Patient, on recovery from this attack, underwent a course of office treatment, part of which will be mentioned later. She has since passed through the menopause with but little trouble, and when last seen said she was enjoying better health than she had

for years.

Case 2.-At 3 A. M. of January 31, 1909, was hurriedly summoned to Mr. E. V., age 31 years, single. Patient had tonic and clonic spasms, great pain in left iliac region, heart action very weak, semi-conscious, or rather almost comatose condition. Glonoine and strychnine were administered. Examination showed a great deal of gas in the intestines; the transverse and descending colon was very sensitive, the region of the solar plexus hypersensitive, clutching pain in left iliac fossa; left leg drawn up on abdomen. Patient had eaten nothing for some time; bowels moved during the day, but I suspected they were still overloaded and in spite of protests of family, gave high soap-suds enema, which afforded much relief, and followed this by boric acid enema and left the patient asleep. Remedies,-Belladona and Salol.

At 9 A. M. the patient had slept well, woke and passed a foul liquid stool; nauseated, vomiting and retching. Some gas still present in colon; burning and feeling as of something alive in region of sigmoid. Rep., Mercurius cor.

This case was very interesting from a good many points of view. The patient was the treasurer of a local theater and often in the performance of his duties would be seized with cramps and severe nausea, resorting to the use of stimulants when feeling faint, but receiving only temporary benefit. Purging would follow and relief of symptoms in a few days, but digestion was permanently impaired and often nausea lasted for a week. He had been picked up unconscious and taken to the receiving hospital during an attack.

Local treatment was resorted to in this case and continued at irregular intervals with great benefit. Patient was markedly neurasthenic and personal influence had a great deal to do with his general improvement. Kali phos. and Zincum val. were prescribed at times.

Case 3-A third case of chronic sigmoiditis, in a male, aet. 26 years, has been under my observation for some time. Injections and medication help the sub-acute attacks that come on, the

patient being able to take care of himself at most times. I have tried to obtain his consent to an operation for the relief of prolapse of the colon, but as yet have not succeeded. Great burning and tenesmus follow the appearance of an attack, and I fear the presence of an ulcer from the symptoms and the continued appearance of pus, but have been unable to locate it.

The treatment of chronic sigmoiditis may be considered under several heads, viz.: The causal treatment, the local treatment, the treatment of pain, and the homœopathic remedies for the various conditions.

Causal Treatment.-It is impossible to enter into detail in this brief résumé; suffice it to say that the causal treatment should consist of efforts for the regulation of the functional activity of the sigmoid flexure. The diet is a matter of prime importance. A preponderance of proteids will tend to obstipation, owing to the small amount of waste matter, while an excess of carbohydrates produces flatulency and intestinal irritation. Green vegetables, eggs and fats with a high melting point are advised, while starches and sugars should be avoided until the bowel is functionating properly. Exercise, both active and passive, massage, electricity and hydrotherapy all have their proper sphere and may be used at the discretion of the physician.

Local Treatment.-Local treatment is perhaps the most important in the management of chronic sigmoiditis. The sigmoid flexure must be evacuated and cleansed with a high soap-suds enema before attempting any local measures. The colon tube need not be introduced more than 12 to 14 inches,-just sufficient to properly engage the tube in the sigmoid. For soothing as well as a healing agent to the inflamed mucosa I employ an aqueous solution of calendula to advantage. Mild astringent agents undoubtedly hasten the healing process. Borax or boric acid, 2 to 4% solution, or zinc-sulphate (1-1000) solution may be used freely. Too strong astringents, as silver nitrate, tannic acid, etc., while reducing the inflammatory phenomena quickly, tend to a hypertrophy of the tissue and the formation of a thickened improperly functionating mucosa.

Stern has given us several useful formulas for local treatment. The following I have found to have decided analgesic and antiseptic action:

The compound infusion of sage can be made at the patient's home and serves as an excellent emollient.

Infuse the drugs with water and dissolve borax in the colature.

I have used also an injection of "tar-water" (made from blackpine tar) as a healing agent. Of course, numerous other drugs and remedial agents may be employed as the conditions suggest and the physician deems necessary.

Pain. For the relief of pain it has been my plan to avoid the use of opiates. Emptying the bowel, hot applications externally and local mild astringents usually suffice. In case severe pain continues and tenesmus is present, a glycero-gelatinous suppository containing belladonna, or, better still, belladonna with the addition of one grain of lupulin should be inserted as high up as possible.

