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XXVI.

Case of Gastrosis.

By S. C. KNICKERBOCKER, M. D.

Mr. W., aged about thirty-eight, of sanguine temperament, head bald, had suffered from dyspepsia for several years; was obliged to change his business from that of a dry goods merchant, to, that of a farmer; since the change, had been somewhat better.

At different times I had prescribed arsenicum, carbo veg., bryonia, pulsatilla, nux vom., and sulphur, but with only temporary relief.

On the fifth of October last, he called, and wished me to give him something to relieve the difficulty of the stomach, which was more or less troublesome all the time, and caused him to feel uncomfortable, uneasy and unhappy.

I examined the case carefully, and elicited the following symptoms: Burning and uneasiness in the stomach: relieved by eating: canine hunger, at noon and evening. This was all there was of it. Mezereum covered the case perfectly. (Lippe's Materia Medica.) Gave a single dose of mezereum3 on the tongue, to be followed in ten days, if not better, with a single dose of the two hundredth potency.

Have heard no more complaint of the stomach since mezereum was given.

XXVII.

Case of Biliary Calculi. Morbid Deposit in the Urine.

By HANS POWELL, M. D.

Mrs. J., an English lady, aged eighty-seven, had been suffering for about twenty-four years, with almost complete prolapsus uteri. Had steadily refused to allow various physicians to apply any instrument, bandage, or other remedy, and, with the exception of occasional difficulty in passing urine, and some cedema of the feet, has enjoyed remarkably good health.

On the twenty-sixth of January, I was summoned, she having for some hours complained of difficulty and pain in urinating, which had been somewhat relieved by the administration of a few drops of spirit of nitre. Found the patient sitting in an arm-chair, having refused for some months to lie down. Complained of severe pain, which came in paroxysms, in the region of the epigastrium, or toward the right side, and thence shooting to the back; pale skin, small and feeble pulse; anxiety, restlessness, hurried respiration, and great prostration, with desire to pass urine every few minutes, and inability to retain in, or to rest in any position with ease. The uterus was almost entirely protruded from the vagina, resting upon the edge of the chair, considerably ulcerated, with discharge of purulent matter. Administered lycopodium in conjunction with aconite, and within six hours she passed, with considerable pain, ten or twelve regular gall-stones, of a yellowish brown color, of various shapes, but all with irregular faces and rounded angles, produced by their mutual pressure and attrition. On the morning of the twenty-seventh, the uterus had receded or contracted, and disappeared into the vagina, causing the attendants considerable alarm and anxiety, the urine still continuing to pass involuntarily every few moments. Continued the same remedies, with the addition of a few drops of tincture of belladonna, and before evening, ninetysix similar stones were passed, one or two of which were of unusual size. On the twenty-eighth, the patient was somewhat easier. The intermissions or paroxysms of pain being longer, continued the same remedies, and before the following morning, one hundred and forty

Biliary Calculi.

Representing size and appearance.

two similar stones were passed. The uterus having again come down to its abnormal position, for the next two or three days the pain and difficulty of passing urine continued with longer intervals, and almost every time it came away, various quantities of similar stones were voided, the exact number of which could not be counted, owing to the fact that they would be scattered and lost upon the floor. The accompanying box full were voided within five days. The following week she continued passing a few almost every time urine was voided. The bowels during almost the entire time, were constipated, relieved however by the administration of nux vomica. The patient is now convalescent and likely to live some time. The uterus is still protruded, and some slight discharge of purulent matter continues, but the urine is passed without pain or difficulty, and otherwise is as well as she has been for twenty odd years, and able to be about her room; appetite good, and bowels regular. It was impossible to determine, owing to the protrusion of the uterus, whether the stones were located in the gall bladder, biliary ducts, or in the posterior portion of the vagina; none were passed by the bowels.

The accompanying illustration represents the size and color of the gall stones.

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