in actual coma. If awakened out of this they complain of vertigo, of a feeling as if a heavy load were pressing upon the head, of weakness and a paralyzed feeling in the limbs, but especially in the eye-lids, which they can hardly keep open."

"Sometimes, instead of the paralyzed feeling, there is a sensation of twitching and jerking. The patients think correctly but slowly. They soon fall back into the comatose condition: the expression of countenance is devoid of all signs of mental activity. This condition is not uninterrupted, for there occur sometimes intervals of moderate excitement, during which the patients, awakened from their stupor, look eagerly around, move themselves quickly, and by the hastiness of their replies seem to seek to hide their lack of force; sometimes there is mild, uneasy delirium."

"In this torpid condition of the nervous function the rest of the organism participates but little. The pulse is weaker, it is true; but seldom sinks below the average frequency; often even rises above it. The temperature remains normal, or changes but little; the skin is pale but lax; the tongue moderately coated, sometimes even clean; the bowels generally constipated, diarrhoea rarely present; the respiratory mucous membrane almost never involved." "Symptoms of a blood dyscrasia, such as exanthemata, decubi tus, hemorrhages, are never observed. The spleen is always

swollen."

Among the applications of cocculus must not be forgotten its use in inguinal and femoral hernia, of which several cases are recorded as cured by cocculus. Among them, one in which four herniæ existed simultaneously. Precisely what cases are curable by cocculus it is not easy to say, a priori; other remedies, as for example, nux vomica, aurum and nux moschata, have also cured hernia.

Until the functional pathology of hernia shall be better understood it will be impossible to divide the affection into groups corresponding to the different modes of treatment or different remedies which experience has shown to be useful. While the affection is, by most practitioners regarded as exclusively a mechanical accident, to be met by surgical methods, the history of many cases and experience in their cures, shows them to be amenable to dynamic agencies.

In all of these applications, as in others which may be made o cocculus to the treatment of diseased conditions, the similarity of symptoms must be our chief, as it will prove our sufficient guide.

The case of poisoning by cocculus, which Hahnemann treated with camphor, and to which allusion was made at the beginning of this paper, is recorded by Hahnemann as follows,* in a contribution to Hufeland's "Journal der Practischen Arzneikunde, V. I., 1798," entitled "Antidotes to some heroic vegetable substances :" "A druggist, of fine senibility and otherwise healthy, although but recently convalescent from an acute disease, some years ago wished to ascertain the taste of the cocculus seed, and as he considered it a powerful substance he weighed out a single grain of it, but did not take quite the half of this into his mouth, rolled it about with his tongue over his palate, and he had not swallowed it two seconds when he was seized with the greatest apprehensiveness. This anxiety increased every moment; he became cold all over; his limbs became stiff, as if paralyzed, with drawing pains in their bones and in the back. The symptoms increased from hour to hour, until, after the lapse of six hours, the anxiety, the stupefaction, the senseless stupidity and the immobility, had risen to the greatest height, with fixed, sullen look, ice-cold sweat on the forehead and the hands, and great repugnance to all food and drink. At the slightest increase or decrease of the temperature of the air (75 Fahr.) he expressed his displeasure; every loud word put him in a passion. All that he could still say was that his brain felt as if constricted by a ligature, and that he expected speedy dissolution. He gave no indication of inclination to vomit, of thirst or of any other want in the world. He wished to sleep, as he felt a great inclination to do so, but when he closed his eyes he immediately started up again, so frightful, he asserted, was the sensation he felt in his brain on going to sleep, like the most hideous dream. The pulse was very small, but its frequency was not altered.

A few drops

"In these frightful circumstances I was called in. of thebaic tincture appeared not to agree with him. This led me to fix upon a strong camphor emulsion, which I administered to him, a tablespoonful about every minute. I soon observed a happy change in his expression, and after he had thus taken fifteen grains of camphor, his consciousness was restored, the anxiety gone, the heat natural, in something less than an hour. He perspired a little during the night, slept pretty well, but the following day he was still uncommonly weak, and all the parts, which during the direct action of the cocculus were yesterday painful in

* Hahnemann's Lesser Writings-Dudgeon's translation, English edition, p. 377.

ternally, were to-day uncommonly painful externally to the slightest touch. The bowels remained constipated for several days. It is very probable that all these after-sufferings could have been prevented if, in place of giving fifteen grains of camphor, I had at once given thirty. During the increase of the symptoms from the cocculus, he attempted to smoke tobacco with considerable aggravation; they also increased from taking coffee, though not so strikingly as from the other."

In connection with the successful use of camphor, as a remedy in this case, it is interesting to the homoeopathist to notice that Orfila* considers that "the cocculus exerts its influence, like cam. phor, on the nervous system and especially on the brain, etc." He points out its similarity to camphor, on physiological grounds. Hahnemann recognized the similarity of the symptoms produced by the two drugs.

ARTICLE CXIII.

The Re-Discovery of the Screw. By CARROLL DUNHAM, M.D., New York.

