followed by extreme heat and feverishness; but the tendency to somnolence and the general prostration of the bodily powers commenced only the preceding evening. A fourth of a teaspoonful of the tincture of Lobelia was directed to be given every two hours, cool bandages to the head and throat, copious light draughts of cold water to allay thirst, and at evening a bath of tepid water, with a moderate dose of a gentle cathartic.

The next day there was inclination to somnolency, but the skin was more hot, with a slight indication of eruption on the chest, more thirst, and bowels acting from the medicine. The following day every indication of rash had disappeared; the patient more comatose, breathing oppressed, with a slight cough. Another bath was ordered, with tar soap added as a detergent, and the dose of Lobelia increased from a fourth to three-eighths of a teaspoonful, with the cool applications to the head and throat continued. The next day the chest sounded natural on percussion, but in the right side in front mucous rales were discoverable; the countenance was still pale and expressionless, but the discharges from the bowels had now changed to a dark brown matter, and very offensive. The tongue continued coated but moist; the skin also had become moist, but the extremities were cool. During the next two days the soreness in the throat subsided, the cough ceased, and all the alarming symptoms disappeared under the simple treatment mentioned. I now directed the occasional use of Lobelia in broken doses, together with the following prescription:

The recovery was somewhat protracted from various causes, but the little patient finally regained his health.

This, it seems to me, is an instance in which congestion was to a certain extent evident, while almost all the symptoms of eruption were absent first in the head, next in the lining membranes of the lungs, and the tendency to drowsiness and disinclination to answer questions. The evident oppression in the chest, the cough,

and mucous rales discoverable in the right lung on auscultation, were all significant. On the other hand the inflammatory form, either alone or complicated with more or fewer of the symptoms of congestion, were equally suggestive. But a further consideration of this topic must be reserved for another paper and for another occasion.

PREVALENT DISEASES OF NEBRASKA.

BY WILLIAM S. LATTA, M. D.

If there is any disease in this State that may be called "prevalent" it is typhoid fever. In the Fall of the year we have a form of typhoid of "typho-malarial" fever which partakes of the nature of intermittents of more malarious regions, yet the intermissions are but slight, and the fever continuous and protracted for several weeks under the best treatment. In this respect and in the peculiar condition of the bowels, inflammation and sloughing of Peyer's glands, occasionally diarrhoea, high state of temperature, hectic flush on the cheek, and in some, symptoms of inflammation of the lungs, it resembles typhoid.

If the disease comes on in the winter, which it sometimes does, the lungs are more effected, and when much inflamed and congested it is generally called "typhoid pneumonia," which appellation seems quite appropriate.

This disease is generally treated successfully by mild cholagogue cathartics at first, followed by tonics, cinchona and iron (tinc. ferri chlor.) and Dover's or diaphoretic powders with gelsemium and veratrum when indicated.

Very little food or stimulants are required, especially in the first stages. In convalescence the extract of malt and other easily digested food may be given carefully.

The symptoms, which are varied, will indicate any other treatment necessary.

We generally have a visitation every winter of measles, scarlet fever, and sometimes whooping-cough and diphtheria ; the latter disease is the most formidable of all others; indeed, at times, is very malignant. There are many theories as to its cause, most of which are unsatisfactory. It may appear in the filthy "slums" and alleys of the city or it may visit the best

families in high, dry localities in the country, where the imputation of filthiness would be regarded as the greatest insult. But in all cases which I have witnessed there is a depraved state of the system—a septic condition connected with a so-called “bilious state" which, in most cases, if taken in time, may be removed by cholagogues, tonic and antiseptics, podophyllin, cinchona, tincture of perchloride of iron and chlorate of potassa, fluid extract of Eucalyptus globulus and Baptisia tinctoria, with gargles and external applications to the throat, of carbolic acid, or vinegar and salt. I use chlorate of potassa for the chlorine but have little faith in any alkali for diphtheria. Some malignant cases seem to baffle all treatment.

