tinct twitchings and movements, either in isolated" or associated muscles. Jahr says: "Continual movements of the muscles which are under the control of the will, so that the patient cannot remain sitting or standing; the head turned first to one side and then to the other, gait shuffling and leaping; remission at night, renewal on awaking; incapability of seizing the object he may want; confused, tongue bitten in the effort to speak." The earlier symptoms here relate to the disease at an early stage; the later ones to it as fully formed.

Causticum.-Partial convulsions of the limbs, and of the muscles of the face. Jahr says: This is a principal remedy in serious cases, "Emaciation at first, with pallor, gait tottering; loss of memory and power to fix the attention; later, singular movements of the head, eyes, hands and feet; by degrees the patient forgets how to write, count, or talk with distinctness; finally, there is almost complete paralysis of the left side, with frightful convulsions of all the muscles, day and night. General convulsions occurring in the course of chorea, and continuing day and night, are unfavorable symptoms. Jahr says this remedy has been successfully employed in chorea, succeeding a retrocedent eruption of the head. (On Nervous Diseases.)

Rhus.-Twitchings in the extremities and muscle, unsteadiness of the limbs, vascillation of the extremities when attempting to stand or walk. Chorea occurring after a cold bath, or repelled measles.

Sulphur.-Sudden suppression of an acute chronic eruption having caused the disease.

Strychnine.-M. Trousseau administers a syrup of Strychnine, which he seems to have learned from Hahnemann, though he rejects the small doses. This we regret, as although he makes some fine cures he has certainly hastened the death of some of his patients. (See Inaugural Thesis of M. Moynier, Casa, p. 60.) This girl died from medicinal aggravation of the disease by an over-dose. We also learn from the same thesis, (p. 113,) that "choreic agitation augments from the beginning of the treatment, which should cause no uneasiness; reaction promptly supervenes, followed generally by rapid improvement."

Ignatia.-Extreme precipitation, involuntary lifting of the knees in walking; is obliged to sit down; tottering walk, liability to fall, false steps at the slightest obstacle. There are early symptoms of chores. Hartmann recommends Ignatia in recent cases of chorea. It also produces "trembling of the whole body with pruritus and convulsions, so that he can hardly stand; convulsions greatest in the jaws, obliging the patient to distort the mouth, as in moderate laughter.

Nux-vomica.-Symptoms similar to the last; uncertain gait, with fear of falling; feebleness of the knees; trembling of one knee and one leg. Like Ignatia, it presents the remarkable phenomenon of

augmentation of distress by movement; which is diminished by repose, and disappears by lying down, a feature of chorea proper.

Cocculus.-Has medicinal relations with Ignatia and Nux. The Coque of the Levant produces partial convulsion, incomplete paralysis, difficulty of walking, &c., like the preceding. In homoeopathic doses it has cured the following symptoms: absurd movements and gesticulations, sometimes of the hand or left foot; also of the facial muscles at each effort to speak, babbling gaiety, face puffed, red, and bluish, cessation of convulsion on going to bed, (Jahr. Nervous Diseases, p. 76.) Thus we have good reasons for using Cocculus, Ignatia, and Nux-vomica in chorea. We distinguish in our selection between the peculiarities of constitution of each case. While M. Trousseau uses Sulphate of Strychnine in the most dissimilar of cases, and in dangerous doses.

Agaricus-muscarius.-Dr. Clifton, of Northampton, Eng., gives a case, with the following symptoms: Miss B., aged sixteen, amenia, six months ago showed spasmodic twitching of upper lip and winking of right eyelid; then twitching of fingers of right hand; then movement of right arm and hand, and turning of it inward, so that she could not feed herself. The twitching and spasms all ceased during sleep; a little spinal tenderness in lower cervical vertebræ. Agaricus, 60 (centes.), twice a day. No improvement. It was changed for Agaricus, 2° (centesimal), twice a day. In a month she entirely recovered, and remained well a year or two after.

