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ITS PRINCIPLES AND PRACTICE, WITIS AN APPENDIX, I1. 6d. XIII. ROSENSTEIN (J. G.) THE COMPARATIVE MERITS OF ALL/EOPATHY, THE OLD MEDICAL PRACTICE, AND HOMCEOPATHY. 8vo., 8s. XIV. RUOFF. REPERTORY OF HOME(OPATHIC MEDICINE. NOSOLOGICALLY ARRANGED. 12Mo., 7s. XV. SIMPSON (M1.D.) PRACTICAL VIEW OF HOMCEOPATHY. Svo., 10s. Gd. XVI. YELDHAM. HOMCEOPATHY IN ACUTE DISEASES. 8vo., s. 6d. DO 6 (TtV HOME:OPATHY IN ACUTET DISEASES. BY STEPHEN YELDHAM, M.R.C.S., SURGEON TO THE LONDON HOM(EOPATHII HOSPITAL; LATE SENIOR SURGEON TO THE ROYAL SOUTH LONDON DISPENSARY, AND ASSISTANT SURGEON TO THE ROYAL MATERNITY CHARITY. " TO KNOW WELL THE IRRESISTABLE EVIDENCE ON WHICH THE TRUTH IS FOUNDED, IS TO BELIEVE IN IT, AND TO BELIEVE IN IT FOR EVER."-DR. TIOMAS BROWN. SECOND EDITION. LONDON: H. BAILLIERE, 219, REGENT STREET; AND AYLOTT AND JONES, 8, PATERNOSTER ROW. 1850. PREFACE TO THE FIRST EDITION. FIVE years ago an opponent of Homoeopathy from prejudice, I am now its disciple from conviction. Like most other members of the profession who had passed the ardour of youth, and submitted their doctrines to the test of experience, I had become painfully alive to the inefficiency of the prevailing system of medicine; but had never thought of looking to Homceopathy as affording a trustworthy substitute. lMy acquaintance with that system was most superficial-enough to impart an erroneous impression, but not enough to prevent me from joining in the laugh against its professors, or restrain me from denouncing it as a chimera, fit only to "occupy the mind of an enthusiast. Urged by a non-professional friend to look into this new doctrine, I procured a popular treatise on the subject; read it; and-unconvinced, as those who trust to reading without experience, generally are-dismissed it from my memory. A few months later Hlomceopathy was again brought accidentally under my notice. I now felt it my duty to submit the question to a practical examination. The result is before the reader. Truth triumphed alike over custom, education, and prejudice. It is the fate of those who change their faith, whether in religion, politics, or science, to have that change attributed to unworthy motives. For this I am prepared: I cannot hope to escape the common lot. The foregoing facts are my iv. PREFACE. answer to any such imputations. Having followed the old system with sufficient pecuniary success for ten years, nothing short of conviction would have induced its abandonment. Escaping, not unwillingly, from personal matters, I turn to the objects of this volume. Too palpable to be denied, the superiority of Homoeopathy in the treatment of chronic* diseases is the more readily admitted, because its opponents believe that they possess an indisputable vantage-ground in the treatment of acute diseases. Referring to our Homceopathic literature, we find numerous instances of the efficacy of the system when applied to the former; but instances of its successful application in the latter, are few and isolated. To supply this deficiency is the first object of the work. The cures of Homoeopathy are generally referred to faith, time, and unassisted nature. To reduce these agents within their proper limits, and to exhibit the unrivalled power of Homceopathy over acute diseases, is my second object. In the first place, not one of the patients, whose cases are related, was conscious that he was treated Homoeopathically. This fact at once overthrows the first objection; for, where no object is presented for its exercise, there can be no "faith." Again, in reference to the second supposed agent, while indispensable in chronic diseases, in acute cases time is death. In the following examples the mitigation of the disease follows too closely upon the application of the remedy, to admit of its being referred to time. In reference to the third supposed agent, the diseases selected are, for the most part, of that violent character, that, Chronic diseases-long-standing-slow of progress-symptoms mild. Acutc diseases-violent symptoms-rapid course-fatal tendency. vi. PREFACE TO THlE SECOND EDITION. In responding to the demand for a Second Edition of this volume., the Author has not deemed it necessary to make any material alteration, either in its form or contents.,lie has, therefore, simply to acknowledge the very flattering reception it has met with, both from the profession and the public. In the prescriptions, the figures indicate the attenuation of the medicines employed; it being always -understood, whennot otherwise specified, that one drop, or globule, is, the proper dose. -9, Stamford Street, London, November 15th, 1850.ý Wi. CONTENTS. PAGE. Preface to the First Edition iii.-Y. Preface to the Second Edition..Vi. Bleeding 1 Salivation 13 Purgatives... 18 Inflammation of the Lungs, and Pleurisy.. 26 in Robust Persons 33 in Delicate Persons 41 in Children. 50 Bronchitis..... 57 Inflammation of the Windpipe...62 Croup..... 71 Hooping- Cough.... 77 Inflammation of the Mouth. ~. 87 Inflammation of the Throat... 90 Inflammation of the Stomach, including remarks on the subject of Dose.... 95 Inflammation of the Liver, and Jaundice. ~ 109 Inflammation of the Bowels.. 118 viii. CONTENTS. -PAGE. Bowel Complaints.-Cholera... 123 SDysentery.. 135 - - --- Diarrhoea... 139 Inflammation of the Kidneys, and Bladder.. 145 Inflammation of the Brain.1. 153 Hydrocephalus, or, Water on the Brain.. 157 Delirium Tremens1. ~ 164 Apoplexy.... 172 Inflammation of the Eye... 180 Lying-in Fever.... 187 Inflammation of the Breast.. 197 Convulsions.... 202 Erysipelas. 210 Scarlet Fever... 218 Measles..... 228 Acute Rheumatism. 233 Lumbago.. 239 ____ -- Sciatica 242 Tic-Douloureux.... 245 Fever. 252 Spitting of Blood, and Consumption.. 260 Injuries.... 271 BLEEDINGr. REMEMBERING that the blood is the source from whence every orgtn of the body derives its nutriment, and through whose renovating agency the whole frame is sustained, it is difficult to conceive of any proceeding more irrational than that which is adopted by the Allopathist* of abstracting large quantities of this fluid at the very moment when the system is engaged in a desperate struggle with disease, and consequently stands so urgently in need of its support. Sanctioned by no other consideration than this, the Homceopathist would feel himself perfectly justified in avoiding a practice, which, being so diametrically opposed to the plainest dictates of reason and common sense, cannot be otherwise than medically erroneous. But weighty as such an argument undoubtedly is, he by no means regards it as forming the chief ground of his opposition to blood-letting. His objections to that operation are of a practical character, and refer principally to the following points, namely,t its pernicious * Allopathist is a term used to designate the Professor of Allopathy-the old system of medicine. Homoeopathist, in like manner, is applied to the Professor of Homoeopathythe new system of medicine. t The difficulties which surround this remedy may be inferred from the number of works which have been written on the subject. Dr. Marshall Hall enumerates the following as the principal morbid effects of the loss of blood, viz.:-syncope (or fainting,) convulsions, delirium, coma (or insensibility,) sudden dissolution, excessive re-action, mania, alnaurosis (blindness,) sinking. A 2 BLEEDING. influence over the progress of the disease-and the tedious and precarious state of convalescence, which, as a natural consequence, it superinduces. The circumstance that most forcibly arrests the attention in connexion with this remedy, and to which most, if not all, the other evils attendant upon it may be traced, is its weakening effect upon the system. No one who has watched the progress of an acute disease, in which blood-letting has been largely employed, can have failed to be struck with the extreme state of exhaustion, to which, in a remarkably short space of time, the patient has been reduced. To understand this more clearly, let us suppose the case of a patient labouring under inflammation of the lungs, or plurawe find him complaining of severe pain in the side, and difficulty of breathing: this is his chief, probably, his only source of suffering-we find him moving, walking, and performing any other action not requiring much bodily exertion. Do we hear him complain of weakness? Certainly not! Observe this same patient after the lapse of only a few hours-the change startles you! He is already reduced to the lowest point of physical depression-he can scarcely speak above a whisper, move without being supported, or drink unless the cup is held to his lips. Whence this sudden alteration? Assuredly not from the progress of the disorder. There is no inflammatory complaint, however severe, which, even if left to itself, will, in so short a space of time produce such powerful effects upon the vital energies. Nothing can afford a stronger proof of this, than the condition in which we often find cases of the most dangerous character, which have existed for several days, unchecked by the use of any remedial measures whatever. In these instances, we have as might be expected, sufficient evidence of the inroads of disease upon the constitution, but certainly nothing at all approximating to that state of BLEEDING. 3 exhaustion which has just been described as dependent upon the loss of blood. The alternative is unavoidable-it is to the remedy and not to the disease, that we must look for a solution of the question. The explanation is but too palpable:-he has been bled till he fainted: till his cheek was blanched, his eye dim, and his pulse scarcely perceptible. Re-action manifesting itself, the operation was repeated and the system brought down to its former level. This is done again and again till it can be borne no longer: then only does the destroyer arrest his progress. But though the victory of the lancet is complete, let not the reader imagine that the struggle has terminated: subdued, but not annihilated, the eradication of the disease is committed to the leech, the cupping-glass, the blister, nauseants, purgatives, and salivationthese, after bleeding has done its work, even if they be not employed simultaneously with that operation, are brought to bear upon the exhausted patient. Melancholy as this picture is, I do not hesitate to declare that it is a faithful transcript of a large class of cases. Without asserting that in every instance, depletion is carried to such an extent, it is nevertheless true that to a greater or less degree it is adopted in all cases which are treated in accordance with the written rule of the old school; and it may be further affirmed without fear of contradiction, that it is alone by producing this state of depression that bleeding ever does any good. According to Drs. Crawford and Tweedie, it is "employed with the object of diminishing the quantity of blood, and at the same time of abating the force and frequency of the action of the heart and arteries." To the same extent that it robs the system of its "'vital fluid," so in proportion, does it deprive it of its vital energy. Beyond this, from the very nature of the operation, it does not possess, and therefore cannot exercise, any remedial virtue.* * The following is extracted from a lecture on the treatlmnt of pleura-pncu 4 BLEEDING. The foregoing remarks have special reference to those more favourable cases, which, occuring in persons of robust habit and sound constitution, run their course rapidly, and notwithstanding the employment of the violent measures I have described, result in the restoration of perfect health. But it unfortunately happens that the most critical attacks of inflammation occur, not as might be expected, in the strong and robust, but in those who, possessing constitutions naturally weak, or from other accidental circumstances rendered so, are least able to withstand the effects of depleting remedies-delicate females, infants, aged persons, and those predisposed to consumption. That the medical man of the old school cannot be placed in a more perplexing situation than when called upon to treat a case of this description, I can testify from personal experience. On the one hand he sees a disease, which if left to itself, will in all probability, directly or indirectly, prove monia, or inflammation of the lungs with pleurisy, written by Mr. Guthrie, and reported in the "Medical Times" of February 19th, 1848 -"In the year 1801, I found myself, not seventeen years of age, in charge of a regiment of infantry, on the top of the Berry Head, the outermost point of Torbay. The men were soon attacked by pneumonia. I had been taught the practice of physic in London-had followed, among other avocations, the late Drs. Rowley and Hooper for three years, and, in consonance with their views, bled my patients three and four times in the first forty-eight hours. I first drew sixteen ounces, then fourteen, then twelve, then abstracted, as the complaint continued, eight ounces; gave tarter-emetic, so as to keep up nausea; then calomel, antimony, and opium, and lost my patients. Discomfitted by my failures, I reconsidered every case, and saw that, however systematically I had acted, the disease had not been arrested in any one of them. In fact enough had not been done. Recollecting what I had been told of northern constitutions, and of country practice, I determined that in future, they should die of the bleeding, and not from excess of inflammation. I then took away on each occasion, as much more blood; my sixteen ounces became from twenty to thirty. It would not do. I arrested the rapid course of the disease, but did not effectively subdue it. It was evident that, to succeed, I must place no limit to the abstraction of blood in the first instance, but the decided incapability of bearing its further loss." BLEEDING. 5 disastrous to his patient: on the other, he meets with an array of circumstances which forbid the application of the only effectual means he has at his command-he dare not resort to his favourite remedy-he must sheath his lancethe is reduced to the half measures of cupping, leeching, blistering, and salivation: expedients which, whilst they exercise, nine times in ten, little or no beneficial influence pver the progress of the disease, still exert the baneful property of debilitating the system, and thereby depriving nature of that power, by the aid of which she might otherwise successfully struggle against her adversary. Following the natural tendency of all these cases, the disease, still unsubdued, runs on into the chronic form, and if the chest has been the part affected, consumption but too commonly manifests itself as the disastrous consequence. I express no novel' opinion when I declare my firm belief that bleeding and other debilitating remedies, so often recklessly employed in Allopathic practice, may be justly regarded as among the most powerful causes of those numerous chest affections which are generally, though wrongfully imputed to the ficldeness of our climate. There is another class of cases, less numerous, but scarcely less important than the foregoing, in which the abstraction of blood frequently leads to the most unhappy results: that in which the seat and character of the disorder are involved in obscurity. Uncertain as to the nature of the disease, but desirous of alleviating the sufferings of his patient, the physician, possessing no fixed principle to guide him in the choice of a remedy, is too apt to select that one which custom has taught him to consider the best calculated to produce a decided impression upon the system at large, and consequently upon the disease. That remedy is blood-letting. Adopted with so much the more confidence, as these cases, notwithstanding their obscurity, are for the most part attended by symptoms of a 6 BLEEDING. febrile or inflammatory type, it is nevertheless certain, as "is evinced by the subsequent developement of the disease, that bleeding is powerless in checking its onward progress. The symptoms which determined its employment were but the ushering-in of a long enduring disease, which time, aided by judicious means on the part of the physician, could alone overcome. When too late to be repaired, the fatal error is discovered-the system has already been robbed of its life-blood -the patient's energies undermined-disarmed and rendered totally unequal to the contest, he finds himself doomed to strive with an enemy whose strength increases in proportion as his own diminishes. The result need scarcely be toldhe sinks in the struggle. The foregoing remarks, referring to the use of bleeding in the treatment of inflammatory diseases in adult patients, apply with equal force to that remedy, as it is employed in the diseases of childhood. Though in the former, its operation as we have seen is so objectionable, still it is generally speaking unattended with any immediate danger to the life of the patient, who, being older and stronger, is better able to withstand its effects. With children the case is different. It is well known that they are peculiarly wanting in that power which is necessary to sustain the loss of blood; nor do they, like adult patients, furnish us with those tests which enable us to judge of the extent to which it may be carried. Fainting, as a criterion, is no longer available-the pulse is no safe index-the blood, moreover, being usually abstracted by leeches, the quantity lost is necessarily uncertain. The result, as might be anticipated, is often most lamentable. I retain a vivid recollection of having in one instance seen a fine and beautiful child, labouring under inflammation of the lungs, rapidly sink and die in the course of two or three hours, solely from the loss of blood, sustained by the application of BLEEDING. 7 four leeches. In other cases, although the Jlittle patients survive the immediate effects of the loss, they become so exhausted by repeated leechings, and remain for so long a time in a weak and languid condition, with pallid skin, flabby flesh, and wasted forms, as to be rather dead than alive. These and many other reasons which it is unnecessary to enumerate, render it specially desirable to avoid the abstraction of blood in treating the diseases of children. Allopathy shows it be hazardous and injurious: Homoeopathy proves it to be unnecessary. Remarking upon the diseases of children, it may not be inapposite to introduce a few words upon the practice of applying blisters in these cases. There can hardly be a practitioner of any experience who has not witnessed their fatal effects. They are generally resorted to at an advanced stage of the complaint, when the patient has been thoroughly reduced by depletion. The system, not possessing the requisite power to restore the blistered surface, the sore becomes converted into an eating ulcer, which, resisting every means for its cure, wears out the sufferer by the constant irritation which it superinduces. Several melancholy instances of this kind came under my own observation in the earlier part of my professional life; and many years before I abandoned the Allopathic practice, I had entirely relinquished the employment of blisters in the class of cases now under consideration. Mustard poultices always afforded a safe and effectual substitute; but even these, as well as blisters, I regard as useless in all cases since I have become acquainted with the more certain and painless remedies which Homceopathy supplies. As bleeding in its different forms, during the progress of disease, induces the deplorable state of things which has been described in the foregoing remarks, so does it, as a necessary consequence, entail upon those upon whom it has been 8 BLEEDING. practised, a correspondingly painful and precarious convalescence. Daily experience has brought this matter to be so thoroughly understood and appreciated by the public as well as the profession, that it is scarcely requisite to do more than simply refer to it, as forming a strong point of objection against the depleting system of treatment. Let the reader recall to his mind the wretched condition of a man who has undergone the antiphlogistic treatment for an attack of acute disease. - What a shattered frame does he present! What a long and weary time he is in crawling back to his former self! Reduced to the helplessness of childhood, he is forced to be nursed and fed like a child. Undermined in constitution, and stripped of all power to resist, either a recurrence of his former complaint, or the invasion of new diseases, how often do we find him the subject of a relapse, or a prey to dropsy, diarrhea, chest disease, or some other exhausting malady. His body is a citadel from which the garrison has.been withdrawn, and which falls an easy prey to the first foe by which it is attacked. In the third place, the Homceopathist maintains that the best experience proves the abstraction of blood to be totally unnecessary in the treatment of any disorder whatever. The best experience is clearly that which can show the most successful results. So far from shrinking from such a test, Homoeopathy courts it: it is her strong-hold. She does not ask the world to listen to an empty theory: she invites it to examine her practice, and judge her by its fruits. If Homoeopathy could boast of no greater amount of success than Allopathy can produce, she would long ere this have been compelled to quit the field of contest in favour of her ancient and more powerful rival, notwithstanding the superior attractions of her painless and tasteless remedies. But it is alone through the irresistible force of her successful experience that she has been enabled not only to withstand, but to triumph BLEEDING. 9 over the flood of opposition, which from her birth up to the present moment, has been incessantly, but fruitlessly endeavouring to effect her destruction. The marvellous power which Aconite exercises over the circulation, and the specific action of other remedies, enable the Homoeopathist to overcome the most violent and fatal disorders, with a rapidity and certainty, infinitely surpassing any thing that can be accomplished by bleeding and its auxiliaries. This is no unsupported assertion: on the contrary it is believed, that the large number of cases distributed through this volume, and depicting disease in its most destructive forms, will alone be sufficient to convince the candid and unprejudiced reader of its truth; and when it is remembered that these cases constitute but the fractional part of one man's experience, and that hundreds of other practitioners, during,the last fifty years, have pursued the same system of treatment with equal, if not greater success, it is not easy to imagine that even the most incredulous mind can resist the accumulated evidence which such a consideration affords.* Let us now take a hasty glance at the other side of the picture.--It will at once appear evident, that as the patient in the hands of the Homoeopathist, loses not one drop of blood; as he is neither harrassed by blisters, depressed by nauseants, nor exhausted by purgatives, so does he, as a natural consequence, escape that prostration of strength to which he would be reduced by the employment of those measures. And, as the course of the disorder is unmasked by the artificial production of debility, recovery from its effects is proportionably rapid and certain-convalescence, or the inter* Those who may be desirous of statistical evidence on this point, will find some interesting tables, too long to be introduced here, of the comparative results of the two modes of treatment in a variety of diseases, in the Appendix to " A Concise View of Homeopathy," published by the Dublin Homoeopathic Society. 13 10 BLEEDING. mediate state between health and disease, (a period in Allopathic practice, so replete with danger to the patient and anxiety to his friends) is here almost entirely wanting. An impression once made upon the disease-the first few hours of active suffering past, and the patient's danger is over-hie has nothing further to apprehend. Nor need he dread any of those evil consequences which mar the benefit of Allopathic treatment-there is little or no fear of a relapse-no chance of dropsy, and the host of other ailments which follow in the wake of the lancet. There is, moreover, no call for that interminable nursing and codling; those courses of bitter tonics-rarely any of that longing for the life restoring influence of pure air, and the bracing sea-breeze, which distinguish the exhausted patient of the old-school practitioner. Homoeopathy demands of her subjects simply to remain in bed and swallow a few doses of tasteless medicine-they sustain no loss beyond the temporary loss of food-they emerge from illness nearly the same persons they were when it overtook them-they have no emptied veins to replenishno emaciated forms to remould-no undermined energies to renovate: all those restorative means therefore which have been referred to above, though they may be. indulged in to please the taste of the convalescent, are rarely necessary in Homoeopathic practice. Having thus passed in rapid review, and placed side by" side, the mischief which arises from bleeding in Allopathic, and the advahtages of its omission in Homoeopathic practice, I am mistaken if the reader does not experience both astonishment and regret that an operation which is confessedly on all hands calculated to produce so much harm, should so long have retained its place at the head of our remedial agents-I say " confessedly on all hand," because, universal as its adoption has been in every age and country, there is perhaps no 12 BLEEDING. Though it is beyond a doubt, that much of this mistrust of blood-letting, as in the instance just quoted, is due to the rapid promulgation of Homoeopathic doctrines, much is also to be attributed to the enlightened spirit of the age. The days are gone by for rendering homage to any custom which can prefer no stronger claim to our allegiance than that which is founded upon its antiquity. Faith has been superseded by reason; and that system, whether of medicine or any other science, which will not bear the application of such a test, stands but little chance of maintaining its hold upon the respect of the present generation. There can therefore remain no doubt in any reflective mind, as to the ultimate fate of bleeding. Having no foundation either in reason- or sound experience, it will assuredly, ere long, be superseded by the milder, surer, and more rational powers with which we are supplied by Homoeopathy. 