alkalescent like that of inflamed mucous membranes. Mr. Curling inclines to the latter opinion, adding that the extension by continuity of tissue, or by the general lesion of innervation of this irritable state of the bladder to the kidneys may cause the urine to be actually secreted in an alkaline state. Mr Bird has observed the change from alkaline to normal urine in a case of complete paraplegia, effected by the simple precaution of washing out the bladder with warm water injections, a measure imperative in such cases, whether it be regarded as a prophylactic or merely as palliative of an incurable state. Still G. Bird regards the depressed vitality of the bladder as the initiative in the alkaline fermentation of urine. The reduction of the vesical sensibility probably coincides with sub-acute inflammatory change, by abstracting the control of the sympathetic nerves over the vascular system, as observed in the numerous experiments on the cervical plexus and elsewhere where sections have been made, isolating a given part of the body from this ganglionic innervation. The eye becomes immediately suffused by congestion, while the iris no longer dilates consensuously with the needs of the retina. The lesion of organic sensibility here as in the bladder coincides with modifications in the vascularity and consequently in the secretion from the capillary vessels.

Alkaline urine from nervous exhaustion, watching, mental exertion in study, mental exertion in the forum, &c., sexual excesses, spermatorrhoea, will be appreciated on the same general principles with deficiencies of the sympathetic innervation through lesions of the spinal cord. Whatever depresses the nervous vitality opens the tissues to vascular inundation; as on the other hand, all that depresses the circulation and reduces or deteriorates blood globules, gives the signal for spontaneous manifestations of neuralgia, spasm, or other forms of hyperæsthesia.

Owen Rees has shown the benefit of alkaline treatment where the alkalinity of the urine is due to irritation or inflammation of the mucous membranes.

Dr. Simon states from observations made under the authority of Prof. Schönlein, of Berlin, that in continued fever, about the end of the second week, and in severe typhoid, at the period when comatose symptoms set in, the acid and deep-colored urine becomes pale and alkaline, containing carbonate of ammonia in solution. This general observation is not confirmed by G. Bird or Becquerel, but G. Bird observed it to be the case in one epidemic of maculated typhus and Dr. Graves, of Dublin, has made similar remarks in sporadic cases where great exhaustion existed.

The researches of Drs. Sutherland and Rigby on the urine of the insane, appear to authorize the assumption that central lesion, independent of any obvious implications of spinal mischief may induce

the conversion of urea into carbonate of ammonia. They found the urine effervescent on the addition of Acetic-acid in thirty-four per cent. of cases of dementia, thirty per cent. of melancholy, and sixteen per cent. of mania.

The urates often coexist with free uric-acid, oxalate of lime, pus, or blood. Such deposit will be diminished by heat, which dissolves the urates. Uric-acid appears in visible yellowish-red crystals, which behave as before-mentioned, and are not affected by acetic-acid. Pus and blood are both albuminous; they are made to deposit by the same heat and nitric-acid tests which dissolve the urates and phosphates, and uric-acid; they in turn are dissolved and gelatinized by alkalies. Blood contains hæmatine, which pus does not. If difficult of recognition on account of its dissolved state in ammoniacal urine, cautiously neutralize this with a trace of acetic-acid in excess, heat in a waterbath at 151 F., when all the albumen will be found in form.

5. ALBUMINURIA.

We have already treated of albuminous nephritis at p. 21, of this volume. Dr. Joslin details some cases of this disease* by homoeopathic attenuations, which are thus summed up: Case 1. A New-York merchant, temperate, aged thirty-three; found to be subject to this disease. Nov. 13, 1857. A month before spent some nights at a country-seat in a malarious district, where he took intermittent fever, from which he recovered under Bry. 30. After dropsical symptoms appeared he was treated for a month with little effect, while the enlargement of abdomen and limbs increased; by the 25th of November his ordinary clothes would not button round him, the feet, legs, and abdomen were distended, breathing becoming difficult.