Agaricus is useful in spasmodic affections, ceasing during sleep. In several cases of spinal irritation and tenderness in youths; in spermorrhoea, not the result of abuse, with pains and weakness in the thighs; also as a lotion for frost-bites on the feet of children, tincture one drachm to a pint of water; internally also.

Case by Dr. Bloede. A boy, aged ten years, sanguine temperament, merry disposition, had chorea at the age of ten years. Four months ago showed impediment in his speech; drags his right foot; losing control over the muscles of right arm and leg; limbs were in incessant motion; involuntary jerking; pushing or pulling in all directions; motions continuing all day and ceasing during sleep. Strong appetite; bowels natural; passed two long worms some time ago. Cannot control the muscles employed in talking, eating or drinking, or walking; disposition inclining to fun and mischief. Hyoscyamus was tried a week without benefit. Agaricus-muscarius, 3, exhibited a slow but decided action upon all the symptoms at the end of a week's trial. Four weeks later he walked out alone, dressed himself without assistance; could drink alone; but muscular action of the mouth disorderly: speech and walking improved. Agaricus, 42, gradually restored him to perfect health. (U. S. Jour. Hom., Vol. II., p. 120.)

Case by Dr. Leopold.—A girl, aged twelve years, has had chorea for two weeks. The whole body and every limb in violent motion. After one dose of Agaricus-muscarius she slept for six hours. She continued to take it for eight weeks, four drops of the tincture, four times a day. The disease gradually abated. But she quickly got worse when she tried Ignatia or Stramonium. She had great appetite, slept for eight or ten hours at night, the bowels were regular, the mind clear, and the power of speech returned. She gained flesh, her cheeks rosy. She continued well.

Cuprum.-Hartmann and Jahr recommend this remedy in chorea; but their description of the disease is too vague for safe practice. Copper has the following symptoms suitable for true chorea: "Agitation of the body and limbs; convulsions of the face and eyelids." Gross cured with Copper a case of chorea produced by fright. "There were involuntary movements of the right arm and leg, passing gradually to the other limbs; so that while awake the patient was violently agitated; this was sometimes accompanied with loss of speech.

Iodium.-The occasional cure of a case of chorea with Iodine and Iodide of Potassium, call our attention to these articles. Iodine produces, says Hahnemann, "very great excitability; uncertain and vacillating gait; trembling in the lower limbs; zig-zag movements of the hands; muscular feebleness and incomplete paralysis; head confused and incapable of serious thoughts; when carried still further it gives the symptoms of a grave case of chorea, which is usually fatal"trembling of the hands, arms, feet, and back, vacillating and uncertain gait; he can carry nothing direct to the mouth; zig-zag movements of the hands; motion painful; circulation accelerated; pulse filiform. Dr. Pells gave the Tincture of Iodine in solution for three doses. M. Guersent cured a child with Iodide of Potassium in thirteen days, in which sulphur baths and exercise had been unsuccessfully

treated.

Hodine is more appropriate in scrofulous cases; but it cures only according to the Hahnemannian law of similars.

In the later stages of chorea any of the remedies indicated in the first stage may be proper; though Calcarea, Causticum and Iodium will be preferable.

Macrotrys-racemosa.-We have known one case cured by this remedy. It is the basis of a successful secret remedy for chorea. Argentum-nitricum.-Allopathic cures of chorea have often been accidentally made with Nitrate of Silver, and Dr. Gross, of Regensburgh, gives some cases of great severity cured rapidly with this remedy by homoeopathists, used at the fourth and also at the twelfth

*

potency. He compares it with Cuprum, Stramonium, Hyoscyamus, and Cina. He says the abuse of the remedy in local application to the os and cervix uteri often produces symptoms in the regions of the eye, and respiratory apparatus, which point to its specific action on these organs, and suggest to us its therapeutic use.

When the symptoms have followed the drying up of chronic cutane ous eruptions, Cuprum-acetate, Sulphur and Lycopodium, will be called for; if they have set in after measles, Calcarea-carb. is proper. If the cause can be traced to masturbation, Phosphorus and China are applicable; if they have arisen from constipation and collections of fæcal matter in the intestines, Nux-vomica and Sulphur are the best remedies; if the malady has been induced by excessive loss of blood, or by general debility, we advise Ferrum, China, Acid-phosph., Acidnitr. and Rhus-toxicodendron.

