times in succession, and the inspiration was so strong that the flame was drawn in with the breath, singing the hair in the nostrils. In other experiments the muscles of the face were drawn in various directions, elevating the angles of the mouth, closing the eyes with tremulous movements; the arms and hands were flexed and extended, and moved from place to place; the muscles employed in mastication performed all the functions imitating the actions of tasting and eating. (Western Jour. Med. Sciences, p. 264, May, 1840.)

Asphyxia from Carbonic-acid Gas.-Persons will shut themselves up in a room in which charcoal or mineral coal are burning without a free draught to carry off the gases formed, or in confined places which old wood work has reached that point in decay in which it becomes phosphorescent, giving out light in the dark (called "fox-fire") in a state of very slow spontaneous combustion. Such persons have often been found "dead or dying, and so feeble as to be unable to go into the open air to open a door or window, or to call for aid. They suffer much and know the danger, but cannot make up their minds to move from the spot, as persons who in extreme cold weather, sit down to sleep in the cold air; they know the fate that is before them, but want energy to resist it." (Hering.)

Symptoms of Carbonic-acid Gas.-Before animation is suspended there are: nausea, retching and vomiting-sometimes of blood; a heavy burden seems to oppress the chest; the face becomes red, and at last purple and bloated; the patient is seized with involuntary and hysteric weeping; he talks incoherently, is seized with convulsions or apoplexy and falls down suddenly.

Treatment.-Carry the patient into fresh air; rub with vinegar and let him inhale it. If the face is already red and beginning to rave, throw cold water on the head, apply warmth to the feet. Give Opium first, and after some trials of that, give Belladonna. If the patient talks much and rapidly, complains of shooting pains; or feels as if he were flying, feels giddy when lying down, give Coffea.

When rooms are long shut up without ventilation, the air becomes stagnant and putrid, almost like the stagnant water of standing pools. Persons who try to sleep in such rooms are likely to be attacked by "nightmare, frightful dreams, visions, depression of spirits, and fearfulness approaching to horror.

Treatment. There must be entire purification of the air by ventilation, opening all doors and windows, and making up a blazing fire; place water in shallow vessels about the room. Remedies: Aconite, Opium, Veratrum, Vapor of Camphor, or Ammonia.

Oxygen Gas.-Experiments on animals show that inhalation of oxygen gas increases the fibrine and diminishes the corpuscles and albumen of the blood. In the treatment of disease, Dr. Erichson (Mono

graph on Aphyxia) says: he never succeeded in re-exciting the contractions of the ventricle by means of the inflation of the lungs, when only common air was employed, "provided they had fairly ceased to act before artificial respiration was set up." He was then led to try oxygen, and in several experiments was successful in restoring the action of the ventricles, after entire cessation of the heart's action.

Unpleasant Symptoms of Oxygen.-Extremely small doses (inhaled) often cause sense of contraction of the forehead and temples; weight over the centre of the parietal bones and occiput; rush of blood to the head; fullness, pain or oppressive sensation in the neck and base of the brain; sudden faintness, palpitation of the heart; spasmodic contraction of the affected parts; violent reflex movements in the extremities affected with paralysis of voluntary motion; unnatural excitement of the entire nervous and vascular systems, lasting several days after one moderate dose.

Large doses produced in thin anæmic persons, sudden or gradual disappearance of the pulse; pallor of the countenance; coldness and partial collapse. In plethoric and sanguine persons the reverse, viz.: too excited a circulation; full bounding pulse; intense heat of the head, face, and skin; severe oppressive headache; frequent and longcontinued use of it has caused much emaciation.

Beneficial Effects.-Complete relief from oppression of the brain; sight improved in defective vision consequent upon venous congestion; general warmth even to the ends of the toes and fingers, succeeding to great nervous depression; permanent relief given to the uterus, ovaries, and spine by sudden induction of long-suppressed catamenia, particularly at the change of life; unexpected diarrhoea of highly offensive character, with dark inspissated bile, in long-continued torpor of the liver and portal system; cutaneous transpiration, suddenly and freely induced; improved appetite and powers of digestion and assimilations, increased strength; clearer, fairer, and softer skin.

Fainting, Swooning, Syncope.-Treatment.-Avoid all excitement, loosen the clothing, if tight about the neck, chest or abdomen; place the patient in a comfortable situation; remove any object which might make a disagreeable impression on the mind when consciousness returns. Sprinkle fresh water lightly on the face, neck, back of the head or pit of the stomach. Hold Camphor to the nose. Hartshorn may also be tried but with caution.

Remedies may be selected according to the supposed cause of the disease.

Colocynth, Aconite, or Opium for fainting caused by fright. Aconite when caused by violent pain.

China-Fainting from loss of blood or other debilitating causes. Wine for similar cases, but give it in very small quantities.

VOL. II-40.

Ignatia or Chamomilla.-Fainting from mental emotions, from great pain.

Hepar. When the slightest pain causes fainting.

Cocculus or Chamomilla.-Fainting from violent pain, preceded by giddiness.

Veratrum.-Fainting after excessive pain, or after trifling exercise. Nux-com.-Fainting in the morning, in persons who have used ardent spirits, have been injured by severe application; or fainting after dinner. Phosphoric-acid also for the same symptoms.

Carbo- Veg.-When the system has been debilitated by Mercury. The proper remedy should give relief in ten or twenty minutes at

most.

Apparent Death-In cases of apparent death too much should not be done nor too many things tried until some examination of the patient and surrounding circumstances is made. There may be appearance of death, especially after some violent injury, when the functions of life only are suspended. When there is the least uncertainty, and in all cases where animation has been suddenly suspended, and putrefaction does not commence as suddenly, nothing should be done that can possibly cause death. Interment should be postponed to at least the third day, at which time some changes will take place that will be decisive. If at the end of this period no marks of decay be perceived, all further proceedings should be delayed till putrefaction evidently commences, though a week should elapse. The body should be treated with the greatest care, giving opportunity for resuscitation so long as that is possible.