13 SALIVATION. IT may be asserted without fear of contradiction, that there is no substance in the whole list of remedial agents, whose abuse has entailed so much suffering upon the human race, as Mercury. One of the most powerful drugs, either for good or evil, with which we are acquainted, there is no other which is used so thoughtlessly and indiscriminately. The medical man seeks its aid in almost every case of disease-the druggist shrouds it in his nostrums, and non-professional persons prescribe it with all the confidence of conceited ignorance, whenever they undertake to doctor themselves, their children, or their friends. Administered in rather large doses in the form of calomel, its action is simply purgative. This is perhaps its most merciful effect; for notwithstanding that it generally produces violent irritation and pain in the bowels during its operation, the system is at all events speedily relieved of the noxious substance, and so escapes the more lasting misery which results from its continued employment in small and repeated doses. In these latter cases the preparations known as blue-pill and grey-powder are most commonly employed, and are exhibited for the purpose of exciting the disease called Salivation. By this term is understood the impregnation of the system with mercury to such an extent, as to cause soreness of the mouth, and to stimulate the glandular apparatus connected 14 SALIVATION. with it to a preternatural discharge of saliva. Those who have undergone salivation themselves, or have witnessed it in others, will retain too vivid a recollection of the suffering it has superinduced, to render necessary an elaborate description of its effects, or of the painful symptoms accompanying its progress. Nevertheless, for the information of those persons who are unacquainted with the disease, the following account is subjoined, as recorded by Dr. Pereira. "The first symptoms of this affection, are slight tenderness and tumefaction of the gums, which acquire a pale rose colour, except at the edges surrounding the teeth where they are deep red, gradually the mouth becomes exceedingly sore, and the tongue much swollen, a coppery taste is perceived, and the breath acquires a remarkable foetidity. The salivary glands soon become tender and swollen; the saliva and mucus of the mouth flow abundantly, sometimes to the extent of several pints in twentyfour hours. Diuring this state the fat is rapidly absorbed, and the patient becomes exceedingly emaciated." We are then presented by the same authority with a list of the ill cffccts which often arise from salivation, viz.:-mercurial fever-excessive salivation, attended with ulceration and sloughing of the gums; falling out of the teeth; ulceration and sloughing of the fauces; mercurial purging; profuse sweating; skin diseases; inflammation of the eyes; enlargement of the inguinal, axillary, and mesenteric glands; ulceration of the mouth and throat; various symptoms indicating a disordered state of the nervous, system, such as shaking palsy, cachexia or wasting diseases, &c. Such is salivation, one of the most favourite and universal remedies of the Allopathist. The above description is applicable more particularly to the symptoms manifested when mercury is administered in acute diseases. It is also frequently cmployed as a last resource-a kind of hit or miss 0 SALIVATION. 15 remedy-in obstinate diseases of long standing and doubtful character, where the physician is at a loss what otlEr course of treatment to pursue. As administered in such cases, it is from a variety of circumstances an easily manageable and comparatively harmless medicine. Given in small doses and at long intervals to individuals who have not been exhausted by bleeding, the system is less easily brought under the influence of the metal; and when that influence does exert itself, its action is so gentle and gradual, that it may be easily regulated, and checked at pleasure. In acute diseases the case is very different. Intended here to affect the system as speedily as possible, the medicine is exhibited in larger doses, frequently repeated, and is often applied internally and externally at the same moment.- Generally following immediately upon free and copious bleeding from the arm, its absorption is thereby rendered very rapid, and its effects require but a few hours for their developement. But, unfortunately in these, cases the physician has lost that controlling power, by the exercise of which, he is able to protect his patient from its overaction in chronic diseases. The system being exhausted by blood-letting, and absorption rendered proportionally active, it is impossible to predict how far the local and constitutional symptoms of salivation may extend. A five grain blue-pill, which, administered to a person not previously reduced in strength, would excite no sensible result, when given to a patient who has been bled to relieve an acute disease; may produce any one, or more of the "ill effects " mentioned in the passage quoted from -Dr. Pereira. These examples of violent salivation are of such frequent occurrence, that there can scarcely be a member of the faculty who has not witnessed them in his own practice. So long as mercury continues to be used in Allopathic doses, so long 16 SALIVATION. will similar cases arise in its condemnation, and medical men be doomed to the pain of beholding their patients suffer infinitely more from the remedy than from the disease which it was given to eradicate. Language is almost inadequate to describe the full extent of suffering which it inflicts upon its unhappy recipient: intense aching in the head and face, swelling of the neck and cheeks, loosening of the teeth, inflammation and ulceration of the tongue, inside of the cheeks and gums, rendering it impossible to swallow any thing but liquids: the fever, diarrhoea, melting sweats, and general prostration of strength which accompany it; these are among its most striking and constant attendants. In spite of their fearful character the Allopathist constantly employs it: his erroneous system not having taught him how he may better cure those acute diseases, for the relief of which it is administered. Let it not be supposed that we would indiscriminately prohibit the use of mercury. On the contrary, we hold it to be one of the most interesting and useful remedies furnished to us by the mineral kingdom. It is against its administration in such quantities as to produce the lamentably injurious effects just enumerated that we enter our uncompromising protest. We do so unhesitatingly, because Homaeopathic practice proves beyond the power of contradiction, that there is no disease, for which mercury is the proper remedy, which it will not cure more speedily and safely, in the small Homoeopathic dose. The Homoeopathist gives it as he gives all other medicines, not as a universal and quack remedy, eradicating one disease by superinducing another, but acting in strict conformity with the Homoeopathic law. And he administers it, moreover, in such minute doses as to render it impossible for it ever to produce the constitutional disturbance known by the name of salivation. SALIVATION. 17 It is to Haahnemann we are indebted for the knowledge how to secure all the good, without incurring any of the evils arising from the use of mercury. Had he left behind him no greater claim upon our gratitude, this alone ought to ensure to his memory our lasting veneration. 18 PURGATIVES. THERE is nothing in Homoeopathy which excites more astonishment than the announcement, that in its practice, it entirely discards the use of Purgatives. Nor can we be surprised at this, when we consider, that from our earliest days we are taught to regard aperient medicines, as almost as essential to our well-being, as food and raiment. The nurse welcomes the new-born infant with a dose of castor-oil, as a fore-taste of what it will have to endure in its course through this world; and till its latest breath it lives up to its destiny. On this point, increase of years rarely brings increase of wisdom; for it cannot be denied, that the older people get, the more confirmed they become in their predilection for family and antibilious pills, and other mysterious compounds. The extent to which the population of this country indulge in the pernicious habit of dosing themselves with these domestic medicines, would appear incredible, was it not too notorious to be disputed. For the continuance of this mischievious custom, Government, and the Members of the Medical Profession are alike responsible: the former, in the encouragement it holds out to the nostrum vendor; the latter, in their indiscriminate prescription of aperient medicines. A very little consideration will convince us that such a practice is both unphilosophical and injurious., In the first place, every one will acknowledge that the body is not only marvellously perfect as a whole, but that every PURGATIVES. 19 separate organ is adapted in an equally admirable manner to the performance of its peculiar function: that the eye could not be more beautifully constructed for vision, the limbs for motion and apprehension, the heart for propelling the blood, and the lungs for respiration. Faithful and unfailing in the discharge of their duty, we never dream of medicating these organs, unless called upon to do so by the presence of disease. This being admitted in words, why is it so perpetually contradicted in practice? If every portion of the frame be furnished with innate power proportioned to the labour it has to perform, what plea can be urged in excuse for the incessant prompting to which the bowels are subjected? Did HE, by whose fiat man was called into existence, leave these organs so imperfectly endowed, that they have ever since remained inadequate to the discharge of their functions, except when assisted by human instrumentality? Unless we have been sent into this breathing world, in this respect " scarce half made up," on what ground can we justify our unending interference? This suggestion will serve to expose the absurdity of the habit in which many persons, in the enjoyment of perfect health, indulge, of taking aperient medicines, simply because the action of their bowels- is not sufficiently frequent and systematic to suit their capricious notions: forgetting that there is no prescribed standard to regulate this function; that nature is the best judge of her own necessities; and that individuals differ almost as much in this respect, as in their physical form and constitutional temperament. In the next place, without dwelling upon a subject, which, until the problem of LIFE is solved, will in all probability remain a mystery, viz.:-the intimate and essential nature of disease, we may yet venture to state broadly, that it consists, as far as we can understand the matter, in a disordered action of the part or parts most prominently affected. This being the ease, it follows, that for the rectification of that disordered 20 PURGATIVES. action, a remedy should be employed, which will exert a direct influence over the seat of disease. The simple action of an aperient is to stimulate the intestinal canal. Yet this is the agent which the Allopathist employs, when the object sought is to rectify the defective performance of its duty, on the part of some other, and probably distant organ of the body. Has a patient inflammation of the eye? His physician purges the bowels! Has he inflammation of the toe? The same thing is done! Is there disease of the lungs? Still he purges! Fever? Still aperients! Gout-rheumatism-headache? whatever be the disorder, the remedy is everlastingly the same: like the laws of the Medes and Persians, it alters not. This mode of treatment would lead us to conclude, that every disease has a material existence in the abdomen, and may be expelled by the physical force of aperient medicines! It is difficult to conceive how expulsion of the natural contents of the bowels, can influence the progress of disease in a different part of the body, any more than would the expulsion of the contents of any other organ-the blood from the heart, or the air from the lungs. As well might we cause a patient to run about his room to accelerate his breathing, or apply an airpump to his mouth to exhaust his lungs, as compel him to swallow an aperient to increase the action, and evacuate the contents of his bowels. But one remove from the universal remedy of the quack, there is nothing else in the whole sphere of "Cold physic" which partakes so thoroughly of the empirical, as this illimitable indulgence in the use of purgatives. It places in a forcible light the pitiable poverty of a system, whose loftiest flights into the regions of philosophical deduction, can reach no higher than the barren conception of a dose of aperient medicine, as a panacea for " the thousand ills that human flesh is heir to." But purgatives are not more opposed to the dictates of PURGATIVES. 21 reason, than to the well-being of the patient. Their effects upon the system are positively injurious, and manifest themselves in two ways: first upon the intestinal organs themselves; and secondly upon the constitution generally. If, (to use a familiar illustration,) we introduce any irritating substance, such as sand or dust into the eye, its natural secretion is instantly augmented: a copious flow of tears ensues-in other words, it is purged. The part at the same time becomes red, painful, and inflammed. If this be done only once, the injury, under the restorative power of nature, in all likelihood, speedily subsides. But let the operation be repeated again and again, for days, weeks, years! What would then be the result? The organ, for all its natural purposes, would be destroyed. Losing its functional powers, it would become a source of constant trouble and suffering to its unhappy owner! In this we have, as nearly as possible, a parallel to the action and effect of purgatives upon the intestinal canal: with this difference-that in the one case the mischief may be seen and appreciated: in the other, though not less certain and enduring, it is hid from our sight, and therefore is less thought of, and less understood. The office which the eye fulfils in the animal economy needs no description. The function of the bowels, though perhaps as well understood, is not sufficiently considered. It should be borne in mind, that those organs are intended by nature to receive only such articles of diet, as, being perfectly suited to their organization, are capable of undergoing digestion, and being converted into blood. Remembering this, the absolute necessity for maintaining them in the highest possible state of health, and studiously avoiding the introduction of every thing, which, by disturbing them, might interrupt their function, becomes at once apparent. As delicate in their structure as the eye, they are as incapable as that 22 PURGATIVES. organ, of bearing with impunity the contact of uncongenial substances. The admission into them of harsh matters, such as irritating drugs, must as effectually interrupt the process of digestion and nutrition, as would sand and dust, used in the place of oil, impede the action of a delicate piece of mechanism. How does the Allopathist regard this self-evident truth in his practice? No sooner (as I have before stated) does a patient come under his care, complaining of illness, it matters not of what kind, or of what part of the body-what may have been its cause-what the age or sex of the sufferer, than he at once, almost as a rule, prescribes a dose of aperient medicine, the unavoidable effect of which is to irritate and inflame the whole extent of the alimentary canal! Originating, in acute diseases, another source of disturbance to be superadded to that already in operation, this practice, in these cases is sufficiently unjustifiable; but it is in chronic diseases or those of long standing and slow progress, that the pernicious influence of aperients is most vividly apparent. In the former case, their operation, being repeated perhaps but a few times in a comparatively short period, the evil effects resulting from their action more speedily subside. In the latter, forming as they do, nine times in ten, the principal part of a course of treatment extending over a considerable space of time, their consequences are more lamentable. Digestion is interrupted or entirely suspended; the patient, being imperfectly nourished, becomes weak and emaciated; exhausting diarrhosa supervenes, or the bowels, losing their natural power, become obstinately constipated, and find no relief but in a constant repetition of the destructive dose. Chronic dyspepsia, with its thousand concomitants-headaches, palpitation, piles, fistula, flatulence, &c., fill up the catalogue of aihnents which render life a burden, even if they do not curtail its duration. PURGATIVES. 23 Disregarding for the moment the foregoing objections to the use of purgatives, there are, on the other hand, several powerful reasons, why the bowels should not be disturbed during sickness. In the first place, the patient, in severe cases, being compelled to keep his bed, this alone with the attendant loss of exercise, has a natural tendency to check the action of the bowels. In the second place, their principal office consisting in passing on the food, and the patient taking none, clearly they have no duty to perform. In the third place, the disease weakening the whole system, the bowels partake of the general debility. In common with the legs, the arms, the stomach, the brain and every other organ, they become deprived of that power, by the possession of which in a state of health, they are enabled to discharge their proper function. Why are they, more than the other organs, to be impelled to the performance of a duty, to which, at the time, they are totally unequal? Again, under the process of disease, the whole vital power is devoted to the struggle which is going on in the affected part. The attention of the system is, as it were, drawn off as well from the bowels, as from every other organ, not immediately engaged in the contest. On this account, also, they remain quiescent; and any interference with that quietude, by diverting the vital energy, weakens that force which nature requires to be undivided, to enable her to conduct her combat with disease to a successful issue-an additional reason why purgatives should be avoided. Sufficiently convincing as these arguments might be considered, in reply to any objections against the Hiomoaopathic plan, so accustomed have the public become to the employment of purgatives, that the question constantly arises, "If the bowels be constipated, what must we do?" The answer is simple-LET THEM ALONE. 24 PURGATIVES. Constipation is an effect, not a disease. If it were, there might be some show of reason in the use of aperients. But being merely a temporary loss of power, we can no more restore that power by forcing the action of the bowels, than we can impart strength to a weakened leg by compelling it to walk. In the latter instance we should instinctively rest the part, until, by the removal of disease, motion might be resumed. The same reasoning applies with equal force to the removal of constipation. The exercise of a little patience, and the employment of judicious means for the eradication of that disordered condition on which the inaction depends, will as infallibly restore the bowels to their duty, as in every other instance, the effect must cease when the cause is removed. In acute diseases this rule may be acted on with unlimited confidence. The resumption on the part of the patient of his accustomed food and exercise, by invigorating the frame generally, imparts also to the bowels that energy which enables them, in conjunction with the other organs, to resume the exercise of their proper function. It is in diseases of long standing, particularly those affecting the digestive organsdyspepsia, &c.-which so often owe their origin to the abuse of aperient medicines, and are always aggravated by their action-that the Homemopathist experiences the greatest difficulty in carrying out his principles. He is, however, sure to find his reward for strictly adhering to them, in the rapidity and certainty with which he eradicates diseases that have baffled all the ordinary method of treatment. If, however, as sometimes happens from the sudden withdrawal of a long accustomed stimulant, the bowels become obstinately confined; or to satisfy the mind of the patient, it be desirable to prompt them, the safest, as well as the most rational mode of accomplishing that object, is by the employment of an enema. Unirritating in its operation, and acting on the lower portion of the bowel, where the accumulation naturally takes place, this, in all cases where assistance is PURGATIVES. 25 required, is an unobjectionable remedy. The blandest fluids, such as water, gruel, and the like, will generally be found to answer the desired end, without the admixture of castor-oil or other irritants. Administered in this form, the injection may be repeated at pleasure, without inflicting any injury upon the inside-it is, in short, the only legitimate aperient. I am aware that in the foregoing remarks I have run counter to one of the most cherished dogmas of the oldschool of medicine-a dogma sanctioned by age, and perpetuated by universal adoption. So far from these circumstances either modifying my opinion, or qualifying my opposition, they do but make me the more earnest in my desire to see abolished a practice which both reason and experience compel me to regard as radically erroneous; and though it may be long ere its abandonment becomes general, that it will ultimately yield to the spread of Homceopathic principles, I am as well satisfied, as that darkness will ever recede before light, and error before truth. 26 INFLAMMATION OF THE LUNGS, INFLAMMATION OF THE LUNGS, AND PLEURISY. CONSTITUTING by far the most numerous and fatal class of diseases which affect the human frame, and calling into action in a pre-eminent degree the heroic or active mode of treatment adopted by the Allopathist, the affections of the respiratory organs naturally demand our first attention. Bearing in mind that these affections include inflammation of the lungs and pleura, bronchitis, croup, asthma, hoopingcough, and consumption, we shall be at no loss to account for their frequency; and the same list at once recalls to our mind the familiar names of the most dangerous and deadly diseases with which we are acquainted. It is calculated that. at least one fourth of all the deaths that occur in this country, are caused by consumption; and when to these we add the scarcely less numerous victims of inflammation of the lungs, and pleura, together with the quota contributed by the other complaints just named, it will not be overstepping the bounds of truth to say, that, at the lowest computation, one half of the diseases which swell our bills of mortality, have their seat in the organs of respiration. Next to consumption, (to which we shall afterwards refer more fully,) by far the most formidable in the list, is inflammation of the lungs. Beyond comparison the most frequent cause of death amongst children, in adults also, though not often immediately fatal, it but too commonly leads to that result, by calling into action a previously existing consump AND PLEURISY. 27 tive tendency. It is a well ascertained fact that this consumptive tendency or tuberculous diathesis, as it is technically termed, will remain quiescent in individuals for many years, and in families from generation to generation, until, on the application of some deleterious influence, the latent germs of the disease are stimulated into active developement. That influence-however much the fact may be questioned by some high authorities-there can I think be no doubt, is, in many instances, an attack, more or less acute, of inflammation of the lungs, bronchi, or pleura. It has not therefore been without good cause that the public have learned to regard this disease with feelings of the deepest apprehension. It is, however, a lamentable fact, that this anxiety is in justice attributable, not more, if so much, to any inherent danger in the disease, as to the inefficient means commonly adopted for its suppression. Startling as this assertion may appear, it is made, neither in forgetfulness of its importance, nor without its accuracy having been thoroughly established on the most careful and extensive observation. Personal experience in some hundreds of cases, in which not one drop of blood was drawn, nor any other of the usual remedies employed; but which were treated in accordance with Homoeopathic rules, has convinced me, beyond the possibility of error, that when so treated, there is scarcely any disease which is more thoroughly within control, or which need less excite the fears of the patient, or the anxiety of the physician, than inflammation of the lungs. We will now pass rapidly in review the two modes of treatment to which allusion has been made: that pursued by the Allopathist, and Homoeopathist, respectively. Dr. C. J. B. Williams, in an article on inflammation of the lungs, in the " Cyclopcedia of Practical Medicine," quotes, and subscribes to this opinion of Dr. Cullen, " that a first bleeding, however large, will seldom prove a cure of tlhe 28 INFLAMMATION OF THE LUNGS, disease, and as the pain and other symptoms recur, the measure must be repeated even in the course of the same day, to as full an extent as before, and although the greatest efficacy is in the first three days, this recurrence will make a repetition of the measure proper at any period of the disease, within the first fortnight. At the first bleeding a quantity varying from sixteen to forty ounces may be taken." Mr. Guthrie, in the lecture from which I have already quoted, says: "In young people, the bleeding should be repeated until the desired object is effected; and the quantity required to be drawn in inflammations, particularly after injuries, is often very great. It is almost a question in some cases, whether the patient shall be allowed to die of the disease, or from loss of blood." Bouillaud, whose authority is great in France, gives the following as an example of his mode of proceeding in a moderately severe case: " 1st day. Morning sixteen ounces, evening twelve ounces. In the interval twelve ounces to be drawn locally by cupping or leeches. 