as our business in life is probably quite as much to relieve suffering without loss of time as to advance science, we shall do well as a rule not to omit the hypodermic use of morphia, the employment of rest, and of any systemic treatment which may be indicated, whilst the very potent influence of the current is added to these measures of relief.

THE RETURN ON SCIATICA.

IN answer to our second issue of questions-the subject of sciatica being selected this time—we have to acknowledge answers from no less than sixty-three subscribers to the Practitioner. To these gentlemen we return our sincere thanks for the trouble they have so kindly given themselves to meet our wishes. In many of the cases elaborate pains have been taken to answer the questions categorically, while in other cases more general answers have been returned. As an outcome of this lack of uniformity our report will not be so complete as we could have wished. We also should have liked to give some representation of each gentleman's views, if space would have permitted of our doing so. As far as is possible the return will be the reflex of the practice of the profession. Of the gentlemen who have been good enough to answer our questions, we find the names of Mr. Alderson, Hammersmith; Dr. Barkwell, Cheyenne, U.S.A.; Dr. John Beddoe; Dr. Brandt, Oporto; Dr. Brockman, Madras; Mr. S. Burrows; Dr. Cahill, of Knightsbridge; Dr. A. Carroll, New Brighton, N.Y.; Dr. Collins, of Melbourne; Dr. Creighton, Tavistock; Mr. Couldroy, of Littleborough; Dr. Deville, of Harrogate; Dr. Douglass, of Bournemouth; Dr. Edgar, of St. Louis, U.S.A.; Dr. Fairbanks, of Wells; Dr. Forrest, of Florence; Mr. Gabb; Mr. Grabham, Pontefract; Dr. A. Grinders, Normanton; Dr. Hackett, Sidney, N.S.W.; T. Hayden; Dr. S. Holden, of Sudbury; W. B. Holderness, Huntingdon ; Dr. A. Hudson, of Dublin; Dr. Talfourd Jones; Dr. Londereggio, St. Gall, Switzerland; Dr. T. Mays, Upper Lehigh, Pa., U.S.A.; Mr. Monat, Swansea; Dr. Nicol, Llandudno; Dr. David Page, Kendal; Dr. Purdon, Belfast; Dr. Polargii Putoryii, India; Dr. Hall Redwood, of Rhymney; Dr. Kent Spender, of Bath; Dr.

Wilberforce Smith; Mr. Spark, of Bucklyvie; Mr. S. Thomson, of Ashton; J. A. Watson and Dr. D. Wooman, U.S.A.; W. O. Derby; 2PNAET; several names illegible; one which is dated Enniscorthy, and the rest anonymous. To these gentlemen our kindest thanks are due, and though many have not signed their names, their returns are equally carefully made: in fact, some of the most careful returns are from these anonymous writers.

Pursuing the plan adopted in the first return, we will give the results in figures, believing this to represent in the fairest way the opinions of those who have answered our questions. Out of the total number of answers received up to the present time -viz., 63-we find that 49 recognise the rheumatic form of sciatica, 40 the gouty, and 39 the neuralgic form. The syphilitic form is spoken of by 12; while 11 have seen it produced by pressure in two cases it has resulted from the pressure of the gravid uterus. Chronic periostitis has been found to cause it in the experience of 7 writers. No less than 5 speak of malarial sciatica, evidently regarding it as one of the neurosal sequelae of malarial infection. Other 3 writers describe an inflammatory form of sciatica. Of the remainder, 1 alludes to cancer as a cause, 1 to struma; while 1 speaks of a toxic form, 1 of its dyspeptic origin, and 1 is opposed to any divisions.

Of the remedial agents resorted to for the relief of this affection some are evidently largely used, while others are in less repute. It would be impossible in the space at our disposal to arrange the different agents as used in each form, so great is the diversity of practice. So we give them in numerical order, after which the more especial application of different agents to the various forms will be furnished. As might be supposed from the order of recognition given above, the agents chiefly used are iodide of potassium, colchicum, and quinine. Quinine heads the list-29; the iodide follows-28; while colchicum is mentioned in 27 of the returns. Bicarbonate of potash is given by name by 15, while 14 speak generally of alkalies. Iron is alluded to by 14, arsenic by 11, opium or morphia by 10, guaiacum by 7, aconite by 7, and mercury by 6. The combination of colchicum with magnesia is referred to by several writers in different sections of their No less than 6 resort to the chloride of ammonium; while but 4 refer to lithia. Actea racemosa is in use with 4;

answers.