Intermittents occasionally appear but are readily cured by cathartics and tonics with Dover's powders, and where there is threatened congestion of the brain, veratrum and gelsemium, which gives present relief. Iron should be combined with the other tonics. Quinine and other extracts of cinchona can be given even during the fever when gelsemium is freely added. A good formula to be given after the operation of the cathartic is the following:

Sig. Take a teaspoonful every two hours. This arrests the night sweats and meets every indication.

This preparation should be given one day at the end of each week for three weeks, counting the time from the day of the last chill. Give it six times a day and always precede this day's administration of the drops by a cholagogue cathartic the night before. This course will remove the worst case of ague almost invariably.

Our State has a porous soil and is free from swamps or marshy ground; hence intermittents do not prevail. What malaria we have seems to come from the decay of vegetable matter in rainy seasons, when the grass grows very luxuriantly

and the lower blades die and undergo decomposition during the warm season. And if such a season is followed by a mild winter and the decomposition not arrested, we have our "winter fevers" or "typhoid pneumonia," which are always attended with a bilious condition.

Phthisis seldom if ever originates in this State, and persons who come from the East and who have contracted the disease before coming, seem to recover and often without much treatment, excepting hygienic.

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Asthmatic patients are greatly benefited by the rarity and dryness of the atmosphere. I have known a few cases cured by lobelia alone, but lately have seen the most marked benefits resulting from the use of Grindelia Robusta and Yerba Santa combined, equal parts of the fluid extracts, and give of the mixture a teaspoonful three times a day, and an additional dose, if necessary, on going to bed.

This State is cut out of a vast plain running from the base of the Rocky Mountains to the Missouri River, with a gradual or even descent of about six feet to the mile for a distance of about six hundred miles, and the face of the country is comparatively level for nearly a thousand miles to the east of it. There being but little timber, and the winds meeting with but little resistance, pass over the country at about the same altitude, and the consequence is that in the Autumn and Winter we have but little rain or snow. And were it not for the counter-currents common in the Spring of the year, and beginning in Summer, agriculture would be impossible. However, these Spring rains are abundant, lasting until near harvest time, when they subside, and the sandy, alluvial or porous soil absorbs all the surface-water; and stagnant water on the surface of the earth is a thing almost unknown during the season of the year which, in most Western States, malaria is generated.

In Western States generally, as the soil is brought under cultivation, malarious affections diminish in proportion to the amount of land cultivated; and although the rain-fall in our State is becoming more abundant in late years (perhaps from the planting of so many groves), we do not anticipate any increase of malarious affections, because of the porous soil and the great increase of the lands cultivated.

Neuralgic, rheumatic and paralytic affections are perhaps more frequent here than in the East in proportion to the number of inhabitants, which is a little surprising when we consider our dry, light atmosphere. The altitude seems to favor it, as they are more prevalent in the mountains west of us than here. Thus I have briefly mentioned the diseases which most frequently occur in our State, but the title under which these remarks are made is really a misnomer, as none of the diseases mentioned or any other may be properly called "prevalent" in Nebraska.

PREVALENT DISEASES OF CALIFORNIA.

BY SAMUEL CLARK, M. D., LAWRENCE, ILL.

The elevation of some districts of California, and the near proximity of the ocean to others, exercise a powerful influence in the way of determining the character of diseases infecting those regions. Whatever we may read or hear concerning the climate and salubrity or unhealthfulness of the State should be weighed carefully by this consideration. I will endeavor to show the distinction as it has come under my observation.

I. The valleys are alluvial, and abound with volcanic deposits formed by the washings from the mountains on either side. This makes a foundation of very rich and deep earth. The annual rains which soak into this rich accumulation of sediments, and the subterranean current of water flowing from the mountains, keep the earth continually wet. Thus we have malarias and malignant diseases of the type caused by noxious gases proceeding from the decomposing matter. We also have bilious and malarial fevers, and the worse forms of disorders of the liver. The great variation in the temperature during the day in Summer-the thermometor standing at from 80° Fahrenheit to 100°, falling at night to 30° Fahrenheit or 40°, so that overcoats and blankets are in request-causes the worst and lasting form of rheumatism and neuralgia, and the easy taking of colds which result in inflammation of the lungs, and many times their decay, by its chronic form. A cold which would wear off in the course of two weeks without medication in the State of Illinois or the Eastern States, would take as many months in