U T ERINE DISEASES,
WITH AN APPENDIX,
CONTAINING AN
ABSTRACT OF 180 CASES
oF
UTERINE DISE-ASES AND TIIEIR TREATMENT,
TOGETIIER WITH
ANALYTICAL TABLES OF RESULTS, AGES, SYMPTOMS, ETC.,
TO WHICII IS ADDED
A CLINIC.AL RECORID OF INTERESTING CASES, TREATED IN TIIE MANCHESTER
IIOICEOPATHIC HOSPITAL.
BY HENRY R. 3MADDEN, 3I. D.
NEW-YORK:
WILLIAM RADDE, 322 BROADWAY.
PHILADELPHIA: RADEMIACHER & SHEEK.-BOSTON: OTIS CLAPP.-ST. LOUIS:
-.C. F. NVESSELHOEFT.-CINCINNATI: H. F. DAVIS, MI.D.
Is YL2








UTERINE DISEASES,
WITH AN APPENDIX,'CONTAINING AN
ABSTRACT OF 180 CASES
OF
UTERINE DISEASES AND THEIR TREATMENT,
TOGETHER WITH
ANALYTICAL TABLES OF RESULTS, AGES, SYMPTOMS, ETC.,
TO WHICH IS ADDED
A CLINICAL RECORD OF INTERESTING CASES, TREATED IN THE MANCHESTER
HOM(EOPATHIC HOSPITAL.
BY HENRY R. MADDEN, M. D.
NEW-YORK:
WILLIAM RADDE, -322 BROADWAY.
PHILADELPHIA: RADEMACHER & SHEEK.-BOSTON: OTIS CLAPP.-ST. Louis:
C. F. WESSELHOEFT.-CINCINNATI: H. F. DAVIS, M.D.




ANGELL, ENGEL & HEWITT,
Printers,
1, 3 and 5 Spruce-st., N. Y.




UTERINE DISEASES,
THERE is perhaps no class of diseases concerning which the
views of the profession have undergone so complete a revolution, within a comparatively short period, as that to which I am
now about to draw your attention. Prior to the appearance of
the well known work, " On the Diseases of Females which are
attended by Discharges," from the pen of Sir Charles Clarke in
the year 1814, the medical men of Great Britain appearto have
been in almost mid-night darkness respecting the true nature of
this most common source of delicacy among famales; and subsequent to the advance in knowledge attributable to the above
work, but little real progress appears to have been made until
about 1843, when Professor Simpson startled the profession by
his bold advances upon the almost untrodden field of uterine
diagnosis. —It may be well to observe en pcassa/nt that these
remarks refer only to Britain, since the'advancement in the
knowledge of uterine pathology in France has been far more
steady and progressive for many years past.-Since the appointment ofthe present Midwifery Professor of Edinburgh however,
a most complete change has occurred in the feelings of the profession towards this field of research. The stimulus given at
our Scottish University has excited a deep and lasting interest
in the whole subject, and has encouraged, or called into active
exercise, so many ardent minds that we now seem likely to suf



4                   Dr.  afcdden,
fer from an evil the'very opposite of that which characterizedl
the last generation of practitioners;' and every aberration of
health in the female sex runs no small risk of being at once
attributed to' uterine-engorgement,'' inflammation of the cervix,''retroversion,' or some other metritic malady,.the very
mention of which has a'harrowing interest' for the poor sufferer. This however is an evil which may be avoided by due
care and circumspection; and we cannot feel otherwise than
grateful to those who have directed our special'attention to this
most interesting class of diseases, and who have led the way into
an entirely new field of pathological enquiry. On viewing,
however, what has hitherto been done, the cautious and the
wary cannot avoid feeling, that while some advance has been
already made, much more yet remains to be achieved; and while
some solid foundation has been laid whereupon to rear a useful
and practical pathology, a careful examination of the superstructure will excite some doubt as to its stability and endurance. Time will not permit me to dwell any longer upon such
general remarks, and I must, accordingly, advance without
further delay to the consideration of the subject itself.
To any one who has read much of the recent literature of
uterine disease, it will at once be apparent that any attempt
to touch, even in the most sketchy and superficial manner,
upon all the various points of this wide-branching subject,
would occupy vastly more time than can possibly be commanded on an occasion like the present. It is, accordingly,
my purpose to limit the following remarks almost exclusively
to one portion of this subject, which, however, is of itself so
extensive and important as well to merit all the attention and
time we can devote to it. I shall therefore, at once, draw
your attention to thie consideration of
Subacute and Chronic Inflammation of the Uterine Tiessues,
and still further to limit our subject, I shall confine'my observations chiefly to the disease in its most common form, namely,
as affecting chiefly the cervix uteri, and as limited to the mucous
membrane ofthat portion of the genital apparatus. Although




on Uterine Di-lseses.             -
in the remarks with which I opened up this subject, I referred
to Professor Simpson as the individual to whose labours I would
trace the extraordinary stimulus given to the'study of this class
of diseases in Britain, yet it will appear from the sequel that
Dr. Henry Bennet, of London, has done more than any other
practitioner in this country to advance our knowledge of that
special form of disease which we are now considering.
It will facilitate greatly our examination of this subject, if I,
in the first place, give a short and rapid sketch of the views
which have been progressively advanced regarding this disease
during the last seven years. It was in 1843 that Professor
Simpson first publicly introduced to the notice ofthe profession
that instrument of diagnosis, which is now so well known by
the name of the Uterine Sound; and he, at the same time, informed his confreres that he had proved, by its means, that
flexures of the uterus, in place of being conditions of rare
occurrence, were among the most requent accompaniments of
uterine derangement. Nay,more,he believed himself authorized
in affirming, -that these flexures were the cause of verymuch, if
not of all, the distressing symptoms under which such patients
suffered; and- yet further, he added, that these morbid conditions admitted of a mechanical cure, subsequent to which the
whole symptoms yielded,and the patient was restored to health.
To this statement we may trace the origin of what may not
inaptly be termed the " Mechanical School" of uterine therapeutics. This school has grown largely in numbers since the
enunciation of the above related facts, and counts among its
advocates many of the leading accoucheurs of this country.  It
has, however, been vigorously opposed by a large number of
those who have made uterine pathology their chiefstudy. Neither has this opposition been solely on the part of the conservative
section of our profession-whose peculiar prerogative it seems
to be, to exert all their efforts for the purpose of impeding progress, or, as.they would themselves say, of putting a wholesome
curb on reckless innovation-but an equally energetic resistance
to the adoption of these mechanical views has been made by




6                    ItDr...zadden,
some of the most ardent reformers of uterine pathology, and
who, thejmselves occupying a position quite as far in advance of
the mass of the profession as the Edinburgh professor and his
pupils, share equally with them the opprobrium of those
whose affections are placed upon things as they are.
The leaders of this second, or Inflamtnatory School, as it
might be termed, is Dr. Henry Bennet, of London, who, after
studying his subject fully in Paris, has developed his views
in the very best book of uterine diseases extant in this country, I mean his work on " Inflammation of the Uterus and its
Appendages," published in 1849.
Dr. Bennet andhis followers, unlike the conservative section
of the profession, freely acknowledge the importance of the
uterine sound as a most useful, nay, often indispensable, means
of diagnosis, while they altogether differ from Dr. Simpson in
their estimate of the importance of those frequently occurring
flexures of the organ, whiQh have become known to the profession through its instrumentality; and so far from viewing them
as the chief object of treatment, they aver that if the inflammatory condition of the uterus be subdued, no attention whatever need be paid to the bent state of the organ, save in rare
exceptional cases. This opinion they support by the declaration, that when the flexure is-slight it rights itself as the organ
resumes its healthy condition; while, on the other hand, if the
fiexure is not unbent, but remains stationary, it ceases to cause
any inconvenience once the inflammation is entirely subdued.
We have here, therefore, another of those frequent instances
of a disease, wherein the most opposite opinions are held and
acted upon by different practitioners, and yet the followers of
both methods of treatment, meet with a sufficient amount of
success to encourage them to persevere with the plan they
have adopted, and uphold the accuracy of the opinions they
have propounded respecting the nature of the disease and its
therapeutic requirements. In what way are we to explain this
apparent anomaly? Are.we to consider it as a proof that
aeither method of treatment does any real good,? or, should




on  Jterine lisea8se8.               7
we not rather examine the whole question more closely, and see
whetherthe two methods oftreatment do, in their essence, differ
as much from each other as they at first sight appear to do;
and whether a rational explanation of their action may not be
found, which will equally account for the success ofboth? This,
however, will be mnore conveniently considered when we are
engaged with the whole question of treatment.
I will now endeavour to lay before you the, various points
which it appears to me have been, more or less, positively
established by recent investigators of uterine pathology, irrespective altogether ofthe school to which the propounders may
belong; for in this, as in most other instances, a careful and
dispassionate consideratioA.of the statements made by'each party has led me to see that both contain much that is valuable, and
that the safest plan is to keep clear of parties altogether,:and
endeavour to reap the benefits rendered available by the labours of each and all of those engaged in the investigation.
Perhaps one of the most important facts, in a practical point
of view, which has been established, is that leucorrhcea is an
invariable proof of an inflammatory condition of some part
of the uterine system. The converse of this is not indeed true,
in so far as inflammation of the uterus or its appendages is by
no means invariably accompanied.by leucorrhoea; but, on- the
other hand, it appears to have been clearly demonstrated that
in every case of continued leucorrhcea,-there exists more or
less inflammation of one or other of the'uterine tissues. It
is curious, but not uninstructive, to-notice the reception which
the declaration of the inflammatory origin of leucorrhcea mnt
with in this country. The first announcement of this doctrine
in later years which I have met with, is by M. Lisdranc, in his
Clin/ique Chirzrgicale,.published in 1842, and reviewed in
the XMedico-Chirurgicca Review for April, 1843.- In that periodical we find the following remarks (p. 366-7):" Leucorrhoea. — The following most lucid exposition of the vetiology of this very common complaint is given by M. Lisfranc:'This disease is' produced either by a phlegmasia, or by an irritation,




8                     Dr.  fadden,
or by an injection, or, perhaps, by a sanguineous fluxion, which may
exist at one and the same time, in the vulva, the vagina, the internal
surface of the uterus, and the ovarian tubes; whence arises a white
coloured discharge.' We verily believe that, for once that it is owing
to any increased vascular action-be the name that we give to such
a state what it may-it is in nineteefi, or ninety-nine cases, at least,
dependent upon weakness and atony of the vessels of the mucous
membrane affected."
And a little further on, the reviewer winds up his remarks
by observing —
" But it is unnecessary to address arguments to the English physician on this subject, as very few are likely to be misled by the fantastic notions of many continental writers.?'
Such, then, is the opinion of an influential review, in 1843,
concerning the inflammatory nature of leucorrhcea. But what
says the same Review, or, rather, its successor, the British
ad Foreignn fedico-ChAirzrgical Review, in 1850? In speaking of Dr. Bennet's work on "IInflammation of the Uterus and
its Appendages," we find at page 115, the following remarks:"Among the disorders of the female constitution, there is none so
frequent, none so much misunderstood as leucorrhoea. Its name'
implies nothing more than an effect of some pre-existing disease.
The cause of that effect should be enquired into and understood,
before we undertake its removal; yet the treatment formerly adopted, almost exclusively consisted in remedies to check the discharge;
every variety of astringentswas used for this sole purpose; and
whether administered by the mouth, and taken into the circulation,
or applied locally, the whole object was to arrest the fluor albus, and
nothing more."
After referring to the one step -in advance, made by Sir
Chas. Clarke, the reviewer proceeds" Such was the state of our ignorance on this class of diseases,;,ntil within the last few years;-an ignorance which was not the
result of,a careless attention to them, or of want of acuteness on the




on Uterine IDiseases.                 9
part of-the obstetric physician, but which was inevitable so long as
the mode of ascertaining their character was not adequate for the
purpose."
Further on, in the same article, we meet with the following
sentence (p. 132)"Practitioners have considered these symptoms as purely functional; and although often embarrassed to explain their anomalous
character, or to decide exactly upon the function that was disordered, a local phleginasia was the very last cause that would have been
looked for to unravel our entangled ideas."
Nevertheless, it appears obvious from the whole tenor of
the article, that the doctrine of the inflammatory origin of
leucorrhcea commends itself to the judgment of the reviewer;
and in the July number of the same periodical, in treating of
Dr:; Tilt's work on the "Diseases of Menstruation," we find,
apparently the same writer, remarking that the term leucorrhcea
"Must for the future have a precise meaning, and be regarded almost
entirely as symptomatic ofwell-recognised organic disease." —(p. 212.)
Thus, it appears, that the "fantastic notions" which "are
not likely to mislead" the English physician in 1843, become
acknowledged truths in 1850. How passing strange, that a
learned profession like that of medicine, should be acting and
re-acting the same farce of ridicule and concession, of disparagement and adoption, of incredulity and faith, respecting
almost every new fact which may be presented to its notice!
Let us examine, however, the ground upon which this opinion, respecting the inflammatory origin of leucorrhcea, rests.
This we find to be two-fold, viz., experimental and deductive.
Experimentally, it has been proved by examination of the
uterus.  D)eductively, the results of such examinations have
been brought to bear upon certain cases, evincing similar
symptoms,but where no opportunityfor examination was afforded, or where there appeared no paramount necessity for the
performance of an -operation which must ever be far from




10                  Dr.,2ladden,
agreeable to the feelings both of the physician and his
patient.
It is perfectly obvious, that the true nature of leucorrhcea
Would have ever remained undiscovered had not the speculum
been extensively resorted to for its elucidation. Sir Charles
Clarke had already pointed out to the profession the..importance of a physical examination of the condition of the generative apparatus in all cases of leucorrhcea; but he limited his
investigations to the data afforded by the sense of touch, and
the. profession soon found, that the information thus obtained
assisted them very little more in their treatment than the
symptoms which were related to them by the patient, and
thus, except in aggravated or very obstinate cases, this mode
of investigation was emplo3ed only by a few of those who more
especially devoted their attention to female diseases; and, as
a consequence,; but little real advance was made, either in the
knowledge or treatment of this most common ailment. When,
however, the speculum came into general use, first in Paris, and
subsequently in this country, and an opportunity was thus
afforded for carrying out the physical examination of the uterus
to a much fuller extent, it was very soon ascertained, that the
cervix and cervical canal, in all cases of leucorrheea, presented,
to a greater or less degree, certain alterations and morbid conditions which obviously indicated the existence of inflammation. It would be impossible, without altogether overstepping
the ordinary bounds of a paper like: the present, for me to
enter fully into a description of the natural condition of these
parts, as ascertained by the speculum, and the alterations and
modifications which they undergo, when affected with inflammation; still less will it be possible to show the grounds upon
which Dr. Bennet bases his opinion, which limits the disease,
in the majority of such cases, to the mucous membrane of
the cervix. Nevertheless, I may briefly lay before you the
results of Dr. Bennet's investigations,grnd more especially those
which I have had opportunities of fully verifying in practice.
If a female, labouring under leucorrhcea, or even decided
menstrual derangement, such as dysmenorrhwea, mehorrhagia,




on Utermine -Diseases.              1
&c., -be examined by the speculum, one or other of the follo wing appearances will be detected.
1. The cervix uteri may appear perfectly normal, smooth,
and unctuous, and of its healthy pale flesh colour, and the oos
may be smooth and circular, but the cervical canal will be
seen filled with a transparent glairy fluid, which is removed
with difficulty, by a piece of lint or sponge, and which is so
viscid as to draw out into long threads; and, if this secretion
be carefully removed; and the lips of the os uteri carefully
separated, the lining membrane of the canal will be seen of a
bright red colour, very much deeper than the surrounding
mucous membrane of the cervix, and resembling greatly the
appearance of a pretty large bronchial tube, in a case of acute
bronchitis. If the uterine sound be passed along the canal,'it frequently, though by-no means always, causes considerable
pain, and is still more frequently followed by an oozing of
blood from the inflamed membrane. This is the mildest form
of the disease, and: may. be termed the first stage of cermvcmetritis, by which name we can distinguish the disease when
confined to the neck of the uterus, from the general disease
of chronic metritis with which it is ordinarily confounded.
2. One step in advance of this, at least as regards the-severity of the pathological modificationi of the part, is when the os
uteri is dilated, and more or less transverse, or oval in place
of circular: this change varying from a slightly oval form of
aperture, to that of an irregular gaping slit. In this case, the
lining membrane of the cervical canal is generally found to'be more or less excoriated, and the inflammatory redness extends beyond the orifice, and spreads slightly.over the lips of
the cervix,; the secretion, in such a case, may be entirely of
the glairy character above described, but it is more frequently
either milky or, toi a greater or less extent, mingled with
muco-pus. The dilatation of the cervical canal, in these cases,
is a symptom of great importance, since Dr. Bennet has brought
forward numerous arguments to prove.that the extent of this..dilatation marks accurately the extent of the inflammation,




LAS             fi~~Dr. 2Jacddcen,
that is to say, when the dilatation only extends part of the
way up the cervical canal, we may conclude, that-to this extnt only has the inflammation advanced. Or, again: if the
dilatation only reaches to the os 2uteri interntum, leaving the
co-arctation at this point in its normal condition, we may then
conclude that the disease is limited to the canal of the cervix,
and that the interior of the uterus remains unaffected.
3. Ulceration, more or less extensive, of the lips of the uterus
constitutes a third stage in the severity of this disease. In
strict language, it would, perhaps, be better to call these' granulated abrasions" than ulcers, seeing that they seldom
present any excavation, and but rarely do the granulations
project above the general level of the surface.. Uterine pathologists have spoken of Several different kinds of ulcer'as
occurring in this region, but, for practical purposes, three varieties only require to be noticed, viz., the simple, which I
have just described; the syp ilitic, which, according to Dr.
Bennet, is of much rarer occurrence' than is generally supposed; and the phagedeie, which is a much graver disease,
is of by no means frequent occurrence, and is most usually
associated with cancer, or somie other malignant disease of
the uterine tissues. These two latter varieties will not be examined or discussed in the present paper.
4. A fourth stage of severity may be noted, when, in consequence of the inflammation affecting the deeper tissues of the
uterine neck, there has occurred more or less extensive infiltration into the cellular tissue, and consequent enlargement of this
organ, giving rise to induration and irregularity of the cervix,
which may or may not be accompanied by ulceration. This
induration has often led medical men to give a very unfavourable prognosis of a case, and to suspect the existence of schirrus;
it is of great importance, therefore, that we should bearin mind
the characteristics by which simple inflammatory induration
may be distinguished from the graver malady.  Dr. Bennet
describes' these very well, in the first edition of his work on




on Uterine.Diseases. 
"Uterine Inflammation."  He remarks at p. 129, speaking of
Cancer:
"In the iirst stage of the disease, the uterine neck becomes ve!r
hard, the indurated tissue being irregular in its surface, lobulated,
presenting shot-like tubercles. It is' not, however, the hardness of
the diseased cervix which indicates the invasion of cancer, for, as we
have' seern, cases of non-malignant inflammation may be followed by
stony hardness' of the organ, or a part of it, but the irregularity'of
the hardened surface, and the existence of tubercles, which projiet
here and there."
It must not be supposed, however, that every irregularity of
the indurated portions is a proof of-the cancerous character of
the affection, for, on the contrary, when this disease occurs, as
it very. frequently does, in women who have had large families,
we very often find the surface of the uterine neck irregular
and lobulated, and some of the lobules may be indurated to a
degree of hardness almost, if not quite, equal to that existing
in the'first stage of.cancer..A careful examination of such a
case, however, will show that while the diseased'part, considered as a whole, is, indeed, lobulated, or rather divided into
segments by fissures, each lobule is smooth and regtlar, and
there are none of those characteristic tubercles projecting from
its surface to which Dr. Bennet refers.
Another important point to notice is,' that since the fissures,
in the non-malignant disease, are invariably the fissures so
well-known to accoucheurs, as occurring -after severe labours
or miscarriages, and which always radiate from  the os uteri
towards the exterior of the labia uteri, to in these cases "-the
fissures which separate the lobes radiate round the- cavity'of
the os as a. centre, which is not, the case in cancerous tumours."-(Bennet, 1st edit...130.)
5. Hitherto I have been describing the disease as confined to
the cervix uteri and its canal; unfortunately, however, both foir
the patient and the physician, this is by no means always the
case; for while I feel disposed, in a great measure, to agree
with Dr. Bennet in his views, respecting the infinitely greater




14                    DS..Miadden,
fquene-y of-inflammation of the mucous membrane of the'cervical canal, than of true endo-metritis, it is most obvious
tat chronic  metritis, especially as affecting certainportions
oly of the' body of the uterus, is a disease of extreme frequency, and proves the cause of much discomfort and func-'tional'distress to the patient.
In discussing this subject, I feel that I must, of necessity,
pass over much which might be interesting and not without its
value, but the necessity'for keeping my remarks within convenient limits will render such a course imperative. I shall
accordingly confine myself almost entirely to the development of the results which have been arrived at by myself and
various investigators, without detailing the controversial process through which each of these results has passed ere it could
be admitted as proved, or even rendered highly probable.
When the uterus becomes congested, it of course increases
-in bulk and weight, and being a floating organ, it sinks down
more or less, into the pelvis. The mobility of this organ is
vastly greater than one would suppose; thus M. Lisfranc states
that it can descend one or two inches in the act of defecation,
and I have myself little doubt but his statement is correct.
When the uterus descends in the pelvis, as for example, at each
successive menstrual period, and still mnore at the commencement of pregnancy, it follows the well known curvilinear direction of the pelvic axis, and in so doing it does not exercise any
unequal pressure upon the surrounding organs, and; accordingly unless the descent, or prolaps-is, is to a considerable extent,
it causes little or no discomfort to the patient beyond a-sense of:weight. In order, however, that the uterus should thus descend
in the direct line of the pelvic axis, it is obvious that its increase
of bulk and weight must be perfectly uniform —-because, as it
is a floating organ, and can move in many other directions, as
well as downwards, it follows, that if the increase of bulk be
partial, the position of the centre of gravity of the whole organ
will be altered, and in falling downwards it will also fall either'forwards, backwards, or towards one side, according to the
direction of the preponderating weight.




on Uttere Diseases.                15
This accordingly happens in a large proportion of cases,
owing, to the fact, now distinctly proved, that the uterus is
more frequently affected with partial than general metritis,
and that, in consequence, one or other of- its walls becomes
proportionably the heavier. Of the two walls it is generally
supposed that the posterior is the more frequently affected.,
and certainly my experience would go to corroborate this;
nevertheless the more extended experience of Professor Simpson would lead to the conclusion, that the affections of the
two'walls are almost equally common, since he speaks of antiversion of the uterus being "almost equally common" with
retroversion, and these conditions are, I believe, capable of
being demonstrated as the results of partial inflammation and
subsequent enlargement of the uterus.
Bearing in mind what I have already said respecting the influence of irregular enlargement on the position of the uterus
when descending from its increased weight,-let us follow the
progress of a uterus.wherein the posterior wall has become enlarged, owing to chronic metritis. The uterus, in this instance,
Fig. 1.                 Fig. 2.    Fig. 3.
I'.
will not follow the direct axis of the pelvis, but will be tilted
backwards, and thus assume the form represented in figure 4 of




6                    -Dr. Xadden,
the accompanying diagram-its fundus pressing against the
rectum, and the cervix tilted forwards in the direction of the
pubis. Matters, however, do not long remain in this position,
for the fundus now pressing and causing mechanical contraction
of the calibre of the rectum, an obstacle is offered to the descent
of the faeces, which accordingly accumulate to a certain extent
above the obstruction, and then, when carried forward,.have a
tendency to carry the uterus along with them; and this process
being continually repeated, the uterus gradually assumes the
mal-position figured in Nos. 5 and 6 of the diagram, and which
Fig. 4..          Fig...S                Fig. 6.
constitute. different degrees of well marked. retroflexion. On
examining these two figures, you will observe one or two circumstances well deserving of attention: for example, in figure
6, the finger passed along the posterior wall of the vagina, will
not detect the fundus uteri, but will come in contact with the
engorged part of the posterior wall, and will feel this, projecting like a knuckle, immediately behind the point where the
mucous membrane ofthe cervix is reflected on to-the posterior
wall of the vagina-and this projection will be found very tender to the touch-in many cases. This projection has been repeatedly mistaken for tumour, pelvic abscess, &c., and, more
recently,. by some of the followers of Dr. Simpson, for the fundus. A careful examination, however, with the uterine sound,
reveals, its true nature; for if the finger be kept in contact
with it, and: the sound be introduced, it will be found to pass
over, without entering, this projection; and when the uterus is
replaced in its normal position, by revolving the sound, this




on Uterine Diseases.                17
projection is carried forwards and upwards, and by the stretching of the posterior wall, consequent on'the re-adjustment,.it,
in many cases, altogether disappears. In cases where the retroversion is greater than at Fig. 6, however, the fundus uteri
can be distinctly felt through the posterior wall of the vagina,
and on examining with the sound, the instrument is felt to
enter the tumour, which, in its turn, entirely disappears,
when the instrument is turned round.
In the case of the anterior wall being engorged, an opposite
series of changes are set on foot, but owing to the much greaterelasticity and pliability of the cervix, which is the part that in
this case presses against the rectum, and owing to the steady
support afforded to the fundus when tilted forwards by the
bladder and its ligaments, we much less frequently meet with
cases of antiversion where the flexure of the organ is by any
means so great as that which accompanies the bending of the.
organ backwards.
Such I believe to be the serie's of changes which occur in
consequence of partial engorgement of the uterus, owing to the
existence of chronic metritis; and it is in this manner, I believe,
that the very common flexures of this organ, which the uterine
sound has revealed to us, are produced. I am well aware that
other and very different explanations of the cause and manner
of production of these flexures have been brought before the
profession, but no explanation which I have met with, except
the preceding, appears to harmonize with all the facts revealed
to us by practice. Thus, Mr. Joseph Bell, of Glasgow, in an
excellent and ingenious paper, on the displacements of the unimpregnated uterus, which appeared in the Afonthly JoUrnal of
]ledical Sciences for September, 1848, after speaking of congestion and enlargement of the uterus giving rise to displacement, asserts that if either wall of the uterus be hypertrophied
or atrophied, curvature must occur, since the largest wall must
also be the longest, and the two being united together the longer
will, of necessity, become convex. The great objection to this
proposition, however, is the undeniable fact, that in retroversion the posterior wall is felt to be enlarged and tender, whereas, according to Mr. Bell's theory, it should be either healthy or,
Pax.-  2




18                  DDr. ifadden,
atrophied. Again: Professor Simpson remarks, in his essay
on'" Retroversion," which appeared ih the Dzublin Quarterly
Journal of Afedical Science for May, 1848, that-" in a large
proportion of cases, the retroverted uterus is in no degree
enlarged or increased in volume, but natural in size."  N-ow,
while there are certainly many. cases in which the normal
length of.the uterine cavity is not increased, yet, in a very
large number of such cases, we find tenderness and other
symptoms of engorgement of the posterior wall, and all experience tells us that where there is engorgement there is, at
the same time, increase of bulk and weight. Moreover, in
chronic cases it is perfectly conceivable that the organ, once
fully-bent, should retain its abnormal position even after all
trace of engorgement has disappeared.
Before quitting the subject of uterine flexures, I must guard
those who make use of the sound against a by no means Unfrequent cause of error in diagnosis, whereby retroversion is apt
to be made out a much more frequent disease than it really is.
On referring to the diagram it will be seen that in simple
prolapse, without torsion, when the uterus has assumed the
position indicated by figure -3, if one attempted to introduce
the sound, its point must be directly backwards, and this being the case, the mobility of the uterus at all times admitting
of considerable change of position by pressure, &c., it will
often be hnpossible to judge whether the whole organ be simply inclined backwards, or is really more or less bent upon itself, and in this way, I feel assured, that many cases of simple pr6lapse are considered to be cases of slight retroversion.
SYMPTOMATOLOGY.
We come now to the consideration of the most important,:
and:yet, alas.! the most unsatisfactory part of our inquiry, viz,,
the symptoms by which the above lesions can be detected. All
my experience has led me fully to appreciate the truth of Professor Simpson's statement made in 1843, to the following
effect: —" There can be no doubt of the fact, that there seemsl
to be no organ in which there is a less strict relation observable between the intensity and character of the existing pa



on 1Uterine Diseases.               19
thological disease, and the intensity and character- of the
accompanying symptoms, or between the exact nature of the
structural lesions that are present, and the exact combi ation
and succession of functional derangements to which they
give rise."*  And again, in 1848, in the paper already referred to, he remarks:-" In uterine disease, as in pregnancy,
the same specific affection of the organ excites sometimes
very different phenomena in different cases; and the same
specific phenomena frequently result from affections of the
organ which are entirely at variance with each other in their
pathological character, in their course, and in the treatment
required."t  In the disease under our consideration for example, I have met with the greatest possible variety in the
symptoms complained of, where a physical examination revealed-the greatest possible correspondence between the pathological conditions of the various cases; I have found enlargement:
and ulceration of the cervix uteri in a case examined for another purpose, and where there was no detectable aberration
from robust health. I have found the slightest of all th6e forms
of disease mentioned above, i.e., the first stage of cervico-metritis, (vide p. 27,) where the constitutional disturbance was very
grave, and the symptoms had continued along time; and lastly,
I have known the symptoms to connect themselves as completely with some distant organ, as the head, the stomach, the
heart, the mamma, or the extremities, that indirect causes alone
led me to suspect the uterine complication; and yet in all these
varieties (save the first case, which was not treated) such a
marked improvement followed the cure of the uterine affection,
as to leave little doubt respecting the important part it played
in each. It must not be supposed, however, from the above
remarks, that I wish it to be understood, that we possess no
criteria' in the form of symptoms by which to judge oif the probable or positive presence of uterine disease in any given case,
buit rather that we cannot determine, from an examination of
the- subjective symptoms, as to the exact nature or intensity of
the uterine affection. - In a large majority of cases there is but
* Monthly Journal, 1843, p. 553.   t Dublin Journal, May, 1848, p.:376.




