Nux-vomica. Giddiness from close thinking; better on lying

down.

China.-Vertigo better when lying still; weakness in the head. Rhus-tox.-Better on rising; Chamomilla, better on stooping; the patient feels that he is going to fall; thinks he will die.

Sulphur.-Dizziness, with bleeding of the nose. (Hering.)

Ipecac.-" Vertigo, dizziness when walking, with tottering when staggering," showing its direct action on the brain. Dr. Bayard, of New-York, gives a case in which vertigo was produced by the extravagant use of Ipecac.

A girl eight years old complained of vertigo. She had been subject to croup, which had frequently threatened her life. Ipecac., in allopathic doses, was repeatedly given to her, with the effect of alleviating the paroxysms of croup. She was considered as being promptly cured by it. The mother ventured on other occasions, to give her the same medicine whenever the symptoms of croup appeared; and it appeared always to check the disease with equal promptness. The attacks of croup became less frequent, and the remedy was eulogized. But the child complained of dizziness. When walking she would have vertigo to such a degree as to cause her to stagger. The doctor said that it was an affection of the stomach, and tried his remedies; but the vertigo continued. It was then referred to the liver, and a few blue pills were proposed. These being objected to, a homoeopathist was consulted. Dr. Bayard found the symptoms to correspond with the pathogenetic symptoms of Ipecac. He says, "I gave the antidotes for Ipecac. and the child was relieved. In this case the vital current was determined to the throat, producing the phenomena we call croup. The Ipecac. in large doses, produced another disease by changing that current, and this relieved the croup, leaving, however, another more permanent disease."

Agaricus-muscarius. Case by Dr. Leopold.-A woman, after cessation of the menses, was affected with partial deafness, prolapsus uteri, vertigo coming on so violently every day from two to six times, that she would fall upon the stove, at one time burning herself badly. Many allopathic physicians had tried to cure her without success. Agaricus-muscarius, 12°, a powder given morning and evening, wrought a cure. Two months after, there had been no relapse.

Tartar-emetic-Is homoeopathic to vertigo with scintillations, particularly on rising up, walking, or lifting any thing; heat in the head; violent headache, with vertigo and palpitation of the heart; pressure in the temporal region; dullness, drowsy and weary feeling, vertigo and nausea; weight and heaviness in the head, pressure, nausea, weakness, trembling, drowsiness, and aggravation of symptoms on raising the head or walking. It is given successfully in dull headaches

or vertigo arising from gastric derangements. Third trituration pre ferred in acute cases.

Hyoscyamus. It possesses, in a high degree, the power of creating vertigo, as attested by many authors. (Hahnemann, Mater. Med. IV.) Accordingly Schenkbecher succeeded in curing a vertigo of twenty years' standing with this remedy.

Cyclamen.-Case by Dr. Eidherr, of Vienna.-A young lady, after recovering from typhus fever, had constant trouble from vertigo. She took Cyclamen 30, for three days, and the vertigo left her; but she now complained of obscuration of sight, diplopia and slight strabismus. The remedy was suspended, and in a week the cure was complete.

Two other cases, in ladies, aged 18 and 33, both recovering from pulmonary catarrh, were completely cured in two days, one by Cyclamen 15°, the other by the same remedy, 3°.

GENUS III.-SYSPASIA.-CONVULSIONS.

Convulsions. (Convulsio from convellere, "to tear or pluck up.” This term is now applied to sudden spasmodic, involuntary action of the muscles. Convulsions are generally the result of disease, either functional or organic, of the cerebro-spinal axis; sometimes they are the effect of injury.

I. Those dependent on derangement of the circulation of blood in the brain or lesion of its substance.

II. Convulsions from direct violence done to the brain.

The morbid phenomena which originate in diseases of the great nervous centres, such as epilepsy, eclampsia parturientum, chorea, have, says Hahnemann, one cause for them all. This cause he considered to be PSORA. Later authors have considered the different manifestations of the disease known as syphilis, sycosis, and scrofula, as being dependent on different miasmas or dyscrasias. Dr. Wolf, of Berlin, says: Sycosis is "the result of the combination of psora and syphilis, in their highest potency." From this combination originate: tubercles, warts, varicose veins, gout, chronic catarrh of the urinary organs, Bright's disease of the kidney, diabetes mellitus. "Syphilis is an effervescence of sycotic poison. Vaccination causes much chronic disease, which manifests itself under the various forms to which some of the above names are given."

The following diseases of the psoric origin will be treated of elsewhere under their respective names:

1. Rheumatism, gout;

2. Catarrh;

3. Morbid affections of the nervous system;

4. Diseases of the bones.

Pathology-In inflammatory affections mental excitement is an indication of inflammation, or irritation of the hemispherical ganglion; and convulsions are indications of irritation or inflammation of the tubular neurine, either where it is in contact with the vesicular neurine, or in its course to the muscles of the vesicular neurine from whence the power which excites the muscles emanates.

Thus the same law holds good, that irritation of the cerebral substance, either by inflammation or by mechanical means, first excites its normal action, though it may lead to its ultimate destruction.

Many cases are given in the books in which the brain is injured, and convulsions attack the side of the body, the same as that injured, and paralysis appears on the opposite side to that injured. Some think the convulsions are produced by inflammation and the paralysis by the mechanical compression of the brain. In the convulsions which appear as the most serious phenomena following an injury of the head it is remarked, that if the convulsions occur within a few hours after the accident, it is generally indicative of laceration of the brain; if it does not supervene for some days, it is dependent on subsequent inflammation.

