the lower attenuations almost exclusively, and have afterwards worked upward to the higher, while perhaps a smaller number have begun with the high attenuations and afterwards abandoned them for the lower. I do not claim to belong to either of these two classes to the exclusion of the other. When I first began my practice, I never used internally a preparation lower than the first decimal, nor higher than the two-hundredth, but made use principally of the medium and lower attenuations. In later years, I have extended my range from an occasional dose of the mother tincture or crude drug, to the ten-thousandth, and have seen no reason to regret the change, for while results have occasionally been produced by the crude preparations that could not have been obtained by the attenuations, I have seen in a few cases, from the five-thousandth and ten-thousandth, results which were as brilliant and equally undeniable.

For several years prior to 1875, I used the thirtieth attenuation more frequently than any other, for the reason that a large proportion of the cases treated were chronic. At the present time, however, most of my cases being acute, I prescribe most frequently the third and sixth, next to these the first and thirtieth and next to these the crude drug, or mother tincture in water, and the twohundredth, while it is only in rare instances that the attenuation is selected from among the thousandths.

The medicines adapted to the cure of acute diseases are generally primarily homoeopathic, while the homoeopathic relation of those which are adapted to the cure of chronic diseases, is as truly secondary; hence, the rule which would limit the use of the lower preparations to the treatment of acute disease, and the higher preparations to the treatment of those affections which are chronic, is equally true with that other proposition, which says that the lower preparations should be used when primarily homoeopathic, and the higher when the homœopathic relation is secondary. Yet I know of no law of dose which is of universal application. The two rules already mentioned are in most instances applicable, and might satisfy one who could be content with a routine practice; yet there are exceptions to each, to ignore which would be to deprive ourselves of the power of making some of our most bril

liant cures.

MANIA A POTU.

BY GEO. F. FOOTE, M.D.

The effects of all stimuli and all narcotizing substances, be it alcohol in any of its forms, be it tea or coffee, or irritating condiment, be it opium or tobacco, is to retrograde the metamorphosis of tissue. It in a measure prevents the transfer of elementary fibre into excretory matter. Constant change, waste and supply, are functional requirements for a healthy existence. Prehension, mastication, ensalivation, deglutition, digestion and assimilation are the pre-requisites, that each and every tissue of the whole organism may take to itself the elements of its constituency, to supply, build up and sustain it in a normal condition. By this dissolving process there is a solution of continuity in preparing the food prior to its being organized into animal tissue without chemical combinations and consequent putrefactions. Vital forces control the dissolving processes, while the action of chemical affinities are held in abeyance. This controlling energy, that gives to vitality its supremacy, subordinating chemical operations, continues so long as matter in an organized state furnishes the elements of nerve power and physical force. But when the sustaining vigor has all been consumed, this matter ceases to be under vital control, becomes excretory substance and subject to chemical unions, and, therefore, should be rapidly thrown out of the system before becoming offensive.

Thus we see vitality has a limit, and in due time loses its supremacy over matter which has served its uses in sustaining the vital economy. The nerve power, energy or activity of the system depends upon a proper supply of food, its healthy assimilation and also its rapid change into effete matter after use. Every beat of the heart, or contraction of a muscle, every breath we inhale, or word we utter, aye, every thought we think, is at the expense of matter which thereby becomes effete. Now, therefore, all vital force

depends upon the presence of new matter from which it gathers energy that develops power. It follows then that anything that retards the wastes of the system, leaving old matter to occupy the space and relations of that which should be new; anything that disturbs the excretory functions, by which process room is made for new matter, must greatly interfere with the development of healthy tissue and nerve force.

But stimulants, like all disturbing forces, have a primary and secondary effect. Their primary effect is an exalted and exhausting production of nerve force, with a retrograding effect upon the excretory functions. The secondary effect is the opposite of the primary, a general relaxation, with an increase of metamorphosis and expurgation of effete matter. The flood gates of the excretory organs are thrown open to give exit to the pent up matter, which now reaches the surface with an offensive odor, showing that chemical combinations have already commenced in matter that was yet in situ. Hence we see persons after a debauch with an offensive breath, offensive and profuse perspiration, offensive and profuse discharges of urine, and with putrid and colliquative diarrhoea.