20                  Dlr. Mladden,
little difficulty in arriving at a definite conclusion as to the existence of'uterine disease, while on the other hand it is very
hazarlous to risk one's accuracy of diagnosis, by attempting to
decide upon the exact nature and extent of the affection until.
the case has been submitted to a rigid local examination. It
is only by means of the speculum and a digital examination,
that we can obtain that precise information which is essential
ere we can prognosticate the probable result of the case, or, as
we shall see presently, ere we can determine the course of treatment which offers the best chance of success. When speaking
of the pathology of this disease, I should have observed that
it occurs with not very' unequal frequency in the single or
married, and in the latter, whether they have had families or
not  the disease presents very nearly the same character in all
the three classes of patients, and calls for pretty much the same
treatment in each. As, however, any examination of the uterus
in the unmarried'female, and more especially when the speculum requires to be used, is far too serious an operation to be unwarrantably proposed, it is of great importance that a medical
man should be fully convinced of its absolute necessity ere he
ventures to have recourse to such an expedient,or even to suggest the propriety of its adoption. It is impossible to lay down
any rule upon this subject which will apply to all cases, but I
may safely observe in a general way, that it will be rarely found
necessary to have recourse to such -a proceeding when a case
first presents itself for treatment.'But, if the diligent employment of general means do not effect the desired relief, this very
want of success will afford a good foundation on which to
ground our arguments as to the necessity of alocal investigation.
Professor Simpson, in his paper on retroversion, gives a very
clear and concise summary of the symptoms attending that disease, which are, however, so precisely similar to those accompanying many other non-malignant diseases of the uterus, that
with the exception-of those produced by the direct mechanical
action of the misplaced organ, the description will-prove equally apposite to the more comprehensive classof diseases embraced by this paper. Dr. Simpsonremarks, "Inretroversion,
as in other morbid conditions and diseases of the unimpregnated




on Uterine _Diseases.             21
uterus, the accompanying sympathetic derangements or symptoms are, when they are well and highly marked, more or less
perfect imitations of the secondary phenomena of pregnancy.
Dyspeptic and hysterical symptoms are sometimes present
with local neuralgic pains in the mamma;;in some portion of
the vertebral column; or what is still more frequent, in the
parietes of the abdomen or chest; and more especially in a
limited spot beneath the left mamma. * * * Symptoms
of weight, tension and bearing down in the regions of the uterus
and rectum, with dragging at the loins, and in the regions of
the uterine ligaments, are very common. Pains often stretch
down one or both lower extremities, and in general all the
symptoms, local and constitutional, which I have alluded to,
are aggravated more or less, by exercise in the erect position;
and they are more particularly liable to be-increased in their
intensity, when the uterus becomes periodically congested and
heavier, at the recurrence of each menstrual period."*
Such is a very correct summary of the symptoms most
usually met with in cases of inflammation of the uterus and its
appendages; for practical purposes, however connected either
with diagnosis or treatment, we must analyse the symptoms further; but before doing so I would make a remark which appears
to me of great importap.ce. When examining symptoms -for
diagnostic purposes we must of necessity lay the greatest stress
on those which are pathognomonic, or nearly so, of the disease in
question, since it follows, of necessity, that among many symptoms, the most important, in this view of the case, must be that
which most accurately expresses the pathological conditionwith
which it is connected; or in other words, the symptom which is
most intimately and invariably connected with a certain pathological state is regarded as the most characteristic, independent
altogether of its intrinsic severity. When, on the contrary, one
is called upon to prescribe for a case, it is impossible to prevent
the patient laying the greatest stress on that symptom or symptoms which are the most severe and annoying, and-one is re —
peatedly obliged to direct the treatment specially against some
* Dublin Quatterly Journal of Medical Science, May, 1848, pp. 377-8.




22                 - r. Afacdden,
symptom of peculiar distress to the patient, although fully
aware that it is by no means inseparably connected with the. disease in question; nay, when one knows full well that it may be
entirely removed, although the disease itself remains unchanged. This distinction between the characteristic symptoms of the
disease, and the symptoms constituting the chief complaint. on
the part of the patient, must be constantly borne in mind if one
desires to avoid the endless seeming contradictions which are to
be met in the reported results of various modes of treatment —
for it will be found, on enquiry, that among the practitioners of
the old school, (who are so accustomed to view their cases solely
from a pathological starting point, that they will unhesitatingly
affirm that a patient " has nothing in the world the matter with
her," though racked with pain, and shattered in nerve, provided-there is no pathological lesion on which they can fix their
eye.;) there are few who do not report as perfect cures every
case which,: under their treatment, is relieved of the objective
symptoms of the disease under which they were labouring, or
who had ceased to suffer from certain indications which they
have been led to regard. as pathognomonic of the disease in question. While, on the contrary, there has been too great a tendency among our hommeopathic brethren to regard those patients as cured who have ceased to complain of the symptoms
for which they sought relief, without employing the necessary
means for ascertaining whether or not the actual pathological
lesion, which originally gave rise to these phenomena, has been
removed." In consequence of this, it is by no means uncommon
to meet with patients who have been reported as cured of uteririe inflammation, or ulceration, by some celebrated accoucheur, and, who, nevertheless, pourinto your ear a long sad list
of aches and pains which make life a weariness, and render
them wholly unfit for their usual avocations; and, on the other
hand, I have known patients report, from time to time, their
supposed rapid and steady progress towards recovery, in consequence of the continued diminution of the symptoms which
led them to seek advice, while the speculum revealed the unwelcome fact, that the disease itself had throughout the whole
period of treatment, remained unaltered: We, have thus two




on Uterinwe: Diseases.            i23
distinctly opposite conditions of partial cure, which are each,
in their turn, reported as complete recoveries; and it comes to
be an important practical question as to which species of relief
is best for the patient-whether to have the pathological lesion
cured, while many of the pains and discomforts continue unabated,.or to have these distressing aches removed while the
local affection remains unchanged.
As regards the diagnostic value of the various symptoms,
perhaps the most important is the peculiar sense of weight in
the hypogastrium, which is seldom, if ever, altogether absent
in this disease. This symptom consists of a peculiar gense of
dragging heaviness in the uterine region, most distinctly perceived in the erect posture, and accompanied at all times with
an amount of general mrnalaise and discomfort altogether disproportioned to the actual amount of pain —the pain-itself is seldom
violent, except in acute metritis, and yet be it ever so slight, it
is invariably spoken of as most wearing and wearisome. In
many cases, indeed, the general effects so far exceed the local
discomfortthat the patient confines her cbmplaints to the feeling
of universal weariness and malaise, and it is only by direct interrogation that you ascertain the existence of the pain in question;
and, nevertheless,as a proofthat the latter is the exciting cause of
the former, if you remove the hypogastric heaviness, the patient
at once becomes much brighter and cheerful, and almost inva&
riably describes her relief as "the removal of a.great weight."
Next in diagnostic importance is the presence oi leucorrhoea;
this symptom, however, cannot be viewed as absolutely pathognomic of inflammation of the uterine neck, seeing that in
some cases of well-marked disease, it is so small in quantity.
that it does not reach the vulva, and its existence is not made
known, until by the aid of the speculum, you obtain a view of
the os uteri, and then perceive the canal filled with a true
leucorrhoekl secretion. While, on the other hand, an occar
sional leucorrhcea must not at once be set down as infallibly
indicating the presence of uterine inflammation, seeing that
in' many patients, the normal periodic congestion of the uterus
at each menstrual crisis is accompanied by a discharge of this
character, which' in such cases, appears either for a few days
before or after each period.




24                   Dr. AMadden,
With these exceptions, I believe we may unhesitatingly affirm,-that, in every case of continued leucorrhoea, there exists:;tmore or less chronic inflammation of a larger or smaller portion'of the uterus; and, moreover, we may also conclude, that how-:ever much a patient may improve in general health,-her uterine:affection cannotbe considered as cured until the leucorrhea shall
have altogether ceased; nay, more, seeing that some degree of
inflammation may exist without any external appreciable leucorrhea, it follows that we cannot actually pronounce upon the
complete cure of any such ease without the aid of the speculum.
Menstrual irregularity, either as respects the time, quantity
-or quality of the secretion, should perhaps hold the next place
in point of importance among the symptoms of this disease,.whose presence will aid us in diagnosis. In a large majority of
those suffering from uterine inflammation, there will be found'some more or less marked abnormality in this respect. The
-menses will be either too early or too late in their appearance,
the flow will be more or less unsteady during the time of its
existence, and the duration will be either unusually shortened
)or prolonged. Again: the quantity will vary from the merest
trace to an amount well meriting the title of menorrhagia; and
yet, again, the quality of the secretion will show every variety,
Ifrom an almost colourless watery fluid to a thick viscous mate-!rial, more like tar in its aspect, and vying with ink in its bfckness. As, however, all those, and many more varieties maybe
met with in company with one and the same organic lesion, it
is obvious, that while the fact of any menstrual irregularity
may lead us to suspect the existence of uterine inflammation,
the peculiar abnormality will be of little service in enabling us
to decide upon the exact morbid condition of the uterus itself.
Painful menstruation is another symptom of very frequent
occurrence, but of little diagnostic value, save in some few'cases where there is reason to suspect a mechanical cause for
the impeded function.
Pains of various kinds, from a mere sense of weariness to an
alniost continued agony which prevents all'motion, are found
occurring in the loins and across the sacrum; the variety, however, and diagnostic uncertainty of these symptoms are so great
that, common though they be, we cannot be guided by them in




on Uterine Diseases.;25
our decision as to the nature of the case. The same remarks
apply to the pains in the ovarian and iliac regions, and that under the left mamma, which, though proving so intensely troublesome in practice, are of little if any value as elements of diagnosis, beyond the fact that their presence may lead us to suspect
the possibility of the existence of uterine inflammation, and
thus induce us to follow up our inquiries in that direction, for
lthe purpose of obtaining some surer guide to our decision.
Let us, now, for a moment examine the symptoms which
especially lead patients suffering under this malady to apply
for relief.
Beyond all question, the symptom which causes the patient
most distress in this disease, is the general feeling of debility
that almost invariably accompanies it.. In the vast majority of'patients who apply for'relief,. the very first thing they complain
-of is this same weakness, and, on inquiry, you find it has gradually come upon them,. assailing them with slow but steady
steps, and gradually incapacitating them for one duty after
another, until, in severe cases, the sufferer is completely prostrated, and drags on a weary life of confinement to the bed, or
couch, with occasional airings in a horizontal wheel-chair.
Nothing can be more complete than the enervation consequent
upon this disease; and what adds so vastly to the trials of the
patient, and the distress of all around -her, is the fact that but
-few minds are strong enough to bear up against this protracted
debility, and, in Consequence, we have, in addition to the physical symptoms, a variety of mental ones embracing a large field
of moral phenomena, from slight irritability and'caprice to
more or less complete. mental aberration.
The next symptom as respects the frequeney with which it
constitutes the chief cause of the patient's application for advice, is headache. This might almost be surmised from the remarks I have just. made, respecting the very common union. of
physical with moral or mental symptoms, as it is notorious that
but few morbid mental conditions occur unaccompanied by
some degree of pain in the head. As might be supposed, the'cha-racter of headache complained of varies immensely, but one. of:the most frequent and, at the same time, intractable varieties,is




~26'                 Dr. iadden,
pain, more orless pressive, on the vortex, accompanied by heat,
sometimes amounting to severe burning, which appears to
extend deep into the brain.
Almost equal in frequency, as a cause of complaint, is pain
in the baek; this also varies much in its specific character,
being at times much more acute, while at others it resembles
more a dull aching, similar'to that occurring to the healthy
when over-fatigued. It also is frequently accompanied by'a
sense of burning'in the part affected, which proves peculiarly
harrassing to the patient. This pain in the back, when it constitutes at all a chief source of complaint, is usually the symptom of all others from which the patient craves relief, and any
amelioration in this respect at once impresses her with the conviction that she must be decidedly better, and yet,there is scarcely any symptom connected with this disease which is of less value diagnostically, since it may altogether disappear; while the
uterine affection remains unimproved (though this is rare);
or, again, which is much more common, the uterus may be
restored to perfect health, while the pain in the back continues unabated, or even increases in severity.
Various neuralgic symptoms occupy the next step inthe order
of frequency, and, then; may be' placed leucorrhcsa, which thus
comes to occupy a position vastly different from that whichit
held among the elements of diagnosis; but, the fact is, that
unless the discharge is copious,; the patient, seldom, if ever,
lays any stress on its existence, except,' indeed, where some
former medical attendant has told her that her debility and
other causes of complaint are traceable to that source.
Much more might be advanced respecting the symptomatology of this disease, but I feel my subj ect so much too extensive for
apaper, that I must resist the temptation of dilating upon these
points, and proceed: at once to say a few words respecting
PROGNOSIS.
The peculiar characteristic of this disease, as far as my own
experience goes, is its tendency to remain unchanged; itcertainly has no great tendency to become worse, and as little disposition does there:appear to be to spontaneous amendment.




on Uterine Diseases.             27
I have known of cases which remained for months, or even
years, without any appreciable variation; and I have repeatedly
been consulted by patients whose sufferings had extended over
periods of ten, fifteen, or more years, and who, on examination,
did-not exhibit proofs of graver disease than are to be met with
in persons whose ailments are distinctly referable to somerecent
cause. Dr. Bennet obviously holds much the same opinion, and
explains it by reference to the periodic congestion of the uterus,
which occurs at each menstrual crisis, and which congestion so
nearly approaches to inflammation, that it is nothing extraordinary to find it giving rise to an aggravated condition of the
pre-existing disease. In consequence of this tendency to periodic aggravation, the disease never gets, as it were, an opportunity of spontaneous cure, for long ere the process is half completed the recurring congestion reproduces the morbid condition, and thus tends to perpetuate the malady. Such -being the
character of the local disease, let us see what is the prevailing
tendency of the general derangement which accompanies it. I
have already stated that the amount.of general derangement
varies immensely, and that while many patients with the slightest form of uterine inflammation have completely shattered
health, you may occasionally meet with considerable enlargement, and even ulceration of the cervix uteri, unaccompanied
by any appreciable symptoms of ill-health, and, it seems to me,
that, in many respects, it remains still an open question, how
far in cases of general ill-health,accompanied by uterine inflammation, the local disease is to be considered the true point of
departure from the healthy state. This isa question full of deep
and practical interest, and while, for some reasons, I regret that
time will not admit of my entering upon its consideration, still
as I do not possess materials upon which I could found a conclusive opinion, I should have been obliged to confine myself to
the throwing out of various hints which might have guided those
who felt inclined to pursue the question. It is a question, however, of which I-shall certainly not lose sight, and anything of
practical interest which may result from my investigations can
be made known at some future period. Three things, however,
are quite certain-viz., lst. That in the vast majority of females




28                  Dr. Ml1adden,
who are suffering from inflammation of the cervix uteri and its
consequences, the general health is far from good; 2d. That such
derangement of health, for the most part, proves extremely difficult to relieve, except by the employment of remedies known
to have a specific action on the uterus; and 3rd. That although
many females may be, to a considerable degree, restored to
health without the local affection being cured, yet it but rarely, happens that such persons become really or permanently
well until the uterus is restored to its normal state. Founded
upon these data, we may form the following prognosis in the
great majority of cases-viz., that, if the case is left to nature,
the probability of a spontaneous cure is exceedingly small,
whereas if submitted to treatment for the purpose of restoring.the general derangement, such treatment will not prove entirely successful, unless combined with means which will, at
the same time, cure the uterine- disease. The reason four this
guarded mode of expression will be seen immediately. As
regards the time necessary to effect a cure, it, of course, varies
much, but it is always considerable, and a physician will do well
to be very guarded in his promises in respect to the time when
his patient may calculate on a complete cure. This slow progress is not to be wondered, at when we consider that every
month there is a considerable risk of a relapse, and, accordingly,
it is only from month to month that we can be assured of having
gained any step towards recovery. Beyondthe question of time,
however, the prognosis may- be decidedly favourable, as the
vast majority of patients recover ifj udiciously treated. Let us
now, therefore, proceed to the examination ofthe most practical
and important part of the whole subject-viz., the
THERAPEUTICS OF THIS DISEASE,
The following observations are founded chiefly on the results
of my own experience in the treatment of 180 cases, an abstract
of which will be found in the Appendix that accompanies this
paper. Three months ago Drs. Black and Ker forwarded to the
majority of my colleagues a schedule of questions, which Ihad
drawn up for the purpose of eliciting information upon this
subject, which might advantageously have been embodied with




on Uterine Diseases.               29
the following remarks. Up to the present moment, however,
(Sep. 6th) I have only received one of these schedules, and as
I find that the analysis of amy own cases will occupy all the
remaining time which can be allotted to this paper, I havelimited'my remarks to the latter, and shall let the schedule,
or schedules, should more arrive, speak for themselves.
Before proceeding to analyse the cases which are to be found
in the Appendix, I must say a few words regarding their selection, and the rules by which I have been guided in making
the accompanying abstract. As regards the cases themselves,
~they have been selected from among all those which I have attended during my residence at Brighton, a period of 5, years,
and they constitute themajority of the cases of uterine disease.
which have come under my notice during that period. I have,
however, omitted almost all cases of tumours and malignant diseases of the uterus and its appendages, and have taken no notice
of many which I lost sight of so early in the treatment that no
opinion could be formed of the result of the remedies prescribed.
It will be further observed, that only 70 of the whole number,
or little more than one-third, were subjected to examination, and
hence it follows, that I cannot speak with absolute certainty as
to the existence of inflammation of the uterus, or its consequences in every case; nevertheless, Ihave carefully applied
the principles laid down in the remarks Imade upon diagnosis,.
for the purpose of avoiding error as far as possible, and by comparing the characters of the unexamined cases with those which
were submitted to this method of diagiosis, and proved to be
suffering from the disease in- question, I feel confident that
at least the vast majority were actually suffering from the
same local affection. For it will be. remembered that when
treating of the diagnosis, I remarked, that while it was impossible to. decide, from the subjective symptoms, as to the exact
nature, and still less, as to the degree of severity, of the uterine
disease; yet it was by no means difficult to determine, with alarge measure of accuracy, as to the existence or non-existence
of some phase of uterine inflammation;'and on the other hand
it may be observed, that in the whole of the cases examined,
distinct evidence of inflammation was detected, thus proving




30                   Dr. iladden,
that the means of diagnosing the probable existence of the disease are very trustworthy. It would serve no useful purposevto
explain the various reasons why the whole cases were not examined, since so many different causes operated in the different
cases; but with the exception of a few of the slighter ones, and
of those which I treated early in my homoeopathic career,-at a
time when trusting to what I had read in homoeopathic works,
I had fancied that such cases would easily yield to general treatment alone,-I can safely affirm, that it was not because I
concluded there was no detectable uterine disease that I abstained from this only absolute method of verifying my diagnosis.
As regards the rules by which I have been guided in drawing up
the abstract, I have only a few remarks to offer. As respects
the chief symptoms, I have invariably noted only those for
which the patient specially sought relief; or which, during the
course of the treatment, constituted the chief source of her complaint. My reason for doing so must be obvious, because, in the
first place, had I confined myself to the more purely diagnostic
symptoms, I should have failed altogether in individualizing
the cases; and secondly, as the patient's impression respecting
improvement or otherwise will, for the most part, depend upon
the amelioration or the contrary of these chief causes of her complaint, it follows that no true comparison could be made between
the characteristic symptoms and the effects of the remedies employed, had any other course been adopted. It is, however, of
importance to bear this fact in mind, since the absence of any
symptom in the abstract is no proof that it did not occur in the
patient;,one or two examples will make this clear. Of the 180
patients referred to, 134 had, more or less, distinctly marked'leucorrhcea, whereas this sympton is only reported twenty-nine
times as being a chief cause of complaint. Again, only eleven
cases are reported as suffering from amenorrhcea, whereas in
thirty-six the menses were absent. On the contrary in the column devoted to the state of the menstrual functions, I have endeavoured to indicate its precise condition in every instance
in as far as that could be done without entering into details,
and. hence a summi'ary of these conditions, such as is given in:
table 5, affords precise numerical information respecting -the




on Uterine Diseases.              31
comparative frequency of each symptom. Again: regarding
the notice of the medicines, I have strictly limited my remarks
to those which proved more or less decidedly beneficial. At first
I attempted to make a periect transcript of the treatment, but I
soon found that such a course was both useless and unintelligible without the notes appended to each prescription, as in those
who were any length of time under treatment, there were almost
invariably one or more intercurrent attacks requiring specific
remedies, and which would have appeared altogether inexplicable if appended to the short summary of chief symptoms,
which alone find a place in the abstract. I have invariably noted
the potency in which the medicine was given, and the usual
mode of administering the medicine was as follows: —in a few
cases I allowed an interval of six or eight days to elapse after
each course of medicine, and occasionally I gave single doses
every third or fourth day; but in most of the cases the plan pursued was, to give medicines daily for six days and then wait
one day, if the patients were seen every week; or if only seen
once a fortnight, as was sometimes the case with convalescents,
they took three short courses lasting three days each, with an interval of two days between each course. The order in which the
medicines are put down is the order in which they were administered; I have not, however, indicated whether the remedies
were given in immediate succession, or whether other medicines had been administered unsuccessfully during the interval.
Lastly, as regards. the objective uterine symptoms and their
local treatment, whenever such was had recourse to, I have
noted them separately, and in such a manner as to avoid. the
possibility of confusion. These preliminary remarks will serve
to introduce the Appendix to your notice, and I shall now proceed to detail the results to which my experience has brought
me, and also to indicate the many points which still demand
patient investigation, ere we can pronounce any decided
opinion regarding them.
According to the usual method of selecting a homaeopatfiic
remedy, we must choose one whose pathogenetic effects bear a
close, if not exact, resemblance to the symptoms of the disease
we are about to treat. If therefore the disease in question be




32:Dr. Xiadden,
characterized by two series of phenomena, composed respectively of subjective sensations and objective symptoms, we must
select for its cure a remedy capable not only. of producing the
peculiar sensations complained of by the patient, but of doing
so in conjunction with the objective phenomena which equally
constitute the disease; and if we fail in this, we at the same
time fail in selecting a truly homneopathic remedy. Let us
therefore turn to the ]fXaterica iledica, and ascertain whether
it is rich in remedies which have been proved capable of producing the various symptoms complained of by females suffering under uterine iaznammnatgion, and at the same time of
inducing those local changes in the uterine tissues which especially characterise this complaint. On going over the whole
of the remedies which have been proved by Hahnemann and
his followers, with the exception of those introduced by Dr.
Mure and others within the last few years, I can only find
four purely pathogenetic symptoms which indicate organic
changes in the uterus, and these are as follow:1~. " Irregulbarity of the os uteri," as a symptom of natrum
carbonicumn, reported by Noack and Trinks, but not to be
found in Hahnemann's Chronischen Krankheiten; which contains the original proving.
2.'" /etritis," as a sympton of secale cornutum, reported
in the proving of this remedy, which appeared in the Appendix to the British Journal of Homceopathy, and where it is
quoted on the authority of Spajrani and L'Admirault.
3. " Softness of uterus," a most indefinite and not very intelligible term, as a symptom of opium, reported by Noack
and Trinks, but not to be found in Hahnemann's Reine Arzneimittellehre, where the medicine was first proved.
4. And lastly, " Swelling of the cervix," as a symptom of
oanthcaris, reported by Noack and Trinks, in connection with
burning in the neck of the bladder, and other symptoms of
inflammation of that organ.
With the exception of these I cannot find any objective symptom connected with the uterus, which hhs not been obtained ex
Usu irn moris, a source far too subject to fallacy to warrant.our
trusting to it exclusively in our selection of remedies. This




on Utertne Diseases.              83
extreme paucity of objective uterine symptoms cannot be wondered at, when we considerthe obstacles in the way of obtaining
such evidence in our ordinary methods of proving; for not to
mention the difficulty of obtaining female provers, and the immens6ly greater difficulty of inducing such to submit during the
taking of the remedy, to repeated examinations by the speculum, obstacles of themselves sufficient to deter most men from
entering upon such an investigation; it is very seldom warrantable to continue the experimental taking of medicine until"such
time-as actual organic changes have beenproduced by its toxic
influence. Being. thus, in a great measure, shut out fronm this,
the only absolutely trustworthy method of proving our remedies, is there any other way by which we can judge, with some
measure of accuracy, respecting the action of any medicine on
the uterus, and from which we can infer, with tolerable certainty, that organic changes have either actually taken place, or
would do so, if the experiment were continued? The only
other method of investigation that I am aware of is, that of
observing carefully the'effects of various medicines upon the
uterine functions; and this seems to have been most extensively done, since there are but few medicines in whose provings,
various functional derangements of the uterus, as for instance,
respecting the periodicity and character of the menses, have
not been observed. Unfortunately, for our purpose however,
it has been most distinctly proved, that there is no constant
correspondence between the condition of the uterus and the state
and mode of performance of its functions; and surely a remedy capable of producing a given derangement of function, accompanied by a certain morbid condition of the. uterus,- cannot be viewed as truly homceopathic to the same functional derangement in association with an altogether different local state
-so that we cannot arrive at any degree pfcertainty in this way.
One'other method remains open to us-viz., by investigating
the morbid secretions produced by a medicine, and comparing
that with the secretion accompanying the disease, and if this
were capable of being fully carried out, and an exact correspondence detected, I should imagine the consequent selection
of the remedy to be decidedly trustworthy. In connection with
PAM.-3




34                   Dr. Kadden
this subject I have examined all the leucorrhceal symptoms in,the lateria ~fedica, and when' analysed they give the following
results: —LeucorrAhca is reported as a symptom of between 70
and 80 medicines; in 11 it is characterised as copious, and in 12
the duration is mentioned. In 8 the mere fact of leucorrhcea
occurring is reported, without detailing its character or concomitants; and in 10 the symptoms appear to have been chiefly
derived " ex usu in morbis."  Now, the duration of the discharge is one of the most important characteristics, in as far as
occasional or temporary leucorrhcea can never be viewed as
pathognomonic of an inflammatory condition of the uterus; experience having taught us that very slight and transient causes
(mere mental-excitement in some cases), are often capable of
producing a more or less copious, though temporary vaginal
discharge. On referring again to the liateria iledica, regarding the length of time during which the leucorrheoa lasted in
the different provings, we find, as I before remarked, only 12
instances in which this is noted, and of these, with one exception, 10 days is the longest period observed. The exceptional
case is that of ignatia, concerning which Hahnemann reports,
as a symptom, " long-continued leucorrhcea."
These facts collectively lead us to the conclusion, that as yet
we have no absolutely certain'guide in our iateria lfedica
towards the selection of the most suitable remedies for this
disease, and as corollaries to the above we may concludefirst, that should homceopathic treatment fail in any degree
in' relieving this disease, such want of success is no proof of
any defect'in our law of healing; and, secondly, if other'than
ordinary homzeppathic treatment is at present required to
effect a complete cure in certain cases of this disease, we must
not,infer from this that the time will not- some day arrive
when purely specific treatment may be found capable of
effecting all that can be -desired.
In the tables, which occur in the Appendix, it will be found
that I have classed together those who were " cured" and those
who were " greatly benefitted," and I had many reasons for
doing so. 1. In dispensary practice it is almost impossible to
-ascertain the exact number of cures, as so many of the patients




on (Uterine Diseases.              35
fail in reporting themselves. 2. Very many patients will say
that they feel quite well, and will return to their ordinary avocations, while continuing at times to experience unpleasant sensations, which would induce a more fastidious personto remain
under treatment. Under the head, therefore, of "cured or
greatly benefitted," I have classed together those patients who
reported themselves as cured, and those who voluntarily gave
up treatment, and whose reports for some time previous had
shown steady and great improvement. I have, however, invariably distinguished those who, though greatly benefitted,
had not felt so for a sufficiently long time to warrant the conclusion that they would continue to enjoy comparative health, anid
have denoted these as having'"left treatment too early tojudge."
It may, perhaps, be asserted that I have placed the standard
of cure too high, and I quite believe that all the cases reported
by -me in the combined form of " cured or greatly benefitted,"
would have appeared in most statistical accounts under the
simple title of "cured."  But I have purposely exercised
this'precaution, lest I should fall into the error which I referred
to in an early part of this paper (p. 38), and which leads to
such misapprehension when comparing the results of different
kinds of treatment. As in the abstract of the cases I have
reported the exact condition, as far as known to me, of every
patient at the close of the treatment, the blending of the two
degrees of benefit cannot mislead any one.
On referring to the first table in the Appendix, which gives
the general results of the cases treated, we find,. that of 180
cases reported, 1'12 were cured or greatly benefitted, 51ireceived benefit, and 17 remained unchanged: this gives a per
centage of 621 cured or greatly benefitted, and only about 9.
per cent. of cases unchanged, an amount of success which; I
believe, will be considered very fair by any one who has had
much experience in the treatment of this disease. In the ge-:
neral table, however, there are included 22 cases which are still
under'treatment, and 34 who left treatment; or were lost sight
of, too early to judge accurately of the result; these, therefore,
must be deducted before an-accurate estimate of the success ot




