rest, and by movement after having been for some time quiet; rigidity, lameness, and weakness of the muscles in the vicinity of the diseased textures; increase of the febrile symptoms, and of the pains, at night in bed; perspiration, especially during the pains; pains alleviated by exercise; throbbing and burning in the knees, or ankles; painful involuntary contractions of the muscles of the calves of the legs; chronic rheumatic pains occurring early in the morning, and disappearing on moving about. Intellect unimpaired; disposition irritable and impatient. ADMINISTRATION.-One drop of the first dilution may be given in a dessert spoonful of water, every two or three hours, until the pains begin to subside, or until a medicinal action is produced upon the inflamed tissue.

Bryonia.-Swelling and redness of the inflamed textures: countenance pale or sallow, or flushed and hot; tongue covered with a white or yellow fur; hot and dry surface, or perspiration of an acid character after exercise; considerable thirst, frequent and soft pulse; red or yellowish urine; position such as to relax the muscles bearing upon the diseased parts; pains of a tearing, throbbing, or lancinating character, aggravated by movement, by the touch, by the contact of cold air, and by eating; a relaxed state of the muscles; perfect rest affords almost entire relief from suffering; bitter taste, or dryness of the mouth, with thirst; nausea; bilious vomiting; severe pulsating headache; morbid sensibility of the touch; stitching pains in the region of the liver, and in the intercostal muscles; symptoms worse during the night; general uneasiness, anxiety, and irritability; sleeplessness.

ADMINISTRATION.-The second or third dilution may be employeda dose every two, three or four hours according to the violence of the disease. For the active febrile symptoms which occasionally accompany the affection, we usually prescribe Aconite and Bryonia in alternation with satisfactory results.

Colchicum is a valuable remedy in both acute and chronic rheumatism. The pains are lancinating, jerking, tearing, worse at night, and increased by care, anxiety, or movement; or there may be only stiffness and lameness in the joints, when attempting to walk, with œdematous swellings of the parts in the vicinity of the inflammation. Dr. Schroen commends Colchicum in those cases which resist the clearly indicated medicines, provided the skin is moist, and the urine turbid. Dr. S. advises it to be given in the form of vini seminis Colchici and in doses of twelve drops daily. We have found a single drop of the first dilution, repeated once in from three to six hours according to the acute or chronic nature of the case, very efficacious in several obstinate cases which had resisted the action of other medicines.

It has been observed that Colchicum produces the symptoms of tympanitis in goats which feed on this plant in pastures, Dr Meyhoffer

says "in at least fifty cases of tympanitis in cattle, sheep and goats, I gave the strong tincture of Colchicum, two or three drops at a dose, and always with success. The dilutions disappointed me."

Belladonna will prove an excellent remedy, in rheumatic attacks accompanied with a high degree of nervous irritability, and a morbid activity of the cerebral organs. The pains are very severe, especially at night, increased by touch, or by remaining too long in one position. Pulsatilla is indicated when the pains shift rapidly from one part to another, and are unattended with any great swelling or redness of the integuments; also, in chronic rheumatism characterized by weakness, rigidity, coldness, and sensation of weight in the disordered structures.

Dulcamara often proves speedily curative in rheumatic inflammations which have been caused by exposure to cold and dampness. The affected parts usually feel as if bruised or beaten, and after remaining for some time in one position are attacked with severe pains which do not subside until the patient moves about. The pains are most common in the back, and in the joints of the arms and legs.

In cases of frequently-recurring rheumatism, of scrofulous or psoric subjects, we must use one or more of the following medicines: Calcarea-carbonica, Sulphur, Lycopodium, Mercurius.

When the disease has become chronic and inveterate, and abnormal depositions occur about the joints, with thickening of the membranous tissues, and permanent rigidity, weakness, and tenderness on motion a persevering employment of Rhus, or Hepar-sulphur, or Nux, or Phosphorus, or Veratrum, or Lachesis will induce curative results of the most satisfactory character.

