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       Surgeon  General's  Office











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^Gi3,^A.Q'QCiaQNaaQaagQOQ3>agQOQ<3'e$& 
 
 
UTERINE  DISEASES,
      WITH AN APPENDIX,
CONTAINING AN
ABSTRACT OF 180 CASES
UTEKINE  DISEASES AND THEIE TEEATMENT,
TOGETHER WITH
ANALYTICAL TABLES OF RESULTS, AGES, SYMPTOMS, ETC.,
TO WHICH IS ADDED
A CLINICAL RECORD OF INTERESTING CASES, TREATED IN THE MANCHESTER
             HOMOEOPATHIC HOSPITAL.
/
BY HENRY R. MADDEN,- M. D.
              <y/ZMlt
               NEW-YORK:
   WILLIAM RADDE, 322 BROADWAY.
Philadelphia: Rademacher & Sfeek.—Boston : Otis Clafp.—St. Louis:
      C F. Wesselhoeft.—Cincinnati : H. F. Davis, M.D. 
1852,
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 revolu-
tion, 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 Eemales which are
attended by Discharges," from the pen of Sir Charles Clarke, in
the year 1814, the medical men of Great Britain appear to have
been in almost mid-night darkness respecting the true nature of
this most common source of delicacy among females; and sub-
sequent 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 passant 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 appoint-
ment of the present Midwifery Professor of Edinburgh however,
a most complete change has occurred in the feelings of the pro-
fession 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.  Madden,
fer from an evil the very opposite of that which characterized
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 cer-
vix ' 'retroversion,' or some other metritic malady, the very
mention of which has a 'harrowing interest' for the poor suf-
ferer.  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 super-
structure will excite some doubt as to its stability and endur-
ance.   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 com-
manded 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 the consideration of
  Subacute and Chro7iic Inflammation of the Uterine Tissues,
and still further to limit our subject, I shall confine my obser-
vations chiefly to the disease in its most common form, namely,
as affectiDg chiefly the cervix uteri, and as limited to the mucous
membrane of that portion of the genital apparatus.  Although 
on Uterine Diseases.                 5
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 of the profession
that instrument of diagnosis, which is now so well known by
the name  of the Uterine Sound ; and he, at the  same time, in-
formed 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 frequent accompaniments of
uterine derangement. Nay,more,he believed himself authorized
in affirming, that these flexures were the cause of very much, if
not of all, the distressing symptoms under which such patients
suffered ;  and yet further, he added, that these morbid condi-
tions 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 thera-
peutics.  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 chief study. Neith-
er 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 pro-
gress, 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
Dr. Madden.
some of the most ardent reformers of uterine pathology, and
who, themselves 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 Inflammatory 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 coun-
trv, I mean his work on " Inflammation of the Uterus and its
Appendages," published in  1849.
  Dr. Bennet and his 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, which have become known to the profes-
sion through its instrumentality; and so far from  viewing them
as the chief object of treatment, they aver that if the inflam-
matory condition of the uterus be subdued, no attention what-
ever need be paid to the bent state of the organ, save in rare
exceptional cases.  This opinion they support by the  declara-
tion, that when the flexure is slight it rights itself as the organ
resumes its healthy condition ; while, on the other hand, if the
flexure 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
neither method of treatment does any real good ? or should 
on Uterine Diseases.
7
we not rather examine the whole question more closely, and see
whether the two methods of treatment 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 of both ? This,
however, will be more 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, irre-
spective altogether of the school to which the propounders may
belong  ; for in this, a§ in most other instances, a careful and
dispassionate consideration of the statements made by each par-
ty 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 la-
bours 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 leucorrhoea 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 leucorrhoea, 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 leucorrhoea met
 with in this country.  The first  announcement of this doctrine
 in later years which I have met with, is by M. Lisfranc, in his
 Clvnique  CMrurgiccde, published in 1842, and reviewed in
 the Medico- Clivrurgical ^Review for April, 1843.  In that pe-
 riodical we find the following remarks (p.  366-1):—
   " Leucorrhoea.—The following most lucid exposition of the aetiol-
 ogy of this very common complaint is  given by M. Lisfranc:—
 'This disease  is produced either by a phlegmasia, or by an irritation, 
8
Dr.  Madden,
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 nineteen, 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 phy-
sician on this subject, as very few are likely to be misled by the fan-
tastic notions of many continental  writers."

   Such, then, is the opinion of an influential review, in 1843,
concerning the inflammatory nature of leucorrhoea. But what
says the same Eeview, or, rather, its  successor, the  British
and Foreign Mcdico-CMrurgical Review, in 1850 ? In speak-
ing of Dr. Bennet's work on " Inflammation 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 adopt-
ed, almost exclusively consisted in remedies to check the discharge •
every  variety of astringent was  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 fluoralbus  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
until 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 Diseases.
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  func-
tional ; and although often embarrassed to explain their anomalous
character, or to decide exactly upon the function that was disorder-
ed, a local phlegmasia 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 (Joctrine  of  the inflammatory origin of
leucorrhoea 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 leucorrhoea

   " Must for the future have a precise meaning, and be regarded almost
entirely as symptomatic of well-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 dispa-
ragement 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  opin-
ion, respecting the inflammatory origin of leucorrhoea, rests.
This  we find to be two-fold, viz., experimental and deductive.
   Experimentally, it has been proved by examination of the
uterus.   Deductively, the results of such examinations  have
been brought to bear upon certain cases, evincing  similar
symptoms,but where no opportunity for examination was afford-
ed, or where there appeared no paramount necessity for the
performance  of an operation which must ever  be far  from 
10                   Dr.  Madden,

a-reeable to the feelings  both of the  physician  and his

^Itls perfectlv obvious, that the true  nature of leucorrhoea
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 import-
ance of a physical examination of the condition of the gener-
ative apparatus in all cases of leucorrhoea; 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 employed 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 leucorrhoea, presented,
to a greater or less degree, certain alterations and morbid con-
ditions which obviously indicated the existence of inflamma-
tion.  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 inflam-
mation ; 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, and more especially those
 which I have had opportunities of fully verifying  in practice
   If a female, labouring under leucorrhoea, or even decided
 menstrual derangement, such as dysmenorrhea, monorrhagia 
on  Uterine  Diseases.
11
.  &c, be examined by the speculum, one or other of the follow-
  ing appearances will be detected.
    1. The cervix uteri may appear perfectly normal, smooth,
  and unctuous, and of its healthy pale flesh colour, and the os
  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 cervico-
  metritis, 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 severi-
  ty of the pathological modifications 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 ex-
  tends 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, to 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, 
12
Dr.  Madden,
that is to say, when the dilatation  only extends part of' the
way up the cervical canal, we may conclude, that to this ex-
tent onlv has the inflammation advanced.  Or, again : if the
dilatation only reaches to the os uteri internum, 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 pa-
thologists have spoken of several different kinds of ulcer as
occurring in this region, but, for practical purposes, three va-
rieties only require to be noticed, viz., the simple, which I
have just described; the syphilitic, which, according to Dr.
Bennet, is of much  rarer occurrence than is generally sup-
posed ; and the phagedenic, which is a much graver disease,
is of by no means frequent occurrence, and is  most usually
associated with cancer, or some other malignant disease of
the uterine tissues.  These two latter varieties will not be ex-
amined or discussed in the present paper.
  4. A fourth stage of severity may be noted, when, in conse-
quence of the inflammation affecting the deeper tissues of the
uterine neck, there has occurred more or less extensive infiltra-
tion 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 unfavoura-
ble prognosis of a case, and to suspect the existence of schirrus •
it is of great importance, therefore, that we should bear in 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.
13
" Uterine Inflammation."  He remarks at p. 129, speaking of
Cancer:—
  " In the first stage of the disease, the uterine neck becomes very
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 seen, 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  project
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, consid-
ered as a whole, is, indeed,  lobulated, or rather divided into
segments by fissures, each lobule is smooth and regidar, 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, so 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  tu-
mours."—(Bennet, 1st edit. p. 130.)
  5. Hitherto I have been describing the disease as  confined to
the cervix uteri  and its canal; unfortunately, however, both for
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
Dr. Madden,
 frequency of inflammation of the mucous membrane of the
 cervical canal, than of true cndo-metritis, it is most obvious
 that chronic metritis, especially as affecting certain portions
 only of the  body of the  uterus, is a disease of extreme fre-
 quency, 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 con-
 venient limits will render such a course imperative.  I shall
 accordingly confine myself almost entirely to the develop-
 ment of the  results which have been arrived at by myself and
•various investigators, without detailing the controversial pro-
 cess 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 more at the commence-
 ment of pregnancy, it follows the well known curvilinear direc-
 tion of the pelvic axis, and in so doing it does not exercise any
 unequal pressure upon the surrounding organs, and according-
 ly unless the descent, or prolapsus, 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 Uteri/ne 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 Simp-
son would lead to the conclusion, that the affections of the
two walls are almost equally common, since he speaks of an-
tiversion 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 in-
fluence 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 en-
larged, owing to chronic metritis.  The uterus, in this instance,
Fig. 1.                    Fig. 2.     Fig. 3.
   v..
        \
will not follow the direct axis of the pelvis, but will be tilted
backwards, and thus assume the form represented in figure 4 of 
16
Dr. Madden,
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 fasces, 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 wjiich
Fig. 4.               Fig. 5.                   Fig. 6.
constitute different degrees of well marked retroflexion.  On
examining these two figures, you will observe one or two cir-
cumstances 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, project-
ing like a knuckle, immediately behind the point where the
mucous membrane of the cervix is reflected on to the posterior
wall of the vagina—and this projection will be found very ten-
der to the touch in many cases.  This projection'has been re-
peatedly mistaken for tumour, pelvic abscess, &c, and, more
recently, by some of the followers of Dr. Simpson, for the fun-
dus. 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 stretch-
ing of the posterior wall, consequent on the re-adjustment, it,
in many cases, altogether disappears.  In cases where the re-
troversion 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 greater
elasticity 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 series 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 un-
iinpregnated uterus, which appeared in the Monthly Journal of
Medical Sciences for September, 1848, after speaking of con-
gestion and enlargement of the uterus giving rise to displace-
ment, 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 retrover-
sion the posterior wall is felt to be enlarged and tender, where-
as, according to Mr. Bell's theory, it should be either healthy or
         PAM.—2 
18
Dr. Madden,
atrophied.   Again : Professor Simpson remarks, in his essay
on  " Retroversion," which appeared in the Dublin Quarterly
Journal of Medical Science for May, 184S, that—" in a large
proportion,  of cases, the retroverted  uterus is in no degree
enlarged or increased in volume, but natural in size."  Now,
while there are  certainly  many cases in which the normal
lengt!* 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 expe-
rience 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 unfre-
quent 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 be-
ing the ease, the mobility of the uterus at all times admitting
of considerable change of position by pressure,  etc.,  it will
often be impossible to judge whether the whole organ be sim-
ply inclined backwards, or is really more or less bent upon it-
self, and in  this  way, I feel assured, that many cases of sim-
ple  prolapse 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 Pro-
fessor Simpson's statement made  in  1843,  to the following
effect:—" There can be no doubt of the fact, that there seems
to be no organ in which there is a less strict  relation observ-
able between the intensity and character of the existing pa- 
on Uterine 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 combination
and  succession of functional derangements to which  they
give rise."*  And again, in  1848,  in  the paper already  re-
ferred 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."f  In the  disease under our  consideration for ex-
ample,  I have met  with the greatest possible variety in the
symptoms complained of, where a physical examination reveal-
ed the greatest possible correspondence between the pathologi-
cal conditions of the various  cases ; I have found enlargement
and  ulceration of the cervix uteri in a case examined for ano-
ther purpose, and where there was no detectable aberration
from robust health.  I have found the slightest of all the forms
of disease mentioned above, i.e., the first stage of cervico-metri-
tis, (vide p. 27,) where the constitutional  disturbance was very
grave, and the symptoms had continued a long time; and lastly,
I have known the symptoms to connect themselves as com-
pletely 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 of the pro-
bable or positive presence of uterine disease in any given case,
but  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. 
2D
Dr. Madden,
 little difficulty in arriving at a definite conclusion as to the ex-
 istence of uterine disease, while on the other hand it is very
 hazardous 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 treat-
 ment 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 specu-
 lum requires to be used, is far too serious an operation to be un-
 warrantably 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 sug-
gest 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 employ-
ment 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 a local investigation.
  Professor Simpson, in his paper on retroversion, gives a very
clear and concise summary of the symptoms attending that dis-
ease, which are, however, so precisely similar to those accom-
panying 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 equal-
ly apposite to the more comprehensive class of diseases  em-
braced by this paper.  Dr. Simpson remarks, " In retroversion
as in other morbid conditions and diseases of the unimpregnated 
on Uterine Diseases.
21
uterus, the accompanying sympathetic derangements or symp-
toms 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 mammas; 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 fur-
ther ; but before doing sol would make a remark which appears
to me of great importance.  "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 symp-
toms, 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 patho-
logical 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 symp-
toms which are  the most severe and annoying, and one is re-
peatedly obliged to direct the treatment specially against some

    * Dublin Quarterly Journal of Medical Science, May, 1848, pp. 377-8. 
00
Dr. Madden,
symptom of peculiar distress  to the patient, although fully
aware that it is by no means inseparably connected with the d is-
easo in question; nay, when one knows full well that it may be
entirely removed, although the disease itself remains unchang-
ed.  This distinction between the characteristic symptoms < >f 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, pro-
vided 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 ques-
tion.  While, on the contrary, there has been too great a ten-
dency among our homoeopathic  brethren to regard those pa-
tients 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 uter-
ine  inflammation, or ulceration, by some celebrated accou-
cheur, and, who, nevertheless, pour into 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 con-
sequence of the continued diminution of the  symptoms which
led them to seek advice, while the speculum revealed the un-
welcome fact, that the disease  itself had throughout the whole
period of treatment, remained unaltered. We have thus two 
on Uterine Diseases.
23
 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 un-
 abated, 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 sense of
 dragging heaviness in the uterine region, most distinctly per-
 ceived in the erect posture, and accompanied at all times with
 an amount of general malaise and discomfort  altogether dispro-
 portioned 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
 discomfort,that the patient confines her complaints to the feeling
 of universalweariness and malaise, and it is only by direct inter-
 rogation that you ascertain the existence of the pain in question;
 and, nevertheless,as a proof that 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 of leucorrhoeay
 this symptom, however, cannot be viewed  as absolutely pa-
 thognomic of inflammation of the uterine neck, seeing that in
 some cases of well-marked disease, it is so small in quantity
 fhat 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
leucorrhceal secretion.  While, on the other hand, an occa-
 sional leucorrhoea 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. Madden,
   With these exceptions, I believe we may unhesitatingly af-
 firm, that, in every case of continued leucorrhoea, there exists
 more 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 cannot be considered as cured until the leucorrhoea shall
 have altogether ceased; nay, more, seeing that some degree of
 inflammation may exist without any external appreciable leu-
 corrhoea, it follows that we cannot actually pronounce upon the
 complete cure of any such case 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  respeet.  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,
from an almost colourless watery fluid to a thick viscous mate-
rial, more like tar in its aspect, and vying with ink in its black-
ness. As, however, all those, and many more varieties may be
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
almost continued agony which prevents all motion, are found
occurring in the loins and across the sacrum; the variety, how-
ever, 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 un-
der the left mamma, which, though proving so intensely trouble-
some in practice, are of little if any value as elements of diag-
nosis, 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
the 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 gra-
dually come upon them, assailing them with slow but  steady
steps, and gradually  incapacitating  them for one duty after
another, until, in severe casesj the sufferer is completely pros-
trated, 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 thie protracted
debility, and, in consequence, we have, in addition to the physi-
cal 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 frequency with which it
constitutes the chief cause  of the patient's application  for ad-
vice, is headache. This might almost be surmised from the re-
marks 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.  Madden.
pain,moreorlesspressive, 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
inihebaclc; 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 con-
stitutes at all a chief source of complaint, is usually the symp-
tom of all others from which the patient craves relief, and any
amelioration in this respect at once impresses her with the con-
viction that she must be decidedly better, and yet,there is scarce-
ly any symptom connected with this disease which is of less val-
ue 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 contin-
ues unabated, or even increases in severity.
  Various neuralgic symptoms occupy the next step in the order
of frequency, and, then, may be placed leucorrhoea, which thus
comes to occupy a position vastly different from that which it
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 inore might be advanced respecting the symptomatolo-
gy of this disease, but I feel my subj ect so much too extensive for
a paper, 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 ; it cer-
tainly has no great tendency to become worse, and as little dis-
position does there appear to be  to spontaneous amendment. 
                   on Uterine Diseases.                27
                                      *
I have known of cases which remained for months, or even
year:;, without any appreciable variation; and Ihave 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 some recent
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 extraor-
dinary to find it giving rise to an aggravated condition of the
pre-existing disease.  In  consequence of this tendency to peri-
odic aggravation, the disease never gets, as it were, an opportu-
nity of spontaneous cure, for long ere the process is half com-
pleted the recurring congestion reproduces the morbid condi-
tion, 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 slight-
est  form of uterine inflammation have  completely shattered
health, you may occasionally meet with considerable enlarge-
ment, 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 inflam-
mation, the local disease  is to be considered the true point of
departure from the healthy state. This is a 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 conclu-
sive 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, how-
ever, 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., 1st. That in the vast majority of females 
o>                   Dr. Madden,
                  *
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 dif-
ficult 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*rare-
ly 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 entire-
ly successful,  unless combined  with means which  will, at
the same time, cure the  uterine  disease.  The reason for 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 pro-
gress  is not to be wondered at when we  consider that every
month there is a considerable risk of arelapse, and, accordingly,
it is only from month to month that we can be assured of having
gained any step towards recovery. Beyond the question of time,
however, the prognosis may be  decidedly favourable, as the
vast majority of patients recover  if judiciously treated.  Let us
now, therefore, proceed to the examination of the most practical
and important part of the whole subject—viz., the