December 13. The face pale and yellowish, the abdomen much distended, and the pressure of the liquid, especially against the diaphragm, rendered the respiration laborious. No oedema of the abdomen, but it had pervaded the whole subcutaneous areolar tissue of the inferior extremities, feet, legs, and thighs; urine reddish brown, and after standing, turbid; cough.

The following symptoms have been produced by Apis-mellifica.†

"Paleness of the face; abdomen full, swollen; with swollen feet and scanty secretion of urine; scanty, highly-colored urine; cough in the morning; breathing difficult." For the above symptoms Apis 2 was prescribed in water every four hours.

In the first day the abdomen increased in circumference threefourths of an inch, and a general aching through the head, unusual o the patient. These two symptoms were regarded as medicinal * Amer. Hom. Review. Vol. II. p. 260. † Hering, Brit. Jour. Hom. Vol. IX

symptoms. On the next day the abdomen was diminished half an inch, and as much more the next day. There was no change in size of abdomen in two days under Apis ; in the next two, under the same, decidedly reduced; and by the same amount in the next three under Apis 2. This last was continued four days longer, and the ascites was slightly reduced, that of the extremities also lessened, that of the thighs gone. In the three succeeding days, much reduction of swelling, especially in the feet, under the prolonged action of Apis 3 previously given. In the following week, beginning Dec. 31st, the improvement continued under Apis 12: the upper half of the legs became normal and the fat reduced. In the next thirteen days, under the same, a great improvement in general strength and flesh, and limitation of effusion to the lower part of the legs, where only a very small quantity remained. In eight days more the oedema was entirely removed under Apis 30. After two years neither the encysted nor cellular dropsy had in any degree returned.

In a second case treated by Dr. Joslin, the urine was half albumen. The dropsy increased in three days under Apis 12. In the next two days, under Apis 10, the peritoneal dropsy increased with a rapidity unprecedented in the case, whilst a little improvement occurred in the thighs, and more in the urinary secretion. Two days afterwards, under Apis 3, the albumen was found to have entirely disappeared, the ascites to be greatly, and the oedema of the whole inferior limbs decidedly reduced, and the urine to present a remarkable violet hue. In the next two days, under Apis 3, diluted one hundred fold, the ascites slightly improved, and the oedema decidedly reduced, the albuminuria remaining cured. In four days, under Apis 12, the ascites and the dropsy of cellular tissue were entirely removed. Some tinge of violet was observed in the urine till after the action of Apis 30, but no dropsical symptom, nor any evidence of albuminuria had appeared a year afterward.

GENUS III.-HYDATIDS.

Hydatids are found in serous cavities, the alimentary canal, in the passages that open into the cellular tissue between the muscles, and in the proper substance of different organs. They are found in mammalia, all reptiles, birds, and fishes; though they are not known to exist in insects. In the human subject no period of life is exempt from them, from an early stage of uterine existence. (Portal.)

Hydatids are parasites. They have no genital apparatus, no organs for respiration or circulation, and no apparent nerves. They only live in the interior of other animals, perish within a year or two after development, and often in less. Few only can be excited by

stimulants to distinct movements. The cystercus whirls itself about in water, protruding its suckers.

Hydatids are divided into two classes, cephalocysts and acephalocysts.

I. Cephalocysts.-Divided into,

1. Cystercus, or bladder-tailed hydatids.

2. Polycephalus, or many-headed; not found in man.

3. Dicerus, or two-headed.

4. Echinococcus, rough hydatids, very rare.

II. Acephalocysts.-These are more common in man, in various organs and of all sizes from a mustard seed to a large orange. Gene rally spherical, composed of a white, clear, limpid, semi-opaque, pulpy vesicle. This vesicle, which forms the hydatid proper, is from of a line to of an inch in thickness, often separable into two or more tunics, and so delicate as to yield to the slightest pressure; its own contents often break through the thin walls after removal from the body. After being ruptured it sinks into a soft, irregular, pulpy mass, of opaline color, which swims in water, and resembles coagulated albumen. Sometimes the acephalocyst contains several smaller ones, each within another. Each one having arrived at maturity, produces another within itself, each successive production being smaller (Gross.)

