case, and then slept soundly; at 1, A. M., became more restless, at hal. past five started up with dyspnoea, moaned as if in pain; breathing became more and more labored, and about 6, A. M., he ceased to breathe Post-mortem examination revealed extensive ossification of the aorta, and as the immediate cause of death, rupture of the aorta near its arch. (Dr. Bowers' Address.) 4. STRABISMUS.-SQUINTING. This affection may be either acute or chronic. 1. Acute strabismus, which is symptomatic of disease of the brain 2. Chronic strabismus, (a.) divided into essential and consecutive, to eclampsia and chorea; (b.) organic shortening of the muscles of the eye, which may be congenital or consecutive to a traumatic lesion. 2. Chronic strabismus. (a) essential strabismus. Remedies: Alumina, Belladonna, Hyoscyamus, Stramonium, Taba cum. The symptoms we enumerate relate mainly to the eye, but the totality of the symptoms should be considered in each case. Belladonna, for scrofulous patients. Strabismus upwards (rectus superior muscle); or, outwards (rectus externus.) The left eye drawn upwards (rectus superior muscle,) whilst the right eye is drawn upwards and outwards (rectus externus and rectus superior.) Exophthalmia (obliquus, major and minor.) Convulsions of the eyelids, tending to separate them. Pupils contracted, then dilated, and lastly, insensible to light. Scotopsia, diplopia; amblyopia, amaurosis, blindness; he sees objects variously. Alumina.-Strabismus of both eyes (of which muscles?); convulsions of the eyelids; ptosis; paralysis of the upper eyelid; ophthalmia; blepharitis scrofulosa; lippitudo; frequent styes; photophobia; amblyopia; the patient sees objects yellow. Hyoscyamus.-Strabismus inwards (rectus internus muscle); strabismus upwards (rectus superior muscle,) strabismus upwards and inwards (rectus internus and obliquus minor muscles.) Myopia (obliquus major and minor muscles;) triplopia; great congestion of the eyes, which are sparkling, haggard, bright, or dull and dim. Look stupid and dull. Dr. Gallivardin gives the case of a child aged twelve years, of lymphatic temperament, a fair-haired blonde, who had strabismus for eight years. When two years old she had two convulsions, each lasting ten ɔr twenty minutes. At four, when playing with a pitcher, she fell, and it broke and cut her hand. After the fright the right eye was found to squint strongly inwards; half the pupil disappeared behind the nose The rectus internus, habitually contracted, was sometimes tremulous with slight clonic motion. Sulphur 30° was given thrice a day for one week. In a month there was no improvement. She then took Hyoscyamus 3° for eight days, three doses per day. It was then well. Some slight relapses afterwards occurred and were always promptly removed by Hyoscyamus 35 Eight years after this treatment she continued well. The author says he tried this remedy in some other cases, but without success. (Jour de la Soc. Gallicane.)* Cyclamen.-Case by Dr. Eidherr, of Vienna.-A child aged two months and a half, fell from the table to the floor without receiving apparent injury. A few days afterwards it was attacked with measles after recovering from which it was noticed that it squinted. Arnica failed to cure it. Cyclamen was directed for ten days. It became entirely well from this medicine. Dr. Wurmb, of Vienna, also cured a coachman of strabismus by Cyclamen. Stramonium.-Strabismus in every direction (elective action on all the motor muscles of the eye); fall of the upper eye-lid, apparently produced by a spasm of the orbicular muscle. Pupils contracted, dilat ed, and lastly, immovable, as if paralyzed; myopia, diplopia. Visual hallucinations respecting the color and position of objects. Tabacum.