This is particularly noticeable in delirium tremens, where, by the continued use of stimulants in excessive and increasing quantities, this pent up matter has accumulated until finally either the system becomes obtuse to any further stimulation, or by the sudden withdrawal of all stimulus, dissolution of the integral parts rapidly ensues, beyond the power of digestion and assimilation, in their weakened conditions, to supply the nourishing element needed to sustain the exhausting tissues. Hence the patient is in the condition of being starved, and unless the excessive waste can be checked until new matter can take its place, he dies-literally starves to death, with the same nervous prostration and delirium that accompanies starvation from the absence of food.

Perhaps there are no class of diseases where the homoeopathic law of cure shows its benign and healing influences more fully than in those produced by the intoxicating cup, particularly in mania a potu. When we consider the devastating influences of alcohol upon the system, the excited imagination it produces, the mythical illumination of the perceptions, the ravings of an over stimulated

brain, the incoherent talking, the spectral panorama, the suffering from real but causeless fear, the deliria of madness, the supra-active circulation, the colliquative excretions, and then to witness the subsidence of all these symptoms within a few hours, sometimes within two or three, after the administration of a single attenuated remedy, is a triumph for the law of similars, well calculated to impress one with its importance.

The prompt relief that follows a well selected remedy where it is the first and only one administered, is in striking contrast to the allopathic practice, where bromides, chloral, and opiates in toxic effects are given, with a sequence both painful and alarming, lasting for days and weeks, or with a sudden quietus terminating in articulo mortis. The transition in so short a time, as is often seen, from the frenzy of a delirium that fills the mind with so many forms of sensual hallucinations and mental delusions, with physical sufferings, painful to look upon, to a quiet sleep, is a pleasing result that brightens the arduous and responsible duties of professional life, and inspires us with an abiding faith in a system of practice pregnant with good uses to mankind. I will report two cases from my note book:

Mr. A., aged 29; financial clerk. Active business habits, social and cheerful. Constant drinker, with paroxysms of excessive and prolonged sprees. Came under treatment at 5 P. M. Had been carousing for two weeks and had been seeing strange sights and hearing unusual noises for 24 hours; greatly alarmed, and afraid of being left alone; walked the floor incessantly, talking to himself and answering imaginary questions from imaginary sources; anxious and greatly distressed about the movements of the Seventh regiment, (of which he was a member) who were being drawn up in line to shoot him as soon as he should have a trial. Face flushed; pulse accelerated and weak; profuse perspiration; complains of pain in the head and stomach; intense thirst; stomach rejects food and drink. At 9 o'clock, as he was being undressed for bed, he made a spring for an open window of the third story, from that to the roof of a veranda, and from there he fell to the ground. He was rendered insensible by the fall for a few moments only, when, springing up, he fought his attendants furiously,

screaming at the top of his voice, "Let me go! Let me go! What have I done? Let me go!" He was carried to his room struggling, put into a camisole and confined to his bed. Given a single dose of Arsenicum 40m Jhenican. In two hours he was quiet, all restraints removed and he fell into a quiet and refreshing sleep, waking in the morning convalescing. His recovery was rapid and restoration complete under the curative influence of the one dose. Mr. B., aged 31; traveling agent. Active temperament, social drinker, fond of a good time. Disliked the taste of liquor, but drank for the effect, as it made him feel happy and rich. He was brought from the Tombs, where he had been confined for twentyfour hours, having been found in the streets delirious, after a continuous debauch of several weeks. While under arrest he had been dosed with appreciable quantities of bromides, which had the effect of quieting him for the time. As the primary effects of these subsided, the true character of the disease developed itself, greatly aggravated by the secondary effects of the nervine previously given. He had many marked characteristic symptoms of Kali bromium, viz.: an excited, rambling manner, hands all the while busy, buttoning his shirt, arranging his clothes, picking out threads, hunting in his pockets, etc. Great thirst, but difficult deglutition, as if there was a spasmodic contraction of the œsophagus. Vomiting, rejection of food and water. With this there was deliriumhallucinations; saw police standing about the room, ready to arrest him; showed marks upon the body, where they had struck him with their clubs; nothing would satisfy or divert him from this until he had felt about with his hands to find his illusion; then returning to his bed he would exclaim, "Now that verily did seem real." A moment's rest, and he would pursue some other phantom. His mother, who was a thousand miles away, was calling him from the next room, and there would be no rest until he had explored the room; when satisfied for the moment, he would return to find his bed alive with vermin; rats, snakes and huge monsters were his constant companions, with many other hallucinations and delusions, all of which were to him positive realities. The pulse was variable, sometimes weak and very slow, sometimes fast. The excretions were abundant and offensive; the breath was intolerably