceding this prescription the boy had had twenty stools daily, and very great pain.

On the third day after the remedy was administered, I called again. The lad had had but one stool daily since the day after my visit; and during the ten months which have since elapsed, his bowels have moved regularly, but once daily, the stool being in all respects normal. In the space of one month the lad became so ruddy and plump-having gained twenty-two pounds in weight that I should not have known him. As he gained flesh and strength, the rotundity of the abdomen disappeared, and at the end of the third month the indurated abdominal glands were no longer to be felt, He received no medicine besides the single dose of Calcarea carbonica 200, above mentioned.

It may seem incredible, and I confess I cannot explain it, that a drain so long established and so copious could be instantaneously checked without producing at least temporary disturbance of some other character. fact, however, does not admit of dispute. In a review of this case, two points seem worthy of notice:

The

1. The prompt and enduring action of the high potency. I would not venture to say that a low potency would not have acted as promptly; certainly, however, nothing better could be imagined or desired.

2. The great importance of paying careful regard, in the selection of a remedy, to the general symptoms of the patient, as denoting the dyscrasia, and to the conditions (time and character of aggravation, etc.) of every symp

tom.

CASE II. PANAMA FEVER CURED BY ARSENICUM. This case speaks for itself. The remedies prescribed are:

1, Baptisia; 3, Lachesis; 16, Arsenicum. A. J., aged thirty, strong, muscular and hitherto healthy, sent for me. He had been exposed about eight weeks before, while on the isthmus of Panama, to unusual vicissitudes of weather, and three weeks after he left Panama had sickened with chill, fever, vomiting, etc., more or less severe, which, however, he succeeded in suppressing by large doses of quinine, so as to be able to travel for a few days at a time. Three days before I

saw him he was taken with an unusually severe chill, followed by high fever and alternations of chill and fever, with severe constitutional symptoms, which continued, notwithstanding large and repeated doses of quinine, until I found him in the following condition: Though still quite stout he had lost flesh greatly, having decreased in weight thirty pounds during the last month. His face was of a dusky red hue, hot and dry, eyes injected dry and ferrety, the pupils contracted, with a very restless, anxious expression. The patient had constant thirst, though satisfied with a single swallow of water at a time. The stomach was

exces

sively irritable drink was rejected as soon as taken; a profound disgust for food of all kinds. The tongue was covered with a thick, brownish coat, and felt to the patient dry, though not actually so. When protruded, the tongue trembled and was moved involuntarily back and forth, in spite of efforts to keep it still. The hands trembled excessively when held out, and the patient complained of indescribable weakness and prostration. Nevertheless, there was uncontrollable restlessness, it being literally impossible to remain for more than an instant in one position -the recumbent posture was intolerable; alternations of chill and heat, partial and fugitive in character, were experienced, each lasting about fifteen minutes, the heat, yielding for a few moments to a partial, clammy sweat, which was soon succeeded by chill again. There were dyspnoea and short, dry cough. The spleen was much enlarged and dull on percussion. During the last two nights the patient had been unable to sleep at all, but had been exceedingly restless and uncomfortable, tormented by thirst. The pulse was 140, very quick, small and wiry. The head was confused, and I found the sensorium much clouded, it being difficult to get definite answers to my questions; there was, however, a constant effort to give expression to a sense of great uneasiness and vague apprehension of severe illness.

No one who has been at all conversant with Panama Fever could fail to recognize the gravity of the above. I expected to have a long and perhaps a doubtful battle with the disease, and proceeded accordingly to make arrangements for an indefinite sojourn on the part of my patient, who was not a resident of this place. From the symptoms as detailed,

* Newburgh, N. Y.

there could be no doubt of the prescription required at the moment. The excessive prostration, conjoined with the great nervous and vascular erethism, the irritability of the stomach, the great thirst, satisfied for the moment by a small quantity of water--the intermingled heat, chill and partial sweat, presenting at no time a definite paroxysm of intermittent -along with the dyspnoea and anxiety, and the peculiar pulse, weak and yet excited, made it a matter of course that I should give Arsenicum, which as the indications were so clear that the selection of the remedy could not be a matter of doubt, I gave in the two hundredth potency, deeming this a very fair case, both as regards the clearness of indication and the severity of the disease, for the demonstration of the power of the high potencies. I gave at 4 p. m. a powder of saccharum lactis containing two globules of arsenicum 200, to be taken dry, and to be followed by a similar powder every four hours.

The following day I found that my patient had slept three hours the night before; his stomach, no longer irritable, tolerated beef tea and toast, the chills and heat occurred about once in four hours, lasting for a few moments only; cough and dyspnoea had disappeared. Prostration still excessive, restlessness moderate, intelligence good, tongue and hands less tremulous. Arsenicum 200 as be fore, every six hours.

The third day. A better night, no chills or heat to-day, strength increasing; no restlessness. Arsenicum 200 every eight hours.

The fourth day. Slept well last night, feels like walking out; appetite good, tongue clean. Saccharum lactis.

The fifth day. Feels quite well and strong.