DIAGNOSIS-Indications of the Eye.-The iris is designed to protect the retina as an intelligent curtain to guard it from injury. In diseases of the globe of the eye, the dilated pupil indicates more or less pressure on the retina by some cause in the globe itself, such as permanent turgidity of the choroid. But if with a healthy eye, in connection with a blow on the head, we find a dilated pupil, we have the sign of some pressure or injury to the nerve in its course within the skull or the ganglia in which it terminates.

A dilated pupil, then, indicates very serious injury to the optic nerve or the nervous centres with which it is connected, though it may happen in a case of severe concussion, that the injury may be remedied.

The contracted pupil, on the contrary, indicates an irritability of the nervous instruments, an undue excitement of their natural function, not an alteration of it. When we see in case of injury of the brain, dilation of one pupil and contraction of the other, we find the most severe injury of the brain on the side opposite the dilated pupil.

Symptoms of Compression from Depression of Part of the Internal Table of the Skull.-Entire loss of consciousness; the mental faculties are suppressed and he cannot be aroused. Many of the functions of vegetative life are less interfered with; breathing labored, stertorous; often the sphyncters are relaxed; excretions passed involuntarily.

3. CONVULSIONS OF CHILDREN.

Convulsions, in some cases, result from an appreciable cerebral dis ease; in others they develop themselves spontaneously, or in the course of affections of a very different nature, without any connection being visible between the prior disease and the convulsions; and also, without leaving any pathological change in the structure of the brain appreciable to our senses. We make, therefore, the following division of these forms of disease for practical purposes:

1. Convulsions without primary lesion, or without appreciable changes of structure from sympathetic action originating in other

organs.

2. Convulsions symptomatic of lesion of the brain or its appendages. Diagnosis.-The diagnosis of convulsions in children is always involved in the question of their origin. In illustrating this question, M.M. Rilliet and Barthez say: "A child, from one to six years of age, is suddenly seized with convulsions. He is strong, robust, sanguine; the attack has followed a sudden fright, a blow, a fall, or indigestion; that is, some appreciable occasional cause. What is the affection he is suffering from? You are in doubt whether the convulsion is primary, sympathetic, or symptomatic, or whether it is not a prelude to epilepsy. If the child was quite well; if the determining cause is well made out, if the constitution is good, and the fit not violent, you may suspect it is a primary or sympathetic convulsion, or an attack of epilepsy. You examine with care the various organs, and after you have assured yourself that there exists no symptom of pneumonia, pleurisy, &c.; you hesitate only between deciding between its being a convulsive or an epilepic attack, and are obliged to trust to the future for the solution of this doubt-acting in the mean time. according to the urgency of the case, just as if you had to do with a simple case of convulsion." If at the time of the attack there was already some disease, as pneumonia, pertussis, &c., we may decide that the case is evidently sympathetic of the visceral lesion; is it also symptomatic of brain disease? In the great majority of cases it is not so. The brain is suffering sympathetically, and not from any disease of its own substance that need to cause any new alarm; though it may still be dangerous.

But when convulsion attacks a child already the subject of chronic disease, if for weeks or months it has been losing flesh, color, and strength; if it has excessive appetite, irregular digestion, or vomitings If we learn that the parents were phthisical, or that it has been brought up in hygenic conditions fitted for the generation of tubercular disease; then, although the convulsion may even be the result of

an appreciable occasional cause, we must fear that the attack is but symptomatic of some grave cerebral affection." (Maladies des Enfans.)

When the child is more than ten years old the diagnosis is much easier, for it is rare at this age for convulsions to be sympathetic; and they are, for the most part, symptomatic of disease of the brain, or con stitute a first attack of epilepsy.

A most important point in the diagnosis of all cases of convulsions in children, between the ages of four months and three years, is the condition of the teeth and gums. During this whole period, the protracted and perilous process of dentition is going on; and there is hardly a week or a month in which there is not a high degree of irritation and fever excited by the inflamed gums. In a great proportion of the many cases of convulsions in children, we have seen the convulsions have ceased immediately after the swelled gums were freely scarified.

PATHOLOGY.-In ordinary cases, in which convulsions suddenly attack a child which has been generally healthy, there is a temporary congestion of the brain at the time of the spasmodic paroxysm. This may be the case in children previously feeble and anæmic, but in them its duration is short, if it exist at all. In most children who have died from convulsions, we find traces of congestion; but in many no traces of hyperæmia are discovered; and it is now well known that convulsions of various forms often arise when the state of the brain is absolutely anæmic.

In those cases in which traces of congestion are found in the brain on dissection, it is often difficult to decide whether the hyperemia has preceded or followed the attack, or whether it has coincided with it. Many recent authors have avowed the opinion that the marks of congestion originated in the convulsive effort, and are scarcely ever the cause of it. But it is easy to understand that a sudden congestion may produce a convulsive attack, just as we see this phenomenon result from an effusion of blood into the cavity of the arachnoid or the substance of the brain. "But we maintain that frequently things come to pass in another manner; and besides the hyperæmia there is a lesion of innervation, which is the proximate cause of the phenomenon. The solution of this problem is not a mere matter of curiosity. Practitioners have, in fact, but too great a tendency to treat all combinations by bleeding-a practice useless, and often fatal." (Rilliet and Barthez. Maladies des Enfans.)

Precursory Symptoms.-Bad humor, whining mood, sudden starting during sleep, sleeplessness, screams without sufficient cause, frequent and rapid change of complexion, sudden relinquishing of the breast, &c. In other cases there is heat and redness of the gums during dentition, fever with eruptions, vomiting, morbid appearance of the