2nd day. Venesection to sixteen ounces; local bleeding, if pain continues, by leeches or cupping. 3rd day. If disease permit, another bleeding, although it is usually cut short on this day. 4th day. If the disease should attain to the second stage, another venesection may be resorted to, but it is in general best to abstain from it, and apply a blister. As a general rule, however, the abstraction of blood should not be refrained from until the febrile action is removed or nearly so, until the dyspncea and the pain have nearly dis"appeared; and this rule admits of very few exceptions. On the whole, four or five pounds of blood may be drawn in the case supposed above." So much for bleeding. As to Mercury-Dr. Copeland says, "mercury with opium, in large doses has been much employed, both with and after blood-letting, and calomel in doses of from five to twenty 30 INFLAMMATION OF THE LUNGS, Such is the programme which Allopathy presents for curing inflammation of the lungs-bleeding to the extent of a few pounds; antimony ad nauseam; salivation; blisters; purgation. This is the system which, with some modifications, has existed from age to age up to the present moment. It is this system which Homceopathy undertakes boldly, unhesitatingly, and without reservation to dispense with and supersede. In dealing with this division of our subject, we will commence by recounting what Homoeopathy omits. In the first place, she never draws blood. I have shown at some length, in a previous chapter, that this remedy is always unnecessary, and generally injurious. I will therefore not dilate upon it here. In the second place, although in this, as in other diseases, if the symptoms 'accord with those of mercury, we do not hesitate to employ that remedy, it is never, in Homoeopathic practice, given in sufficient quantities to produce salivation. In a former chapter, also, I have shown the mischievous effects of this remedy. In the third place, neither here, nor in any other disease, does Homoeopathy sanction the administration of medicines in such quantities as to produce nausea and vomiting. It is entirely opposed both to her practice and principles. In the fourth place, as I have already demonstrated in the foregoing pages, purgatives are sanctioned neither by nature, reason, nor common sense. They are never necessary, they never do any good, and consequently they are never employed by Homoeopathy. The same may be said of all the other expedients to which Allopathy resorts: blisters and other counter-irritants, expectorants, opiates, &c., &c. These are our negative reasons for dissenting from Allopathy. But we do not stop here: the foregoing measures are rejected, not only on account of AND PLEURISY. 31 their own imperfections and insufficiency, but because we possess the power (by means so gentle that they cannot possibly inflict injury, and so powerful that they seldom fail in their action,) of subduing inflammatory diseases with a facility, certainty, and promptitude such as no other system affords. The tasteless dose is the Homceopathist's only weapon. Beyond this broad and general statement, it is not intended to enter here into any description, either of the Homoeopathic doctrine, or the rules for selecting and the modes of applying the remedies. Both these departments of the science would demand more time and space than we can devote to them: such an undertaking, moreover, forms no part of our present design. Those persons who may be desirous of becoming more intimately acquainted with the principles of the system, may consult the works mentioned below.* As to the other branch of the subject, the selection and application of the remedies, involving as it does a thorough knowledge of disease, and a nice appreciation of every variation in its symptoms, it is evident that nothing short of a complete medical education, together with untiring perseverance, and extensive practical observation, can supply the requisite qualifications for such a task. Passing over these points, therefore, as irrelevant to our present object, we proceed to place before the reader a series of cases, in which he may himself witness what Homeopathy has done, and infer what it is capable at all times of doing, under similar circumstances. Concerning these cases it may be remarked, that they are taken almost promiscuously from a host of others of the same kind, detailed at length in my note book. So much selection only has been exercised as was necessary to exhibit the * Hahnemann's Organon of the Healing Art. Concise View of Homceopathy, published by the Dublin Homoeopathic Society. Introduction to the Study of Homoeopathy, by the Editors of the British Homeopathic Journal, &c., &c. wow' AND PLEURISY, IN ROBUST PERSONS. 33 INFLAMMATION OF THE LUNGS, AND PLEURISY, IN ROBUST PERSONS. WHAT reputation attaches to the old system of medicine for curing inflammation of the lungs, is due to this class of cases. Persons of good constitution, and in the vigour of youth, or the prime of life, are endowed with a power of vitality which enables them to bear with seeming impunity the effects of depressing agents, under which more delicate persons would either sink at once, or by the operation of which, they would be rendered weakly and ailing for the remainder of their lives. So, in the cases we are now considering: occurring in individuals whose,systems are fortified, by active habits and robust health, against the inroads of disease, when it does attack them, the same resisting power shields them against the noxious tendency of the depleting and exhausting treatment to which they are commonly subjected. With such a foundation to work upon, bleeding and its auxiliaries are employed with an unsparing hand. The physician, undeterred by any apprehension of that failure of strength, which in more delicate subjects arrests the flow of blood, bleeds fearlessly to any extent, and repeats the operation to any number of times. In spite of the loss he has sustained, the patient, backed by a good constitution, and aided by good nursing, time, and perhaps pure air, ultimately recovers. Thus a cure is effected, of which bleeding enjoys the credit. Nor will I assert that it is altogether undeserved. The Allopathist, so long as he remains true to his colors, cannot do without the lancet. Compared with a dangerous and E 34 INFLAMMATION OF THE LUNGS, destructive disease, it is certainly the lesser evil of the two. But if, as I boldly and firmly maintain, it may not only be safely and totally abandoned, but the disease be cured more quickly and certainly, by Homoeopathic remedies, it is clearly the interest of the patient to demand, as it is the duty of the medical man to supply, such an alternative. CASE I.-Mrs. P., aged 36. February 28th, 1847.-Has been ill twenty-four hours. She is labouring under all the symptoms of acute inflammation in a very aggravated form. She has extreme pain around the lower part of the chest on the right side, which becomes excruciating when she breathes deeply, coughs, or moves: nor can she bear pressure on that part. The pulse is 100, full, and hard; skin hot; she is very thirsty; there is dulness on percussion, and very imperfect respiratory sound in the region of the disease. Take Aconite 3, every two hours. March 1st.-Her husband calls at nine o'clock, on his way to business, to inform me that she has had no sleep during the night, and is still in much pain. To commence directly with Bryonia 3, every three hours. Visiting her in the afternoon, I find her in a sound sleep. The pain has greatly abated, and with it the fever, thirst, and heat. The skin is now perspiring freely; she breathes calmly, and with comparative ease. Continue the Bryonia. 3rd.-She has no pain, thirst, or fever; her pulse is calm, soft, and beating 75 in a minute. She feels well, and complains only of some weakness. Imperfect respiration in the lung. Take Sulphur 12, twice a day. 5th.-Sends to report herself so well as to require no further attendance. This patient had previously a similar attack, and among other remedies adopted for its removal was bleeding; and so satisfied was she of the necessity of resorting to that measure on the present AND PLEURISY, IN ROBUST PERSONS. 35 occasion, that she strongly urged me, as soon as I entered her room, to perform the operation. I had much difficulty in persuading her that she would recover more speedily without it.-She was not a little astonished at the result. CASE II.-Edward S., a bedstead maker, aged 21. March 13th, 1848.-Has been ill four days, and has not been able to work since he was attacked. He is now labouring under severe headache, pains in his limbs, chills, much thirst, quick pulse, hot skin, and a severe pain, which darts through his chest immediately under the right nipple, every time he breathes. It is increased to an intolerable degree when he coughs, which he does frequently, and then spits up a quantity of thick, yellow phlegm. He cannot lie on the affected side. Percussion and the auscultatory sounds distinctly indicate inflammation of an advanced kind in the right lung. He attends at my house. Aconite 3, every three hours. 14th.-Considerable relief. Bryonia 3, every four hours: Aconite at bed-time. 15th.-The feverish symptoms have disappeared, and he feels the pain only a little, occasionally. The expectoration is easy, and the phlegm is not so thick; he feels hungry. Continue Bryonia, twice a day. 16th.-He attends again at my house, having nothing to complain of but a little debility. Respiratory murmur still imperfect, and considerable dulness on percussion; occasional loose cough. Phosphorus 12, twice a day. With this he was perfectly restored, and needed no further attendance. CAsE III.-I. C., aged 31, a hatter. A tall thin figure; dark complexion. Has been ill twelve hours. March 7th, 1847:-Was seized yesterday with shivering, followed, almost directly, by a shooting pain in the left side of the chest, extending from the breast through to the back, causing excessive agony at each inspiration, and compelling him to keep both hands firmly fixed upon the spot, in order to steady the ribs, and so 36 INFLAMMATION OF THE LUNGS, procure a little mitigation of his sufferings. His breathing is short, suppressed, and catching; he is harrassed by a severe hard cough, and already expectorates a quantity of brick-dust coloured sputum. His pulse is 100 in the minute, small, and sharp; his skin burning hot; he is very thirsty, and his tongue is covered with a yellow coating. There is much dullness on percussion, and distinct crepitation in the diseased portion of the lung. Take Aconite 3, and Bryonia 3, alternately, every two hours. 8th.-Some amelioration in the symptoms generally. Continue the medicines. 9th.-Great and decided amendment in every respect. The pain is still felt, but in a mitigated degree; expectoration not so red; breathing more calm and deep; tongue cleaning; and but little thirst. Continue both medicines, at longer intervals. 10th.-He is much astonished at his improved condition, being, to all outward appearance, well. Has no pain; no fever; no thirst; but little cough; and spits a small quantity of white phlegm. He sleeps well, and can lie on either side. Auscultation betrays considerable consolidation of the lung, there being dulness, and almost entire absence of respiratory murmur in the seat of disease. Take Phosphorus 12, three times a day. 12th.-Respiratory sound much restored; otherwise quite well. Continue the medicines a few days longer. Cured. CASE IV.-W. F., a wheelwright, aged 48; a tall, thin person, generally considered strong. March 8th, 1848.-Twenty-four hours ago taken with shivering, which still continues when he moves or turns in bed. He complains of pain shooting through the right breast to the back, catching and stopping his breath every time he inspires. His breathing is short and rapid; he is distressed with a violent cough, which causes him great agony, and compels him to cry out; he expectorates a little white, thin phlegm; his pulse is 100, full, and hard; he has a hot skin; is very thirsty; and loathes food. Take Aconite 3, directly, then Phosphorus 6, every four hours. 10th,-Wonderfully better. There is but very little pain remain 38 INFLAMMATION OF THE LUNGS, 3rd.-Eight hours after commencing the medicine, the pain began to abate, and has continued to do so up to this time. He now lies on his back, breathing freely and calmly. Constitutional excitement much subdued; pulse 80-is nearly free from thirst and headache. This morning has spat up a considerable quantity of phlegm, streaked with blood. Take Bryonia 3, every three hours. Aconite 3, at bed time. 5th.-Mending rapidly. Scarcely a trace of pain remaining, even in coughing. Expectoration purulent and brickdust color: pulse natural; tongue moist; no thirst. Complete absence of resonance and respiratory murmur in region of disease. Loud bronchial respiration in the upper part of the lung, with mucous rale. Take Phosphorus 6, every four hours. 7th.-Convalescent. Dull space in the chest more circumscribed. Loose cough. Continue Phosphorus, twice a day. 10th.-He walks to my house, a distance of half a mile. Complains of shortness of breath, and weakness. Continue the medicines. 13th.-Attends again, feeling perfectly well, and intending to resume his occupation in a few days. The healthy sounds in the chest are nearly restored. Sulphur 12, twice a day. This man had a similar attack some years previously. He was then bled five times, blistered, &c., and detained at home three weeks. The present attack (inflammation of the lungs and pleurisy combined) was as severe a case of the kind as I ever saw. Yet we see him restored to health, and fit to resume his occupation in about twelve days. There was here no loss of blood-consequently, but very little debility, and a proportionately rapid recovery. CASE VI.-A., a girl, 15 years old. July 10th, 1847.-Has been ill twenty-four hours. Was taken in the first instance with shivering. She is now burning hot; complains of headache, and thirst. Her pulse is rapid, hard, and jerking; she has a severe, sharp, piercing pain in the left side of the chest, high up under the arm. It hurts her dreadfully every AND PLEURISY, IN ROBUST PERSONS. 39 time she draws her breath; and when the cough, with which she is troubled, comes on, she cannot help calling out with the agony. There is slight dulness on percussion. A little roughness in the pleuretic surfaces. The respiratory murmur but slightly altered. Take Aconite 3, every two hours. 1lth.-The feverish symptoms have entirely subsided, and the breathing is much easier. The pain is felt, and causes a slight catch, only when she breathes deeply, or coughs. Take Bryonia 3, every four hours. 13th.-The pain felt very slightly on taking a deep inspiration, experimentally. She considers herself well. There are no unnatural sounds in the chest. A few more doses of Bryonia, at longer intervals, followed by Sulphur 12. Cured. She attended at my residence throughout the attack. CASE VII.-A. L., aged 38. February 9th, 1847.-Has been ill three days. Complains of a severe, darting, piercing pain, immediately under the left breast, catising a sudden stop or catch every time she inspires. She can speak only in broken sentences, and holds her side for ease. She had severe shiverings at first, but is now in a high state of feverbeing hot in skin, thirsty, and complaining of headache. Her pulse is quick, small, and incompressible. There is some slight dulness on percussion-the rubbing pleuretic sound is very distinct. The respiratory murmur is interrupted only by very slight crepitation, in a circumscribed portion of the lung. Take Aconite 3, every two hours. 10th.-All the febrile symptoms greatly abated. The pain is still severe. Take Bryonia 3, every four hours. Aconite 3, at bed time. 11th.-Much relieved of the pain and difficulty of breathing; she has no fever and the pulse is natural in every respect. There is a good deal of dulness on percussion and imperfect respiratory murmur; the sound being at the same time louder than natural in the upper part of the chest. Take Sulphur 12, every four hours. AND PLEURISY, IN DELICATE PERSONS. 41 and only ceases to do so, when the remedy is discontinued. Under Homoeopathy the case is just the reverse. The abatement of the symptoms, and the return of the patient's strength are simultaneous: they keep even pace with each other; and at that point in the disease, at which, in Allopathic practice, the patient reaches his lowest degree of debility, in Homoeopathic practice, he is found with powers comparatively unimpaired. INFLAMMATION OF THE LUNGS, AND PLEURISY, IN DELICATE PERSONS. THE following examples represent a large, and in respect to our present object, the most important class of cases of Pneumonia. Occurring in persons' debilitated by age or other circumstances, they show at one view, the inadmissibility and insufficiency of the ordinary severe remedies, and the admirable suitableness and complete efficacy of the Homoeopathic treatment. Such cases, more frequently than any others, place the Allopathist in a painful dilemma between the disease on the one hand, and his patient's want of constitutional power on the other. Actively inflammatory in its character, the disease, according to his system, cannot be combated successfully without free blood-letting; but the employment of that remedy is forbidden by the patient's want of stamina. Left to itself, the disorder is pretty sure to terminate fatally, either directly by its own destructive F 42 INFLAMMATION OF THE LUNGS, action, or indirectly by superinducing consumption: the debilitating effects of depletory remedies, or the imperfect cure of the disease by milder means, but too commonly lead to the same result. CASE I.-Mrs. C., aged 32, of rather small stature, thin, spare, and at all times delicate. She is eight months gone in pregnancy. November 25th, 1847.-She has been poorly the last week, with cold, and lingering pains in the abdomen, as if premonitory of labour. Three days ago these pains increased greatly, and have continued to do so up to the present time. They recur regularlyabout every ten minutes, and are evidently spasmodic, and not expulsive. There is no remarkable constitutional excitement. A few doses of Belladonna are ordered. 27th.-She is no better. The spasmodic pains are not relieved, and in addition, there is an accession of a train of symptoms of the most alarming character. Her pulse is beating 140 in the minute; her skin is burning hot; her features are pinched and shrunken. She has intense headache, and is confused in intellect. Her tongue is dry; she has constant thirst, and vomits frequently. Her breathing is rapid, short, and catching, and now for the first time she complains, on being closely questioned, of a dull pain in the left side of the chest, under the arm and towards the back. She has a troublesome cough and cannot lie down in bed, but is forced to be propped up with pillows. On applying the ear to the chest, there is unequivocal evidence of inflammation of the left lung, which has no doubt being going" on for days. The middle and lower parts of that organ, are quite dull in respiration, and on percussion. There is very loud bronchial murmur; the right lung is sound. Take Aconite 3, and Bryonia 3, alternately, every hour. 28th.-The action of these medicines has been magical. Yesterday the whole aspect of the case was so frightful, as to excite serious doubts of the patient's safety: to day she is another creature. Her pulse is subdued in force, and beating only 110, instead of 140, 41 INFLAMMATION OF THE LUNGS, being compelled to leave town yesterday afternoon, and the patient continuing to get worse, I am summoned to attend her at nine o'clock this evening. I find her in a most dangerous and deplorable condition: in short, to all appearance sinking rapidly. She lies prostrate on her back, sunk low down towards the foot of the bed, and throwing her limbs about, as persons do, from extreme exhaustion. Her breathing is rapid, short, and spasmodic; she has a dreadful cough, with rattling of phlegm in the chest, which she has not power to expectorate. She complains (as distinctly as she can, being almost speechless) of an agonizing pain in her side when she breathes and coughs. There is a hectic flush on her cheeks. Her tongue is dry, brown, and parched; and she is intensely thirsty. Her skin is dry, and the pulse 150 in the minute, as nearly as it can be reckoned. Take Aconite 3, directly, and Rhus 3, afterwards, every hour. 18th.-Ten o'clock-morning. Already a marvellous change has supervened. She is lying comfortably on her side, and well up in bed; complains of no pain; the cough has nearly left her; her tongue is moist; and she has no thirst. She says, in a firm voice, and with clear intellect, "I know I am better: I feel my disease relieved." Notwithstanding this improvement she is still alarmingly weak, owing in a great degree to a severe bowel complaint, which came on in the night, and still continues. She attributes it to the Calomel powders which were taken up to the time I saw her. Take Arsenicum 3, every two hours. 19th.-The purging ceased a few hours after she commenced the medicine. In every other respect she is greatly better, with the exception that she is distressingly restless; breathing spasmodically, and at times tossing about from side to side: all this resulting, evidently, from debility, and not from the progress of the disease. Take Rhus 3, every two hours. 20th.-Very much better. The restlessness has entirely subsided. She is perfectly calm and quiet, and altogether so much improved as to warrant me in pronouncing her out of danger. Continue the Rhus, every four hours. 21st.-Up and dressed, and sitting in another room; enjoys light food. Has a little loose cough, and perspires at times. Take'Phosphoric Acid 12, three times a day. AND PLEURISY, IN DELICATE PERSONS. 45 22nd.-Again up and doing remarkably well: eating a mutton chop for dinner. She continued her medicine two or three days longer, and at the end of a week, was sufficiently restored to travel a considerable distance to her own home, in the country. CASE III.-R. T., a compositor, aged 50. September 21st, 1847.-Though in years, in the prime of life, his constitution has become completely shattered by a complication of chronic diseases, from which he has suffered many years, and for the relief of which he has undergone a great deal of surgical and medical treatment, The present attack has existed three days. He was seized in the first instance with cold shivers, succeeded, shortly, by a severe pain in the side. On visiting him, for the first time, to day, I find him alarmingly ill. His breathing is hurried, short, irregular, and attended with a catch or sudden stop in the middle of each inspiration. He -complains of a stabbing pain through the right breast, which is increased to an agonizing amount in coughing;. it also prevents his lying on that side. There is crepitation in the superior and middle portions of the lung, and dulness on percussion; mucous rale in the lower portion. He expectorates a good deal of white phlegm. I never saw a man so thorougly prostrated by such an attack. His limbs tremble like an aspen leaf when he attempts to move, and his speech is faltering. His pulse is 120 in the minute, full, and jerking. His skin burning hot; his tongue brown, dry, and parched; and he is intensely thirsty. Aconite 3, every two hours. 22nd.-At four o'clock this morning he broke into a profuse perspiration, which lasted till six. His skin is now cool and soft; his breathing calm, deep, and much more free; sputum mucopurulent. His pulse is reduced to 95, and is soft and yielding; his tongue is moist, and he is scarcely at all troubled with thirst. Repeat Aconite at longer intervals, and take Bryonia 3, every four hours. 23rd.-Rapid improvenient.. His pulse is now at the healthy standard, (75,) his tongue is moist, and he has but little thirst. Continue the Bryonia, at longer intervals. AND PLEURISY, IN DELICATE PERSONS. 47 16th.-Greatly relieved. Repeat the medicine. 17th.-He has but little pain, and no fever or thirst; the cough is comparatively slight, and the sputum scarcely tinged with blood. Continue the Bryonia. 19th.-No pain. Pulse 60, soft and natural; skin cool; no thirst; appetite pretty good; absence of respiratory sounds in diseased portion of lung. Take Phosphorus 12, three times a day. 21st.-Slight crepitating rale in some portion of diseased part. He is quite convalescent, visiting me at my house, and anticipating a resumption of his employment in two or three days. He is perfectly well at the piesent date, (March, 1848,) and has had no illness in the interval. CASE V.-Thomas B., aged 31; of spare, delicate habit, and weakly constitution. Formerly a waterman. The last year and a half employed in boiler-making, which he thinks is too laborious for his strength. Five weeks ago he had an attack of inflammation of the chest, not so severe as that under which he is now laboring; he was then attended by a gentleman from a dispensary; leeched, blistered, &c., &c., and detained at home three weeks. April 26th, 1847.-Having resumed his work a fortnight, was seized two days ago, with shiverings and headache, speedily suc-ceeded by sharp pain in the right side of the chest, extending downwards from under the arm, and piercing through the back every time he breathes; and particularly so in coughing. He spits up a quantity of brown stuff, tinged with blood. There is almost a total absence of respiratory sound, and complete dulness on percussion. His pulse is 110, full, and hard; skin hot and dry; tongue coated, and parched; he is very thirsty; and has no appetite. Feels exceedingly weak and depressed. Take Aconite 6, every four hours, alternately, with Rhus 6. 27th.-Reported as in every way much relieved. Take Bryonia 3, every four hours. 28th.-No pain whatever except when he coughs hard. No fever; no thirst; tongue clean, and moist; pulse 60, soft, and compressible; expectorates a little clear phlegm. Continue Bryonia three times a day. 48 INFLAMMATION OF THE LUNGS, 29th.-Mending rapidly. Take Phosphorus 12, twice a day. May 3rd.-He attends at my house, reporting himself well; no cough, pain, fever, or thirst; good appetite; can lie with equal Scomfort on either side; breathing sounds nearly natural. Take a few doses of Sulphur. Cured. CASE VI.-I. H., aged 40, a printer, addicted to over-indulgence in ardent spirits. He had delirium tremens slightly three years ago; and has ever since been in a very delicate, ailing, shaky condition. March 31st, 1846.