Other medicines which have occasionally proved successful in rheumatic affections, are: Colocynth, Iodine, Ferrum, China, Arsenicum, Arnica, Carbo-vegetabilis, and Hyoscyamus.

ADMINISTRATION.-In the acute form of the malady, we employ from the third to the sixth attenuations, and repeat the doses every two hours until a medicinal impression is evident. In chronic rheumatism, we prefer the first attenuation and prescribe a dose once or twice daily.

Actea-racemosa in Acute Rheumatism.-Dr. F. R. McDonald, of Edinburg, has made some rapid and surprising cures with this remedy. He gives twenty-five to forty drops of the tincture three times a day. Dr. Hale says: "Our provings show it to be homoeopathic to many forms of rheumatism, chiefly muscular. It affects in preference the muscles of the back, neck, chest and uterus. The first dilution, or two or three drops of the tincture repeated every hour or two, has in my hands acted magically in acute rheumatism of the parts above named." Dr. E. A. Guilbert says he has found that cases treated by topical use of remedies recover much more rapidly and are less liable to relapses than others treated by internal remedies only. Actea-racemosa,

Acon., Rhus-rad., Rhus-tox., Bell. have been tried, of these Actea is the most powerful. Two teaspoonsful of the tincture may be added to a pint of soft water, and used warm or cold, as the patient's feelings may direct; after using the selected remedy for twelve hours, it is better to change for another.

Propylamine.-Dr. Awenarius, of St. Petersburg, says he used this remedy in 250 cases of rheumatism, and in every case the pain and fever disappeared the day after its administration. Propylamine is prepared by distillation from herring-brine. The dose was twenty drops, every two hours.

Tartar-emetic.-Rheumatic pain, burning and obstinate, in the back, left shoulder blade on turning the neck; in sacro-lumbar region before rising from bed: Weakness of cervical muscles that she can not hold her head up. (Hahnemann.) Pain in the shoulder; trembling of the hands; cold hands; icy coldness of the fingers; jerking of the muscles of the arms and hands; eruption of pimples in the forearm resembling itch; disappearing on scratching; flea-bites on the hand; ends of the fingers feel dead, dry, hard, without feeling for many days; dark-colored spots on the fingers: rheumatism connected with porrigo or other eruptive diseases, particularly such as have been repelled. Itching pustular eruptions in the arms and hands: Tartar-emetic sometimes requires to be preceded by Sulphur-hepar, or other antipsorics.

LOWER EXTREMITIES.-Heaviness in the loins; rheumatic pain in the lower region of the knee; cold feet; very painful cramps in the calves of the legs in the afternoon, which disappear on walking. The thighs spasmodically contracted towards the bowels, weakness of the legs; coldness of the extremities; cases in which the patients have been reduced by protracted, watery diarrhoeas: extremities become cold and powerless; frequent cramps in the calves of the legs. The third attenuation of this remedy is perfectly homoeopathic to this condition.

Review of Allopathic Treatment.

The different modes of treatment in use in some of the various schools are:

1. Bleeding. The temporary palliation of symptoms from bleeding is always followed by chronic rheumatism of long duration; extreme anæmia from which the patient scarcely ever recovers.

2. Moderate Bleeding and Diaphoretics.-The relief is but slight and transient, but the evil is decided. The tendency of the disease is to impoverish the blood of red globules, increasing the tendency to chronic rheumatism, prolonging convalescence, increasing the danger of internal inflammations; of internal effusions into the pericardium and pleura, and to the synovial sacs of the joints, Dr. Todd (in his Cli

VOL II.-11

nical Lectures p. 23,) says, this treatment "also produces troublesome cases of delirium which do not occur under other treatment; it also predisposes to carditis and endo-carditis; and these affections, arising in a case in which bleeding has been practiced, are much less manageable than in others who have not been bled.