colocynth is the favourite therapeutic missile of 1 gentleman; scoparium is used by 1; croton chloral 1; chloral 1 (it may strike some readers as strange that these two powerful agents are not more largely used; but it is evident from the comparatively small resort to opium that analgesics are not much relied upon for the relief of sciatica when given by the mouth, that is), conium 1, and henbane 1. Turpentine is the sheet-anchor of 1, phosphorus of 1, salicine is mentioned by 1, and trimethylanine by 1; while one gentleman regards sciatica as entirely a neurosal affection, to be exclusively treated by the combination of strychnine and arsenic. The answers to the query, "What preparations and dose do you prefer?" are generally of too vague a character to be classified, and where the dose, &c. of one favourite drug is given, the details would occupy more space than they seem to warrant. Of the total answers, 15 speak of the necessity for full doses of the agents employed; 9 refer to the use of purgatives; one gentleman has great faith in the citrate of iron, while 1 uses no drugs specially, and 1 ignores them on principle, preferring other measures.

As some further elaboration of the answers to this question, and as including the most practical answer to the query, we will give the following verbatim extracts from several of the most elaborate answers :-" Rheumatic or gouty, alkalies, bicarbonate (9ss) and iodide of potassium (9ss). Neuralgic, quinine (2 to 5 grs.) and nux vomica (m5). Mechanical from pressure, purgatives, followed by sulphate of magnesia (3i.), quinine (gr. 1), or nux vomica (m5)." A second says:-" Rheumatic, iodide of potassium. Gouty, alkaline waters with colchicum occasionally. Neuralgic, quinine with iron, strychnia, or valerianate of zinc. Syphilitic, bichloride of mercury." A third says:—" Rheumatic, bicarbonate of potash and iodide of potassium, from 5 to 30 grains three times daily. Gouty, the same with colchicum. In the neuralgic form, quinine, bromide of potassium, and iron. Specific, the biniodide of mercury, or large doses of iodide of potassium." A fourth says:-"In rheumatic form, 12 grains of salicine every six hours. Gouty, colchicum and opium in full doses. Neuralgic, aconite and iodide of potassium. Syphilitic, the bichloride of mercury, with arsenic and large doses of iodide of potassium." A fifth says:-"In rheumatic forms,

alkalies, purgatives, and sedatives, white mixture and pulv. Dover (ss) at bedtime. Gouty, alkalies with colchicum (mx.), and sedatives, as opium (gr. i.) or morphia (gr. ). Neuralgic, bromide of potassium or ammonium (7 grs.), morphia, (gr. §), or ten minims of tincture of aconite." A sixth puts it:"Rheumatic, alkalies and iodide of potassium. Gouty, colchicum with magnesia. Neuralgic, quinine and arsenic. Of all full doses." And a seventh, who only recognises the rheumatic and the neuralgic forms, says:-" Rheumatic, iodide of potassium (grs. v. to x.) and tinct. aconite (mx.), ter in die. Neuralgic, tincture of actea racemosa (3i. to 3ii.) and bromide of potassium, ter in die." Finally, an eighth says:-"Rheumatic, bicarbonate of potash (3ss), ter in die. Gouty, same with vin colchici (mxx.). Neuralgic, quinine, (grs. 5), ter in die. Chronic periostitis, iodide of potassium, (grs. 5), ter in die." While the favourite external application with this gentleman is a liniment containing "ext. belladonna (3ii.), liq. opii sed. (3vi.), chloroform and glycerine a.a. (3ss), to be spread upon lint and covered with oil-silk."

:

The local measures employed are various in kind and nature. The hypodermic injection is spoken of (often in terms of high praise) by no less than 34 practitioners; of these 12 use a combination of opium and belladonna for the purpose of injection. No less than 33 resort to liniments, the formula of which, when given, is much like that quoted above. Blisters are used by 23, of whom 5 prefer to dress the blister afterwards with morphia. Ointments containing analgesics are used by 5 it is clear that local analgesics are more in favour than the general administration of them in this affection. Counter irritation is mentioned by 5. Hot baths are spoken of by 5, hot flannels by 3, and warm fomentations by 1. Poultices are advocated by no less than 11 of our answerers; while 2 resort to cupping; and 2 others believe in dusting the limb with sulphur; while one gentleman declares that local measures are useless. Plasters have 3 advocates. As to the particular form preferred, the only agent especially mentioned is Corrigan's hammer, and that chiefly in answer to the last question, viz., the surgical measures employed.

As to the question of diet and regimen, it is simply impossible to give a strictly true representation of all the views except by giving the answers verbatim. We may say that 18