              Therapeutics of rais  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 I had
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 my own cases will occupy all the
remaining time which can be allotted to this  paper, I have
limited 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  se-
lection, 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 at-
tended during my residence at Brighton, a period of 5| years,
and they constitute the majority 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 dis-
eases 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 subj ected to examination, and
 hence it follows, that I cannot speak with absolute certainty as
 to the existence of inflammation of  the uterus, or its conse-
 quences in every case ; nevertheless, I have carefully applied
 the principles laid down in the remarks I made upon diagnosis,
 for the purpose of avoiding error as far as possible, and by com-
 paring the characters of the unexamined cases with those which
 were submitted to this method of diagnosis, 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 impo*
  Bible 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 a
  large 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.  Madden,
 that the means of diagnosing the probable existence of the dis-
 ease are very trustworthy. It would serve no useful purpose to
 explain the various reasons why the whole cases were not exam-
 ined, 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 treat-
 ment alone,—I can safely affirm, that  it was not because  I
 concluded there was no detectable uterine disease that I abstain-
 ed 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 com-
 plaint. 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 eauses of her com-
 plaint, it follows that no true comparison could be made 1; ct ween
 the characteristic symptoms and the effects of the remedies em-
 ployed, 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
 leucorrhoea, 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 co-
 lumn devoted to the state of the menstrual functions, I have en-
 deavoured to indicate its precise condition in every instance
in as far as that could be done  without  entering into details
and hence a summary of these conditions, such as is <riven 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 perfect transcript of the treatment, but I
soon found that such a course was both useless and unintelligi-
ble 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 inexpli-
cable 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 pur-
sued 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 in-
terval of two days between each course. The order in which the
medicines are put down is the order in which they were admin-
istered ;  I  have not, however, indicated whether the remedies
were given in immediate succession, or whether other medi-
cines 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 pro-
ceed 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 homoeopathic
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 
Mi
Dr. Madden,
 characterized by two series of phenomena, composed respect-
 ive! v 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 homoeopathic remedy.   Let us
 therefore turn to the Materia Medica, and ascertain wrhether
 it is rich in remedies which have been proved capable of pro-
 ducing the various symptoms complained of by females suf-
 fering under uterine Inflammation, and at the same  time of
 inducing those local changes  in the uterine tissues  which es-
 pecially 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. " Irregularity of the os uteri," as a symptom of natrum
 carbonicum; reported by Noack and Trinks,  but not to be
 foimd in Hahnemann's  Chronischen Krankheiten, which con-
 tains the original proving.
  2. " Metritis," as  a sympton of  secale cornutum, reported
 in the proving of this remedy, which appeared in the Appen-
 dix to the British Journal of  Homoeopathy, and where it is
 quoted on the authority of Spajrani and L'Admirault.
  3. " Softness of uterus," a most indefinite and not very in-
 telligible term, as a symptom of opium, reported by Noack
 and Trinks, but not to be found in  Hahnemann's Eeine Arz-
neimittellehre, where the medicine was first proved.
  4. And lastly, " Swelling of the cervix," as a symptom of
cantharis, 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 symp-
tom connected with the uterus, which has not been obtained ex
usu in morbis, a source far too subject to fallacy to warrant our
trusting to it exclusively in our selection of remedies.  This 
on Uterine Diseases.
33
 extreme paucity of objective uterine symptoms cannot be won-
 dered at, when we consider the 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 im-
 mensely greater difficulty of inducing such to submit during the
 taking of the remedy, to repeated examinations by the specu-
 lum, obstacles of themselves sufficient to deter most men from
' entering upon such an investigation; it is very seldom warrant-
 able to continue the experimental taking of medicine until such
 time as actual organic changes have been produced by its toxic
 influence.  Being thus, in a great measure, shut out from this,
 the only absolutely trustworthy method of proving our reme-
 dies, 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 certain-
 ty, 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 extensive-
 ly 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 reme-
 dy capable of producing a given derangement of function, ac-
 companied by a certain morbid condition of the uterus,  can-
 not be viewed as truly homoeopathic to the same functional de-
 rangement in association with an altogether different local  state
 —so that we cannot arrive at any degree of certainty 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 corres-
 pondence detected, I should imagine the consequent selection
 of the remedy to be decidedly trustworthy.  In connection with
           pam.—3 
34                   Dr.  Madden,
this subject I have examined all the leucorrhocal symptoms in
the Materia Medica, and when analysed they give the following
results:—Leucorrhoea 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  s the mere fact of leucorrhoea
occurring is reported, without detailing its character or conco-
mitants ; and in 10 the symptoms appear to have been chiefly
derived " ex usu in morbis."   Now, the  duration of the dis-
charge is one of the most important characteristics, in as far as
occasional or temporary leucorrhoea can  never be viewed as
pathognomonic of an inflammatory condition of the uterus ; ex-
perience 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 Materia Medica, regard-
ing the length of time during which the leucorrhoea lasted in
the different provings, we find, as I before remarked, only 12
instances in which this is noted,  and of these, with one excep-
tion, 10 days is the longest period observed.  The exceptional
case is that oiignatia, concerning which Hahnemann reports,
as a symptom, " long-continued leucorrhoea."
  These facts collectively  lead us to the conclusion, that as yet
we have no absolutely certain guide in our Materia Medica
towards the selection of the most suitable remedies for this
disease, and as corollaries to the above we may conclude—
first, that should homoeopathic 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 homoeopathic  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. Yery many patients will say
that they feel quite well, and will return to their ordinary avo-
cations, while continuing at times to experience unpleasant sen-
sations, which would induce a more fastidious person to 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, in-
variably distinguished those who, though greatly benefitted,
had not felt so for a sufficiently long time to warrant the conclu-
sion that they would continue to enjoy comparative health, and
have denoted these as having "left treatment too early to judge."
  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, 112 were cured or greatly  benefitted,  51 re-
ceived benefit, and 17 remained unchanged : this gives a per
centage of 62| 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 oi
t 
36
Dr. Maddoi,
the treatment can be obtained. Of the 22 cases still under treat-
ment, 10 are reported as greatly benefitted, and 12 as some-
what benefitted ;  and of the 34 who left treatment 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^.
  I have already stated (p. 46), that early in my homoeopathic
career I had been led to  expect such perfectly satisfactory re-
sults 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 wTas found-
ed on the general reports of the degree of success of other ho-
moeopathic 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 homoeopathic 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 cor-
responding accurately to the disease under our notice. The local
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 me-
chanical means introduced to the profession by Dr. Simpson •
and, 3. various caustics,  especially the nitrate of silver.
  Of the douche I need 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.                37
prescribe it. I have found it, in many cases, a very useful adju-
vant, 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 retro verted 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 treat-
ment 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 assume its abnormal position.
In one case of considerable engorgement of the uterus, with
slight prolapse, but no other  mal-position (case 103), I em-
ployed 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 the 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 de-
cidedly did harm, the patients being in every respect worse af-
ter its employment than before; in  one the benefit was but
slight, and in six the patients recovered, but in three of these
the treatment was immensely aided by the use of Caustics, thus
leaving ^  only of the cafces  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 instru-
ment caused  so much local discomfort, after the patient had
worn it S\ months, that I was obliged to remove it, and I then
found that the uterus, though benefitted, had by no means 
38
Dr.  Madden,
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 unphilosophi-
cal.  My belief is, that it  acts by converting a partial into a
general affection. I have already stated my belief that flexures
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 increa-
ses this congestion, and causes it to spread over the whole ute-
rus, 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 re-
moval 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 the
purpose 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; and,  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 homoeopathic 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 Uterine 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 haemorrhage; and as regards its local action, it produces a
diseased condition which most strikingly resembles the different
stages of cervico-metritis. If, 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 ag-
gravated, indeed it is 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 :*f 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 distin-
guish between them.   An example of this occurred in case
180.  Again: the experiments of Professor Simpson, of ap-
plying pulverized Nitrate of Silver to the interior of the uterus
itself, have shown that while acting locally on the uterus, it sym-
pathetically affects the ovary, in so much as in a case of amen-
orrhoea, where he employed this means to endeavour to restore
the menses, and where the 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, in
addition to its obvious chemical efects, acts in such a manner
upon the uterus when applied locally, that it may be viewed in
the light of a strictly homoeopathic remedy.  Analagous argu-
ments might be brought forward in respect to the only other es-
charotics which I have employed, viz., pernitrate of mercury
2^&potassafusa,\>yh 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 argentum nitricum when employing the Ni-
trate of Silver locally, and administering one or othe* of the
preparations of mercurius when using the pernitrate of mercu-
ry. Lastlv, I have of late been trying the effects of certain other 
40
Dr.  Madden.
remedies, as kali bichromieum, and the cloridcs of gold, plati-
num andft'w, as local remedies, having been led to their employ-
ment by their homceopathicity to various phases of this disease;
my results, however, are not as yet sufficiently definite to admit
of my drawing any conclusions from them. On referring to table
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 ware cured or greatly benefitted; while
of 105 cases treated entirely  by general remedies, only 63 re-
covered ; or, in other words, while 73| per cent, of those 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 ah nost 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 ex-
perienced 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 men-
tioned 36 who had been previously subjected to general treat-
ment, and of whom, at  the time the local treatment was com-
menced, 25 had received no benefit, while 11 had experiencd
some degree of relief.  Calculating the per centage upon these
data ifr will be found that, while the combined local and general
treatment cured or greatly benefitted 73£ per cent., only 44* 
on Utervne 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 cure the local manifestation of the disease, they leave
the constitutional derangement unchanged. But this argument
cannot apply to the treatment I am advocating, wherein the con-
stitutional is invariably combined 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
thel80 cases treated,will show that it contains materials where-
with 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 found 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 sub-
jected 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, those between 30 and 35 proved the most
manageable, no less than 82| per  cent, having been cured or
greatly  benefitted.  Then follow the cases occurring between
20 and  25, of which  76£ per  cent, yielded to treatment; be- 
12
Dr. Madden,
twcen 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 56£; and lastly, from  25 to 30,
half yielded to the means employed.  Again: confining our ob-
servations to the graver cases, we find that between 35 and 40,
no less than S4£ 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 benefit-
ted; while between 30 and 35, only 46£ 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. Influence 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 ap-
pear to be more readily cured, since 30 out of the 46 were cured
or greatly benefitted, i. e. 65\ 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 occur-
rence, is of a more inveterate character in the unmarried female.
  3. Influence of the state of the  Uterine Functions.  From
table 5 it appears, that in 52 cases the menses were regular, and
of these 72-/^ 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 fre-
quency, we meet with the complete absence of this secretion,
36 cases of amenorrhcea being reported, of which 70T9^ 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 Uterine Diseases.                43
    benefitted.  On the whole it appears that whereas irregularity
    as respects quantity is much 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 treat-
    ment, while of 9 cases wherein it was  delayed, 33^ per cent.
    were cured or greatly benefitted.
      4. Influence of the Duration of the Disease on its Curabi-
    lity.  The 3rd table in the Appendix shows us that a large ma-
    jority 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 pe-
    riod during which the treatment was continued; and if we sub-
    divide the table into sections, we find that of the whole 83 cases
    cured, 50 or 6Q\ per cent, recovered within six months; while
    23, or 27| per cent, required various periods, from six months
    to upwards of two years, to effect a cure. And of 7 the dura-
    tion of the treatment cannot be accurately calculated as they
    were only seen occasionally, and often at considerable intervals.
      6. Influence of the Presence of Leucorrhoea on the Curabi-
    lity of the Disease.  I have already mentioned, that of the 180
    cases reported, 134 had more or less well marked leucorrhoea,
    and as this 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 
14
Dr.  Madd,n,
residt, viz., that of the 83 cures whose results can be sufficiently
traced, 66, or 79 \ per cent, were suffering from leucorrhoea.  < )f
the 2* somewhat benefitted, 10, or 35 J per cent, showed this
symptom; while the whole of the 13 who remained unchanged,
presented this symptom.  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, leucorrhoea, in 44 per cent, of whom it was recorded
as copious; while of the 30 cases cured by combined general
and local treatment, 66% per cent, had leucorrhoea, and 33^
per cent, are reported as having had it copiously.
  As respects the Age. Leucorrhoea occurred on the whole most
frequently between 30 and 35, while the greatest number of co-
pious cases were between 30 and 40, especially during the latter
half of that period.   With respect to curability, the cases cha-
racterized 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 leucorrhoea
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 leucorrhoea, we find that 65 of these
were married, while 39 only were single, showing a large pre-
ponderating frequency of the occurrence of this symptom among
married females.  In connection with the* state of the uterine
functions, leucorrhoea has more frequently accompanied regu-
lar menstruation than any of its abnormalities, and among the
latter, it has been most frequently associated with copious men-
struation ; next in order, comes scanty menses; then amenor-
rhcea; then dysmenorrhcea, and what would hardly have been
expected, it occurs least frequently when the menses themselves
were prolonged.  As might have been anticipated, the com-
parative frequency of the occurrence 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  Uterme  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 6| months, being about three
weeks above the average of the whole cases, irrespective of
the existence of this symptom.
   7. Influences 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 fre-
quent 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 con-
stituted 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 m the back, 28, or about 56 per
 cent., were restored to health.  Of 31 cases, where the suffer-
ings 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 leucorrhcea
 constituted a chief source of annoyance, 19 recoveries occur,
 thus giving a per centage of 69.  Dyspepsia appears the next
 in frequency, having been reported 27 times as characterizing
 the case, but the cases wherein it existed as a prominent symp-
 tom 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 bewmg down pain, 14,
 or 58 per cent., were cured or greatly benefitted; and of 18,
 who suffered much from characteristic pain in the left side, 13,
 or 72 per cent., were restored to health. Menorrhagia was the
 chief cause of 15 cases applying for advice, and of these 10, or 
46
Dr. Madden,
 66 per cent., were cured or greatly benefitted; while of 14
 cases suffering especially from dysmcnomdxva, only 0, or 42
 per cent., are found among the list of cures.  A general sur-
 vey of this table will corroborate fully  the remark I made
 previously, to the effect that many pains of frequent occur-
 rence are by no  means as frequently complained of by the
 patient.   Pain  in the  left ova eg, 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. Influence of the various objective 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, that of ulceration of the cervix, was
 the most 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 suf-
 fering under engorgement were restored to health.   Of the
 11 cases, where the uterus 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 spec-
 ulum was not employed, neither was any local treatment had
 recourse to, 8 cases only, or 40 per cent., regained their health.
  9.  Influence of various Remedies upon the Constitutional
Symptoms, which accompany this Disease.—In a chart which
 constituted Table No. 8,1 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 how-
 ever 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 end-
less business to direct your attention to all the points of inter-
est 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 smaljsed,pulsatiUa 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. Nux vomica is
on a par with sepia, in the frequency of its usefulness, and then
follows  sulphwr.  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
headache, Pulsatilla benefitted 35; this, however, does not prove
that Pulsatilla relieved the headache in 35 cases, but that 35
cases, relieved in there totality by Pulsatilla, presented head-
ache as  a chief symptom, and so with all the other symptoms re-
ferred to in the table. A very strong argument in favour of the
truth of homoeopathy 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, character-
ised by headache, being relieved bjptdsatilla; 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 Pulsa-
tilla ; and 11 out of 15  cases with menorrhagia,  receiving
benefit  h-omplatina, it being impossible to conceive that any-
thing 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 homoeopathic 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 employ-
ment of auxiliary means was felt, it was not in consequence of
any want of care in conducting the homoeopathic treatment.
Lastly, we have some interesting facts respecting the compara- 
48
Dr. Madden,
tive effects of high and low potencies: for it appears from table
11, that  of 108  cases treated exclusively by high or low po-
tencies, So 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 con-
nection with this 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 leu-
corrhcea owe their origin to this disease, save when dependent
upon much graver causes.
  3. That many cases of functionally deranged menstruation,
are connected with this disease.
  4. That the constitutional  disturbance which 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 bene-
fitted, 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 treat-
ment, without any immediate relief to the constitutional dis-
turbance.  But once the local mischief is remedied, the consti-
tutional treatment becomes more facile, and affords a much
better prospect of complete success.
  7. That the treatment by general remedies alone proves suffi-
ciently 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  Uterine 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 gene-
ral 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  " similia
simibus 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 careful examination by the
finger and speculum.
   12. That owing to this same want of correspondence, and to
the extreme poverty of our Materia Medica in objective ute-
rine symptoms, our treatment of this disease by general reme-
dies 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 breth-
ren regretted that I had not entered into symptomatic details.
Nay—one  went so far as to assert that a  single fully deline-
ated case would have  been more useful than the 180 in the
condition in which they appear.  Now, the fact is,  that it is
simply impossible 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. Madden.
 the minute differences render all comparisons intensely diffi-
 cult, and often impossible.  Who has not felt this in our Ma-
 teria M<dica? wherein, if you attempt a minute comparison
#of two or more remedies, you soon land yourself in inextrica-
 ble 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 Hahnemann, in his oft-quoted chal-
 lenge of  1817.  "Take a case,"  said he,  "of course one for
 which a homoeopathic 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 homoeopathy shall be perfectly satisfied;
 apply that drug which shall be perfectly homoeopathic 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 effi-
 cient help, then publish the failure to the world in a manner
 which shall make it impossible  for me to deny the homceo-
 pathicity of the drug and the correctness of your proceedings,
 and the  author of homoeopathy will stand confounded and
 convicted."  Four separate reasons lead me to regret, exceed-
 ingly, that the above sentence has been so often and so boast-
 fully referred to.  1st. 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 homoeopathic to the disease, but still
 more contrary does it appear to be to the instances deduced
 from allopathic sources, by Hahnemann, in proof of the
 homoeopathic  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  influ-
 ence of  mixed medication.  2d. If the terms of  this  chal-
 lenge be accepted as the essential ground upon which the
 non-success of homoeopathy in any case must be based we
 cannot resist the conclusion, that all the so-called cures by ho-
t 
on Uterine Diseases.
51
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 adminis-
tration 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, homoeopathy 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 found possessing so absolute and minute a cor-
respondence 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  II. Davy, and while acknowledged by all as
absolutely superibr 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 glori-
ous therapeia.  4. The challenge as it stands proves injurious
to our cause, as it lays its author open to the charge of soph-
istry, since he  has not left the materials wherewith the test
can be applied; the state of our Materia Medica, where, from
an over desire to simplify, all clue has been lost to the  natural
grouping of the symptoms; the discordant opinions entertain-
ed respecting the dose and its repetition; the vague ideas cur-
rent as to the length of time  during which a remedy sustains
its action, and our almost entire  ignorance as to the recipro-
cal 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 Hahnemann
 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  be-
 tween the above  challenge, and that often given by school-
 boys  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 
52         Dr. Madden, on  Uterine Diseases.

most valuable in advancing our knowledge of therapeutics but
I maintain that it is impossible to test with absolute certainty
the correctness of the treatment of any case by the minute de-
tail of symptoms alluded  to in Hahnemann's challenge,  and
accordingly where a large number of cases of the same  dis-
ease are brought under review, it is quite unnecessary to en-
ter 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
detail would have extended it altogether beyond the ordinary
limits of an oral address.
  My views respecting the practical working out of the ho-
moeopathic principle may be briefly stated as follows :—We
must in the first place,  learn to diagnose the medicines,  just
as we would study the diagnosis of a disease, and  until we
have attained such knowledge  we cannot employ our  reme-
dies with  confidence.
  2d. As regards those maladies  which evidence themselves
by subjective sensations only, we cannot be too minute in
the examination of details.
  3d. Where objective symptoms exist, and where the actual
pathological condition is detectable,  we must consider a  cor-
respondence in this respect between the pathogenesis of the
medicine and the disease as a question of vastly more conse-
quence, than minute shades of difference in the subjective
sensations.
  4th. We shall find it of more practical 'value to gain ac-
quaintance with the sphere of  action of a remedy, together
with its characteristic groups of symptoms and special pecu-
liarities, than if we succeeded in retaining in our minds the
whole mass of symptoms  recorded in the provings.
  5th. In entering into minute detail we must  never  forget
that the power of accurate observation is  very small in the
vast majority of patients, and  hence the grounds' whereon to
rest our selection,  if influenced by minute  shades  of  differ-
ence, is very insecure, and may mislead us  far more than
the  well  grounded deduction of a pathological comparison
between the known action of the remedy and the ascertained
condition of the patient. 
53
APPENDIX.
             ABSTKACT  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  re-
entries 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  in-
stances of double entry  throughout the  abstract.

  Note 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 scale—
thus Puis. 3. denotes the 3d  centesimal and Puis. 3x the
3d decimal potency of this remedy. The  letter O denotes
the mother tincture. 
ABSTEACT OF ONE  HUNDEED AND EIGHTY  CASES,
etc. etc.
			i		Length of		
No.	Age.	Length of illness.	Uterine discharge. | Chief symptoms.		time under treatment.	Results.	Remedies which relieved.
1	29	6 or 8 months	Menses scanty — no Leu- Weak, dyspeptic, short-		9i months	Benefitted Puis. 3x—Sulph. 3— Calc.	
	Single		corrhcea breathed Xot examined. 1				12—Puis. 6—Nux vom. 12—Nux v. 6—Puis. 12— Sep. 12—Ferrum Sulph. lx—Arson. 6 0.
2	18 1 9 months		Menkes copious-—much Weak, dyspnoea, pain in		71 months	Has varied much, at times Sepia .">—Puis. 12—Bell.	
Single			Leucorrhoea. i back, nervous			much better 12—I^rn. •',—Bell. 3.v—	
			Examined	Vagina and Uterus very		1 Sepia 12—Puis. 3x.	
				sensitive			
3	21 12 months		Menses absent, never re-	Weak, severe headache	4 months	Cured. Has had relapsesPuls. 12—Kali carb. 12	
	Single		gular—much Leucorrhoea Not examined			of headache when mensesj Pi—Puis. 12—Kali carb. delayed 0—Sepia 12 12.	
4	16	6 months	Menses not commenced Chlorotic, vomiting, pains		10 months	Menses came on in four-'/i/y. 3x—Puis. 30 30—	
Single			Not examined i in abdomen			teen weeks and contin-i Sulph. 12 Sep. 12—.Val-	
			'			ued, but with much pain] pan ac. 1—Cocculus 3— at times—general health Puis. 6.	
	i		i			better	
5	20 6 months		Menses absent—frequent Palpitation, dyspnoea, de-		2 months	Some benefit Sep. 5—Natrum mur. 12	
Single |			Leucorrhoea bility, pains in back and			■ Ferr. ac. 2.	
			Not examined •	abdomen			
6 1 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 o.	
i Simile			Leucorrhoea	back '		ses returned, and she was 3 6,	
1			Xot examined			well	
 
  15
Single

  28
Single
  22
Single


  25
Single

  18
Single

  20
 Single
40—50
 married,
 a large
 family.

  25
 Single
  25
Single

  26
Single
 Many years




 Some years



Many months


 7 months


 2 months

 2 or 3 years



 6 years




 a long time


 3 years
Menses irregular — some
  Leucorrhoea
Not examined
Menses very  scanty  and
  painful—slight  Leucor-
  rhoea
Examined

Menses very  scanty, too
  late, and painful—much
  Leucorrhoea
Xot examined
Menses scanty and pal<
  copious Leucorrhoea
Xot examined
Menses absent—no Leu-
  corrhoea
Not examined
Menses absent
Xot examined
Menses very copious every
  14" days—some Leucor
  rhoea
Not examined
Menses very scanty

Xot examined
Menses regular — copious
  Leucorrhoea
Xot examined
Menses regular—painful

Xot examined
Headache  and  irregular 4 months
  menses

Extreme  debility,  net- 6 weeks
  vousness, pains all over
  especially in light ovan
Uterus tender, but looks
  healthy
Dysmenorrhoea,     head- 12 months
  ache, dyspepsia
Leucorrhoea, Debility     6 weeks
  (faceache,)   backache

Vertigo,   congestion   of 1 month
  head, flushed face

Headache,      tremulous 1 month
  weakness
Menorrhagia,  burning in 3s months
  back, debility, &c.
Dysmenorrhoea,  pain  in  3J months
  back
Languor  and  debility,  18 days
  cough

Dysmenorrhoea, severe ab-  7 months
  dominal  pain  for a
  week before  menses
Improved
Bell.  6 —Puis.  6   12-
  Kali c. 6—Sep. 12  12.
Not   much  change—was Arsen. 30.—Bell. 3.
  formerly under my care
  many months with doubt-
  ful benefit
Occasional  relief, 'but  nei
  ther great,  nor  perma-
  nent

Improving,     Leucorrhoea
  much better

Nearly cured, menses have
  returned,  some  nervous
  trembling alone remains
Headache  better,   menses
  returned
Benefitted,    but   varied
 much—left the Town
Sep. 12—Puis. 6—Cocc. 3
  —Nux v. 3—Graph. 5.
  Bell. 3x.—Graph. 5.

Sulph. 12—Calc. 12.
A^con. 3.—Bell. 6.
Puis. 6.