36                   Dr. Jadden,
the treatment can be obtained. Of the 22 cases still under treatment, 10 are reported as greatly benefitted, and 12 as somewhat benefitted; and of the 34 who left treatmenit too early
to judge, 19,are reported as cured or greatly benefitted, 11
as having received some benefit, and 4 as unchanged. Making
the necessary deductions, therefore, from the gross number,
the tables would stand thus-Cases whose results are fully
known 124, of whom 83 were cured or greatly benefitted, 28
were somewhat relieved, and 13 continued unchanged; thus
making the correct per centage of cure 66 9?.
I have already stated (p. 46), that early in my homoeopathic
career I had been led to expect such perfectly satisfactory results from general treatment alone, that for a considerable
time I trusted entirely to constitutional remedies; so many
cases, however, occurred to me where my best endeavours
proved unsuccessful, that after two or three years' experience
of the constitutional treatment, I resolved on trying the effect
of combining local treatment with it, for the purpose if possible
of doing more good to my patients. The reasons which led
me to adopt this course are too numerous and would require
too much detail to explain; suffice it to say, that it was founded on the general reports of the degree of success of other homoeopathic practitioners in this disease, as well as my own; and,
moreover, I did not make the change until I had examined the
whole subject well, and had been led to conclude that the local
treatment, so far as it was medicinal, was, in point of fact, as
truly homceopathic to the disease in question as the general
treatment itself, nay, in some respects more so, since, as I have
already shown, we do not possess pathogenetic symptoms corresponding accurately to the diseaseunder our notice. Thelocal
means which I have had recourse to have been-1. the water
douche, employed either warm or cold, and, in some few cases,
using sea-water- in place of the pure element; 2. various mechanical means introduced to the profession by Dr. Simpson.;
and, 3. various caustics, especially the nirzate of s8iver.
Of the douche I ieed say but little: you all know its value,
and there would be no hesitation on the part of any of you to




on Uterine Diseases.               3t
prescribe it. I have found it, in many cases, a very useful adjuvant, but only one case of ulceration is reported (i. e. 23rd),
wherein it, alone, proved sufficient to cure the disease.
As respects the mechanical treatment, I must confess my
results do not at all come up to the expectations I was led to
form of it, from the statements of Dr. Simpson, Dr. Protheroe
Smith, and others, who have had recourse to it extensively.
One case (84) was evidently much benefitted by the repeated
introduction of the uterine sound into the retroverted uterus and
the-replacement of the organ by its means. This little operation
I performed twice a week for two or three months, leaving the
sound in the uterine cavity for some hours,. during which treatment.the patient greatly improved in general health, the uterus
lost, to a considerable extent, its tendency to retrovert, and the
patient married, soon became pregnant, bore a healthy child,
after which the uterus did not assumes its abnormal position.
In one case of considerable engorgement of the uterus, with
slight prolapse, but no other mal-position (case 103), I employed Scofield's porcelain pessary; which has the advantage
of being easily removable by the patient for the purposes of
cleanliness, and after wearing — it a few months the uterine
symptoms completely ceased.
Of Dr. Simpson's celebrated uterine support or pessary, (I
mean the one composed of a stem, to be introduced into the
cavity of tlhe uterus, a'shield upon which the cervix rests, and a
curved wire which serves to retain the instrument in situ,) I
have made 9 trials with the following results:-In two it decidedly did harm, the patients being in every respect worse after its employment than before; in' one the benefit was but
slight, and in six the patients recovered, but in three of these
the treatment wasqimmensely aided by the use of Caustics, thus
leaving ~ only of the cases. as. decidedly benefitted by this
means alone; the cases referred to are Nos. 19, 29, and 73.
Still further, however, to diminish the real success of this mode
of treatment, it must be mentioned that, in case 73, the instrument caused so much local discomfort, after the patient had
worn it 31 months, that- I was obliged to remove it, and I then
found that the uterus'though benefitted, had by no means




38                   Dr.A, ladden,
entirely lost its tendency to retrovert. The rationale of this
means of treatment has, I think, been much misunderstood, and
hence it has been inveighed against as altogether unphilosophical. My belief is, that it acts by converting a partial into a
general affection. I have already stated my belief that fiexures
of the uterus are the result of partial congestion of its walls;
now, the introduction and retention within its cavity of a foreign
body, such as the stem of Simpson's pessary, invariably increases. this congestion, and causes it to spread over the whole uterus, for I have invariably found this to be the condition of the
organ when the pessary has been removed. When, however,
the congestion of the uterus is uniform, there no longer exists
any tendency to assume a bent position, and if, after the removal of the instrument, -judicious means are employed to
cure the congestion, the patient is completely restored to
health. I therefore look upon this mode of treatment as very
similar to that of the surgeon who would intentionally break
a limb which had been ill-set and healed distortedly, for thepurpose of repairing the former malposition. It is, to my
mind, an obvious instance of doing evil that good may come,
of aggravating the existing disease because the greater is in
this case the more amenable to treatment; aind, although I
believe but few cases really call for this method of treatment,
yet in an aggravated case of retro- or anteversion, where the
misplaced uterus gave rise mechanically to many symptoms,
I would not hesitate to have recourse to it, provided other
means had failed of giving relief.
With respect to the application of Caustics, I fear many of
you will look upon' the deed as very heretical, -but I trust a
little consideration will prove to you that it is a mode of
treatment much more homceopathic in its action than may, at
first sight, be supposed. When a Caustic is applied to any
surface, two actions are produced, viz.1st. The local or chemical effect.
2nd. The general effects of its absorption when the latter
takes place at all.
Now as regards nitrate of silver, which has been the chief
local remedy employed by me, the admirable proving published




on uJterie Diseases.               39
in the Austrian Journal has shown it to act specifically on the
uterus, giving rise to capillary congestion, and in some instances
to hmemorrhage; and as regards its local action, it produces a,
diseased condition which most strikingly resembles the different
stages of cervico-metritis. IfU, for example, in a patient suffering
from the first stage of this disease, the solid Nitrate of Silver be
passed up the cervical canal and retained there a few seconds,
it will be found a few days after that the disease is simply aggravated, indeed itis impossible to distinguish between the first
effects of the Caustic and an increase of the local mischief from
any other cause. But this is not all: if the Nitrate of Silver be
used freely in an irritable constitution, it will, at times, give
rise to sudden enlargement and induration of the cervix, which
so exactly resembles the -fourth stage of cervico-metritis that
nothing but the history of the case could enable one to distinguish between them. An example of this occurred in case
180. Again: the experiments of Professor Simpson, of applying pulverized Nitrate of Silver to the interior of the uterus
itself, have shown that while acting locally on the uterus, it sympathetically affects the ovary, in so much as in a case of amenorrhcea, where he employed this means to endeavour to restore
the menses, and wherevthe patient died two days afterwards
from other causes, he found that a graafian vesicle had been
developed and ruptured, in a manner precisely analogous to
what occurs at a normal menstrual period. These facts seem to
me fully to warrant the conclusion that Nitrate of Silver, ina(ddition to its obvious chemical effects, acts in such a manner
upon the uterus when.applied locally, that it may be viewed in
the light of a strictly homceopathic remedy. Analagous arguments might be brought forward in respect to the only other escharotics which I have employed, viz., pernitrate of mercury
andpotassafcsa, both of which drugs have also a specific action
on the uterus and its appendages. I may mention, that for some
time past, I have combined the local with the internal use of the
remedy, giving argentumn nitriczum when employing the Nitrate of Silver locally, and administering one or other of the
preparations of merucrmus when using thepernirate of mercury. Lastly, I have of late been trying the effects of certain other




40                   Dr. iladden,
remedies, as kali bichromicum, and the clorides of gold, plainurn and tin as local remedies, havingbeenled to their employment by their homoeopathicity to various phases of this disease;
my results, however, are not as yet sufficiently definite to admit
of my drawing any conclusionsfrom them. Onreferringtotable
6 it will be found, that the results'of the cases treated locally as
compared with those who had internal remedies only, were as
follow: after making the deductions already alluded to of the
cases still under treatment, and those which left too early to,
judge of the result, it will be found that of 41 cases examined
and treated locally, 30 were cured or' greatly benefitted; while
of 105 cases- treated entirely by general remedies, only 63 recovered; or, in other words, while M73 per cent. ofthose treated
locally were cured or greatly benefitted, only 60 per cent. of
those who were treated by general remedies obtained the same
amount of relief.' If, however, we examine a little closer, we
shall find a still greater balance in favor of the employment of
local treatment, for it must be remembered that in almrost every
instance I commenced with general treatment only, and did not
think of having recourse to local measures until-these had proved
inefficient, so that it follows, that in the first place the cases not
examined or treated locally embrace all the slight cases, while
the 47 cases treated locally must comprehend most of the severer
cases which came under my notice, excepting only the few who
refused to submit to examination. And again, on examining
the notes of these 47 cases I find that no less than 25 had experienced no appreciable benefit ere the local treatment was'commenced, although the general remedies were sometimes
persevered in for several months before a change of treatment
was had recourse to. For the purpose, therefore, of comparing
accurately, the results of the general and the combined general
and local treatment, we must add to the 105' cases above mentioned 36 who had been previously subjected to general treatment, and of whom, at the time the local treatment was commenced, 25 had received no benefit, while 11 had experieffcd
some degree of relief. Calculating the per centage upon these
data it will be found that, while the combined local and general
treatment cured or greatly benefitted T31 per cent., only 441




on U7terine.Diseases.            41
per cent. obtained the same benefit from purely constitutional
treatment, and this in spite of the fact already mentioned, that
the class treated locally consisted, of necessity, of a much graver
set of cases than those where general treatment alone was had
recourse to. As examples of local treatment proving successful
where general remedies had been found more or less insufficient,
I would refer to cases 27, 46, 81, 84, 127, and 174. The usual
arguments against the employment of local remedies are, that
while they curethe local manifestation of the disease, they leave
the constitutional derangement unchanged. But this argument
cannot apply to the treatment I am advocating, wherein the constitutional is invariably bombined with the local treatment, and
thus both phases of the disease are attacked. ~Much more could
be said upon this subject, and a careful perusal of the abstract of
the180 cases treated,will show that it contains materials wherewith most, if not all, of the usual arguments against this mode of
treatment might be refuted, but I cannot dilate upon them now.
In the abstract will be found a large number of tables, from
which materials could be drawn capable of furnishing much
interesting and important information, some points of which I
will now endeavour to lay before you.
1. Influence of Age. In this respect it will be -uEnd that the
greatest number of cases occurred between 20 and 25; next in
order comes those between 15 and-20; then between 30 and 35;
next, between 25 and 30; then, 35 and 40; and lastly,, from
40 upwards. If we confine our observations to the cases subjected to examination, or in other words, to with few exceptions
the graver forms of the disease, we shall find that the greatest
number of cases occurred between 30' and 35; next in order
came the periods of 25 to. 30, and 35 to 40, which present an
equal number"of cases; then follows the period of 20 to 25;
then 15 to 20; and lastly, that of from 40 upwards.
As regards the curability of the disease at the different ages,
it will be found, after making the usual deductions, that of the
whole number treated, thdse between 30 and 35 proved the most
manageableno less than 82- per cent. having been cured or
greatly benefitted. Then follow the cases occurring between
20 and 25, of which M76 per cent. yielded to treatment; be



42                   Dr. X.-adden,
tween 35 and 40, 61 per cent. were cured or greatly benefitted;
between 40 and upwards, 58~ per cent. were cured; between
15 and 20, the per centage was 56a; and lastly, from 25 to 30,
-half yielded to the means employed. Again: confining our observations to the graver cases, we find that between 35 and 40,
no less than 84  per cent. yielded to treatment; of those aged
40' and upwards, 75 per cent. were cured or greatly benefitted;
between 20 and 25, 66- per cent. were cured or greatly benefitted; while between 30 and 35, only 461 per cent. yielded to
treatment. Thus, we find, as a general result, that on the
whole the greatest number of cases occur between the ages of
30 and 40, and that it:is at that time also most amenable to
treatment, with this peculiarity, that while among the slighter
cases the most unmanageable ones occur between 35 and 40,
among the graver ones the period from 30 to 35 comprehends
the cases most difficult to treat.
2. In/uennce of Social Condition. A reference to table 13
shows us that of the 70 cases examined, 46 were married, and'24
were single, showing a considerable preponderance, as might
be expected, in favour of marriage, as an exciting cause of this
disease. As regards the treatment however, the married appear to be mwe readily cured, since 30 out of the 46 were cured
or greatly benefitted, i. e. 651 per cent.; whereas only 50 per
cent. of the unmarried received the same amount of benefit;
thus showing that the disease though of less frequent occurrence, is of a more inveterate character in the unmarried female.
3. InfWuence of the state of the Uterine Functions. From
table 5 it appears, that in 52 cases the menses were regular, and
of these'72T per cent. were cured or greatly benefitted. The
commonest abnormality appears to have been an increase of
the menstrual discharge, 43 cases having shown that symptom,
and of these 53- per cent. yielded to treatment. Next in frequency, we meet with the complete absence of this secretion,
36 cases of amenorrhoea being reported, of which 709 per cent.
were cured. Scanty mentsruation occurs almost as frequently,
there having been 35 cases, of whom 54' per cent. yielded to
the treatment employed. Dysmenorrhcea is reported as having
occurred 25 times, of whom 50 per cent. were cured or greatly




on Uterilne Diseases.              43
benefitted. On the whole it appears that whereas irregularity
as -respects quantity is fuch the most frequent of the uterine
abnormalities, it is by no means the most intractable,; while
irregularities as regards time, though less frequent, are much
more difficult to manage, for it appears that of 22 cases where
the period was, accelerated, only 23 per cent. yielded to treatment, while of 9 cases wherein it wras delayed, 33- per cent.
were cured or greatly benefitted.
4. Inrenceeof the Du1ration of the eDisecase on'ts lu/rability. The 3rd table in the Appendix shows us that a large majority of the accompanying cases was of long standing, no less
than 61 having been upwards of one year ill, while 32 of these
had suffered many years; indeed of the whole 180 cases, 19
only could be considered as of recent origin. The influence
of the duration of the illness on the curability of the disease
is as might be expected, progressive, since of 43-who were
less than twelve months ill, 74- per cent. recovered. Of 29
whose length of illness varied from one to six years, 62 per
cent. were cured or greatly benefitted; while beyond that
time the per centage of recovery fell to 50.
5. Average length, of Treatment. If we strike the average of
all the cases cured or greatly benefitted, as given in table 4, we
shall find that'it gives rather more' than 5~. months for the Period during Which the treatment was continued; and if we subdivide the table into sections, we'find that of the whole 83 cases
cured, 50 or 60- per cent. recovered within six months; while
23, or 273 per cent. required various periods, from six months
to upwards of two years, to effect a cure. And of 7 the duration of the treatment cannot be accurately calculated as they
were only seen occasionally, and often at considerable intervals.
6. Inftiuence of the Presence of leeucorrhceaon. the Curability of the Disease. I have already mentioned, that of the 180
cases reported, 134 had more or less well marked leucorrhcea,
and as thisi symptom is one of great diagnostic value, it will be
interesting to examine somewhat carefully its influence upon
the duration and curability of the disease; for this purpose I
have prepared a complete set of tables, being Nos. 15 to 19 of
the series. The first point we may notice here is the general




44.        Dr..MJfadden%,
result, viz., that of the 83 cures whose results can be sufficiently
traced, 66, or 79- per cent. were suffering from leucorrhoea. Of
the 28 somewhat benefitted, 10, or 35' per cent. showed this
symptom; while the whole of the 13 who remained unchanged,
presented this symptonm. Separating the examined from the
unexamined cases, we find that 73 per cent. of the cases who
recovered under the use of general treatment alone, had, more
or less, leucorrhcea, in 44 per cent. of whom it was recorded
as copious; while of the 30 cases cured by combined general
and local treatment, 665 per cent. had leucorrhcea, and 331
per cent. are reported as having had it copiously.
As respects the Age. Leucorrhcea occurred on the whole most
frequently between 30 and 35, while the greatest number of copious cases were between 30 and 40, especially during the latter
half of that period. With respect to curability, the cases characterized by this symptom whose ages were between 20 and 25,
were found to yield most readily to treatment, and also the
greatest proportionate number of cases with copious leucorrhcea
were cured during the same period; while on the contrary, the
most intractable cases accompanied by this symptom, ranged
between 25 and 35. Of the 66 patients who exhibited this
symptom and recovered, 36 were married and 30 were single, so
that the difference between the two classes is not marked.'If,
however, we examine the social condition of the whole 134 cases
who were suffering from leucorrhcea, we find that 65 of these
were married, while 39 only were single, showing a large preponderating frequency'ofthe occurrence of this symptom among
married females. In connection with the state of the uterine
functions, leucorrhcea has more frequently accompanied regular menstruation than any of its abnormalities, and among the
latter, it has been most frequently associated with copious menstruation; next in order, comes scanty menses  then amenorrhcea; then dysmenorrhea, and what would hardly have been
expected, it occurs least frequenitly when the menses themselves
were prolonged. As might have been'anticipated, the comparative frequency of thesoccurrence of this symptom increases
as the cases are more and more chronic, so that while 84- per
cent. of the cases which have been many years ill are charac



on Uterine -Diseases.               45
terized by this system,! and 83 per cent. of those which have
suffered from two to six years, are afflicted in like manner,
only 58 per, cent., or little more, than one half of those who
have more recently lost their health, are found to suffer from
this common cause of female delicacy. Lastly, respecting
the length of time required to complete a cure, we find, by
referring to table 19, that the average length of time during
which the treatment lasted, was 61 months, being about three
weeks above the average of the whole cases, irrespective of
the existence of this symptom.
7. InWjences of the various concomitant Symptoms in the
Curability of this Disease. —Table No. 11 furnishes us with
an account of the frequency with which the various concomitant
symptoms presented themselves as chief causes of complaint,
and also informs us'of the results of treatment in every case.
Of these, as I have previously remarked, by far the most frequent is, debility, it having been reported nearly twice as often:as any other. As regards the curability of cases characterized
by this symptom, we find that of 95 cases wherein debility constituted a chief cause of' complaint, 54, or about 58 per cent.
yielded to treatment. Next in frequency we find headache, and
of 51 cases, characterized by this symptom, 28, or about 55
per cent., were cured or greatly benefitted. Of 50.cases, whose
chief complaint was of pain in the back, 28, or about 56 per
cent., were restored to health.  Of 31 cases, where the sufferings were mostly of the kind included in the general term of
nervous symptoms, 16, or about 51 per cent., were cured or
greatly benefitted; and among 29 cases, where leucorrhwel a
constituted a chief source of annoyance, 19 recoveries occur,
thus giving a per centage of 69. D)yspe psia appears the next
in frequency, having been reported 27 times as characterizing
the case, but the cases wherein it existed as a prominent symptom must have been somewhat mild, since no less than 22, or
nearly 82 per cent., are stated to have recovered. Of the 24
patients, who especially complained of bearing down pain, 14,
or 58 per cent.; were cured or greatly benefitted; and of 18,
who suffered much from characteristic pam &n the left side, 13,
or 72 per cent., were restored to health. Jienorrhagia was the
chief cause of 15 cases applying for advice, and of these 10, or




46                    Dr. Mladden,
66 per cent., were cured or greatly benefitted; while of 14
cases suffering especially from dysmenorrhoec, only 6, or 42
per cent., are found among the list of cures. A general survey of this table will corroborate fully the. remark I made
previously, to the effect that many pains of frequent occurrence are by no means as frequently complained of by the
patient. Pain in the left ovary, for example which is so
generally found to exist, on questioning the patient was only
referred to as a chief source of annoyance in 5 cases.
8. Injftence of the evarious objecetive Uterine Symptoms on
the Curability of this Disease. Table No. 7 affords us at a
glance a comparative statement of the frequency with which
the various.objective uterine symptoms were observed in the
70 cases submitted to examination, and also informs us of the
results of the treatment in each case. Setting aside the results
of digital examination alone, we. find that 36 cases were suf-'
fering from one or other of the four stages of cervico-metritis,
of which the third stage, ithat of ulceration, of the cervix, was
the mbst frequent. In 18 cases the uterus was engorged, and
in 11' there were distinct flexures. As regards the relative
curability of the various conditions, we find-that 77 per cent.
of those suffering from inflammation and. ulceration of the
uterine' neck were cured, while only 55 per cent. of those suffering under engorgement were restored to health. Of the
11 cases, where the uterug was more or less bent, 9 recovered.
And, lastly, of 20 cases where digital examination afforded
evidence of the existence of this disease, but where the speculum was not employed, neither was any local treatment had
recourse to, 8 cases only, or 40 per cent., regained.their health.
9. InfluJence of various Remedies upon the Constitutional
Symptoms, ivhiCch accompany tis Disease. —In a chart which
constituted Table No. 8, I had noted every remedy, and every
potency of each, from which benefit accrued to the various
cases, and I had noted the several characteristic symptoms
which occurred in each case..It was found impossible however to reduce this to a size capable of being printed in the
Journal. I have therefore simply given the names and
potencies of the remedies which relieved, and have prepared
Table 9, which is an analysis, as it were, of the former, limit



on Uterine Diseases.               47
ing however the observations to the 18 symptoms of most
frequent occurrence, and noting only the remedies which have
most frequently proved useful. It would be an almost endless business to direct your attention to all the points of interest contained in these tables, but one or two are well worthy
of note; and, first, I would mention what to myself was most
unexpected, viz., the remarkably high place held bypulsatilla,
as a curative agent, in this disease. Of the 18 symptoms whose
treatment I have carefully analysed,pulsatilla occurs as a chief
remedy in no less than 16, and is superior to all in 12. Whereas,
sepia, which stands next on the list, occurs as'a chief remedy in
9 symptoms only, and as the chief in two alone. Nuzx vomica is
on a par with septia, in the frequency of its usefulness, and then
follows.si4phur. I must, however, guard you here against a
possible error, in the use of this table, which will be best illus-'trated by an example-e. g., of the 51 cases characterised by
iecadache, Pulsatilla benefitted 35; this, however, does not prove
that Pulsatilla relieved the headache in 35 cases, but that 35
cases, relieved in their totali-ty by Pulsatilla, presented headache as a chief symptom, and so with all the other symptoms referred to in the table. A very strong argument in favour of the
truth of homceopathy may surely be drawn from the frequency
with which each case, characterised by any given symptom,
yielded to one remedy, as, for instance, 35 out of 51, characterised by headache, being relieved bypulsctilla; 29 out of 50,cases, withpain in the back, being benefitted by Sepia; 10 out
of 18 cases with _pain in the left side, being relieved by pulsatzila; and 11 out of 15 cases with menorrhagia, receiving
benefit fromplatina, it being impossible to conceive that anything'short of a casual connection could produce such frequent
recurrences of the same phenomenon. And I.may perhaps be
allowed to add, that while thus affording evidence of the truth of
the homceopathic law, it, at the same time, indicates that my
efforts to select the proper remedy for each case have not been
unsuccessful; and, hence, that where a necessity for the employment of auxiliary means was felt, it was not in consequence of
any want of care in conducting the -homceopathic treatment.
Lastly, we have some interesting facts respecting the compara



48                  D)r. Xadden,
tive, effects of high and low potencies: for it appears from table
11, that of 108 cases treated exclusively by high or low potencies, 85 were benefitted by the low, and only 23 by the high
attenuations; and among the cases where both high and low
potencies were used, there were 19 in which the low potencies
proved decidedly the most beneficial. These results are all
the more trustworthy since, throughout the treatment of the
cases, I had no thought of comparing the results, and hence
could not be misled by any foregone conclusion.
I must now draw this lengthy paper to a close, and I think
this can best be effected by recapitulating a few of the most
important conclusions which I have been led to form. in connection with tlis disease; and these are as follow:1. That inflammation and ulceration of the cervix uteri is
a very common cause of female delicacy.
2. That, almost without exception, cases of permanent leucorrhea owe their origin to this disease, save when dependent
upon much graver causes.
3. That many cases Qf functionally deranged menstruation,
are connected with this disease.
4. That the constitutional disturbance whMich accompanies
this disease varies so much in different cases, that no unvarying
connection can be traced between the exact state of the uterus
and the subjective sensations experienced by the patient.
5. That the constitutional disturbance may be greatly benefitted, if not altogether removed, by general treatment, while
the state of the uterus remains unchanged, but that such cases
seldom retain their health for any length of time.
6. That the local disease may be cured by purely local treatment, without any immediate relief to the constitutional disturbance. IBut once the local mischief is remedied, the constitutional treatment becomes more facile, and affords a much
better prospect of complete success.
7. That the treatment by general remedies alone proves sufficiently successful, in slight cases, to warrant a trial of these
means in almost all cases in the first instance, and warrants the
hope that the time may come when local treatment may be
dispensed with.




on ZUterine Diseases.              49
8. That of the various objective symptoms met with in this
disease, the one most amenable to general treatment alone-is
enlargement and induration of the cervix. Case 33 illustrates
this point.
9. That we have no positive evidence of a sufficient number
of cures of severe cases, especially of ulceration, by general
treatment alone, to warrant our persevering in the use of general remedies.to the exclusion of all local treatment, in such
cases as present well marked signs of uterine ulceration, and
which are not benefitted locally after a fair trial of internal
remedies.
10. That the local treatment of ulcerations and congestions
of the uterus by nitrate of silver, pernitrate of, mercury and
potassa fusa is in strict conformity to the law of "simnilia
s&mibus curantur."
11. That owing to the want of correspondence between the
local and general symptoms of this disease, it is not safe to
pronounce positively on the local condition of any given case
until it has. been subjected to a careftul examination by the
finger and speculum.
12.' That owing to this same want of correspondejce, and to
the extreme poverty of our Jliateria liedica in objective uterine symptoms, our treatment of this disease by general remedies must be somewhat empirical, and, for the. same reason,
we are not in a position to decide how far purely constitutional
treatment may ultimately succeed in curing this disease.
POSTSCRIPT.
I cannot allow this paper to go to press without endeavoring
to guard my readers against an erroneous impression which
-several of those gentlemen entertained who heard it read. I
refer to the apparent meagreness of the "abstract of cases"
which occurs in the Appendix.. Several of my medical brethren regretted that I had not entered into symptomatic details.
Nay-one went so far as to assert that a single fully delineated case would have been more useful than the 180 in.the
condition in which they appear. Now, the fact is, that it is
simply imipossible to write full details of every case, if.you
desire to compare numbers together; the bulk of material and
VOL. IX) NO. XXXV. —JANUARY, 1851.             F




