The summer following the paper-it was read by title in Detroit-I returned from a months vacation. As soon as I got there, the Superintendent of the hospital called me in. He said, “We had a call here from Mellon Brothers.” The caller asked if he had a physician on the staff interested in aluminum.

This proving, for want of a better term, is not scientific in that it was not conducted according to rules. It was a forty year conquest with an unknown foe: alumina poisoning from kitchen aluminium utensils. Three successful hurdles were in this conquest, viz., pulmonary tuberculosis, left-sided hemiplegia and a paretic-like syndrome. All the obstacles were met by the single, similar, infinite remedy.

The forty years insidious march of destruction by alumina was finally met by a Cadmium combination. Some physicians are successful with Barium combinations.

In presenting symptoms developed over a period of forty years, those most outstanding with reasonable degree of permanency are recorded. New symptom manifestations other than expressed in the materia medicas are disclaimed. Ultimate as well as common symptoms are mentioned as suggestive in the outward drift of the disturbed autonomic system.

The vital symptoms, intrinsic signs of a disordered vital force, will be our chief concern.

MIND: Sadness. Depression, worse on waking mornings. Melancholy. Dullness. Lack of concentration. Irritability. Anxiety. Fear. Aversion to company. Lack of memory. Timidity, will avoid meeting people. Inquietude, at times a feeling of everything being unreal.

VERTIGO: Dizziness, aggravated violent exertion.

HEAD: Pain is gastric; with nausea; right side with vomiting. In morning awakening with headache, increases and gone by 3 p.m. Sensation tired sleepy, bruised sore, right side extending to liver region.

Heat of head with pain, ? by slow motion and cold application and cold air. Pain in occiput extending to forehead with chilliness, with coldness of hands and feet; with paleness of face and forehead.

EYES: Pain, burning and smarting. Itching, inner canthi. Lachrymation in wind. Photophobia. Pupils unequally dilated.

EARS: Burning and itching.

HEARING: Impaired, sounds seem muffled.

NOSE: Cracks, tip of root of nose; expansive in character. Sneezing followed by > of pain at root of nose. Ulcer inside, very sensitive. Furuncles inner and outer side.

FACE: Pale with headache. Itching, sensation of hair. Hair falls out of eyebrows. Furuncles on the chin.

MOUTH: Bleeding gums. Dryness. Sensation of tingling desire to scratch it. Ulcers. Tongue enlarged.

THROAT: Dryness on waking and when talking. Constant presence of mucus that necessitates clearing the throat, especially so on rising mornings. Sensation roughness of throat.

STOMACH: Nausea during headache > lying down. Vomitus yellow or green. Sensation of fullness and tension. Empty eructations when changing position.

ABDOMEN: Borborygmi. Fullness and tension which is alleviated by having extremities elevated. Liver enlarged, sore and tender.

RECTUM: Constipation, obliged to strain when stool is soft, or is hard. Itching and burning after and during stool. Cutting pain during stool. Frequent ineffectual urging for stool after going two or three days without a stool. Stools, like balls; may be large, hard, dry and dark; frequent, scanty and covered by mucus.

CHEST: Shallow respirations.

BLADDER: Urination retarded, must wait a long time; then a slow feeble stream. Frequent urging to urinate.

GENITALIA: Impotency. Sexual passion diminished.

LARYNX AND TRACHEA: Irritation with sensation of dryness. Feeling of soreness and roughness; obliged to clear throat frequently. Scanty mucous discharge in throat with difficulty to impossible to speak. Voice at times has sudden weakness, almost impossible to speak. Again hoarseness. There were times when there was aggravating hacking cough either from mucus or tickling in air passages.

HEART: Palpitation while thinking about what to say in public. The longer the suspense in speaking the more violent the pulsations.

BACK: Aching, drawing, tiredness between shoulders and lumbar region while sitting. So severe at times obliged to change position which temporarily relieved.

EXTREMITIES: Dryness of joints. Coldness of hands, feet. Bluish hands and feet. Varicosity of legs. Trembling and weak, at times numbness. Heaviness and awkwardness, weakness of lower limbs. (Incoordination). Coldness of feet and hands during headache. Blueness of hands and feet. Cracking in joints. Jerking of arms and legs falling asleep. Trembling. Furuncles identical, one on each forefinger at the same time. In healing left rough cicatrix. Cracks between the toes with excoriation and discharge light colored sticky fluid.

SLEEP: Sleepiness in evening followed by sleeplessness before midnight.

SKIN: Dry inability to perspire. Fine bran-like scales, roughening of arms and legs, followed by itching, scratching, smarting; itching when becoming warm as by exercise or in a warm room.

V. T. Carr