Vinca a 1-20 Bell. 3—Plat.
  3 3—Rhus. 6.
Decidedly  benefitted,  but Nux v. 3.—Bry. 12—Sep.
  left Town.  I believe she   12—12—Alum.  12-
  had  retroversion, proba-   Berb 3.
  bly requiring mechanical
  aid
Decidedly  benefitted,  but Phos. 3—Sep. 6.
  left the Town
Varied much,  pain ceased
  for 2 and  3  periods and
  then   returned — there
  were   many  untoward
  moral causes in operation
  throughout
Carb. v. 5-^Sep. 12. 
No. | Age.
16
  33
Single
17
  33
Single
18
  16
Single
Length of
 illness.
Uterine Discharge. ^
Chief symptoms.
many years
Menses irregular, too late. Headaches—Hypogastric
  occasional Leucorrhoea    pain—Dysmenorrhoea
Examined once ' toucher
Cervix very tender, os pa-
  tent and edges soft as if
  excoriated
long  delicate,
 11 months ill
2 or 3 months
Menses too early, copious,
  Leucorrhoea  before and
  after menses

Examined ' toucher ' and
  'sound'
Menses too early—oopious
  and long
Xot examined
General debility — uterus
  only examined  shortly
  before she left Town
Os patent, considerable en
  gorgement of uterus
Anaemia,  debility,  head-
  aohe
Length of
time under
treatment.
18 months
on two oc-
 casions,  2
 months
 each time
5 weeks
Result.
In 1846 I treated her head
  aches with much benefit.
  During the  18  months
  of treatment for uterine
  symptoms, but little be-
  nefit accrued.
  N.  B.—This  case  was
  treated chiefly by corres-
  pondence.
Occasional   benefit :   but
  this  case  I  believe deci-
  dedly required local treat
  ment, which was not fol
  lowed, from want of op-
  portunity
Xot much benefitted before
  leaving town but she con
  tinued the treatment and
  got quite well
Remedies which relieved.
Arsen. 12—Bell. 3—Puis.
 3—3—Nux.  v.  3—(ad-
 vised Lye. 30—Graph. 30
 Sulph. 30—Calc.  30, oc-
 casionally in single doses,
 used for 6 weeks).  Exa-
 mined uterus, and ordered
 Douche,  which was used
 4 months with temporary
 benefit; advised Bell. 30
 —Kali. c. 30—Sep. 30—
 Bry. 30  occasionally—no
 change — treatment fol-
 lowed very irregularly.     Or
Sulph. 12—Calc. 12—Xux  &>
 v. 3—3—Sulph. —Nux.
 v. 3—3—Puis.  3—Sop.
 12—Ignat.   3—3—Bry.
 3—this attendance  was
 chiefly for catarrhs—18 -19
 had first severe dysentery,
 diarrhoea, and then uterine
 symptoms—Bry.  3—Ar-
 sen.  6—.Sulph.  12—Ign.
 3—3—3 — Lach.  12 —
 Puis.  3—Tgn. 3—Ipec. 1
 ordered Douche.
Bell.  3—3—6 —Chin. 1
 Calc. 6—6. 
married,
no chil-
  dren
many years
Menses absent for a time
  then   regular—copious
  Leucorrhoea
Examined and treated by
  Simpson's pessary
2 years;  since
     first
 confinement

  14 months
12 years
Menses regular—copious—
  slight Leucorrhoea
Xot axamined

Menses too early—copious
  much Leucorrhoea
Examined and treated lo-
  cally  with much more
  success  than  general
  treatment.  —  Argenti
  Nit. Pernit of Mfrcury

Menses very copious—oc-
  casional Leucorrhoea
Examined,   treated   by
  Simpson's pessary with-
  out any benefit
Debility and local  weak
  ness  as   of  threatened
  prolapse—her general
  health much  disordered
  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 incon-
  venience and was cured
Anteversion  and  uterus
  engorged
Debility,   irregular   and
  very slow action of heart.
  Membranous    dysme
  norrhosa
Debility, pain in back,Hy-
  pogastric  weight.  In-
  flammation and ulcera-
  tion of cervix and canal.
Pain in back, constipation.
Retroversion  and  second
  stage of cervico-metritis
9 months
3i months
8 months
3 months
No decided benefit.
General  health   somewhat
  benefitted by the general
  treatment,   but  uterine
  symptoms remained un-
  changed  till  local  treat-
  ment  was  commenced,
  since which she has be-
  nefitted considerably
No real  benefit,   and the
  pessary appeared  to  do
  harm.  I, however, lost
  sight of the case  while
  she was wearing it
Dig. 3—3—Alum.  30—  «J
 Sep.  30.— Lye.   30—  ~*
 Graph. 12.

Kali. c. 3.— 12. (menses
 ceased now, Jan. 3d, and
 did not  return,)  Merc.
 corr. 2—  2—Bry. 3x.—
 3x.
Sulph.   O—Alum.   3.—
 Bry. 3. 
27
Age.
23
24
25
26
Length of
 illness.
I'tei-ine Discharge.
Chief Symptoms.
time under
 treatment.
Results.
Remedies which relieved.
-10—5(1
 age.
poimgeat
b years

  33
Single
 14
Singh
 35
Single
 27
Singh
Singl
years
Menses regular —
  Leucorrhoea
Examined
Ceneral (Irbility, nervon
  symptoms,  liypugastri
  pain.  A large uieer n
  cervix healed  in eentr.
  raw round edges
34 months Completely  cured   locally,1 Kal
             and general health much
             improved,  hysteria often
             returns.  Local treatment
             consisted of douche only.
a long time  .Menses regular, copious— Debility,  neuralgic pain-
               slight  Leucorrhoea        in back, headache, &c.
             Not examined
some  months
many years
many years
many years
Menses irregular

Examined ' toucher:



Menses regular


Examined  ' sound,'  and
  treated  with Simpson's
  pessary
Constipation,   disinclina-
  tion for all exertion.
Uterus sensitive to touch,
  she masturbated
Menses  regular, Leucor
  rhoea
Xot examined
Menses regular,—Leucor
  rhoea
51 months! Decided benefit to general
             health — many  uterine
             symptoms return at times.
    Iod.  1.  Mag. Carb.
6.   Nux  M.  f>.   Kali
Carb. 3—3.  Lnch. 6.
9 weeks
Hysteria, spinal  and ute-j 11 months
  rine irritation, constipa-
  tion
Retroversion   of  uterus,
  also uterus sensitive to
  touch, os patent
                         Hysteria,  faintness,  pain
                           in back,  debility, &c.

                         Hysteria, faintness, pain in
                           back, debility, &c
Examined and treated by|Retroversion, ulceration of
  Simpson's pessary, and'  cervix and  canal,  pos-
  Argenti  Nit.  "         terior wall engorged
But little benefit before she
  left town, but ultimately
  recovered under homoeo-
  pathic    treatment.     I
  chiefly treated the  con-
  stipation.
For  some  months  greatly
  benefitted,   but   became
  worse after the use of the
  pessary,  and returned to
  allceopathic treatment
Xux v. 12. — Ign.  6 —
 Xux  m.  3x.—Plat. 12—
 Plat. 12—12.—Cham. 12
 —Bell. 3.
Puis. 3-^-Bry.  3—Plat. 6.
CO
6 months
1 year and
 7 months
Some temporary benefit
Xux v.  3.—Sulph.   6.—
 Xux  v. 6. — Puis.  6.—
 Sep. 12. —Bry.  3x—3x
 1.—Merc. 3—Nux. v. 3s
 —Bry.3x. (Get. 17 intro-
 duced pessary) Chin. I.—
 Bell.  3x. — Nux   v.  3.
 (March 2d removed pes-
 sary;  Plat. 6.—Ignat. 3x.
Puis. 6—Xux v. 30—Sep.
 30.
The  local  treatment  didJMerc.  5.  {Argen. nit. at
  much   good,   but  was! times from Jan. 22 to Nov.
  given up before the cure; 7th) Kali. Iod. 1—Merc.
  was  complete;    many! ac 1—Merc. 1.  1 (intro-
  moral symptoms checked duced pessary Dec. 30th,
  the progress much       I removed it Oct. 11th,) 
30—40
  i riscl,
27
  27
married,
has chil-
 dren
 20
Single
some years
4 years since
 child-birth
some years
some years
Menses always have been
  copious;  for some time
  Menorrhagia
Examined  shortly  before
  she left town—'toucher'
Menses very copious and
  long  continued,   occa-
  sional Leucorrhoea
Examined and  treated by
  Douche and  Simpson's
  pessary
Menses too frequent, pale
  copious  Leucorrhoea at
  times.
Xot examined
Menses regular,—Leucor-
  rhoea  copious,  yellow,
  foetid.
Examined,   treated   by
  Douche  and Simpson's
  pessary
Hysteria,  great  general
  debility.

Menorrhagia,    posterior
  wall  engorged,  uterus
  sensitive  to  touch,  os
  patent
Menorrhagia,     debility,
  bearing down pain, spas-
  modic cough
Enlargement and antever-
  sion of uterus,  os pa
  tent
Pain in left ovarian region
Leucorrhoea, hysteria, he-
  patic pain, &c.

Retroversion of  Uterus,
  and 1 st stage of cervico
  metritis
7i months
2 years  and
 5 months
                          at one  time the  pessary
                          caused much pain, but this
                          was at once removed by re-
                          adjusting the  instrument)
                          Lach. 6—Merc. corr. 2—
                          Bry. 3—Rhus. 3x.
All the usual remedies for excessive menstruation and
  hysteria were given in various ways,  as  regards po-
  tency, dose, &c, with only occasional and temporary
  benefit—Plat. 12—Ign. 3  and, at one time,  Secale 3
  did good:  Oh examination, however, chronic inflam-
  mation of posterior wall  of uterus was  discovered,
  and I believe local remedies alone will do  good.  The
  patient left  town  before  these were tried,  but will
  probably return.
3 months
7i months
Much benefitted by pessary,
  after which she  became
  pregnant, had a still-born
  seven months' child and
  has since felt  weak  at
  times,  though,   on the
  whole, decidedly  better,
  the  menses  much  less
  copious
Benefitted,  but  not  cured;
  left too soon to judge
Much  benefit  to  general
  health,   some    uterine
  symptoms  remain  but
  much less urgent.  Pessa-
  ry appeared  to  do good
  and caused no inconveni-
  ence.  The  retroversion
  was completely cured
Vinca  1. (applied  pessary
  March 8th, and removed
  it  July Sth,) Chin. 1—
  Kali carb. 3—Cina. 3x
  —Amnion,  carb.  3x—
  Thuja. 3.—Chin. sul. 1.
  Ammon. carb. 3x.
Sulph. 30.—Bell. 30.
[gn. 3x.—Calc. 6.—Sulph.
  12.—Bry. 3x.—Kali c.
  3. (she wore the pessary
  from Dec. 30th to July
  9th.) 
 Length of
time under
treatment.
No.	Age.
32	30—40
	married, 8 children
33	41
	married,
	chil.lreii
34	30—40
	Single
35	40
	married, 4 or 6 children
36	30—5
	married, 4 children,
	riaget
37	22
Length of
 illness.
Uterine discharge.
Chief symptoms.
Single
many years
2 years
many year;
2 years
3 months
Menses usually  very co-
  pious — copious yellow
  Leucorrhoea
Examined and found
Menses copious and almost
  constant — thick yellow
  copious Leucorrhea
Examined ' toucher'

Menses, frequent, copious-
  copious Leucorrhoea for 8
  or 9 days after menses
Xot examined
Menses copious early—oc-
  casional  copious serousi
  Leucorrhoea
Examined,' toucher' and
  ' sound,' which caused
  spasm
Menses irregular

Examined
Menses too late, painful
Examined just before she
  went away
Hysteria, catalepsy,  debi-  2 years
  lity, Leucorrhoea, &c.

Ulceration  (syphilitic) —
  uterine engorgement

Leucorrhoea,   Menorrha-  64 months
  gia,  debility,  pain
  back
Irregular  induration  of
  cervix
Debility,    Menorrhagia, 11 4  months
 Leucorrhoea,an abdominal
 tumor which is probably
 fibrous tumor of Uterus
Numbness  of right  arm  64 months
  and leg, debility         occasional
Has  had perinseum   rup
  tured which permits of
  partial prolapse.  Uterus
  engorged, os patent
Bearing  down pain,  debi-  24 months
  lity, is hysterical
Os patent
Opisthotonos, — hysteria,  54 months
  pain in  back,  debility
  second stage of cervico
  metritis
Results.
Was very irregularly under
  treatment, never long at
  a time, and  refused to
  submit to local  remedies
  only  temporary  benefit
  was obtained
Cured without  local treat
  ment.   The recumbent
  posture was enjoined for
  two or three months

Considerable  benefit to ,
  neral health, not  much
  change in  the  uterine
  symptoms.
Xot much change  in 1848—
  decided benefit  in 1850
Remedies which relieved.
Nit.  ac. 2—Merc.  5—
  Rhus. 3x.
Chin. G.—Arson.  6.—
  Sep. 12 —Sep. 30 —
  Sep. 30.—Aur. 30.—
  Sulph. 30.—Sep. 30.

Sulph. 30.—Bry. 30.—
  Graph. 3.
Zinc 30.—Nux v. 12.—
  Bry.3x.—Nuxv.3x.
Cured—Very   soon  after Bry. 3x—Nux v. 6 12—
  examination  with   the   Puis. 12—Sulph.  (>
  " sound,"  she   became   12.—Had  a  healthy
  pregnant  and soon got   child, made  a good
  well.                   I  recovery.
Is extremely fanciful about the medicines,  and every
  remedy produced some kind of aggravation.  I only
  treated the fits, and without any success, except that
  traceable to moral causes.   Dr. Bennet then took
  tiie 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.
OS
o 
S8
39
40
  50    21 years
married,
no chil-
 dren.
40—5
married,
no chil.
 dreu.
  25
 married,
  child S
years old
Menses have  ceased—oc-
  casional Leucorrhoea

Examined, hymen perfect
41    21
    Single
42
  35
 married,
 ehild 7
year» old,
many years
2 years
3 or 4 years
many years,
 worse 18
  months.
Menses with  much pain—
  Leucorrhoea

Examined,' toucher.'

Menses  regular   till  six
  weeks before treatment,
  now  absent—Leucor-
  rhoea   occasionally   in
  gushes
Examined
Menses never  free,   too
  late,  absent,  pale   or
  brown—copious   Leu
  corrhosa
Not examined
Menses regular
Examined once,' toucher
  and' bound'
Burning pain and tender-
  ness in sacrum, inability
  to walk far
Inflammation and ulcera-
  tion of cervical canal

General  debility, bearing
  downpain,constipation,
  dyspepsia
Enlargement and conges-
  tion anteriorly
Bearing  down pain  after
  all exertion, debility
Anterior  wall  congested
  and tender, lip red, not
  excoriated
Leucorrhoea, pain  across
  top of thighs, easily fa
  tigued
Great  debility,  discharge
  of pus per  anum,  has
  evidently pelvic abscess,
  which showed itself after
  the use of Simpson's pes-
  sary, but probably ex-
  isted previously
Retroflection
12 months
7 months
occasional
1 month
1 month
4 months
General  remedies  had no
  effect:  Argenti  Nit.
  healed  the   excoriation
  and  removed inflamma-
  tion  of cervical canal, but
  symptoms continue
Cured.   The   case   pro-
  gressed slowly, and went
  on  well  during   her  ab-
  sence,  when . she   pre-
  scribed for herself p.r.n.
Relieved, but left the town
  too soon to judge the ef-
  fect  of treatment.   Sea
  water douche used
Much  improved,  but left
  town too  soon to judge.
  Menses  occurred  once,
  more healthily, she used
  cold sitz  bath and ab-
  dominal  compress  occa-
  sionally
A  little   improvement   to
  general   health,  varied
  much
Bry.  3x.—Kali Bichrom.
  3x.
Puis.  6—Sep.   30—Bell.
  30—K. Bich. 2 6—Merc.
  acet. 3x.—Nux v. 3x.—
  Arsen. 6.
Sepia 12.
OS
Sulph. 12.
Silic. 6—Puis. 6—China 3. 
Age
Length of
 illness.
Uterine dischasge.
Chief symptoms.
Length of
time under
treatment.
Results.
Remedies which relieved.
  18
Single
  18
Single
3 years
35—40
married
several
childr'n

30—5
Single
  27
married
 1 child
5m'ths
  20
Single

  18
Single
a long time ill
11 years
5 months


3 years


3 months
Menses too Sequent, scan-
  ty, and  painful—copious
  Leucorrhoea
Xot examined
Menses regular,  scanty,
  and  very dark—copious
  Leucorrhoea
Xot examined

Menses very copious and
  frequent— Leucorrhoea
  copious
Xot examined
Menses  pretty   regular.
  painful—occasional Leu-
  corrhoea
Examined,   treated  by
  Douche, Simpson's pes-
  sarv, and Argenti Nit.
Leucorrhoea, pain in
  side, pain in back
left' 0 weeks
Nervous debility extreme.
  Severe left side pain, Arc.
  Bearing down pain.
Menorrhagia,    vomiting,
  pain in left side
Pains in back and groins,
  great debility,headache,
  retroversion of  uterus.
  Inflammation and  ulce-
  ration  of cervical  canal
  —engorgement of poste-
  rior wall
Menses absent, is suckling!Pain [in left side. Leucor
  —copious Leucorrhoea
Xot examined
Menses too late—some Leu-
  corrhoea.  Not examined
Menses absent
Not examined
6 months
4i months
2 years  4
 months
2 months
  rhoea, sinking at epigas-
  trium
Headache, —  occasional- 1 month
  nausea

Amenorrhoea, — headache,] 6 months
  dyspepsia, pain in loins
Very much  improved, but Nux  v.  12—Sep.  12—
  left too early to be cured   Sulph. C>.
Xo improvement of any du-
  ration ;  this case  should
  have been examined, and
  most likely required local
  treatment.
Cured                     Sep. 12—Hell. 6—Carb. v.
                            30—Alum.  3D—(ham.
                            30—Alum.  30—Graph.
                            30.
A very instructive case, general remedies did no  per-
  manent good ; neither did  the  douche: Simpson's
  pessary  did  fully more harm than good, though it
  removed the retroversion.  But when Akgenti Xit.
  was freely applied to the cervical canal, improvement
  commenced  and progressed satisfactorily, though not
  rapidly—Bell. 3x. Hyper. 3x. relieved the headache.
  Xo remedy was of marked use, but many relieved.
Cured                    I Aeon.   6— Sulph.  30—
                            Nux v. 30.
Cured.   Relieved from a
  relapse, and she then left
  the town
At  first  relief to  general
  health,  then no  further
  improvement.    M.-ns^
  did not return.  Widow
  Welch's pills cured  her
  soon after she  left  un-
  charge
Puis.  3—Puis.  G—Puls.
  12—Bell. 0.

Bell, (only high  potencies,
  and  at  long  intervals,
  were tried) 
50


51



52




52x


53



54




55




56




57
  24
Single

  44
married,
  38
married,
  28
Smgl
23
  28
Single
  23
Single
6 months


16 months



some time
4 years
2 months
12 years
some time
  20   9 weeks
Single
Menses absent 12 months
 —no  Leucorrhoea
Xot  examined
Menses copious every 14
 days—occasional Leucor-
 rhoea. Not examined

Menses regular — copious
 Leucorrhoea
Examined, treated by Ar-
 genti Nit.

Menses regular — copious
 Leucorrhoea
Xot examined
Menses absent,  or   very
 scanty
Examined  ' toucher' and
 ' sound '*
Menses absent, is nursing.
 Leucorrhoea
Examined  and treated by
 Argenti  Nit.

Menses  regular,  painful,
 occasional Leucorrhoea
 Examined  after 7 months
 unsuccessful general treat-
 ment—Argenti Nit.
Menses scanty, pale, pain-
 ful—Leucorrhoea
 Xot examined
Menses absent
Not examined
Headache, Amenorrhea.
 nausea

Menorrhagia, debility
Leucorrhoea, debility, pain
 in abdomen
Os  irregular and  patent.
 cervix ulcerated

Leucorrhoea, debility, pain
 in abdomen

Chlorosis, debility, cardiac-
 pain, and breathlessness
Uterus low. down, os pa-
 tent and irregular
Debility, pain in left side

Ulceration of cervix uteri
Headache,  pain in right
 side, debility
Inflammation of  cervical
 canal

Dysmenorrhoea,  pain  in
 loins
Amenorrhoea
6 months
17 months
64 months
10 weeks
12 months
 3 or 4
months
17 months
5 months
8 days
Xo marked  improvement,
 and no return of menses

General  health  quite  re
 stored,  menses  continued
 copious  till  near  end  of
 treatment
Cured, and continued well
 until  after  another  con
 finement,   when  uterine
 symptoms returned — see
 52x
Cared
Xo permanent benefit—pro-
 bably7  the speculum  would
 have revealed local disease
Low potenccies hiefly were
 tried.

