With these marked mental symptoms we find the usual characteristics of Nux, so that one is not likely to make a mistake in the selection of the drug. When indicated we have found this remedy one of the most satisfactory in its results, although it is often slow in its action and requires to be continued for some time.

Phosphorus.-Violent delirium, with restlessness, fear of death and constant desire to escape. Loud screaming, with attempts to bite and strike those about him. Hallucinations of sight; sees faces

leering at him wherever he may look. Nervous excitement; starts at the slightest noise. Intense sexual desire, with entire shamelessness and constant attempts to remove all clothing and go naked. Imagines that he is in several pieces, and cannot properly adjust the fragments. Irritable, fretful and peevish.

Although not as frequently demanded as some other drugs Phosphorus is exceedingly satisfactory when indicated. One of its most positive indications is the presence of hallucinations of sight, "faces peering from every corner"; with this symptom present we have never failed to relieve the patient by the exhibition of Phosphorus. It is most frequently demanded in cases with sexual excitement, and where the disease has arisen from a depleted state of the brain and general nervous system.

Platina.-Illusions-everything about her seems small, and all persons about her physically and mentally inferior to her. Thinks she does not belong in her own family. Arrogant, proud. Treats in a contemptuous and pitiful manner people usually venerated. Changeable mood, great joyousness alternating with sadness and depression. Anxious, morose, quarrelsome, peevish, irritable.

The ever-present proud, arrogant, contemptuous mood will preclude any possibility of mistake in the selection of this drug. It is most frequently indicated in women with a tendency to Nymphomania caused by initation and excitement of the Genitalia.

Spongia.-Happy, joyous, with a constant irresistible desire to sing, followed by distraction of mind and disinclination for all work.

Especially valuable in cases with a tubercular diathesis, and in patients subject to glandular enlargements, or where organic disease of the heart exists.

Stramonium.-Delirious, violent, foolish, noisy, joyous, furious, maniacal. Delirium of fear, as though a dog were attacking him. Violent, delirious, with hallucinations of sight; sees bugs, cats, dogs, rabbits and horrid beasts on all sides of him. Aggravation from the darkness, being alone, and in the morning. Ameliorated by light and company. Constant movement of the limbs during excitement.

Great aversion to fluids, the sight of which, at times, will almost produce convulsions. Incorrect ideas of distance and the size of surrounding objects. Screaming, catching and striking at frightful imaginary spectres, which fill them with the utmost terror. Furious, bites and strikes at every one who approaches. Fear, with sensation as if the bed was being drawn from under her, and that everything was falling on her. While sitting on sofa kept holding on to everything to keep from falling off. The horrifying images appear at the side more often than in front. Sees black objects, black people and black clouds. Has a constant vision of an executioner standing before him; laughs and jokes about the hallucination, although it seemed a reality. Things and persons around him appear to be changed. Imagines that he is alone and abandoned in a wilderness. Talkative. Imagines that he is very large and tall, but surrounding objects are small. Hallucinations of hearing; hears dancing, music and men talking in foreign tongues. Hears a voice under the bed at night. Exposes genitals.

While representing by its provings a wide range of mental symptoms, Stramonium has achieved its greatest curative triumphs in the severest class of cases.

When the delirium is wild and furious, and the patient is possessed by the most fearful delusions and hallucinations, then is Stramonium most clearly indicated and seldom fails to bring speedy relief. Soon banishing the horrid fiends and haunting images which have driven the sufferer into a perfect frenzy, Stramonium quiets his fears, quells his excitement and soothes him into a restful sleep, which is the first step in the return to health and reason. In the delirium of Acute Mania, Epileptic Insanity and Delirium Tremens, no other remedy is so often indicated or so frequently curative.

Veratrum Album.-Delirium, with coldness over the whole body and cold sweat on the forehead. The patient prattles about religious subjects and vows to be performed. Imagines he is a prince and behaves in a haughty manner. Persistent raging, with great heat of the body. Noisy cursing, howling, with frequent attempts to escape. Imagines she is pregnant and in labor. Runs about howling and screaming, worse in the evening. Ill-humored, irritable, vexed from slightest cause. Nymphomania, with violence and destructiveness, sexual excitement, with lewd lascivious talk. Rushes about the room and tries to kiss every one. Hallucinations of sight; room appears full of people, with whom the patient converses for hours. Sleeplessness, with constant talking and loud laughter.

The furious delirium of Veratrum Album, with violence and

destructiveness, resembles that of Belladonna and Stramonium. In Veratrum Album, however, we have much greater physical exhaustion, evidenced by a weak pulse, coldness of the body and cold. sweat on the forehead. The Veratrum patient must have speedy relief or die. Veratrum Album is especially efficacious in Mania. occurring in women where the disease is dependent upon some disorder of the sexual organs, and is aggravated at each menstrual period. Veratrum is often curative in Puerperal Mania.

Veratrum Viride.-Furious delirium, with screaming, howling and striking. Delirium with incessant muttering. Silent, suspicious, fears being poisoned. Sleepless. Loquacity, with exalted opinion of her own ideas and powers.

Although few mental symptoms can be found in its provings, Veratrum Viride has shown itself to be one of our most valuable adjuvants in the treatment of mental disease. In Acute Mania, Acute Delirious Mania, Puerperal Mania, or whenever an extremely high temperature, hurried respiration and rapid pulse exist, and death seems imminent, Veratrum Viride will often, as by a miracle, rescue the patient when apparently beyond human aid.

