character, and although no false membrane exists, the secretion is viscid, and with difficulty expelled; thence the cough, preceded by a long inspiration, and having that peculiar sound like the crowing of a cock.

From my own observations, I believe I am right in asserting that hooping-cough is caused by parasites of the genus penicillia, which attach themselves to the mucous membranes of the larynx and trachea, and which the vibratile epithelium is unable to dislodge. In the trachea of a child aged three years, which died in an asthmatic paroxysm, produced by hooping-cough, I found on the extremities of the vibratile prolongations, those small corpuscles, which, like carmine, manifested the Brownian movements.

What also lends support to this opinion is the fact that the sulphurous preparations calm the paroxysms of hoopingcough. I have prescribed, with uniform success, sulphide of calcium internally:

Three or four granules a-day for a child aged three or four years.

The fever which accompanies hooping-cough, the paroxysms of which might prove fatal, should be combated by aconitine and hydroferrocyanate of quinine :

A granule of each, together, in the intervals of spasmodic coughing. Narcotics must be avoided, but expectoration should be facilitated by syrup of ipecacuanha. If broncho-pneumonia supervenes, characterised by sibilant râles and moist crepitation, difficult respiration, with injection of the face, pulse 110, and the temperature 40°c., etc., it must be vigorously attacked by revulsives to the lower extremities, Seidlitz salt to clear the intestinal passage, and veratrine, which must be pushed to counter-stimulation :

A granule every half-hour until the desired effect.

The danger having passed, recourse must again be had to hydroferrocyanate of quinine, in order to prevent fresh

accessions:

C

A granule every half-hour until complete sedation.

Hooping-cough has remained till now rebellious to the powers of art, because these have been wrongly employed, or rather, they have not been employed at all, for that is not a proper treatment of the disease which relies upon expectorants. In sound therapeutics, the cause and the effects (symptoms) must be combated at the same time. Thus dosimetry acts.

When hooping-cough assumes an epidemic form, it makes numerous victims among young children. Adults are not exempt.

It would be wrong, therefore, to consider it as an affection of slight importance. (Vide Manuel des Maladies des Enfants.)

6. Edema of the Glottis or Virulent Laryngitis. I have confirmed the fact that this symptom,-which may prove rapidly fatal, follows bites inflicted by rabid or hydrophobic animals. It is not essential that madness should be distinctly manifested, for the patient, when the wound is already in course of cicatrization (which indicates the longer or shorter incubation period of the rabic virus), is suddenly seized with a constriction or laryngeal spasm, with hoarse voice and expulsion of minute bubbles; the respiration is whistling and embarrassed; the face is injected, and the eyes assume that brilliancy and expression of anxiety which characterise most stridulous diseases. The skin is hot (40°c.), and the pulse small and accelerated.

The patient manifests a condition of extraordinary agitation, and wanders from his bed, especially if the paroxysm happens in the night, as is most usual. The second or third paroxysm is fatal, because it terminates in oedema of the glottis.

There is not, therefore, properly speaking, anything of diphtheria; but the cause being a poison, assimilates this disease somewhat to the former.

As regards the treatment, it is useless to cauterize the wound, since it is already healed, or is in process of cicatrization. It can, however, be done as an extra precaution.

Hydroferrocyanate of quinine, digitaline, and hyosciamine, must be administered internally, so as to calm the paroxysms and diminish the congestive effort of the heart :

A granule of each every quarter-of-an-hour until sedation.

That being effected, it should be maintained by a potion of chloral and chlorhydrate of morphine:

A granule, with 30 grains of hydrate of chloral, dissolved in a tablespoonful of simple syrup, to be repeated, if necessary, should sleep be delayed beyond half-an-hour.

The medication should be resumed if, when the patient awakes there is still danger of suffocation.

Such should be the treatment of hydrophobia, against which we are as yet unacquainted with any specific.*

* Dr. Burggraeve has recently communicated an article on the dosimetric treatment of rabies to the Répertoire. He advocates the administration, at the same time, of granules of arseniate of strychnine, hyosciamine, cicutine, and monobromide of camphor, and the hypodermic injections of subnitrate of pilocarpine. His reasons for such treatment are most rational:

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Knowing nothing of the precise nature of the rabic virus, and consequently having no antidote for it, all we can do is to endeavour to get it eliminated as quickly as possible. The hypodermic injections of subnitrate of pilocarpine are thus a great resource on account of the rapid and abundant salivation they determine.