50                   Dr). Jlfadden,
the minute differences render all comparisons intensely difficult, and often impossible. Who has not felt this in our  kateria Jledica?  wherein, if you attempt a minute comparison
of twoor.more remedies, you soon land yourself in inextricable confusion, seeing there is no standard wherewith to mark
the limits within which the minuter elements of a symptom
may. vary, without entitling it to be considered as a distinct
variety. The object of this demand for the minute details of
every symptom of a case,, is to bring any failure which may
occur to the test given by HIahnemann, in his oft-quoted clallenge of 1817. "Take a case," said he, "of course one for
which a honmceopathic remedy has already been discovered,
note down all its perceptible symptoms in the manner which
has been taught in the Organon, and with a correctness with
which the author of homceopathy shall be perfectly satisfied;
apply\ that drug which shall be perfectly homceopathic to all
the symptoms, the dose being of the size prescribed in the
Organon, and avoiding all those heterogeneous influences
which might disturb the action of the drug; and if, under
these circumstances, the drug does not afford speedy and efficient help, then publish the failure to the world in, a manner
which shall make it impossible for me to denyvthe homceopathicity of the drug and the correctness of your proceedings,
and the author of homceopathy will stand confounded and
convicted."  Four separate reasons lead me to regret, exceedingly, that the above sentence has been so often and so boastfully referred to. ist. It ill accords with the spirit of various
parts of the Organon, and especially with paragraphs 162-3
and 4, where Hahnemann speaks of the results obtained by
remedies only partially homceopathicto the disease, but still
more contrary does it appear to be to the instances deduced
from allopathic sources, by Hahnemann, in proof of the
homceopathic law, since in many of these, no such minute
accordance of the symptoms is perceptible, and no reference
is made to the question of dose, or the counteracting influence of mixed medication. 2d. If the terms of this challenge be accepted as the essential ground upon which the
non-success of homceopathy in any case must be based, we
cannot resist the conclusion, that all the so-called cures by ho



on Uterine Diseases.:5
mceopathic remedies which do not come up to this standard
must be rejected, and the results taken as belonging to the
large class of recoveries which take place after the administration of medicine, not in consequence thereof. 3d. I am
surprised it has never occurred to those who refer to the above
sentence, that if it were strictly true, homceopathy would be
at once- reduced to the condition of a pretty, scientific,toy,
possessed of no practical value whatever, since it would be
impossible for any one to prescribe, in strict accordance with
the rules laid down, in so far as it but seldom happens'that a
remedy can be foundpossessing so absolute and miznute a correspondence of symptoms as is here demanded. I would like
those who bandy about this challenge to weigh well the fate
of the electric light, which was discovered more than thirty
years ago by Sir H.-Davy, and while acknowledged by all -as
absolutely superior to every method of illumination yet known,
has hitherto baffled the efforts of our ablest mechanicians to
render it available in- practice-surely no well wisher of his
race would desire that'such a calamity should befall our glorious therapeia. 4. The challenge as it stands proves injurious
to our cause, as it lays its author open to the charge of sophistry, since he has not left the materials wherewith the test
can be applied; the state of our Mciateria lfedica, where, from
an over desire to simplify, all clue has been lost to the natural
grouping of the symptoms; the discordant opinions- entertained respecting the dose and its repetition; the vague ideas current as to the length of time during which a remedy sustains
its action, and our almost entire ignorance as to the reciprocal influence exerted by a medicine over one subsequently
administered; combine to render it impossible that any one
shall so conduct a case, that another disciple of Hahnemaun
shall " find it impossible to deny the homceopathicity of the
drug or the correctness of the proceedings."-Under these.
circumstances, one cannot avoid tracing.a resemblance between the above challenge, and that often given by schoolboys to a new comer, to engage at " pitch and toss" under
the auspicious terms of " heads I win, tails you lose."
Let it not be supposed,. however, that I object altogether to
minutely detailed cases, far from it, such details may; prove




Dr. 3Madden,"on Uterine Diseses.
imost valuablen:in-advancing our knowledge of therapeutics buit'I-'maintain that it is impossible to test with absolute certainity
cthe correctness of the treatment of any case by the minute detail of symptoms:'alluded to; in lHahnemann's challenge,:aind:accordingly:wherea -large number of cases of the same dis"ease- are brought" under -review, it is quite unnecessary to enfr -into each in such a manner as to individualize and separate
it from  the':mass;'besides which, the whole scope of my
paper is to illustrate: general principles, since any attempt at
det`ail would have extended: it altogether beyond the ordinary
li"mits of an oral address.
My views respecting —the:practical working out of the ho~;-:eopathic'prineiple may be briefly stated as, follows: —We':iust in the'first place, learn to diagnose the medicines, just
i' wewould studyf t'he diagnosis of a disease, and until we
hBave:attained-such' knowledge'we cannot employ our remedies' withi: confidence.
id. As regards th'osemaladies which evidence themselves
b'subjectivesensations'only,'we cannot be too minute:in
lhe examination of details.
8d.'Where objective symptoms exist, and where the actual
pathological':condition is'detectable,  we must consider a correspondence in'this- respect between the pathogenesis of the
ie'dicine-and -the disese  as a question of vastly more consequence, than': minute'shades of difference in the subjective
sensations.
ith. We shall find it of more practical value to gain  ac4iuaintance with the:sphere of action of a remedy, together
with its charaeteristic groups of symptoms and special -pecui.arities, than' if- we -succeeded in retaining in our -minds' the
kihoble. mass of symiptonms recorded in the provings.' 5th. In'entiering-'ito'm-inute detail'we must never forget
that the power' of' acc''urate' observation is very smal' in:the
~.ast majority of patients, and hence'the grounds whereon to
rest'our selection,-if influenced by minute shades' of' differ~ence, is very. inse'ure,'and' may mislead us far'more thian
the well grounded deducltion of a pathological comparison
between the known action of the remedy -and the'ascertained
eondition of the -patient.




53
APPENDIX.
ABSTRACT OF 180 CASES
OF
UTERINE DISEASES AND THEIR TREATMENT,
TOGETHER WITH ANALYTICAL TABLES OF RESULTS,
AGES, SYMPTOMS, ETC.
NOTE 1. Among the 180 cases reported in the following
abstract there occur one case of Cancer, (90,) and two of
Scirrhus, (62, 157,) these however do not find a place in the
calculations which follow, and are only introduced to show
that while the two cases of Scirrhus'obtained no benefit from
general treatment alone, the case of'Cancer was for a time
decidedly relieved by local remedies in conjunction with
general treatment. In the calculated tables the places of
these three are supplied by (6x, 27x, 102x,) which are reentries of the preceding cases (6, 27, 102), as the patients
returned under treatment suffering from a distinctly different
condition of the Uterus. These and 52x are the only instances of double entry throughout the abstract.
N1OTE 2. As regards the medicines, the figures following
each indicate the potency, and when the letter x is added, it
denotes that the potency was according to the decimal scalethusP uls. 3. denotes the 3d centesimal and Puls. 3x the
3d decimal potency of this remedy. The letter O denotes
the mother tincture.




ABSTRACT OF ONE HUNDRED AND EIGHTY' CASES,
ETC. ETC.....  I ~~~~~~~~~~~~Length of.
No.  Age.    Length of        Uterine discharge.       Chief symptoms.      time under          Results.           Remedies which relieved.
illness,                                                     treatment.
1   29   6 or 8 months Menses scanty -no Leu- Weak, dyspeptic, short- 9  months Benefitted                      Puls. 3x-Sulph. 3-Calc.
Single                corrhoea                 breathed                                                      12-Puls. 6 —Nsx yom.
Not examined,                                                                            12-Nux v. 6-Puls. 12Sep. 12-Ferrum Sulph.
x —Arsen. 6 6.
2    18   9 months    Menses  copious -  much Weak, dyspncea, pain in  71 months Has varied much. at times Sepia 5-Puls. 12-Bell. e:
Single                 Leucorrhoea.            back, nervous                        much better              12-Ign. 6-Bell. 3x- ~
Examined                 Vagina and Uterus very                                          Sepia 12-Puls. 3x.
sensitive
3   21   12 months   Menses absent, never re- Weak, severe headache   4 months  Cured. Has had relapses Puls. 12-Kali carb. 12
Single               gular-much Leucorrhicea                                        of headache when menses 12-Puls. 12-Kali carb.
Not examined                                                   delayed                  6 —Sepia 12 12.
4    16   6 months    Menses not commenced    Chlorotic, vomiting, pains 10 months Menses came on in four- Bry. 3x-Puls. 30 30Single              Not examined               in abdomen                           teen weeks and contin- Sulph. 12 Sep. 12-Manued, but with much pain gan ac. 1-Cocculus 3at times-general health Puls. 6,
better
5    20   6 months    Menses absent-frequent Palpitation, dyspncea, de.. 2 months  Some benefit                 Sep. 5 —Natrum  mur. 12
Single               Leucorrhosa               bility, pains in back and                                     Ferr. ac. 2.
Not examined               abdomen
6    15   3 months    Menses absent —much   A fit once a month, pain in 2 months  Fits left her at once, men- Bell. 3 3-'Sep. 5 —Kali c.
Single               Leucorrhca                back                                 ses returned, and she was 3 6.
Not examined                                                    well




6x    15                Menses irregular - some Headache  and  irregular 4 months Improved                     Bell. 6 - Pulse 6  12Single                 Leucorrhoa              menses                                                        Kali c. 6-Sep. 12 12.
Not examined
7   28   Many years  Menses very scanty and Extreme. debility, ner- 6 weeks   Not much  change-was Arsen. 30.-Bell. 3.
Single                painful —slight Leucor-  vousness, pains all over,           formerly under my care
rhoea                   especially in right ovary           many months with doubtExamined                Uterus tender, but looks              ful benefit
healthy
8   22   Some years  Menses very scanty, too Dysmenorrhea,    head- 12 months Occasional relief, but nei- Sep. 12 —Puls. 6-Cocc. 3
Single                late, and painful-much  ache, dyspepsia                      ther great, nor perma-  -Nux v. 3-Graph. 5.
Leucorrhoca                                                 nent                      Bel. 3x.-Graph. 5. -
Not examined
9   25  Many months Menses scanty and pale- Leucorrhoea, Debility        6 weeks  Improving,    Leucorrhcea Sulph. 12-Calc. 12.
Single                copious Leucorrhca       (faceache,)  backache               much better
Not examined
10    18   7 months    Menses absent-no Leu- Vertigo,  congestion   of 1 month   Nearly cured, menses have Acon. 3.-Bell. 6.
Single                 corrhcea                head, flushed face                  returned, some nervous
Not examined                                                  trembling alone remains
11   20   2 months    Menses absent              Headache,      tremulous 1 month   Headache  better, menses Puls: 6.
Single              Not examined'              weakness.                           returned
12 40-50 2 or 3 years Menses verr copious every Menorrhagia, burning in 32 months Benefitted,   but   varied Vinca a 1-20 Bell. 3-Plat.
marr ied,             14 days-some Leucor-  back, debility, &c.                   much —left the Town        3 3-Rhus. 6.
family.              rhosa
Not examined
13   25    6 years      Menses very scanty       Dysmenorrhcea, pain  in 3& months Decidedly  benefitted, but Nux v. 3. Bry. 12-Sep.
Single                                         back                                left Town. I believe she  12-12 -Alum. 12Not examined                                                  had retroversion, proba-  Berb 3.
bly requiring mechanical
aid
14   25   a long time  Menses regular- copious Languor  and  debility, 18 days   Decidedly  benefitted, but Phos. 3 —Sep. 6.
Single                Leucorrhca               cough                               left the Town
Not examined
15   26   3 years       Menses regular-painful  Dysmenorrhcea, severe ab- 7 months  Varied' much, pain ceased Carb. v. 5-Sep. 12.
Single                                         dominal pain  for a                 for 2 and 3 periods and
Not examined              week before menses                   then  returned - there
were  many  untoward
moral causes in operation
throughout




No.  Age.    Length of       Uterine Discharge.'     Chief symptoms.     time under           Result.           Remedies which relieved.
illness.                                                    treatment.
16   33   many years  Menses irregular, too late, Headaches-Hypogastric 18 months In 1846 I treated her head- Arsen. 12-Bell. 3-Puls.
Single                occasional Leucorrhcoa   pain-.Dysmenorrhcea                 aches with much benefit. 3-3-Nux. v. 3 —(adDuring the  18 months vised Lye. 30-Graph. 30
Examined once  TOUCHER' Cervix very tender, os pa-            of treatment for uterine Sulph. 30-Cale. 30, octent and edges soft as if           symptoms, but little be- casionally in single doses,
excoriated                          nefit accrued.          used for 6 weeks). Exa-.N. B.-This case was mined uterus, and ordered
treated chiefly by corres- Douche, which was used
pondence.               4 months with temporary
benefit; advised Bell. 30
-Kali. c. 30-Sep. 30Bry. 30 occasionally —no
change - treatment followed very irregularly.    C
17   33  long  delicate, Menses too early, copious, General debility - uterus on two oc- Ocoasional  benefit    but Sulph. 12-Calc. 12-Nux'
Single 11 months ill-  Leucorrhoea before and  only examined  shortly casions,  2  this case I believe deci- v. 3-3 —-Sulph. —Nux.
after menses            before -she left Town   months      dedly required local treat- v. 3 —3 —Puls. 3 —Sep.
Os patent, considerable en- each time   ment, which was not fol- 12-Ignat. 3 —3 —-Bry
Examined  TOUCHER 7  and  gorgement of uterus                 lowed, from want of op- 3-this  attendance was.'S1OUND                        D                           portunity                chiefly for catarrhs —1849
had first severe dysentery,
diarrhcea, and then uterine
symptoms-Bry. 3-Ar..
sen. 6-.Sulph. 12 —Ign.
3 -3-3 - Lach. 12Puls. 3 —Ign. 3-Ipec. 1
ordered Douche.
18    16  2 or 3 months Menses too early —opious Anmia, debility, head- 5 weeks   Not much benefitted before Bell. 3-3 —6 — Chin, I
Single                and long                 ache                                leaving town but she con- Calc. 6 —6.
Not e~xamined.                                  tinned the treatment and
got quite well




19   38   many years Menses absent for a time Debility and local'weak- 9 months
married,             then  regular-c opious  ness as of threatened
no chil-Leucorrh                              prolapse -'her general
dren                Zuorca
Examined and treated by  health much disordered
Simpson's pessary       from other causes, chiefly
imperfect nutrition from
irritable stomach; the
treatment of the uterine
symptoms was purely
mechanical and perfectly
satisfactory. She wore
the pessary from May
14, 1849, to February 8,
1850, without any inconvenience and (vas cured.
Anteversion and uterus
engorged
20   40  2- years; since Mfenses regular-copious- Debility,  irregular and 31 months No decided benefit.      Dig. 3-3-Alum. 30-  OX
marricd    first      slight Leucorrhcea      very slow action of heart.                                   Sep. 30. - Lyc.     0confinement Not axamined               Membranous   dysme-                                         Graph. 12.
norrhnoea
21   22    14 months  Menses too early-copious Debility, pain in back,Hy- S months General health  somewhat Kali. c. 3.- 12. (menses
Single                much Leucorrhca         pogastric weight. In-               benefitted by the general ceased now, Jan. 3d, and
Examined and treated lo-  flammation and ulcera-              treatment,  but uterine did not return,) Merc.
cally with much more  tion of cervix and canal.             symptoms remained un- corr. 2- 2-Bry. 3x.success  than  general                                      changed till local treat- 3x.
treatment. -  ARGENTI                                       ment was commenced
NIT. -PERNIT OF MFRCURY                                     since which she has benefitted considerably
22   30   12 years    Menses very copious-oc- Pain in back, constipation  3 months No real benefit, and  the Sulph. 0-Alum.  3
married,             casional Leucorrhea    Retroversion - and -second            pessary appeared to do Bry. 3.
no chil-trae
nodreuhd~l~       Examined,  treated   by  stageofcervico-metritis               harm. I, however lost
Simpson's pessary with-                                     sight of- the case while
out any benefit                                             she wasJ wearing -it




Length of
No.  Age.   Length of        Uterine Discharge.       Chief Symptoms.      time under           Results.         Remedies which relieved.
illness.                                                    treatment.
23 40-50  8 years       Menses regular - scanty General debility, nervous 3- months Completely  cured  locally, Kali Iod. 1. Mag. Carb.
married,              Leucorrhoea              symptoms. Hypogastric               and general health much  6. Nux  M. 6.  Kali
1dren.-l          Examined chpain. A  large ulceron                                improved, hysteria often Carb. 3-3. Lach. 6.
dren. -1            Examined                                  uroe-                                                       L     6
miscarri-                                      cervix healed in centre             returns. Local treatment
youngest                                       raw round edges                     consisted of douche only.
8 years
24-  33   a long time  Menses regular, copious- Debility, neuralgic pains 51 months Decided benefit to general Nux v. 12. - Ign. 6 -
Single               slight Leucorrhoea       in back, headache, &c.               health - many  uterine Nux m. 3x.-Plat. 12Not examined                                                   symptoms return at times. Plat. 12-12.-Cham. 12
-Bell. 3.
25    14   some months Menses irregular          Constipation,  disinclina- 9 weeks  But little benefit before she Puls. 3-Bry. 3 —lat. 6.
Single                                        tion for all exertion.              left town, but ultimately
Examined'TOUCHER'    Uterus sensitive to touch,               recovered under homoeoshe masturbated                     pathic  treatment.    1
chiefly treated the con-                          Ox
stipation.                                         o
26   35   many years Menses regular              Hysteria, spinal and ute- 11 months For some months greatly Nux v. 3.-Sulph. 6.Single                                        rine irritation, constipa-           benefitted, but became Nux v. 6. - Puls. 6.lion                                worse after the use of the Sep. 12. - Bry. 3x-3x
Examined   SOUvND,  and Retroversion  of  uterus,              pessary, and returned to 1. —Merc. 3 —Nux. v. 3s
treated  with Simpson's  also uterus sensitive to            allceopathic treatment   -Bry. 3x. (Oct. 17 intropessary                 touch, os patent                                              duced pessary) Chin. 1.Bell. 3x.-Nux  v. 3.
(March 2d removed pessary) Plat. 6.-Ignat. 3x.
27    27   many years Menses regular, Leucor- Hysteria, faintness, pain 6 months Some temporary benefit    Puls. 6-Nux v. 30-Sep.
Single               rhoea                    in back, debility, &c.                                        30.
Not examined
27x  27   many years Menses regular,-Leucor- Hysteria, faintness, pain in 1 year and The  local treatment did Merc. 5. (Argen. nit. at
Single               rhoca                    back, debility, &c.     7 months   much  good,  but was times from Jan. 22 to Nov.
Examined and treated by Retroversion, ulceration of            given up before the cure 7th) Kali. lod. 1-Merc.
Simpson's pessary, and  cervix and canal, pos-               was  complete;   many ac. 1 —Mere. I. 1 (introARGENTI NIT.            terior wall engorged                 moral symptoms checked duced pessary Dec. 30th,
the progress much       removed it Oct. 11th,)




at one time the pessary
caused much pain, but this
was at once removed by readjusting the instrument)
Lach. 6-Merc. corr. 2Bry. 3-Rhus. 3x.
28 30-40 some years  Menses always have been Hysteria, great general 7- months Allthe usual remedies for excessive menstruation and
mavried,              copious; for some time  debility.                            hysteria were given in various ways, as regards po4or 5
children              Menorrhagia                                                 tency, -dose, &c., with only occasional and temporary
Examined shortly  before Menorrhagia,   posterior              benefit-Plat. 12-Ign. 3 and, at one time, Secale 3
she left town —'ToUCHER'  wall engorged, uterus              did good. On examination, however, chronic inflamsensitive  to touch, os             mation of posterior wall of uterus was discovered,
patent                              and I believe local remedies alone will do good. The
patient left town before these were tried, but will
probably return.
29    27   4 years since Menses very copious and Menorrhagia,    debility, 2 years and Much benefitted by pessary, Vinca 1. (applied pessary
marriedl,
I child  child-birth   long  continued, occa-  bearing down pain, spas- 5 months   after which she became  March 8th, and removed
sional Leucorrhcsa      modic cough                         pregnant, had a still-born  it July Sth,) Chin. 1-  C
Examined and treated by Enlargement and antever-               seven months' child and  Kali carb. 3-Cina. 3x
Douche and Simpson's, sion of uterus, os pa-                has since felt weak  at  -Ammon. carb. 3xpessary                 tent                                times, though,  on the  Thuja. 3.-Chin. sul. 1.
whole, decidedly better,  Ammon. carb. 3x.
the'menses much legs
copious
30    27   some years  Menses too frequent, pale, Pain in left ovarian region 3 months Benefitted, but not cured; Sulph. 30.-Bell. 30.
married,              copious Leucorrhmea at                                       left too soon to judge
has children                 times.
Not examined
31   20'  some years  Menses regular,-Leucor- Leucorrhoea, hysteria, he- 7- months Much benefit to  general Ign. 3x.-Calc. 6.-Sulph.
Single               rhea  copious, yellow,  patic pain, &c.                      health,  some   uterine   12. —Bry. 3x.-Kali c.
fcetid.                                                     symptoms  remain  but  3. (she wore the pessary
Examined,  treated   by Retroversion  of Uterus,               much less urgent. Pessa-  from Dec. 30th to July
Douche and Simpson's  and 1st stage of cervico-             ry appeared to do good  9th.)
pessary                 metritis                             and caused no inconvenience.  The retroversion
was completely cured




Length of 
No.  Age.    Length of       Uterine discharge.        Chief symptoms.     time under          Results.         Remedies which relieved.
illness.                                                   treatment.
32 30-40 many years  Menses usually very co- Hysteria, catalepsy, debi- 2 years   Was very irregularly under Nit. ac. 2-Merc. 5married               pious -  copious yellow  lity, Leucorrhoa, &c.               treatment, never long at  Rhus. 3x.
children              Leucorrhoea                                                  a time, and  refused to
Examined and found      Ulceration  (syphilitic)               submit to local remedies,
uterine engorgement                 only temporary  benefit
was obtained
33   431   2 years      Menses copious and almost Leucorrhoea,  Menorrha- 6k months Cured without local treat- Chin. 6.-Arsen. 6.mrried,noconstant -thick yellow   gia, debility, pain  in                          ment.   The recumbent  Sep. 12 - Sep. 30 -
chillren              copious Leucorrhea       back                                posture was enjoined for  Sep. 30.-Aur. 30.Examined'TOUCHER'      Irregular  induration   of             two or three months       Sulph. 30.-Sep. 30.
cervix
34 30-40 many years  Menses, frequent, copious- Debility,   Menorrhagia, l11  months Considerable benefit to ge- Sulph. 30.-Bry. 30.Single                copious Leucorrhcea for 8 Leucorrhela,an abdominal           neral health, not much  Graph. 3.
or 9 days after menses  tumor which is probably              change  in  the -uterine
Not examined             fibrous tumor of Uterus               symptoms.
35   40   2 years,    Menses copious early-oc- Numbness of right arm  6k months Notmuch change in 1848 —Zinc 30.-Nux v. 12.married,              casional copious serous  and leg, debility       occasional   decided benefit in 1850    Bry. 3x.-Nux v. 3x. c
4 or 5                                                                                                                               0
children              Leucorrhasa           1I-as had  perinaeum  rup-'
Examined, TOUCHER' and  tured which permits of
SOUND,'   which caused  partial prolapse. Uterus
spasm                   engorged, os patent
36  30-5  3 months    Menses irregular           Bearing down pain, debi- 2i months Cured-Very  soon  after Bry. 3x-Nux v. 612married,                                      lity, is hysterical                  examination  with  the  Puls. 12-Sulph.     6
chilcren,           Examined                 Os patent                              " sound,"  she  became  12.-Had a healthy
3 miscar-[I'                                                                                                                 g
riagespregnant an   soon  got  child made a good
well.                    recovery.
37   22   a long time  1Menses too late, painful   Opisthotonos, -  hysteria, 52 months Is extremely fanciful about the medicines, and every
Single              Examined just' before she  pain in back, debility,             remedy produced some kind of aggravation. I only
went away               second stage of cervico-             treated the fits, and without any success, except that
metritis                            traceable to moral causes.. Dr. Bennet then took
the case; detected ulceration of cervical canal,
treated and healed it with: caustic which did very
much good. A relapse of the fits,'some months
after, yielded to change'of air and scene. The
patient however is still far from well.




38   50   21 years    Menses have ceased-oc- Burning pain and tender- 12 months General remedies had no Bry. 3x.-Kali Bichrom.
married,              casional Leucorrhmea     ness in sacrum, inability           effect.; ARGENTI  NIT.  3X.
no chil- I
dren,                                        to walk far                         healed the  excoriation
Examined, hymen perfect Inflammation and ulcera-.       and removed inflammation of cervical canal             tion of cervical canal, but
symptoms continue
39  40-5  many.years  Menses with much pain- General debility, bearing 7 months  Cured.  The  case  pro- Puls. 6-Sep. 30 —Bell.
married,              Leucorrhwa                                      o     nlw
no chil.              Leucorrhoca             downpain,constipation, occasional   gressed slowly, and went  30 —K. Bich. 2 6-Merc.
dren.                                         dyspepsia                          on well during her ab-  acet. 3x. —Nux v. 3x.Examined, 1 TOUCHER.'   Enlargement and conges-               sence, when  she  pre-  Arsen. 6.
tion anteriorly                    scribed for herself p.r.n.
40   25 i 2 years       Menses regular  till six Bearing down pain after  1 month, Relieved, but left the town Sepia 12.
1 child 2              weeks before treatment,  all exertion, debility             too soon to judge the efyears old.            now  absent - Leucor-                                        feet of treatment.  Sea
rhcea  occasionally  in                                     water douche used
gushes
Examined                Anterior wall congested
and tender, lip red, not
excoriated
41   21    3 or 4 years Menses never free, too Leucorrhcea, pain across 1 month  Much improved, but left Sulph. 12.
Single                late, absent, pale  or  top of thighs, easily fa-            town too soon to judge.
brown-copious   Leu-  tigued                                Menses  occurred once,
corrhosa                                                    more healthily, she used
Not examined                                                  cold sitz bath and abdominal compress occasionally
42   35   many years, Menses regular             Great debility, discharge 4 months  A  little  improvement to Silic. 6-Puls. 6-China 3.
married,  worse 18                            of pus per anum, has                 general  health, varied
years old.  months.                            evidently pelvic abscess,           much
which showed itself after
the use of Simpson's pessary, but probably existed previously
Examined once " TOUCHER' Retroflection
and' S'OUND'




Length of
No.  Age    Length of        Uterine dischasge.        Chief symptoms.      time under-        Results.          Remedies which relieved.
illness.                                                    treatment.          R
43    18    some time  Menses too frequent, scan- Leucorrhmea, pain in left 6 weeks   Very much improved, but Nux  v. 12-Sep. 12 —
Single                ty, and painful-copious  side, pain in back                  left too early to be cured   Sulph. 6.
Leucorrhoea
Not examined
44    18    3 years     Menses'regular,  scanty, Nervous debility extreme, 6 months  No improvement of any duSingle                and very dark-copious  Severe left side pain, &c.            ration; this case should
Leucorrhoea             Bearing down pain.                  have been examined, and
Not examined                                                   most likely required local
treatment.
45 ]35 —40 a long time ill Menses very copious and Menorrhagia,   vomiting, 41 months Cured                    Sep. 12 —Bell. 6-Carb. v.
marriedve             frequent -  Leucorrhoea  pain in left side                                             30-Alum. 30-Cham.
childr'n              copious                                                                                30-Alum. 30-Graph.
Not examined                                                                            30.
46  30-5  11 years    Menses  pretty  regular, Pains in back and groins, 2 years 4 A very instructive case, general remedies did no perSingle                painful-occasional Leu-  great debility,headache,  months    manent good; neither did the douche; Simpson's A
corrhcea                retroversion  of uterus.            pessary did fully more harm  than good, though it tQ
Examined,  treated   by  Inflammation and ulce-               removed the retroversion.  But when ARGENTI NIT.
Douche, Simpson's pes-  ration of cervical canal            was freely applied to the cervical canal, improvement
sary, and ARGENTI NIT.  -engorgement of poste-              commenced and progressed satisfactorily, though not
rior wall                           rapidly-Bell. 3x. Hyper. 3x. relieved the headache.
No remedy was of marked use, but many relieved.
47    27   5 months    Menses absent, is suckling Pain in left side, Leucor- 2 months  Cured                   Acon.  6-Sulph.  30married               — copious Leucorrhoea    rhkea, sinking at epigas-                                     Nux v. 30.
1. child
5I child            Not examined              trium
48   20    3 years      Menses toolate —someLeu- Headache, -   occasional 1 month   Cured.  Relieved from  a Puls. 3 —Puls. 6-Puls.
Single                corrhcea. Not examined  nausea                               relapse, and she then left  12 —Bell. 6.
the town
49    18   3 months    Menses absent             Amenorrhoea, - headache, 6 months  At first relief to general Bell. (only high potencies
Single              Not examined               dyspepsia, pain in loins            health, then no further  and at long intervals
improvement.    Menses  were tried)
did not return. Widow
Welch's pills cured her
soon after she left my
charge