Remedies.-The homoeopath has a wider range of remedial agents than his brother of the old school, and a careful selection of the same will often bring surprising results. I will not attempt to enter into the symptomatology, but suggest the following, which have been of some benefits to me: Belladonna, lachesis, aloes, mercurius, arsenicum.

Since writing this paper, another case of chronic sigmoiditis has come under my care. Mrs. R. G., aet. 33 years, no children. Patient was sent in from a small town on the desert with the diagnosis of appendicitis and advised operation. It must have been rather a tentative opinion, as the physician later told the husband that he "didn't know exactly what was the matter" with his wife, but to get her to town and have a good doctor examine her. This patient has a chronic leucorrœa and a cystitis which have bothered her for years. She is still under treatment.

References.-Boas, Stern, and Gant.

Editorial Chat.

It can scarcely excite surprise to see every evidence of exceptional interest throughout the Pacific Coast in the 1910 meeting of the American Institute. The term "enthusiasm" could justly be used to describe the earnestness with which this project is being discussed wherever there is a gathering of friends and practitioners of homoeopathy. It is quite natural that the profession should be more than pleased at the assurance of welcoming in our own home the national association, for very many of us number among its membership personal friends of many years' standing, while all have the kindest regards for the Institute itself and those connected with it. A practical expression of the pleasure we all feel in contemplating the meeting of 1910 is the promptness with which work was begun. In fact, the President-elect had a very considerable portion of preliminary and important work well started before his return home, and his own energetic way of taking hold has not only created an excellent impression everywhere, but has enlisted the hearty co-operation of all whose personal influence will count for much in determining the measure of success to be achieved. Thus, for instance, the Committee on Transportation has already made a preliminary report, which warrants the hope that exceptionally favorable terms and conditions will be had for the transcontinental journey; and the more favorable the terms and the greater the attractions of the trip, the more irresistible will prove the temptation to come West. To the American Institute it is of vast importance to have every possible inducement held out to insure a large attendance, for our membership is small as compared with that of the American Medical Association, and to make a good showing we must insure an exceptionally large percentage of attendants. The chairmen of the important bureaux-and could better selections have been made?-have also shown signs of early activity, and, best of all, there is not a homœopathic journal in the land but is at work saying a good word for California and the Westerners. Surely, we have much to be grateful for, and will have to exert ourselves to the utmost, every day of the entire year, to prove that confidence in our pluck, ability and resources has not been misplaced.

The writer was fortunate enough to be present at and throughout the first annual meeting of the Washington Homœopathic State Society in July, at Seattle, and, later, had the pleasure of meeting personally and informally quite a number of the profession of Portland, Oregon. It would be ingratitude not to acknowledge the many courtesies received or to remember the rest and comfort which came with the heartiness of the greeting he received everywhere. One's love for the Pacific Coast, based upon twenty years of continuous residence here, is increased by a visit to its northern States, and leaves the fixed impression that in spite of such incidental drawbacks as depend upon purely geographical considerations there is no country on earth so grand in its vastness, so rich in its resources, so bountiful in its gifts, so delightful in its attractions, and so infinitely varied in its characteristics as this marvelous stretch of country along the western ocean. And the cities and the people who dwell in them reflect the country they inhabit; bright, aggressive, aspiring to a high destiny, full of grit and equally full of gentleness, they are the natural products of the soil on which they live and reflect the climate which moulds them.

The meeting at Seattle was in its way a revelation, not of what there is, but of what there will be, of the profession if the fine ability of the men and women who constitute it is fully utilized. It is not merely the excellent quality of the papers read and the professional intelligence showing itself in the discussions following which creates that impression, but the quiet dignity of social intercourse, the heartiness with which members meet each other, and the air of self-reliance which characterizes them, that impresses one so strongly with a regret that our people have been allowed to drift-not away from us, but toward a borderland which is less rich in the faith upon which rests homoeopathic faith and homoeopathic therapeutics. Had we but had the good sense to utilize to the utmost the brightness and the professional ability of the men and women who have peopled that land, and to utilize it for the benefit chiefly of the faith which they embraced in their student days, how infinitely more independent homœopathy would be and how able to take care of its own interests! That this has not been done cannot be wholly charged against the older homœopathic physicians in that State, as though