-Strabismus upwards (rectus superior muscle.) The cyes are deeply sunk in the orbits (all four recti.) Convulsions of one or the other eyelid, sometimes only of the orbicular muscle; pupils contracted, dilated, and at length insensible to the light; ocular and palpebral ophthalmia; hallucinations of the sight, photophobia; amblyopia, blindness sometimes only transient. Phosphorus-Dr. Tavignot gives two cases treated successfully with it. He says† he is usually successful in cases of paralysis of both the third and sixth pair of nerves, by giving Phosphorus internally, and applying it locally around the eye. He applies around the eye a liniment containing twenty centigrammes of Phosphorus, to one hundred grammes of Oleum-nucis, and twenty-five grammes of Naphtha; and of an emulsion containing 0.10 centigrammes of Phosphorus to Oleumamygdalus dulc. 10 grammes, Syrup ninety grammes, gum two grammes, he gives a tea-spoonful or two daily. He says he cured by this mode, in twenty-five days, a case of complete ptosis, strabismus externus, mydriasis, &c., in which electricity had been employed for two months without effect. Another case was that of a rich land pro * Moniteur des Hopitaux. prietor, who had spermorrhoea with paralysis of the right branch of the sixth pair of nerves. He was cured with Phosphorus of the paralysis in ten days. When about to send the patient elsewhere to be treated for the spermorrhoea, it was found that the Phosphorus had cured this also. Other Remedies for Strabismus.-Digitalis.-Both eyes incline to turn to the left side; when turning them to the right side, they feel painful, and then he sees all things double; at the same time the face is bloated. Camphor-Spasms of the muscles. The balls of the eyes are turned upwards. Veratrum-alb.-The eyes are distorted or protruding, or turned back that the whites cannot be seen. Aconite.-Distortion of the eyes; the eye squints upwards. Secale.-Frightful spasmodic contortion of the eyes, with contraction of the pupils, which are sometimes closed. Squinting. Spigelia. Involuntary motion of the eyes. Distortion of the eyes accompanying spasmodic affections from worms. SPASMS OF THE EYELIDS.-Ruta Graveolans.-Spasms of the orbicularis muscle; spasms of the lower lid, the tarsal cartilage moves irregularly; followed by water running from the eyes. When medicines fail to cure strabismus we must resort to: 1. Spectacles properly made. These have in place of glasses, plates of metal or pieces of card, with very small orifices in the centre of each plate, exactly in the axis of normal vision. The use of spectacles ad hoc acts in a way analogous to the method of Ling's method of Swedish gymnastics. This system is founded on an exact knowledge of the anatomy of the muscles, and when properly understood, enables the practitioner to bring into action any given muscle, singly and in succession to any other one. Gallicane.) (Jour. Soc. 5. CHOREA.-ST. VITUS DANCE. Chorea occurs, for the most part, in girls of feeble constitutions and of irritable nervous temperaments, aud between the ages of five and fourteen. The disease is recognized by almost constant involuntary movements of the muscles affected, while in the waking state, either with or without derangement of the intellect. From its resemblance to raphania, it has sometimes been confounded with it. It also presents many marks of similarity to epilepsy and hysteria, and is proba bly somewhat analogous to these maladies in its location and nature. The affection is not usually attended with danger, and terminates at VOL IL-36. the period of puberty; but when it has existed for a number of years accompanied by perversion of the intellectual faculties, permanent idiocy, or at least an impaired understanding may be feared. Finally, the disease may occasionally occur at any period of life, and in individuals of both sexes. Diagnosis. Generally for months previous to the occurrence of the involuntary motions which characterize this disease, it will be found that the child has suffered from constipation, oppression in the region of the stomach, and chest, vertigo, and other bad feelings in the head, appetite morbidly increased or depressed, occasional flushes of fever during the night, palpitation of the heart, nervousness, irritability and coldness of the feet. The involuntary motions commence by slight twitchings in the muscles of the face; which soon become strongly pronounced, and extend to a greater or less extent to other parts of the body, as one entire side, or one arm or leg. When the limbs are affected, the walk becomes awkward and unsteady, and the arms fail to obey the commands of the will, while involuntary gestures and motions are continually made without reason or point, thus causing the individual to present a most ludicrous appearance. The patient may remain in this condition for