§ 255. Orchitis, inflammation of the testicles.

Not only the testicles, but the whole spermatic cord up to the abdominal ring, is involved in the swelling; the pains are stinging, tearing, although permanent, yet at times more violent than at others, as in rheumatism. The skin of the scrotum is not very tight, nor is it red or shining; it does not exhibit any great alterations of any kind. If the disease should have been occasioned by a cold, muscular parts are likewise affected with tearing and drawing pains. The fever is either synochal or erethic.

In traumatic orchitis, occasioned by external injuries, the swelling is generally more considerable than in the former kind, and the sensitiveness to contact is likewise greater. The testicle is drawn up to the abdominal ring.

The swelling is most violent in orchitis gonorrhoica, which generally comes on in consequence of cold, and is accompanied with suppression of the gonorrhoeal discharge.

§ 256. We have already stated, in other parts of this work, that Arnica is a specific remedy for affections arising from external injuries, contusions, bruises, strains, or tearing of solids. It is likewise an excellent remedy for orchitis arising from mechanical causes. If the inflammation and fever should be very acute, the exhibition of Arnica may be preceded by a few doses of Aconite. Contusions of glandular organs, and their consequences, are sometimes removed by Conium, to which we will add Calendula officinalis. Chronic indurations of the glands and testes frequently yield permanently to a few doses of Rhododendron chrysan-thum.

In rheumatic and erysipelatous orchitis, the following remedies are the most suitable: Bryonia, Belladonna, Rhus tox., Puls., Mercurius, etc. Clematis is an excellent remedy when the swollen and indurated testicle is painful and sensitive, and a drawing is felt from the testicle along the spermatic cord; a crampy and bruised feeling when touched, with drawing and stretching in the lumbar region, thigh, and scrotum, is frequently present. In erysipelatous orchitis, Arsenic should not be left out of consideration.

In gonorrhoeal orchitis, Mercurius is frequently the most suitable remedy. Pulsatilla, may prove useful for a painful drawing and stretching along the spermatic cord to the inflamed testicle, both those organs feeling bruised when touched. In other cases, Clematis erecta may be indicated; in others again, Acidum nitricum; if inflammatory fever should be present, a few doses of Aconite should be exhibited, previous to resorting to the more specific remedies. I have found the second and third trituration of Mercurius solubilis the best remedy for induration of the testicles, though, in some cases, Aurum may deserve a preference over Mercury.

If the pain in the swollen testicle should be a crampy, contusive, choking pain, with dull stitches striking suddenly through the part, and reaching into the swollen spermatic cord, Spongia is the most suitable remedy. Spongia, Iodium, positive electricity, and Mezereum, are likewise excellent remedies for induration of the testes.

Pulsatilla and Staphysagria, especially the latter, are excellent remedies for an aching pain and drawing-burning stitches in the testes and spermatic cords. Carbo should not be overlooked.

There is a species of orchitis where the affected 8 testicle swells up to the size of a child's head, particularly under the alloeopathic use of Mercury, and where, according to the doctrines of the old school, the sick testicle cannot be cured without an operation. This affection frequently yields to a single remedy, particularly China, Aurum, Sulphur.

§ 257. Encephalitis, cephalitis, meningitis, phrenitis, inflammation of the meningeal membranes.

The nature of the brain and its surrounding membranes gives rise to a variety of inflammations of that organ. Inflammations of the dura mater are very rare; the arachnoid membrane is more frequently inflamed, and the pia mater, which is exceedingly vascular, most frequently. An inflammation of the latter membrane frequently borders on synocha. If the cortical substance should be the seat of the inflammation, it is still more intense. In inflammation of the medullary substance, the inflammatory phenomena are less marked, but the nervous symptoms are so much more prominent, We know all this from post-mortem examination.

We shall include the symptoms of the different varieties of encephalitis in one group, for the reason that it is scarcely possible to separate them from each other, and that such a separation, even if it were possible, would have no practical value. Encephalitis is either acute or chronic, at times furri-bond, of various degrees of intensity, with delirium, convulsions; at others, with pressure on the brain, depression of the cerebral functions, coma, paralysis; at times, the symptoms resemble apoplexy.

The precursory symptoms of encephalitis, attended with congestion of the brain, are: Dull pain through the whole head, sensation of fulness,- confusion of the head, red and bloated face; throbbing of the carotids; sensation of rushing of blood in the head; increased irritability,vertigo, sleeplessness, restless sleep, which is disturbed by dreams, and starting, as if in affright; or sopor, inability to think; cloudiness of sight, photophobia, diplopia, buzzing in the ears, hardness of hearing, unsteady gait; formication in the limbs, stammering speech. The pulse is full, sometimes suppressed, and generally accelerated; the heart beats, and the nose bleeds. These are the most ordinary symptoms of encephalitis, which, when increasing, change to a dull, aching pain throughout the brain.

After a shorter or longer precursory stage, and sometimes suddenly, a digging-up, beating, boring, or frequently a dull headache, sets in, extending from the occiput over the whole head, and increasing considerably on moving and shaking the head. The patient's head feels hot and burning. He frequently grasps at it, while in a state of unconsciousness. The countenance has a wild and threatening expression, with redness and turgescence, shining and injected eyes, photophobia, contraction of the pupils, disturbance of the sensual functions, stupefaction, sopor, and bland delirium, or else excessive sensitiveness, the patient being painfully affected by the least noise; the eye is wild and staring, with furious delirium, increasing unto rage, attended with a desire to commit acts of violence, and with unusual muscular power, particularly towards evening. Spasmodic or tetanic contractions of the muscles, strabismus, distortion of the eyes, grating of the teeth, are frequently present; likewise sympathetic vomiting, in many cases. The fever is generally a synocha; the heat is great, tongue dry. thirst intense, urine saturated, but sometimes clear, spastic. The pulse is generally small, frequent, and tremulous.