50   24   6 months    Menses absent 12 months Headache, Amenorrhoea, 6 months  No marked improvement, Low potenccies hiefy were
Single              — ho Leucorrhoea          nausea                              and no return of menses   tried.
Not examined
51   44   16 months   Menses copious every 14 Menorrhagia, debility       17 months General health  quite re-Puls. 6-Plat. 6-Arsen.
married,             days-occasional Leucor-                                     stored, menses continued 12.
children             rhesa. Not examined                                         copious till near end of
treatment
52    38   some time    Menses regular - copious Leucorrhcea, debility, pain 6  months Cured, and continued well ARGENTI NIT. locally had
married,             Leucorrhae              in abdomen                           until after another con- most effect, Merc. c. 2several
children            Examined, treated by Aa- Os irregular and patent,            finement,  when  uterine Lach. 6.
GENTI NIT.              cervix ulcerated                    symptoms returned - see
52x
52x                     Menses regular - copious Leucorrhcea, debility, pain 10 weeks  Cured                   Bell. 2x.
Leucorrhoea             in abdomen
Not examined
53   28   4 years       Menses absent, or very Chlorosis, debility, cardiac 12 months No permanent benefit-pro- Plumb.  12-Graph. 30.
Single               scanty                   pain, and breathlessness            bably the speculum would iNux'v. 30.
Examined' TOUCHER' and Uterus low down, os pa-              have revealed local disease
SOUND'                tent and irregular
54   23   2 months    Menses absent, is nursing. Debility, pain in left side    3 or 4   Cured locally. This patient had threatened phthisis
married,             Leucorrhcea                                       months   for-years, the ulceration followed a miscarriage, and
Examined and treated. by Ulceration of cervix uteri          was cured by ARGENTI NIT. She again became pregARGENTI NIT.                                                nant, and had a healthy child, after which she had no
return of uterine symptoms but sank from phthisis.
55    28   12 years     Menses regular, painful, Headache, pain in right 17  months Not any relief till after I commenced local treatment,
Single               occasional Leucorrhsa   side, debility                      in March, 1850, since which she has progressed
Examined after 7 months' Inflammation of cervical            slightly, and is still under treatment. After examiunsuccessful general treat- canal                           nation, in September, the douche wasl tried, without
ment-ARGENTI NIT.                                           benefit.
56    23   some time    Menses scanty, pale, pain- Dysmenorrhcea, pain  in 5 months  General health' restored, Puls. 6 —Sulph. 12Single               ful-Leucorrhcea         loins                                menses were better and Puls. 6.
Not examined                                                 less painful, but just before
I lost sight of her they
passed their time
57   20   9 weeks        Menses absent           Amenarrhcea              8 days    Cured                      Puls. 6 (no other remedy).
Single              Not examined




Length of
No.  Age.    Length of      Uterine discharge.       Chief symptoms.    time under           Results.          Remedies which relieved.
illness.                                                   treatment.
58   50   2 years       Menses constant, pale dis- Nervousness,  occasional 6 weeks   General health  improved, Lach. 12-Bell. 12.
married              charge-query, was not fits, apparently epileptic           fits less frequent, and was
this' Leucorrhwea?                                        then lost sight of
Not examined..
59   35   3 months    Menses, scanty and pale —Pain in loins and hypo- 5 months  Cured; but when the ute- Sulph. 6-Puls. 6-Graph.
Single               Leucorrhwa              gastrium                            rine symptoms  ceased 6-Bell. 6-Ferr. 6Not examined                                                 pectoral ones supervened  Sep. 30.
which lasted nine months.
No local remedies were
used.
60   30   8 years       Menses, too copious and Headache, dysmenorrhcea, 3 months  No permanent relief (this Ign. 3-Cocculus 6.
married              too frequent, Leucorrhoea bearing down pain                  case should have been
no                Not examined                                                  examined and  pobably
children            Not examined            l                                     t
treated locally)
61   16   5 or 6 months Menses absent 7 months, Pain in leftside and epi- 3 months  Health  restored;  menses Puls. 6-Puls. 3-Bell. 3  ~
Single               have only occurred twice gastrium, dyspepsia                 did not re-appear       Puls. 3-Kali c. 3.
Not examined
62   53   4 months    Menses constant, sanguine- The discharge, great debi- 5 weeks   No change, no local rememarried              ous discharge           lity                                 dies were used.   She
Examined'TOUCHER'    Posterior wall of uterus               went into the hospital
very hard, scirrhus?
63   67   many years  Not examined              Prolapse of uterus and rec- 2 months  Pain  removed, no  local Sepia 5 —Sulph. 0.
married                                      tum,  some  abdominal                improvement
pain
64   17   some time    Menses regular, not much Hysteria, debility, dyspep- 19 months Only  occasionally  under Puls. 3-Nux v. 6-Lach.
Single               pain, pale —slight Leu- sia, &c.                            treatment, and was  at 6 —Carbo v. 5-Car. v. 5
corrhoea                                                    times much better. After 12 30-Graph. 5 12 30
Not examined                                                 May, 1849, she became -Calc. 3 12 30 —Puls. 6
worse;   dysmenorrhcea 12 30.
and convulsions came on,
which were treated locally
by Dr. Simpson, and,'by report' cured




65    So30   some time   Menses very painful, and Dysfnestorrhk a, debility, 10 months Conducted chiefly by co.- Canth. 3 —eSecate 6-Se
married,              with false membrane    hysteria                             respondence, and not re- cale 6
children           Not examined                                                  gularly; no marked benefit.'She is at present
(1850) under Dr. Blake's
cure and is improving,
- headache at times much.~f~~~~~~~~~~~~~~~~~~~~~ -                                           ~relieved
66   18   11 months  Menses absent 11 months, Amenorrheca,  Chlorosis, 4 months Menses   occurred   once Sep. 12 —Puls. 6 —Graph.
c>t~    Single                occasional Leucorrhwoa   Cardiac symptoms                   scantily and then again 6 —Puls. 6-Puls. 6
Not examined                                                  ceased-general  health
improved   considerably.
She worked too hard at
her needle
67   29  4 or 5 months Is pregnant-copiols Leu- Leucorrhcea, pain in loins, 3 months. Improvement  in  health, Sulph. 30-Sepia   30married,              corrhoea, yellow        hypogastric pain                    Leucorrhcea   continued, Sepia 30
children           Not examined                                                   though less in  quantity
— left too soon to judge
68   39    12 months  Menses regular and very Gastrodynia,  headache, 6 weeks  Dyspeptic symptoms cured. Puls. 6
married              copious - copious Leu-  Leucorrhoea                         Uterine  symptoms not                             c
corrhoea, yellow                                            mentioned in lastetwo reNot examined                                                  ports
69    38   12 months  Menses  regular,   very Leucorrhoea, pain in loins, 3k months Not much benefit          Cale. 30-Sulph.  30married,             scanty-copious  white  debility, frequent mictu.                                     Cale. 30-Sep. 12
children,             Leucorrhoea             rition.
youngeat            Not examined
70    25   2 years      sfMenses absent two years, Pain. in  hypochondria, 2  months Some benefit.  No return Sep. 5-Puls. 3x.-Sulph..Single              some Leucorrhoea         headache, pain in back.             of menses. Left the town. 12-Nat. m. 6.
Examined,' TOUCHER and Nothing detected, except
B SOUND'               os and cervix unusually
small and soft.
71    17   some time  AMenses too seldom, copious Pain in epigastrium and 3 months Very much benefitted       Puls. 3x.-Sep. 5-Sep.
Single               -much Leucorrhaea        over abdomen, pain in                                       12-Sulph. 6.
Not examined              Hypogastrium
72   25   some months Menses regular, pale, and Dyspepsia, pain in back  6 weeks  Vey irregular in her at- Nux v. 3.
Single               watery-much Leucorr-  debility, constipation                tendance —not'much beh                   -                                      nefitted,  left townNot examined




Length of
No.  Age.   Length of  U. tefine -discharge.           Chief symptoms.     time under          Results.          Remedies which relieved,
illness.                                                   treatment.
73  30-5  17 years-   Menses pretty  regular — Hcemorrhagefrom rectum, 23 months Greatly  benefitted.  Ute- Lach. 6-Nux  v. 3x.Single               some Leucorrhoea         weight  in  hypogas-                rine  symptoms  cured, Lye. 5-Natrum m. 6trium, general debility            though  the  retroflexion Lye. 5 —Sep. 3x.-Puls.
Examined, and treated by Retfoversion of uterus-               was not; general health 3x. —Kali i. 1-Merec. a.
douche and Simpson's  uterus engorged, os pa-                greatly  restored.  The l —Kreos. 2-Nitr. ac. 2
pessary                 tent                                 pessary produced much -Chin.s. 1 —Ign. 3x. Ars.
iiritation and had to be 3-Bry. 3x.-Nux v. 3
removed, after wearing
it from Oct. 24th to Feb.
13th-3t months
74    18                Menses  vqry  irregular, Chlorosis, cardiac symp- 5 years   Has repeatedly  been  un- Dig. 6-Sep. 30 —Puls.
Single 2 years       often absent-occasional  toms,  vomiting,  and                der my care, and is on 30
Leucorrhsea             much  dyspepsia, with               the whole very much betNot examined              much gastralgia                     ter, at times much relieved-but she sits too close
to needlework, *and  is
thus subject to relapses.
75   55    2 years       lenses ceased -  copious Leucorrhoe a            1 month  No change -  Medicine (Sep.) made her constantly
married               yellow Leucorrhoea                                           drowsy all day long, which she had never been beNot examined                                                   fore.
76   26   2 years       Menses  regular,  scanty, Pain in abdomen, pus pe  2 months Greatly benefitted, but did Sulph. 12-Calcar. 18.
Single               painful-thick cQrrosive  anum at times.                       not attend  regularly.Leucorrhoea'                         Leucorrhoea became less
Not examined
77   1S    8 months   1Menses-absent 8 months  Headache,   nervousness, 42 months Cured. It is  not  stated Bell. 3-Ign. 6&
Single             Not examined               fear of becoming  de-                whether menses returned
ranged
78    19   a long time  Menses too frequent, long, Ieadache,     debility  6 weeks  Menses became more regu- Calc. a. 3
Single                and copious-somlr e Leu-                                     lar-and normal, headache
corrkoa Isa                                                  continued bad. and she
Not examined.             was  removed  by  her
friends in-to the hospital
N9   26   some months Menses very  scanty and Palpitation, cardiac bruit. 31 months No marked improvement;Low potencies were used,
Single               pale-some Leucorrhcea  chlorosis and debility                 she was constantly over- except at the two last
Not examined'                         worked  at her needle, visits, when Sep. 30'was.  and confined to the house given with slight benfi




80   22   a long time  Menses absent 4  or 5 Constipation, swelled legs, 2~ months Much relieved, menses oc- Puls. 3-1.
Single               months                   headache                            curred. once, and  then
Not examined                                                 again passed their time,
just before I lost sight of
35                                                                              the case
81  Single  many years  Menses very often absentNMany symptoms, debility, 5f months This patient evidently suf- Bell. 3x.-  Puls. 3x.
-occasional Leucorrhoea pain in back, 4c.                   fers from   many  other Lach. 6-Sep. 6-Plumb.
Examined, treated  with Great distension of abdo-            symptoms  besides  the a. 1.
ARGENTI ANIT.           men,  inflammation  of              uterine ones; the latter
cavity of cervix                    did not yield until- local
treatment   was   used
which  completely  cured
them, and, for a time,
benefitted  the   general
health
82   25    9 months    Menses very scanty and Pain in left side, general 3~ months Much   benefitted;   lost Graph. 30 -Graph. 6 30.
Single               pale -  occasional Leu- debility                             sight of before she was
corrhosa                                                    well.. Menses continued
Not examined                                                 pale and scanty, Leucorrhbea decreased
83    25   2 years      Menses,  condition   not Hypogastric weight, pain only seen  This case has only been
married,             stated                   in left iliac region, vertical occasion-  treated by medicine, and
children                                      headache.           ally     has varied much, is eviExamined'TOUCHER) and Vagina, os and cervix very            dently not yet cured —
4SOUND'         tender, uterus slightly re-         July, 1850
troflexed, os patent
84. 33    15 years    Menses  regular -occa- General health bad, has 5i months Was treated by medicine The medicines did not inSingle               sional Leucorrhosa       diseased ears, &c., &c., in         alone, from  Dec., 1845, -fuence the uterus at all
addition to uterine symp-          to Jan., 1848, with but
toms, these are chiefly            little  real benefit, then
dysmenorrhcea, hysteria,            examined, and treated by
&c.                                 frequent introduction  of
Examined, and treated by Retroflexion, uterus en-            SOUND.    Her   general' SOUND)                gorged, os somewhat pa-             health  improved, uterus
tent                                became less. retroflexed,
she married and soon became pregnant, and had
a healthy child, and afterwards no uterine symptoms




ini~~           mLength of
l  Age.    Length of       U terine 4iare.          Chief symptoms.      time under |         su:s,         t Remedies which relieved
85   35   8 or 10 years Menses every three weeks Hppogastric pain,  and 6 months  Notmuch. benefitted          Nux v. 6-Nux v. 3married,             -much Leucorrhcea        bearing down, great de-                                      (state of uterus-at close of
children,                                     bility, headache                                             treatment not known).
youiigeUt           Examined once           Enlargement and irregularity of os
86   21   a long time  Menses regular, vety pale Great weakness, hysteria, 3 months On  the  whole  she  felt Puls. 12-Lach. 30-Puls,
Single                                       palpitation, bearing down           much  better, but.con-30-ep  30-Bell. 3pain, &c.                           tinued far from well; she Puls. 3-Mere. 5.
Examined  TOUcEa'    Cervix  uteri  elongated,               subsequently married and
tender (inflamed?)                  had children, and  continued delicate
87   25   several years Menses irregular, often ab- Headache,  debility, nau- 2 months  General health much im- Mere. 6-Arsen  12-(SiSingl               sent, scanty, and pale    sea, &.                            proved; menses did not lie. 6).
Leucorrhoaa before menses                                    become regular, her atNot examined                        l r                      tendance was very irregular
88   27    14 months  Menses regular, too short Bearing down pain, Leu- 41 months  Ulceration        completely Mere. iod. 3x.-Chiin 1..married,            -Leucorrhoeea            corrhmpa, debility                  cured and health  much
14 months           Examined and treated by Ulceration of os                      improved she  how
14 months                                                                       improve, she, hotever,
ARGENTI NIT.                                                frequently  caught  cold
and  thus  retarded  her
progress
89   25    12 months  Menses scanty,  regular, Pain in sacrum, much dys- 6 weeks    Greatly benefitted         Sep. 5-Tr. Sulph. OSingle              and pale-constant Leu- pepsia                                                          Bell. 3
corrhcea
Not examined
90   40   2 or 3 years Menses copious, and tooCachexia, debility, severe 1 year      Died.   The caustics re- Nux v. 3-Ars. 3-Bry.
married,             frequent- copious Leu-uterine pains                          lieved  for  a  time  she 3-3x.-Bell. 3x.-Lach.
childrenma           corehca                                                     rallied much; the dcancer 6-Ars. 2.-Con. 1 -od.
Examined, and treated by Fungoid cancer of the ute-          then increased more rapid- 2.
PERNITR. HYDR. and Po- rus                                  ly, and with it her strength
TABSSA FUOA.                                                 gave way




91   86   7 years       Menses regfilar, painful, Spinal  disease,  aching 8* monds Uterus   eured;   general Mere. e. 2 —Nux v.  x' —
married,              copious  and  brown-  pain in loins                         health improved  for a  Mere. lod. 3
children,             milky Leucorrhoa.                       time, but the symptoms
you6gest            Examined, and treated by Ulceration of os, enlarge-           were chiefly spinal, and
ARGENTI NIT. and PER-  ment and hardness of                 remained pretty much as
NITR. HYDR.     -       cervix                              before. Ulcer was cured
in 4 months
92   25  4 years, since Menses copious, too long, (Gonorrhcea) pain in left 4 years   Uterus was not examined Puls. 6-Calc. 12-Bry.
married, a miscarriage  dark-occasional  Leu-  side of abdomen, dys-              till 2 years after treat-  6 —Sep. 12 —Bell. 6children             corrhoea                 menorrhoea                          ment commenced, pre-  Lach. 6-Ammon. c. 5
Examined,  treated   by Enlargement of anterior               viously her health im-  -Merc. c. 2 —Merc. a.
ARGENTI NIT., POTASSA  lip of uterus, os patent,            proved  much at times,  3x. —Amm.  c. 3x.FusA  canal excoriated                                      and   the   gonorrhcea  Bell. 2.
cured; for 1 year more,
the case was treated by
medicine only, with the
same effect of temporary
improvement.   Caustics
were  then  used  repeatedly and the uterus
improved, as also general
health. She is, however,
still delicate, and has
laterodynia
93   22   4 years       Menses very scanty and Debility, headache, pain 7 weeks  Much relieved; treatment Sep. 5-Puls. 3-Puls. 6
Single               painful-much Leucor-  in  left  side,  bearing              was not continued long
rhosa                   down                                enough
Not examined
94   21    4 years      Menses very copious every Menorrhagia, ancemia, de- 15 months Menorrhagia.  cured  aud Sep. 12 —Bell. 6-Bell. 6
Single               three  weeks -  much     bility                             amenorrhcea  came  on;  -Plat.  6-Plat.  6Leucorrho3a                                                 health varied, was better  Bell. 18-Puls. 6-Bell.
Not examined                                                  at times, latterly  less  30-.Calc. 30
well
95   30. |  21 yrs.   Menses every 14 days, co- Menorrhagia,    debility, 10 months Greatly improved;   local Igna. 3x.-Bell.  3x.married,  since last    pious - much'Leucor-  sinking in epigastrium             remedies   were  com    Bry. 3x —Puls. 3x. —
children    child    rhosa                  I                                     menced after 7 months,  Sabina 3x.-Kali B. 3x.
Examined andatreated lo- Inflammation and ulcera-.         prior  to  which  loca   -Plakt Chl. 3.t.ann.' ally,  Aai*Tr   NIT.  tion of oervix and eanal              ymptom'  had imnpr"      ~a.




Length of
No. )'Age.   Length ofI   Ut~erine~ dsarge.          Chief symptoms.    time under           Results.          Remedies which relieved.
illness.                                                  treatment.
96   31   a long time  Menses  never  regular, Amenorrhea,  dyspepsia, 41 months Greatly improved in health Sulph. 30-Gale. 30-Bell.
Single                often absent - Leucor-  eruption on face                    -only one slight appear-  12-Nux v. 30
rhlzcca                                                     ance of menses
Not examined
97   35   some years  Men'ses often too frequent Pain in epigastrium  and 3* years  Has been under my care Tr. Sulph. 0-Mere. 5married,, and copious - frequent  groin, hysteria, &c., &c.,         for various  causes, and  Amm. c. 3-Kreos. 3x.
de~en.              Leucorrhea               rheumatism, &c.                    is always relieved  by
Examined after 2 years, Engorgement of. uterus,              medicine, but the uterine
douche and  mercurial  frequent large discharge             symptoms  have  beneballs-no effect         of pus, as if from pelvic           fitted but little, though
abscess, bursting  into            she has varied  much.
vagina                             Uterine symptoms have
benefitted chiefly from
98.  24   5 years       Menses irregular, copious, Hysteria, fainting, cardiac 14 months Very much benefitted, wa5 Puls. 6-Ars.  12-Puls.
Single                and dark-copious Leu-  symptoms,  dysmenor-                 not -regular  in her  at-  12-Puls. 30-Ars.   30
corrhcsa                rhcea, &c.                         tendance                  -Sulph. 30-Calcar. 30, 
Not examined                                                                           -China. 30-Sep. 30Sulph. 30-Bell. 30Ferr. 12-Sep.  30Ferr. 2.
99   22   6 months    Menses regular, painful- Pain in stomach and abdo- 2* months General health benefitted Nux v. 3-Puls. 3-Tr.
Single                much Leucorrhwa          men, left side pain, pal-         less  Leucorrkaia;  still  Sulph. 0.
Not examined              pitation, headache                  dysmenorrhca, and menses scanty and pale
100  16   12 months   Menseg absent 7 months  Chlorosis, left side head- 6 weeks  Mbrnses came on and ge- Puls. 3-Pals. 12-Mere.
Sifigle             Not examined              ache                                neral health much  im-  6
proved-lost sight of
101   23    5 years    Menses regular, copious, Dysmenorrhcea  most se- 2 years and Only occasionally and for Tr. Sulpv. 0-Coce. 3
married,             A' cposvrmn~                                                 ne
-1 child             -dark, painful - copious  vere, hysteria        31 months   a short time under treatLeucorrhoea                                                  ment; the  dysmenorExamined'TOCHE         Engorgement, os and cer-              rhoea was cured but revix rather hard                    turned now  and  then
under the influence of
excitement, &c.




102   35   3 months    Menses violent and copi- Menorrhagia -from  con- 3 months Cured                          Puls. 3-China O.
married,              OUS and too long         gested uterus
2or3   |
children            Not examined
102x  35                 11Menses too seldom-pain- Bearing down pain, debi- 5i months Much  benefitted, left off Sep. 30-Bry. 3-3x.2,or 3d               ful-Leucorrhoea         lity                                treatment before she was  Puls. 3x.
children            Examined ARGENTI NIT. Enlargement,      induration,            well
and ulceration of cervix
103   30   some time   Menses regular - much Pain in back and side, and 52 months General health greatly im- Bell. 1-Nux v. 3-T.
manroed,              Leucorrhea               across abdomen                      proved; she continued to  Sulph. O-Rhus. 3x.children            Examined  and  treated Enlargement and chronic                 year the pessary for some  Lye. 5.
with Scofield's pessary   inflammation of uterus            months after discontinuing her medicine, and has
since felt well
104   15   9 months    Menses absent 9 months  Amenorrhea, debility,         months Only  seen   occasionally; Sep. 12 —Sulph. 12.
Single              Not examined                                                   menses  returned  twice
but did not continue regu- lar
105   18       5 or 6    Mlenses too frequent,"copi- Debility, palpitation, dys- 33 months Cured; state of menses and Calc.  30-Sulph.  30-.
Single    months      ous, dark —much Leu-  pepsia, &c.                            leucorrhcea  not  men-  Calc. 30-Sulph. 30. 1
corrhcaa                                                    tioned at end of treatNot examined                                                  ment
106  30-5    3 years   Menses regular and pain- Leucorrhea, pains in geni- 6 months Cured                       Mere. c. 2-Bell. 3x.marred,[              ful-muclh yellow Leu-  tals after all exertion                                         Sep. 12.
children.             corrhaea
Examined-douche         Had gonorrhcea, and now
chronic inflammation of
vagina
107   35    some time  BMenses copious, too early Pain in abdomen nd back, 3 months  Had been treated by caus- Bry. 3x.-Nux v. 3x. -
6married, I      I                        I bearing down, debility,              ties, before coming to me,  Bry. 3x.
children..&C.                                                      and  pronounced cured
Examined-' douche'      Enlargement  of  uterus                but still suffereel muchwith endometritis                   general health improved
greatly
108   18       3 years   Menses never regular, now Amenorrhcea,   debility, 4 months Health restored, menses did Puls.  3-Sulph.  12
Single      -         9 months absent          faintness, depression               not return                Graph. 12 —Puls. 30.
Not examrineris?




No.  Age.    Length of       Uterine discharge.       Chief symptoms.      time under          Results.          i Remedies which relieved.
illness.                                                    treatment.
109    16  2 years       Menses never regular, ab- Dyspeptic  and  nervous 7 weeks  This poor girl had been se- Merc. iod. 3x.-Puls. 3.
Single                sent five months-Leu-  symptoms i                            duced and was, pregnant,
pregnant              corrhcea.                                                   suffered much  morally.
Examined —A/RGENTI NIT. Ulceration of cervix                   The ARGENTI NIT. greatly benefitted the ulcer, but
she left the town before
she was cured.         I
110 135-40  many years  Menses regular            Hy'steria, debility, pain in at intervals A very complicated case; long ill; treated 3 years hpmarried,                                       back, &c., headache        only      mceopathically with some benefit. Dr. Ashwell then
family.             Examined                 Cervix enlarged, os patent            found ulceration of os and cervix, which he treated
and irregular                       with ARGENTI NIT. and healed. Her system had become very susceptible by the strict hygienic rules she
had followed, and she gradually and steadily became
worse in- health, all medicines appearing to aggravate, till at length she became deranged, and was.~
then treated Allopathically by stimulants and tonics L
with decided but temporary benefit.
111    18       2 or 3    Menses absent 3 months  Amenorrhcea, Dyspepsia, 21 months Menses returned - health Bell. 12-Bar. c. 6.
Single    months   Not examined               throbbing of carotids                improved  much-throbbing  of  carotids continued
112   35   many years Menses  scanty,  dark- Hysteria, toothache, aph- 1 year and Symptoms often temporarily relieved, but the general
married,              thick Leucorrhosa        thie, &c., pains in vari- 10 months   features of the case remained unchanged; she was
3
children,                                      ous places                          however constantly transgressing  our -rules, and
Examined'TOUCHER?      Cervix enlarged, os irre-              moral causes were in continued counter-operation.
gular
113  30-5  3 years       Menses copious, clotted  Debility,   Leucorrhcea,   1 year    General health much im- Puls.  12 —Kreos.  12married,              Leucorrhoea              pain in back                        proved, but she became  Puls. 12-Car. v. 12chi.                No examined                                                    pregnant,  and  aborted  Zinc. 6 —Sep. 30 —Graph.
(afterwards became preg-  30-Puls. 30.
nant, and. had a healthy
child, and continued to
improve under Dr. Black's
care)




114  30-5  some tme   Menses capiou-Leuoor-Pain  in  back, debilty, 21 years  Is over-worked as a dily Sep. 12 —Tr. Sulph. OSingle               rhosa                    Leucorrhoka            occasion-    governess;   much  re- Sulph. 30- Plat. 12Not examined                                     ally only   lieved at -times, but the, Bry. a. 1-20th
symptoms occasionally returned
115   21    2 or 3       Menses regular-Leucor- Pain  in side, flatulence, 1 month  Much improved, but lost Carb. v. 12 —Cham.  6married, months       rhoa                    dyspepsia                           sight of                Lach. 12-Carb. v. 12.
children           Not examined                                                                         I
116 35 -40 8 or 10 years Menses regular —not much Bearing down pain, pain 5{ months General symptoms improved, and but for moral causes
married,              Leucorrhcea             in back, debility, hys-             would-have done so much more. Dr. P. Smith afterchila &C.                                                                         wards restored the uterus and relieved her much by
Examined, treated mecha- Retroversion   of   uterus           Simpson's pessary, but she still remained weak. No
nical]y                 and chronic inflamma-               remedy seemed to influence the uterine symptoms.
tion, engorgement
117   35   many years Menses regular-constant Neuralgia, chiefly of face 15 months No great benefit, though at times relieved  This case
Single               Leucorrhiea              and  head,  headache,              I believe to have been one in which the uterine
Not examined              bearing down pain, great            symptoms were the most important, and where local
debility, constipation             treatment would probably have done good.
118    19   some time  Menses irregular absent 6 Headache, pain in hypo- 61 months Cured                      Puls.6-Sulph 30-Sep.30
Single               months                   chondria                                                  -Lyc. 30 (menses return-.,
Not examined                                                                          ed)-Tr.Sulph. O-Bell.3  c;
-Tr. Sulp71. O-Bell. 3.
119   30  10 months   Menses every 14 days, co- Weakness in Epigastrium, 51 months Improved, general health Ign. 3-Nux v. 3x.
married,              pious —much   Leucor-  pain between shoulders,              better    ulcer   more
10 childrhcea                               bearing down pain, de-             healthy   and   smaller
months                                        bility                             from ARGENTI NIT.; she
Examined —ARGENTI NIT. Inflammation and ulcera-               attended irregularly, and
tion of cervix                     was lost sight of
120.36,   8 years      Menses every three weeks'Irritation of bladder, dys- 13 months Health improved, and dys- Bry. 3x.-Tr. Sulph. Omarried,              — Leucorrhoea           uria, pain in back, de-             uria became less before Nu  v. 3x.
children,                                      bility                             local  treatment  comyoungest            Examined-ARGENTI NIT. Ulceration of cervix                    menced,'has progressed
KALI BIcIuOM, &C.                                           more rapidly since, and
is still under treatment
121   58 - 12 years    Menses ceased two years Debility, heat in lower 7 months Generalhealthimproved; ul- Lach. 6-Puls. 3 - Mere.
married,              -occasional   Leucor-l belly,  dysuria,  right             cergreatlybenefittedbyAR- c. 2-Merc. Iod. 1-Tr.
children,           irhea                    hand and leg feel numb             GENTINIT., hbunot healed, Sulph.O-B3ell. 3x.
youngeb            Examined-ARGENTI NIT. Enlargement and ulcera                 local symptoms much redoich  tion of eervix                                     lieved (subsequently
}~~]~              ~             l                                      aar