years, without the occurrence of any other serious consequences, unless the intellect becomes impaired, when a total loss of mind may result. Some cases are attended with difficult respiration, dysuria, vague pains in the limbs, confusion of ideas, and failure of memory. Causes. A naturally delicate constitution or one which has been impaired by the abuse of medicines, and a nervous temperament, are conditions most favorable to the production of chorea. Probably the most frequent exciting cause is the repercussiou of some chronic cutaneous eruption. Many facts are on record which go to prove this; as for example, the cases cited by Hahnemann, Stapf, Pouchet, Frank, &c., where the malady has arisen in consequence of sudden drying up of tetter, plica polonia, herpes, scald head, psora, or some habitual discharge. Other exciting causes are: the depressing passions, fear and terror, masturbation, irritation of the bowels from worms and fæcal accumulations, cold, insufficient nutriment, and excessive loss of blood. TREATMENT. In all cases of chorea the patient should be removed to the country, where she may enjoy pure and salubrious air, abundant exercise, and a plain, but highly nutritious regimen. The remedies for chorea are, Stramonium, Belladonna, Cuprum acet., Sulphur, Calcarea-carb., Hyoscyamus, Rhus, Nux-vomica, Ignatia, Lycopodium, Phosphorus, China, Ferrum. If the disease has been caused by fright or terror, and we find great contortions of the face, eyes, and limbs, head thrown back, or drawn frequently to the left side, oppressed respiration, wild and staring ex pression, convulsive laughter or weeping, restlessness, convulsive twitch ings of the muscles, anxiety, pale face, features sunken, small pulse, and delirium, we may select one of the following medicines: Stramonium, Belladonna, Hyoscyamus, and Ignatia. In the early stage the remedy should be selected from Belladonna, Stramonium, Ignatia, Cocculus, Acon. and Nux-vomica. Belladonna-Agitation and continual movements; unceasing motion of the head and hands; feebleness, and uncertain gait, paralysis of one side of the body, so the patient draws one leg after him. These symptoms are characteristic of chorea proper. In more confirmed cases we see convulsive movements of the lips and risus sardonicus; absurd grimaces, feebleness and trembling of the tongue. Children poisoned by it showed: " continual agitation; they could not keep still nor remain erect; they threw themselves forward, extending their hands towards the ground; constant catching at small objects which they let fall; choreic convulsions. Mr. Edwards gives in the London Lancet a case of poisoning by Belladonna which confirms the common observation of its power of producing a partial or imperfect paralysis, shown only in a want of due controlling power, almost confined to the lower limbs, and lasting some days after the other symptoms had subsided. Orfila found it to pro duce weakness of the posterior limbs; Pereira saw seven cases at the London hospital. Symptoms affecting the nerves: "paralyis, sopor, or coma, power of the mind or of the will, over the muscles disordered, muscular movements irregular, causing staggerings and jerkings, weakened or paralytic condition of the muscles. Some French physicians have endeavored to show that chorea has its seat in the cerebellum. (Watson's Practice, Vol. I., p. 672.) Dr. Fuller gave Bell. to twelve choreic children in St. George's Hospital; in seven cases its action appeared decidedly curative, in two it failed to affect the spasms; in the other three cases the improvement was ascribed to other causes. Stramonium.-The child totters in walking; vacillation of the limbs in walking or remaining erect; uncertain walk; he does not feel his legs under him, thinks he touches the ground when yet some distance off, causing false steps: precipitate seizing and losing the object he wishes to grasp; when holding it, he does not perceive it in his hand; babbling loquacity. Jahr has given some cures by Stramonium, but his cases are not clearly distinguishable from hysteria and other nervous diseases. Hyoscyamus-niger.-Has only a few chorea symptoms; twitchings of the tendons, and choreic movements. (Roth. Materia Med., 753. Par.) Calcara-carbonica.-Hahnemann observed under its use "indis |