It is related of James Ferguson, the somewhat celebrated Scotch Astronomer, that, while a poor shepherd boy, his mind intent on mechanical subjects, he devised what he supposed to be a new mechanical power, but which, when exhibited, turned out to be the Screw.

It seems incredible that a Scottish lad, old enough to tend sheep, should never have seen a screw; but such was the fact in Ferguson's case in 1725. His invention, therefore, had all the merit, though not the profit, of originality, and he was and has. been honored accordingly.

But suppose it had appeared that Ferguson, instead of having grown up in the solitude of the sheep-walks, away from books, and ignorant of the ways and mechanisms of civilized men, had been in constant communication with the most learned of his time,. had had access to every publication, had even lived in the center of a vast throng of clanging engines and whirring machinery, and from such a position had come forth parading an alleged discovery of a new mechanical power, which, on examination, proved to be the screw, well known for ages, and in constant manufacture and daily use by thousands of his fellow-citizens! What adequate

• Toxicologie Generale, Vol. II., p. 410.

name could we apply to such a claim, of which only the effrontery could surpass the dishonesty?

Dr. Archibald Reith, a countryman of Ferguson (we know not that he began his career as a shepherd boy), physician to the Royal Infirmary of Aberdeen, in a paper on "The Therapeutical Action of Medicines in Dilated Conditions of the Blood Vessels," read before the Medico-Chirurgical Society of Aberdeen and published in Edinburgh, 1868, presents us with alleged discoveries of his own, in which we recognize the well-known screw.

Beginning with a confession of the confused state of Therapeutics and deprecating, as illogical, the skepticism regarding the value of drugs which has grown out of this confusion, Dr. Reith says, that the difficulty in reaching a satisfactory theory of the therapeutic value of drugs comes from incorrect views of the fundamental nature of diseases and of the action of drugs upon the system, as well as from the erroneous notion that the therapeutical action of a drug must be the same as its physiological action.

He says that" if our pathology be correct," all diseases "arise from the same centre. This centre is the joint cerebro-spinal and vaso-motor nervous systems."

Confining his attention now to the consideration of inflammation, which occupies so prominent a place in the production of disease, he says: "Inflammation is, as I understand it, primarily and essentially a disorder of the nervous system. The stagnation of blood, the effusion of lymph and serum, the suppuration, etc., which are commonly identified with inflammation, are themselves only the result of deeper-seated morbid processes affecting conjointly the cerebro-spinal and vaso-motor nervous systems.”

Stating the order of this affection of the nervous system to be, first, excitement, producing contraction of the capillaries, diminution of blood and decrease of vital properties; and second, paralysis, producing dilatation of blood-vessels, afflux of blood and increase of vital properties-Dr. Reith goes on to say: "A serious oversight has been made, leading to very erroneons practice. It is commonly supposed that the paralysis of the sympa thetic, on which inflammation in great measure depends, is the primary effect of the exciting cause; whereas, in truth, it is its secondary effect. * * * Thus, inflammation, as observed in the body, is a reaction from a previous and often invisible stimulus upon the motor system." To illustrate. "If ether spray be directed on the skin, the effects of the intense cold will be seen

by the naked eye; contraction of the blood-vessels, diminution of blood and decrease of the vital properties, manifested by the whiteness and insensibility of the part. When the stimulus is removed, reaction gradually takes place, till the parts resume their natural appearance. But it does not stop there. It goes beyond health and approximates disease. The surface is congested; there is dilatation of the blood-vessels, more blood and more vital energy, as increased heat and sensibility, than are found in the ordinary state."

He continues: "If a strong stimulus be directed on the nervous circle, such as cold from without or a poison from within [such as a fever poison] it is thrown into a state of temporary excitement, causing those rigors and general depression which usher in a fever and constitute its cold stage. The reaction from this is its hot or febrile stage," etc.

"Having thus," says Dr. Reith, "given a brief outline of the part played by the vaso-motor system in the incipient stages of inflammation; I have now to show that the action of medicine on the living body is precisely analogous. Whatever may be the ultimate effects of a substance, whether it be known as a purgative, tonic, or a narcotic, its primary action is on the vaso-motor system. The local effects of drugs will be found always to involve, more or less, the vaso-motor system, and to produce in it changes similar to, if not identical with those which occur in inflammation. Medicines may be arranged under two heads; pure astringents, acting chemically on the tissues, and those which, after their stimulant or spasmodic action has passed off, are followed by more or less reaction to paralysis of the sympathetic or dilatation of the blood-vessels. To this latter class belong nearly all the contents of the materia medica. They possess the double property of stimulating and paralyzing the sympathetic-in other words, of contracting and dilating the blood-vessels. Take the case of purgatives; a double action is universally ascribed to them, their purgative effects being usually followed by more or less constipation. But what I wish particularly to call attention to, is, that in accordance with the laws of inflammation, prior to their purgative action, and essential to it, the cause of it as it were-there is a previous spasm of the bloodvessels or excitement of the sympathetic, and that the subsequent purgation is in proportion to the intensity and duration of that excitement. We know well that laxative medicines act by creat