advanced cases, such is the implication of the brain and nervous system a cure is not always possible, even with the most enlightened treatment.

However, I am happy to assure you that homeopathy in this, as in other diseases, has been and can be a priceless boon to the poor unfortunate. When remedies administered in accordance with the principle similia fail to relieve, then is the case hopeless.

With a knowledge of the cause, a rational hygienic and moral treatment, together with a well-selected homœopathic remedy, the physician can generally recall vigor and elasticity to the wasted frame, dispel mental aberrations, and soothe the anguish of the troubled and dispairing mind.

Treatment.

Of course, the first point is to endeavor to ascertain and remove the cause. This will be found at times to be a matter of more or less difficulty, but the success of our treatment will depend upon it. As I have remarked, in a majority of cases the disease is the direct result of onanism, and in one-half of the remaining cases it will be found to result from too frequent excitation of the sexual instinct, either from sexual excess with women, and from a perverted and excited imagination, consequent on the mind dwelling upon subjects connected with the sexual passion, or from reading lascivious literature and works of fiction which pander to a depraved taste.

In either of those cases, the first duty of the physician is to show the patient the ultimate result of such a course if persisted in, and obtain from him a solemn promise to abandon his evil practices.

It is absolutely necessary to obtain the confidence of your patient, and by a little tact you will succeed in gaining both the confession and the promise. You can then endeavor to direct his mind to newer and purer channels of thought, at the same time giving him that comforting encouragement which is so necessary in the treatment of diseases of this nature. In dealing with sexual weakness, it is necessary first to depress the fancy, then to strengthen the will; in a word, endeavor to secure a victory over the moral forces, and you will then have a promising and substantial basis of treatment.

I place much stress on the hygienic measures which are at our command in the treatment of this difficulty.

No general rule can be given as regards the diet. The physician must use his best judgment in each individual case. That which is most frequently indicated is a plain, nutritious diet, not partaking

of a stimulating character. Coffee, tea, spices, game, spirituous liquors, oysters, celery, and, in fact, anything and everything that will prove an excitant to the sexual organs, must be interdicted.

Female society, especially in the evening, must be avoided. If possible, it would be well to abstain from the use of tobacco. Where the system is much run down, a little light wine may be used.

Where masturbation is the cause, the patient should go to bed early, sleep on his left side, on a straw bed or mattrass; the covering should be just enough to keep him from taking cold. As the most frequent time of emission is early in the morning, he should make it a point to arise the moment he awakes, say at five o'clock, take a quick, cold bath, taking care to rub himself with a rough towel, till he gets up a re-action.

His dinner should be the heartiest meal; the supper light. Some active exercise should be taken after supper, and when he retires, particular pains should be taken to evacuate the contents of the bladder and rectum. Where the bowels are constipated, recourse may be had to cold water injections.

In regard to the drugs to be used, it would be superfluous on my part, to give all the indications bearing on this malady. You have your materia medica ever at hand, and you all know what the totality of the symptoms mean. I will however, mention some of the remedies which in my hands have proved especially effacacious in this disease.

. China will commend itself " after loss of animal fluids." I generally use five or six drops of the mother tincture, after each emission.

Digitalis.-I can give you no indication for the use of this drug. The provings show an undefined action, something like an irritation of the brain, and genital organs; it is without doubt an efficient agent in the treatment of spermatorrhoea proper. Sometimes the heart symptoms point to me its use.

Nux vomica.-For "old sinners," those addicted to spirituous liquors, late suppers, etc. The indications are constipation, bad taste in the mouth from headache, nausea, etc. This remedy and its alkaloid strychnia are worthy of attention, where impotence is feared, or has resulted.

Phosphoric acid is a noble remedy, and has proved a priceless boon to the victim of self-abuse. From its well known action on the cerebro-spinal system and great sympathetic, it has a powerful influence on the generative organs. When you have moral emotions,

nervous symptoms, loss of animal fluids, sinking of the vital energies, phosphatic deposits in the urine, etc., this remedy will demand your earnest attention, and closest investigation.

Other agents are caladium, gelseminum, lupulin and kali bromat, anacardium, for its "weakness of the memory, mind and the senses" should prove beneficial in certain cases, though as yet I have not had occasion to test it.

As a prophylactic for children and boys given to self-busc, I would have no hesitation in applying a blister to the penis.

As a valuable adjuvant I can heartily speak a good word for electricity, it has helped me out of some close corners, and I would especially recommend it for your consideration in obstinate cases.

XXIV.

Case of Aphonia.

By S. C. KNICKERBOCKER, M. D.

Miss A., aged sixteen, of slender form, and subject to menstrual irregularities, had suffered from several attacks of aphonia, and at times would be unable to utter a loud word for a week. Prescribed pulsatilla, to be taken in water every three hours during the day.

The following morning found the patient no better. While examining the anterior portion of the neck, discovered a spot very tender to the touch. This symptom led me to prescribe lachesis. Prepared the thirtieth dilution in water, and ordered it to be taken every three hours, till three doses had been taken, and then to omit the medicine until I should call again.

On calling the following morning, found the patient had regained voice in its usual strength and clearness, and said that immediately after taking the third dose of the medicine, the voice returned, and the tenderness in the cervical region soon passed away. I have not learned that there has been any return of the aphonia since this attack, which occurred four years ago.

XXV.

Spasms of the Larynx.

By S. C. KNICKERBOCKER, M. D.

Mrs. W. F., aged about fifty-five, of nervous temperament and delicate constitution, had been under the treatment of a physician of another school, at intervals, for some years, for a difficulty which he diagnosed as croup, but obtaining no permanent relief, and the attacks becoming more frequent and severe, she concluded to try homœopathy, and, accordingly, I was called to visit the patient. I found that the attacks consisted of a sense of constriction of the larynx, attended with dryness of the whole throat and mouth, and that they invariably occurred after sleeping.

The exacerbation after sleeping being the "key-note" of lachesis, that never fails me, I prescribed lachesis, with perfect confidence that it would give relief. The day following, I learned from the patient that there had been no paroxysm during the night. There was no return of these spasms for several weeks, when, one day, she sent to my office a message saying that the night previous there had been a slight return of the throat difficulty. I sent a powder of lachesis, to be dissolved in half a tumbler of water, and a dessert spoonful taken three times a day, until the solution was gone. I have heard of no return of the disease since that time, which was two years ago.