-The day before yesterday, was attacked with vomiting, chills and heats, followed by severe pain, piercing through the right breast to the back, much aggravated by coughing and deep inspiration. His breathing is now quick, and short, and attended with a catching stitch in the side. He has a loose, hacking cough, which causes him great agony. His pulse is 118 in the minute, throbbing, full, and soft; his skin is hot; and he has much thirst and headache. There is almost entire absence of respiratory murmur and resonance over the diseased part of the lung. Mustard poultices have been applied to the chest, and opening medicines taken inwardly, without procuring the smallest relief. Take Aconite 3, every two hours. April 1st.-Yesterday he could not move in bed without great pain and difficulty-to day he is dressed and sitting tip in another room. The pain in his side is gone, his skin is cool; he has no thirst; his pulse is 95, soft, and compressible; cough not nearly so troublesome. In the afternoon, symptoms of delirium tremens manifested themselves: he sees horrible objects in the room; talks about them rediculously; starts, and jumps up under some sudden impulse, which as instantly vanishes. He has not slept the last two nights. He perspires freely. Take Opium 3, every two hours. April 2nd.-The spectres were neither so frequent in their visits, nor so frightful in appearance, during the night: being chiefly composed of fantastical figures, and laughing faces. At five in the morning, he fell into a sound sleep, which lasted some hours. He AND PLEURISY, IN DELICATE PERSONS. 49 awoke calm and collected, and continues so at the present moment. He is now only disturbed by his cough. Take Rhus 12, every four hours. 5th and 7th.-Progressing most favourably. His appetite is good. He is so much better as to be able to attend me at my residence. Hepar Sulph. 12, every night. 10th.-Reports himself perfectly wvell. There is no point in the practice of medicine better understood than the drunkard's inability to bear the loss of blood, or any other depletory remedy. A few leeches applied, or a brisk purgative given, to a person predisposed by intemperance to delirium tremens, will sometimes induce that formidable disease. Such a state of constitution, combined with inflammation of the chest, presents to the Allopathist the most embarrasing combination. The original disease calls aloud for the lancet-delirium tremens as loudly forbids its employment. Between the two the patient sinks. Homceopathic remedies, as in the case before us, at once dispel the difficulty. These cases are exceedingly interesting, as exhibiting, in a forcible manner, the vast importance attaching to the fact, that Homoeopathic remedies are not in the slightest degree debilitating. None of these patients (if we except case No. 4) would have borne the loss of blood to a sufficient extent to arrest the disease. No. 2, was actually sinking under its influence. In the case of No. 6, its employment was absolutely interdicted by a predisposition to delirium tremens. In the others, either from age, or constitutional weakness, there was a general want of that power, which would have been necessary to enable them to bear up under the combined forces of the disease, and exhausting remedies. The probability is, that they would all have died. We have also in these cases, a striking illustration of a truth to which I have before alluded, viz.:-that once. a favorable impression is made upon the disease, the subsequent G 50 INFLAMMATION OF THE LUNGS, amendment is almost sure to be steadily and uninterruptedly progressive. In Allopathic practice the physician's nerves are kept constantly on the stretch, by the fear that any advantage gained over the disease by bleeding, one moment, may the next be lost, in the accession, either of reaction, calling for a repetition of the operation, or a failure of strength from the loss that has already been sustained. The case is thus reduced to a game of chance: the patient being the stakes: the players, Death, and the Doctor. INFLAMMATION OF THE LUNGS, AND PLEURISY, IN CHILDREN. THE greater mortality which prevails in the first five years of existence, over any other period of equal length, suggests two important questions, viz.:-to what is this attributable? and how may it be prevented? Among the children of the poorer classes, much of this fatality may doubtless be ascribed to the untoward circumstances often inseparable from their condition in life-impure air-insufficient and unwholesome food-imperfect clothing, and bad nursing. Hygienic observances, and sanitary regulations, may do much towards lessening the mortality arising from these causes. There are, however, other causes constantly in operation, affecting alike the children of the rich and the poor: the influence of atmospheric changes, and the peculiar excitability of the nervous and vascular systemswhich AND PLEURISY, IN CHILDREN. 51 characterizes the age of childhood. These must ever remain beyond our control. We are thus forced to the conclusion, that in spite of all our preventive efforts, the spring-time of life will continue to be harvest-time of death, and remain more exposed than any other period to the attacks of disease, until some means more prompt and efficient than those at present in use, shal be adopted for the purpose of curing these diseases. Prevent them we cannot: Cure them we may. Either in their simple form, or as accompaniments of other disorders, such as scarlet fever, measles, hooping-cough, &c., inflammation of the lungs and pleurisy operate miore powerfully to the destruction of infantile existence than all other diseases put together. Placing all his reliance in the treatment of inflammation generally in the use of depletory agents, the Allopathist endeavours to subdue these diseases by bleeding, leeches, blisters, and purgatives. The experience of the last 2000 years has proved how unequal these agents are to effect such an object. Employed with comparative impunity in the cases of adults, in whom the circulation is not easily excited, and the vital energies are strong and enduring, these agents, applied to children whose organization is both more susceptible and more delicate, so far from arresting the disease, do but hurry it on to a fatal termination. This is mainly owing to the peculiar susceptibility just mentioned. So rapid is the circulation in childhood, that it is almost impossible to subdue it by the loss of blood, or if it be subdued, so sensitive is the nervous system, that reaction is almost sure to be established within a space of time far too short to have allowed of any healing process taking place in the diseased organ. With the appearance of reaction, however frequent, the necessity for repeating the bleeding also recurs, and then the little patient, exhausted by the remedy, and unable to oppose any resisting force to the inroads of the disease, falls-an easy victim to the one or the other, or what is more common, to 52 INFLAMMATION OF THE LUNGS, the combined influence of both. Fortunately, where Allopathy fails, Homoeopathy comes to our rescue. There is perhaps no practical point in the whole Homoeopathic system of such inestimable value as the prompt and all but irresistible command it gives us over the diseases of children. So unfailing is the rule which guides the Homoeopathist in his operations, that the two diseases of which we are now speaking, and which under Allopathic treatment always prove formidable, and so often fatal; when submitted to the action of Homoeopathic remedies, scarcely excite in the mind of the prescriber, an anxious thought or doubt as to the issue. I say this on the strength of my own experience. I have tested the system in hundreds of cases, with this result-that, where I formerly lost ten patients, I do not now lose one. Such results will ever flow from a careful and steady adherence to the Homoeopathic doctrine: and it is to this source we must look for a diminution of that fearful mortality among children which hitherto we have been doomed to deplore, but have not been able to avert. CASE I.-Emma H., aged 5 years. November 21st, 1847.-Eight o'clock in the evening. Through a mistake on the part of the messenger who was sent for me, a neighbouring medical gentleman was called to see this patient. The desperate condition in which he found her, induced him at once to declare her case hopeless-that in fact she was then dying. He declined prescribing any medicine; but as a last resource, told the mother to apply cloths soaked in hot vinegar to her chest, and put the feet in a mustard bath. The mistake, above referred to, being rectified, I saw the child about ten minutes after. The following is the condition she then presented-she was lying across her mother's lap, her legs hanging over one side, and the head thrown as far back as possible over the other. Her mouth was wide open, and gasping for breath; the eye-lids were half closed-she was conges AND PLEURISY, IN CHILDREN. 55 on the right side, and rubbing sound very distinct in the pleura. She is burning hot in skin; and her pulse is too rapid to be reckpned. She has incessant craving for cold water. "Take Aconite 3, half a- globule, every hour. 14th.-Ten in the morning. Very much relieved: her breathing is deeper and more regular, and has lost the "catch;" but it is still too rapid, (95 in the minute); she is not so thirsty; there is a loose cough, which still causes her to cry out with pain. She is more 'lively and happy, and her eyes are open and bright: skin still hot and dry. Take Aconite 6, and Belladonna 6, alternately, every two hours. 15th.-Skin cool and natural. There is some catching and difficulty in the breathing. Take Aconite, and Bryonia 12, alternately, every three hours. 16th.-Decided amendment. The rubbing sound has disappeared-there is some dulness, with crepitating and mucous rale in the diseased lung. Notwithstanding these improvements, she is still seriously ill, and breathes too quickly. She is also very weak. Take Phosphorus 12, every four hours. 18th.-Progressing most favorably. Respiratory action, and murmur much improved, skin cool, she is lively aiid cheerful. Continiie the medicine: under the action of which in a few days, she perfectly recovered. This case appeared at the commencement so desperately severe, and proved ultimately so obstinate, that had I treated it Allopathically, I believe I should have stood no chance of subduing the disease. The child would not have borne the repeated use of those active m;easures which such a case, in Allopathic practice, would have imperatively demanded. CASE V.-Ellen D., aged 8 months; naturally a weakly, delicate child, and still further reduced by the present attack. November 8th, 1847.-Was poorly with a cough all last week. The last twenty-four hours she has been much worse. She is now in a high fever; has hot skin, rapid pulse, and much thirst. Her breathing is quick, short, and catching, and attended with a severe and painful cough. Auscultation detects complete dulness and 56 INFLAMMATION OF THE LUNGS, ETC. absence of respiration in the lower part of the right lung, with loud bronchial and mucous rales above. Take Phosphorus 12, every two hours. 9th.-Better in every respect. Continue. 10th.-No fever, heat, or thirst; breathing sounds much restored; some loose cough. Continue the medicine twice a day for a few days longer. She was then well, and had no further attendance. 57 BRONCHIT IS. THIS is a term applied to inflammation of the bronchi-- the air passages intervening between the windpipe and the substance of the lungs. In its milder forms it is the common cause of temporary cough; and when, as often happens in our damp and variable climate, it becomes confirmed, it constitutes the long standing, or what is called " constitutional cough," with which niany, especially aged, persons are troubled. Although individuals of all ages are exposed to -its attack, children and old people suffer from it most severely. Less dangerous than the disease we have just been considering, it generally lasts longer, and, when very acute, is productive of more suffering to the patient than that complaint. Frequently complicated with inflammation of the lungs, and closely allied with it in many of its symptoms, it yet has peculiar signs of its own, by which it is easily and clearly distinguishable. Of these the most striking are the loud wheeze, which, in the earlier stages, accompanies the breathing; the cough, more constant and distressing, and attended with a Smore copious expectoration; the pain in the chest, often very severe, and of a burning kind, and more widely diffused than in inflammation of the lungs. The last symptom, as well as the cough, is often greatly aggravated by the recumbent posture, so that the patient is not able to lie down in bed for several days and nights together. The physical signs elicited by auscultation are also indicative of the disease. H 58 BRONCHITIS. The treatment ordinarily adopted is most complicated and indefinite. Some medical men treat it actively, by bleeding, cupping, leeches, blisters, mercury, &c. Others, running into the opposite extreme, do but very little, and leave nature to her own efforts. The greater number pursue a middle course, bleed moderately, apply blisters and embrocations to the chest, administer expectorants, emetics, and purgatives. Of these three plans, the second, possessing the advantage of not exhausting" the patient's strength, is the least objectionable. The others harrass and debilitate the patient, without eradicating the disease. The Homceopathist adopts neither of these modes. He does not exhaust his patient by bleeding, and other antiphlogistic means; nor does he pursue the do-nothing system, and leave nature unaided; but by the employment, in the first instance, of such remedies as exercise a strong controlling power over inflammatory action in general; and secondly, of such as act upon the bronchial membrane in particular, he succeeds in bringing this painful, and, at times, obstinate disease, to a more speedy termination than can be effected by the ordinary Allopathic measures. CASE I.-Mr. P., aged 45. A healthy, plethoric man. January 9th, 1848.-Has been poorly the last week, with cold and slight cough. He is now labouring under all the symptoms of acute bronchitis, viz.:-quick, laboured breathing, greatly acc-elerated by the least exertion, and attended with a loud wheeze; a sense of oppression, and tightness across the upper part of the chest, and a violent, irritating, almost incessant cough, giving rise to a scanty watery expectoration. A racking headache, hot skin, rapid pulse, great thirst, alternating heats and chills, indicate much constitutional disturbance. Auscultation betrays loud sonorous rattle in the upper part of both lungs, but more particularly the right. He is unable to lie down in bed. To take Aconite 3, every two hours. 60 BRONCHITIS. 8th.-The change in her complaint since yesterday is very striking. The wheezing which might then be heard distinctly outside the room, is now scarcely audible at the bed side. Her breathing is so calm and easy, that, without questioning her, one would not suspect that she was labouring under disease of the chest. She has but little fever or thirst, and the pulse is nearly natural. She still feels the pain through the chest in breathing deeply, or coughing. There is free expectoratipn of mucous, and loud mucous rale in upper part of chest; some dulness on percussion and auscultation in centre of left lung. Take Bryonia 3, every four hours. 9th and 10th.-Progressing most favorably under the action of the same medicine. 12th.-She got up yesterday, and is now dressed and sitting by the fireside, feeling " quite comfortable." Her breathing is natural; she has but little cough; the pain in the side is removed; she begins to take food. A few doses of Sulphur are prescribed, and being now quite convalescent, no further medical attendance is needed. CASE III.-A fine fat child, aged 16 months; of a very irritable temperament. January 12th, 1847.-Has been ill two days; his present symptoms are of an unusually aggravated character. The breathing is very rapid, the wheezing remarkably loud, producing a sawing noise. He is very hot, feverish, and thirsty. There is also much gastric disorder: he is sick and the bowels are much relaxed. Take Aconite 6, and Chamomilla 6, alternately, every two hours. 13th.-He is greatly relieved; the purging has ceased; he is less restless and irritable; skirr cooler; cough loose, and less constant; the wheezing much abated. He still vomits occasionally. Take Ipecacuanha 6, every two hours. 14th.-He has the same medicine again, and on the 16th is perfectly well. CASE IV.-R. W. aged 21 years. A florid, stout, hearty boy; has been ill 24 hours. April 21st, 1847.-Has a loud dry cough; is husky and hoarse; BRONCHITIS. 61 'his breathing is rapid, and attended with the characteristic wheeze; he is feverish, very thirsty, hot in skin; his pulse is rapid, and he is very restless. Take Aconite 6, every four hours. 23rd. With the exception of a little troublesome cough this child is perfectly well, his breathing is natural, skin cool, has no thirst. He is laughing and romping. Take Chamomilla 12, twice a day. Cured. These cases might be multiplied, if needful, almost to -infinity. Enough have been quoted to show with what facility the disease yields to the action of Homoeopathic remedies. Thorouglfdy efficient, even in persons of the-most advanced age, it is in the disorder, as it occurs in children, that the power of these remedies is most strikingly conspicuous. In the latter respect we shall have occasion to recur to the subject when treating of hooping-cough, measles, &c. 62 INFLAMMATION OF THE WINDPIPE. THE windpipe is the uppermost portion of the apparatus devoted exclusively to breathing. It connects the mouth with the bronchial tubes named in the last chapter. Like the other parts of the respiratory organs, it is liable, under the influence of cold, damp air, and other causes, to be attacked by active inflammation, and when so attacked, the disease is called Laryngitis-the larynx being the part of the tube most commonly affected. In a chronic form, it is a frequent attendant upon consumption, and then constitutes one of its most painful symptoms. We are now about to consider it in its simple acute form, unconnected with disease of the lungs. There is scarcely an inflammatory disorder, in the treatment of which the Allopathic practitioner is not exposed to embarrassment and disappointment, arising from the violent and uncertain action of his remedies. This is more conspicuous in some cases than others; but in none more so, than in the different affections of the throat. That it is true, as regards the complaint now in question, medical literature supplies us with numerous melancholy examples. One of the most interesting is that of General Washington. *" Some time on the night of Friday, the 10th December, 1799, having been exposed to rain on the preceding day, General Washing * Cyclopaedia of Practical Medicine. INFLAMMATION OF THE WINDPIPE. 63 ton was attacked with an inflammatory affection of the upper part of the windpipe, called in technical language, cynanche trachealis. The disease commenced with a violent ague, accompanied with some pain in the upper and fore part of the throat, a sense of stricture in the same part, a cough, and a difficult, rather than a painful, deglutition, which were soon succeeded by fever, and a quick and laborious perspiration. The necessity of blood-letting suggesting itself to the General, he procured a bleeder in the neighbourhood, who took from his arm in the night, twelve or fourteen ounces of blood. He. could not by any means be prevailed on by the family to send for the attending physician till the following morning, who arrived at Mount Vernon at about eleven o'clock on Saturday. Discovering the case to be highly alarming, and foreseeing the fatal tendency of the disease, two consulting physicians were immediately sent for, who arrived, one at half after three, and the other at four o'clock in the afternoon. In the mean time were employed two pretty copious bleedings, a blister was applied to the part affected, two moderate doses of calomel were given, and an injection was administered, which operated on the lower intestines, but all without any perceptible advantage, the respiration becoming still more difficult and distressing. Upon the arrival of the first of the consulting physicians, it was agreed, as there were yet no signs of accumulation in the bronchial vessels of the lungs, to try the result of another bleeding, when about thirty-two ounces of blood were drawn, without the smallest apparent alleviation of the disease. Vapours of vinegar and water were frequently inhaled; ten grains of calomel were given, succeeded by repeated doses of emetic-tartar, amounting in all to five or six grains, with no other effect than a copious discharge from the bowels. The powers of life seemed now manifestly yielding to the force of the disorder; blisters were applied to the extremities, together with a cataplasm of bran INFLAMMATION OF THE WINDPIPE. 65 morning the symptoms had considerably increased-and it was quite evident active inflammation had set in, sufficient to warrant him, as he thought, to deplete by the application of a considerable number of leeches, and to purge himself by repeated doses of the mixture of salts and tartarized antimony. By this time the power of deglutition and speech was lost. During Sunday lancinating pains shot through the larynx, which led to a repetition of leeches, and an injection was administered, all by his own directions. It was clear that by this time the inflammation had travelled to parts of equally vital importance-the air passages of the lungs, which, (from the specific nature of the inflammation, added to his own, it is to be feared, injudicious treatment of himself,) was combated in vain, and he died on Wednesday morning." " It would be out of place here (observes the author,) to discuss the question of the propriety of active and extreme antiphlogistic treatment in any cases of sore throat, but the case of Dr. Lynch is one of many in which depletory measures, it is feared, hastened, rather than retarded the fatal termination." Almost simultaneously with this event, another valuable member of the profession fell a victim to a similar attack. Mr. Quekett, of London, was taken ill on Monday, the 21st of June, 1847. Symptoms of inflammation of the throat and windpipe speedily manifested themselves-within a few hours the pain shifted to the larynx-deglutition became almost impossible, and the voice was reduced to a whisper. This condition continued, with slight and temporary alleviation, for several days. On Saturday he suddenly exclaimed that something had burst in his throat, and he instantly swallowed half a pint of liquid, though with some -difficulty, and his voice began to mend. As soon as this affection subsided, the lungs became diseased-the symptoms rapidly augmented, attended 66 INFLAMMATION OF THE WINDPIPE. with great exhaustion, and on Monday evening,-the 28th, he died. "The remedies employed were venesection, (once,) leeching, (about seven dozen leeches were applied, at different times to the throat and chest,) blisters, 2 doses of calomel, mercurial inunction and enemata. After the first day it was found impossible to administer remedies by the mouth."* Not disputing that this treatment was in strict accordance with the generally received notions of correct practice, the question forces itself irresistibly upon the mind, "What part, seeing that it effected no good, did the loss of blood from venesection and eighty-four leeches play in inducing the extreme exhaustion under which this patient died?" Again, "I Had this loss been avoided, and a system of medicine employed, which always admits of remedies being administered by the mouth, is it not fair to presume that the result would have been very different?" These fatal examples of the utter inadequacy of bleeding, and other active remedies, to arrest the onward progress of the disease, (to say nothing of their acknowledged injurious properties) convey an important lesson to the Allopathist. They admonish him, in language more powerful than living lips could utter, to abandon a system, to which, almost in the same breath, one of its ablest advocates is compelled to apply the terms, "hurtful," " difficult," c "doubt," and "dilemma." Dr. Lynch wrote an essay on Laryngitis-and, as if in condemnation of his own principles, we see him falling a selfimmolated victim to their mischievous application. The American Patriot uttered a no less cutting satire upon Allopathy, when, sinking under its painful and exhausting remedies, he prayed "that he might be permitted to die without further interruption." The superiority of the Homoeopathic plan of treatment, over that just detailed, is too obvious to need description. * Condensed from the Medical Directory. 68 INFLAMMATION OF THE WINDPIPE. he cannot bear the least pressure on that part. His breathing is dry, husky, and sawing, and is accompanied by a cough of the like character. Take Aconite 3, one dose, then Belladonna, 6, every two hours. 26th.-Much the same. The larynx excessively tender; and the voice hoarse and broken. Take Spongia 12, every two hours, preceding it by another dose of Aconite. 27th.-Wonderfully relieved. He can speak, and swallow with ease. The cough is less frequent, and less painful; still some tenderness on pressure in the front of the throat. Constitutional excitement subdued. Take Hepar Sulph. every four hours. 28th.-Some hoarseness-in other respects all but well. Lachesis, twice a day. 29th.-Up and dressed, and eating cold lamb for dinner. Cured. CASE II.-H. H., aged 31; a cook. April 3rd, 1847. Went out five evenings ago in a cold east wind. The next morning, felt an uncomfortable sensation in her throat, which has gone on increasing to its present condition. She speaks in a low whisper; has a tight feeling across the upper part of the throat, as if a cord were drawn around it. It gives her great pain to speak, breathe, or swallow, and the larynx is exceedingly tender to the touch. She has a troublesome, tickling cough, and occasionally expectorates a small quantity of phlegm. There is loss of appetite, thirst, headache, some heat of skin, and rather accelerated pulse. Take Aconite 6, and Spongia 6, alternately, every four hours. 