3. Calomel and Opium to the extent of Ptyalism.—This is the alterant system of treatment; exciting one disease to cure another, and the new disease worse than the old. Dr. Todd thus describes the patient after being thus "cured": he has "loose teeth, ulcerated gums and all the painful and offensive accompaniments of ptyalism; as bad or worse than the original disease. And then it does not in the least guard the patient against the accidents of internal inflammation, pericarditis, endo-carditis, pneumonia, pleuritis, peritonitis." He has often seen these come on patients who were already salivated. The effects of Mercury are so various on different persons that the result can not be foreseen: and it offers no assurance of speedy cure or speedy convalescence.

4. Colchicum.-Is a chief reliance in the schools for both gout and rheumatism. Dr. Todd says, in rheumatism he found it of no use.

5. Treatment by Opium.-This is lately revived. It is claimed that Opium soothes the pain, ealms the nervous system, promotes diaphoresis, does not diminish the eliminating action of the kidneys, and that the disease causes remarkable tolerance of the remedy.

Lime Juice.-Dr. Inman, of the Liverpool Northern Hospital, proposes this remedy in inflammatory rheumatism. His conclusions from large experience are:

1. That the worst rheumatic cases are those in which perspiration is most profuse.

2. In such he has only seen lime juice fail in one case.

3. Great improvement follows diminution of perspiration, which is not an eliminative effort of nature to be encouraged.

4. That in rheumatism the blood is as poor in globules as it is in consumption or Bright's disease or anæmia. The worst cases inherit a constitutional dyscrasia.

ARTHRITIS.-GOUT.

Although rheumatism and gout are described by authors as different diseases, it is altogether probable that the nature of the inflammatory action is the same in both instances. When this peculiar inflammation seizes upon the young and robust, and pervades the larger joints and the muscular structures, it receives the name of rheumatism; but when individuals advanced in life, are the subjects of attack, and it appears in the small joints, it is recognised as gout.

A fit of the gout is almost always preceded by some gastric or intestinal derangement, like impaired appetite, furred tongue, bitter taste, acid or bitter eructations, flatulent distention of the stomach and intestines, and occasionally diarrhoea. The inflammation is, for the most part, situated in the ball of the great toe, but it may attack any of the smaller joints, and as the disease advances, the veins in the vicinity of the pain become distended; the integuments swollen, oedematous, and of a bright scarlet color; the pains become severe, of a darting throbbing, or a persistent aching and burning character, increased by contact or by movement; there is an almost entire loss of muscular power of the affected parts; the pains are worse during the night, and accompanied during this period by active febrile symptoms; nearly all the functions of the organism are sympathetically deranged; the urine is small in quantity, high colored, and becomes turbid on standing: the patient is restless, irritable, and morbidly sensitive to moral and physical impressions. The disorder usually arrives at its maximum of intensity, in two or three days from the commencement of the inflammation. At this period, the whole toe, and sometimes the foot itself, becomes oedematous, and numbness and prickling are frequently experienced in the swollen textures, especially during the day; the pains. and the nightly febrile exacerbations now commence subsiding, until at the end of from seven to ten days the active inflammatory symptoms have disappeared and left the patient with a debilitated and oedematous limb.

When the paroxysms of acute gout occur very frequently, they serve, after a time to impair the constitution, and to cause permanent thickenings of the articular membranes, or cretaceous deposits about the joints, and to induce that condition of the parts which leads to chronic gout. This form of the complaint is characterized by dull, burning, or tensive pains, oedema, thickening of the membranes of the affected joint, with rigidity, weakness, and partial loss of muscular power; more or less gastric derangement, augmented sensibility of the mind and body to external impressions, depression of spirits, and general restlessness and irritability.

CAUSES.-Gout is generally supposed to be hereditary, although cases are constantly occurring in which no natural predisposition can be traced. There is no doubt, however, that in the majority of instances, a hereditary predisposition exists.. The exciting causes of gout, are: high-living, want of sufficient exercise, abuse of stimulants, especially wines, and general irritability of the nervous system, from loss of rest and irregularity in eating.

Dr. Wolf says:-Gout in its worst and most intractable form, is the consequence of the sycotic dyscrasia. Tuberculosis, which has spread fearfully in this century, has also a relation to sycosis. Tubercles on the placenta are only found in the cases in which the parents are sy