Puis. 6—Plat.  6—Arsen.
 12.
Argenti Nit. locally had
 most effect, Merc. c. 2—
 Lach. 6.
Bell. 2x.
Plumb.   12—Graph.  30.
 Nux v. 30.
Cured  locally.  This patient had threatened  phthisis
 for years, the ulceration followed a miscarriage, and
 was cured by Argenti nit.  She again became preg-
 nant, and had a healthy child, after which she had no
 return of uterine symptoms but sank from phthisis.
Xot any relief till after I commenced local treatment,
 in March,  1850,  since which she has progressed
 slightly, and  is still under treatment.   After exami-
 nation, in September, the douche  was tried,  without
 benefit.
General  health  restored.'PuZs.  6 — Sulph.  12 —
 menses  were  better  and Puis.  6.
 less painful, but just befo
 I lost  sight of  lie
 passed their time
Cured
they
to
Puis. 6 (no other remedy). 
No.	Age.
58	50
	married
59	35
	Single
60	30
	married
	no
	children
61	16
	Single
62	53
	married
63	67
	married
64	17
	Single
Length of
 illness.
2 years



3 months





8 years



5 or 6 months


4 months



many years


some time
Uterine discharge.
dis-
not
Menses constant, pale
 charge—query, was
 this Leucorrhoea ?
Not examined.
Menses, scanty and pal
 Leucorrhoea
Xot examined
Menses,  too  copious  and
 too frequent, Leucorrhoea
Not examined

Menses absent  7 months,
 have only occurred twice
Not examined
Menses constant, sanguine-
 ous discharge
Examined' toucher '

Xot examined
Menses regular, not much
 pain,  pale — slight Leu-
 coyhoea
Not examined
Chief symptoms.
Nervousness,   occasional
 fits, apparently epileptic
Pain in loins and hypo-
 gastrium
Headache, dysmenorrhoea
 bearing down pain
Pain in left side and epi-
 gastrium, dyspepsia

The discharge, great debi-
 lity
Posterior  wall  of uterus
 very hard, scirrhus ?
Prolapse of uterus and rec-
 tum,  some  abdominal
 pain
Hysteria, debility, dyspep
 sia, &c.
 Length of
time under
 treatment.
6 weeks
5 months
3 months
3 months
5 weeks
2 months
19 months
Results.
General  health  improved
 fits less frequent, and was
 then lost sight of

Cured;  but when the ute-
  rine  symptoms   ceased
  pectoral ones supervened,
  which lasted nine months.
  No local  remedies  were
  used.
No permanent relief (this
  case should have  been
  examined and  probably
  treated locally)
Health  restored;   menses
  did not re-appear

No change,  no local reme-
  dies were  used.    She
  went into the hospital
Remedies which relieved.
Lach. 12—Bell. 12.
Sulph. 6—Puis. 6—Graph.
 6—Bell.   6—Ferr.  6—
 Sep. 30.
Ign. 3—Cocculus 6.
Puis.  6—Puis. 3—Bell.
 Puis. 3—Kali c. 3.
Pain  removed,
  improvement
os
no  local Sepfa 5—Sulph. O.
Only   occasionally   under
  treatment,  and was at
  times much better. After
  May, 1849, she became
  worse;    dysmenorrhoea
  and convulsions came on,
  which were treated locally
  by  Dr.  Simpson,   and,
  ' by report" cured
Puis. 3—Xux v. 6—Lach.
 6—Carbo v. 5—Car. v. 5
 12 30—Graph.  5 12 30
 —Calc. 3 12 30—Puis. 6
 12 30. 
  30
married,
  no
children
 18
Single
 29
married,
 39
married
11 months
Menses  very painful,  and
  with false membrane
Not examined
Menses absent 11 months,
  occasional Leucorrhoea
Xot examined
Dysmenorrhoea,
  hysteria
debility,
Amenorrhea,   Chlorosis
  Cardiac symptoms
                                      i
4 or 5  months Is pregnant—copious Leu- Leucorrhoea, pain in loins,
                corrhcea, yellow        j  hypogastric pain
              Xot examined
10 months
12 months
38    12 months
children,
youngest
  7
  25
 Singh
 17
Sine
 25
Sing
2 years
Menses regular  and very
  copious — copious  Leu-
  corrhoea, yellow
Xot examined
Menses   regular,   very-
  scanty—copious  white
  Leucorrhoea
Xot examined
Menses absent two years,
l  some Leucorrhoea
Examined,' toucher ' and
  'sound '
Gastrodynia,   headache,
  Leucorrhoea
4 months
3 months
6 weeks
some time   Menses too seldom, copious
               —much Leucorrhoea
            | Xot examined
some months'Menses regular, pale, and
               watery—much Leucorr-
               hoea
             Not examined
Leucorrhoea,  pain in loins,| 3^ months
  debility, frequent mictu-j
  rition.
                        |
Pain   in  hypochondria,' 2» months
  headache, pain in back.
Xothing  detected,  except
  os and  cervix  unusually
  small and soft.
Pain  in  epigastrium and 3 months
  over abdomen, pain in
  Hypogastrium
Dyspepsia, pain in Jback.i 6 weeks
  debility, constipation
Conducted chiefly by  cor-Canth.  3—Secale 6—Se-
  respondence, and not re-  cale 6
  gularly; no marked  be
  nefit.   She  is at present
  (1850) under Dr. Blake's
  cure and is  improving,
  headache at times much
  relieved
Menses    occurred   once
  scantily and then again
  ceased—general   health]
  improved    considerably.
  She worked too hard at
  her needle
Improvement   in  health, Sulph.  30—Sepia
  Leucorrhoea   continued,  Sejria 30
  though  less in  quantity!
  —left too soon to judge
Dyspeptic symptoms  cured.1 Puis. 6
  Uterine  symptoms  not]
  mentioned in last two re-j
  ports
Xot much benefit
Sep. 12—Puis.  6—Graph.
 6—Puis. (I—Puis.  6
30—
Calc.   30—Sulph.    30-
 Calc.  30—Sep. 12
Some benefit.   No return Sep. 5—Puis.  3x.—Sulph.
  of menses. Left tho town.!  12—Nat. m.  6.
Very much benefitted
Puis.  3x.—Sep.  5—Se
 12—Sulph. 0.
Very  irregular  in  her  at-jXux v. 3.
  tendance—not much be-
  nefit ted,   left  town too
  soon 
					Length of	1	
No.	Age.	Length of iilue.-.«.	Uterine discharge.	Chief symptoms.	time under tientment.	Results. Remedies which relieved.	
73	30—5	1 7 years	Menses pretty regular—	Httmorrhase from rectum.	23 month.'	Creatly benefitted. Ute-	Lach. 6—Nux v. 3x —
	Singh		some Leucorrhoea	n:e:<ri:t in hypapas		rine symptoms cured.	Lye. 5—Xiitrtmi m. ('—
				triuin, general del):lay		though the retroflexion	Lye. 5—Sep. 3x.—Puis.
			Kxamined, and treated b; I Retroversion of uterus—			was not; general health	3x.—Kali i. 1 — ?>U-ie. a.
			douche and Simpson't	uterus engorged, os pa-		greatly reMoied. The- 1—hrcos. 2—Nitr. ac. 2	
			pessary	tent		pessary produced much! —Cliin.s. 1—Ign 3x. Ais.	
						irritation and had to be	3—Bry. 3x.—Xux v. 3
						removed, alter wearing	
						it from Oct. 24th to Feb.	
						13ih—3 s months	
74	18		Menses very irregular.	Chlorosis, cardiac symp-	5 years	lias repeatedly been un-Dig. 6—Sep. 30—Puis.	
	Single	2 years	often absent—occasional	toms, vomiting, and		der my care, and is on	30
			Le uror rhoea	uueh dyspepsia, with		the whole very much bet-	
			Xot examined j uueh gastralgia i !			ter, at times much reliev-ed—but she sits too close to needlework, and is thus subject to relapses.	
75	iS/>	2 yorfrs	Menses ceased— copious Leucorrhaa		1 month	No change — Medicine (Sep.) made her constantly	
	married		yellow Leucorrhaa			drowsy all day long, which she had never been be-	
			Xot examined			fore.	
76	26	2 years	Menses regular, scanty.	Pain in abdomen, pus pef	2 months	Greatly benefitted, but did Sulph. 12—Calear. 18.	
	Singh		] >ai n ful—t hic k corrosive Leucorrhoea Xot examined	anum at times		not attend regularly.—, Leucorrhoea became less:	
77	18	S months	Menses absent S months	Headache, nervousness,	4* months	Cured. It is not stated Bell. 3—Ign. 6.	
	Single		Xot examiued	fear of becoming de-ranged		whether menses returned	
78	'9 Single	a long time	Menses too frequent, long. and copious—some Leu-corrhoea Xot ovnuihied	Headache, debility	6 weeks	Menses became more regu- Calc. a. 3 lar and normal, headache continued bad and she; •was removed by her] friends into the hospital	
79	26	some month>	Menses very scanty and Palpitation, cardiac bruit.		3i months	No marked improvement :'Low potencies wire used,	
	Singh		pale—some Leucorrhaa chlorosis and debility Xot examined			she was constantly over- except at the two last worked at her needle, visits, when Sep. 30 was	
						and confined to the house	given with slight benefit
 
a long time
[ Menses  absent
  months
Xot examined
or  5]Constipation, swelled legs,
       headache
Menses very often  absent Many symptoms,  debility,
 —o'-ca.-ional Lsucorrkceal pnia in hack, #c.
i>:a n.::ed,  treated   with'; ireat distension  of abclo-
 Aruenti Is it.            men,    inflammation   of
                          cav.ty of cervix
Menses very  scanty  and Pain in left side, general
2i months
f>i months
 pale — occasional
 vo: rhoea
Xot examined
Lea-
Menses,
 stated
condition   not
Examined ' toucher ' am
 • sound'
Menses   regular — occa-
 sional Lcueorrhoea
Examined, and treated b;
 ' SOUND '
,-bility
Hypogastric weight,  pain
 in left iliac region, vertical
 headache
Vag.na, os and cervix  very
 tender, uterus slightly re-
 trotlcxcd. os patent
General  health  bad,  has
 diseased ears, ore, o:e.,iii
 addition to uterine symp
 terns, these are chiefly
 dysmenorrhea,  hysteria
 ecc.
iletroflexion, uterus  en-
 gorged, os  somewhat pa-
 tent
3i months
only seen
occasion-
   ally
54 months
Much relieved, menses oc^PuIs. 3—1.
 curred  once,  and  then
 again  passed  their time,
 just before I lost  sight of
 the case
This patient evidently suf [Bell.  3x. — Puis.  3>
fers  Iron
symptoms
             many
            bes'des
uter.nc  ones;  the
d;d not  yield  unt:
treatment    was
which  comp'ete'y
them,  and,  for  a
                     other'
                       the
                     latte.
                      Leal
                      used
                    cured
                     time.
 benefitted   the   general
 health
Much    benefitted ;    los!
 sight  of before she  was
 well.   Menses  continued
 pale and  scanty, Leucor-
 rhoea decreased
This case  has  only  been
 treated  by medicine,  and
 lias varied much, is  evi-
 dently   not  yet cured.—
 July, 1S50

Was treated  by medicine
 alone,  from  Dee., 1845,
 to Jan.,  1S48, with  but
 little  real  benefit,  then
 examined, and  treated by
 frequent   introduction   of
 sound.     Iler   general
 health   improved,  uterus
 became  less  retroflexed:
 she married  and soon be-
 came  pregnant, and  had
 a healthy  child, and after
 wards  no  uterine  ssymp-
 terms
Lach. 6—Sep. 6-
  1.
-Plumb.
Graph. 30 -Graph. 6 30.
cs
The medicines did not in-
 fluence the uterus at all 
					l.ength of		
No.	Age.	Length of illness.	Uterine discharge.	Chief symptoms.	time under treatment.	Results.	Remedies which relieved.
85	35	8 or 10 years	Menses every three weeks	Hppogastric pain, and	6 months	Not much benefitted	Xux v. 6—Nux v. 3—■
	married, 3		•—much Leucorrhaa	bearing down, great de-			(state of uterus at close of
	children,			bility, headache			treatment not known).
	youngest 7		Examined once	Enlargement and irregu-larity of OS			
86	21	a long time	Menses regular, very pale	Great weakness, hysteria,	134 months	On the whole she fell	Puis. 12—Lach. 30—Puis.
	Single		Examined 'toucher'	palpitation, bearing down pain, &c. Cervix uteri elongated, tender (inflamed ?)		much better, but con-tinued far from well; she subsequently married and had children, and con-tinued delicate	30—Sep. 30—Bell. 3— Puis. 3—Merc. 5.
87	25	several years	Menses irregular, often ab-	Headache, debility, nau-	21 months	General health much im- Merc. 0—Arson. 12—(Si-	
	Single		sent, scanty, and pale Leucorrhoea before menses Not examined	sea, &c.		proved; menses did not! lie. 6). become regular, her at-! tendance was very irregu-lar Ulceration completely] Merc. i0d. 3x.—Chin. 1.	
88	27	14 months	Menses regular, too short	Bearing down pain, Leu-	4i months		
	married,		—Leucorrhaa	corrhoea, debility		cured and health much	
	1 child, 14 months		Examined and treated by Argenti Nit.	Ulceration of os		improved, she, however. frequently caught cold and thus retarded her	
89	25	12 months	Menses scanty, regular.	Pain in sacrum, much dys-	6 weeks	progress > Greatly benefitted Sep. 5—Tr. Sulph. O—	
	Single		and pale—constant Leu- pepsia cor rhoea 1 Not examined			Bell. 3 I	
90	40	2 or 3 years	Menses copious, and toojCachcxia, debility, severe		1 year	Died. The caustics re- Xux v. 3—Ars. 3—Bry.	
	married,		frequent—copious Leu-\ uterine pains			lieved for a time, she 3—3x.—Bell. 3x.—Lach.	
	children		corrhwa Examined, and treated by Fungoid cancer of the ute-rERNiTR. iiydr. and po-j rus			rallied much; the cancer G—Ars. 2.—Con. 1—Iod. then increased more rapid-! 2. . ly, and with it her strength i	
	1		TASSA FUSA			1 gave way	i
C5
00 
  36
married,
   5
children.
youngest
   6
  35
married
7 years
4 years,  since
 a miscarriap-e
Menses regular,   painful,
  copious  and  brown—
  milky Leucorrhoea
Examined, and treated by
  Argenti Nit. and Per-
  N1TR. HYDR.
Spinal   disease,
  pain in loins
aching
Ulceration of os, enlarge
  ment and  hardness  of
 22
Single


 21
Singh
  30
married,
   2
 children
4 years



4 years
 2* yrs.
since  last
  child
  corrhoea
Examined,  treated   by
  Argenti Nit., Potassa
  Fusa
     copious,  too  long. (Gonorrhoea) pain  in  left
dark—occasional   Lcu-\  side  of abdomen,  dys-
  menorrhea
Enlargement  of  anterior
  lip of uterus, os patent
  canal excoriated
Menses  very scanty  and
  painful—much  Leucor-
  rhoea
Not examined
Menses very copious cvery
  three   weeks — much
  Leucorrhoea
Xot examined

Menses every 14 days, co-
  pious — much  Leucor-
  rhoea
Examined and  treated lo-
  cally,   Argenti  Nit.
  Kali Bichrom.
Debility, headache,  pain
  in  left   side,  bearing
  down

Menorrhagia, anoemia, de
  bility
Menorrhagia,     debility,
  sinking in epigastrium

Inflammation and  ulcera-
  tion of cervix and canal
8i months
4 years
7 weeks
15 months
10 months
Lach. 0—Ammon.  o. 5
—Merc. c. 2—Merc. a.
3x.—Amra,   c.  3x.—
Bell. 2.
Uterus   eured ;    general Merc. c. 2—Nux v. 3x.—
  health improved  for a   Merc. Iod.  3x.
  time,  but the symptoms
  were  chiefly spinal,  and
  remained pretty  much as
  before.   Ulcer was cured
  in 4 months
Uterus  was not  examined pu]s.  6—Calc.  12—Bry.
  till 2 years after treat-!  6—Sep.  12—Bell.  6—
  ment  commenced,  pre-
  viously  her  health   im-
  proved   much  at times.
  and   the    gonorrhoea
  cured; for 1 year more,j
  the case was  treated  by-
  medicine only, with  the
  same  effect  of temporary
  improvement.     Caustics
  were   then   used   re-
  peatedly  and the  uterus
  improved, as also general
  health.   She is, however.!
  still   delicate,   and   has1
  laterodynia
Much relieved ;  treatmentSep. 5—Puis. 3—Puis. 6
  was not  continued  long;
  enough                 I
Menorrhagia   cured   aud
  amenorrhoea  came  on;
  health varied, was better
  at  times,  latterly  less
  well
Greatly  improved;   local
  remedies   were   com-
  menced after 7  months.
  prior   to   which   local
  symptoms had improved
Sep. 12—Bell. 6—Bell. 6
  —Plat.   6—Plat.   0—
  Bell. 18—Puis. 6—Bell.
  30—Calc. 30

Ignat.  3x.—Bell.   3x.—
  Bry.  3x—Puis.  3x.—
  Sabina 3x.—Kali B. 3x.
  —Plat.  Cld. 3—Stann.
  3x. 
Acre.
married,
no chil.
 dreu.
  24
Single
  22
Single
  16
Single
Length of
 illness.
a long time
some years
5 years
6 months
12 mouths
5 years
Uterine discharge.
Menses  never   regular,
  often  absent —- Leucor-
  rhoea
Not examined
Menses often too frequent
  and  copious — frequent
  Leucorrhoea
Examined after  2  years,
  douche  and   mercurial
  balls—no effect
Chief symptoms.
 Length of
lime undfr
treatment.
rhrrlleve.l.
Amenorrhea,   dyspepsia,
  eruption on face
Pain in epigastrium and
  groin, hysteria, etc., &c,
  rheumatism, <fcc.
Engorgement  of   uterus.
  frequent large discharge
  of pus, as if  from pelvic
  abscess,  bursting   into
  vagina
Menses irregular, copious, Hysteria, fainting, card'ac
  and dark—-copious Leu-'-   symptoms,    dysmenor
  corrhea                  rhoea, &o
Not examined
Menses regular, painful—Pain in stomach and abdo-
  much Leucorrhaa     I   men, left side pain, pal-
Not examined              pitation, headache

Menses absent 7 months   Chlorosis,  left side  head-
Not examined           !   ache
                        |
Menses regular,  copious, Dysmenorrhea most  se-
  dark, painful — copiou.   vere, hysteria
  Leucorrhoea           >
Examined ' toucher'      ^agorgement, os and cer-
                           vix rather hard
41 months Greatly improved in health Sulph. 3;!—Calc. 30—Bell.
            —only one slight appear-!   12—Nux v. 30
            ance of menses
31 years
14 months
Has  been under  my care Tr. Sulph.  O—Merc. 5—
for  various  causes,  and
is   always   relieved   by
medicine, but the uterine
symptoms   have  bene-
fitted  but  litde,  though
she  has  varied  much
Uterine symptoms  have
benefitted chiefly from
Amm. c. 3—Kreos. 3x.
Very much  benefitted, was
  not regular in  her  at-
  tendance
                                     Puis. 6—Ars.   12—Puis.
                                        12— Puis. 3!)— Ars. 3D
                                        —Sulph .3D—Calcar.30
                                        —China. 30—Sep. 3D—
                                        Sulph.  30—Bell.  30—
                                        Ferr.  12—Sep.   30—
                                     ,   Ferr. 2.
 2i months  General health benefitted.]Nux  v. 3—Puis.  3—Tr.
             less  Leucorrhoea;   still]   Sulph. O.
             dysmenorrhea, and men-j
             ses scanty and pale
 6 weeks    Menses came on  and  ge- Pals. 3—Pals.  12—Merc.
             neral  health  much   im-|   0
             proved—lost sight of     i
2 years  and Only occasionally   and for Tr.  Sulph. O—CV-c. 3
 3s months j  a short time  under treat-!
           I  ment ;   the   dysmenor-|
             rhoea was cured, hut re-
             turned  now  and  then
           I  under the   influence of
             excitement, etc. 
103    35
       rried,
       or 3
     children
102x   35
103
104
105
106
107
108
  30
married,
  no
children
  15
Single
  18
Single
30—5
married.
  35
married.
  18
Single
3 months
some time
9 months
5 or 6
months
3 years
some time
3 years
Menses violent and  copi-
  ous, and too long
Not examined
Menses too seldom—pain-
  ful—Leucorrhea
Examined Argenti Nit.

Menses  regular — much
  Leucorrhoea
Examined   and  treated
  with Scofield's pessary
Menorrhagia   from  a
  gested uterus

Bearing down pain,  debi-
  lity
Enlargement,  induration,
  and ulceration of cervix
Pain in back and side, and
  across abdomen
Enlargement  and chronic
  inflammation of uterus
Menses absent 9 months  iAmenorrhcea, debility
Not examined
Menses too frequent,'copi-
  ous,  dark—much Leu-
  corrhea
Not examined
Mewses regular and pain-
  ful—much yellow Leu-
  corrhea
Examined—douche
Menses copious, too early


Examined—' douche'
 Menses never regular, now
i   9 months absent
INot examined
Debility,  palpitation,  dys-
  pepsia, &c.
Leucorrhea, pains in geni-
  tals after all exertion

Had gonorrhoea,  and now
  chronic  inflammation of
  vagina
Pain in abdomen  and back,
  bearing down, debility,
  &e.
Enlargement   of   uterus
  with endometritis

Amenorrhea,     debility,
  faintness, depression
3 months  ICured
[Puis. 3—China O.
5* months; Much   benefitted,  left  off Sep. 30—Bry.  3—3x.—
            treatment before she was  Puis. 3x.
            well                    |
5 i months
7 i months
35- months,
6 months
General health greatly  hn- Bell.  1—Nux  v.  3—T.
  proved ; she continued to!  Sulph. O—Rhus. 3x.—
  wear the pessary for some!  Lye. 5.
  months  after  discontinu-
  ing her medicine, and has
  since felt well
Only   seen  occasionally : Sep. 12—Sulph. 12.
  menses   returned  twice,
  but did not continue regu-
  lar
Cured; state of menses and
  leucorrhoea   not  men-
  tioned  at end  of treat-
  ment
Cured
Calc.   30—Sulph.   30—  ^
  Calc. 30—Sulph. 30.     m
Merc.  c.  2-
  Scp. 12.
-Bell. 3x.—
3 months  Had been treated  by caus-Bry. 3x.—Nux  v.  3x.—
            tics, before coining to me.   Bry. 3x,
            and  pronounced  cured)
            but  still suilered much—J
            general health improved
            greatly
4i months Health restored, menses didlPuZs.  3—Sulph.   12—
            not return              I  Graph.  12—Puis. 30. 
109
111
112
113
  10
Singl
lircgnant
110  35—40
     married,
     ft large
     family.
  18
Single
  35
married,
   3
child rea
 30—5
married,
 1 child.
LeDgth of
 illness.
2 years
Uterine discharge.
Chief  symptoms.
Menses never  regular, ab-
  sent five months—Leu-
  corrhea
Examined—Argenti Nit.
many years   \Menses regular

             Examined
 2 or 3
months
many years
3 years
Menses absent 3 months
Not examined
Menses  scanty,   dark-
  thick Leucorrhea

Examined ' toucher'

Menses copious, clotted-
  Leucorrhaea
Not examined
Dyspeptic  and   nervous
  symptoms

Ulceration of cervix
Hysteria, debility,  pain  in
  baek, Arc, headache
Cervix enlarged, os patent
  and irregular
Amenorrhoea,   Dyspepsia,
  throbbing of carotids
 Length of
time under
 treatment.
Results.
Remedies which i eliored.
7 weeks
at interval
    only
2i months
 Hysteria, toothache, aph-]l  year and
I   tha\ A'c, pains in vari- 10.months
   ous places
 Cervix enlarged,  os irre-
   gular
■Debilitif.    Leucorrhea,  1 year
   pain in back
This poor girl had been se-._M.-re. iod. 3x.—Puis. 3.
  duced  and  was pregnant.!
  suffered  much  morally!
  The Argenti  Nit. i.n-:i J
  ly benefiiled ihe vi 1 • -• v. hi/
  she left  the town Ik-for,
  she was cured.          i
A very complicated case ;  long ill; treated 3 years ho-
  nionopathically with some benefit.   Dr. Ashwell then
  found ulceration of os and  cervix, which ho treated
  with Argenti Nit. and healed.  Her system had be-
  come very  susceptible by the strict hygienic rules she
  had followed, and she gradually and  steadily became
  worse  in health,  all medicines appearing to aggra-
  vate, till at length she  became deranged,  and was  „-.
  then treated Allopathically  by stimulants and tonics  Li
  with decided but temporary  benefit.
Menses   returned — health Bell. 12—Bar. c. 0.
  improved  much—throb-
  bing   of  carotids  con-]
  tinned
Symptoms often temporarily relieved, but the general
  features  of the case remained unchanged ; she was
  however constantly  transgressing  our  rules, and
  moral causes were in continued counter-operation.
                  12—
                  12—
Zinc. 6—Sep. 30—Graph.
30—Puis. 30.
General  health "much  im-lPuls.   12—Krei
  proved, but  she became  Puis. 12—Car
  pregnant,  and  aborted
  (afterwards became preg-
  nant, and  had  a healthy
  child,  and continued  to
  improve under Dr. Black's;
  care) 
114
115
116
117
118
119
120
121
30—5] some time
Single
  21
married,
   2
children
35—40
married,
   no
children
 3;
Single


 19
Single
  30
m arried,
 1 chdd
   10
 months
  36
married,
   7
|cliil(lr°n
youn
   1
Menses copious-
  rhea
Not examined
-Leucor- Pain   in  back,
           Leucorrhea
debility,
2 or 3      ^Menses  regular—Leucor- Pain  in  side
months        rhea                  j  dyspepsia
             Not examined
8 or 10 years Menses regular—not much
               Leucorrhea
flatulence
many years
some  time
10 months
est
  58
married,
8 years
12 years
Examined, treated mecha-
  nically
                        Bearing down pain, pain
                          in  back,  debility, hys
                          teria, &c.
                        Retroversion   of   uterus
                          and' chronic  inflamma-
                          tion, engorgement
Menses regular—constant Neuralgia,  chiefly of face
  Leucorrhea
Not examined

Menses irregular absent 6
    onths
Not examined
Menses every 14 days, co-
  pious—much   Leucor-
  rhea
  and  head,   headache,
  bearing down pain, great
  debility, constipation
Headache,  pain  in hypo
  chondria
                        Weakness in Epigastrium,
                          pain between shoulders,
                          bearing down  pain, de-
                          bility
Examined—Argenti Nit. Inflammation and  ulcera-
                        |  tion of cervix
Menses every three weeks Irritation of  bladder, dys
  —Leucorrhea           uria, pain in back, de
                        I  bility
Examined—Argenti Nit.! Ulceration of cervix.
  Kali Bichrom.,  ore.