5th.-Greatly relieved. The voice is all but natural, there being only an occasional failure of a part of a word. The larynx is not tender when pressed; she has no fever, or thirst, and her appetite is returning; the cough is loose, and the expectoration easy. Hepar Sulphuris, three times a day. 7th.-The hoarseness which existed the other day has left her. All she complains of now is the cough. Continue the medicine. INFLAMMATION OF THE WINDPIPE. 69 12th.-There is no cough. She has leucorrhoea, and a little hysterical rising in the throat. Take Pulsatilla 12, daily, for a week. 19th.-Perfectly well. CASE III.-C. D., aged 21. A pale, delicate, young woman, of a scrofulous habit, having at the present time an enlarged gland under her jaw, on one side. April 15th, 1847.-Has felt unwell the last four days, having caught cold from going out in a sharp cutting wind. She has completely lost her voice, and cannot speak, breathe, or swallow, without considerable difficulty; nor can she bear any pressure on the larynx. She got no sleep last night, on account of a burning heat in the throat. She has headache, thirst, hot skin, quick pulse, and loss of appetite; is troubled also with a hoarse, short, hacking cough, and her breathing is attended with a loud, sawing noise. Take Aconite 6, and Spongia 6, alternately, every four hours. On the 16th.-Continue the Spongia. 17th.-The throat considerably relieved; the voice returning; there is not so much pain in the larynx, though still tender on being pressed. She is dizzy, and feels a throbbing pain in the left side of the neck, extending up to the top of the head. Take Belladonna 6, every four hours. 19th.-She is much better of the last named symptoms, but complains of a burning pain in the upper part of the chest and throat. Take Arsenicum 12, three times a day. 22nd.--Greatly improved: voice natural; no pain or burning in the throat; some cough. Take Hepar Sulph. 12, twice a day. 26th.-Perfectly well in every respect. CASE IV.--A stout, strong, servant girl; has been ill eight hours. October 14th, 1847.-In a high fever; has thirst, headache, hot skin, quick pulse, and alternating heats and chills. She complains of pain in the left side of the larynx, much increased by swallowing, and by pressure. Voice imperfect; breathing laboured, and longdrawn. Take Aconite 6, and Belladonna 6, alternately, every four hours. 70 INFLAMMATION OF THE WINDPIPE. 1 6th..-Voice quite gone. There is no redness" in the throat within sight, but the larynx' is more tender on pressing it outwardly. There is a slight husky cough, and the constitutional excitement' still continues. Take Aconite 6, and Spongia 6, alternately, every four hours. l9th.-No soreness in the windpip~e; voice returning; and in other respects -proportionately better. There is at times a little fever and thirst. Take Hepar S-ulph. 12, twice a day. Cured. 71 CROUP. THIS is another inflammatory affection of the windpipevery analogous to the one we last considered-but differing from it in the following respects: it is principally incidental to children, and young persons under the age of puberty-it extends lower down in the air passages; and gives rise to the formation of a peculiar adventitious membrane, which lines those passages, and, obstructing the entrance of air into the lungs, proves fatal by inducing suffocation. It is known by reputation as one of the most rapidly and certainly fatal diseases to which children are liable; and in its symptoms as being characterized by the peculiar noises which accompany the cough and breathing. The former" of these is like the short, sharp, half suppressed bark of a dog; the latter like the noise caused by sawing a piece of wood, only more prolonged. Without hearing them it is difficult to form an exact notion of these sounds: once heard they can never be mistaken, or forgotten. But, even when heard for the first time, these comparisons will serve to excite the suspicion of the mother or nurse as to the nature of the attack. Let them not lose one moment-in acting upon that suspicion, for the principal hope of safety for the child, depends upon the disease being met with the utmost promptitude in its earliest stage. As regards the treatment ordinarily adopted, I have alrheady implied that it is lamentably unsuccessful; and affirming the 72 CROUP. disease to be inflammatory, I have sufficiently, indicated in what that treatment consists. In spite of the notorious inability of children to bear with impunity, the application of depressing remedies, in this disease we have their employment pushed to its utmost limit. Bleeding from the arm, the jugular vein, and by leeches; tartar-emetic in vomiting doses, frequently repeated, and long continued; mercury in large quantities; blisters; warm baths: these are all brought into action, not as in some other diseases, successively, and at intervals spreading over several days, but almost simultaneously, or, at the utmost, within the space of a few hours. The number of patients that recover under this process is marvellously and deplorably small: it would be a curious experiment to ascertain how many more would survive, simply from its omission! Without pretending to assert that Homceopathy, even in the majority of cases, is equal to the task of subduing this formidable disease, it may nevertheless be safely affirmed, that it holds out an infinitely better prospect of success thanany other mode of treatment. This assertion is amply borne out by Homoeopathic experience. In my own practice, until I began to apply this system to such cases as came under my care, I never had the good fortune to see more than one recover. Since then I have treated several cases, and though I have had to regret the loss of two or three of them, the greater number have been restored. The following are striking examples of the latter class. CASE I.-H. H. aged 2 years. Sanguine temperament, dark complexion. Three years ago another child in this family was attacked with croup, which ended fatally in the course of twentyfour hours. November 12th, 1846.-A cold, damp north-east wind prevailing. Seized, twenty-four hours since, with an almost incessant, shrill, CROUP. 73 metallic sounding cough. The breathing, both in inspiration and expiration, is remarkably laboured and long-drawn, producing a loud, sawing noise. He is completely prostrated by the attack, lying motionless and almost insensible across his mother's lap: at the same time throwing his head back as far as possible in order to straighten the windpipe, and if any attempt is made to raise him, he appears as if he would be strangled. He is bloated and congested in the head and face; pulse rapid, and throbbing; skin alternately dry, and bathed in perspiration; incessant thirst. Take Aconite 6, every half hour. 13th.-The cough was so severe in the night, that his parents feared he would be suffocated. It is more metallic, and thoroughly croupy, than yesterday. The breathing is still as loud and rasping. He keeps putting his hands to his throat as if to tear -away something that distresses him. Pulse less rapid, and the skin not so hot. Take Aconite 6, and Spongia 6, alternately, every hour. 14th.-Slept two hours yesterday evening; in the night was again most alarmingly ill, and is now greatly exhausted. The breathing, though still laboured, is certainly considerably relieved; being more free and calm, and less dry and husky. The cough is also somewhat looser, and less metallic. The pulse is subdued, and the skin of a more natural warmth. Continue the Spongia, every two hours, 15th.-He was so much better this morning as to get down and run about the room; but now, at noon, he has resumed his old position on his mother's lap, lying perfectly still, in a heavy, lethargic state; breathing rapidly, and with the old sawing noise, but the cough, though troublesome, has lost its dry, metallic sound, and betrays the collection of a good deal of phlegm in the throat and bronchial tubes. Take Hepar Sulph. 6, every two hours. 16th.-The breathing has nearly lost its croupy character, and is now quick, thoracic, and catching, indicating, together with the auscultatory signs, an attack of inflammation of the bronchi, and lungs. There is fever, thirst, and heat of skin. Take Aconite 6, every two hours. K 74 CROUP. In the evening much relieved. Take Bryonia 6, every three hours. From this time his amendment was rapid and uninterrupted, and on the 19th he was perfectly well. This child had another attack in the spring of 1848, almost as severe as the foregoing, and recovered as favorably under the use of the same remedies. CAsE II.-M. B., a weakly, delicate girl, aged 9 years. Has been three weeks under medical treatment, at one of the hospitals, for an attack of sub-acute inflammation of the windpipe, attended with general constitutional disturbance. She continues to get worse; and at the present date, December 30th, 1847,-she speaks in a whisper; has a crouplike cough; is very tender to the touch in the larynx; breathing produces a loud, sawing noise, and she points to the top of the windpipe as being the seat of her suffering. She has used gargles to the throat, and taken Rhubarb and Magnesia inwardly. Hepar 12, every night; Spongia 12, every morning. January 2nd.-The breathing, and cough became, in the course of the night, so alarmingly laboured and suffocating, that her friends were apprehensive of her immediate dissolution, and summoned me in great haste to visit her at four o'clock this morning. I found her somewhat relieved, but still struggling for her breath. Take Spongia 6, and Aconite 6, alternately, every hour. 3rd.-Greatly better in every way; breathing and coughing with freedom and ease. Continue the same medicines, at longer intervals. 6th.-Sitting up, nearly well, getting her voice perfectly, and breathing with a healthy sound. Take Hepar Sulphuris 6, three times a day. 10th.-Improving: some hoarseness. Lachesis, twice a day. 14th.-Voice good; still a little hoarseness, and headache. Continue Lachesis, twice a day. She requires no more medicine. Cured. Nine months since, a brother of this child died in an attack of croup. CROUP. 75 CASE III.-James S., aged 2 years. A stout, florid child. September 11th, 1848.-He is stupid and lethargic, lying perfectly still, and taking no notice of anything, His skin is burning hot; pulse exceedingly rapid; his breathing, both in inspiration, and expiration, is laboured, loud, and long-drawn; and he coughs with the dry, barking, metallic sound, peculiar to croup. Take Aconite 3, every hour. 12th.-His mother brings him to my house, sitting upright in her arms, comparatively well. He is cheerful, wakeful, and playing with a toy; is cool in skin, and has but little thirst; his breathing is still rough, and when he coughs, the noise is the same. He had a dreadful night, and was very ill till two hours ago, when he all at once rallied, and assumed his present improved aspect. Take Aconite 12, and Spongia 12, alternately, at intervals of four hours. 13th.-He comes trotting in by his mother's side, cheerful, and well; le has simply a little cough, which seems to hurt him, since he cries out when it overtakes him. Spongia 12, twice a day. Cured. CASE IV.-E. S., a girl. Aged 4 years. May 19th, 1848.-The present attack has been coming on several days. She has now all the symptoms of croup in a severe form: loud, sawing breathing-so loud (especially in the night, when she gets worse,) as to be audible in any part of the house. A dry, barking cough comes on in paroxysms, threatening suffocation. She is very thirsty and- hot; and her pulse is rapid. She is heavy and congested in the head, and throws it back on the pillow, and rolls it from side to side. Take Aconite 6, and Spongia 12, alternately, every two hours. 20th.-Considerably better: she had a very bad night; but this morning her breathing is greatly relieved, having nearly lost the croupy sound, and the cough is loose and easy. The fever has entirely subsided. Take Hepar Sulph. 12, every four hours. 21st.-Still progressing rapidly, and favorably. "Spongia, every six hours. With this she quite recovered. 76 CRiOUP. It is rather remarkable that the parents of this patient also -lost a child in croup some years ago. A similar circumstance has been recorded in connection with two out of the other three cases: strongly corroborating a fact which has often been observed, viz.:-that the disease is very apt to prevail in particular families. .77 HOOPING-COUGH. So named from the singular shrill noise, or hoop, produced by inspiration at the end of each paroxysm of coughing, is an affection of the respiratory organs, to which many children fall a prey. In its simple form, it is a comparatively harmless complaint, and runs its course, generally extending over a period of some weeks, without materially interfering with the health of the patient. When, as frequently happens, it becomes complicated with bronchitis, inflammation of the lungs, or convulsions, it assumes a more serious aspect, and often leads to a fatal termination. There exists amongst medical authors much discrepancy of opinion, both as to the precise nature of hooping-cough, and the organ, or part in which it is situated: some maintaining that it has, its origin in the brain and nervous system; others, that it is simply a spasmodic affection of the windpipe; and a third party, that it consists in an inflammatory condition of the bronchial tubes. Without pretending to decide a point on which so many wise heads differ, I wish to call the reader's attention to the conclusion which Dr. Johnson deduces from this unsettled state of the question, namely, "that the young practitioner is left without any steady guide to regulate either his prognosis or practice." Founded on an assumption, as fallacious as it is plausible, * Cyclopaedia of Practical Medicine. Article, " Hooping-Cough." 78. HOOPING-COUGH. this sentence opens to our view one of the weakest points in the old system of medicine. It takes for granted, that, failing our knowledge of the precise nature and seat of a disease, we are left without a standard by which to regulate our treatment. A proposition so destructive of all sound therapeutical doctrine, the Homoeopathist utterly repudiates. The Allopathist, by admitting it, robs his system of the only basis on which any system of medicine, to be permanent and useful, can rest-and presents to us the absurdity, of a superstructure without a foundation. To prove this we have but to name at random any of the commonest diseases, and see what we know of them, either as regards their precise nature or situation. Fever for the first example-in this disease, the whole body from head to foot is on fire; every sense disturbed; every function implicated-what is its nature, and in what particular spot is it located? Rheumatism-how shall we fix its habitation,-how determine its essence? To day the pain is here, to-morrow there; now in one joint, now in another. Once more: the glutton indulges in a debauch, and awakes in the morning with an agony in his toe! Is that the seat of the disease? If so, what mean the aching head, the general fever, the vomiting, and other stomachic derangements which mark the accession of Gout? Question almost any other disease in the same way: the result is equally unsatisfactory. Our acquaintance with disease, in these respects, being so exceedingly imperfect, and, as a necessary consequence, totally inadequate "to regulate our practice," it becomes a question, Do we possess any other "steady guide " to direct us in the application of our remedies? We unhesitatingly answer in the affirmative. Since the dawn of medicine, those devoted to its study must have observed, that wherever disease existed, certain outward signs called "symptoms " were never want HOOPING-COUGH. 79 ing to indicate its presence: and further, that those symptoms assumed an infinite variety of feature, according to the varying character of the disease. It must also have struck them, that a state of things so extraordinary, and so constant, could not exist without an adequate object: that they must be designed to perform some important office for the good of the individual in whom they appeared. That office it was reserved for Hahnemann to discover and explain. He has done so in his grand doctrine of " similarities," or the necessary agreement between the symptoms of the remedy, and those of the disease. He has shown, on incontrovertible grounds, that these latter-nature's voice made audible to our sensesconstitute the only sure and unfailing rule to a safe and rational mode of treatment. Hidden from our view by an impenetrable veil, the nature and operations of the vital principle, of which disease is only a transient condition, are alike beyond our grasp, and unnecessary to our practice. We have no knowledge of the intimate nature of a disease, but from its external manifestations, or symptoms. What language is to thought, the symptoms are to the disease-the outward and sensible expression, of an inward condition. Neglecting the light and guidance which these afford us, we are left to follow the promptings of imagination and custom, which will infallibly lead us astray. Following them, as the faithful guide which nature has voluntarily placed at our service, they will as unerringly regulate our practice, as does the compass the course of the mariner. The Allopathic mode of proceeding, when hooping-cough is complicated with bronchitis, or pneumonia, is the same as that which is adopted in those diseases when they appear in their simple form; such as bleeding, blistering, antimonials, and calomel. The vascular excitement attendant upon hooping-cough; though it may from time to time be subdued, is exceedingly prone, from the peculiar nature of the malady, to 80 HOOPING-COUGH. be as frequently renewed. To day you flatter yourself that you have annihilated your enemy: to-morrow, phoenix-like, it rises from its ashes to mock your fruitless efforts. The effect upon the already debilitated constitution of the patient, of such a lengthened contest, conducted with Allopathic wea-. pons, may easily be imagined-repeated leechings, repeated blisters, repeated emetics! The frame of a Hercules could scarcely withstand them: how can the helpless infant hope to triumph! It is with regard to this question of debility, arising from the protracted existence of the disease, and the frequent recurrence of inflammatory attacks, that the excellence of the Homoeopathic system is displayed. Making no call upon the strength of the patient, but being, on the contrary, purely curative, and, therefore, invigorating, the Homoeopathic remedies may be repeated, and continued, not only with impunity, but with the most decided advantage, as often, and as long, as any severe symptoms demand their employment. In this we possess the great desideratum, of which medical men have always felt the need-the means of converting hooping-cough from one of the most intractable, dangerous, and fatal of complaints, into one as manageable, and little to be dreaded, as any other acute disease. CASE I.-Edward N., aged 1a years. December 2nd, 1847.-Has had hooping-cough the last two months. There did not appear to be much inflammatory action till a week ago. He then became so alarmingly ill as to induce his parents to call in a medical gentleman, who attended him up to this morning, when he pronounced his condition to be so hopeless that he could not live the day out. He declined prescribing any medicine, but as a last resource, ordered a large blister to be applied to the chest. The mother, much alarmed, sought my assistance. On visiting him, I find him labouring under the following HOOPING-COUGH. 81 aggravated symptoms of hooping-cough, conjoined with acute bronchitis. He is lying across his mother's lap, lethargic, stupid, and drowsy, and if roused for a moment he instantly relapses into a state of insensibility. The whole face is puffed, bloated, and livid. His breathing is short, rapid, and catching, and attended with loud rattling of mucus in the chest and throat. His pulse is exceedingly quick, and beating tumultuously. His skin is hot, and he has an insatiable thirst for cold water. The fits of coughing are very violent, and each one appears as if 'it must inevitably end in suffocation. Take Aconite 6, and Belladonna 6, every hour, alternately. 3rd.-He is sitting up on his mother's knee, looking intelligent, and cheerful. There is scarcely any excitement of system remaining. The breathing is calm and deep, and attended with only slight mucous rlle. His skin is cool; pulse regular, quiet, and subsided in force. There is very little thirst, and no confusion of intellect. He takes some light food, and appears -altogether better than for some time pasf. Having made up their minds yesterday morning to lose their child, it is no matter of surprise, that the parents should be wonder-struck at this change, and regard it, considering the shortness of the time, and the simplicity of the means employed, as almost amounting to a miracle. He continued the same medicine, at considerably longer intervals. From this tinme his restoration was rapid, and interrupted only by one other slight attack of inflammation, which occurred about a month after, and was subdued in a few hours. Naturally delicate and scrofulous, he had become still further debilitated by the hoopingcough, before I saw him. He was therefore kept under care for some time longer, in order to restore the general health, which by a little careful treatment was soon effected. CAsE 11.-Mary-Ann C., aged 21 years. A stout, florid child. March 17th, 1847.-Has been labouring under this attack two days. She has already undergone active treatment: been leeched, put into warm baths, had castor-oil, &c., with no beneficial result; but, on the contrary, she is now so alarmingly ill, as to compel me to give a very qualified opinion as to her recovery. She breathes L HOOPING-COUGH. exceedingly rapidly, performing 70 respirations in the minute, each inspiration being attended with a loud noise, as though the windpipe was inflamed and narrowed. There is a short, dry, barking, shrill cough. The eyelids have this afternoon become inflamed and swollen, and discharge a quantity of thick matter. Her pulse is very rapid, and she is " burnt up with fever." Take Aconite 6, every hour. 18th.-The improvement in her condition since last night is such as almost to lead one to question her identity. After the second dose of medicine she fell into a sound sleep. This morning she is sitting up, cheerful, happy, and playing with her toys. Her eyes are bright and clear, and free from discharge. Her breathing is nearly natural, and her skin cool. There is only a little thirst, and loose cough remaining, of all the alarming symptoms which yesterday threatened her very existence. 19th.-A slight return of the discharge from the eyes, and the cough continues, and becomes more paroxysmal in its character. Take Mercurius, every four hours. 20th.-All the inflammatory symptoms have disappeared; and genuine, distinct hooping-cough manifests itself. She has Belladonna 6, three times a day, under the influence of which the disease speedily and entirely subsided. CASE III.-S. N., a boy, aged 21 years. Has had hooping-cough three weeks. The mother is very nervous about him, having lost his sister with the same disease not long since. In that case there was inflammation of the lungs and convulsions, and active treatment, such as leechings, &c. was employed. March 17th, 1847.-The paroxysms of coughing are very violent. The last three days he has had symptoms of inflammation of the lungs. He has quick, short, catching respirations (55 in the minute.) His pulse is very rapid; skin burning hot; he is drowsy, and heavy in the head, and flushed and congested in face. Take Aconite 6, every two hours. 18th.-Yesterday as ill as he could well be, he is to day a different child. He is now sitting up on his mother's lap, seemingly HOOPING-COUGH. 83 well. He had a pretty good night. His breathing varies from the natural standard only in being a little too quick, and somewhat irregular. His pulse is good; skin cool; thirst abated. 20th.-Much the same: has bad nights. Fits - of coughing severe. Take Belladonna 6, every night. 22nd.-Greatly improved. His cough is much less frequent and severe. He runs about the room and joins in the gambols of the other children. 23rd.-In a violent fit of coughing he became strongly convulsed. He remains now, half an hour after, very heavy about the eyes, and drowsy, stupid, and hot in the head. Take Cuprum Acet. 6, directly, and repeat it in four hours. 24th.-He is to-day better than he has been before during the attack. All traces of inflammation and head symptoms have vanished. Take Belladonna, three times a day. 26th.-Still improving; has very little cough. A few doses of Drosera. 31st.-Cured. In closing this subject, I wish to direct the reader's attention to one particular stage in the progress of hooping-cough, at which children of a scrofulous habit, in whom the disease has been neglected, or mismanaged, are almost sure to arrive. I allude to a state of extreme debility, connected with, and probably arising from, chronic inflammation of the lungs or bronchi. Now, as this condition is not unfrequently induced by the repeated use of those depletory measures to which the Allopathist is forced to resort for the purpose of subduing inflammatory action, their further employment, to remove the still lingering remains of that condition, are of course inadmissible. What curative resource, then, does the practitioner of the old-school possess, upon which, under these circumstances, he can fall back? None. As was done in the two cases I am now about to relate, he can only preach 84 8HOOPING-COUGH. patience and resignation: excellent philosophy, truly, when the case is hopeless-but a very poor substitute for the life of a child, when death is not necessarily inevitable. That such an event in the majority of instances is not inevitable, I have had repeated and ample proof, not only in 'the treatment of cases which were throughout under my own care, but more strikingly so still, in the favourable termination of others which had been previously treated by Allopathic physicians, and pronounced by them, as beyond the reach of their art, but which. subsequently recovered under the use of Homoeopathic remedies. The two following are instances of this kind. CASE IV.