No.  Age.   Length of        Uterine Discharge.        Chief Symptoms.     time under          Results.          Remedies which relieved.
illness.                                                    treatment.
122   - 51    7 months    Menses leaving  her, at Pain' in hepatic  region, 8 months Greatly improved, at times Bry. 3x.-Bell. 3x.-Bell.
married,              times flooding-copious  varicose veins, flooding             felt almost well, but was 3x.
Leucorrhoea             at times                             oftenthrown back by reNot examined                                                   turn of copious menses
123    18   2 or 3 years Menses  never  regular, Dyspepsia, debility, con- 2 months Crured.  Menses  became Puls. 3 —Merc.  3 —Con.
Single                 often absent            stipation, pain in left              regular;  she was not, 3 —Puls. 3.
Not examined               side                                however, robust
124    14   a few weeks Menses  have  stopped- Eruption of head, swelled 2 months Cured.  State  of menses Lyc. 12-Lyc. 30.
Single                have only occurred three  glands, amenorrhcea                 not reported
times,
Not examined
125   24   7 years       Menses irregular, pale, and Pain in left side of abdo- 21 months Much relieved, and went Puls. 30-Sulph. 30-Sep.
Single                scanty, often-absent     men, and swelling                    to service; menses con- 30.
Xot examined                                                   tinued absent
126   23   5 months    Menses absent 5 months Severe pain in left hypo- 14 days   Relieved  decidedly,  and Bell. 6-Nux v. 6.
married,              -much yellow Leucor-  chondrium,  dyspepsia,                 lost sight of.   Menses -
children              rhoa                     debility                            not reported at last visit'
Not examined
127    30   4 or 5       Menses  regular,  scanty Bearing down pain, pain 3 months Much better, still under treatment. She -however did
Single  months        and  too  short-occa-  in back, debility                     not improve until ARGENTI NIT. was used
sional Leucorrhoea
Exarinedl —ARGENTI NIT. Inflammation'and excoriation of cervical canal
128  30-5 Some years  Menses regular, painful  Headache, hysteria, debi- 3 years and Greatly. benefitted in  ge- Ars. 30 —Puls. 12-Ars.
Single                                        lity, bearing down pain, 2 months   neral health, often well 30-Sulph.  30 —Graph.
&c.                                 for months together, but 30-Car. v. 30-Arsen.
Examined'TOUCHER' Cervix  uteri  shortened              liable  to'relapses;  at 30.
shortly before she left  And enlarged                       length, Dr. Ashwell saw
me                                                          her, pronounced the existence of  chronic  inflammation, and used
caustics  with  reported
benefit




129 30-5  manyyears Menses very copious and Debility, pain in  back, 2 yrs. -and 9 Greatly benefitted, menses Nuxv. 3-Sep. 30-Sulph.
Single                debilitating             headache, &c.          months oc-  regular and normal, much   12 —Alum. 30-Bry. 30
Not examined                                      casionally   stronger, but does not be-  Alum 30-Plat. 6 30come quite strong        Natrum m. 3.
130   21    10 weeks    Menses absent 10 weeks  Amenorrhcea,  toothache, 21 months Menses returned, but did Puls. 3.
Single             -Not examined               headache                            not  continue  regular;
health improved greatly,
attendance irregular
131    7     some time  Thick yellow Leucorrhosa Leucorrhcea               7 weeks   Cured                      Puls. 3-Calc. acet. 3Single              Examined externally                                                                      Merc. c. 2.
132   32   2i1 years    Menses regular — copious Leucorrhcea, hypogastric 5 months.Uterus  cured;  general Nux v. 3x.
married,              yellow Leucorrhiaa       pain, debility                      health improved greatly,
children            Examined once, used AR- Cervix  enlarged, irregular,           but over-fatigue and mo.
GENTI NIT. slightly'    indurated and excoria-               ral causes prevented comted                                 plete recovery
133   18    3 years      Menses  irregular, dark, Palpitation,weakness,ner- 2 months  Benefitted, leucorrhcea ceas- Puls. 3-Puls. 30-Phos.
Single                painful- copious Leu-  vousness                              ed, but left town too soon  30-Tr. Sulph. O.
corrhosa              -                                     to judge.
Examined, once' TOUCHERI jJterus tender to the touch
134   17   5 months    Menses absent — Leucor- AmenorrhAsa, debility, pain 1 month   Cured                      Puls. 3-Puls. 3-Sulph. 6
Single                rhsa                    in back,' swelled feet,                                        Puls. 6 —Sulph. 6
Not examined              headache, &c.
135   21    4 months    Menses occur slightly, but Debility, sinkingin epigas- 21 months Cured  (a  change to thelCarb. v. 30-Ignat. 6
ma3red,               she is nursing — much  trium, dyspepsia, consti-             country did good)
children,             Leucorrhoa.             pation, headache
4 months.          Not examined
136/ 33   6 years        Menses regular and scanty Debility, severe pain in 5 months Very  much  relieved;  is Bry. 3x. —Puls. 3x.'Single               -occasional Leucorrhsa.back after all exertion              still under treatment, had
Not exiamined                                                  she been more cautious
she would- have been
well
137   21   3 years       Menses too late, scanty, Languor, palpitation, pain 2 months  Verymuch better,lefttreat- Sep. 5-Puls. 3-Bell. 3
Single                and pale, copious Leu-  in left side, short breath           ment too soon; menses  -Tr. Sulph. O-Sulph.
corrhwoa                                                     more healthy, leucorrhcea  30
Not examined                                                   ceased




gel l ~~~~~~~~~-     ~~~~~~~~~L-length o
No.  Age    Length of        Uterine discharge.        Chief symptoms.     time under          Results.          Remedies which relieved.
illness.                                                     treatment.
138    16   3 months   Menses absent 3 months IPain in left side, chlorosis, 3 months Menses returned, felt bet- Puls. 3-Kali c. 3-Lach.,
Single              Not examined               palpitation, headache               ter at times, still had pain  6.
in side; left treatment too
soon
139   25   2 years       Menses irregular, scantyJIrregular  menstruation, 1 month   Felt quite well for _some Sep. 6-Puls. 6-Bell. 6
Single                and pale                 headache, nausea, pain              months,  then   became  Puls. 6.
Not examined              in thighs                            dyspeptic, without menstrual irregularity, and
was again much benefitted
140    24'  6 weeks      Menses absent, is nursing Pain in left iliac region, 21kmonths Very much relieved; leu- Sab. 6-Sab. 6 Several remarried,              -copious Leucorrhea   leucorrhma,debility, dys-              corrhcea  greatly  dimi- medies as Sulph. 30-Sep.
children.           Not examined               pepsia, &c.                         nisled                   30-Bell. 30Puls. 30
yo6ngestt                                               bwere  previously  given
without any benefit.
141   22   6 months  IMenses absent 6 months  Pain in left side of chest 4 months  Menses  returned, health Ars. 30-Sep. 30 —Merc.
Single              Not examined               dyspepsia, debility, &c.            greatly improved         3 —Puls. 3.
142   29      several    Menses every 14 days —  Debility,, nervous depres- 6 weeks   Cured.  Leuchorrcea  not Ign. 3-Ign. 3.
Single' months       Leucorrhoea              sion, bearing down pain,            reported
Not examined               piles
143    19   some years   Menses irregular, scanty, Wausea, dyspepsia, pain 3 months  But  little  benefit,  left Puls. 6 —Bell. 30
Single                and pale-copious Leu-  in back, depression                   treatment too soon
corrhcea
Not examined
144   16                 Menses  irregular, very Debility, short breath     2 weeks  No change whilst under ob- Tr. Sulph. O
Single                scanty                                                       servation, left too soon to
Not examined                                                   judge. I heard afterwards
that she was better.
145    38   2 months    Menses absent, is nursing Pain in left mamma, pain 31 months Uterus  cured, health im- Puls. 3x.
married,             — yellow Leucorrhea  in loins, weight in hypo-                proved, at once became
children.                                      gastrium                            pregnant, when ulcer was
youngest            Examined -ARGENTI NIT. Inflammation and ulcera-                healed; the pain in mamtion of cervix                      ma ceased when uteru
became well




1468  24   several years Menses very irregular, oft- Dyspepsia,   eon3tilpaon, S months   Very  much  benefitted, Nux v. 3-Lye. 5 6 13
Single'en absent, are so now-  headache                              menses returned  and  30 100.
occasional Leucorrhkea                                        continued  regular  for
Not examined"                                                 some months; subject,
however, to relapses.
147   24   some time   Menses  regular, scanty, Debility, much headache 2 months   Very  much  relieved —  Sulph. 30 —Merc. 12Single               pale-much Leucorrhoea dyspepsia, pain in back                 menses came of a na-  Sulph. 30-Graph. 30.
Not examined                                                  tural color; leicorrhoea
continued and also pain~
in back; gave up treatment too soon
148   19   a long time  Menses regular-Leucor- Severe pain in sacrum, 4tmonths  Much benefitted in health- Bell. 3 —-Sep. 12-Puls. 6
Single              rhcoa                    palpitation                           -Leucorrhcea not re-  -Plumb. 6-Puls. 6Not examined                                                  ported                   Tr. Sulph. O.
149   22   4 or 5 years Menses regular, painful- Pain in hepatic region, 2 months   Cured, leucorrhcea ceased Nux v. 6 30-Sulph. 30
Single              much Leucorrhwa          dysmenorrhaea                                                 Merc. 6-Sulph. 30.
Not examined
150   37   12 months   Menses regular - copious Leucorrhoea    headache, 5 months  Very much relieved; leu- Lach. 12-Sep. 12 —Sep. _;
married             yellow Leucorrhoea       dyspepsia, weakness  in              corrhcea much reduced  30-Sulph. 30 —Calc. 30.
Not examined             loins                                in quantity
151   42   many years  Menses regular, copious, Pain in abdomen, head- 10 months  Varied much, no essential Calc. 30 —Ars.12 —Graph.
married             with much pain-copious ache, much palpitation.                change                   30-Chin. s. 1.
Leucorrhoma
Not examined
152   38   16 mofiths   Mlenses regular- copious Pain in right side of abdo- 6 weeks    Not much change, left Sulph. 30-Sep. 12.
married             Leucorrhaca              men, severe headache at              treatment too soon
Not examined             times
153  30-5  a long time  Menses  regular  slight Great debility, hysteria; 6 months   Decidedly benefitted, and Tr. Sulph. O-Calc. a. 3married             Leucorrhciea            formerly  had  ulcerated              continued  to  improve  Alum. 30-Sulph. 30Not examined             cervix, under Dr. Simp-              under    Homceopathic  Bry. 30.
son                                  care;   was  formerly
treated'locally by Dr.
Simpson
154    15   3 months    Menses suppressed —copi- Backache, severe head- 10 days    Menses returned, and she Puls. 6.
Single               ous Leucorrhcea         ache                                  felt so well as not to de,!ot examined                                                  sire further treatment




Leng-,th of'
u{.>.  Age  Lef.zth of     Uterine Discharge.         Chief symptoms.      time under           Result.           Remedies which relieved.
illness..                                                    treatmen;t.
155    1S      c,,::e time  Men'ses irregular      Ilregular menses, head- 3 months  Cured                          Puls. 6.-Ferr. ac. 2.
S'ngle               Not examined               ache, swelled legs
During treatment she had
smallpox,  which  was
treated by Acon. 3. and
Tart. em. 1.
156    28    some years  Menses irregular, scanty, Dysmenorrhcea, hysteria. 11 months Many  symptoms  relieved Cale. 3-CGalc. 100-Sep.
Single                 painful qr not -  occa-  severe pain in back, &c.,             at times, but she conl-  100
sional Leucorrhea        debility                             tinued very  weak, and
Not examined                                                     at last went, under allopathic  treatment,  and
still continues (4 years
later) without any mate- 
rial change. All kinds of
local treatment have been
tried, I believe
157    40    some years lMernses are leaving her, Edematous legs, throbbing 6 months No material improvement  Carb. v. 3-Puls. 3.
Single                 often violent and clotted   and cutting hypogastric
pain, vertical headache
Examined' ToucuHER      Hardness and irregularity
of cervix-`sc'rrhus?
1585-   34 4 Lyears       Me,,sevs too early, scanty, Pain in back, leucorrhmea, 5 months  Very   much   benefitted Nux v. 3x.-Sep. 5-Nux
3Siglg-e               and bright recd-much   pain  in  hypogastrium,                 menses  became  more  v, 3x.-Sep. 12.
Leucorrhlea              pimples on face                      healthy,  and   leucorNot examined                                                     rhcea less
159    18    12 months   Menses absent 12 moths Headache, Rflushing, pain 1 month   Cured, has had  frequent Nux v. 6-Puls. 6-Bell.
Single                   slight Leucorrhoa      round Vaist                           returns of Amenorrhcea   6.
Not examined                                                     always, however, benefitted by treatment




160    30   several years Menses every three weeks. Hysteria, pain in  right 3 yrs. and 2 General health improved, Nux v. 3 —Bell. 3-Bell.
Single                scanty and ale, copious  side, pain in back, verti- months, oc-  is still far from well  30-Nux v. 12-Sep. 6
Leucoirhoea            cal headache            casionally                           -Ti. Sulph. O-Silic. 6
Examined, and treated by Retroversion,  inflamma-                                      Kali c. 3-Nux v. 3x.
ARGENTI  NIT.  and  tion and ulceration  of
Simpsonl's pessary      cervical canal
161    23    2 years     Menses irregular, too sel- Palpitation, debility, pain 51 months Very much benefitted  Puls. 30 —Puls. 30-Puls.
married,              dom, scanty and pale-  above left. hip, throbbing                                     12-Sep. 30-Sulph. 30
much Leucorrhoa         of carotids,'bruit de                                       Sep. 30.
Not examined              diable,' frequent headache   -
162    24   some time   Menses scanty and painful Flushing, and  at times 41 months Much benefitted            Nux v. 6-Sulph. 12Single                -slight Leucorrhaea      erysipelas of face, insuf-                                   Sulph. 12-Sep. 12Not examined              ficient menses  swelled                                      Puls. 6.
legs
163   4S    12 months   Menses abundant, haemor- Menorrhagia,    occipital 4t months Cured of the flooding, and Arsen.  12 —Chin.  6inarried,             rhagic clotted —copious  headache, great debility            greatly  improved  in  Arsen. 12-Ars.  6-.Leucorrhcea                                                 health; after menses left  Arsen. 30..
Not examined                                                   her, an uleer broke out
inone leg, and continues
to discharge
164   51    2 years      Menses ceased three years Debility, flushing, dysp- 1 month   Greatly improved        Bry. 6-Sulph. 6.
Single                -yellow Leucorrhea       nmea, swelling of vulva
Not examined              at times
165    31   a year       IfMenses copious and weak- Some bearing down pain            Some relief-left  treat- Nu v. 3x.-Bry. 3x.. ar. ried,           ening-i-loody  Leeucor-                                      ment toosoon
chil.hren            rhwa, copious
Examined' TOUCHER'    Tenderness  of anterior 20 days
wall of uterus (Metritis?)
166    22   a long time   eaenses  regular —copious Hevmornioids, dyspepsia, 3 months Cured both of original dis- Aecon.  6-Sulph.  30Single                Levcorrhbea              leucorrhba,  pain  in               ease and syphilis        Puls. 30-(VMecrc. 6Not examined               back, (cout acted syphi-                                     Thuja 6 —Merc. 6.)
lis during treatment)




Length of
No.  Age. Length ofillness    Uterine discharge.        Chief symptoms.       time under           Result.           Remedies which relieved.
treatment.
167    38    3 years      Menses too frequent, co- Menorrlagia, leucorrhoea, 10- months No permanent benefit; was Cham. 6-Sep. 12-Lach.
married,               pious and clotted-dirty   headache, dyspepsia                  dismissed because she re- 30 —-Secale 30-Puls. 30.
white Leucorrhcea, co-                                        fused to be examined
pious.
Not examined
168    25    3 years      Menses regular, painful- Gastrodynia,    enuresis,  4months  Much improvement, leucor- Bell. 30 -  Arsen. 30 -
married,               much thick Leucorrhcea    headache, pain in  left    not       rhoa lessened; notmuch   Calec. 12.
Not examined               side                     regularly    change in enuresis
169    41    6 or 8       Menses regular and pain- Leucorrheea, debility, fde- 1 year and No permanent improvement Sep. 5-Bell. 3   Calc.
married  months        ful-copiousyellow Leu-  pression, violent head- 7 months    before or after local treat-  acet. 3-Sep. 5-Puls.
children,              corrheea,                ache, pain in back                    ment, which was com-  12-Ignat. 3'Sep. 5.
youngest           Examined and treated by Ulceration   of   cervical               menced after 1 year and                            oo
ARGENTI NIT.,  KALI  canal and cervix                          4 months 
BiCHR., AURUM. MUR.n
PLAT. CHL.
170    31    2 years      Menses regular,  scanty, Headache, dyspepsia, leu- 6} months Cured                        Puls. 30-Calc. 30-Puls.
married,               very dark-copious Leu-  corrhoea, some cough                                              6-Sulph. 30-Calc. 30
children,              corrhma                                                                                   Sep. 12-Calc. 30.
youngest             Not examined
171    30    1. year      Mensesabsent 3 months- Debility,  yellow  leucor- 3 weeks  Improving, still under treat- Sep. 3x.
Single                 copious yellow Leucor-  rhoa, bearing down.          ment
Examined, treated locally Large unhealthy ulcer of
-ARGENTI NIT.            cervix
172    27    8 years      Menses  regular-copious Cough, violent retching, 3 weeks   Improving, still under treat- Bell. 3x. —Arg. Sr.
married,               purulent Leucorrhwea      debility-  bearing down              ment
zawitdoW,            Examined, treated locally Large unhealthy ulcer of
ehildren               -'ARGENTI NIT.            cervix




173    37    3 years       Menses  too seldom, but Debility,    menorrhagia, 3 mouths Improving, still under treat- Plat. Chl. 3-Plat. 12-.
married,               very copious and debili-  bearing  down, swelled                ment                      (locallyARGENTINIT. once
a widow,l
I child               tating                    legs                                                            and PLAT. CHLOR. once
Examined and treated lo- Cervix  enlarge~d,  finely                                         cured the  cervix  comrncally at first, ARGENTI  granular, bleeding easily                                        pletely)
NIT.
174  3arried  9 months    Menses absent  copious Dyspepsia, with  redness 4 months Cured.  General treatment Bell. 3x.-Bell. I-Nux v.
marrchild             Leucorrhmsa               and rawness of mouth,                 relieved   the   general 3x.-Aurumn Mur. 1-50,
prolapsus uteri                       health, but uterus  re- locally and internally Aur.
Examined, treated locally, Cervix uteri projects ex-              mained  unchanged  till Mur. 3.
ARaGENTI NIT., AURUAM  ternally, and is cleft in                local  treatment  comM.                        two, and the interior of              menced;  the  prolapse
lips are granulated.                  and ulceration were both
completely cured
175    40    2 years       Menses regular            Headache, pain and occa- 3 months  Greatly   improved,  left Puls. 3-Ign. 3x. —K.Bicl.
married,                                         sional htemorrhage after              treatment too soon; an- ~3x.
children,                                        coition                               terior lip  smaller,  and
youngest             Examined, treated locally, Smooth induration of an-               canal more healthy
ARGENTI NIT. and KALI  terior lip, canal red and                                                                    0o
BICHROM.'                raw
176    35    12'months   Menses regular, scanty —Bearing down pain, pain  5 months  Cured; is still dyspeptic Nux v. 12 —Bell. 3x.marl ed,               copious Leucorrhea        in groins                             and has inguinal hernia   Aur. M. 3 —Nux v. 3ahildo,           Examined and treated lo- Retroflexion of cervix, soft                                        Sulph. 3-K. Bich. 3x.
youngestc             cally, ARGENTI NIT. and  enlargement of cervix,
6                   KALI BICEnRO.              os and canal patent and
excoriated
-177 married,   8 or 9 years Menses much, too copious Menorlragia t    debility, 3 months Greatly benefitted, still un- Bell. 3x.-Plat. Chl. 3.
married,                           too                                      m tr
a widow,               -copious Leucorrhma       backache                              der treatment
child en,            Not examined
youngest
178    29ed  5 years       Menses  regular -  thick Prolapsus- uteri            5 weeks   Decidedly benefitted, ute- Aur. M. 3-Stann. 3x.twinsm                 white Leucorrhoa, co-                                          rus entirely  within va-  (Puls. 3x.)
four and'pious                                                                        gina; left treatment too
years ago            Examined, treated locally, Labiae- uteri greatly en-               soon
AURUM Muit. and STAN- larged, and projecting
NUyt (CaioL'. from vagina




~- -r~?  -         -r                             I ~~~~~~~~~~Lengrth   0fI-ILI   J-      -` —
No.  Age.    Length of          Uterine discharge.          Chief symptoms.      time under            Results.            Rbmedies which relieved.
illness.                                                         treatment.
179  30-5  20 months   Menses absent (is preg- Debility, leucorrhea,shoot-  5 months Much benefitted  was de- Nux v. 3.-Car. v. 5.
married,  -              nant)-Leucorrh e          ing pains in vagina        occasion-   livered of a healthy child
201 onths             Examined' TOUCHER' onceeReported  by  a  London   ally              one month after but some
old                                              physician to have vagi-                of the uterine symptoms
nitis andulceratedcervix               returned afterwards
180    40    6 or 8         Menses  very   copious  Debility,    Menorrhagia, 4 months Decidedly better; after the Plat. 6-Arg. 3x.
married,   months       some Leucorrhcea           bearing down                           second application of AR-.8or9
children,             Examined, treated locally, Enlargement, and granu-                   GENTi NIT. there came
youngeas                ARGENTI NIT.               lated excoriation of cer-              an induration of anterior
2 years
and a                                             vix                                    lip  exactly  resembling.half
that occurring in chronic
inflammation
TABLE No. 1.
GENERAL TABLE.
No. of Cases cured or greatly benefitted.....................  112
No. of Cases somewhat benefitted.........................   51
No. of Cases unchanged..................................    17
No. of Cases still under treatment...............22.......   22
-No. of Cases left treatment to early to judge...............   34




83.TABLE No. 2, SHOWING AGES AND RESULTS.'0'Left treatment too early to judge.
ce   a)       A.-                         -   0
(U'Z
8  m   bacu   ba  r                            CdEi  a P b.   t9 C'
H.,       g   a.. a
Married.. 15 —20! Ma-rried.. 15 —20
Single...     1   14   2        33    Single...           3.4         7
u ~          ~~~~~~.C a)
~C~    O~jj        a'    1
-        1~~~~~           ~~.i.. W 73   Single...  3               _
aF1              Ed  ~~~i 7  
Married.. 20-25   7   2..              Married.. 20-25  2             2
Single..         26   8   2        37      ingle.           7   1   1  9
Married.. 25-30  5   5   1.. 11         Married. 25-30   1   4.      6
Single.7  4  5   16  ingle.1.6
Marrled...30-5 14   5   1        20      Married. 30-35  2   1     
Single.10   2   1                   13   Single....
Married.. 35-40 15   4   21               Married. 35-40  1   1   2
Single...  2         5  Sin      g lege...... 
Married.. 40-50  5   4   3.12              ied. 40-50  1   1..,       and 2  1                3,             50and             1 1 
0upwds.                       16 Mpwds.
Single.           1.... 1  1         Single...
Married                                   Married
and            34  1 3 3..51  51  and                    7   3   1..  11
families                            --   families._ _ _ _   ~180
TABLE No. 3, SHowING LENGTH OF ILLNEss AND RESULTS.
d~   ~:~~         Left treatment too early to
4_., ~~~~~~ ~judge.
a
Cd~~~~~~~. 4 i: 
Time.                                   Time.               Ia
"~         F    F1~.. ~..s i'i....~~~~ ny''s1 4   3o                             yea r. a2   3n 2.a   ]
CD..103 1V 13                                       r...4..
A   log   tme... 0  3E-I9   A ln                    tim...'4 I.
o~ ~ ~c  o8 0
iio!0    i                              ii
Under 3 months 14   5..   1  19  Under 3 months  1   1..               2
6..   94..  313.. 6    1                                   1   2
12..   16   9   2   3 27.. 12                3  1      1        5
2years..14 4   3   3  21..  2years..  2   3   2                  7
3         9   5   1   2  16            3          31    1            4
6    10 3 1 113..                               4.                 4.Many years.    18  17   8   8. 43  Many years... 2   1        3
Along time..  20   3   2   1.25  Along time.            4    1             5
Unknown.2  1                        3 Unknown.           1  1               2
80




84
TABLE No. 4, SHOWING LENGTH OF TIME UNDER TREATMENT.
Cases under treatment steadily.     Cases seen. occasionally. Cases'left too early
___ ___       ___to judge.
~~~~~~~~~~~~~~c,8
le_.               0.,
C.)  a        d    Cd:C
Cd               E-         Cd   EO      I    -CCd
Time.  bn~,~    )-.'d
~~~~~~~~~~C.0    C)   H    C)g  ~1
"  ~~~~~~o'..              
a-    0.,   a    0                      a1 month and
nder...  12    7    1..    0.....    0    5    3   1    9
~,...16   10    I    27... 2.    7    7    3    2   12
3....  19    8    2         29.....   2..    9    2   4..    6
4....12    4    2           18......   18    3.....3.. 1 4    x.      5..       1...5....8.. 55                          18  2                22 "                      3 0  3
9    2    1        12    1    I          2  14...           1.5    4.  3               12.              12 
years..3 2 1   66....6
23    2  1I    1 3;. 
2-. or moreyrs   5    3              8    3    2          5   13.
V'iknown                                             1  3  3..
TABLE No. 5 SHOWING STATE OF UTERINE FUNCTIONS.
- -, ]'&  1....   ~~~Leift'treatment tooStill under treatment.
a  u                early to judge.    __________
hi)   ~     "    ~~~~~~~~~~~~~~~~~~~~~i
to                  A          0                    0
fucios;~,'a    ~.0'0
Q''        Cc;J 00                   0
il                                       U)'C                          kC    3                      
0                        o                C.   0
Menses-absent.. 24   12.. 36    4    3..        7    3    2.. 
regular.. 34   13    5   52    5    1   2,  8    2...          7
irregular. 10    4    418..           2..        2...    5..
scanty.. 22    8.535     6    1..7    3    1..  4
*copious..23l13    6 43    2   2 1I    5    5'  3                    8
tooo I..    1..
duration
painful.. 13    7.7      25    3    1        4    2    3..
pale.     12    6.  1.19    4    1    1    6..
dark....  4    3.. 1   8             I          I
too early.4.    14112           3    2..        54
too late.. 5.22   9  4....    4.  2.2. 2
L. some...26  6537   53..  3                                   22..    4
copious.. 50   14    9   7 3    9   4    3   1 6    4    6          10.occasionall14    8    2  24    1   2.            3    3    1.        4
Sfiixg. discharge                      1'SABE  ~ilo  5  HOWNG TIJE    O  UTRIN  FUCTI,~ 3
~                                      ~
~ms~~~~~~~~~~Lf ~esabsment 241 3 -'  
~~~,, regum'. 34   13'5525'      82.               7
cuopious..  23B P  13Ui
t ~         + d f~u O~          rationb
d~~~~~~~~ark... 4 3    1..  
I~c, some... 2                     61cC 5~ 37 5~'3 8'
~~~48~ene    2asnt.4   1                2. 1  6B~.  3   3  1,.' 4...         4    3....    3     1'  11.... i.  
~   ei~~l. dichr    g 1'?. 521.14       23.I 




TABLE No: 7, ANALYSIS OF CASES EXAMINED, SHOWING UTERINE SYMITOMS, MbD: OP
TREATMENT AND RESULTS.
Cured or greatl.Somewhat        Unchanged.                Still under
be~~~~~~~~~~nchanged.                                                 CD ~e~:
benefitted.    benefitted                    P           treatment.
~                      c. O: ~.~         _.,  CD
bj~~                                   ~      ~ __        --                   __ __                               a ~~ ~ ~
Objective Uterine symptoms. 
P,   -;   9 ~                  ga,   tr     ~,~'~3::   CC
c?~ ~ ~~~~~~c
C)  E-i ~ ~ ~ ~ ~   ~ ~ ~ ~ ~~) G
0               0    CZ        0        c;               =:            a 0             CD      
Uterus siv  to tc..    4
0  0    0  0    0    C)    0    0~~~~~~~~~~~~~~~~~~~~~~~~~~~~5 0,
en.,-4._.~
Symptose of cervico-metritis                                                 4
detected  by t         whr 1
u        o    ~~~    ~;~    Do ~'"
O ~ ~ ~ ~   ~    ~ ~ ~ ~ ~~~    ~ 9)   a                                       a O,
Thereo                                                6    1..       5........6    1...                Tot
First  stagei  of cevico-metritis  3 1.... 4                                                                 _...  ~ _~                 -
Seond r.......                                                                  3                                     Somewhat      
Syphiliticlcanteion.1aI.......'.; 1
T d     0Unchanged.
Indmptions of poservico eriwals~
S       Third, q y...... 2.. 2 6,                          t 1 5    2a.
Fouanrth                  8 setm1  1 u  ud                                                                             Cured or greatly.    oI..  014~ c    benefitted.' o?    co
Anteversesion. of uerus......I.  I                        _          f.engorged........             3..  1.. 3  "              Somewhat......... posterior wall.....'  I....:: "' 1    3......                   benefitted.. anteriorwall..                            1......  I.... "3 "0'  t co Unchanged.  J
Symptoms of cervico'metrwis                                                                                                            C+]
Schirrus~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~, qy,,Z% 
de tected by the finger,.where. died
there was an oPlportunity 0f['.-~W
using the speculum'.....~'J,~    ue r~et.t ~ P    ly benefitted. 
Retroversion............. I..  3                  ~       "        1...  3    9..'                      Smwat-q  B
Prolanpse                1         i.. 1..   i'ii...I...               3...:I..           ~-, 3      benefitted.'e
Syphilitic 5aIceration      -.... I... I:''.an~.'o  1
Induration'of' posterior wall,                                                                                ~"...  ~2.ic
Schirrus, qy.?.....................
Cancer of uterus........,I,died... 1.. I....~;... ~..I.. I1...I. 1




