question whether it may be due to enlarged thymic, cervical, or thoracic glands. Look at the neck; feel of it; press your fingers deeply under the sterno-cleido-mastoid muscles; for this is the location of the deep-seated lymphatic glands which are most likely to give rise to the trouble. Inquire into the history of the parents and grandparents for scrofula. Has the patient had glandular disease elsewhere? Is it well nourished? Is its belly tumefied and hard? If you have good reason to apprehend scrofulous glandular enlargement, you will need to institute what one school calls constitutional, and the other antipsoric treatment. The nutrition remedies, as Grauvogle aptly calls them, will come in, as well as function remedies for the laryngeal symptoms. You may give calcarea, sulphur and their iodides-whichever is most appropriate-say twice daily, and repeat your function remedy as seems best.

I have left myself little room for the specific treatment of the complaint, and, as I have said, this is mostly theoretic. However, I will tell you what has proved useful, and when, as well as give you a few therapeutic prophecies as to what may be of service.

Remedies for Spasm of the Glottis.

Most prominent of these is chlorine gas, in a weak watery solution; and we owe the development of its relations to this disease to your respected dean, Dr. Carroll Dunham, to whom the whole profession owes so much in many directions. Its symptoms are as follows:

"Spasm of the glottis, which interferes but little with inspiration, giving to it a crowing sound, but which prevents expiration. The respiratory acts consist of a succession of crowing inspirations, each followed by an ineffectual effort at expiration; the whole serving to inflate the chest to a most painful extent. This finally results in more or less complete asphyxia, with or without convulsion, during which the spasm relaxes and free respiration takes place." These are the symptoms given, but you will note that they are those which occur in every case of spasm of the glottis, to a greater or less degree. The characteristic and distinctive symptoms of the drug have never been evolved.

This remedy, gentlemen, has cured several cases of this disease promptly, and a large majority of instances of simple idiopathic spasmus glottidis may be expected to yield to it. You will find the mode of preparing it in Pareira's 'Materia Medica, or in works on chemistry.

The remedy which most closely resembles chlorine in its action, according to the proving of Lippe, is mephitis. It has the suffocative feeling, with inability to exhale; the bloated face and convulsions; but I am not aware of any characteristic symptoms which indicate it in distinction from chlorine, nor has it ever cured spasm of the glottis, to my knowledge.

Sambucus, you know, was the remedy selected by Hahnemann for this disease; but its signal failure to cure the large majority of cases has led some to question whether the usual sagacity of the master did not desert him on this occasion. The fact, however, does not prove that the remedy is not homoeopathic to some modalities of the disease, and the trouble lies in our failure to discover these modalities; not in Hahnemann nor in the remedy. This is made evident by its prompt cure of some cases of spasmus glottidis. One of the most marked of these you will find numbered "Case 304," American Journal Homeopathic Materia Medica; but, unfortunately, the characteristic symptoms are not stated. You will find in the pathogenesis of this remedy the usual symptoms of spasmus glottidis, but the determining ones for its employment are these: Burning, red, hot face, hot body, with cold hands and feet during sleep. On awaking, the face breaks out into a profuse perspiration, which extends over the body, and continues, more or less, during the waking hours; then, on going to sleep again, the dry heat returns.

Should you ever meet with a case presenting these peculiarities, you may be sure sambucus will cure it, and nearly as sure that it will fail, if these symptoms are absent.

Moschus has similar symptoms to the foregoing remedies, and is said to have cured laryngismus. It was probably hysteric in

character.

You may meet with cases for which lachesis will be indicated. Of course the sensitiveness of the larynx and trachea to touch will be its leading indication, and a distinctive one.

Besides these five, I am unable to find any remedies that have cured, or are likely to cure, a case of true spasmus glottidis.

Treatment of Paralysis Glottidis.

Baehr says that the symptoms of closure of the rima are more marked in the pathogenesis of plumbum than that of any other drug. It has the mucous rale, with sudden difficulty of breathing, and asphyxia, but I do not know that it has ever been tried as a remedy for this disease.

Cuprum presents similar symptoms. Cases demanding it should have cold perspiration at night, and any accompanying cough should be relieved by a swollow of cold water.

Spongia and iodine, bearing as we know, a relation to scrofula, should be studied when we have reason to suspect enlarged glands as the cause of the disease.

Ignatia has the eminently characteristic symptom of difficult inspiration, with easy expiration.