-S. T., aged 21 years. From birth tainted with scrofula, which has continued to develope itself rapidly since she was weaned. Tabes mesenterica is the leading form it has assumed. Her abdomen is immensely large and protuberant, and the rest of her body emaciated and diminutive. Her appetite is generally ravenous; she is very thirsty, particularly in the night; her bowels, the secretion from which is very unhealthy, are commonly relaxed four or five times in the twenty-four hours. She has firom time to time had severe attacks of illness-bronchitis, threatening of water on the brain, &c., under which, had she been treated Allopathically, she must inevitably have sunk; but from which, with the aid of Homceopathic remedies, and the most sedulous nursing, she has hitherto recovered. In the intervals I was unable to persuade the parents (deterred by the seeming hopelessness of the case) to persevere in the use of the proper remedies, for the relief of the scrofulous affection. It was upon this exhausted and diseased frame that five months ago hooping-cough made its attack. It was attended from the outset with a considerable amount of fever and bronchial irritation, which yielded to Aconite, Belladonna, Mercurius, &c. From that time to the present date, I was only occasionally consulted. The disease pursued its course rather severely, and still further reduced her little stock of strength. HOOPING-COUGH. 85 A return of inflammatory symptoms in the chest now appeared to banish even what faint hope might have before existed of her ultimate recovery. The parents, yielding naturally and properly, to the persuasions of some friends, took her to a physician, who makes the diseases of women and children his peculiar study. He at once pronounced the case hopeless. Under these circumstances the child came again under my care, and resting on my experience of the power of Homceopathic remedies, I ventured to offer an opinion directly opposed to that just stated. I examined the chest carefully, and though the bronchitis had existed some time, was still severe and universal, and the chest loaded with mucus, I was satisfied that there was no necessarily destructive process going on in the lungs. She was in other respects in a most unpromising state: languid and powerless; feverish and thirsty; perspiring at night; relaxed in the bowels; loathing food; and coughing violently. I prescribed Phosphoric Acid, at first twice, subsequently once a day, and under the action of this medicine alone, at the end of two months, she had lost every trace of the hooping-cough and bronchitis; the hectic and night sweats had disappeared; she had regained her appetite; and her bowels had put on a much more regular and healthy action. Her general health inmproved in proportion, and at the present time (beginning of September, 1848,) she runs alone for the first time, and in other ways holds out every prospect of entirely out-growing the scrofulous disease which has so long rendered her life precarious. CASE VI.-K. G., aged 51 years. When healthy, is fat, and square built; having large head, protuberant joint bones, unsteady gait, and other signs of a scrofulous constitution. September, 1848.-Six months ago was attacked with hoopingcough, which continued unattended with any urgent symptoms for the first twelve weeks; at the end of that time, the fits of coughing became more severe, febrile symptoms manifested themselves, and bronchitis supervened; she vomited all her food, took to spitting blood, and was in other respects exceedingly ill. Several remedies were administered, with no marked benefit. Her condition at length became so alarming, as to induce her mother to take her to 86 HOOPING-COUGH. a physician, who prinounced her lungs to be in such a state of disease, that she could not recover. He prescribed an ordinary mixture of paregoric, mucilage, nitre, syrup of poppies, &c. Giving this a fortnight's trial, and deriving from it no advantage, she was taken to a consulting surgeon, who gave a very similar opinion to the above, and prescribed nearly the same kind of medicine. At this juncture she came under my care. I found her exceedingly emaciated and weak; the cough still existed in unmitigated violence, each paroxysm being attended with vomiting, and the ejection from the lungs of a quantity of blood and phlegm, and leaving her for hours after languid and exhausted. Her breathing was short, quick, and laboured; on examining the chest, the lungs were discovered to be loaded with mucus; the loud crepitating rMe superseding all the other sounds; she had no appetite; was thirsty, and perspired profusely in the night. Directed to take Drosera 12, and.Phosphoric Acid 12, alternately, at intervals of twelve hours. Decided amendment manifested itself with the commencement of this treatment; her appetite speedily returned; and with it her strength; the cough became less frequent and violent, and unattended with vomiting or spitting of blood; the breathing became calm, deep, and free; the perspiration ceased, and her skin resumed its natural temperature. At the present date, having continued the treatment two months, she retains no trace of her disease, and is the fattest and healthiest child of a large family. 87 INFLAMMATION OF THE MOUTH. HAVING in the preceding pages illustrated the power of Homeeopathic remedies in subduing some of the most important diseases of the organs of respiration, we come now to the consideration of another class of disorders, viz.:-those affecting the organs of digestion: the mouth, throat, stomach, liver, and intestines. The mouth, in common with the rest of the body, is liable to a variety of diseases. Partaking of the leading characteristics of the other portions of the alimentary canal, it is, like them, most frequently affected with inflammation and ulceration. The subject is introduced here, not because inflammation of the mouth is generally to be regarded as a serious or very acute disorder, but because its treatment affords a good example of the application of the Homceopathic law. Bearing in mind the symptoms produced by mercury when administered in large or salivating doses, it will at once be understood, by those who are acquainted with Homcoepathy, why, in minute doses, it was the proper remedy in the two subjoined cases, in which the disease did not originate in the abuse of that medicine. CASE 1.-James I., aged 35. A coal porter. June 28th, 1847.-Has had four similar attacks. The whole of the membrane lining the mouth is intensely red and inflamed. The inside of the cheeks, the lips, and gums are covered with 88 INFLAMMATION OF THE MOUTH. virulent, burning ulcers. The saliva pours in streams from his mouth, and the stench from his breath is intolerable. He can swallow nothing but liquids, and those not without the utmost pain. His teeth are all loose, and feel as if they would drop out; they are coverea with a soft, white, offensive secretion. The eyes also partakegof the irritation, being injected with red blood, and are swimming in tears. He is very thirsty; his pulse is quick; tongue thickly coated. He has not taken any medicine lately. Aconite 3, directly; followed by Mercurius 6, three times a day. 30th.-Some melioration of most of the symptoms, though his mouth is still in a deplorable condition. Take Sulphur 3, directly. To-morrow commence with Acid Sulphuricum 12, three times a day. July 3rd.-Greatly relieved; not nearly so much inflammation, and the flow of saliva is diminished. Take Mercurius 6, night and morning. 7th.-The disease has almost disappeared; the mouth is comparatively well. Repeat the Medicine. Then Sulphur, two doses. Cured. CASE II.-John P., aged 12. Engaged in a shop; has been ill one week. Commonly healthy. April 17th, 1847.-He had a cold in the first instance, followed by the present attack, which has continued to get more severe up to the present time. His mouth and face are in a miserable condition. He sits writhing with agony; the saliva pours from his mouth, and his breath is most offensive; the cheeks are swollen and the corners of the mouth ulcerated and scabby. On examining the mouth internally, it presents a pitiable spectacle; it is intensely inflamed and studded in different parts, especially around the lower gums, with grey, burning ulcers. The tongue is thickly coated, white and yellow. He has no appetite; is thirsty; suffers from headache, and is greatly prostrated in strength. He took two pills a day or two ago, after this attack set in; beyond this he has had no medicine; it is therefore non-mercurial. Take Mercurius 6, every four hours. 19th.-Much better: " still in pain, but nothing to what it was." 90 INFLAMMATION OF THE THROAT. SEVERE in its symptoms, and of very frequent occurrence, there are few diseases which cause a greater amount of temporary suffering than inflammation of the throat, or quinsy. This is due mainly to the complicated offices in which the throat takes a part. The acts of swallowing, breathing, and speaking, are at times so much impeded as to threaten suffocation. This danger, however, is more apparent than real, since, depending as it does upon suppuration or "gathering," relief is nearest at hand at the very moment when the danger appears to be most imminent: the abscess bursts, and the interrupted functions are instantly restored. This is the way in which nature, unassisted by art, most commonly conducts these cases to a successful, though protracted, issue. It is the duty of the medical man, by appropiate treatment, to afford nature such assistance as shall enable her to bring about the same result by a shorter and less agonizing process: by inducing a subsidence of the inflammation before suppuration has commenced. This object the Allopathist endeavours to effect by bleeding in the arm, when the patient is young and plethoric, and the symptoms run high; by leeches in most cases; and in all, by blisters, and active purgation. That, in the majority of cases, these means are totally inadequate to the end they are intended to fulfil, no medical man, who submits his experience of their efficacy to an impartial examination, can deny. In obedience to the routine practice INFLAMMATION OF THE THROAT. 91 of the old school, I formerly employed them in hundreds of instances; and so far from finding them arrest the disease, they as often, if not oftener, prolonged its duration, by delaying, without preventing, the suppurative process. Though a serious evil, this is by no means the only one that results from the old mode of treatment. It is not an uncommon thing to see patients, especially delicate women, emerge from these attacks in a state of debility, little short of that which follows a case of fever, or any other protracted and dangerous disease. That this is due, not so much to the intensity of the disorder, as to the exhausting effects of the treatment, my own observation had led me strongly to suspect, long before I relinquished the old system. Subsequent experience in Homoeopathic practice, has thoroughly confirmed the correctness of that suspicion. It is worthy of remark, in the Homoeopathic treatment of acute diseases generally, that although a local affection may continue to run its course, the constitutional symptoms which arise from it and constitute the patient's chief source of distress, speedily subside, and leave the system comparatively undisturbed. In no case is this more strikingly apparent than in inflammation of the throat. Even in cases of the most obstinate kind, where suppuration becomes inevitable, after twenty-four hours use of the medicines, the system resumes its usual condition: there remains scarcely any fever or thirst; the head becomes easy; the pulse good; the skin cool; the abscess forms and bursts; and the patient, at the end of the attack, finds himself only so much weaker than he was at his commencement, as that he has been unable, in the interim, to swallow his usual quantity of food. With an appetite ready prepared to make good this deficiency, he loses, almost in a few hours, the evidences of having gone through one of these formidable attacks. This result alone would be a great advance upon the " old style," but the action of Homoeopathic remedies, in 92 INFLAMMATION OF THE THROAT. arresting recent cases, is so strikingly beneficial, as to be almost incredible to those who have not witnessed their effects. This is exemplified in the following cases. CASE I.-I. K., aged 16 years. October 11th, 1847.-Felt ill last night. This morning got up with a violent headache, and pains in all his limbs, and shivering; has hot skin; quick pulse; much thirst. His throat is very sore; he is unable to swallow anything. Both tonsils are very red and swollen; his voice is thick, and he has a tickling cough. Take Aconite 3, directly, then Belladonna 6, every four hours. 13th.-No sore throat whatever, and in other respects perfectly well. He ate his breakfast very comfortably yesterday morning. S CASE II.-C. R., aged 19. A compositor. February 9th, 1847.-111 three days. Has great pain in his throat; both tonsils are so much swollen as to prevent deglutition; the whole of the fauces and throat are also inflamed. His tongue is coated and white. He suffers from headache, which is greatly increased by a cough. There is high fever, thirst, hot skin, and aching pains in all his limbs. Take Aconite 3, directly; four hours after Belladonna 3, and repeat it every four hours. 10th.-He is up and dressed; can swallow freely and easily; the throat slightly inflamed and not much swollen; no headache; trifling thirst; skin cool; pulse natural. Repeat the medicine. He required no further assistance. CASE III.-Mrs. E. G., aged 29 years. June 16th, 1847.-Yesterday forenoon seized with shivering, which compelled her to go to bed, where she now remains. She % was at the same time attacked with pains in her back and limbs, intense headache, and sore throat, and has had heats and chills running through her ever since. Both tonsils are much swollen and inflamed; she can swallow nothing: not even liquids without INFLAMMATION OF THE THROAT. 93 - much difficulty. Her pulse is rapid; skin dry, and burning hot; there is incessant thirst; white, foul tongue. She vomited last night; and got no rest on account of the pain in her head. Take Aconite 6, and Belladonna 3, every four hours, alternately. 17th.-At noon up, dressed, and making her bed: at the same hour yesterday she was confined to it by severe illness. The constitutional symptoms have entirely subsided, and with the exception of a little weakness, there is scarcely a trace of her disease. A trifling redness may be detected about the fauces, and the tonsils are still a little enlarged, but nothing to cause her inconvenience. Continue the Belladonna a few hours longer. Cured. CASE IV.-A married woman, aged 28 years. October 8th, 1847.-Was taken ill four days ago with headache and sore throat. The constitutional fever, &c., have subsided, and there remains now an amazingly enlarged state of both tonsils. They are about the size of walnuts, and completely meet across the isthmus faucium, impeding deglutition to such an extent, as to render the swallowing a little liquid almost an impossibility. On the anterior part of the glands are a number of small, grey ulcers. She is very weak. She took some aperient medicine of her own accord, and yesterday consulted a medical gentleman, who advised that the tonsils should be scarified; on her objecting to this, he gave a stimulating embrocation, to be applied externally. Finding no relief, she attends me to-day, and has Lachesis 12, three times a day. 1lth.-She returns, exceedingly delighted at her improvement. She got ease the first day, and next morning felt little or no inconvenience. The tonsils are only slightly enlarged, and the ulcers have entirely healed. She enjoys her food, and her health is altogether better; in short, she feels quite well. -Continue the medicine. 14th.-She calls to express her gratitude for her speedy and perfect restoration. CASE V.-Mrs. C., aged 26 years. June 20th, 1847.-Has been poorly with a cold the last three 94 INFLAMMATION OF THE THROAT. days. Yesterday morning felt a soreness in the throat, which has rapidly increased to its present painful condition. Both tonsils, but more particularly the right, are red, inflamed, and much swollen. She cannot swallow even a drop of liquid without great pain, which causes her, in the effort, to lower the head to one side, and make the peculiar, ugly grimace, which characterizes the deglutition of persons labouring under sore throat. She is very thirsty; has headache, hot skin, quick pulse, and pains in every limb. She got up about two hours ago, but intends going to bed again directly, as she feels dizzy, chilly, and so weak as to be unable to sit. Take Aconite 6, and Belladonna 3, alternately every four hours. 21st.-Nearly free from all constitutional suffering, but the tonsils are enlarged, and ulcerated in several spots. The mouth and throat are clogged with a quantity of tenacious mucus. Take Mercurius 6, every four hours. 22nd.-Better in health; throat still troubles her nearly as much, except that it is cleaner and more free from mucus. Take Lachesis 12, every four hours. 23rd.-Great amendment. Her throat feels totally different; she can swallow without impediment, and enjoys her food. The ulcerated spots have nearly healed. Continue the medicine. 25th.-She is quite well, and expresses, in strong terms, her satisfaction at what she considers a very speedy termination of the attack; for, like the previous case, she had suffered greatly on several former occasions, from the same complaint; and had been accustomed to be leeched, and blistered, and to take strong purgative medicines, which always induced extreme debility, and led to a long and tiresome recovery. 96 INFLAMMATION OF THE STOMACH. disorders are neither serious nor deep-seated: time and temperance are generally quite equal to their removal. The stomach is, however, occasionally liable to attacks of so formidable a nature, as to demand the prompt interference of the medical man. They are mostly inflammatory; and are treated of under the generic term of " gastritis." It is of this we are now about to speak. Availing myself of this.opportunity to offer a few remarks upon the comparative advantages of large and small doses of medicine, it may be observed, that there is, perhaps, no surer proof of the accuracy of a new doctrine, than the fact, that those who oppose it, are reduced to the necessity of employing ridicule, in the place of argument, in their efforts to controvert it, or arrest its progress. This is peculiarly the case with Homoeopathy. Unable to detect any unsoundness in its doctrines, or inconsistencies in its practical details, its opponents have generally descended to the unfair alternative, of endeavouring to throw ridicule upon the whole system, by exciting a laugh against the smallness of the dose in which the medicines are administered. The attempt, however, has invariably failed: nor is there any fear that it will ever meet with better success. If, when she rested upon the strong faith of the lion-hearted Hahnemann alone for her very existence, Ilomcmopathy could triumph over all antagonism, little has she to apprehend from the puny shafts of ridicule, now, that, in the place of one champion, she can boast of her legions. Those who know nothing of Homoeopathy beyond its name, and the fact that its remedies are exhibited in exceedingly minute quantities, generally suppose it to be a system of medicine, differing from the old only in this latter respect. A greater mistake could not be committed. The small dose, it is true, has, from custom, and experience of its superiority, come to be regarded as an essential part of Homoeopathic "parfti;c: but so far from forming an integral part of the INFLAMMATION OF THE STOMACH. 97 Hpmoeopathic doctrine, or having originated in any caprice or fanciful theory of Hahnemann, it is notorious that lie commenced, and for some time continued to practice the new system with the ordinary doses of medicines. Close and careful observation alone divulged to him the fact that medicines, which, administered in the customary mode and doses produced but slight effect, when administered in the same quantities, in accordance with the Homceopathic law, excited the system in a inanner too powerful to be borne with impunity. He began, consequently, to diminish the dose, and, as he descended the scale, discovered to his astonishment, that not only did his medicines lose all their irritating properties, but actually cured diseases more rapidly and certainly than when exhibited more copiously. It appears therefore that the difference consists more in the doctrine than the dose; that experience, not fancy, suggested the change; and that Hahnemann adopted it, not from choice, but necessity. "Truth is so terrible when exhibited in its concentrated form of a principle, and involves such consequences, that all the energies of man are required to test it in the furnace of human passions, ere it can be purged of its dross and fitted for use. Mankind feel that it approaches them as a conqueror, and they receive it as an enemy."* This beautiful passage furnishes a clue to the otherwise unaccountable spirit of obstinate incredulity, and undying opposition, which Hahnemann's great discovery has every where encountered. Had half the ingenuity which has been displayed in devising arguments against the Homoeopathic system, been devoted to a candid and truth-seeking examination of its principles, we should not now be doomed to hear the frivolous, and oft refuted objections against the small dose, which still meet us at every turn. * Quarterly Review. No. cxliii., p. 192. N 98 INFLAMMATION OF THE STOMACH. It is not my intention to waste time upon all these absurdities. One only-as untenable as the rest-because it exerts a more extensive influence than any other, demands a moment's attention. It is based upon what is called the " unreasonableness" of the thing. Persons complain of the difficulty they feel in bringing themselves to believe in the power of the infinitesimal dose, because we cannot demonstrate, nor they understand, its mode of operation. But to reject a new truth on account of its unfathomable depth, and withhold from it our assent, simply because it passes our comprehension, is in the highest degree unphilosophical, and totally inconsistent with that submission of our reason to the requirements of faith, which we are constantly called upon to exercise in a thousand other instances. Every natural phenomenon presents the same difficulty, and makes the same demand upon our credulity. To the Allopathist who may urge such an objection, it will be sufficient to reply, that when he shall be able to explain the modus operandi of a dose of epsom-salts, castor-oil, or any other drug, then-but not till then-will he be entitled to ask for an explanation of the action of the Homoeopathic dose. The whole subject, in short, resolves itself into a question of evidence. In this respect the two opposing parties are on an equality. No one will deny that any statement, capable of being confirmed by personal observation, would present as irresistible a claim upon our belief, if supported by the concurrent testimony of five hundred intelligent and independent observers, as it would if its truth were attested by five thousand. In both instances, the numbers would be too great to admit of the possible intervention of those sources of error which might invalidate the testimony of only a few individuals. Let the larger number represent the Allopathists, and the lesser the Homoeopathists-we find both parties equally qualified to observe facts and appreciate their value INFLAMMATION OF THE STOMACH. 99 both founding their faith upon the results of experience, and affirming with equal earnestness the positive effects derivable from their respective doses! PHow shall we dispute the vali"dity of their evidence? If that cannot be done---neither can we award our confidence to the one party without extending it to the other. Passing by a host of interesting facts and arguments, commonly adduced in support of Hahnemann's plan of prescribing medicines in small doses, we proceed to a brief consideration of two or three, which bear more directly upon the question, whether extremely minute quantities of matter, when introduced into the system, possess the power of influencing its functions. -The first example-in which the substances are not swallowed, but merely 'applied to the olfactory nerves-is afforded in the, overpowering effects produced upon some constitutions by the odoriferous particles of musk, or flowers, or the scent arising from the presence of certain animals. A second is supplied by the absorption of marsh miasmata, the virus of cholera, typhus, small pox, and other infectants. The following example came partially under my own obser - vation.-A strong, healthy, country female, was stung in the arm by a wasp. In less than ten minutes the limb became intensely painful, and, with the whole body from head to foot, swollen and as red as scarlet. The tongue became also much enlarged, obstructed her speech, and threatened suffocation. Her brain became affected, and her sight confused and indistinct. It was some days before she thoroughly recovered. In each of these cases how powerful the effect, yet how infinitely small the dose! Did the most powerful microscope ever detect, the finest balance ever weigh, the nicest test ever discover, the odour of flowers, the marsh miasm, the infection of fever, or the venom of a wasp? Let those who hesitate at the doctrine of infinitesimals, and deny, INFLAMMATION OF THE STOMACH. 