Menses ceased  two years Debility,  heat  in  lower
  ■—occasional    Leucor-  belly,   dysuria,   right
  rhea                   hand and leg feel numb
Examined—Argenti NiT.Eidargement and  ulcera-
  douche                I  tion of cervix
2i years
occasion-
ally only
1 month
Is  over-worked as a daily Sep. 12—Tr. Sulph.  O—
  governess;   much  re-, Sulph.  30—Plat. 12—
  lieved at  times, but the Bry. a. l-20th
  symptoms occasionally re-
  turned
Much  improved,  but  lost'Carb. v. 12—Cham. 6—
  sight of                 Lach.  12—Carb. v.  12.
5i months'General symptoms improved, and but for moral causes
            would have done so much more.  Dr. P. Smith after-
            wards restored the uterus and relieved her much by
            Simpson's pessary, but she still remained weak.  No
            remedy seemed to influence the uterine symptoms.

15 months No great benefit,  though at times relieved.   This case
            I  believe to have  been one in which the uterine
            symptoms were the most important,  and where local
            treatment would probably have done good.
   months Cured                  " Puk(5—Sulph 30—Sep. 30
                                    —Lvc. 30  (menses return-
                                    ed )—Tr.Sulph. O—Bell.3
                                    —Tr. Sulph. O—Bell. 3.
5s months Improved,  general  health Ign. 3—Nux v. 3x.
            better:    ulcer    more!
            healthy   and   smaller.
          I  from Argenti Nit.  ; she
          I  attended irregularly, and
            was lost sight of
13 months Health improved, and dys-
            uria became  less before
          |  local   treatment    com-
            menced, has  progressed
            more  rapidly  since, and
            is still under treatment
7 months General health improved jui-
           cer greatly benefitted by A r-
           gentiNit., but not healed,
           local symptoms much re-
           lieved  (subsequently   had
           cancer mamma?)
Bry. 3x—Tr. Sulph. O-
 Nux v. 3x.
Lach. 6—Puis. 3 — Merc,
 c. 2—Merc. Iod.  1—Tr.
 Sulph. O—Bell. 3x.
 
No.	Age.	Length of illness.
122	51 mariicd,	7 months
123	18 Single	2 or 3 years
124	14 Single	a few week
125	24 Single	7 years
126	23 married, 4 children	5 months
127	30 Single	4 or 5 months
128	30—5 Single	Some years
!       I
Uterine Discharge.
Chief Symptoms.
 .. nuth ot
ti'iir  under
 iciitmi nt.
debility,  con-
 pain   in  lef
dn in left side  of abdo-
men, and swelling
Menses  leaving  her,   at Pain  in  hepatic  region
  times  Hooding—copious-   varicose veins,  floodin<
  Leucorrhea          |   at times
Not examined
Menses  never   regular,1 Dyspepsia,
  often absent              stipation,
Not examined           i   side
Menses  have   stopped— Eruption of head, swellc
  have only occurred three;   glands,  amenorrhea
  times
Not examined
Menses irregular, pale, and
  scanty, often absent
Not examined
Menses absent 5  monthsl&erere pain in left hypo-
  ■—much yellow Leucor-   chondriiun,   dyspepsia
  rhea                 ,   debility
Not examined
Menses  regular,   scanty Bearing down  pain,  pain
  and   too   short—occa-   in back, debility
  sional  Leucorrhea
Examined—Argenti Nit. Inflammation  and excoria-
                           tion of cervical canal
Menses regular,  painful    Headache, hysteria,  debi-
                        I   litv,  bearing down pain.
                           &c.
Examined     '  toucher 'Cervix  uteri   shortened
  shortly  before she left   and enlarged
Results.
Remedies which relieved.
S months  Greatly improved, a! times Bry. 3x.— Bell.  3x.—Bell.
          !   felt almost well, but  \va-  ox.
          |   often thrown back by re-
             turn of copious menses   |
2 months \Cured.   Menses  became Puis. 3—Merc.   3—Con.
             regular;  she  was   not,  3—Puis.'.i.
             however, robust         |
2 months  Cured.   State  of   menses Lye. 12—Lye. 30.
          i   not reported
2« months Much relieved,  and  went Puis. 30—Sulph. 30—Sep.
             to service;  menses con-  30.
             tinucd absent           i
 14  days   Relieved  decidedly,   and Bell. 6—Nux v. 6.
             lost sight  of.    MenseSj
             not reported at last visit

 3 months  Much better,  still under treatment.  She  however  did
             not improve until Arge.nti Nit. was  used
5 years and
 2  months
Greatly benefitted  in   ge-i Ars. 30— Pali.  12—Ars.
  neral health,  often  weli| 30—Sulph. 30— Graph.
                                            Arsen.
for months together, but
liable  to  relapses;   at
length, Dr. Ash well sawj
her,  pronounced the ex-
istence  of  chronic  in-
flammation,   and   used
caustics  with   reported
benefit
-Car.
30-
30- 
1291 30—5
     Single
130



131

132
  21
Single
-  7
Single
  32
married,
  'I
children
133    18
     Single
134


135



136




137
  17
Single
 21
arricd,
  33
Single
  21
Single
many years



10 weeks



 some time

2j years




 3 years



 5 months


 4 months



 6 years




 3 years
] Menses  very copious  and
   debilitating
Not examined

Menses absent 10 weeks
Xot examined
Thick yellow Leucorrhoea
Examined externally
Menses regular —copious
  yellow Leucorrhea
Examined once, used Ar-
  genti Nit. slightly
Menses  irregular,  dark.
  painful — copious  Leu-
  corrhea
Examined, once' toucher'
Menses absent — Leucor-
  rhea
Xot examined
Menses occur slightly, but
  she  is nursing — much
  Leucorrhea
Xot examined
Menses regular and scanty
  —occasional Leucorrhea
Not examined
Debility,  pain  in  back,
  headache, &c.
Ainenorrhoea,   toothache,
  headache
Leucorrhea

Leucorrhea,  hypogastric
  pain, debility
Cervix enlarged, irregular,
  indurated and  excoria-
  ted
Palpitation,-wea]incss,neT-
  vousness

Uterus tender to the touch
Amenorrhea, debility, pain
  in back,  swelled  feet
  headache, &c.
Debility, sinking in epigas-
  trium, dyspepsia, consti-
  pation, headache

Debility,   severe  pain in
  back after all exertion
Menses too  -late,  scanty,Languor, palpitation, pain
  and  pale, copious  Leu-\   in left side, short breath
  corrhea
Not examined           i
2yrs. and 9 Greatly  benefitted, menses
 mouths oc-   regular and normal, much
 casionally     stronger, but does not be-
              come quite strong
 2s months Menses returned,  but .did,
              not   continue  regular ;
              health improved greatly.
              attendance irregular
   weeks    Cured                     Puis.  3—Cal
                                       Merc. c. 2.
   months   Uterus   cured  ;   general Awx v. ox.
              health improved greatly
              but over-fatigue and mo
              ral causes prevented com-
              plete recovery           I
 2 months   Benefitted, leucorrhoea ceas- Puis.
              ed, but left town too soon   30
              to j udge.
Nuxv. 3—Sep. 30—Sulph.
  12—Alum 30—Bry. 30
  Alum 30—Plat. 0 30 —
  Natrum m. 3.
Puis. 3.
1 month


21 months



5 months




2 months
Cured
acet.  3—
3—Puis. 30—Phos.
-Tr. Sulph. O.
Puis. 3—Puis. 3—Sulph. 6
  Fiife. tj—Sulph. 6
Cured  (a  change to the Carb. v. 30-
  country did good)
-Ignat. 6
Very  much  relieved ;   is\Bry. 3x.—Puis. 3x.
  still under treatment, had
  she been  more  cautious
  she  would   have  been
  well
Very much better, left treat-
  ment  too soon ; menses
  more healthy, leucorrhoea
  ceased
Sep. 5—Puis. 3—Bell. 3
  —Tr. Sulph. O—Sulph.
  30 
No.
Age
Length of
 illness.
Uterine discharge.
Chief symptoms.
I.en-tll of
Mm- under
treatment.
Results.
Remedies which relieved.
138



139




140



141

142


143
145
  10
Singl
 25
single
  24
married,
  3
children.
youngest
6 weeks.
Single
  20
Single

  19
Single
144    16
     Single
  38
married,
3 months
2 years
6 weeks
 6 months

  several
  months

some years
2 months
Menses absent 3 months   Pain in left side, chlorosis
Not examined
Menses irregular, scanty,
  and pale
Not examined
palpitation, headache
Irregular  menstruation,
  headache, nausea, pain
  in thighs
Menses absent, is nursine Pain  in left iliac region,
  —copious Leucorrhaa \   leucorrhea,debll\ty,dys-
Not examined           J   pepsia, &c.
Menses absent 6 months
Not examined
Menses every  14 days—
  Leucorrhea
Not examined
Menses irregular, scanty.
  and  pale—copious Leu-
  corrhea
Not examined
Menses   irregular,  very
  scanty _
Not examined
Pain in left side of chest,
  dyspepsia, debility, &c.
Debility,  nervous  depres-
  sion, bearing down pain,
  piles
Nausea,  dyspepsia,  pain
  in back, depression
Debility, short breath
3 months YMcnscs returned,  felt  bet- Puis. 3—Kali o.  3—Lach.
          |   ter at times, still had painj  6.
             inside; left treatment tooj
             soon
1 month   Felt  quite  well  for  some Sep. 6—Puis. 0—Bell. G
             months,   then   became   Puis. G.
             dyspeptic,  without  men-
             strual  irregularity,  and
             was  again  much bene-i
             fitted                   |
2£ months- Very  much relieved;  leu-Sab. 6—Sab. 6 Several re-
             corrhcea   greatly   diini-j medics as Sulph. 30—Sep.
             nished                  | 30—Bell. 30—Puis.  30
                                      were   previously  given
                                     j without any benefit.
4 months  Menses  returned,  health Ars. 3n—Sep. 30—Merc.
             greatly improved        j 3—Puis. 3.
6 weeks   Cured.   Leuehorroea   not Ign. 3—Ign. 3.
             reported                 |
3 months
2 weeks
Menses absent, is  nursing Pain in  left mamma,  pain  3i months
  —yellow Leucorrhaa     in loins, weight in hypo-
                           eastrium
Examined—Argenti Nit. Inflammation and ulcera-
                           tion of cervix
But   little   benefit,
  treatment too soon
left 'Puis. G—Bell. 30
No change whilst under ob-jTr. Sulph. O
  servation, left too soon to1
  judge. I heard afterwards
  that she was better.,      |
Uterus  cured,  health  im- Puis. 3x.
  proved, at once  became
  pregnant, when ulcer was
  healed; the pain in mam-
  ma ceased  when  uterus
  became well. 
146




147




148


149


150


151



152


153




154
  24
Single
  24
Single
  19
Single

  22
Single

  37
married

  42
married
  38
married

30-5
married
  15
Single
several years




some time





a long time


4 or 5 years


12 months


many years



16 months


a long time





3 months
Menses very irregular, oft
 en absent, are so now—
 occasional Leucorrhea
Not examined

Menses  regular,  scanty,
 pale—much  Leucorrhea
Not examined
Menses regular—Leucor-
 rhea
Not examined
Menses regular,  painful—
 much  Leucorrhea
Not examined
Menses reg ular — copious
 yellow Leucorrhea
Not examined
Menses regular, copious,
 with much pain—copious
 Leucorrhea
Not examined
Menses regular — copious
 Leucorrhea
Not examined
Menses  regular — slight
 Leucorrhea
Not examined
Menses suppressed-
 ous Leucorrhea
Not examined
Dyspepsia,    constipation
 headache
Debility,  much headache
 dyspepsia, pain in back
Severe  pain in  sacrum,
 palpitation

Pain in  hepatic region,
 dysmenorrhoea

Leucorrhea,   headache,
 dyspepsia,  weakness  in
 loins
Pain in abdomen,  head-
 ache, much palpitation
Pain in right side of abdo
 men, severe  headache at
 times
Great debility, lrysteria :
 formerly  had  ulcerated
 cervix,  under Dr. Simp-
 son
eo\)\-.Backache,  severe  head-
     ache
 3 months




 2 months





4i months


2 months


5 s months


10 months



6 weeks


6 months





10 days
Nux v. 3—Lye.  5 6  12
 30 100.
Sulph.  30 —Merc.  12 —
 Sulph. 30—Graph. 30.
 Very  much   benefitted,
  menses  returned  and
  continued   regular  for
  some months;  subject,
  however, to relapses.
 Very  much  relieved —
  menses came of a na-
  tural color;  leucorrhoea
  continued and also pain
  in back ; gave up  treat-
  ment too soon
Much benefitted in health [Bell. 3—Sep.  12—Puis. 6
  —Leucorrhea not re- I  —Plumb. 0—Puis. 6—
  ported                 |  Tr. Sulph. O.
Cured, leucorrhoea ceased |Nux  v.  6  3d—Sulph.  30
                          Merc. 6—Sulph. 30.

Very much relieved ;  leu- jLach. 12—Sep. 12—Sep.
 corrhcea  much reduced j 30—Sulph. 30—Calc. 30.
 in quantity
Varied much, no essential 'Calc. 30—Ars.12—Graph.
 change                 j  30—Chin. s.  1.
Not  much  change, left Sulph. 30—Sep. 12.
 treatment too soon

Decidedly benefitted, and Tr. Sulph. O—Calc. a. 3-
 continued  to  improve | Alum. 30—Sulph.  30-
 under    Homoeopathic ' Bry. 30.
 care ;    was  formerly |
 treated  locally by  Dr.
 Simpson
Menses returned, and she {Puis. Q.
 felt so well as not to de-
 sire further treatment 
155
15G
157
15S
IV.)
A-c.
Length (if
 ill 110S3.
Uterine Discharge.
Chief fymiitoms
 I.I 11-tie of
time Mider
 treatment.
Remedies which relieved.
  IS
Single
  28
Single
  40
Single
some time
some years
some years
Menses irregular
Not examined
Puis. 0.—Ferr. ac. 2.
                         Irregular  menses,  head-'  3 months  Cured
                           ache, swelled legs
                         During  treatment she had
                           smallpox,   which   wa>;
                           treated by Aeon. -3. and            i
                           Tart, em." 1.           j                                      !
Menses irregular, scanty.1 Dysmenorrha'a,  hysteria.,  11  months Many symptoms   relieved Calc. 3—Culc.  100—Sep.
  painful or  not — ocea-
  s';o:i;'l Leu  orrhea
Not examined
severe pain in back, Ca'c.
debility
34	4 years
Single	
IS	12 months
Single	
Mouses  are leaving  her. (Edematous legs, throbbin
  often violent and clotted!  aud cutting  hypogastric!
                           pain, vertical headache
                         I                        I
Examined ' toucher '     Hardness  and  irregularity
                           of cervix—scirrhus ?
Menses  too  early, scanty. Pain in back, leucorrhea.
6 months
  at  times,  but she  con-
  tinued  very  weak,  audi
  at  last went  under allo-
  pathic  . treatment,   and
  still  continues  (4 years
  later) without any mate-!
  rial change.   All kinds ofj
  local treatment have been
  tried, I bel'eve
No material improvement
100
Carb. v. 3—Puis. 3.
pain  in  hypogastrium,
pimples on face
  and  bright  red—much
  Lcwori haa
Xot examined
Menses abs, nt 12  months'Headache1,  flushing,
  —slight Leicorrhaa   I   round waist
Not examined
5 months  -Very   much   benefitted : Nux v. 3x.—Sen. 5—Nux
             menses   became   more!  v. 3x.— >SVyi.  12.
          I   healthy,   and    leucor-j
          I   rhcea h ss
3 month  !Cured,  le - had  frequent Nux v. 0.—Puis. 6—Bell.
             r.-uirns  of Anienorrhira I  0.
             always,  however,  bene-
             fitted bv treatment 
several years \Mcnses every three weeks.
            ;   scanty and pale, copious
               Leu ".-rrhrra
            [Examin     . i  treated by
               Arge\-    Nit.   and
               Simpson's pessary
2 years     \Mcnses irregular, too sel-
               dom, scanty and pale-
               much Leucorrhaa
             Not examined

             Menses scanty and painfn
               —slight Leucorrhea
             Not examined
 12 months





 2 years


 a year





a long time
Menses abundant, hnomor-
  rhag'c  clotted—copious
  L';!.eorrha:a
Not examined
Menses ceased three years
  —yellow Leucorrhea
Not examined
Muiscs (opioid and weak-
  ening—.jloody  Leucor-
  rhea, e -ipious
R.v-jinin, d ' toucher1
3 yrs. and 2
months, oc
 casionally
Hysteria,  pain  in  right
  side, pain in back,  verti-
  cal headache
Retroversion,   inflamma-
  tion  and  ulceration  of
  cervical canal
Palpitation, debility,   pain; 51 months
  above left hip, throbbing
  of carotids,  ' bruit  de
  diable,'  frequent head-
  ache
Plashing,  and   at times
  erysipelas of face, insuf-
  ficient menses,   swell
Menorrhagia,    occ'pital
  headache, great debility
General health improved, Nux v. 3
  is still far from well
Very much benefitted
45 months  Much benefitted
        -Bell. 3—Bell.
30—Nux v. 12—Sep. 6
—Tr. Sulph. O—Silic 6
Kali c. 3—Nux v. 3x.
41 mouths
Puis. 30—Puis. 30—Puis.
  12—Sep. 30—Sulph. 30
  Sep. 30-.
I Nux  v.  6—Sulph. 12-
  Sulph.  12—Sep.  12-
  Puls. 6.
Debility,  flushing, dysp   1 month
  no?a,  swelling  of vulva,
  at times
Some bearing down pain
-copious
Aol exa;
Tenderness   of  anterioi
   vail  of  uterus  (Met:-;-

Hemorrhoids,  dyspepsia.
  leucorrhoea,    pain   in
  baek, (cont acted .'yphi-
  l.G during ii-eatiuCiitJ
20 d:
Arson.  12-
Arsen. 30.
-Ars.  6—  -*
 yirred of the flooding, andL(rSf,w    jo__Chin.   6-
  greatly   improved   in
  health ;  after w/e/iseslefi
  her, an  ulcer broke oui
  in one leg-, and continue;
  to discharge
Greatly  improved
Some  relief—left   treat-
  ment toosoon
3J months i Cured both of original dis-
          I  ease and sythiiis
Bry. 6—Sulph. 6.
Nux v. 3x.—Bry. 3x.
Aeon.   fi—Sulph.   30-
  Puls.  30—(.Merc,  (i-
  Thuja ti—Merc. G.) 
 38
married,
 25
married,
1C9    41
31
children
youngest
172    27
     married,
     a widow,
Length ofillness
3 years
3 years
6 or 8
months
2 years
1 year
Menses too frequent,  co-
  pious and clotted—dirty
  white Leucorrhea,  co-
  pious
Not examined
Menses regular, painful—Gastrodynia
  much thick Leucorrhoea
Xot examined
Uterine discharge.
Chief symptoms.
I., n-tli el
lime nn.ler
treatment.
Result,
Remedies which relieved.
Menorrhagia, leucorrhaa.
  headache, dvspeusia
lOi months iNo permanent benefit; was Cham. 0—Sep. 1;.'—Lach
|   dismissed because she r<
   fused to be examined
30—Secale 30— Puis. 30.
head;
side
    enuresis.
pain in  left
4 months  .Much improvement, leucor-,Bell.  30 — Arson. 30 —
Menses regular and  pain-
  ful—copious yellow Leu-
  corrhaa,
Examined and treated by
  Argenti  Nit., _ Kali
  Bichr., Aurum.  Mur.,
  Plat. Chl.
Menses  regular,   scanty7.
  very dark—copious Leu-
  corrhea
Not examined
Menses absent 3 months—
  copious yellow  Leucor-
  rhea
Examined, treated  locally
  —Argenti Nit.
Menses  regular—copious
  purulent Leucorrhea
Examined, treated locally
  -—Argenti Nit.
Leucorrhea, debility, de-
  pression,  violent  head-
  ache, pain in back
dee-ration    of   cervica1
  canal and cervix
|Headache, dyspepsia, leu-
  corrhaa,  some cough
Debility,  yellow  leucor-
  rhea,  bearing down

Large  unhealthy ulcer  of
  cervix
Cough,  violent  retching,
  debility, bearing down
Large  unhealthy  ulcer  of
   not     ;  rhea lessened ; not much
regularly  {  change in enuresis
1 year and
 7 months
6i months
weeks
weeks
Calc. 12.
No permanent improvement j^ep. 5 — Bell. 3 — Calc
  before or after local treat-   acet.  '.',—Sep.  5—Puis
  ment,  which  was  com-   12—Igna.t. 3—Sep.
  meiiced after 1 year and
  4 months
Cured
Puis. 30—Calc. 30—Puis.
  6—Sulph. 3n—Calc. 30
  Sep. 12—Calc. 30.
Improving, still under treat- Sep. 3x.
  ment
Improving, still under treat- Bell. 3x.—Arg. 3x.
  ment 
173
  37
married,
i widow ,|
 1 child
£174
39
175	40
	married,
	2
	children,
	youngest
	11
176	35
	married,
	a widow,
	'2
	children,
	youngest 6
177	35
	married,
	a widow,
	3
	children,
	youngest
	11
178	29
	married,
	four and
	a hair
	yeart ago
	
Menses  too  seldom, but Debility,    menorrhagiaj
  very copious and debili-   bearing  down,  swelled!
  fating                    legs                   J
Examined and treated lo- Cervix  enlarged,   finclvj
  cally at  first, Augentij  granular, bleeding ea^iiyj
  NlT.                  j
Menses  absent — copious Dyspepsia,  with   rodnes:
  Leucorrhea              and rawness of mouth
                           prolapsus uteri
Examined, treated locally, Cervix uteri  projects
3 mouths
4 months
Argenti Nit., Aurum
M
Menses regular
Examined,  treated locally
  Argenti Nit. and Kali
  Bichrom.
Menses regular, scanty—
  copious Leucorrhea
Examined and  treated lo
  cally, Argenti Nit. and
  Kali Bichrom.