Apparent death may be caused by: Hunger, a fall, suffocation, hanging, pressure of choking, from drowning, from being frozen, from lightening, from apoplexy.

Apparent Death from Suffocation, Hanging, Pressure, Choking. Remove all tight clothing, place the patient in a proper position, with the head and neck high, and the neck in easy position. Then commence rubbing gently but steadily, with warm clothes. Give at once by injection a drop of tincture of Opium in a pint of water. This may be repeated every quarter of an hour, continuing the rubbing of the limbs. When respiration begins in the slightest degree it will be observed by holding a looking-glass before the mouth and nose occasionally, that the dampness of the breath may show on the glass. Warm cloths, or hot stones wrapped in cloths may be applied to the feet, between the thighs, to the neck, the sides, and under the shoulders.

Opium may be given by the mouth occasionally. Aconite may also be tried.

4. CATALEPSY.-TRANCE.

This remarkable affection of the brain and nervous system is thus defined by systematic writers: A sudden deprivation of sense, intelligence, and voluntary motion, the patient retaining the same position during the paroxysm as that held at the moment of attack; or in which he may be placed during its continuance; the pulse and respiration being little affected, sometimes quick and small.

The paroxysms of cataleptic seizure are intermittent, but without regard to regularity of periods. They are sometimes announced by premonitory headache, mutability of temper, yawning, tinnitus aurium, vertigo, palpitations, lassitude, pain or slight spasms of the limbs or neck, confusion of mind, &c. But in most clearly-marked cases the attack is sudden, the patient retaining the same expression of the countenance and posture of the body as before. The eyes are fixed, either open or shut; the pupils usually dilated, but contracting when a strong light is thrown upon them; and from their unvarying expression, and the unchanged attitude, the body has the appearance of a statue. Any position, in which the head, trunk or limbs are placed, is retained without deviation; the condition of both the flexor and extensor muscles is such as to admit of a change to any possible position, and its retention for the whole term of the paroxysm. During this time the countenance is little changed, sometimes paler than usual, or slightly suffused, respiration little embarrassed.

The duration of the state of unconsciousness varies from a few minutes to many days. Restoration to the natural state is usually instantaneous, accompanied with sighing, and followed by pain or confusion in the head, with a feeling of lassitude. The patient has no recollection of what has passed during the fit; and the same ideas, and in some cases the same sentences which have been suspended by the seizure, have been resumed at the moment of recovery. No efforts to restore consciousness are effectual, the loudest noises, and even moving the body or pinching it, are not felt at the time or remembered afterwards.

In an imperfect form of catalepsy, called CATOCHUS, the abolition of the senses is only partial; the patient being conscious of what is passing, but incapable of moving or speaking.

Case by Dr. Gooch.-A lady who was suffering from puerpural mania was restrained in a strait-waistcoat. Dr. Gooch says: "A few days after our first visit, we were summoned to observe a remarkable change in her symptoms; the attendants said she was dying or in a trance. She was lying in bed, motionless, and apparently senseless. It had been said that the pupils were dilated and motionless, and some apprehensions of effusion on the brain had been entertained; but on examining them closely, it was found that they readily contracted when

the light fell upon them; her eyes were open, but no rising of the chest, no appearance of respiration could be seen; the only signs of life were her warmth and pulse; the latter was weak, and about one hundred and twenty.

"The trunk of the body was now lifted so as to form rather an obtuse angle with the limbs, (a most uncomfortable posture,) and there left with nothing to support it; there she continued sitting while we were asking questions and conversing, so that many minutes must have passed. One arm was now raised, then the other, and where they were left there they remained. It was now a curious sight to see her, sitting up in bed, her eyes open, staring lifelessly, her arms outstretched, yet without any visible sign of animation. She was very thin and pallid, and looked like a corpse that had been propped up and ład stiffened in this attitude. We now took her out of bed, placed her 'ipright, and endeavored to arouse her by calling loudly in her ears, ut in vain. She stood up, but as inanimate as a statue. The slightest push put her off her balance. No exertion was made to regain it. She would have fallen if I had not caught her. She went into this state three several times. The first time it lasted fourteen hours, the second time twelve hours, the third time nine hours; with waking intervals of two days after the first fit, and one day after the second." After this the disease assumed the ordinary form of melancholia, and she recovered ordinary health after three months..

Case by Dr. Johnson, King's County Medical Society.—“A Mr. J., teacher, having charge of a large academy; takes little exercise; constipation lasting for a week at a time without movement; he would perform the labor of the day, and then sit up till twelve or two o'clock, A.M., engaged in solving some difficult problem, thus overtasking the mind and disregarding the laws of health. On one evening, when a little tired with travelling, while conversing with a friend, he was suddenly seized with catalepsy; was thought to be dying; was perfectly unconscious; every muscle was tense and rigid, hardly moveable; the limbs were in a straight line with the body; arms folded across the chest; no movement of the thorax, or respiration perceptible; pulse feeble and scarcely felt between the rigid tendons; beating of the heart very faint; eyelids closed, impossible to open them; pupils contracted, rolled up under the lid; he is completely unconscious of pinching, pricking with pins; joints stiff; he was raised up by the heels so that his body was held in a horizontal position, the neck resting on the back of the chair till the assistant supporting his feet was tired, but there was no relaxation of the muscles or return of consciousness. There was neither opisthotonos nor emprosthotonos, otherwise the case resembled tetanus. Almost impossible to move the hands or feet, but they remained wherever placed. After remaining in this condition an hour a flutter