86
TABLE No. 7, Continued.
- Left treatment too early to judge.              STILL UNDER TREATMENT.
a Da,                Greatly      Somewhat
ad.~ e                 benefitted.    benefitted.
Objective Uterine symptoms.
o        i         i        1 
osmptoms o c o0
o    o ~p            o t  t of..
0    0    0         o    O 
First stage of cervico-metritis. J.......  I...         I.         2
Second...I'...    1....    1..
Third....4 1    1......                   
Fourth..        M N1                     1..  T..  D... 
Uterus sensitive to touch....  3    1    4..          1 a.....
engorged.  1                                     I.........    1.. 1
anterior wall.'....     1..............
Symptoms of cervico-metritis 
detected by the finger, where
there was no opportunity of....
using the speculum...... J
Prolapse of uterus..........                       1
TABLE  No. 8.  MEDICINES AND POTENCIES THAT DID GOOD.
Aconite......................  3  6. Calcarea acet.........3
Alumina..................... 3 12 30,,  carbon............  3  6 12,, 3 altern. with Bryonia...3.,,.18 30 109
30,,,,... 30.  I,,,,   1l alt. with Zinc.  6
Ammonium  carbonicum.......... 3x  3  5 Cantharis......................  3
Argntum'.3. C.........arbo vegetabilis........., 2.
Arsen icurn.................    3........2 3.................... 12 30.,,      1  alt. with Cham. 6,,    12 altern. with China..  6.,,      12 alt. with Lach.,  12,,    12,,       Puls.    12.,,       30 alt. with Arsen. 30
30,,.  30.. Chamomilla............. 3x  3  6,, 30,,    Sulph.. 30......,,......                     12,,    30,,    Carb. veg. 30..,    6 alt. with Carb. veg. 12
Aurum............30.. China off.......                    0   1  3,  30 altern. with Sepia...... 30......................  6 30
Aurum muriaticum..........  3,,   6 altern. with Arsen...    12
Baryta carbon...............  6.   Chininum sulph.............. 1.  I
Belladonna...............      1 3x  2 Gina....................... 3x,....................  3  6 12 Cocculus.....................  3  6,.............            18 30     Conium...................... 1  3,,  6 altern. with Sepia... 12.    Digitalis......................  3  6,, 6,,       Graph.    6.'   Ferrum...................... 6 12,,  6,,      Plat,...   6.,,  acet................... 2,,    6,,    Puls.      6,,  sulph.................. lx,,   18,,....  6.       Graphites..............   3  5  6
Berberis vulg........            3            1,,.. 12 30
Bryonia alba........... 1-20 1 3x,,   6 altern. with Bell.....   6...............  3  612,,   6,,       Sepia.... 12.,..........30.  Hypericum..............    3x,,    3 altern. with Alum.   3..     Ignatia...................... 3x  3  6,,   30,,,  30.       Iodium....................... 2




87
TABLE No. 8.-Continued.
Kah'-i Bichrom................. 3x  2  6  Pulsatilla 6,,    Sulph..   12
carbon...................3x  3  6,   6,,                  6,,............12                   6            Sepia....12,  odidu.1.                                  6,     Bell.       18
Kali Iodid. 1 alt. with Mere acet. 1                 6            Sepia        6
Kreosotum..3x  2 12,,  6,,    Bell.....  6,  12 altern. with Puls.  1 1 2              12,     Arsen.      12
Lachesis...............6 12 30,, 12,,    Kreos.   12.
"    12 altern. with Carb. veg. 12.            30,     Arsen..   30
12              Sepia... 12         Rhus Tox..................       3x  6
Lycopodium.............5 12 30  Sabina........................3x  6
Magnesia carb................    6..    Secale Corn..................3  6 30
Malaganum acot.                   1.       Sepia.........................3x  3  5
Mercurius acet...        1.................  3x.  6 12 30
iid  alt. with Kali Iod. 1                                        100
17~~....... 3x    a                  "...........................0.1iodi..........1 3x             6 altern. with Puls........ 6,   ol............. 3  5  6,12,,                     6............ 12.,12,      Bell........  6
Subl. Corr......... 2,12,      Graph.         6
Natrum muriat,.............. 3  6.12, 12,,     Sulph...... 12
Nitri. acidum................ 2.,12             Lach... 12
Nux moschata..............3x  6          30,,     Aurum.....30, vomical..............3x  3  6  Silicea............6..............,.............. 1230           Stannum......................3x
Phosphorus..      3 30       Sulphur...................... 3  6 12
Platina....................... 3  612....................30
6 altern. with Puls.        6.,  6 altern. with Puls.    6.. 
6             Bell...                6.6    Puls.....    3
Platinum Chlor..3..                    12,,    Sepia         12
Plumbum..6 12.............,, 30,,    Arsen..... 30
acet..      1         Sulphuris tinct0.'
ace..................  I.  - S lh rstn t..................    O'. 
Pulsatilla...............1 3x  3  Thuja Occ.................... 3,,..........6 12 30  Vinca.1-20  1,      3 altern. with Sulph..   6      Zilncum..................... 6:6,,   6          Plat Pt.     6,    6 altern. with Calcar.... 12
TABLE No. 9, SHowIN  REMEDIES MOST FREQUENTLY USEFUL FOR CHIEF SYMPTOM1S.
Number Diratt'
Total                        Numberlrelieved alternaSymptoms.         Number Remedy and potency most  re-  by vari- tionwitb Total.
reported   frequently useful,   ported. ous po- otberretencies. medies
1. Debility............  95      1 Pulsatilla.   3    12    39       5    44
2Sepia......30    11    27           3    30
2. Headache.               51     1 Pulsatilla...  3         30      5    35.I6 Pul..               3 0     510
2Sepia....    13       2    15
l3 Nux vomica,.      12            12
3. Pain ir back........  50      1 Sepia.... 2 12           26............   30 
3 Sulphur. 30         5    18       3    21
2 Pulsatilla....            1 9     5    24
j4 Belladonna..    16       1    17
5 Nux vomica,...    15.      15
4. Neuralgic..........  31   (1 Pulsatilla. 6 12 30    5    15        1    16
2 Tr. Sulphur.0       5    11       1    12
3 Nuxvomica... -  12             12
5. Leucorrhaa... 29    2 Sulphur.... 30    9    14..    14
1 Sepia.........      15      2    17.
3 Pu-lsatilla.....~     8..      8
6. Dyspepsia........27   (1 Pulsatilla, 612 30          7    18.      18
(2 Belladonna.               10..    10
3 Nux vomica.,.    10..    10
7. Bearing down pain...  24   r1 Nux vomica. 3x    3           9..      9
2 Pulsatilla.... 12    3    8,..       8
3 Sepia....... 30    3       6..      6
4 Bryonia..... 3x    3       4.      4
5 Ignatia.... 3    3        3             3




88
TABLE No. 9.-Continue&d
i'Nuber. Tota'                      Num- relieved Ditto. in 
Symptoms.          Num- Remedy and Potency most ber re- by vari-, alern - Total.
ber re-   frequently useful.   ported. ous po-  other,
ported.                             tencies remedies.
8. Pain in left side...   18        Pulsatill.....3      7    10.        10
9. Pains in abdomen..-16     1 Tr. Sulphur. O          4      7             7
2 Pulsatilla.....  7              7
10, Menorrhagia......       15       Platin. Clilor.  3    3  3
Platina'.                8
I 2 Belladonna.. 3x    3      5      4      9
3 Sulphur.... 30    3                      3
11  Dysmenorrhoa.......   14       1 Pulsatilla;  6    4       5      3      8
2 Sepia           12    4      7       1      8
12. Painin hypogastrium.   14   I  Nux vomica    3    4           8..     8
2 Lachesis        6    4      4      *.      4
13. Cardiac symptoms         12     I Pulsatilla     3     5    13       2     15' 3 Sepia....         30    5               7
2 Sulphur.......  8
14. Amenorrhoa.......   11        1  ulsatilla     3    3       6      3      9.2 Sulphur........      5
15. Constipation.......   10        Nux vomica    3    3        6..      6
Pulsatilla     3    3               6     6
16. Anaemia and Chlorosis   9       f1 Pulsatilla    3    2..........    6    2       7      2      9
~'   30    2
j2 Belladonna    6    2        3       4' 7
3 Sepia.    30.   2       2      3      5
4 Platina.....  6    2       1      2      3
17. shortnessofbreath..   7        3  epila..     5    3       4             4...t.es  I        Pulsatilla.....      6..      6
]  2 Sulphur..        -.. 6..      6
4 Belladonna                    3..    3..  3
5 Nux vomica...      3             3
18. Swelled legs........Pu 6                           Pulsailla        2 3
1  Pulsatilla occurs among the most useful in 16 symptoms, ds chief in 12
2  Sepi                                     9,,,,      2
3  N.ux vomica,,                            8,,               3
4  Sulphur,,,               8,,,,      1
TABLE  No. 10) SHOWING RELATIVE RESULTS OF HIGH AND
Low POTENCIES.
Left treatment.coz..' too early.
N.B.-The low potencies R        Fg,o     p   
include 6 and under-'         o    
The high potencies, 12         t 
and above. _           __   _
Cured or greatly bene-      62   ]6     78     5   5 
fitted'
Somnewhat benefitted...  23     7     30     5   1   6
Unchanged............    7'     10      1   1   2
RESULTS OF TREATMENT WITH BOTH HIGH AND LOW POTENCIES.
Cases in which both high and low potencies were given with decidedly more }  19
benefit.from the low than the high.
Cases in which no marked difference was observable between the effects of high.46
and low potencies................




T'ABLE No. 11., SHOWING FREQUENCY OF OCCURRENCE.OF VARIOUS SYMPTOMS AS A CHIEF SOURCE OF COMPLAINT.
0                                                                o
SYMPTOMS.  ~   ~     0     Ca       Cd0                  SYMPTOMS.                q —   =4
SYMPTOMS.                                  0                                      0      a;    ~        
a)                                                                              cc       E-H 
~ Ca       Cda                                                                  a 
o                                                               cc 
c,~~~~~~~~~~~~~~~~~~~~~~~~1
1 Debility................... 54  29   12   17   17   95  30 Eruptions on the skin..             3...       3
2 Headache.                      28 16  7  6  7 51, 31 Nervousness,..                                   1  1  2             2
3 Pain in back............... 28   18    4   10   10  50  32 Epileptic fits'                             I..          1 
4 Neuralgie.16 9 6    4 31 33 Irregular menses..  I..         2
5 Leucorrhcea.. 19  9  1  2  5 29 34 Cough......                                                  1..  1              2
6 Dyspepsia.2........ 2  5                        2  7 27 35 Numbness of right arm and leg 2...       2
7 Bearing down pain..            14   8    2    5    5  24 36 Pain in the thighs.......1    1                         1   2
8 Pain in left side.              13  3  2             7 18 37 Pelvic abscess...    2..        2
9 Pains in abdomen.9    6    1   2                          16  38 Throbbing of carotids.......                 2
10 Menorrhagia..'......... 10  4  1  3  3 15 39 Hoemorrhoids.....2...       2 
11 Dysmenorrhcea..............  6    3    5    1    1  14  40 Palpitation..... I.  
12 Pain in hypogastrium.9    3    2    1    1   14  41 Pain in right ovary:.                  i               1.   1
13 Cardiac symptoms.                7    3'  2    1    3   12  42 Vertigo...............                                      1
14 Amenorrhcea..  6    4..  11  43 Congestion of head.,..      1..     
15 Constipation................  5    3    2            i  10  44 Irregular action of heart.....    11
16 Ancemia and Chlor6sis.......'2    5    2    2    2    9  45 Spinal irritation...'.......          1                 I 1
17 Shortness of breath..........  3    3    1   2    2    7  46 Hepatic pain............1.                      1
18 Swelled legs.                    5         I  1..  6 47 Hysterical convulsions.....I.1
19 Pains in various parts..        1   2,   2    1          5  48 Sanguineous discharge...      1               1
20 Pain in left ovary....           2    3               1    5  49 Haemorrhage from rectum......                1
21 Nausea..  3    1    1                                 1   5  50 Dischiarge of pus per anum.   1...               1
22 Pain in right side..             3    1    1    I    1    5   51 Gs'eat distension of abdomen    1..                       1
L~~~~~~~~1~~.  e,....' 
23 Vomiting.2    2.                               3..    4   52 Pain in genitals.........  1
24 Flushed face................ 4.....4 53 Apthne in mouth........                                                       1
25 Fainting fits................  2'           4   54 Varicose veins....                                 1
26 Sinking in stomach.........   3    1           1    1   4   55 Swelled glands..........  I1
17 Pain in iliac region..........    9   1    1       3  56 Pain in left mammaI.... 
28 Irritable bladder..............    3  57 Pain & hemorrhoidsafter coitus  1......             1 
29 Pain in hypochondria....2....         1              1..  I  3   58 Shooting pains in vagina:.. I..        1
9~~~~~~~~~~~ Paniiboe:....:..11     8'Hhobn   fc~td.... l1i..I.  




~ M.E  z   m U2 r* ~     q           qe
D CD-. i CD C.D:..                                                                      - I: cs:,: |L    LP:: ~:              o.
Z o:)          Locally. n~...                                   _         _:o
z:o  Cured or greatly 
~.1.) 2~:>~ -|Not Locally.~~~ a:L %    ",-benefitted. ff
Mechanically  F'                                                 Somewhat'.... *|Mechanically.    CD P    ~.                                         ~ ~  cD  -       benefitted..1  ~.-I
r ~....... 1 r:    I Locally and                                                              Unchaned:::         | Mechanically.       r 
~ m
_~             _ _ _ _ _,..........N.
_ _._,_. _:   Locally.           0   o                                   ~                Did harm.
*c   * * *    * c                                         E: aNot locally.                      Total.
N.. Mechanically. 
Mechanicall    -....       ]EXAMINED EXAMINED AND TREATED LOCALLY, AND ALSO
~:.:::::    Locally.."                   LOCALLY AND MECHANICALLY.. ~rr.:  ~~~Not Locally.'Whether examined or otherwise.  Married Single.   Total... ~Mechanically   tjc......QExamined  and  treated  mecall acvcvcr  Total.    Eically.....................   4                         1      5
F -, CO C3            j C m chanicall...-... -...:.
-~~~~~~~~~~~~~~~Eaie n t r e t d m ca
-,~, Total. nical...........     




TABLE No. 2, Continued. STILL UNDER
TRE&TMENT.                         TA:BLE No. 3, Continued.  STILL
UNDER TREATMENT.
State.      Age.   |    |                                                   a |
0 0 C)    E-i           Length of illness.      | i
Single....   15-20      1  2..  3
20-25    1   4..  5                Under 3 months..  1             1
Married      25-30.   I..  I   3....
Single....   1..  2..    1   2...3
Married..  30-35       1.   2                     years..  3               3
Single....2..     2                       6               3...    3....   2
Married..   30-40      4....  4..  6..         1..            1
40-50..    1..  1               Manyyears....  2   5   1   8
Married and              5   2..  7              Along time...        1..
families..                                         _........ _ _
TABLE No. 4, Continued. STILL
UNDER TREATMENT.                        Z..~  ~,.
Length of,                                   / a'gauaq omog 
treatment.                 I                          pajaD      j i
Q) $; Q)  V                              pal4j9u9q  | e- -
Underlmonthl        3..    3. -  
3 more    3   1 ya       4 1.    4a
~,                       I                           ~','
9          r..3..            i 3 
2 or more year   3   1        4




TABLE No. 15, BEING ANALYSIS OF CASES OF LEUCOREH(EA,.SECTION 1.
Still under                 Lt treatment i...... _.   treatment.              too early.
Cured or Some-                   Great-  Some-               Cured or! Somegreatly   what    Un-             ly      what    Un-        greatly   what    Unbene-   bene-  changed.         bene-   bene-  changed.      bene-   bene- changed.
fitted.  fitted.                fitted.   fitted.            fitted.  fitted.
StateA.    A g.   
Single. -.                                 1 1Under.. 1.....!
15-20    4.....                                                                             5
Married    20-25    1 5.1                                                                                    3. 
Single...-.         4 2..2 1.....1O         1                             5  I I                8
Married0. 25-30..  41.     1.    1.......2....      2         4
Single                 2-1 1 —. -!        1 7              I    2
Married.   30-35  5.                    1..                           1 1.  1. 1. 
Single..                12 2 2.... 1                                                                  1.....
Married  35 —430.. 4 1.. 12..                                                   1
Single......1..  e............  2                                                        I..   1
Married.   40 —50    22 2..1.... **I**...1..11       11       1..2.. 
Mg~arried. 50 and upwards. l... 11.....1.. 1
With  faSilies..              31         1    2       1    24     2.... 2......    3....   1                 9




TABLE No. 16, BEING ANALYSIS OF CASES OF LEUCORRUI(EA, SECTION 2.
Still under treatment.:   D eft treatmenttoo early to judge
Cured or Some-                         Some-               Cured oI  Some 
greatly   what    Un-        Greatly   what    Un-         greatly   what    Unbenefit'd. benefit'd. changed.   be nefd  enefit'd. changed  enefit'd. enefit'd. changed
Comparative Numbers of     8-                                    8'";  8   8 co, 
Examined, Unexamined, &c.;  o i    c 5    0    i s 0                       0         
Notexamined.         1313 24 4   3 2 3 5 157... 1  1 1   I  1                    7  1    5.... 18
DO.... m"".. 2  1.... 1,...d  m  5  1   1   1 4.
Examined and treated locally.  2 |7              I. 14  2 * 1 | 1 -   1| 3..  9*    2 2                       4 
Do.            do. mechanically                   c:.  I    i  1 4
~Do. i~echanic~do. locally and'.




TABLE No. 17, BEING ANALYSIS OF CASES OF LEUCORRH(EA, SECTION 3.
Still under treatmenlt.    Left treatment too early.
Cured or Some-                          oe-  ome  -       Cured or Somegreatly   what    Un-       Greatly   what    Un-         greatly   what    LIUn-.
bene-   bene-  changed.     bene-   bene-  changed.       bene-   bene-  changed.
fitted.  fitted.            fitted.   fitted.             fitted.   fitted.
S  S    S      d         a                  a   -a    C8
Lengthoftimeill.   e  8          i |  @  8                 8     8      Z  0  S C 5                     0 5 |'[
0     o V  V  V _ VO       VO       V 0; 5     O O    02 V      O  
Under3 months.....................             6....................e 6........ 3..                                          I... 1.5
ars... 12......   2        I....  1                       1..................   1..1.l 3  2    6  7                                  4  
6..........4 2  7                                                         2
Many years...... 4 3 7 1 2 1........            I..........  1.1.....2...
A long time            66.1...... 6 6  I. I.. 1.... 1..........
Unknown.......                                      1.  2
Unknown.1.. 1................ 1




