A remarkable and interesting feature of this case, was the little inconvenience experienced by the patient, from so grave a malady, and one usually attended with great suffering.

CASE II.

Mrs. B―, aged 74 years, had been for many years in feeble health. Had been much troubled with dyspepsia, and many years ago, suffered from a distress in the chest, with suffocating sensations, which finally disappeared. Had for a few years before death, symptoms of spinal disease, with sciatica and contraction and loss of use of right leg; finally dying at the above age (after having been confined many months to her bed), apparently from exhaustion and old age.

Upon opening the body after death, found but slight evidence of disease in the heart, lungs or digestive organs, and was about concluding the examination, when, in passing the hand behind the left lung, felt a large tumor, which, upon removal of the contents of the chest, proved to be a large aneurism of the thoracic portion of the aorta.

Commencing in the descending portion of the arch, quite the whole of the thoracic portion of the vessel was involved in the disease. Largest in its upper portion, it gradually diminished in size towards the diaphragm. Developed wholly upon the left side of the aorta, the tumor extended far into the left pleural cavity, while the right side of the vessel, unaffected by the disease, occupied its normal position.

Upon laying open the vessel, the sac of the aneurism was found to be filled with an exceedingly dense fibrinous mass, adhering closely to its walls, and presenting a polished and groved or concave surface towards the sound side of the artery, leaving thus a channel for the passage of the blood, very nearly of the normal size of that portion of the aorta. See figures 2 and 3.

That an aneurismal tumor should become filled with fibrinous deposits, when situated as in case first, would not seem extraordinary; the obstructed circulation through the sac, under such circumstances, greatly facilitating such a result. But, that in an aneurismal dilatation so freely communicating with such a current of blood as flows through the aorta, as seen in case second, the filling up of the sac by such a process would seem most remark. able, the force of the current being sufficient, apparently, to wash away any clot as soon as formed.

In this case, indeed, there is good reason to believe, that an embolic mass may have been carried down the aorta, lodging in some of the branches below the bifurcation, and giving rise to the neuralgic pains and loss of use of the left leg. The anomalous character of the symptoms in this case had baffled the diagnostic skill of many physicians.

The existence of the aneurism, as far as I could learn, had never been suspected, yet its presence, as shown by the autopsic examination, unquestionably gives the key for unraveling the whole mystery of the case.

The question is here naturally suggested: is there nothing within the range of our materia medica capable of inducing, or at least promoting, Nature's method of cure? that of the disposition of fibrinous layers within aneurismal sacs?

When the disease affects any of the vessels within the reach of the surgeon, we do not hesitate to place the case in his hands for operative treatment; while, where the aorta is the seat of the disease, the case is usually left to Nature; remedies being seldom prescribed with any other view than that of alleviating some of the more distressing symptoms.

It is true, we have remedies producing many of the symptoms attending aneurism of the aorta, but with what confidence of effecting a cure they are prescribed, may be judged from the fact that two of our best authors, in treating of this subject, suggest no remedies whatever.

The question to be solved is as follows: Is there any known substance, which, when taken into the system, in either large or small quantities, has the power of inducing such a coagulability of the blood, as to facilitate the filling up of aneurismal sacs with clots? This is sometimes effected by unaided Nature, and mechanically by the surgeon, in cases where the vessel be within his reach.

*

In answer to this question, I wish only to call attention to a remarkable series of twelve cases, treated by the internal use of the iodide of potassium, in doses of from five to fifteen grains, repeated three times a day.

In all of these cases, but one, striking relief of the suffering followed the use of the remedy; in eight, an undoubted diminution of the size of the sac took place; while in the remaining three,

[Part 47, page 127, of Braithwaite's Retrospect.]

complete subsidence of the tumor seems to have occurred. The beneficial effect of the drug in these cases, was attributed to its power of increasing the coagulability of the blood.

While treatment by this method may not be looked upon as purely homoeopathic, still, the true physician, in so grave a disease, will not hesitate to avail himself of every means for increasing the chances of the recovery of his patient.

Finally, in the management of these cases, let us not lose sight of the circumstances of an occasional spontaneous cure, and give the patient all the advantage of the hope which may result from a knowledge of this fact, to cheer him while suffering from one of the most distressing, as well as from its frequent suddenly fatal termination, one of the most terrible maladies to which human flesh is heir.

ARTICLE XV.

Cases treated at the Clinic of the Hahnemann Medical College. Reported by HENRY NOAH MARTIN, M. D., of Philadelphia, Professor of Clinical Medicine.

CASE I.

September 4th, 1867.-Sarah K, aged 35. Has been sick for about two years; gets out of breath from walking up stairs; generally worse from exercise; burning sensation under right shoulder blade; pain in right side extending to the left; hunger at about eleven o'clock every day; nausea after eating. Gave sulphur 1 one dose, followed by sacch. lac. September 10th, reported better in all respects, September 20th, after exertion (marketing), vomited a substance mixed with blood; still some cough, with opaline expectoration, which sometimes tastes salty; sometimes burning under the sternum. Gave arsenicum 10m followed by sacch. lac. She received no more medicine, and was cured.

CASE II.

September 5th, 1867.-Mrs. B. H—, aged 23. Pain in left side, from under the false ribs around to the back. Yellow leucorrhoea, not very thick, constant; most at the menstrual period; back always feels weak; no pain during menstruation; natural in color and quantity; occasional sharp, shooting pains through the head, sometimes in the occipital and sometimes in the frontal region; feels very tired in the morning; in the daytime feels better after a short sleep than after a long one; has sometimes palpitation in the cardiac region. Violent exercise is very exhausting; perspires easily; sleeps at night with her arms over head, and feels stiff on rising.

Gave pulsatilla 5 one dose, followed by sacch. lac.

September 7th.-Reports considerable improvement. The pain in the left side nearly gone.

This patient received no more medicine, and was cured.

CASE III.

September 14th.-Mrs. A. B, aged 50. Has a beating, fluttering sensation in the left breast, in the region of the heart;

gasps for breath; sometimes has slight cough; no expectoration; occasional headache.

Laurocerasus 1m. One dose cured her promptly.

CASE IV.

September 16th, 1867.-W. H-, aged 34. Had gonorrhoea, with burning and scalding during urination; thick, yellow discharge.

Gave cannabis sat. 2° in repeated doses.

September 18th.-Reports no pain or scalding when urinating; some yellow discharge from urethra, and chordee at night. Cantharides 2.

In three days this patient reported himself cured.

CASE V.

September 30th, 1867.-Miss A. P——, aged 28. aged 28. Has pain during menses. which commences in the hypogastric region and goes down the legs; then sharp pains in the back; chills during pains, commencing in the breasts. Vertigo at night in bed; everything turns round. Fullness and bearing down in the abdomen; menstruation five days too soon, too profuse, but natural in color; has weak spells.

One dose of conium 1m cured this patient.

The foregoing related cases, excepting the case of gonorrhoea, were of long standing, and like most of the cases that come before the class, supposed to be incurable cases. The homoeopathic public clinics are generally the last resort of such patients.

The case of gonorrhoea was not treated before the class, but privately, in the dispensary. It is somewhat unusual for gonorrhoea to recover so rapidly under any treatment. It is quoted to show what the properly selected remedy will do, even in a case of gonorrhoea, and without injections of any kind.