101 drance to any salutary action which the medicines might otherwise possibly exert, even though not administered in accordance with Homoeopathic rules. What effect does an ounce of epsom-salts, the common dose of that drug, produce upon the tongue? Is it not that of powerful astringency? Is this action less powerful when the medicine comes in contact with the stomach? Let the nausea, vomiting, pain, and prostration of strength, which so frequently ensue, answer the question! It is in the act of swallowing the doses that the non-professional person forms an estimate of their comparative advantages. Compared with the disgust engendered by the approach to the lips of the nauseous draught, other arguments against the Allopathic dose, dwindle into insignificance. The loathsomeness of its drachms forms one of the strongest drawbacks against which medicine, as commonly practised, has to contend. Persons cannot (and no wonder,) dissociate in their minds, the professor fiom the repulsive measures by which he endeavours to effect his salutary objects. Many persons, taking a retrospect of a past illness, regard the bitter draughts they were compelled to swallow, as constituting a part of their suffering, scarcely more endurable than the pains of the disease itself. The prejudicial influence which this disagreeable necessity at times exercises over the progress of the malady must not be forgotten. Adult patients are not unfrequently injuriously excited by the arrival of the hour for repeating their dose-and the almost total impossibility, in many cases, of surmounting the antipathy of children in this respect, and the terrible excitement caused by fruitless efforts to do so, are too well known to all who have been so unfortunate as to have the management of them in sickness. The evils of the large dose do not end when it is swallowed. The Allopathist gives his medicines in such quantities that both he and his patient are disappointed, if what are called 102 INFLAMMATION OF THE STOMACH. " sensible effects" do not follow. New symptoms are expected to arise, being for the most part of a distressing kind, such as pains in the stomach, nausea, vomiting, headache, thirst, and an infinity of other sensations of an anomalous and less striking character. These potent remedies may produce an aggravation of the symptoms of the disease, proverbially understood by the patient as the "searching of the remedy," and persons who have been habituated to taking Allopathic medicines, are so accustomed to experience these effects, that it is not easy to persuade them that any good can result from the non-perturbing Homoeopathic dose. Opposed to this mass of inconsistencies and mysticism, stands Hahnemann's clear and simple plan. In the first place, the dose is perfectly tasteless. Dissolved in water it imparts not the slightest flavour. Placed upon the tongue it melts and passes into the stomach without the patient being conscious of its presence. In the second place, when swallowed it entails no evil consequences. Beyond the abatement of his sufferings, the patient experiences no sensible evidence of its action. Purposely too small to generate any symptoms of its own, it does not in the least degree mystify those of the disease. The practitioner knows that every change, not favourable in its character, belongs to the disorder, and not to the remedy. Using no means which can either harass his patient or aggravate the disease, he is at all times prepared to give an opinion, proximately correct, as to the progress and probable termination of the malady. Practised in this manner, instead of being a dreaded instrument of torture, medicine becomes what it was designed to be by its Beneficent Author-an unalloyed blessing to his suffering creatures. These remarks are suggested by the disease now under consideration. One of the most distressing and intolerable INFLAMMATION OF THE STOMACH. 103 symptoms is incessant vomiting: the least thing, even a drop of cold water, is often instantly rejected. If, then, in consequence of its irritability the stomach is unable to retain such a simple and innoxious body, it is absurd to expect its retention of a mass of nauseous medicines administered in large and unsparing quantities. An insurmountable barrier being thus raised against the introduction of direct remedies, the medical man of the old-school is forced to rely upon the secondary influence of leeches, blisters, mustard poultices, and other outward, and consequently, less efficient measures. I recollect having had, many years ago, a case of this kind under my own care, in which the sickness was so protracted and uncontrolable, that at length the only prospect of appeasing it, and so saving the life of the patient, presented itself in a total withholding of every kind of ingesta. The result justified the means. After a few hours abstinence-rendered almost intolerable by intense thirst-the irritability of the stomach had so far subsided as to admit of the introduction of bland and cooling liquids. A further lapse of time was, however, necessary ere medicines, though prepared in the mildest form, could be resumed-showing, that not only had these latter done nothing towards subduing the disease, but, on the contrary, had absolutely contributed to its prolongation. Such a circumstance-by no means uncommon-affords the strongest evidence in support of Hahiemann's mode of administering medicines. Even in these urgent cases, the small, tasteless Homoeopathic dose, placed upon the tongue, allowed to dissolve there and descend into the stomach with the saliva, may be administered with as much facility as in any other disease. Thus, while we secure the fall advantage of applying our remedies directly to the part affected, we obviate the injurious effects of the large dose, to say nothing of the painful external remedies to which we have already alluded. 104 INFLAMMATION OF THE STOMACH. CASE I.-Mrs. C., aged 26 years. Generally healthy. January 18th, 1847.-Has been poorly some time with loss of appetite, nausea, and occasional vomiting; she has been wasting, and getting very weak, to counteract which, she has taken a variety of stimulating things, both as food and drink. Twenty-four hours ago she was seized with a violent shivering fit, succeeded by high fever, and severe pain in the pit of the stomach. She is now in bed, lying on her back, from which position she cannot move, on account of the pain in the stomach. Pressure at that part causes so much suffering, that she shrinks even at the approach of the hand: deep inspiration also, or the least cough increases the pain to an intolerable degree. Her tongue is foul and perfectly dry; there is intense longing for cold drinks, but as soon as anything is swallowed it creates nausea, and is instantly ejected. Her pulse is small, and very rapid; her breathing quick; countenance anxious; and she is exceedingly restless and irritable. Take Aconite 3, every two hours. In the evening much the same, except that the skin is moist. Continue the Aconite, and between each dose take Arsenicum 12. 19th.-Noon. Has had a bad night: no sleep, on account of the pain in the pit of the stomach. This morning the tenderness on pressure is mitigated; there is not quite so much thirst; the pulse is reduced to a 100, and is softer; tongue moist; expression of face not so distressed; no vomiting. Continue the medicines. Seven o'clock-evening. She is now in a sound sleep, lying comfortably on her side. Waking accidentally, she says, that about three o'clock, a feeling of delightful calmness and drowsiness came over her senses-she fell into a sweet refreshing slumber, and awoke free from pain, which seemed to have left her, as by a charm. She is now altogether a different being: sits up briskly in bed, to show how much she has improved. Her skin is cool and soft; pulse 95; breathing calm and easy; very little thirst; felt a desire for food, and had some dry toast; can bear considerable pressure at the pit of the stomach without discomfort. Continue the medicines, at much longer intervals. INFLAMMATION OF THE STOMACH. 105 20th.-Comparatively well: feeling only some soreness in the former seat of pain. 21st.-Still mending rapidly. Some little soreness remaining in the epigastrium. Take Nux Vomica 12, three times a day. 22nd.-Convalescent. No pain or other trace of disease; is cheerful and laughing; and anxious to get up; taking solid food with a hearty relish. Cured. This was an unusually severe case. The action of the medicines was most striking. I am unacquainted with any other means by which such results could be obtained so painlessly and in so short a space of time. CASE II.-Robert P., aged 41 years. Works at an iron-foundry, where he is much exposed to sudden alternations of heat and cold. His work is very hard, and he occasionally drinks large quantities of beer, water, &c. January 18th, 1847.-He has been ill three days. His wife applied to me yesterday, and from her description of the case, Aconite was prescribed, to be taken every four hours. On visiting him to day, he presents the following condition:, he is stretched out on his back at full length;.his head thrown back as far as possible over the pillow; the eyes shut; he breathes in a sighing, irregular manner; answers questions hesitatingly, and slowly; all these symptoms, together with coldness of the surface and slow pulse, indicate great depression of the nervous power. The only pain he feels is in the pit of the stomach, where he cannot bear the least pressure without flinching and crying out. He loathes food, and there is nausea with everything he swallows: even a little cold water, for which he craves, causes much pain; he has vomited once to day: his tongue is very white, large, and coated: urine deposits a thick sediment. Take Nux Vomica 12, every four hours. 19th.-Some, though not a great deal of amendment: pain in the pit of the stomach nearly as severe; not so thirsty; nor so much nausea. Take Arsenicum 12, every four hours. o 106 INFLAMMATION OF THE STOMACH. 20th.-Great improvement. He scarcely feels the pain in the stomach: the nausea has ceased. Continue the medicine. 21st.-Still mending rapidly. No thirst, or headache, or nausea: takes light food, and feels stronger and better in every respect. 22nd.-He is so well as to require no further attendance. CASE III.-H. B., aged 32 years. A baker by trade. March 13th, 1847.-Has been ill nine days, and during the whole time, under Allopathic treatment, for "liver complaint and bile." Finding no relief, but on the contrary getting rapidly worse, he is induced to consult the writer. He has taken much medicine, which has purged him violently, and he is now in a pitiable state of debility; he cannot stand without tottering; his breathing is short and panting: speaks in broken sentences; his lips quiver and look ex-sanguine; keeps himself in a bent posture, on account of the pain he experiences in the stomach, if he attempts to stand upright; there is also excessive tenderness in the same part, on the least pressure; every thing swallowed causes excruciating pain, and is instantly vomited; he is distressed by parching thirst, which he dares not quench. His tongue is red, wide, hollowed, and dry as a chip. His pulse is rapid and small; he is harassed by a little sympathetic cough; his head feels stupid and confused. Take Aconite 12, and Arsenicum 12, alternately, every four hours. 14th.-Altogether wonderfully relieved. He has not vomited since the first dose of medicine; is less parched; tongue moist; very little thirst; slept well last night for the first time during his illness; the pain in his stomach is already much mitigated. Continue the medicines. 15th.-Still mending most satisfactorily. Continue Arsenicum, three times a day. 17th.-So much better as to be able to take some boiled fish for dinner. 19th.-Rapid improvement: scarcely a trace of disease. Take a few doses of Nux Vomica 12. 21st.-He is sufficiently recovered to attend to his business. INFLAMMATION OF THE STOMACH. 107 CASE IV.-A. S., aged 53 years. A very delicate person, tall and thin: liable to a cough of an asthmatical character. The present attack of illness has been coming on three weeks. February 18th, 1847.-Her food, causing intense pain, is rejected the moment it is swallowed. Her " stomach feels like a sore, and burning hot inside;" she cannot bear the least pressure in that part; she has no appetite, and is very thirsty. Her tongue is dry, and coated; pulse small, and quick; skin dry, and hot; she is so Sexceedingly weak as scarcely to be able to raise herself in bed. She is troubled with a severe cough, and expectorates a good deal of phlegm. Take Arsenicum 6, every four hours. 20th.-Quite another woman. No vomiting; no pain; pulse natural; tongue moist; her cough, also, is greatly relieved. Continue the medicine, three times a day. From this date she became convalescent, and required no more medicine. CASE V.-Eliza B., aged 33 years. Has been ill five days. February 14th, 1848.-The least thing taken into the stomach, even a little liquid, causes intense pain, and is instantly vomited. The pain extends from the pit of the stomach through to the back. It is felt also under the right breast: she coughs, and spits a good deal of thick, blue-looking stuff. Her bowels are much relaxed, with pain and scalding. She is exceedingly weak, having scarcely power to stand. There is general fever, marked by hot skin; quick, small pulse; thirst; and dry, brown tongue. Take Aconite 6, and Arsenicum 12, alternately, every four hours. 16th.-Vomited only twice since I saw her. Very little pain in the stomach; bowels regular; tongue moist; scarcely at all thirsty. Cough and spitting much relieved. Continue the Arsenicum, three times a day. 19th.-No pain, thirst, nor fever. Bowels were a little relaxed yesterday. Take Nux Vomica 12, in the morning. Sulphur 12, at bed time. 22nd.-Quite well, with the exception of a little weakness. China 6, twice a day. Cured. 108 INFLAMMATION OF THE STOMACH. The following case, partaking more of the character of " disordered stomach," than of active inflammation of that organ, is subjoined for the purpose of exhibiting the admirable effect of Homceopathic medicine in correcting such a condition. CASE VI.-W. W., an engineer, aged 44 years. Has been ill five days. January 27th, 1847.-Complete derangement of the digestive functions: nausea; flatulence; loathing of food; thirst; headache; tenderness on the pit of the stomach, and abdomen generally; low spirits; and loss of muscular power. Take Nux Vomica 12, three times a day. 29th.-Feels perfectly well. 109 INFLAMMATION OF THE LIVER., AND JAUNDICE. THERE is a fashion in physic as well as in other things. Witness the lively contest for the palm of public patronage, which for years past has been going on between the liver and the nerves. The latter of the two, younger and more attractive than its ancient rival, reigns supreme in the more favoured circles, and among the gentler sex, whose ailments are almost all interestingly " nervous," and the elegant eau de Cologne, and lavender water, the universal remedies. The former, banished these envied regions, finds a recompense in the greater number of its adherents: it is still the pet of the people, whose diseases continue to be vulgarly "bilious," and their remedies the rude and time-honored blue pill and black draught. Leaving the former of these persuasions in undisturbed possession of its harmless power, I feel bound to protest against the latter, as one of the most mischievous errors that ever invaded the domains of physic. 'This mistaken notion, that all disorders of the digestive organs are "bilious," and to be attributed to the liver, is unfortunately by no means confined to the non-professional public; but, to nearly an equal extent, pervades the opinions, and modifies the practice, of medical men. When diseases were less understood than they are at the present day, professional ignorance found a convenient cloak in being able to give "a local habitation and a name" to an obsdcure ailment, under the indefinite AND JAUNDICE. Iii its acute form, Dr. Watson expresses the opinion of the Allopathic school generally, when he says " blood should be freely taken from the system by venesection, and from the neighbourhood of the inflamed part by leeches. After bloodletting has been duly performed, blisters may be applied to the right hypocondrium," (the region of the liver.) Of the use of Mercury he says, " it should be so administered as to affect the system as speedily as possible." Whatever misgivings the Allopathist may have as to the safety of using mercury in the treatment of some other complaints, of the absolute necessity for its assistance in the cure of the different diseases of the liver, he never entertains a doubt. In his mind, the two are as indissolubly united as the siamese twins; and he would regard a severance of the connection, as inflicting no greater violence upon the ordinance of nature in the one instance, than upon one of the first principles of his art in the other. In the face of a prejudice so deep-rooted as this, we can feel but little surprise that mercury should be even popularly associated with biliousness, sluggish liver, headache, indigestion, pains in the shoulder, and other anomalous symptoms; and less still, that salivation should be prescribed with so much confidence by Dr. Watson, and other authors, in acute inflammation of the liver. Expressing the opinion I have done, under the head of "Csalivation," on the use of mercury, and of "bleeding," in the chapter on that subject, it is almost superfluous to assure the reader that I do not in the smallest degree coincide in the Allopathic plan of treatment just described. We have already sufficiently demonstrated that inflammations of the most acute and dangerous character submit to the action of Aconite, and other appropriate remedies, with a facility quite unheard of as the result of bleeding; and as to the use of 117 INFLAMMATION OF THE LIVER, mercury, though I am quite prepared to admit its great efficacy in many diseases, and in inflammation of the liver among others, I am, at the same time, prepared to maintain, that there are no circumstances which justify its employment in such enormous doses as to produce salivation. These remarks apply with equal force to the treatment of jaundice, which, though for the most part exceedingly obscure in its origin, forms at times one of the complications of inflammation of the liver, and, in Allopathic hands, receives much the same kind of treatment: the difference consisting, principally, in blood being withdrawn by cupping in the side, instead of by the lancet from the arm; and, in addition to the use of mercury, a more free employment of purgatives. Subjoined are the only two cases that have come under my care, within the last three or four years, of what might be considered as acute inflammation of the liver. Jaundice, being a complaint of much more frequent occurrence, has afforded me many opportunities of witnessing the extraordinary way in which it yields to Homoeopathic remedies. Three of these cases are added. CAsE I.-Ann B., a cook in a large house of business. December 4th, 1846.-Ten o'clock at night: she went out yesterday evening in a cold, biting wind, got chilled, was seized with shiverings after her return home, and is now in bed, exceedingly ill. She complains of severe pain in the right side, immediately in the region of the liver. Pressure, coughing, and deep inspiration aggravate the pain, which extends also round towards the back, and forward to the pit of the stomach. There is constant vomiting; much thirst; dry mouth; hot skin; rapid pulse; and intense headache; bowels confined. She has been under medical treatment twelve hours, and half an hour before I saw her, took a dose of aperient medicine, which was instantly rejected by the stomach. Prescription: Aconite 3, every three hours. AND JAUNDICE. 113 5th.-At noon: there has been no return of sickness; passed a bettyr night; pain much the same, though the febrile symptoms have abated considerably. Bowels relieved twice. Take Aconite, as before, and Bryonia 3, alternately, every three hours. 6th.-Amendment. Still a good deal of pain, and general high action. Continue the medicines. 7th.-Better: but still the symptoms are obstinate. There is pain, tenderness, and fever. Aconite, and Belladonna 3, alternately, every four hours. 8th.-A remarkable change for the better. She is entirely free from pain; can bear considerable pressure, and motion, with ease. Has little or no thirst; tongue moist; pulse subdued; skin cool; bowels moved once. Aconite, at longer intervals, and Belladonna, at bed time. 9th.-Seized last night with increased pain in the anterior edge of the liver. On examination, that organ is found much enlarged, and reaching down- a considerable distance below the ribs; presenting to the touch, a hard, flat surface. There is more fever, and quicker pulse. Take Aconite, and Mercurius 6, alternately, every three hours. 10th.-Pain scarcely felt. Can bear pressure; fever subsiding. Continue the medicines. 1lth.-No pain at all; enlargement already diminished; bowels act regularly. Take Mercurius 6, twice a day. 12th.-Quite convalescent: no pain; enlargement scarcely to be detected; no thirst; skin, pulse, and tongue, healthy. Takes light food: has left her bed. Continue the Mercurius two days longer, at the end of which period she was well. CASE II.-G. D., aged 38 years. A dark, stout, plethoric woman. Has been for several years accustomed to indulge rather more freely in the use of potent drinks, than the strict rules of P 114 INFLAMMATION OF THE LIVER, propriety would prescribe as consistent with the female character. The unfortunate consequences have been a gradual enlargement of her liver, and repeated attacks of bilious vomiting, and the loss of blood from the bowels. For these she has taken, at different times, considerable quantities of mercury; been bled, leeched, &c., &c. October 30th, 1847.-Twelve hours ago she was attacked with decided and severe symptoms of inflammation of the liver. That organ now occupies nearly the whole of the right side of the abdomen-its lower edge being clearly definable-and its outer surface presenting to the feel a flat, hard, board-like substance. The whole of this region is exceedingly sensitive to the least pressure. She is feverish; hot in skin; very thirsty; much nauseated; and vomits frequently. Her pulse is rapid; tongue foul; breathing quick and short, being impeded by a sharp, cutting, pain in the side. Take Aconite 3, every two hours. 31st.-The constitutional symptoms all abated. Less fever, heat, and thirst; no vomiting. The liver is still very tender on pressure, and inspiration is painful, and attended with a severe stitch in the side. Take Bryonia 3, every four hours. November 1st.-The side, though still very uncomfortable, is greatly relieved; and in other respects, also, she is much better. Bearing in mind her previous habits, I prescribe Nux Vomica 6, three times a day. 4th.-The liver is entirely relieved of active disease, and has sensibly diminished in size. There is but little discomfort experienced, even on firm pressure. The urinary apparatus has now put on an unhealthy action-her water is nearly suppressed, and what little does pass, is of a blood-red color; but as these symptoms do not, strictly speaking, form a part of the disease we are now considering, I will not enter into the details of the subsequent progress of the case, beyond the statement that the disorder of the kidneys, as well as a considerable amount of dropsy in the feet and legs, yielded under the action of Cantharis, Mercurius, Digitalis, Nux Vomica, and Sulphur. The first two of the following cases of jaundice, were AND JAUNDICE. 115 evidently connected with chronic inflammation of the liverii the others, the cause was less obvious. CASE III.-S. W. D., a porter, aged 25; a very temperate person. SMarch 23rd, 1847.-Has had a cold and cough, and felt languid and poorly for a month past. During the last week has suffered from a fixed, dull, pain in the right side, just under the edge of the lower rib. It is increased on breathing deeply, coughing, or moving suddenly. His pulse is small and quick; appetite bad; is thirsty; has hot skin, and headache. Urine the color of coffee; bladder a good deal irritated. Take Aconite 3, directly; then Mercurius 6, every four hours. 24th.-The white of the eyes, with the skin of the whole body, but more especially of the hands and face, have become of'a bright yellow color; he is much nauseated; the bladder is still very irritable, but the urine not so high colored. Cantharis 6, directly; then Mercurius, as before. 25th.-Better: not so much vesical irritation; skin very yellow; pain in the loins; bowels confined. Take Nux Vomica 6, every four hours. 27th.-Great amendment. The yellowness of the skin and eyes nearly all disappeared; feels altogether lighter, as though a load were removed from his system. The bowels have acted freely. Urine better color; tongue, before thickly coated, is now becoming quite clean. 29th.-Scarcely a trace of disease. He takes one more supply of medicine, and is cured. CASE IV.-James Mc S., an engineer. April 24th, 1847.-Has felt poorly, lanquid, and weak, several days. To-day, a distinct yellowness shows itself in the eyes, and skin of the forehead; there is a feeling of weakness in the pit of the stomach, and a dull, heavy pain, increased on pressure, in the right side, in the region of the liver. He has no appetite, and feels sick after taking anything. His tongue is white, and coated; the bowels are confined, and the urine a deep red color. Take Nux Vomica 12, three times a day. 116 INFLAMMATION OF THE LIVER, 26th.-Some melioration in his feelings; bowels moved; evacuations clayey. Take Mercurius 6, three times a day. 30th.-Greatly better in health. The bowels act regularly and healthily once a day; his appetite is returning; tongue clean; still a faint tinge of yellow. Talks of resuming his work. Take Nux Vomica, twice a day. He required no further attendance. CASE V.-George S., aged 25. June 28th, 1848.-Has been ill ten days, and under medical care a week. Has had a blister to the pit of the stomach, and taken pills, salts and senna, &c. This treatment appears to have weakened him considerably, but to have made no impression upon his complaint. He is now labouring under constant nausea, and occasional vomiting; aching in his limbs; severe oppressive headache; pain in his loins; langour; thirst; his tongue is white and coated. The skin of the whole body is as yellow as a guinea. Take Hepar Sulph. 12, every night. Nux Vomica 12, twice a day. July 1st.-Skin already much clearer. The eyes and forehead, previously the most deeply impregnated with bile, are nearly of their natural color. There is merely a yellowish tinge about the upper and outer parts of the face. He feels greatly better in himself: there is no nausea, sickness, or heaviness in the stomach; his tongue is getting clean, and he has an inclination for food. Continue the medicine. 4th.-Feels perfectly well, with the exception of some debility, and is anxious to resume his employment. Take two or three doses of Sulphur. Cured. CASE VI.-Eliza B., aged 3 years. September 26th, 1848.