increasing effect, in each direction; the left, marked successively "15 grains," and "30 grains" signifying increasing emetic, and the right, marked "15th attenuation" and "30th attenuation," increasing anti-emetic action.

Figure 2 represents, by an elastic spring, firmly erected the vital forces and functions, in their totality-the so-called vital principles, which yields to an irritant impression in the direction of inflammation, a ball striking it from the right, giving it a sinister impulse. Secondarily, by its elasticity, it returns, representing vital reaction, with sundry vibrations, illustrating periodicity, to its normal state; and expelling the abnormal agent. The morbid condition and action of the forces, both here and in life, consists in a disturbed equipoise; the reaction, with whatever fluctuation, effects the restoration of the same.

This plate therefore applies solely to dynamic, as does the first to material, derangements; both coinciding.

Plate III.-Temperaments and drug effects present alike anatomical relations.

The temperaments are defined to consist of predominant erethism of a nervous origin, dependent on unequally active nutrition, (in most persons), of some one of the cardinal nervous spheres or elements. These spheres, four in number, are here figured; the fourth, twice. They are classed accordingly; but variations occur in disease and from culture.

The medicines, having general anatomical affinities, (in entire harmony with their distinct individualities), are classed accordingly as they, by virtue of those affinities, possess the power of creating artificially, a similar predominant erethism, and unequally active nutrition, in either of these four anatomical spheres, as here figured.

This is, in each case, the general sphere of their initial action, as shown by provings, etc.; the effect being propagated thence to all other parts by "sympathy," i. e., by nervous association.

The four classes (of both temperaments and drugs) are named from the corresponding four cardinal nervous spheres, or elements, as here represented. The class-spheres of medicines being recog. nized by provings, by use in disease, and by chemical alliances as already stated.

The nervous system is regarded as consisting of two grand divisions, organic and animal; respectiively concerned mainly with the tissues, organs and functions of "organic" or vegetative," and those of "animal life," the former being the "great sympa

thetic," the latter, the "cerebro-spinal. Each of these has a centric element, and also a peripheral or excentric portion.

The organic nerve-centre is admitted to be formed of the ganglia of the so-called great sympathetic nerve. The fibres going thence, locate themselves, mainly, in the tissues of organic life, the viscera, arteries, and valveless visceral veins, and serous membranes partially, etc. This latter sphere is the organic nervous periphery.

The animal nerve-centre is the spinal cord, with its gangliar prolongations at the base of the brain; consisting essentially of the ultimate roots of all the cranial and spinal nerves, inclusive of the roots of those which radiate thence to the cortical portions of the cerebrum and cerebellum. All the remainder of the cerebro-spinal system is excentric, constituting the animal nervous periphery. Included in this, the animal excentric element, are the tissues of animal life, i. e., the cortical portion of the cere brum and cerebellum; the cranial and spinal nerves, to their termini, exclusive of their roots; the intervertebral ganglia, with the organs of sense and voluntary motion, etc., and the general venous system.

These are the "four cardinal nervous spheres or elements."

The centric elements are for convenience first numbered; afterwards, the excentric, the organic in precedence; the corresponding classes of temperaments and of drugs receiving the same numbers as well as names.

The circles of the diagram are divided to represent a dial, with each three-hourly period of the day noted thereon. The anatomical figures, which are intended to show at a glance, the grand divisions and cardinal elements of the nervous system, are made to occupy those spaces in the dial which set forth, of their general characteristics, one which is of the first rank, viz: their usual range of periodicity; class 1st, 12 to 3 o'clock, A. M., and 9 to 12 A. M.; class 2d, 3 to 9 A. M.; class 3d, 12 м. to 12 P. M.; class 4th, composite, and typically, evening and morning.

The appropriate numbers and names are appended, including, under each heading, the name of a typical drug of such familiar character as to suggest its affinities, in a very general way, how

ever.

The list of the medicines, under these class headings, subdivided to some extent, as explained in the text and in the list itself, is added in the proper place.

ARTICLE XIII.

Pathological Relations of the Deep Fascia. By JOHN C. MORGAN, M. D., of Philadelphia, Professor of Surgery in the Hahnemann Medical College.

On dissection we find the various components of the body ensheathed in an almost ubiquitous framework of "connective tissue," which name is expressive of the association of these components, by its intervention.

The superficial laminæ appear to concern the skin, mainly; the deeper undergo a variety of modifications, of density, of strength, of form, and of connection; fitting them to constitute sheaths for muscles, vessels, nerves, and for whole members; for bones, in the character of periosteum; for joints, by continuity with the periosteum, in the capsular and other ligaments; those of the muscles uniting with these, or with each other, as tendons and aponeuroses; constituting capsules and ligaments for viscera; and, similarly with the transformation of the superficial fascia into skin, so the deep fascia merges into mucous and serous membranes. In all these positions, they afford a bed and protection to vessels, nerves and other highly organized structures; and are paved on all free surfaces, by epithelium.

These fasciæ, besides the yellow elastic tissue which they contain, and the elastic, (or at times compact) arrangement of their fibres, in most situations, derive some part of their tonicity from the muscular system, organic and animal, for which they afford a framework.