Menses much too copious
  —copious Leucorrhea
Not examined
Menses  regular — thick
  white Leucorrhea, co-
  pious
Examined, treated  locally,
  Aurum Mur. and Stan
  NU» CULOR.
  ternally, and is cleft in
  two, and the interior of
  lips are granulated.

Headache, pain and occa-
■  sional haemorrhage after
  coition
Smooth induration  of an
  terior lip, canal red and
  raw
Bearing down pain, pain
  in groins
Retroflexion of cervix, soft
  enlargement of  cervix
  os  and canal patent and
  excoriated
Menorrhagia,     debility
  backache
Prolapsus uteri
Labiae  uteri  greatly  en
  larged,  and  projecting
  from vagina
3 months
5 months
3 months
5 weeks
Improving, still under treat-
  ment
Cured.  General treatment
  relieved    the   general
  health,  but  uterus re-
  mained  unchanged  till
  local   treatment   com-
  menced ;   the   prolapse
  and ulceration were both
  completely cured
Greatly   improved,   left
  treatment  too soon; an
  terior  lip   smaller,  and
  canal more healthy
Cured;  is still  dyspeptic,
  and has inguinal hernia
Greatly benefitted, still un-
  der treatment
Decidedly  benefitted, ute
  rus entirely  within va
  gina; left treatment too
  soon
Plat. Chi. 3—Plat.  12—
 (locallyARGENTiNiT. once
 and  Plat. Chlor.  once
 cured the  cervix com-
 pletely)

Bell. 3x.—Bell. \—Nux v.
 3x.—Aurum Mur. 1-50,
 locally and internally Aur.
 Mur. 3.
Puis. 3—Ign. 3x.—K.Bich.
.3x.       '
Nux v.  12—Bell.  3x.-
 Aur. M.  3—Nux v. 3-
 Sulph. 3—K. Bich. 3x.
Bell. 3x.-Plat. CM. 3.
Aur. M.  3—Stann. 3x..
  (Puis. 3x0 
180
Age!"
Length of
 ilhiefa.
179  30—5
■10
children,
youngest
 2 years
20 months
6 or 8
 months
Uterine discharge.
Chief symptoms.
 Leiutii o:
tinr-  niiilei-
 treatment.
Results.
Remedies whieh relieved.
Menses absent  (is prog- Debility, lcucorrhea,shoot-\  5 months
  nant)—Leucorrhaa       ing pains in vagina
Examined ' toucher'once Reported  by  a  London'
                        j   physician  to have vagi-
                           nitis and ulcerated cervix;
Menses  very   copious—Debility,    Menorrhagia,1
  some Leucorrhea     |   bearing down
Examined, treated locally. Enlargement,  and  granu-
  Argenti Nit.            lated excoriation of cer-
                           vix
occasion-
ally
           Much benefitted: was de-Xux v. 3.— Car. v. 5.
             livercd of a healthy child
             one month after, but some]
             of  the uterine symptoms
             returned afterwards
4 months iDeeidedly better : after the Plat.  6—Arg. 3x.
          I   second application of Ar-
          i   genti Nit.  there  came
             an induration of anterior
             lip  exactly  resembling
             that occurring in chronic
             inflammation                          _____
00
TABLE  No.  1
                             general table.

No. of Cases cured or greatly benefitted......................   112
No. of Cases somewhat benefitted  ..........................    51
No. of Cases unchanged  ..................................    1/
                                                               ----   ISO
No. of Cases still under treatment  ........•.................    22
No. of Cases left treatment to early to judge..................    34 
83
		TA	BLE	No.	2, Showing Ages and Results.								
		j>>	-a CD	1 %.			Left treatment too early to judge.						
		CD .	CD P	T3 a 0) 1 ID		•			>>	a			
CD	§	">«!	,o						S"B	j	T3		
w	to <	sg a-2 6	A is ID S o 03	Uncha Still under		o	a	o to	to ±2 |! 6	AA-C a c ■a a cd ° s o 03	CO 5	3	
Married..	15—20					33 ! <"	Married..	15—20				■ ■ ) r,	
Single...		18	14	2			Single. . .		3	4		7 '	
Married..	20—25	7	2			9 \ 46 37 ) *J	Married..	20—25	2			9 \	
Single...		26	8	2			Single. . .		7	1		9 )	11
Married..	25—30	5	5	1		11 * 0_	Married..	25—30	1	4		.! 3	
Single...		7	4	5		icr'	Single...		1				6
Married..	30—35	14	5	1		20 j90 13 , °°	Married..	30—35	2	1			
Single...		10	2	1			Single. . .						3
Married..	35—40	15	4	2		21 )	Married..	35—40	1		2	4	
Single...		2	2				Single. . .						► 4
Married..	40—50	5	4	3		121	Married..	40—50	1			2	!»
!!	50 and upwds	2	1			3 10	H	50 and upwds.			1	1	
Single...		1				ll	Single...						
Married							Married						
and		34	13	3		51 51	and		7	3	1	.. 11	
families				•		180	families-						
TABLE No. 3, Showing Length of Illness							and Results.					
	&	-a		a			Left treatment too early to					
		a CD	t3 CD bo	a a CD			judge					
							i^M		-o			
Time.	botS	£	a	■£	■g	Time.		■g-u	bo	•a a		
	a	.13 CD 0	1	CD n 13 a a •J3	H		= a a >>	J3 £ CD CD o	a a ,a CD a	a S 03 -P		o
	o	03		02								
Under 3 months	14	5		1	19	Under 3 months	1	1				2
.. 6 ..	9	4		3	13	.. 6 ..	1	1				2
.. 12 ..	16	9	2	3	27	..12 ..	3	1	i			b
„ .. 2 years..	14	4	3	3	21	2 years..	a	3	2			4
.. 3 ..	9	5	1	2	16	.. 3 ..	3	1				
.. 6 ..	10	3	1	1	13	.. 6 ..	4					4
A long time....	18	17	8	8	43	Many years---		2	1			3 5 2
	20	3	2	1	25	A long time....	4	1				
	2	1			3		1	1				
					180							
 
84
TABLE No.			4, SnowiNO Length				of Time		l.NDF.R Tr		EATMF.NT.			
Cases under treatment steadily.						Cases seen occasionally.					Cases left too early			
											to ju		l«o._	
	CD -a	T3			3 1)	0) •	T3 CD				CD	•a CD		
Time.	H boS c 3 o	«3 CD a o .3 "a CD s O w	13 01 bo a JS a	t	Total.	a 2« CD a o	CD 13 CD X> a .a CD B o 03	bo § u □	"3 o	a o H CD L. Ih O o.	h °£ a o	to CD a CD .a 0) & O 03	■d CD cm § a Ld	o H
1 month and														
under.....	12	7	1		. 20					20	5	3	1	9
2 .. ..	16	10	1		. 27					27	7	3	2	12
3 ..	19	8	2		. 29					29	2	4		6
4 ..	12	4	2		. 18					18	3			3
5 ..	14	1			. 15					15				
6 ...	' 8	5	5		. 18	2			2	20	2	1		3
9	9	2	1		. 12	1	i		2	14			1	1
12	5	4	3		. 12					12				
li-years.....	3	2	1		6					6				
li .......	2				2		l		1	3				
2 or more yrs	5	3			8	3	2		5	13				
						1	1	1	3	3				
TABLE No. 5,			Showing		State of		Uterine Functions.					
	01 a CD XI	T3 CD e •a CD	13 CD		Left treatment too early to judge.				Still under treatment			
					>>	a			13			
8tnte of Uterine			a	"a	c-a	x>	01		CD	aJ	-o	
functions.	o -a	a -a	x\ o a p	o	tLAj	■MT3 a 4> -a a £ca	.a o a.	3 o E-<	a CD Xi	Oi a CO .o	t(l p a	o
	u	s			vxi	fl	13			R	p	
		o							AH			
	U	CO		,	O	m			o	tti		
Menses absent..	24	12		36	4	3		7	3	2		5
regular..	34	13	5	52	5	1	2	8	2			7
irregular.	10	4	4	18		2		2		5		
scanty ..	22	8	5	35	6	1		7	3	1		4
copious..	23	13	6	43	2	2	1	5	5	3		8
(too long (duration	4	3		7		1		1				
painful. .	13	7	5	25	3	1		4	2	3		5
	12	6	1	19	4	1	i	6				
dark..;.	4	3	1	8		1		1				
too early.	10	11	1	22	3	2		5	4			4
too late..	5	2	2	9	4			4		2		?
Leuc. some ...	26	6	5	37	5	3		8	2	2		4
copious..	50	14	9	73	9	4	3	16	4	6		10
.. occasional	14	8	2	24	1	2		3	3	1		4
Sang, discharge			1	1			1	1				
 
85
TABLE No. 6 Showing No. of Cases Unexamined, Examined, and
         Examined and treated locally, with Results.
					Left treatment too			
	a . CD H3	« .			early to judge.			
					^			
Whether examined or otherwise.	bo& fa'-13 O CD	a (Bjd	bo a a xi a ►3	"a o E-t	bj: aj	a t3	-a CD bo a XI	'a o
	a				a XI	c S	G	
	o			110 23 47	a >> 14 5	03 J	3 1	
Not examined ....	70 7 35	32 9 10	8 7 2			9 4 1		O^
Examined .....								s
Examined and treated locally								6
.  •  •  e .2 ^s  «> 2 _2 -=  so

      0Q   ~   ^PJPhOI m 
86
TABLE No.  7,  Continued.
Left treatment too early		to ju	■a			Still under treatment.						
	■a a	a		73* I								
	MS			bo J								
	^■S	£.2		a ,		Greatly			Somewhat			
		SS				benefitted.			benefitted.			
	V ">	o 5		a								
	£x>	03,0										
Objective Uterine symptoms.	O											li
						, |					(-.	
			>>	>>		I	>> %			>>	■a	H
							P3 CD			a		
	t*>	>>	a	a		>>		'a	>»		tf	
		^	o	o	"3	"a		43	■a1		J3	
		o				CD						
												
	J	►J	55	55 '	H	^	fc	S	hJ			
First stage of cervico-metritis.						1			l			2
Second .. .. ...			1		1				l			1
Third	1	1			2	2			4			(j
Fourth	1				1	1						1
Uterus sensitive to touch.....			3	1	4		1					1
engorged............			1		1					1		1
anterior wall. .			1		I 1							
Symptoms of cervico-metritis T												
detected by the finger, where 1			]	1	4					1		1
there was no opportunity of [												
using the speculum ......J												
Prolapse of uterus ..........					1							
TABLE No. 8.  Medicines and Potencies that did good.
Aconite ....................
Alumina....................
    „   3 altera, with Bryonia.
    ,.   30   „          „   .
Ammonium carbonicum.......
Arg-Ti'iim ..................
Arsenicum..................
3  5
12 altern. with China..
12   „        Puis. ..
30   „         „   ..
30   ,,        Sulph...
30   „      Carb. veg,
Aurum  ........
    ,,  30 altern. with Sepia.
.Aurum muriaticum  .......
Baryta carbon............
Belladonna...............
    ,,     6 altern. with Sepia.
    „     6   „       Graph.
          6   „       Plat. . .
    ,,     6   „       Puis. ..
         18   „         „  .,
Berberis vulg................
Bryonia alba................
 3 altern. with Alum.
30   „
 3  6   .
 3 12 30
 3
30
3x
3x  .
 2  3
12 30
 6  .
12  .
30  .
30  .
30  .
30  .
30  .
 3  .
 6  .
 1 3x   2
 3  6  12
18 30
12
 6
 6
 6
 6
 3
1-20  1  3x
 3   6 12
30   .   .
 3   .   .
30   .   .
Calcarea acet...
    ,,   carbon.
12 alt. with Zinc,
Cantharis.......
Carbo vesretabilis.
12 alt, with Cham.
12 alt. with Lach.
30 alt. with Arsen.
Chamomilla
China off.
6 alt. with Carb. veg.
    ,,    6 altern. with Arsen.
Chininum sulph............
Cina......................
Cocculus..................
Conium  ...................
Digitalis...................
Ferrum...................
    „   acet................
    „   sulph..............
Graphites.................
    ,,   6 altern. with 1!' 11. .
    „   6   „        Sepia
Hypericum................
Ignatia...................
Iodium...................
 3  .   .
 3  6 12
18 30 100
 6  .
 3  .
 3  5
12 38
 6  .
12  .
30  .
3x  3
12   .
12   .
 O  1
 6 30
12   .
 1
3x   .
 3  6
 1  3
 3  6
 6 12
 2   .
lx   .
 3  5
12 30
 6   .
 12   .
3x   .
3x
 2
3  6 
87
TABLE No. 8.—Continued.
Kali Bichrom.
 „  carbon.  .
 .,  Iodidum...................
Kali  lodid. 1 alt. with Merc.  acet.
Krcoe.oliun.....................
    „      12 altern.  with Puis...
Lachesis.......................
   "    12 altern.  with  Carb. veg.
   „    12     „         Sepia...
Lycopodium...................
Magnesia carb..................
Manganum aoot................
Mercurius acet..................
      „        1 alt.  with Kali Iod,
       „   iodid...............
          sol..................
2 12
      „   Subl. Corr.
Katrum muriat.......
Nitri. acidum .......
Nux moschata.......
vomica
Phosphorus............
Platina  ...............
      6 altern. with  Puis.
  "   6     „       Bell.
Platinum Chlor.........
Plumbum  .............
   „    acet..........
Pulsatilla '..............
3x
3x
12
 1
 1
3x
12
 6 12  30
12   .
12   .
 5 12
 6   .
 1   .
 1
 1
 1
 3
12
 2
 3
 2
3x
3x   3
12  30
 3  30
 3   6
 6   .
 6   .
 3   .
 6  12
  1   .
3x

3x
 5
6 12

6
12
Pulsatilla 6
    >,    6
    „    6
    »    6
    „    6
    „    6
    „   12
    »   12
    „   30
Sulph.

Sepia  .
Bell.  .
Sepia .
Bell.  .,
Arsen.
Kreos.
Arsen.
12
 6
12
18
 6
 6
12
12
30
RhusTox .....................  3x  6
Sabina........................  3x  6
Secale Corn  .........:.........   3  6 30
Sepia.........................  3x  3  5
  „.........................   6 12 30
  »   .........................ioo  .
  „   6  altern.  with Puis........   6  .
12
12
12
12
12
30
 „    .......   6
Bell........   6
Graph.....   6
Sulph......12
Lach.......12
Aurum.....30
3 altern. with Sulph.
6     „      Plat.
3x  3
12 30
Silieea ........................   6
Stannum......................  3x
Sulphur  ......................   3
   „    ....................- • •  30
   ,,    6 altern. with Puis.......   6
   „    6     „      Puis.......   3
   „   12     „      Sepia.......  12
   „   30     „      Arsen......  30
Sulphuris tinct...................   O
Thuja Oec.....................   3
Vinca........................1-20
Zincum  .....................   6
        6 altern. with Calcar.....12
6 12
TABLE No. 9, Showing.Remedies most  freciuently useful  for Chief Symptoms
Symptoms.
 Total
Number Remedy and potency most
reported    frequently useful.
1.   Debility .

2.   Headache
3.  Pain in back
4.  Neuralgia........


5.  Leucorrhea.......


6.  Dyspepsia........


7.  Bearing down pain.
95

51



50





31


29


27


24
Number
  re-
ported.
1 Pulsatilla
2 Sepia ...
1 Pulsatilla
 3
30
 3
 6
 2 Sepia.......
[ 3 Nux vomica  .
 1 Sepia  ......  12
    ............30
 3 Sulphur   ....  30
 2 Pulsatilla___
 4 Belladonna  ..
 5 Nux vomica  .
 1 Pulsatilla. 6  12 30
 2 Tr. Sulphur .. O
 3 Nux vomica  .
 2 Sulphur   ....  30
 1 Sepia.......
 3 Pulsatilla  ...
 1 Pulsatilla, 612 30
 2 Belladonna  ..
 3 Nux vomica  .
 1 Nux vomica  .  3x
 2 Pulsatilla ....  12
 3 Sepia .......  30
 4  Bryonia.....  3x
 ", ":; atia   .....   3
Number: .Ditto in
relieved alterna-
by vari ;iir awith
OUS po- ether la-
tencies. ] meclies
Total.
39
27
30
13
12
26

18
19
16
15
15
11
12
14
15
 8
18
10
10
 9
 8
 6
 4
 3
44
30
35
15
12

29
21
24
17
15
16
12
12
14
17
 8
18
10
10
 9
 8
 6
 4
 3 
TABLE No. 9.—Continued.
Number
relieved
by vnri
ous po-
tencies
Symptom?.
 8.   Pain in left side  .
 9.   Pains in abdomen

10.   Menorrhagia  .....
11.  Dysmenorrhea.....

12.  Pain in hypogastrium

13.  Cardiac symptoms ...


14.  Amenorrhea   .......

15.  Constipation   .......

16.  Anemia and Chlorosis
17.   Shortness of breath
Total
Num-
ber re-
ported
18.   Swelled legs
IS
16

15
14

14

12


11

10

 9
Remedy and Potency most
    frequently useful.
  Pulsatilla___  3
1 Tr. Sulphur  .  ()
2 Pulsatilla ....
1 Platin. Chlor  .  3
  Platina  .....
2 Belladonna .. 3x
3 Sulphur.....30
 Num-
ber re-
ported.
1 Pulsatilla .
2 Sepia.....
1 Nux vomica
2 Lachesis ..
1 Pulsatilla ..
3 Sepia  ....
2 Sulphur ...
1 Pulsatilla ..
2 Sulphur ...
  Nux vomica
  Pulsatilla ..
1 Pulsatilla ...
 6
12
 3
 6
 3
30
10
 7
 7
 11
2 Belladonna
3 Sepia ....
4 Platina  .....  6
3 Sepia.......  5
1 Pulsatilla___
2 Sulphur  ___
4 Belladonna ..
5 Nux vomica  .
  Pulsatilla___  3
 4
13
 7
 8
 6
 5
 6
 6
Total.
10
 7
 7
11
 9
 3
 8
 8
 8
 4
15
 7
 8
 9
 5
 6
 6
1  Pulsatilla occurs among the most useful in 16 symptoms, as chief in 12
2  Sepia       „             „             9     „        ,,       2
3  Nux vomica „             „             8     ,,        ,,3
4  Sulphur    „___________„____________8      _______        1

     TABLE No. 10, Showing Relative Results  of High  and
                          Low Potencies.
	ILow potencies exclusively.	High potencies exclusively.	Total.	l.eli. treatment too early.		
N.B.—The low potencies include 6 and under— The high potencies, 12 and above.				i v. o -	w 5 1 1	3 o Eh
Cured or greatly bene- ) fitted ...........)	62 23 7	16 7 7	78 30 10	5 5 1		10
Somewhat benefitted ... Unchanged...........						6 2
						
             Results of Treatment with both High and Low Potencies.
Cases in which  both  high and  low potencies were given  with decidedly more
    benefit from the low than the high .................................
Cases in which no marked difference was observable between  the effects of high
19
s in wmen no marked  ditterence was  observable between  the effects  of high )
and low potencies.............................................     '  I   46 
SYMPTOMS.
 1  Debility................
 2  Headache................
 3 Pain in back............
 4 Neuralgia?..............
 5 Leucorrhoea.............
 6 Dyspepsia...............
 7 Bearing down pain.......
 8 Pain in left side..........
 9 Pains in abdomen.........
10 Menorrhagia............
11 Dysmenorrhoea..........
12 Pain  in hypogastriuin....
13 Cardiac symptoms.......
14 Amenorrhea...........
15 Constipation............
16 Anosmia and Chlorosis.. .
17 Shortness of breath......
18 Swelled legs............
19 Pains in various parts.. ..
20 Pain in left ovary........
21 Nausea................
22 Pain in right side........
23 Vomiting..............
 24 Flushed face............
 25 Fainting  fits............
 26 Sinking in stomach......
 27 Pain in iliac, region......
 28 Irritable bladder.........
 29 Pain in hypochondria
frequency of occurrence  of various  symptoms as a chief source of complaint.
a «
S c
o c
54
28
28
16
10
22
14
13
  U
10
  6
  9
  7
  6
  5
  2
  3
  5
  1
.2
  3
  3
  2
  4
  2
  3
  2
  2
  2
29
16
18
 9
 9
 5
 8
 3
 6
 4
 3
 3
 3
 4
 3
 5
 3

 *2
 3
  1
  1
 2

 2
  1
  1
  1
  1
12
 7
 4
 6
 1

'h
 2
 1
 1
 5
 2
 2
 1
 2
 2
 1
 1
 2

 i
 l

17
 6
10

 2
 2
 5

'2
 3
 1
 1
 1
EST
17
 7
10
 4
 5
 7
 5
 7

*3
 1
 1
 3

 i
 2
 2
95
51
50
31
29
27
24
18
16
15
14
14
12
11
10
 9
 7
 6
 5
 5
 5
 5
 4
 4
 4
 4
 3
 3
 3
30 Eruptions on the skin.......
31 Nervousness...............
32 Epileptic fits...............
33 Irregular menses...........
34 Cough....................
35 Numbness of right arm and leg
36 Pain in  the thighs..........
37 Pelvic abscess............
38 Throbbing of carotids.......
39 Hemorrhoids..............
40 Palpitation................
41 Pain in  right ovary.........
42 Vertigo...................
43 Congestion of head.........
44 Irregular action of heart.....
45 Spinal irritation............
46 1 lepatie pain...............
47 Hysterical convulsions.......
48 Sanguineous discharge.......
49 Haemorrhage from rectum . ..
50 Discharge of pus per anum..
51 Great distension of abdomen..
52 Pain in  genitals............
53 ApthiB in mouth...........
54 Varicose veins.............
55 Swelled glands.............
56 Pain in  left mamma.........
57 Bain & hiemorrboids after coitus
58 Shooting pains in vagina.  ., 
90
TABLE No. 12,  Showing iocal  remedies
              WITH RESULTS.
	t»>				
	« .	"•d	CO	F	
Local remedies	''■£	> ij	B	>-	"3
employed.	o ~	E 5	J3		o
	p i	C o U2 X>		«	
	O				
	22	7			29
Bichromate of Potash ....	1	3			4
	1 2	1 1			2
Pernitrate of Mercury....					3
Simpson's pessary........	6	1		2	y
	1				i
	8 o 2	i	4		13
					2
Aurum muriaticum, 1 50.					2
Stannum muriaticum.....	1				1
U  Q
Eh
		CO	r-		
	73	<M -#			
					
					
	H	CO CO LO CO			
	ai				
		O 00 i.O i-l			
	.a	1-1			
	CO				
	T3				
	(U				
		co oo i-t -r			
	t.	<-< en			
					
					
			•13		
			• CI		
!*			• C3	^	
►J < u	CJ o		fl	o 13 1	
03 o w S n	u o		13 n3 01 V		
	IS 111		§ s **>	13	
			T3T3 -= B		
■<	M		§^rt		
	t.	rflTSTj 3^			
		ai <u a) rt i- >>			
		d a a ^a c =3			
o	.3	xami xami xami mec xami nica			
-1	r*				
		WWW		w	
TABLE No. 14, Showing  the Ages of those examined, treated locally,  &c.
Single..