"As to the simultaneous administration of arseniate of strychnine and hyosciamine, it is called for by the laryngeal symptoms, indicating spasm and paralysis, in other terms, rupture of the physiological equilibrium between the constrictor and dilator muscles of the glottis. Now we have shown that the upper laryngeal nerves are constrictors, and it results from the experiments of M. Pasteur, that it is precisely in the medulla that the rabic virus locates itself more especially. The hyosciamine would combat this neurosis, whilst the strychnine would fortify and increase the action of the lower laryngeal nerves. With regard to the monobromide of camphor, it is, as we all know, a powerful hyposthenic agent.

"The cerebral inoculations of M. Pasteur also show whence proceed the symptoms of hallucination in rabies, whilst they indicate the means of counteracting them."

Relief might also be obtained from hypodermic injections of curura, Chapman's spinal ice-bag, or the hot-air bath.-H.A.A.

This terrible affection, which is said to be spontaneous in dogs, has been considered as a hysteria. It is quite possible that sexual excitement may be a predisposing cause, since rabies rarely declares itself among those dogs which rove about in a natural state, as in the East. In all such cases, monobromide of camphor must be given on the least appearance of that kind of excitement :

A granule every half-hour until sedation.

The animal must be plunged by its hind quarters into cold water.

It would be more rational not to condemn these animals to a life contrary to nature, and to restrain the number by a tax. It is especially among breed or fancy dogs that sexual excitation may lead to hydrophobia. Such animals, therefore, should be suppressed.*

Dr. Marochetti, an Italian physician, has pointed out in cases of hydrophobia, on each side of the frænum of the tongue, a small vesicle containing a citrine liquid, which he considers to be the reservoirs of the rabic virus. These vesicles are nothing more than the salivary ducts, the necks of which have been obstructed. It is now well known that the virus is transmitted by the saliva. It will be most prudent, therefore, to cauterize these miniature ranulæ.

Dyers' broom (Genista tinctoria) has been considered as an antidote to hydrophobia. If there is any preservative virtue in this plant, it can only be by reason of its purgative and diuretic properties.†

7. Angina Pectoris.-This is an affection which is also allied to the diphtherias, because, independently of the tracheal

* Dr. Dolan, of Halifax, has contributed to the medical journals many valuable articles on the legislation of this subject.-H.A.A.

The most rational proceeding on the part of persons bitten by rabid animals is to have the bites excised and cauterized at once, and then, for six or eight weeks, to have daily hot-air or Turkish baths, so as, if possible, to eliminate the virus.-H.A.A.

spasm, the bronchi are obstructed by a viscid fluid, and pulmonary edema may be the consequence of it.

The disease assumes sometimes an epidemic form, in consequence of certain miasmatic conditions of the atmosphere. The malady is paroxysmal, and is characterised by a retrosternal spasm, with whistling respiration, dyspnoea, and palpitation.

It must not be confounded with sternalgia, of which I shall speak later on. (Vide Neuralgias.)

Angina pectoris must be combated by hydroferrocyanate of quinine, digitaline, and hyosciamine :

A granule of each, together, every half-hour until sedation.

A large camphorated blister should be applied to the chest, and the intestinal canal must be cleansed by the Seidlitz salt, after sedation has been produced by the granules.

CONGESTIONS.-HÆMORRHAGES.

THESE accidents differ, according to whether they happen in the arterial capillary or the venous capillary system.

The former take place at the expense of the red arterial blood, and are preceded by an effort which has been termed molimen hæmorrhagicum. The congested parts are engorged, and a sensation of burning or boiling, a kind of tenesmus, is experienced in them, like as in active hæmorrhagic flux.

In the latter, on the contrary, the blood is black or venous, and a torpid or heavy sensation is experienced.

Hence, two treatments; by defervescents and excitants. The hæmorrhagic congestions should be combated by bleeding, digitaline and aconitine, in a word, by the defervescents; whilst the venous congestions should be treated by the fixed tonics, such as the ferruginous, especially hydroferrocyanate of quinine, which constitutes also a powerful antihæmorrhagic.