The viscera, also, deriving from the deep fascia and its serous modification their capsules and ligaments of support, are thus brought into direct relation with the muscular system, and partake of its condition; whilst the will, as well as the reflex action, maintaining a proportionate influence in muscularity, (themselves influenced by the emotion,) the deep fascia, the visceral supports, etc., are sure to feel their influence.

The superficial fascia contains, in various positions, muscular fibres of organic life, as in the dartos of the scrotum, and about the hairbulbs, etc.; besides which, the platysma myoides properly belongs to it, maintaining its tone with its own. The superfical muscles of the face, and elsewhere, have a like influence, and there can be but little doubt that in cases of so-called "rapid emaciation," much more is to be laid to muscular relaxation, or flabbiness, with, perhaps, loss of fluid, than to any actual loss of fat or other solid tissue.

The subserous fascia of some lower animals have been found to contain organic muscular fibres; and in the human female the same tissue is prolonged from the uterus into its ligamentous attachments, along with the Fallopian tubes. In the intestines, as found in a hernia, or a prolapsed rectum, and in the vagina, in cases of uterine displacements, the same tissues are involved, besides the cremaster, the levatores, and other co-operating striped muscles.

The vagina, like the rectum, possesses, besides longitudinal fibres, an upper as well as a lower sphincter, which aids in sustaining the inverted cone, viz., the uterus. The pelvic viscera and the liver also bear a relation to each other through the umbilical ligaments. "Pouting of the naval" may be attributed to diminished tension of these, during pregnancy. Other viscera are also subject to displacement and prolapse, as post-mortem examinations often reveal, although infrequently recognized during life by their characteristic symptoms.

The stomach, the spleen, the kidney, even the contents of the thorax, are decidedly subject to it. Analogy suggests that, as with the uterus and rectum, the same organic muscularity may be involved. But in addition, we can demonstrate a curious and interesting, as well as most important, series of connections of the muscular system of animal life, with the supports of these and all the viscera. (See diagram.) And the deep fascia, in its varied and modified forms, is the medium of these connections. Similar support is afforded to other portions of the deep fascia, in the limbs and elsewhere, aiding in maintenance of the normal status of such parts as the thigh and the palm of the hand.

Passing from above downwards, we find the dura mater continuous with the sheaths of the vessels and nerves; with the cervical, tracheal and œsophageal fasciæ; the brachial and pectoral fasciæ; with the pericardium, through the cervical fascia, and with all their connections. These connections being with all the fascia of the trunk and limbs, and with the general muscular mass, all are thereby involved.

Internally, the pericardium (itself a mere sac of condensed deep fascia, continuous with the sheaths of the blood-vessels, and with the cervical, pectoral, brachial and other fascia), is a medium of attachment to the cordiform tendon of the diaphragm.

Now to the diaphragm and loins the abdominal viscera have their principal attachment, and below these the continuity of the pelvic fasciæ associates with these the pelvic viscera; whilst the

transversalis and lumbar fascia associate with these, the exterior of the trunk and limbs. The pelvic organs derive additional sup port from the psoas parvus muscle, which acts as a tensor of the pelvic fascia in subjects where it happens to be present.

Thus, in addition to the wide-spread sympathies of these organs, severally considered, there is to be observed the mechanical association thus effected between all of them, and with the trunk and limbs; whence we obtain a satisfactory explanation of many morbid symptoms, characteristic of visceral prolapse. These symptoms are both physical and rational, the former revealed by inspection, palpation, etc.; the latter consisting of sinking, gone feelings, dragging pains and numbness, neuralgic tearing and shooting, or pressing, catching and jerking pains, especially in certain postures and certain kinds of bodily exertion (aside from the direct influence of mere pressure on veins and nerves, by the weight of the displaced organs, of which numbness, cramps and varix are the main results, and besides the pressure of one organ on another, as of the bowels on the uterus), stretching and compression of nerve-trunks imbedded in the fascia, are the efficient cause of many of the symptoms enumerated; others proceed from direct strain of the visceral ligaments.

In such cases, the heart and lungs often suffer; and the brain likewise. Pain, palpitation, even malposition of the point of impulse, with stooping attitude, headache, drowsiness, and cough, or even symptoms resembling angina pectoris, epilepsy, and many other complaints, may give rise to the gravest apprehensions.

In tracing the history of such patients, we shall find that there has occurred one or more of the following circumstances, viz: Atony, either of muscle only, or of connective tissue also, or alone, and these, either general or partial; or engorgement and increased weight of viscera; bad postures in sitting, lying, walking or standing; mechanical violence, as from falling, lifting, straining, or other exhausting effort; collapse or atrophy of other organs adjacent, or conversely, enlargement of the same; or, again, adhesion. Any and all the viscera being subject to displacement, they are prone, in consequence of their anatomical connections, to participate with one another, both mechanically and sympathetically, in the production of many distresses, even rendering life miserable at times. And of all the causes of such troubles, atony of muscular fibre, organic or animal, should probably take the highest rank, in our consideration.