The metal Manganese was isolated in 1774, in the year Priestley discovered Oxygen. It was introduced into the materia medica by Hahnemann, who made provings of the acetate and carbonate. The symptoms of the two have not been kept separate. Manganese is a metal "having a remarkable affinity for, and in some respects a close resemblance to, iron, of which it is an extremely frequent associate." Its medicinal as well as its physical relationship with iron is very close. It has an action on the blood-forming process like iron, and has been successfully used in cases of anaemia. There is one curious symptom they have in common: Cough > by lying down. If there is any difference, the Mang. cough is more apt to be deep, and it is also < in damp weather. Guernsey summarises the Mang. effects thus: "The bones are very sensitive; red spots on the skin, which are elevated, owing to the affections of the bones. Ankles are particularly affected; children may have this trouble and be unable to walk. Typhus fever when the parotid gland is swollen and the bones are very sensitive to touch; affections of the internal ear; upper part of chest. Hoarse voice; drawing sensation of the muscles." I have frequently verified the "cough > lying down," and also this sensitiveness of the bones. Where this occurs in connection with any other condition indicating Mang. it is sure to do good. There are single nodes on the palate (I recently cured in an elderly lady a flat growth on centre of palate with Mang. 30); bluish nodes on the skin; malignant ulcers with blue borders following slight injury. The skin will not heal, slight scratches ulcerate. Inflammation of bones and joints with insupportable nightly digging pains. Anaemia (menses too frequent and too scanty in anaemic girls); laryngeal phthisis; tuberculosis. Chlorosis, if gastric symptoms and loss of appetite predominate. Every part of the body feels extremely sore when touched. This last is quite a keynote of Mang. Rheumatic patients cannot bear any weight on their heels. Rheumatic symptoms with dark, almost blue spots on skin. Mang. has some remarkable paralytic symptoms. Paralysis with inclination to run forward if he tried to walk. Paralysis begins below, extending upward. Paraplegia. Paralysis from degeneration of anterior portion of cord. The tongue symptoms of Mang. are very pronounced. Hansen (H. W., xxiv. 64) cured with Mang. ac. 6 a case of neuralgia of the tongue following the healing of a little ulcer on surface near left border, after pencilling with lunar caustic. Shortly after the healing the patient (man, 60) had severe stinging burning at l. edge of tongue and inner side of l. cheek touching the tongue. In this state he came to Hansen after allopathic treatment. Several medicines having been given without result, Mang. ac. was chosen, and made a rapid and permanent cure. In an article on Mang. by F. H. Pritchard (Minn. Hom. Mag., v. 151), who cites this case, the action of the metal is thus summarised: (1) On mucous membranes: congestion and increased as well as decreased secretions. (2) Liver: a powerful cholagogue inducing inflammation and fatty degeneration. (3) Blood: destroys red corpuscles and = anaemia. (4) Bones and periosteum: sensitiveness of bones with periostitis. (5) Skin: fissures; excoriation; suppuration. (6) Cerebro-spinal system: paralysis and progressive muscular atrophy. Pritchard quotes observations of Grille that workmen in manganese mines do not get itch; and those who come to the work with itch get cured of it. "Suppuration of skin round joints" is a characteristic of Lippe's. The manganese waters of Cransac cause: "Ill-humour, weeping, despondency, sudden palpitation." The headaches of Mang. are boring, pressing, and proceed from above downwards. There is also a headache like concussion on every step or movement. A. W. Palmer (quoted H. W., xxxii. 366) reports this case of catarrhal deafness cured with Mang. 6: Miss H., 38. Dull hearing; dry throat with hoarseness; itching in ears; loud rumbling, < night, r. ear, crackling on blowing nose; deafness in damp weather. The last was the guiding symptom. Cooper gives me the following ear-cases in which Mang. ac. has proved curative: (1) A nodous appearance of malleus handle; thickened irregularly, with history of bilious headaches and of previous discharges from the ears. The tympanal membrane has a granular appearance. Purple glazed appearance of malleus handles, which are thickened and prominent, upper segment of membrane also purple and glazed. (2) Chronic periostitis of the meatus and middle ear, with otorrhoea, left ear. (3) Otorrhoea with earache, pain shoots up from teeth to ear; the earache is worse after early dinner, up till 8 or 9 p.m. ("Pains extend to and concentrate in ears from other parts.") (4) Sensitive ears, takes cold and gets headache; history of gall-stones and jaundice; sleepy and headache in afternoon, bitter taste in morning, lips glued together; whistling tinnitus worse in a cold. (Whistling tinnitus, Mang. ac.; explosions, Mag. carb.; rasping, shrill tinnitus as well as cardiac tinnitus, pumping, K. iod.). (5) Deafness, woman, 36, dating from 14, from over-strain in singing, when she lost voice and hearing for six months; left hearing returned, right remained deaf, worse after a cold or if over-excited or worried; subject all life to bilious attacks which last twenty-four hours and leave suddenly; head throbs, can't put it down on a pillow; headache comes on in morning on awaking and reaches a height at 3 or 4 p.m. and keeps on till next morning. (Bilious headaches went away and the hearing of right ear improved under Mang. ac. 200.) (6) Subject to sore throats and unpleasant breath, tinnitus as of blood rushing fast through the ears (whistling?), membranes translucent, anaemic, malleus handles thickened and "skeletonized"; hearing, right 1 in., left 5 in. After taking Mang. ac. 3x, two pilules thrice daily, steady improvement went on, till hearing was right 10 in., left 20 in.; the deafness was worst in a noise. (7) Deaf from childhood, granular membranes. Mang. ac. 200 caused in a patient of Cooper's a woman, 53, excitement with feeling of whistling through the ears and general fulness of the head with swellings of hands and feet and a stinging as if frost-bitten; sight became dim with tightness round head, felt low-spirited and continual flushings. Among the Sensations of Mang. are: Head as if larger. As if pit of stomach enlarged. Ears as if stopped. Throat as if excoriated. Trachea as if closed with a film. As if bowels drawn together. As if tendons shortened. Nearly all symptoms are < at night, or else in morning. Lying down >. Raising head, bending forward, bending double >; bending backward <. Lying on feather bed < (asthma). Motion, laughing, talking, walking <. Cold <. Cold, rainy weather <. Touching with cold things <. Open air >. Sitting bent over a fire > pain in abdomen. Contractive pain in head and dryness of lips and palate are > indoors. > or < by change of weather. > By eating; > by swallowing. Eating = pressure in stomach and abdomen < from cold food. After eating: cramp pain in jaws; pain in rectum. Smoking > hoarseness.