Married
Single..
Married,
Single..
Married
Single..
Married.
	i 'i	red n>- "rent benefitted.		y	Somewhat benefitted.				Unehnnged.					
Age.	.	>>	£>				j>>	iA T3S			>.	Ti£'	3	
		75	£	5 S		ja"		Nf.			S	re ;3	H	
	j>>	o	C	~l	j>»	o	a a Xi	£>g	"3	o	a A	;=? 5		
														
						o								
	~	fc	«=>	-S	J	S5	«=i	jS	>J	K	2	J2		
Under 15		1												1
15—20	1					3								4
20—25	1	2											3	9
—	1			2	2					1			6	
25—30	4 1		1 1	1	2					1 1	1		10 v Q	13
30—35	4	2	1		2	q				4			16	26
. .—..	2	1		2	1	3		1					10	
35—40	10		1		2									13
40—50	1	1							1					3
yi) and up-														
wards.	1													1
 
91
TABLE No. 2, Continued.  Still under
             treatment.
		T3	«T3 ?	
		t>s CO	■9S S	3 ,-<
State.	Asre.	cS'-G SB CO CD iu A	Sh •£ o co ; WA &	-
Single ....	15—20	1	2 .	. 3
	20—25	1	4 .	. 5
Married ..	25—30		1 .	: U3
Single ....	.. —..	1	1 .	
Married ..	30—35	1	1	: S|«
Single	..—..	2	2 .	
Married ..	i 30—40	4		. 4
	40—50		i .	. 1
Married anc		5	2 .	. 7
families ..		1	1	
TABLE No. 3, Continued'.   Still
        UNDER TREATMENT.
	A^	3t3	T3	
Length of illness.	CD c	A <B S3 O SB	bo a CS CO 13	13 o
		n-=	t>	
Under 3 months		1		1
.. 6 ..	1	2		3
..12	1	2		3
.. 2 years..	3			3
.. 3 ..	2			2
..6 ..	1			1
Many years....	2	5	1	8
A long time....		1		1
TABLE No. 4, Continued.  Still
       UNDER TREATMENT.
			fl-3 'g	1
Length of treatment.		i'-g	A B bo	1
			oo a	
		A	M^ 5	
Under 1 month			3 .	3
.. 2 ..			1	1
	. 3 ..	3	1 ..	4
	. 4 ..	1		1
	. 5 ..	2		2
	. 6 ..		1 ..	1
	. 9 ..	2	1	3
	.12 ..	1		1
	. li years	1		1
	. 1* ..		1	1
2o	r more years	3	1 ..	4
.9  a
O  bS,
'l^jox	ooc*<y» 1	
•pa^nEqanft		
igatzaq araog	CO i-l «o	
•pa^gaaaq	lflH(5	
A"[;uajg		
		
		
		
m i		
,£		. o
		
		
		Its
o		. ^
T3		■ 05
CO		. m
		
		
§-§	13 . i3	
s*.	2 • «	
	'2 13 13	
		
		
A	x •= .a	
	"Eg	
A		
1 ^	!z	
 
Single .. With fa-milies ..		Single .. Married . Married .	Married . j 25—30 Married .| 30—35 Single . .1 ..—.. Married . 35—40	!3L	1, 5'	CO 5' CSa	en S		i
j		in _. © Rj &, 1 I • B ©■ ►a		• 101-m-< 1 1 1 If f • JO JO^ p • WOh cj»					
to		JO ■ • *. JO JO • »0 >—■ rf- ■					Some leucorrhoea	1 (Fa L	
to —.i-i JO- QOi-'Oli-'ifc.iJi.OlCvi						,_,	Cnp. leucorrhcra. Oe.«nl. leucorrhd'p.		
lU .1-4 WM			i-i JO • • i— JO " ■						
			: : : _: :		! m		Some leucorrhoea	1 g1 2 2_£ ;? o 5 ~	
1-4			to • • • JO				Cop. leucorrhoea.		
			JO • • •'		• «o		Ocsnl. leucorrlura		
jo '.			— '■ *- JO i-				Some leucorrluea	3* 1 o.	
*—» •			jo' ^i .		• JO		Cop. leucorrhoea.		
			'. _ _				Ocsnl. leucorrhrea.		
JO ■---- it- i-1 JO • -IO-'S-i-IOaI.							Toul. |		
			JO i— ) O **						
JO 4-A	-1 Co.			1-4 |_l					
to			O • !-• • • •				Seme leucorrhoea Cop. leucorrhoea.	Etio- Ci 1 r? dvj 2 pjCB S-	a a. 32 *3
to			: _; mm		<				
			JO- — • ■				Ocsnl. leucorrhoea.		
			m ; i ! '.				Some leucorrhma.		
JO			. ■ (O M4 kM		1-4 •		Cop. leucorrhoea.		
		._.! !	. .|_1 .		,_,.		Ocsnl. leucorrhoea.		
	-i						Some leucorrhoea.	05 a	
		—.■■-:--f					Cop. leucorrhoea.		
						1 Ocsnl. leucorrhoea.			
-1		1—" • K	0 to JO *- JO JO •		JO-	Total.			
CO CO	-r	_._.. -:_-	4 . ►_. • • • l-i JO •			| Some leucorrhoea.		A*-.^C 3 ro <• m	t-= 5
			• '• • JOHlMM.			| Cop. leucorrhoea.			
			: : : : ,_, : : :			| Ocsnl. leucorrhoea.			
JO			::::_:._.:			| Some leucorrhoea.			
		~: :	: r:-~:	:--r.		| Cop leucorrhoea. | Ocsnl lcucorrhcrn.			
						| Some leucorrhea.		&■ era P CD p.	
	w i		.! i ! . _! . !			| Cop, leucorrhoea.			
						| Ocsnl. leucorrhoea.			"
CO		M>- Jn!	; • to- *«■ c	0 0	s tn •	1	Total.		1
ze 
TABLE No. 16, being Analysis of cases, of Leucorrhaa, Section 2.
  Comparative Numbers of
Examined, Unexamined, &c.
Not examined..............
Examined..................
Examined and treated locally..
Do.      ..    do. mechanicalh
Do.      ..    do. locally and
    mechanically  .....,.•■•.
CO 
TABLE No.				11	, BEING			An.vlysi			^ of Cvf.			r.s	OF	L	KUCORRIIffiA				Section J				.					
											Still under treatment.										Left treatment too early.									
	Cured or			Som										Some-							Cured or			Some-						
	greatly			what			Un-				Greatly			what			Un-				greatly			what			Un-:			
	bene-			bene-			elian-ed.				bene-			bene-			changed.				bene-			bene-			changed.			
	fitted.			fitted.						"rt	fitted.			fitted.						"3 o	fitted.			fitted.						
Length of time ill.	8 A	a 8 ■a	8 A b	a	8	b	8 i * A 8 fc'fl		8 A		cS 8 A	e 8 A	8	cS 1 j 8 su ■fill		8 A	a 8 A	a 8	cj 8 A		d 8 XI	cj 8 .c	e 8 1*	cj 8 A	ca 8 A	I A	8	.1 a 5 2 C ,13 J3 £		3 o
																														
					o																									
		CO	a		c;				a		3		a	3. §				o			CJ				o			°l s		
					3 c				<D												a									
	1-1	CO	m)	.-3	CO	1-1	J ' «		hJ		Ml	Ml	a			A		a			01	c	.B	o		~	CJ	Si ~		
							o "																							
	a	p.		n	ft	"	p ft				f,	p.		pi ft				p.			ft	ft 7		P	ft		p	ft		
	o				o		O i o				o							o	u						o	u		o		
	m	U	U	w	U	°	cc j O		(J		t/j	O	u	tn j D O			m	U	O		m	- o		OJ	U	o	cc	O	~	
Under 3 months.....	2	4'					i			6				! 1 1 I							1									1
.. 6 .......	1	3l..			1		• •			5			1	. .1. .		1				<>	..2..				1		i 1			3
.. 12 .......	2	si				1	1 1			13	2			i 3				|						••1 ]			..j l:..			4
		C, "				1	1 ..			10	1	1						!		o	i			1 1		1	0			fi
.. 3 ........	1, 3 ..						..1 2..			6		1								1	2i 1			.. 1						4
.. 6-........	.J 4> 2				1					7			1		. . i					1	..' 2			.1 .						2
	r 3, :			]	% 1		3 4		§	27		i	1		31 1					0				1[..		1				2
	0 ti . .			1		1				14				1						1	..,3			1 ..						4
		1 ..		1						2											1			1						I
	1																													
CO
4* 
TABLE No.				18	BEING			Analysis			of Cases				OF	LEUC0RRII02A					Section 4									
											Still under treatment.									o Eh	Left treatment too earh								r. ed.	
	Cured or greatly bene-fitted.			Some-what bene-fitted.			Un-changed.			c c-i	Greatly bene-fitted.			Some-what bene-fitted.			Un-changed.				greatly ^bene-fitted.			what bene-fitted.			Un chanf			
Menstrual functions.	8 •s o CJ CJ £ O m	8 A £ o u a n p. o O	1 £ o CJ 'ft U o	08 8 a o o a CJ <D P O	8 A 3 u 3 ft o O	1 A t. O a CJ CJ 1 2 1 1 1	8 *-. o CD P o 1 3 2 ] 1 ] 1	8 £ o cj CJ ft o U	8 ,a *A o CJ CJ s CJ O		o CJ a CJ CJ p o CO	C3 8 •g o CJ 3 CJ ft o O	8 | CJ O	8 ,13 u s CJ a « CJ p cc	8 A u 3 a ft o o	8 ■a u o o a CJ "S O	ci 8 A lH &A o o o o p o Cfi	8 A u. 1a o u 3 ft o o	8 -3, V. o a £ o		C3 8 o CJ CD CD P o 03	si 8 A u o CJ 3 ft o U 1 o 4 1 2 3 o o	C3 8 ■a o o O	a 8 A u AA O CJ a CJ p o m	cc 8 A £ o CJ a CJ ft o o	cc 8 A t* u c CJ 3 CJ o	8 .g ^. o 3 CJ CJ p o 02	cfl 8 A £ o CJ 3 CJ ft o O	8 A o a c CJ O	o
Menses absent...... irregnlar.... regular .... too long du- ) ration .. . ) pale ....... dark ...... too early ....	3 1 5 4 2 3 3 1	8 3 17 8 10 6 2 4 q 2	1 2 ] 1 5 2 i j 2 1	1 2 1	*2 2 1 1			I 3 3 1 1 1 2	1 1 1 1	13 11 31 20 26 2 13 8 7 11 4	1 ■ ■ 1 ]	3 2	3 2 1	1 1	1 o 2 1 2 1 1 1	1 1 1	..	••		3 7 4 6 4 1 4 1	1 1 ] 1 ] 2		i i	1 1 ] 1 1	1 1 1 1	1 1 1		2 1		1 7 5 4 1 4 6 1 5 4
																														
CO 
 g 3

0C5 {a
I"

IHJ







t^ o
-A flj
ft A-.
►H ff.
© O
		1	rA	BI	,E	No. 19,			being Analysis						OF	Cases of Leucorrhoea, Section 5.															
												Still under treatment.									0 Eh 2 1 4 1 1 1 1 2 1 1 3	Left treatment too early to hid ire.									
		Cured or | ereatly l.vne-titted.			. Some-what bene-fitted.			Un-changed.			O Eh	Greatly bene-fitted.			tjomc-what bene-fitted.			Un-changed.				Cured or. greatly bene-fitted.			what bene-fitted.			Un-changed.			
Length of time under ^treatment.		1 c ! 8 ^3 i ^~ 1-O O 3 CJ p 0 02	ci 8 u 0 a CJ ft 0 O	8 J3 £ 0 O	8 A 5 CJ 3 CJ CJ p 0 CO	CS 8 £ 0 0 a 0 0	8 A -O a CJ "B CJ 0	8 .g A* O CJ 3 CJ p 0 02	« 8 .a £ 0 0 31 CJ ft 0 O	8 -S 0 3 CJ "5 O		8 A O CJ CJ CJ p 0 02	CS* 8 A ^. O 0 3 CJ si 0 O	8 5 CJ CJ O	8 0 <u CJ p 0 02	8 A £ 0 0 ft 0 O	8 J3 1-1 O CJ 3 "3 O	8 A 3 V CJ ft c 02	K 8 ^3 0 CJ 3 CJ ft 0 0	8 J3 tH O CJ 3 CJ "5 0		8 A £ 0 3 CJ CJ p 0 02 2 1 1 1	8 A O ft O CJ 3 5 1	8 0 3 'ft O	8 O C" CD CD P 0 02	8 O Cj O, O O	8 A u Eh O CJ 3 0) "S CJ 0	CC 8 A £ 0 a c CJ p 0 02	ci 8 A O CJ ft O u 1 2	8 X. c 3 c "c CJ 0	3 0 Eh
1 month or less 2 .. 3 .. 4 .. 5 .. 6 .. 9 .. 12 ..		Is !.' 3 4 1 1 1	2 9 3 6 4 4 7 1 1 1	3 2 1 2 1 2	i 1	1 2 1	1 1 1 1	1 1 2 1	1 2 1 2	1 1	4 12 10 15 8 10 9 6 3 2 9 1	1 1 'i	2 1	2 1	1	•> 1 1 2	1 1							1	1 1 1	1 2 ]	1 1				8 11 3 2 3
n ........		4																					1								
								i																							
																															
CO
0
3Q P
 ft ft
 0 ft
 2 3
       [While we cannot too highly applaud the diligence and zeal  displayed by Dr. Madden, in making and recording- so many careful exa-
minations 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 homoeopathy ought to be the curing of as many diseases as possible with-
out 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 be done by Dr. Madden.
V* e must first use all the  remedies we  have, then  look for more;  but not till all possible medicinal substances are exhausted", can we confi-
dently assert,  here are the limits  of internal homoeopathic treatment.   To assert that nitrate of silver, 0:0., act specifically as well as ehemi-
calllv, seems to us almost as extravagant as if we were to attribute the benefit of an amputation to the particles of the  ferrum absorbed by the
cut surface, or to the galvanic or odylic influence in  addition to the riddance of the offending member.—Editors.] 
VI
aitimivjiz  hecorb.
           Manchester HommopatTiic Hospital.

  We find that the number of beds in this institution now
amounts to 25, and that from the 29th April to the 15th No-
vember, 77 cases have been treated with in general very sa-
tisfactory 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 initial
of the establishment without the payment of at least half-a-
crown a week, and if without the recommendation of a sub-
scriber the patient is charged five shillings.
  This may prove to be a serious  drawback  to the general
usefulness  of the Manchester Hospital, 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 homoeopathy in  this
country, to strike not only the vulgar mind, but also that of
the investigating  allopathic  physician. All who have  at-
tempted 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  homeopathic hospitals
and dispensaries are opened, we would earnestly call upon
our  brethren to advocate the cause of perfectly free and cha-
ritable institutions.
                      Case  I.—Erysipelas.
  April 29th,  1850.—Elizabeth 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
28 th.  The inflammation has, however, spread to the hairy scalp.
                            Continue.
  May 1st.—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 re-
lieved, and the general febrile symptoms are less.     Continue.
  May 2d to the 6th.—She  has continued to improve.  To-day the
report  is:  no appearance of inflammation about face or scalp ;  desqua-
mation ; bowels quite  regular; tongue moist; no fever.  Sulph. 6.
  On  the 9th.—Dismissed cured.
           Case  II.—Fibrous Tumor  or the Uterus.
  May 1st.—Jane Leatherbarrow, aged 39, married, mother of several
children.  Eighteen months ago had a miscarriage, since then bloody
discharge, very offensive,  frequently clottted.  The lips, gums,  and
conjunctiva  excessively pale;  eyes surrounded  with a  dark circle;
countenance anxious;  pulse rapid  and  feeble; anorexia, nausea,  and
occasional vomiting; pain and tenderness in  the right iliac region;
sleepless nights.
     Secale 1st decimal dilution.  Cocculus 3d ditto, every three
                         hours alternately.
  2d.—Less discharge; nausea relieved.    Continue.
  3d.—Discharge less offensive;  pain in the side relieved;  general
appearance improving. 
Manchester Homoeopathic Hospital.             99
    4th.—Discharge not offensive, scanty, watery.     Continue.
    From- this date to  the  14th, the general health continued to im-
 prove.   Platinum, China, Ipecac., Ferrum, and Secale were prescribed
 m 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.
                              Arnica 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 2| in breadth, 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 homoeopathic remedies  in  palliating the
 symptoms {^previous to  the removal of the  tumor by opera-
 tion, and although the urgency of these would not permit of
 a longer trial of their action  in this case,—in others, less ex-
 hausted, 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 bui-ning;  tongue moist,  with  yellow
 fur, red  at the tip;  eyes suffused;  slight  cough; stabbing pain, ex-
 tending 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.
   5th.—Tongue cleaner; breathes with greater freedom:  pain  con-
 fined  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.
   ■ftk__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.
   9ta.__.is doing very well.  Crepitus still audible posteriorly. 
100
Clinical  Record.
   12th.—States that he feels quite well, and is discharged with a cau-
tion 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 symp-
toms ; intense stabbing pain in the left submammary 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; painless stabbing  in character; rather less  dul-
ness on percussion, but the respiratory murmur is inaudible.
            Bry. 3,  Phos. 3, every three hours alternately.
   June 1st.—Pulse  96 ; less  pain; respiratory murmur  slightly aud-
ible.     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 quito
distil let;  some dulness remains; she complains of nothing  but weak-
ness, and calls loudly for meat.
         China A, T.  Sulph. cp, every four hours alternately.
   10th.—She is dressed, states that  she is quite well; the  chest not
examined, but as she breathed freely, had  no pain or cough,  and  com-
plained of nothing but the still too scanty diet, she was dismissed with
directions to take a powder containing one drop of T. Sulph. <p, each
night for  a  week longer.
   Cases like the above have  occurred to every practitioner
of homoeopathy,  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 Y. S. the  Cucurb.
Cruent., the leeches, the blisters, and last, but  most  danger- 
Manchester Homoeopathic  Hospital.         101
ous, the  Calomel and Opium, (to ptyalism sometimes  in  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
homoeopathy was worthy of his serious attention.  Since then
he has been steadily studying and is now a zealous convert.
                    Case V.—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 applyino-
the stethescope distinct friction sound was heard ; pain  acute on press-
ing upon  the intercostal spaces ; had had rigors; pulse 104, full and
hard ;  skin hot and  dry ; tongue  furred ; countenance anxious  ; great
thirst; urine  scanty and  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 com-
paratively 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 blankets
to the hospital.
   2 p. m.—Symptqms aggravated in  consequence of his removal.  Fe-
ver 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 Aeon, occasionally, Merc. 1, Chin. A.
   7th—Much 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.
   9 th.—Reports himself well and was  discharged this day. 
102
Clinical Record.
                                 Case VI.—Rheumatism.
              Aug. 16th, 1850.—Martin Corrigan,  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, Puis. 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 hos-
«          pital as an out-patient.   Has been  subject to rheumatism.   Complains
           now of pains in the joints of upper  and lower extremities, more particu-
           larly of the ankle-joints and feet;  is cold and  chilly ; thirst;  pulse ac-
           celerated ;  tongue  furred;  bowels  constipated;  urine  scanty  and
           high-colored.
                    Take Aeon. 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 fire,  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.
              17 th.—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  of some  debility.
           Discharged cured. 
Manchester  Hwnceopathic  Hospital.          103
                         Case VIII.
   Sept.  2d.—John  Mews, aged 38, married, admitted into hospital.
States that he has been ill for thirteen months.   After unusual exes-
tion he was seized with pain in  stomach, and in the shoulders, armr,
back  and lower  extremities; the pains have recently become  much
worse, 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 steth-
oscope a distinct bruit is  heard ; action accelerated but feeble  ; starts
from his  sleep with violent palpitation; increased  dulness in the prae-
eordial region.
       Continue Arsen. B, Bry. 3, every four  hours alternately.
   8th.—Same.   Continue.
   9th.—Same.   Continue.
   10th.—Pulse 84 ; heart sounds more distinct.
   11th.—Same.   Take  Arsen.  B, Digit. B,  every four  hours alter-
nately.
   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 ; consi-
derable pain in right shoulder.     Continue.
   20th.—Same. 
101
Clinical Record.
   21st.—Better to day.  Heart  sounds normal; pains much better ;
leg and arm of right side continue a little atiff.
                   Continue Digit. B., Arsen. B.
   2 2d.—Discharged at his  own request,  as he states that he  feels
nearly well.
                           Case IX.
   June 5th.—John Hindley, aged 26,  miner.  Several months ago was
seized with dull aching pain in the region of the kidneys, which w;u«
followed with anasarcous swelling, commencing at the  face and  gradu-
ally extended over the body to the lower  extremities, and which con-
tinues :  legs,  feet, and abdomen are now much swollen, tongue  coated
with a yellow fur ; pulse rapid and feeble ; bowels regular; urine scant)
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 affec-
tion  in less than  a month.  Previous to his  admission  into
hospital  he  had  for two months  been under allopathic treat-
ment, at one of the Manchester dispensaries,  without receiv-
ing 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.     Aeon. 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 Homceopathic 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 Strain. 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 8,
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.
   11th.—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  inchned to ramble, but on the whole much more
rational than yesterday.  Continue Aeon. 3.
   12th.—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 morn-
ing.     Continue.
   16th.—Much better.     China 1, Bell. 3.
   17th.—Convalescent.     Continue. 
MANCHESTER HOM(EOPATHIC HOSPITAL.
©
OS
Disease.
Age.
 Whether
under old
treatment.
How long ill.
How long undar
  treatment.
Event.
Chief medicines used.
 1 Anasarca ..............
 2 Abscess on left thigh.....
 3 Ascites.................
 4 Bronchitis  .............
 5 Bronchitis chronica......