Its sphere of usefulness, however, seems limited to the resuscitation of the physical powers, and when this is accomplished little can be expected from it as regards the restoration of the patient's reason.

A

IODOFORM IN TUBERCULAR MENINGITIS.*

BY WM. S. MINER, M.D.

New York.

S a prelude to the narration of the history of a recent case of tubercular meningitis, treated by iodoform, I beg to refer briefly to a case of this kind reported by me in September, 1887, in the New York Medical Times.

Case I. June 18th, '87, I was called to see Hannah C., aged 4 years. She had had a mild attack of measles two months before. After this had not seemed the same. Her disposition was changed. She was cross, irritable, petulant, and disinclined to play as usual, although she was not sick and had nothing to complain of. During the past week she had cried out in her sleep a great deal. On the evening preceding my visit, without any premonitory chill, she developed a high fever, which lasted throughout the night. She had slept hardly any during the night, kept moaning all the while, and

* Read before the Meissen Club of New York.

when she did get to sleep, would cry out, sometimes waking herself with her screams. She did not complain of any pain.

When I saw her the temperature was 104.2°; pulse 160, face flushed, pupils dilated, with a wild anxious expression, skin hot and dry. Not much thirst, a dull general headache, but no severe pain in head, tongue red and dry, convulsive twitching of tendons of hands; had eaten nothing all day. Child did not complain of anything. R. Bell.

June 19th.-Morning temperature 105.6°; pulse 160. Had not slept at all during the night. Would utter the most piercing shrieks and screams, wanted to be carried the whole time. Would grind her teeth and roll her eyes upward and inward. Would not take any nourishment. Kept kicking and tossing all the time, or would lie still for a few moments, then utter a piercing shriek, and kick and fight in a most savage manner. The head was drawn backward and kept rolling constantly from side to side. Aconite was administered hourly. In the evening the temperature was 104.4°; pulse 144, small, full and soft. All the morning symptoms were present but intensified. The child had lost consciousness altogether; the pupils were widely dilated, had a vacant stare, and much of the time were rolled upward and could not be seen. The hydrocephalic cry was uttered at intervals. Child would grate and grind her teeth in a manner terrible to behold. Vomited two or three times during the day. Vomiting was projectile in character, the contents of the stomach being forcibly ejected without any premonitory retching or signs of nausea.

June 20th.-Had not been quiet more than an hour altogether during night. Morning temperature 105.4°; pulse 144, and weak. Respiration, variable; at times presenting a modification of the Cheyne Stokes respiration, and at times becoming more regular, remaining steadily at sixty per minute. There were no signs of any pulmonary lesions. Bowels moved during the night. They had been constipated, but this morning and during the night had two or three loose evacuations. Child cannot articulate. Swallows with great difficulty. Is extremely prostrated. Head drawn back, boring in pillow and rolling constantly from side to side. Screaming and grating her teeth at intervals. Automatic motions of legs and arms. Tongue heavily coated yellow. Breath very offensive. Has taken scarcely any nourishment in last two days. Totally blind. Deaf. Unconscious. At this juncture, having made a diagnosis of tubercular meningitis, and having given an unfavorable prognosis, I determined to make a trial of the treatment which had been recom

mended by Dr. Eugene Martel (Revue Internationale), viz., iodoform, used by inunctions. Dr. Martel had reported seven cases cured by this method. Accordingly, the child's head was shaved, a pomade was made up of iodoform and vaseline, Ziii to 3ii and one-half drachm of the ointment was rubbed into the scalp twice daily. It was well rubbed in until no traces of the ointment remained. The rubbing seemed to have a soothing effect. The child seemed to like it and would remain quiet while it was being done. The tincture of veratrum viride was administered in drop doses hourly, and the bromide of sodium was used at night only in alternation with it. The evening temperature was 104.4°; pulse 144; respiration 60.

June 21st.-A. M. temperature 103.2°; pulse 132; respiration 44. Child seems a little better. Rested more during night. Took a little milk this morning. Seems a trifle stronger. Otherwise, condition same as yesterday. P. M. temperature 104°; pulse 132; respiration 44.

June 22d.-A. M. temperature 102°; pulse 116; respiration 56. Sight is returning. Child recognizes those about her. Pupils still dilated, but have lost their vacant stare. Hears what is said when spoken to loudly. Seems to understand, but cannot speak. Power of speech entirely absent. Takes more nourishment. Had very little rest last night. The bromide of sodium, which had been used freely during night did not seem to have much effect. It was, therefore, discontinued, and veratrum viride given alone. Evening temperature 103°; pulse 132; respiration 60.

June 23d.-A. M. temperature 98°; pulse 96;respiration 36. Child is brighter. Eyes look more natural. The boring of the head has ceased. Swallows without difficulty. Hears better. Very irritable and cross. Is much improved since yesterday. Evening tempera

ture 97.4°; pulse 96; respiration 36.

June 24th.-A. M. temperature 98°; pulse 100; respiration 40. From this time the temperature continued normal for several days, and the child improved daily. Veratrum was discontinued and sulphur substituted. The power of speech began to return, and the child spoke with more distinctness every day. The appetite returned and the child gained strength rapidly. With the fall of the temperature to the normal standard, an eruption of boils made its appearance upon the thorax and abdomen. They increased in number and size daily, until the entire surface of the thorax and abdomen, anteriorly and posteriorly, was covered with them. The inunctions of iodoform were then discontinued and hepar 3x administered. A moderate