Gelseminum has long inspiration, with crowing sound; expiration sudden and forcible.

Corallia rubra will be serviceable in cases which it is difficult to distinguish from hooping-cough.

Of the other remedies which have been recommended for this disease, perhaps ipecacuanha, hydrocyanic acid, opium, veratrum, and arsenicum deserve some attention; but I am unable to discover their homœopathicity to any form of it, nor have they ever cured a case to my knowledge. Perhaps this may be said of all the remedies I have named for paralysis glottidis; but at least these have this merit, that their symptoms correspond closely to the disease.

In conclusion, gentlemen, I can only express the hope that you may curc every case of laryngismus which falls to your lot, and with this wish I bid you farewell and Godspeed.

XXII.

Intermittent Fever.

By H. E. POWELL, M. D.

It is generally admitted that intermittent fever is caused by the presence of a material poison in the system, although it is sufficiently impalpable to have as yet escaped all the tests which have been applied for its discovery; but whether malaria be a fungus or an animalcule, it is certain that it has the power of vitiating the system, where it finds a lodgment to such an extent and in such a manner as to produce a type of disease which is unique and utterly distinct from any other kind of fever.

Taking it for granted then, that this dyscrasia is caused by the presence of a malarial poison, should it not be met by a material remedy? To illustrate this point, if a man be poisoned by opium, we should not think of prescribing a dose of coffee at some high dilution, but rather administer strong black coffee in large doses, so as to neutralize the effect of the poison. So I maintain must malaria be met, to be treated sucessfully, as in the supposed case of poisoning by opium, the dose may not be sufficient to destroy life, and nature with the assistance of attenuated remedies, may be able to expel it from the system, although it would be done more efficiently by a material antidote. So in some cases of intermittent fever, where the vis medicatrix naturæ is sufficiently powerful, by the assistance of dilutions, the miasm may be eliminated, yet the desired result may be much more confidently counted upon by the use of such a dose of medicine as shall neutralize the poison, which medicine being at the same time homœopathic to the disease, destroys the susceptibility of the system to the invasion of the poison.

The success which has attended me in the treatment of numerous cases of intermittent fever in New York and its environs, justifies the preceding remarks, as during the last three years, I have never used anything but tinctures in the treatment of it, and to the best of my knowledge, I have only failed to effect a cure in one case, to which I will make further reference before closing this paper.

Had my experience been confined to sporadic cases in New York,

I might have doubted the efficacy of the treatment in malarious districts, but I have taken especial care to treat patients in Mott Haven and Harlem, where intermittent fever abounds.

I presume I am laying myself open to the charge of being a low dilutionist; and, as far as intermittent fever goes, I "own the soft impeachment," experientia docet, and it certainly has taught me that tinctures, in the treatment of this disease are more certain, more reliable and more active than any dilution. Let me quote a case or two in point:

CASES I AND II.

Two brothers, residing in New York, had, on a visit to Mott Haven, contracted intermittent fever; the form was tertian. They were treated by a homoeopathic physician, for six weeks, with high dilutions; he left the city and handed them over to another, who treated them for two weeks longer, with high dilutions, and he left the city for two days, and during that period they were under my charge. I found them very much prostrated. The attacks in the case of the elder (his age was about thirty-five) had become duplicated, so that, as he expressed it, he had one very bad day and one not so bad alternately. I first saw him upon the day of the lighter attack, or what should have been the apyrexia. I prescribed nux vomica, five drops of the pure tincture, in a tumbler half full of water, and ipecacuanha, five drops of the pure tincture, in another tumbler half full of water, with directions to take a teaspoonful every two hours alternately. The next day the chill came on two hours later, and that was the last he had.

The younger brother, aged about thirty, had just passed into the apyrexia, when I first saw him. Prescribed nux vomica, five drops of the pure tincture, and arsenicum, five drops of the pure tincture, to be taken in the same manner, and he did not have another attack.

These are two cases out of many that I have cured quite as readily, but I quote them because of the previous treatment by high dilutions. And, let me state, that the physicians were no tyros, but men of large experience, high standing, and extensive acquaintance with their materia medica; so that I am justified in presuming that if it had lain within the power of high dilutions to cure them they would have effected it.

CASE III.

I was called to see Mrs. D., aged fifty, residing in New York. I found her just emerging from a severe chill, with excessive vomiting