 6 Cancerous mamma  ......
 7 Chlorosis...............
 8 Catarrhal fever  .........
 9 Cephalalgia  ..........
10 Caries, ankle joint amputated

11 Delirium tremens  .......
12 Diarrhoea chronica.......
13 Dysuria  ...............
14 Epilepsy..............'.
15 Erysipelas  .............
16 Epilepsy ...............
17 Erysipelas, facial........
18 Epilepsy ...............
19 Epilepsy ...............
20 Erysipelas, facial........
21 Erysipelas, facial ........
22 Fistula laehrymalis  ......
23 Fistula in ano   ..........
24 Gastralgia  .............
25 Gastralgia, hysteria  .....
26 Gastralgia  .............
27 Hysteria...............
26
17
49
31
25
45
24
25

15

23
43
43
28

26

11
34

29
30
45
34
26
23
38
yes
yes

yes
yes
yes
yes
no

yes

no
yes

yes

yes

yes
yes

no
yes
yes
yes


yea
several weeks
  6 months
 2 years
4 months
 3 weaks

9 months
   3 years

  14 years

   4 years


  11 years

2 or 3 weeks

   4 years



   4 years
  1 month
  6 weeks
  2 weeks
  2 weeks
 5 days (dis-
 charged  for
disobedience)
  3 weeks
  1 month
  3 weeks

  7 weeks
 (amputated)
  5  days
  3 weeks
  3 weeks
   1 week

  3 weeks

  2 weeks
 in hospital

   1 week
  2 weeks
 2 months
  5 weeks
  2 weeks

  7 week*
    cured
    cured

    cured
much relieved
    cured
    cured
    cured

    cured

    cured
    cured
much relieved
much relieved
    cured
   relieved
Dig. B, Ars. 6
Nux B, Bell. B, Graph. 5

Aeon. 3, Bry. 3,  Phos. 3, Nux 3,  Ilyos. 1
Mere. 3, Rhus 3
Con. 1,  Nux B
Puis. 3, Ars. 6, Bell. 6, Sulph. 12
Bell. B, Aeon. B, Nux B

Arn. A, Bell. B,  Aeon. B, Merc. 3

NuxB
Oamph. O, Arsenic. 6
Canth. 1,  Sep., Sulph., Carb. veg.
Calc. 12, Nux B, Bell. B, Hyos. B

Bell. B, Nux Op.
Bell.
Bell. 3,  Op. 1, Aeon. B
               Hell. O, Phos. 3, Hyos. 1,  Merc.
    cured      Bell. B, aVcoii. B, Merc. 3, Petiv.
    cured     LMerc. 3, Hep. 6, Sil.  12
              JAeon. 1, Sulph. O, Hep. s. B
much relieved  Hyos. A, Nux, Puis., Sulph. 12
much relieved  Bell. B, Bry. B, Ignat. B, Xux B
              ;Nux B, Pub. B, China 1, Bell.
much relieved ilgn. B, Nux 3,  Cocc. 3,  Mere. 1
S
k
1 
   Hepatitis, chronic.......
29 Hemiplegia............
30 Lateral curvature of spine
31 Lumbago..............
32 Morbus coxarius........
33 Mania................
34 Ophthalmia purulenta ...
35 Phthisis pulmonalis......
36 Psoas Abscess..........
37 Pneumonia  chronica ? ...
38 Pneumonia............
39 Phthisis pulmonalis.....
40 Pleurisy...............
41 Pyrosis................
42 Phthisis pulmonalis.....
43 Phthisis...............
44 Rheumatism, chronic....
45 Rheumatism, chronic....
46 Rheumatism, acute.....
47 Rheumatism...........
48 Rheumatism, chronic....
49 Rheumatism, chronic....
50  Rheumatism, chronic....
51 Rheumatism, acute.....
52  Syphilitic lepra.........
53  Struma of great toe.....
54  Struma of elbow joint ...
55  Synovitis..............
56  Synovitis chronica......
57  Synovitis chronica......
58  Syphilitic rheumatism ...
59  Subacute pleuritis.......
60  Typhus fever...........
61  Ulcers................
62 Ulcer.................
63  Uterine tumor..........
76	yes	14 months
59	yes	4 months
17	yes	several years
53		
8	yes	9 months
25		
35	yes	
54	yes	9 months
38	yes	
16	yes	6 months
20		
18		1 week
33	yes	2 years
18	yes	
22	yes	
27	yes	3 years
51	yes	
25		
38	yes	13 months
21	yes	
42	yes	11 weeks
55	yes	
51	yes	-
43	yes	6 months
24	yes	10 months
16	yes	3 years
57	yes	several weeks
39	yes	3 months
17	yes	11 months
24	yes	
29		
24	yes	9 months
45		
39	yes	18 months
much relieved
    cured
much relieved
much relieved
much relieved

much relieved
    cured
    cured
   relieved
    cured
much relieved

    cured
much relieved-
much relieved
    cured
much relieved
    cured

    cured
much relieved
    cured
much relieved
    cured
    cured

    cured

    cnred
Nux, Dig., Bry. B, Merc. B
Nux, Aeon., Bry. B, Sab. B
Teu. B, Iod. B, Bell. B
Cann. 1, China 1
Sil. 6, Calc. 3

Cann., Merc. 3, Cou.
Phos. B, Ars. B, Hyos., Bell.
Aeon. B, Bell., Hep. s. 3
Phos. 3, Hep. s. 3, T.  Sulph. O

01. Jecoris Ass., Phos.
Aeon. 3, Rhus., Bry. 6
Bry. 3, Bell. 3, Arg. nit. 1, Nux 15
Ars. B,  China 3, Bry.  B
Ars. 3, Bry. 3, Phos. 3, OI. Jecoris Ass., Sulph.
Bry. B,  Rhus B
Bry. B,  Puis. B, Am. B
Ars. B, Bry. B
Bry. B, Ars. B, Dig. B
Aeon. 3,. Rhus, Bry. 6
Bell. B,  Bry. B, Rhus B, Sil. 3
Bry., Rhus 3, Sulph., OI. Jecoris Ass.
Bry. B„ Puis. B., Aeon. B
Sep. 3, Puis. 3
Sil.B
Ars. 6, Hep. s. 3

Sil. 12
Calc. 3, Bry. B
Merc. 3,  Rhus 1, Nit. ac. B, Calc. c.
Merc. B, Bry. B, Aeon. B, Bell. B

Lach. 6, Sil. 12, Puis. 3

Sec. l.Cocc, Plat. 6, Phos.
Co
s-
>§
5H
&
M
o 
THE  HAHNEMANN  HOSPITAL.
©
oo
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.
No.
Sex.	Age.
M	13
M	40
M	28
M	17
Con-
dition.
s
M
typhus fever

 hypertrophy
 of the heart,
  with fever
Disease.
rheumatic
  fever
S    violent  rheu-
      matio  fever
 Duration ot
disease before
  admission
  5 days

10 months
2 weeks
2 weeks
  Date
of admis-
  sion.
Oct. 18

Oct. 23
Oct. 31
Oct. 31
 Date of
Discharge.
Oct. 30

Nov. 25
Nov. 9
Still in
hospital
Result.
  cured

 greatly
improved
cured
cured
Chief Medicines
    given.
ars.  3, bell. 3
 bry. 3
rhus. 3,  nux
 vom.2,bry. 3,
 spig. 2, mere
 30, cocc.  12
 aur. 12
bry. 2, bry. 12
bry.  12, rhus
 12,  bry.   3,
 mere.  30,
 colch.3, chin,
 5, rhus 12
D
Not a veiy  severe  case;  delirious  for four nights after
  admission.
For ten  months he had  been in allopathic hospitals and
  dispensaries ;  amongst  the  medicines he took  were  ~
  stryclinine, sesqui-carbonatc of iron, vinum  antimonii,  <V
  a-tlier  nitricus,  acidum  sulphuris,  &c,  without  any  ^
  relief:  for  the last five  montlis he  had  every second  .
  day castor  oil, to  relieve his costiveness.  The  palpi-  £p
  tation  of the  heart and even the  bellows  sound  is  5
  greatly diminished,  as  well as a particular squeezing  ^
  feeling on  the  right side  of  the chest.  He  is  still  r-'
  improving  since he  left the hospital, as reported on the
  14th December by his  wife.  The disease began pro-
  bably after rheumatism of the legs.
Till  the day  before his admission under  allopathic treat-
  ment.  The pains and swellings of both his hands and
  arms, which  hindered  the  movement  of these  parts,
  disappeared the  sixth day.
The patient came very emaciated, and  looking  very pale,
  to the hospital; almost  all  the articulations, and even
  the bowels, were very painful.  On the  loth Nov.mber
  he was without  medicine, and allowed to get up, as he
  had no  complaint ; the  following  night he  had  a 
orchitis  from
  suppressed
  gonorrhoea

   cardiac
 disease  and
 rheumatism
 morbis coxa-
     rius
 irregular and
  suppressed
menstruation
 swollen legs
 pleurodynia
 bronchitis,
   acute
  diarrhoea

typhus fever
typhus fever
typhus fever
 gonorrhoea a
 month since,
orchitis 4 day*

  6 months
2 years
irregular for 5
  years, sup-
 pressed for 6
    weeks
   3 weeks
3  days

3  days

5  days


10 days



4  days
Nov. 2
Nov. 10
   V
Nov. 11
 Nov. 14



Nov. 14


 Nov. 14

 Nov. 15

 Nov. 19


 Nov. 19



 Nov. 19
Dec.  2



Nov. 21


still in
hospital


Dec.  2



Nov. 23


Nov. 22

Nov. 18

Nov. 22
 still in
hospital


 still in
hospital
cured
 much
 better

mproved
cured



cured


cured

cured

 died
convales
  cent
cured
aeon. &. puis
 clem., cann.,
 nux, canth.,
 mere, sulph.
spig. 3, bry. 3
 bell. 3
sihc,
 calc,
 phos.
 puis.,
mere
puis.,  sulph.,
 nux, bry. and
 calc.

bry.  3, arn. 3,
 nux v. 4

bry.  3, puis. 3

nux  3, ars. 6

ars.  3, bry. 3,
 bell. 3, op. 3
 tart. em. 3
ars.  3, bry. 3,
 bell. 3, carb-
 v. 5, mere. 5,
 stram. 3
bry.,  nux  v.,
 chin,
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.
Aconite, Puis, and Clematis for the acute stage of orchi-
  tis ;  Cannabis, Merc, and  Sulph.  for  the  gonorrhoea,
  and  Nux  for dyspeptic symptoms.  The gonorrhoea
  was  not cured.
Loud bruit with heart's first sound, and great pain in the
  heart and limbs;  the pains were quite removed by the
  treatment.
Mas two abscesses on the left hip, one on the left vulva,
  and one on the upper third of  the right humerus ; the
  Mercurius lessened the night sweats and improved the
  condition of the pus.
The pains were  so  violent, and  accompanied  by fever,
  that the disease was  very  similar to an inflammatory
  state.   Since the 21st Nov. she was without medicine.
A very scrofulous  subject;  much concomitant  gastric
  derangement.
Affected besides with chronic dyspnoea, which was not
  treated.
Very much addicted  to drinking ;  the  fever was compli-
  cated with delirium tremens and nearly total suppres-
  sion of urine.   He died quite suddenly in convulsions.
This case  presented very bad symptoms: almost uninter-
  rupted delirium  for the first ten days, mouth  covered
  with black sordes,  tongue hard, black, dry.  After the
  delirium left, was very weak.  Is now almost well.
Is only in the hospital for weakness.

3
©
so 
 Con-
dition.
M
Disease.
  bronchitis
    and
hypertrophhy
 of the heart
chr.    metritis
   gast. ent.
general  debi-
     lity
gastr. enteritis
 gastric fever
and diarrhoea
bronchitis
 Duration of
disease before
  admission
 1 month

 4 years




 14 days



 4 days


2 months
3 weeks
  Date
of Admis-
  sion.
Nov. 23
Nov. 23



Deo.  2


Deo.  2
Dec. 2
 Date of
Discharge.
Dec. 72
Still in
hospital


Deo. 11


Deo. 10
Dec. 15
Result.
  cured
   and
improved
aeon. 3, bry. 3,
 calc. 12, puis.
30,  aur.  12,
 china 30
aeon. 3, arsen
 3, puis, china
convales-
  cent

  cured
 Chief Medi-
cines given.
The 29th November, the  tenth day, the bronchitis was
  cured.  The three last  medicines were administered
  for the heart disease ; he was  obb'ged to sit up in  the
  bed  when he  entered the hospital—when he  left he
  preferred  to lie almost without a  pillow.   The  disease
  of the heart originated  frcm  a rheumatic fovcr four
  years ago for which he was treated.
aeon. 3, arsen,
 3,  puis.   3,
 bfyon. 3
bry. 3, ipeo. 3,
 china 3
  much  nux 3, ars. 3
improved
REMARKS.
This child suffered, in consequence of aperient medicines,
  for two months from diarrhoea 7—8 times a day ;  she
  was   very  emaciated,  the abdomen  tympanitic,  the
  pulse extremely weak, and deaf for some  days before
  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.
Great dyspnoea and much  viscid expectoration, could not
  lie  down  at   night; these  symptoms   were  nearly
  removed  and  the acute attack cured, but  there re-
  mained chronic bronchitis, to whieh she had long been
  subject. 
20	P	35	Wid.
21 22	F F	13 22	S S
23	M	32	s
24	M	20	s
25	F	22	s
26	F	3	s
chronic  bron-
    chitis
   ancemia
bronchial irri
    tation.
dislocation  of
  the sternal
 end of  right
   clavicle
  disease of
 brain,  indu-
cing delirium

  gastro-en-
    teritis
  bronchitis
for years;  the
  present at-
tack for some
    months
    1 year
   2 weeks
  3 davs



6 months



  7 days

 5 days
Dec. 3
Dec. 3
Dec. 4

Dec. 11
Dec. 1



Dec. 15

Dec. 15
Dec. 13
Dee. 13
 in the
hospital
 still in
hospital
   in
hospital
 still in
hospital
 still in
hospital
 slightly
improved
improved
  cured
improved
aeon. & bry.,
  mere, phos.,
  calc. c.

ferr. &  china
bry. 3,  nux 5
  ipec. 3
arnica, rhus,
Was relieved of pain in the chest, and cough, but remain-
  ed in a sinking state, and left  the hospital of her own
  accord.

Left the hospital of her own accord.
aeon.,    bell.,
  bry., nux
convales- nux vom. 6
  cent
convales- jacon. 3, bry. 3
  cent
The fit of delirium did not  come  on,  although the premo-
  nitory signs  were  present.  Bry.  and  Nux given for
  gastric symptoms.  Mother subject to epilepsy before his
  birth.
Si1
r
fcs 
                           WM,    1IADDE,


 PUBLISHER,  322  BROADWAY,  N.  Y.


                        HOMOEOPATHIC  MEDICINES.
   Wm. Radde, 322 Broadway, Now-York, respectfully informs the Homoeopathic Physicians,
 and the friends of the System, that he is the sole Agent for the Leipzig Central HomcBouu-
 thic Pharmacy, nnd that he has always on hand a arood assortment of the best Homoeopathic
 Medicines, in complete sets or by single vials,  in  Tinctures, Dilutions, and Triturations; also
 Pocket Cases of Medicines; Physicians' and Family Medicine Chests to Laurie's  Domestic (60
 to  82 Remedies)—f'-PP'S (60 Remedies)—BERING'S (82  to 90 Remedies)— Small  Pocket
 Cases, at $3, with Family Guide and 27 Remedies.— Cases containing 415 Vials with Tinctures
 and Triturations for  Physicians.—Cases with 260 Vials of Tinctures  and  Triturations to
 Jahr's New Manual, or Symtomen-Codex.—Physician's Pocket Cases with 60 Vinls of Tinc-
 tures and Triturations.—Cases from 200 to 300 Vials with  low and high dilutions  of medi-
 cated pellets.—Cases from 50 to 80 Vials of low and high dilutions, etc., etc.   Homoeopathic
 Chocolate.  Refined Sugar of Milk, pure Globules, etc.  Arnica Tincture, the  host specific
 remedy for bruises, sprains, wounds,  etc.  Arnica Plaster, the best application for  Corns.
 Vrtica urens, the best specific remedy for Burns.  Also,  Books,  Pamphlets, and Standard
 Works on the System; in the English, French, and German languages.

                           HOMCEOPATHIC  BOOKS.
                                JUST PUBLISHED :
   The Norlh American Homoeopathic Journal will be published by the
 subscriber quarterly, on the first days of February, May, August and November.  It will con-
 tain one hundred and forty-four pages, and will be conducted by Dr. Constantine Heiung,
 of Philadelphia, and Drs. E. E. Makcy and J. W. Metcalp, of New-York.
   TJi<! Sfritish Journal of Ho in otopathy,  and the  NortFi American
 Homoeopathic Journal, will be furnished to subscribers at  Five Dollars a year for both ; or
 they may be had separately.
  Terms : Three Dollars per annum, payable on delivery of the first number.  Subscriptions
 to be directed to W. RADDE, No. 322 Broadway,  New-York.
   Laurie,  Dr.  J., Homoeopathic  Domestic  Medicine, with  the
 Treatment and Diseases of Females, Infants,  Children, and Adults.  f>lh American edition.
 much enlarged, with additions by A. Gerald Hull, M. D. 1850.  Bound, £1 50.
   Laurie, Dr.  J., Elements of Homoeopathic Practice  of Physic.
 An Appendix to Laurie's Domestic, containing  also all the Diseases  of the URINARY AND
 GENITAL ORGANS.  Bound, 1849.  $1 25.
  C. Herinif's Domestic Physician.   Fifth American  edition, revised, with ad-
 ditions from the author's manuscript of the seventh German edition.   1851.   $2.
  Ed. C Chepmell's  Domestic  Homoeopathy restricted to its  le-
 gitimate  sphere  of practice, together with rules for diet and  regimen.  First American
edition,  with additions  and  improvements by Samuel B. Barlow,  M. D.  1819.  Bound,
50 cts.
  Laurie's Homoeopathic Domestic, by A. Gerald Hull, M. D.   Small edition.
 Bound.  1849. 50 cts.
  Heinpel's liocnninghauscn,  for  Homoeopathic Physicians; to
be used at the Bedside of the Patient, and in studying the  Materia Medica Pura.   3 octavo
vol., most complete edition, including the Concordances of Homoeopathic Remedies. Trans-
lated and  adapted to the use of the American profession, by C. J.  Hempel, M.  D.  1847.
81 50.
  Jahr's New  Manual of Homoeopathic Practice ;  Edited,  with Anno-
tations, by A. Gerald Hull, M. D.   From the last Paris edition.  This is the fourth American
edition of a very celebrated work, written in French by the  eminent Homoeopathic Professor
Jahr, and it is considered the best practical compendium of this extraordinary science that
has yet been composed.  After a very judicious and instructive introduction, the work pre-
sents a table of the Homoeopathic Medicines, with their names in Latin, English, and German;
the order in which they are to be studied, with  their most important distinctions,  and clinical
illustrations of their symptoms and effects upon the various organs and functions of the hu-
man system.  The second volume embraces an elaborate Analysis of the indications in  dis-
ease, of the medicines adapted to cure, and a Glossary of the technics used in the work,
arranged so luminously as to form an admirable guide to every medical student.  The whole
system is here displayed with a modesty of pretension, and a scrupulosity in statement, well
calculated to bespeak candid investigation.  This  laborious  work is indispensable to the stu-
dents and practitioners of Homoeopathy, and highly interesting to medical and scientific men
of all classes.  Symptomatology and Repertory complete in 2 vols., bound, $6.
  Jahr'* New  tlunual ?  originally published under the name of Symptomon-Codex.
(Digest of Symptoms.)   Tins work is intended  to facilitate a comparison of the parallel symp-
tom- of the various  Homoeopathic agents, thereby enabling the practitioner to discover the
dmract.'ri-tic .-ymptoms of  each drug, and to determine with ease and correctness what
remedy is most Homoeopathic to the existing group of symptoms.  Translated, with impor-
tant and extensive additions from various sources, by Charles Julius Hempel,  M.  D., assisted
by James M. Quin, M. D., with revisions and clinical  notes by John F. Gray, M. D.; contri-
butions by Drs.  A. Gerald Hull, B. F. Joslin,  and George W. Cook,  of New-York;  and
Drs. C. Hering, J. Jeanes, C. Neidhard, W.Williamson, and J. Kitchen of Philadelphia; with
a preface by Constantine Hering, M. D., 2 vols.  Bound, 1848.  011. 
777^
UTERINE   DISEASES,

      WITH AN APPENDIX,
CONTAINING AN
ABSTRACT OF  180  CASES
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
             HOMOEOPATHIC 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. 
 
 
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