Causes of Acephalocysts." In Cincinnati," says Dr. Gross, "there are annually killed more than one hundred thousand hogs, of which not one-tenth are free from this disease." Whole droves, of several hundred, on being brought from the rich prairie-districts of Ohio, Indiana, and Kentucky, "are highly fed for six or eight weeks with corn, a strong food, which keeps the portal circulation in a state of congestion which tends to inflammatory irritation and development of acephalocysts in the liver. The irritation thus set up is of a specific nature, or, what is the same thing, a sort of plastic lymph is deposited; the particles of this lymph arrange themselves in such a manner as to create an inferior being, an entozoic parasite." There is probably no inflammatory action generally, but the origin of the parasites is certainly connected with the excessive use of a strong diet.

SEROUS CYSTS.-These bear some resemblance to the acephalocysts, but they differ from them in being attached always to surrounding tiseues which supply them with blood. They are sometimes solitary and simple, or with a single cavity. Others are divided into many compartments, each containing a peculiar fluid. In some cases a large number of serous cysts may be aggregated into one cavity, attached directly to its parieties or joined together. (Drake, Louisville Medical Journal, 1841. P. 294.)

These cysts, says Gross, are a new formation caused by a perverted

state of nutritive function. Others appear to be formed out of existing textures, sometimes of serous, at others of a mucous nature. To the former belong the cysts of the ovaries, enlarging the vesicles of De Graaf; to the latter kind belong those developed in the kidneys and female breasts from the obstruction of the excretory ducts. In this situation it may receive no accidental covering from the organ in which it is located. In the ovaries we generally find that the cyst is easily provided with thick, dense parietes, separable into three distinct layers, the internal of which consists of the capsule of the vesicle of De Graaf, the second of the albuginous, the third of the peritoneal coat. The same thing occurs in the spleen and liver. When the cyst is formed out of existing mucous membrane, it generally in a short time assumes all the properties of the serous texture. (Elements of Pathological Anatomy.)

These cysts may be said to be secreting surfaces without excretory ducts, hence their great size, increasing by the stimulus of distention and may arise to the bulk of the gravid uterus, presenting externally all the characteristics of ascites. Dr. Drake mentions two cases in which ovarian cysts so filled the abdominal cavity that their character could only be known from their previous history. (Louisville Medical Journal.)

Mr. Owen (Lectures Compar. Anat., p. 45) regards the common hydatid rather as "a morbidly enlarged organic cell, than as an independent animal even of the simplest kind." He says "the tunic of the acephalocyst is usually studded with more in less numerous and minute globules of a clear substance, analogous to the 'hyaline,' whose remarkable properties in reproductive cells Dr. Barry has recently described, and from which the young acephalocysts are developed." Hydatids have no voluntary contractile property, and no function but the assimilation of the surrounding fluid, and the development of new cells from nuclei of hyaline.

Serous Cysts, when they are not natural cavities enlarged, but are adventitious productions, are in all cases allied to those semi-solid, atheromatous, and steatomatous tumors called wens. Even these may be natural cellules in a state of hypertrophy, reinforced in their parietes by new deposits of nutritive matter, or by condensation of surrounding cellular tissue. In this way an obstructed follicle may, in the opinion of Sir A. Cooper, expand into an atheroina, and the fatty tumors generally may be nothing more than hypertrophied adipose vesicles. (Drake.-Gross, Pathol. Anat.)

Hydatids. These tumors are more common in the liver than in any other organ. They are common in various animals, especially sheep, and the liver with them is the organ most likely to be their seat. When one sheep of a flock is affected with them all the rest of the