TABLEP~   N'oa. 18, BEING ANALYSIS; OF CASES OIV L ESCORH(cA, SECTION 4.
Still under treatment.      Left treatment too early.
Cured or Some-                       - Some-               Cured or somegreatly   what    Un-        Greatly   what    Un-         greatly   what    Unhene-   bene- changed.       bene-   hene-   anged.        hene-  hbene-  changed
fitted,  fitted.             fitted.   fitted,             fitted,   fitted.
d C 6                  c     d     EG4   9   r:4ct    d cI Z.$   d E Cjl ci  C4  Z   4;1 
E3                                         440a -Z aE    0
efnstrual functions.    "!             s  ~     44I.;
ir k k k  k ~~~I,  ~ k k  L,!,!;            k;k 
O                             aaa 0                        01-0               0 
0000                     0           00  00                    000
~~~13~~~
-4~~~~~~~~~~~~~~~~~~~~~~~~a
Menses absent......3  8  1                    O   i                          3 II. 13  1. 1
irregnlar.....1 3 2  1
regular.    517 1 2 2.1 3. I.3 1 2  1...... 7  i 4   1...... 2                 7
scny       4 8...3 312 0....2..                                3..4 1
copious.       210  5.  2 1 2 3  126  1 3..  1 1                       6  1 1                        4
too long du-          2.         2.
ration.
pale bsnt~...   3. 2  1                                                    1    3   i..1   1.1.8.    1Ji1 1.1  1.11....l. 
pain.ul.      36...   1           1 113..           1...scanty'.. 1. 4. 2>7j2  44~ii;  I
too early  1.    3 61.;1 1.1 1 2  11   1....1.... I..B 4  1 2           I.1  1.I.......   54
pale.      321.      1-1      8.1.  4                                              4..dark...    41II.    1,1.. 7.
too earl y....1 3 21        11     1 21..11ll1 2.. 1                          1..1  BI..P 




TABLE No. 19, BEING ANALYSIS OF CASES OF LEUCORRHCEA) SECTION 5.
eD qStill under treatment.                                                                     to           early
_______________________________________________3_______________________               to judze..Cured or Some-                       o me-            Cured or;Somle~-~'                  -'~greatly   what    Un-      Greatly   what    Un-       greatly   what    Unbene-   bene-  hanged.    -bene-    ene-  changed.    bene-.  bene- changed.
o                                  ~ LIZ fitted.  fitted.:   fitted.  fitted.             fitted.  fitted.
Length of time under           c 8    8   8    L                 d 8 =   i 8. 
* * $D          imonthorless. 22.          4.2... 2 2 3...   1 1  1.. 8
~ treatment.                                                             4,' ~ ~  o 
i ~  or morie..3.. 4 1..11 11.11]..                                                                                     2'nkow.-i| ~.... 1::    1 9.:'..,]]                                CD  |             | I           - 1. | |]:1: i |.E~~~iis...*.. 2s..1.1...on.
I -mo th or less       2                     4..          2             2  2 3...   _.
4m ees                 12    1..  1...... 12.. 2.........2.. 2
[While we cannot too highly applaud the diligence and zeal displayed by Dr. Madden, in making and recording so many careful examinations of such a multitude of uterine cases, we cannot give a silent assent to the conclusion he arrives at. As the glory of modern surgery
is the curing, not the performing of operations, so the excellence of homeopathy ought to be the curing of as many diseases as possible without the use of auxiliary aids, such as local applications, especially caustics, and it is far too soon for any one, however great his experience, to
issue a finality bill, and say that such and such diseases can only be cured by surgical operations, unless he can show some better reasons
from  pathology than his mere inability to find an appropriate remedy, nor, indeed, is this done or intended to e done by Dr. Madden.
We must first use all the remedies we have then look for more  but not till all possible medicinal substances are exhausted, can we confidently assert, here are titude limits of ine castenal howe opatic treatment. To assert that nitrate of silver, &., act speci gloally as well as chemicalll, seems to us almost as extravagant as if we were to attribute the benefit of an amputatiobe to the particles of anyhe ferrases absorbed by the
cut slr-face, or to the galvanic or odylic influence in addition to the riddance of the offending member. —EDIToIs.]




97
CLZINZOA: IELEORD.
lanchester Homeopathic Hospital.
We find that the number of beds in this institution now
amounts to 25, and that from the 29th April to the 15th November, 77 cases have been treated with in general very satisfactory results.
We find that at the same date there were 10 cases in the
house.
The fact of this hospital being self supporting and not a
free one, may in some measure account for the paucity of
acute cases, as in Manchester no one can become an inmate
of the establishment with;out the payment of at least half-acrown a week; and if without the recommendation of a subscriber the patient is charged five shillings..
This may prove to be a serious drawback to the general'usefulness of the Manchester tHospital,. and we should fear
would always militate against its having that number of
acute cases (which are most prevalent amongst the indigent),
so essential in the present state of homceopathy in this
country, to strike not only the vulgar mind, but also that of
the investigating allopathic physician. All who have attempted to influence their allopathic brethren by statements
of individual cases; know how these are treated, and how
often the" vis medicatrix" is called in to'explain away/what
they have thought- to be incontrovertible proofs of the truth
of our system.
A Hospital unrestricted in its admissions, except by the
opinions of its medical officers, would soon furnish sufficient
materials to put the "vis" aside and.allopathy also. The
self-supporting system is, however, one of those evils under
which we must for some time labor, and which can only be
PAM. -7




98.                Clinical Record.
got rid of by a wider diffusion of our system amongst the
wealthy laity.. And in towns where homeoopathic hospitals
and dispensaries are opened, we would earnestly call upon
our brethren to advocate the cause of perfectly free and charitable institutions.
CASE I.-ERYSIPELAS.
April 29th, 1850. —EElizabeth Hynde, admitted to-day, states that
on the evening of the 27th she was seized with shivering, and on the
28th the face became swollen and painful, with shooting pains in the
head. There is now erysipelatous inflammation of the face, affecting
especially the nose, the left cheek, and. the upper part of the neck;
and the eyelids of both eyes are much swollen. There is severe
frontal headache, with subdelirium; the tongue dry and red at the
tip and edges.
Belladonna 3d decimal dilution, every two hours.
30th.-She has passed a better night than on either the'27th or
28th. The inflammation has, however, spread to the hairy scalp.
Continue.
May lst.-Slept well last night; the inflammatory redness and
swelling of the face is diminishing; and the swelling of the scalp,:though as yesterday, is much less tender. The headache much relieved, and the general febrile symptoms are less.    Continkue.
May 2d to the 6th.-She has continued to improve. To-day the
reportis: no appearance of inflammation about face or sealp; desquamation; bowels quite regular; tongue moist; no fever.. Sulph. 6.
On the 9th.-Dismissed cured.
CASE II.-FIBROUS TUMOR OF THE UTERUs.
May lst.-Jane Leatherbarrow, aged 39, married, mother of several
children. Eighteen months ago had a miscarriage, since then bloody
discharge, very offensive, fiequently clottted. The lips, gums, and
conjunctiva excessively pale; eyes surrounded with a dark circle;
-cotmtenance anxious; pulse rapid and feeble; anorexia, nausea, and,occasional vomiting; pain and tenderness in the right iliac region;
sleepless nights,
Secale 1stilecimal dilution. Cocculus 3d ditto, every three
hours alternately.
2d.-Less discharge; nausea relieved.    C6ntinue.
3d.-Discharge less offensive; pain in the side relieved; general
-appearance improving.




Manchester Homeo2patlhc Hospital.                99
4th.-Discharge not offensive, scanty, watery.    Continue.
From this date to the 14th, the general health continued to improve. Platinum, China, Ipecac., Ferrum, and Secale were prescribed
in succession as the symptoms seemed to indicate, and in the interval
an examination with the speculum was -made, which disclosed a firm
tumor protruding from the os uteri.
21st. —A ligature was passed round the neck of the tumor.
Armnica 1.
22d and 23d.-She has suffered considerably from abdominal
pain and retention of urine.    Bell 2 and Arnica 1, alternately.
26th.-The tumor separated this morning without'hemorrhage, it
was about 5 inches in length and about 21 in brea/dth,'lobulated on
the surface and somewhat kidney shaped, a section of it displayed its
fibrous texture. She left the Hospital on the 10th of June, perfectly
well and much improved in flesh and strength.
The above case appears interesting, in so far as it shows
the effects of the homceopathic remedies in palliating the
symptoms [previous to the removal of the tumor by operation, and although the urgency of these would not permit of
a longer trial of their action in this case,-in others, less exhausted, might not their continuance lead to a cure 
CASE III.-PLEURO-PNEUMONIA.
May 4th.-John Nicholson, house painter, aged 24; muscular.
Cephalalgia; pulse 112; skin burning'; tongue moist, with yellow
fur, red at the tip; eyes suffused; slight cough; stabbing pain, extending from the point of the right scapula and passing through the
chest to the sternum; dry crepitating rattle on the right side of the
chest posteriorly. Aconite B, Bryonia B, every two hours alternately.
sth.-Tongue cleaner; breathes with greater freedom: pain confined to a small spot to the right of the right nipple, still felt very
acutely on coughing; cough troublesome, with clear thick tenacious
sputa; skin moist; pulse 98; crepitating rattle as yesterday; bronchial
respiration.    Bry. B, Phos. B, every three hours alternately.
6th.-Less pain; more cough; sputa less tenacious; tongue cleaner;
pulse 86.    Continue.
7th.-Has passed a tolerable night, though much troubled with -the
cough; sputa yellowish; pain nearly gone.
Continue the Phosphorus alone, and give it at the 3d dilution.
9th. —is doing very well. Crepitus still audible posteriorly.




100                   Clinical Record.
12th.-States that he feels quite well, and is discharged with a caution to keep quiet for a few days longer. He presented himself a week
after, and had entirely got rid of his cough and the slight uneasiness
in the chest which he felt at first on taking exercise.
CASE IV.
May 29th.-Elizabeth Moorehouse, aged 23, married, and is nursing
an infant six months old, complaining for five days. Present symp4toms; intense stabbing pain in the left submammnary region and lower
end of sternum; troublesome short tickling cough; complete dulness
in the,two lower thirds of the posterior part of the chest, with entire
absence of the respiratory murmur; pulse 132.
Aconite B, Bryonia B, every two hours alternately.
30th.-.Still intense pain in left side, stabbing in character; skin
moist; pulse 128.    Bry. B; Phos. B, every two hours alternately.
31st.-Pulse 110; pain less stabbing in character; rather less dulness on, percussion, but the respiratory murmur is inaudible.
Bry. 3, Phos. 3,.every three hours alternately.:
June lst.-Pulse 96; less pain; respiratory murmur slightly qudible.    Continue.
2d.-Pulse 86; very little pain, and its character is now dull;
more resonance; murmur more distinct.    Continue,
4th.-No pain; very slight dulness; the left side expands on: deep
inspiration.
6th.-Respiration'tolerably free, and the respiratory murmur is quite
distinct; some dulness remains; she complains of nothing but weakness, and calls loudly for meat.
China A, T. Sulph. g, every four hours alternately.
l0th.-She is dressed, states that she is quite well; the chest not
examined, but as she breathed freely, had no pain or cough, and complained of nothing but the still too scanty diet, she was dismissed with
directions to. take a powder. containing one drop of T. Sulph. q, each
night for a we'ek longer.
Cases like the above have occurred to every practitioner
of homceopathy, but are particularly interesting to those
who have treated similar cases on the old plan.  What a
contrast does the noble simplicity of our treatment present
in its administration of a few remedies, and these apparently
inert to the labored complexness of the V. S. the Cucurb.
Cruent., the leeches, the blisters, and last, but most danger



Mlanchester Homaeopathic Hospital.            101
ous, the Calomel and Opium, (to ptyalism  sometimesdin a
strumous subject!)  In this aspect did it present itself to a
young physician, who'saw and watched the case of Elizabeth
Moorehouse, and from what he did see he concluded that
homceopathy was worthy of his serious attention. Since then
he has been steadily studying and is now a zealous convert.
CASE V.L-ACUTE PLEURISY.
July 4th.-Riley Thomas, aged 18, single, laborer, was visited at
his own home, and had the following symptoms, at 11 A. M.  Acute
pain in the right side, striking like a knife running into him, as he,said,
at every breath; his hand was pressed upon the side to restrain the
motions of the chest; breathing abdominal; great inclination to cough,
but restrained as much as possible from the violent pain which the effort
brought on; there was some dulness over the part, and upon applying
the stethescope distinct friction sound was heard; pain acute on pressing upon the intercostal spaces; had had rigors; pulse 104, full and
hard; skin hot and dry; tongue furred; countenance anxious; great
thirst; urine scanty aid high-colored; bowels relaxed from Sulphate
of Magnesia.
Take Aeon. B. Bry. 3, every hour alternataly.
7 P. M.-Found him much relieved. Pulse 98; could breathe comparatively freely; cough with very little pain; skin moist; thirst not so
urgent; countenance much more tranquil.
Continue every two hours.
5th, 9 A. M —Was removed in a car carefully enveloped in blanketa,
to the hospital.
2 P. M.-Symptoms aggravated in consequence of his removal. Fever increased; pain in side worse; tongue dry; diarrhoea has set in.
Aeon. 3, Ars. 6, every two hours alternately.
6th.-Slept tolerably well during the night; cough troublesome; still
pain in right side; no diarrhoea; tongue cleaner and moist; pulse 88,
weak; some dulness on percussion, no friction sound.
Continue Acon. occasionally, Mere. 1, Chin. A.
7th-M — ch better this morning. Skin moist; tongue cleaner;
bowels acted naturally last night; pulse 84, soft- and regular; slight
pain in right side; cough easier, with mucous expectoration.
Continue.
8th-Very much better, all pain gone. Cough very slight.
Continue.
9th.-Reports himself well and was discharged this day.




102                   Clinical RL'ecord.
CASE.  VI.RHEUMATISM.
Aug. 1Gth, 1850-.-Martin Corrigan,l aged 51,  laborer, married,
admitted into hospital- to-day. Has been exposed to cold and wet.
Complains of pains in the back and lower extremities of a shooting
character, with a sense of contraction in the tendons of the thigh;
urine scanty and high colored; bowels sluggish; he feels worse in a
morning.
Take Bry. B, Puls. 3, every two hours alternately.
17th.-Rather better.    Continue.
18th.-Much better. Complains now of pains chiefly in the knees;
perspiring freely.    Continue.
20th.-Better.
Take Bry. B, Arn. B, every three hours alternately.
Continued improving up to 23d, when he was discharged cured.
CASE VII.
Nov. 15th.-Margaret Hobbs, aged 26, married, came to the hospital as an out-patient. Has been subject to rheumatism.. Complains
now of pains in the joints of upper and lower extremities, more particularly of the ankle-joints and feet; is cold and chilly; thirst; pulse accelerated; tongue  furred; bowels constipated; urine scanty and
high-colored.
Take Acon. B, Bell. B, every two hours alternately.
16th.-Was visited at her own home. All the symptoms were much
aggravated. She was sitting close by the fiire, and still cold; pulse 100
and jerking; tongue much furred, dry, red tip and edges; face flushed,
skin dry; pains in the limbs very acute; ankles and feet swollen, hot
and painful to the touch; she dreaded'night approaching, the pains
were so violent when warm in bed, and prevented her sleeping. She
was ordered to continue her medicine, and to come into hospital the
following day.
I7th.-Admitted into hospital. Somewhat better, still pains acute
and ankle-joints and feet still swollen, hot, and painful to the touch;
she is unable to walk; bowels have acted; pulse 104, compressible.
Take BelL B, Rhus B, every two hours alternately.
19th.-Feels better; has had a better night; pain almost gone from
the right ankle-joint.    Continue.
20th.-Pains almost gone; legs continue swollen.    Continue.
23d.-Feels quite well, with the exception 6f some debility.
Discharged cured.




JManchester Homceopcatthic   ospital.           103
CASE VIII.
Sept. 2d.-John Mews, aged 38, married, admitted into hospital.
States that he has been ill for thirteen months. After unusual exestion he was seized with pain in stomiaach, and in the shoulders, armr,
back and lower extremities; the pains have recently become muchworse, and he cannot now raise the right arm; great pain in right
shoulder, between the scapulae and down the back; pain and stiffness of
the right knee, left leg and foot also very painful, with stiffness of -the
heel; left foot.very -hot; bowels regular; tongue coated and brown 
skin hot and dry; pulse accelerated.
Take- Bry. 3, Rhus 3, every three hours alternately.
3d.-Same.    Continue.
5th.-A little better. Tongue clean; bowels relieved.
Ordered a warm bath, and Ars. B, Bry. 3, every four hours
alternately.
6th.-Same. Perspired freely in the night after the bath; bowels
relieved; urine high colored, depositing a thick white sediment.
Continue.
7th.-  Profuse nightly perspiration affording no relief; skin hot;
bowels relieved; tongue coated; on examining the heart with the stethoscope a distinct bruit'is heard; action accelerated but feeble; starts
from his sleep with violent palpitation; increased dulness in the prse-.
cordial region.
Continue, Arsen. B, Bry. 3, every four hours alternately.
8th. -Same.  Continue.
9th.-Same. Continue.
10th.-Pulse 84; heart sounds more distinct.
lith. —Same.  Take Arsen. B, Digit. B, every four hours alternately.
12th and 13th.-Unable still to raise right arm.
14th.-Same. Continue.
15th.-Better.  Heart sounds more distinct, with bruit at apex.
Continue.
16th. —Tingling in right arm.    Continue.
17th.-Same.
18th.-Heart's action more distinct, and bruit not so marked; considerable pain in right shoulder.    Continue.
20th.-Same.




104                   Ci6nical Record.
2lst.-Better to day.  Heart sounds normal; pains much better;
leg and arm of right side continue a little atiff.
Continue Digit. B.,i Arsen. B.
22d.-Discharged; at his own request, as he states that he feels
nearly well.
CASE IX.
June 5th.-John Hiindley, aged 26, miner.- Several months ago was
seized with dull aching pain in the region of the kidneys, which was
followed with anasarcous swelling, commencing at the face and gradually extended over the body to the lower extremities, and which continues: legs,, feet, and abdomen are now much swollen, tongue coated
with a yellow fur; pulse rapid and feeble; bowels regular; urine scanty
and pale, with a greenish tinge.
Digit. 3, Ars. 3, every three hours alternately.
7th.-General health better; on examination, the urine was found
highly albuminous.    Continue.
8th.-Less swollen.    Continue.
9th, 10th and 11th.- Swelling diminishing; urine sp. gr. 10.12.
Continue.
12th.-Urine,-10.14.    Continue.
13th.-Urine, 10.18.    Continue.
15th. —Swelling very much reduced.    Continue.
July 2d.-Swelling has entirely disappeared, although the urine
still contains traces of albumen, and he left the hospital for the benefit
of sea-side air.
In this case but two medicines were given, Digit. and Ars.,
and the effect was to remove completely the dropsical affection in less than a month. Previous to his admission into
hospital he had for two months been under allopathic treatment, at one of the Manchester dispensaries, without receiving any relief, although the most potent diuretics, and amongst
the rest Digitalis had been unsparingly administered.
CASE X.-CONTINUED FEVER.
June 4th-J. Matthews, M.D. Febrile symptoms; great pain in
head; bowels confined for several days; pulse 140.    Acon. 3, Bell.
3, Bry. 3.
5th.-Tongue coated yellow; great heat and pain in head; bowels
acted upon; pulse better; debility.    Ars. B, Bell. 3
6th.-Less fever; less thirst; still bitter taste in mouth; tongue
less coated; pulse better; feels better, though week.    Continue.




-Manchester Homneopathic Hospital.            105
7th.-Slept better last night; symptoms much improved; tongue
cleaning; pulse increasing; bowels acted upon last night.
Ars. B, and Bry.
8th.-Same.    Continue.
9th.-Delirium this morning about 5 o'clock, threatened to get out
of bed; wishes to go out; pulse 94, small; tongue moist and cleaner;
forehead cool; debility much.  Bell. 3, Ars. B, and Stram. 3. 3 P. M.
— Great excitement; talks continuously of going home. Stram. 3,
Bell. 3. Half-past 7 P. M.-Found him up and partially dressed,
expressing a determination to go home; was eventually prevailed on
with much persuasion to return to bed. Aeon. 3, Ars. B, and Bell:,
si opus sit. Quarter past 9 P. M.-Less excitement, but very restless;
skin hot;. pulse 94, full; occasional muttering delirium. 10 P. M.More tranquil; inclined to dose.    Bell 3, Ars. 3.
10th, three quarters past 8 P. M.-Passed a pretty tranquil night,
was rather excited about 3 o'clock this morning, got up and wanted to
go away; he is now tranquil; pulse 94, small; tongue very dry; skin
hot; bowels were opened yesterday afternoon.    Continue.
lIth. —Slept well until about half-past 4 o'clock this morning, when
he got up and wanted to go down stairs, he said, for his clothes; the
nurse with some difficulty got him into bed again, when he became
quiet and remained so till this morning at 9 o'clock; pulse 86; tongue
moist; skin rather cool and moist; tongue coated yellow; bowels
regular; is rather inclined to ramble, but on the whole much more
rational than yesterday. Continue Acon. 3.!2th.-Slept well last night; skin moist; tongue moist and cleaner;
bowels acted upon last night; no rambling, is quiet.   Continue.
13th.-Slept well last night until about 8 o'clock this morning,
when he asked for his clothes, and desired the nurse to procure a cab
as he wished to go home; seems easier now; not much fever; bowels
regular.    Continue Ars. 3.
14th.-Had a very good night's rest; skin cool and moist; tongue
moist and much cleaner;, is much better in every respect.   Continue.
15th.-Slept very comfortably last night; skin cool and moist;
tongue cleaning; perfectly rational; bowels acted naturally this morning.    Continue.
16th.-Much better.    China 1, Bell. 3.
17th.-Convalescent.    Continue.




MANCHESTER HOM(EOPATHIC HOSPITAL.
Whether.I'
Disease.             Age.. under old How long ill. How long under     Event.                   Chief medicines used.
treatment.               treatment.
1 Anasarca.................   26        yes   several weeks   1 month           cured       Dig, B, Ars. 6
2 Abscess on left thigh.......  17      yes.6 months        6 weeks         cured       Nux B; Bell. B, Graph. 5
3 Ascites.................... 49                            2 weeks
4 Bronchitis ~................  31       yes                     2 weeks         cured       Acon. 3, Bry. 3, Phos. 3, Nux 3, Hyos. 1
5 Bronchitis chronica........   25      yes                   5 days (dis-  much relieved Mer. 3, Rhus 3
charged for
disobedience)
6'Cancerous mamma.........      45      yes       2 years       3 weeks         cured       Con. I, Nux B
7 Chlorosis............   24       yes      4 months       1 month         cured       Puls. 3, Ars. 6, Bell. 6, Sulph. 12
8 Catarrhal fever...........  25         no       3 weaks       3 weeks         cured       Bell. B, Aeon. B, Nux B
9 Cephalalgia.......
10 Caries, ankle joint amputated   15     yes      9 months       7 weeks         cured       ArnAm. A  Bell. B  Aco. B, Merc. 3
(amputated)
11 Delirium tremens.........  23         no.5 days          cured       Nux B
12 Diarrhcea chronica..........    43    yes        3 years      3 weeks         cured       Camph. O, Arsenic. 6
13 Dysuria................  43                                  3 weeks    much relieved Canth. 1, Sep., Sulph., Carb. veg.
14 Epilepsy.................   28        yes      14 years        1 week                     Calc. 12, Nux B, Bell. B, Hyos. B
15 Erysipelas...............
16 Epilepsy.................'26         yes       4 years       3 weeks     much relieved Bell. B, Nux Op.
17 Erysipelas, facial...........                                                 cured       Bell.
18 Epilepsy...................  11       yes                     2 weeks'       relieved     Bell. 3, Op. 1, Acon. B
19 Epilepsy..................   34       yes      11 years    in hospital
20 Erysipelas, facial' Hell. O, Phos. 3, Hyos. 1, Mere.
21 Erysipelas, facial........... 29       no    2 or3 weeks    1 week            cured       Bell. B, Aeon. B, Mere. 3, Petiv.,
22 Fistula lachrymalis........   30     yes                     2 weeks         cured       Mere. 3, Hep. 6, Sil. 12
23 Fistula in ano............ 45        yes       4 years      2 months                     Aeon. 1, Sulph. O, Hep. s. B
24 Gastralgia...............  34        yes                     5 weeks    much relieved Hyos. A, Nux Puls., Sulph. 12
25 Gastralgia, hysteria.......    26                            2 weeks    much relieved Bell. B, Bry. i, -Ignat. B, Nux B
26 Gastralgia...............   23                                                           NuxB, Puls. B, China 1, Bell.
27 Hysteria.................  38         yes       4 years       7 weeks    much relieved Ign. B, Nux 3, Cocc. 3, Mere. 1




28 Hepatitis, chro nic............n76  yes    14 months    2 months   much relieved Nux, Dig., Bry. B, Merc. B
29 Hemiplegia...............   59        yes     4 months      5 weeks        cured      Nux, Acon., Bry. B, Sab. B
30 Lateral curvature of spine.... 17      yes   several years   5 weeks    much relieved Teu. B, Iod. B, Bell. B
31 Lumbago...................  53                              3 weeks    much relieved Cann. 1, China 1
32 Morbus coxarius....8........    8     yes     9 months    2 months   much relieved Sil. 6,-Calc. 3
33 Mania....................  25                                1 day
34 Ophthalmia purulenta.........  35     yes                   10 days    much relieved Cann., Merc. 3, Con.
35 Phthisis pulmonalis...........54      yes     9 months      2 weeks         cured     Phos. B;Ars. B,  B Hyos., Bell.
36 Psoas Abscess.......          38      yes                   3 weeks         cured     Acon. B, Bell., Hep. s. 3
37 Pneumonia chronica?.........   16   yes     6 months      5 weeks       relieved    Phos. 3, Hep. s. 3, T. Sulph. 0
38 Pneumonia..
39 Phthisis pulmonalis.......... 20                            2 weeks                   01. Jecoris Ass., Phos.
40 Pleurisy...........        18               1 week       5 days          cured     Acon. 3, Rhus., Bry. 6
41 Pyrosis....................  33       yes      2 years      3 weeks   much relieved  Bry. 3, Bell. 3, Arg. nit. 1, Nux 15
42 Phthisis pulmonalis............  18   yes                   3 days                    Ars. B, China 3, Bry. B
43 Phthisis                       22      yes                   3 weeks         cured     Ars. 3, Bry. 3, Phos. 3, 01. Jecoris Ass., Sulph..
44 Rheumatism, chronic........    7      yes      3 years      3 weeks   much relieved&  Bry. B, Rhus B
45 Rheumatism, chronic..........  51     yes                   1 week    much relieved  Bry. B, Puls. B, Arnm. B
46 Rheumatism, acute..25..   25                                3 weeks        cured      Ars. B, Bry. B
47 Rheumatism..............38            yes    13 months    3 weeks   much relieved  Bry. B, Ars.B, Dig. B
48 Rheumatism, chronic.........  21      yes                   2 weeks        cured     Acon. 3,.Rhus, Bry. 6                        ~
49 Rheumatism, chronic........  42        yes     11 weeks      3 weeks:                  Bell. B. Bry. B, Rhus B, Sil. 3
50 Rheumatism, chronic........  55       yes                   3 weeks'        cured     Bry., Rhus 3, Sulph., 01. Jecoris Ass.      c~
51 Rheumatism, acute.....        51      yes                    1 week    much relieved  Bry. B., Puls. B., Acon. B
52 Syphilitic lepra...............    43  yes    6 months                                Sep. 3, Puls. 3
53 Struma of great toe..........  24     yes     10 months     1 week                    Sil. B
54 Struma of elbow joint.        1...   16  yes,  3 years      2 weeks                   Ars. 6, Rep. s. 3                           2.
55 Synovitis..................57         yes  several weeks  in hospital
56 Synovitis chronica...........  39     yes     3 months      2 weeks         cured     Sil. 12
57 Synovitis chronica.........   17      yes     11 months                nitch relieved  Calc. 3, Bry. B
58 Syphilitic rheumatism........    24   yes                   5 weeks         cured     Mere. 3, Rhus 1, Nit. ac. B, Calc. c.
59 Subacute pleuritis............  29                          3 weeks         cured     Mere. B, Bry. B, Acon. B, Bell. B
60 Typhus fever..................
61 Ulcers.....................    24     yes     9 months      6 weeks         cured     Lach. 6, Sil. 12, Puls. 3
62 Ulcer......................  45                           still in hosp. 
63 Uterine tumor...............    39    yes     18 months    2 weeks          cured     Sec. 1, Cocc., Plat. 6, Phos;               ^>




THE HAHNEMANN HOSPITAL.                                                                     09
This hospital has been in full operation since the 16th of October. We subjoin a short abstract of the cases that have been received
in-doors. The number of out-patients.treated up to this date (December 18th) is above 650.
Con {''.  I...... Duration of    Date
No. Sex. Age. doni    Disease.    disease before of admis- Date of  Result. Chief Medicines                   REMARKS.
_Ion                 admission     sion.  Discharge.            given.
1  M   13   S   typhus fever        5 days    Oct. 18  Oct. 30   cured  ars. 3, bell. 3, Not a very severe case; delirious for four nights after
bry. 3        admission..
9 [ M! 40 IM     hypertrophy ] 10- months  Oct. 23 ]Nov. 25  greatly' rhus. 3, nux For ten months he had been in allopathic hospitals and
of the heart,                               improved  vom.2,bry.3,  dispensaries; amongst the medicines' he took were  T
with fever                                            spig. 2, merc.  strychnine, sesqui-carbonate of iron, vinum antimonii, c>*
30, cocc. 12,  nether nitricus, acidum  sulphuris, &c., without any a
aur. 12       relief: for the last five months he had every second
day castor oil, to relieve his costiveness. The palpi- 
tation of the heart and even the bellows sound is C
greatly diminished, as well as a particular squeezing 9
feeling on the right side of the chest. He is still.
improving since he left the hospital, as reported on the
14th December by his'wife. The disease began probably after rheumatism of the legs.
3  M   28   S        rheumatic      2 weeks    Oct. 31  Nov. 9    cured  bry. 2, bry. 12 Till the day before his admission under allopathic treatfever                                                             ment. The pains and swellings of both his hands and
arms, which hindered the movement of these parts,
disappeared the sixth day.
4  M   17   S   violent  rheu-  2 weeks    Oct. 31  StMI in   cured  bry. 12, rhus The patient came very emaciated, and looking very pale,
matic fever                         hospital           12, bry. 3,  to the hospital; almost all the articulations, and even
mere. 30,    the bowels, were very painful. Onthe 15th November
colch.3, chin.  he was without medicine, and allowed to g't up, as he
5, rhus 12    had no complaint; the following night he had a




return of his disease in a less violent degree, and
the last few days he is again up for some hours at a
time; it is more for his general strength that he  is
still in the hospital.
5   M    18    S   orchitis  from  gonorrhea a  Nov. 2  Dec. 2   cured  acon. & puls., Aconite, Puls. and Clematis for the acute stage of orchisupprlessed   month since,                             clem., cann.,  tis; Cannabis, Mere. and Sulph. for the gonorrhcea,
gonorrhcea  orehitis 4 days                             nux, canth.,   and Nux for dyspeptic symptoms. The gonorrhcea
mere., sulph.   was not cured.
6   F   13    S        cardiac      6 months   Nov. 10  Nov. 21   much  spig. 3, bry. 3, Loud bruit with heart's first sound, and great pain in the
disease and                                     better   bell. 3        heart and limbs; the pains were quite removed by the
rheumatism                                                              treatment.
7   F   17    S    inorbis coxa-    2 years    Nov. 11  still in limproved silie.,   puls., Has two abscesses on the left hip, one pn the left vulva,
rius                             hospital            cale., mere.   and one on the upper third of the right humerus; the
phos.          Mercurius lessened the night sweats and improved the >
condition of the pus.
8   F   20    S    irregular and irregular for 5 Nov. 14  Dec. 2    cured  puls.,  sulph.,
suppressed    years, sup-                               nux, bry. and
mnenstruation; pressed for 6                             cale.
swollen legs    weeks
9   F   21    S      pleurodynia    3 weeks   Nov. 14  Nov. 23   cured  bry. 3, arn. 3, The pains were so violent, and accompanied by fever, k
nux v. 4       that the disease was very similar to an inflammatory
state.  Since the 21st Nov. she was without medicine.
10  M    10    S       bronchitis,    3 days    Nov. 14  Nov. 22  cured'bry. 3, puls. 3 A very scrofulous subject; much concomitant gastric -
acute                                                               derangement.
11  M   45    M         diarrhcea      3 days    Nov. 15  Nov. 18   cured  nux 3, ars. 6  Affected besides with chronic dyspncea, which was not
treated.
12  RM   47    M    typhus fever    5 days,   Nov. 19  Nov. 22    died  ars. 3, bry. 3, Very much addicted to drinking; the fever was complibell. 3, op. 3,  cated with delirium tremens and nearly total supprestart. em. 3    sion of urine.  He died quite suddenly in convulsions.
13   F   35    M      typhus fever   10 days    Nov. 19  still in' convales- ars. 3, bry. 3, This case presented very bad symptoms: almost uninterhospital   cent    bell. 3, carb-  rupted delirium  for the first ten days, mouth covered
v. 5, mere. 5,  with black sordes, tongue hard, black, dry. After the
stram. 3       delirium left, was very weak. Is now almost well.
14   F   10    S      typhus fever    4 days    Nov. 19  still in   cured  bry., nux v., Is only in the hospital for weakness. 
hospital           chin.




Ci       Disioneo                  Date    Date of   Result    Chief 1\edi-                    REMARKS 
No. Sex. Age. dio       ieae      disease before of Admis- Discharge.       cines given.
admission    sion.
15  M   17    S       bronchitis     1 month    Nov. 23  Dec; 72   cured  acon. 3,bry. 3,  e 29th November,  the tenth day, the bronchitis' was
and                                        and    calc. 12, puls.  cured.  The three last medicines were administered
hypertrophhy    4 years...............    improved 30, aur. 12,  for the heart disease; he was obliged to sit up in the
of the heart                                          china 30       bed when he entered the hospilal-7when  he left he
preferred to lie almost without "a pillow. The disease
of the heart originated from a rheumatic, fever four
years ago for which he was treated.
16  F   24    S   chr.  metritis   14 dais   Nov. 23  Still in    -        acon. 3, arsen.
gast. ent.                        hospital           3, puls. china
general debility
17'F  27   M    *gastr. enteritis    4 days    Dec. 2  Dec. 11 convales- acon. 3, arsen.
cent    3,  puls. 3,
biyon. 3
18   F    7          gastric fever   2 months   Dec. 2  Dec. 10   cured  bry. 3, ipec. 3, This child suffered, in consequence of aperient medicines,
and diarrhcea                                          china 3        for two montbs from diarrhcea 7-8 times a day; she ~
was very  emaciated, the abdomen  tympanitic, the  o
pulse extremely weak, and deaf for some days before  I
her admission. These details were reported by the
mother only the second day, and then only she got
ipecacuanha, on which she became better; the eighth
day her deafness began to diminish suddenly, after
having slept a great deal.   China was given  only
after she got up the first time from her bed.
19   F   32    S      bronchitis     3 weeks    Dec. 2  Dec. 15   much  nux 3, ars. 3  Great dyspncea and much viscid expectoration, could not
improved                 lie down  at night; these symptoms  were nearly
removed and the acute attack cured, but there remained chronic bronchitis, to which she had long been
subj ect.




20   F   35  Wid. chronic bron- for years; the Dec. 3   Dec. 13  slightly  aeon. & bry., Was relieved of pain in the chest, and cough, but remainchitis     present at-                    improved   mere. phos.,  ed in a sinking state, and left the hospital of her own
tack for some                                calc. c.      accord.
months
21  EF   13    S        ancemia        1 year      Dec. 3   Dec. 13 improved ferr. &  china Left the hospital of her own accord.
22   F   22    S   bronchial irri-   2 weeks    Dec. 4   in the    cured  bry. 3, nux 5,
tation.                           hospital             ipec. 3
23   M   32    S   dislocation  of    3  a         Dec. 11  still in           arnica, rhus.
the sternal                         hospital
end of right
clavicle               a{
24   M   2`0    S       disease of    6 months    Dec. 1       in   improved aeon.,. bell., The fit of delirium did not come on, although the premo-  s
brain, indu-                         hospital             bry., nux     nitory signs were present.  Bry. and Nux given for
cing delirium.                                                           gastric symptoms. Mother subject to epilepsy before his
birth.
25   F   22    S       gastro-en-      7 days    Dec. 15  still in  convales- nux vom. 6
teritis                           hospital'  cent 
26   F    3    S       bronchitis      5 days      Dec. 15   still in  convales- acon. 3, bry. 3
hospital   cent
QQ
9c"




WM. RADDE,
PUBLISHER, 322 BROADWAY, N. Y.
HOMCEOPATHIC MEDICINES.
WMa. RADDE, 322. Broadway, New-York, respectfully informs the Homomopathic Physicians,
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and the friends of the System, that he is the sole Agent for the Leipzig  Central Homleopathic Pharmacy, and that he has always on hand a good assortment of the best Homceopathic
Medicines, in complete sets or by single vials, in Tinctuzres, Dilutions and Triturations; also
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Cases, at $3, with Family Guide and 27 Reemedies. —Cases containing 415 Vials with Tinctures
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Chocolate. Refined Sugar of MIilk, pure Globules, etc. Arnica Tincture, the best specific
remedy for bruises, sprains, wounds, etc. Arnica Plaster, the best application for Corns.
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