ADMINISTRATION.-In chorea, the whole nervous system is in a morbidly impressible condition, and will generally respond regularly to the higher attenuations. We usually commence with the twelfth dilu⚫tion, and administer a dose once or twice daily, until a suitable impression is made upon the symptoms.

The Spinal Marrow and Ganglionic System are also affected by the sycotic poison; lightning-like, lancinating pains in the face and neck and along the spine; deadness of single parts; inarticulate speech, and, where the par vagum and glosso-pharyngeus are affected, we find a want of feeling of repletion; inability to digest, with normal taste; tympanitis, hernia, and prolapsus uteri and vagina, and of the rectum; paralysis of the urinary organs; impotence, with strong sexual desire. All of these sufferings are the result of the sycotic poison, and can be removed by Thuja, when in the earlier stages.— (Dr. Wolf.)

There are also some cramps, with great tendency to paralysis, and with remarkable variability. Also, the progressive atrophy of the muscles, being often the cause of some kinds of curvature of the spine and some forms of hip disease.

EPIDEMIC CHOREA.-Religious Convulsive Affection of the 19th Century.-(Dr. Barton's Med. Journal, 1805, Vol. II., p. 87.) This epidemic in religious chorea commenced in the summer of 1803, in Tennessee, only three years after the institution of the Camp Meetings, in which large crowds of people were collected together, encamping on the ground and remaining a week or two. The convulsive manifestations greatly increased till the end of that season, and afterwards continued to appear for a quarter of a century, when they gradually subsided. It was looked upon as the effect of a divine religious influ It began among the Presbyterians, afterwards the Baptists, and then other denominations were involved in it. None were affected

ence.

with it but such as had attended the religious meetings, and nearly all took it before leaving the ground. They were of all ages up to sixty years, though the majority were young persons, more females than males. Scarcely one girl in ten between the ages of twelve and twenty escaped it. The affected were generally of the healthy of both sexes. None took the jerking convulsions in sleep. It had intermissions, but they were irregular, but lasting during absence from public worship; the attack might occur on sudden surprize, serious reflection, or depressing spirits. The subjects of it continued in good health, though some females appeared weakened. The paroxysm lasted a half hour or hour; though in some the spasm was momentary. At its first appearance, the effect on men was different from that on women. Men would tremble so as to make the seats at a distance shake; in some there followed what appeared to be painful writhings of the limbs or body, and tumbling about on the ground. At other times they began with one or more perpendicular vaults, as high as any man could rise in health; and this often attended with a deep loud sudden groan, as if from dreadful pain. After the first year or two, these manifestations were less marked, and in their place came a new symptom called the "jerks." This consisted in a sudden jerking backward and forward of the shoulders; the primary motion being chiefly in the breast. The men generally had but one jerk in several minutes, while in women the succession was as rapid as every second for fifteen minutes, each second the hair whipping the ground alternately before and behind. They were sometimes with a single jerk and a loud groan; involuntary laughing was a common symptom in 1803 and 1804.

The Running Exercise was common. The person starts suddenly, and, with remarkable swiftness runs fifty or a hundred yards, and then falls apparently lifeless; after the full length of one breath, he rises perfectly well. Others made, involuntarily, various gesticulations, Jancing or singing.

The dance is a perpendicular motion of the body and limbs when erect, in some the feet moving alternately, in others, both moving at once; the hands and arms generally protruded and elevated, the head suddenly thrown back, the eyes closed by turns, and the movements are made with a graceful softness and elasticity. The subject now commences a tune which is uniformly in a flat key, not rising more than one-fourth of a note from the key note. The women in the beginning of the epidemic commenced with convulsive agitation of the breast, difficulty of breathing, with lamentations, cries, and ejaculations; to this succeeded the "silent exercise," involving a total extinction of perceptible breathing, during which the complexion was florid for half an hour; the mind was perfect but in a morbid state of excite

ment.