-The disorder has been manifesting itself two or three days, and the whole body is now of a bright yellow color. She is constitutionally unwell-being thirsty, and feverish; complaining of pain in the pit of the stomach, loss of appetite, AND JAUNDICE;. 117 headache, &c. The evacuations from the bowels are white and clayey; the urine as dark as mahogany. S Take Aconite 12, directly. After six hours commence Mercurius 12, and repeat it three times a day. 29th.-Better in health, spirits, and looks. Continue Mercurius. 30th.-The yellowness has entirely disappeared; her appetite has returned; her bowels act regularly and healthily; and in every other respect she appears perfectly well. Cured. I have retained records of several other cases of the same kind, occurring in children as well as in grown-up persons. They all yielded quite as readily as the foregoing, which are related, principally with a view of showing how totally unnecessary are leeches, blisters, purgatives, and above all, salivation, to subdue affections of the liver. 118 INFLAMMATION OF THE BOWELS. BY this term is understood inflammation, not of the lining or inner membrane of the bowels, but of the peritoneum, or that membrane, which, forming their outer covering, is also reflected upon the inner walls of the abdomen. In this respect, as well as in the nature, symptoms, and termination of the disease, it presents a close resemblance to pleurisy. In both, the structures attacked are analogous; the pain which accompanies them, is, in both instances, of a sharp, cutting, burning character, and, in movement of the part, is increased to an excruciating degree; each disease, unless checked in its early stage, is liable to terminate in effusion: producing, in the one instance, hydrothorax, or water on the chest: in the other, ascites, or dropsy of the abdomen. Here the parallel ends. Going hand-in-hand to the bedside of the patient, it is there that Allopathy and Homceopathy separate, and their antagonism begins. The former encounters these diseases with the lancet, the leech, and salivation: the latter, with her gentle dose. The difference between these two modes of treatment is too palpable to need ffurther description. The difference between their results is as great. The old system regards inflammation of the bowels as one of the most dangerous diseases it has to. treat: it is certainly one of the most fatal. The Homoeopathist, though equally alive to its rapid course, and disastrous INFLAMMATION OF THE BOWELS. 119 issue if it be allowed to proceed unchecked, is conscious of possessing the means of arresting its progress so certainly and effectually, that in moderately recent cases, he has no doubt of a favorable result; and even in the most neglected and desperate, is not without well grounded hopes of success. CASE I.-Mrs. E. B., aged 24 years. July 4th, 1847.-Though not robust, she represents herself as being an inflammatory subject; having previously had two similar attacks, for both of which she was freely leeched. Eight hours ago she was seized, after a severe rigour, with a burning, cutting pain in the middle of the abdomen, shooting through to the back. This pain is much aggravated by coughing, breathing deeply, pressure, or the least attempt to move from her present position. Her pulse is exceedingly rapid; skin burning hot; is very thirsty; and has severe headache. Aconite 3, every two hours. 5th.-Wonderfully better. She has little or no pain in the abdomen, except on firm pressure, and in sitting up in bed. In other rsepects she feels, as it were, well; she has no thirst; her tongue is moist; skin cool; pulse 90; no headache. Mercurius 6, every four hours. 6th.-Perfectly well. Intends getting up to tea, and hopes to resume her business in a day or two. She received no further medical attendance. - CASE II.-Mr. E., aged 23. A shopman, occupied from early in the morning, till late at night. Naturally delicate and ailing. May 1st, 1847.-Has felt pains in his abdomen, at times, for several days past: they got worse yesterday, and to-day his sufferings have increased to such a degree as to compel him to relinquish business. He is now very ill: complaining of a severe, cutting, burning pain, in the upper part of the abdomen, particularly on the right side. It extends, also, upwards to the pit of the stomach: these parts are so exquisitely tender that he draws himself back at INFLAMMATION OF THE BOWELS. 121 a'piece of board; the skin is hot and moist. Her head aches, and is dizzy when she lifts it from the pillow. Take Aconite 3, directly, and repeat it in twelve hours: in the interval, Mercurius 6, every hour. 23rd. Mending rapidly, in every way. Continue Mercurius, every two hours. The Aconite as before. 24th. The inflammatory symptoms have almost entirely disappeared: that is to say, she can bear pressure over the former seat of pain, without flinching; can sit up in bed, and cough, and move, without inconvenience; but there is some uneasiness in the abdomen generally, passing from one part to another, evidently arising from flatulence. To relieve this she has Sulphur 6, every four hours. May 3rd.-She visits me at my house, apparently well, and complaining only of a little weakness. Take China 3, twice a day. Cured. CASE IV.-Mrs. R. R., aged 46 years. A little, spare, delicate woman; has very bad health, being much debilitated by repeated attacks of internal hemorrhage, from one of which she suffered ten days ago. April 21st, 1847.-Yesterday afternoon she was attacked by severe pain in the lower part of the abdomen, of a fixed character, but increased at times to an agonizing degree. She lies on her back with legs and knees drawn up; cannot move, cough, nor breathe, without great aggravation of her sufferings. Her pulse is 120, and small; skin hot and dry; tongue parched; has incessant thirst, and confused headache. Take Aconite 6, every four hours. 22nd.-Aggravation of all the symptoms: alarmingly ill. Take Aconite 3, and Belladonna 3, alternately, every hour. 23rd.-Decided relief after the first dose of Belladonna; and the improvement has been progressive up to the last half-hour, when there was some return of sharp pain, which I do not however regard as of much importance, since, in every other respect she is greatly better. She can now bear a considerable amount of pressure on the abdomen; her pulse is only 95, and beating softly; Q 122 INFLAMMATION OF THE BOWELS. the skin perspiring; thirst much reduced; tongue moist. Had a comfortable, refreshing sleep, in the middle of the night, during which she perspired profusely. The bowels have acted twice. Continue the Aconite; and take Mercurius 6, (instead of Belladonna,) both at longer intervals. 24th.-She is comparatively well. She experiences no pain or inconvenience from pressure or movement; there is simply a little aching, produced by the shaking of a cough, with which she is at times troubled. The pulse is 70, soft, and compressible; there is no thirst, heat, headache, or other constitutional disturbance; she takes light nourishment; is to remain in bed a day or two, and Continue Mercurius at longer intervals. 26th.-Sent to report herself so well as to need no further attendance. 123 BOWEL COMPLAINTS.-CHOLERA. THE intestines are composed of three layers or coats-the outer or serous; the middle or muscular; and the inner or mucous membrane. All these tissues are liable to be attacked by diseases which are determined in their character, by the peculiarities of these several structures. Thus, -the outer coat is affected almost exclusively by inflammation: it constitutes the painful and dangerous disease we have just been considering, under the general term of "inflammation of the bowels." The middle or muscular coat, on which the motion of the bowels depends, is not so liable, as the other two, to be independently diseased, but is apt to become sympathetically implicated in other intestinal disorders. The affections belonging to this structure are, as might be expected, chiefly spasmodic:-such as colic, and spasms of the bowels, &c. The inner or mucous coat, devoted to digestion and nutrition, is also liable to be attacked by diseases, corresponding in number, and the peculiarity of their symptoms, to the structure of the part, and the important and complicated function it has to perform. These diseases are chiefly comprehended in the collective term of "bowel complaints," and include the three we are now about to notice, viz.:-Cholera, Dysentery, and Diarrhoea. Attended constantly by relaxation or purging, and merging into each other by almost insensible gradations, there are yet some leading symptoms peculiar to each of these diseases, by 1.24 BOWEL COMPLAINTS.-CHOLERA. which they may be distinguished from each other, and in accordance with which they have received the names above mentioned. Without stopping to enter into a minute detail of their respective limits, we proceed at once to the consideration of the most important, as well as the most interesting of the three, namely, CHOLERA. The fears of the public have been too recently excited afresh by the threatened re-appearance of this disease, to render necessary any description of the consternation which reigned, as well in the professional, as in the non-professional mind, when that terrible scourge visited this country sixteen years ago. Those fears, on both occasions, originated, not so much in any particular horror of the disease itself, (than which there are many more painful,) as in the acknowledged inability of medical men to encounter it successfully. There existed then, as there now exists, the utmost diversity of opinion,: both as to its real nature, and the best mode by which it should be treated. If there be any doubt of the correctness of this assertion, let the periodical and other publications of the two periods,bear testimony to its truth. Those publications teemed with suggestions, so inconsistent and contradictory, that no two out of the number could be found to correspond: on the contrary, each successive writer appeared to think that the strength of his claim upon the confidence of the public, increased in proportion to the novelty of the remedy he suggested. Referring back to the period when the cholera raged in England, we find that expedients the most absurd, and till then unheard of as remedial agents, were propounded and adopted, on no better grounds than the whim or enthusiasm of the inventor. A universal and simultaneous quackery pervaded the whole profession. Having no experience to guide them, nor fixed principles of action to fall back upon, medical men gave their remedies, they knew not why or BOWEL COMPLAINTS.-CHOLERA. 125,wherefore; but like persons fighting in the dark, struck here and there at random, impelled by the desperate hope of deal"ing their enemy a chance blow. I was informed by a gentleman, who was, at different times, resident medical officer at two of the temporary hospitals fitted up in the metropolis for the reception of cholera patients, that, after the very first stage of the disease had passed, no kind of treatment whatever appeared to be of any service in arresting its progress. Every conceivable form of remedy was administered, in the most extravagant doses-in short, the utter hopelessness of doing any good, seemed to be regarded as a licence for trying all sorts of experiments upon the unfortunate sufferers. The result was worthy of the treatment: thirty out of the first thirty-three patients admitted into one of the hospitals were taken out dead. This statement is corroborated by high authority. Dr. Elliotson, who was at that time physician to St. Thomas's Hospital, and who, in giving the following account of his own success in the treatment of cholera, may fairly be regarded as speaking for the profession at large, says,-" As respects this country, I cannot but think that if all the patients had been left alone, the mortality would have been much the same as it has been. If all the persons attacked with cholera had been put into warm beds, made comfortable, and left alone,-although many would have died who have been saved,-yet, on the whole, I think the mortality would not have been -greater than after all that has been done; for we are not in the least more informed as to the proper remedies, than we were when the first case of cholera occurred;-we have not been instructed in the least, by those who have had the disease to treat. Some say that they have cured the disease by bleeding; others by calomel; others by opium; and others, again, say that opium does harm. No doubt many poor creatures died uncomfortably, who would have died tranquilly if nothing 126 BOWEL COMPLAINTS.-CHOLERA. had been done to them. Some were placed in hot water, or in hot air, and had opium and calomel, and other stimulants; which, altogether, were more than their system would bear, and more than would have been borne if they had been so treated even in perfect health. I am sorry to say that of the cases I had to treat, the patients nearly all died. I tried two or three sorts of treatment. Some had opium and calomel, in large and full doses; but they died. Hot air was applied externally; and I got two to breathe hot air. It was found vain to attempt to warm people by hot air applied externally. They were nearly as cold as before; we could not raise their temperature; and, therefore, I thought of making them breathe hot air; but both patients died about the period that death usually takes place. It was said that saline treatment was likely to be of use, and I accordingly tried it on some patients; the result however was the same." That such a state of uncertainty and bewilderment, is a disgrace to a system of medicine which boasts of the accumulated wisdom of ages, no one will deny. That it is an irresistible proof of its insufficiency to accomplish the ends which a system of medicine should accomplish, is equally evident. There is no fact in the history of diseases better established than this-that they are constantly undergoing changes in their type and character, and presenting new phases. Any system of medicine which does not supply instant and ready adaptations to these changes, if not entirely useless, is, at least, lamentably imperfect. This is precisely the case with the old-school of physic. No sooner does a disorder, new to us, like that now under consideration, make its appearance, than medical men, rendered powerless by surprise and uncertainty, cry out, hold! We are not ready-we want time to reconnoitre-to study the nature and peculiarities of our enemy-to find out its weak and unguarded points, and experiment upon the best mode of making our attack! But BOWEL COMPLAINTS.- CHOLERA. 127 disease, when it comes in such terrible shape, is an impatient and inexorable foe, and the man who is not ready armed, and prepared to dispute its progress, must abide the consequences of his remissness, from whatever source it may spring. Since, then, the old system of medicine fails at such a juncture, is there, it will be asked, any other which does supply these ready means of encountering successfully, and on the instant, a comparatively unknown and powerful disease? We unhesitatingly reply in the affirmative. As has been before observed, Homoeopathy possesses that property which constitutes the very life and soul of a system of medicine-without which, indeed, it were a prostitution of the term to call it a system, viz.:-universality. This property is never more strikingly apparent than when brought to bear upon a new disease: and for this simple reason-that no delays are required for the purpose of experimentalization. It is one of the fundamental points of the Homoeopathic doctrine, that we must become acquainted with the powers of medicines, by testing them upon the healthy body, before they can be properly applied to the removal of disease. Possessed of this knowledge, the physician, encountering any disease, whether for the first time or not, corresponding in its symptoms with any medicine previously so tested, entertains no doubt as to the perfect adaptation of such remedy to the removal of such disease. A more forcible illustration of the truth of this simple, yet comprehensive, principle, could not be wished for, than is afforded in the following interesting fact,-that Hahnemann, whilst the cholera was yet at a distance from Germany, and long before he had an opportunity of seeing and treating a case of that disease, but merely from description of its symptoms, selected from his materia medica, those very remedies with which the Homoeopathists afterward combated the disease so triumphantly. It is proved by statistical calculations, drawn from Govern 128 BOWEL COMPLAINTS.--CHOLERA. ment reports, and other unquestionable authorities, that whereas nearly fifty out of every hundred cases treated Allopathically, ended fatally, only twelve per cent. were lost of those which were treated according to the new system. At the period to which we are referring, Homoeopathy was a stranger to England. Since then, (to use a homely phrase) we have become "better acquainted;" and the stubborn fact that it is capable of grappling successfully with the giant foe, has been placed prominently before the public.* With no other evidence to rest upon than that which these statements supply, it would be impossible to doubt, should the disease again rear its hideous form to fright us from our propriety, that our greatest security under its attack will be found to consist in a prompt resort to Homoeopathy. But I have other grounds of confidence. My own experience.inclines me to the belief, that we have never, for any length of time, been entirely free from cholera, since its visitation in 1833. At intervals, during the last two years especially, isolated cases have come under my care, differing but little, if at all, from the true Asiatic type Two or three of these cases are recorded below; and I am mistaken if the reader, after perusing them, and observing the all but magical effect of the remedies employed, will not join with me in the conviction I feel, that, with the Homoeopathic remedies in our hands, we need no longer despair, even at the approach of cholera. Since the foregoing remarks were penned, the cholera, in its old malignant form, is said to have reached our shores; to have made its appearance in several different localities; * Various Papers on the Homceopathic Treatment of Cholera, by Drs. Dudgeon, Black, Laurie, &c., &c. BOWEL COMPLAINTS.-CHOLERA.1 129 and among other places, to have visited the metropolis. Not disputing the correctness of these reports, it appears certain, that, as far as London is concerned, the disease has not yet raged as an epidemic; and, indeed, to admit of some doubt, whether it has prevailed much more extensively this autumn, than at the corresponding period of previous years. I have had occasion to treat two or three cases of what authorities on the subject would doubtless designate as Asiatic cholera, but which, like those I have before mentioned, would have passed without exciting any particular notice, but for the existence of those circumstances which just now invest the disease with prominent interest. With the exception of one unfortunate case which had been neglected twelve hours, and was moribund when I saw it, they all yielded to treatment Swith a readiness which completely confirms the opinion I have already expressed, concerning the power of Homoeopathic remedies in controlling the disease. I would close my observations here, but that there is one point, in the modern Allopathic plan of treating the cholera, of too much interest to be passed over in silence-I allude to the almost exclusive partiality lately displayed for purgatives and emetics. This acknowledgement of the beneficial action of these medicines, even when administered in large doses, in a disorder, the leading characteristics of which consist in purging and vomiting, is an open admission-unintentional and accidental, it is true, but on that account the more valuable-of the fundamental truth of the Homceopathic doctrine. In this we have an additional proof of a fact, familiar to every Homoeopathist, and easily demonstrable to any one, viz.:that whatever is really valuable in Allopathy, may always be traced to the leaven of Homoeopathic principles. BOWEL COMPLAINTS.-CHOLERA. 131 CASE II.-M. D., aged 59. A compositor; a tall, thin man, generally in the enjoyment of pretty good health. August 28th, 1847.-Having partaken of a simple, light dinner, and resumed his occupation, was seized about two hours after, quite suddenly, with the most deadly vomiting and purging. He hastened home; and being summoned in great haste to visit him, I find him at half-past five reduced to a fearful state of prostration. The action, both upwards and downwards, continues unabated. It is almost incessant, the egesta being amazingly large in quantity, and consisting of a thin, watery liquid, like gruel. The purging is attended with violent griping pains, and a sensation of " dying faintness." His pulse is exceedingly rapid, and so small and threadlike, as to be barely perceptible. His voice fails; his features are sharp, pinched, and shrunken; and the face, as well as the surface of the body generally, is pale, cold, clammy, and bloodless. Take, immediately, three globules of Arsenicum of the 3rd power, and one globule every quarter of an hour afterwards. Ten o'clock in the evening.-He is lying comfortably in bed. The purging and vomiting ceased almost instantaneously upon taking the medicine. Violent reaction has succeeded to the previous depression: he is now burning hot in skin; has headache, thirst, and rapid pulse. In spite of all this, he feels comparatively well to what' he did a few hours ago. Take Aconite 6, every four hours. 29th.-The febrile symptoms have entirely vanished, and he feels no inconvenience whatever, beyond some weakness, and slight dyspeptic sensations. Take two or three doses of Nux Vomica. CASE III.-Henry B., aged 16 years. October 7th, 1846.-Seven o'clock, evening. Was attacked this afternoon, about five hours since, with excruciating pains in the abdomen, followed, almost immediately, by the most violent vomiting and purging, which continue to recur at intervals of about five minutes. The evacuations from the bowels, at first like gruel, or dirty water, during the last hour have been composed of pure blood. His skin is covered with a cold, clammy perspiration; his tongue 132 BOWEL COMPLAINTS.-CHOLEP.A. is white; pulse small, rapid, and barely to be detected; has constant thirst. In addition to this, his sufferings from cramps in the legs, arms, &c., are really frightful. He rolls about the bed like a madman, and absolutely roars out with agony. His father and mother, are at this moment rubbing his legs with all their energy, to assuage the pain. Take Arsenicum 3, every half-hour. Ten o'clock at night. Greatly relieved: purging much less frequent; vomiting entirely ceased the last hour; slight cramps; skin warm; pulse fuller. He is now lying quiet, and comfortably covered up in bed. Continue the medicine, every hour. 8th.-Bowels relieved three times in the night, without pain; vomited twice, and still feels some nausea. Take Ipecacuanha 3, every three hours. Resume Arsenicum, if the purging return. 9th.-In the night had a slight return of the attack, which lasted an hour; he is now hot and thirsty. Take Aconite 12, every four hours. 10th.-Convalescent. Pulse good; tongue clean; skin cool. Relinquish medicine, and take light nourishment. Cured. CASE IV.-Mr. F., aged 59 years. A stout, heavy, plethoric person. July 16th, 1848.-Has been unsettled in his inside two or three days. At nine o'clock yesterday he was taken with the most violent vomiting and purging, accompanied by " awful cramps " in the legs, left arm, and both hands. The evacuations were watery and pale, and recurred every few minutes. He was intensely thirstyand his tongue be6ame " as dry as a chip." The extremities were cold-and his hands turned blue, and were covered with a damp sweat. Alarmed at these symptoms, and his sufferings becoming intolerable, his wife sent to me at five o'clock in the morning, when, from the description of his case, I was induced to send Arsenicum 6, to be taken every half-hour. Visiting him eight hours after, I am told that the vomiting and action on the bowels ceased after the second dose of medicine. A BOWEL COMPLAINTS.-CHOLERA. 18833 cup of warm tea renewed the attack slightly-but it speedily subsided. The cramps in the legs and thighs continue to torment him at times. Take Arsenicum 12, every two hours. In the evening. The last named symptom has disappeared. Reaction has set in: he is hot, feverish, and thirsty; and his tongue is dry and brown. Take Aconite 6, every four hours. 17th.-These symptoms have vanished; and he complains simply of flatulence, and a little soreness in the abdomen. Nux Vomica 12, three times a day. Cured. CASE V.-W. T., aged 58 years. A weakly, ailing man at - all times. August 7th, 1848.-Has been ill ten hours. Attacked, suddenly, in the middle of the night with urgent symptoms of cholera: incessant vomiting and purging of a thinr watery liquid; agonizing pains in the abdomen, cramps in the limbs, &c. He took hot brandy and water, and other things, for relief, but found none. Continuing to get worse, he summoned me to attend him at 7 a.m. I found him as just described: labouring also under excessive prostration of strength, with small, almost imperceptible pulse, and cold damp surface. Take Veratrum 12, every half-hour. 8th.-Dressed, down stairs, and sitting in his shop. The purging ceased entirely after the first dose of medicine, and has not returned. He has vomited only once since. Feeling weak and flatulent, To take Nux Vomica 12, twice a day. Cured. CASE VI.-James B., aged 9 years. August 26th, 1847.--Has had occasional relaxation of the bowels and vomiting during the last three days. Early this morning he was taken much worse, and the operation both ways is now almost incessant; the evacuations being very copious, white, and watery. He has much pain in the middle of the abdomen, and the action of 134 BOWEL COMPLAINTS.-CHOLERA. the bowels is attended with a good deal of forcing. He is greatly prostrated: his pulse is small and quick; skin cool; no thirst. Take Ipecacuanha 3, every hour. He got ease from the first dose: the next day was almost welland required no more medicine. CASE VII.-Rose B., aged 9 months. July 19th, 1847.-Constant purging, vomiting, and heaving. The stools like dirty clay-water, and very offensive. She is languid, pale, and fretful. Take Ipecacuanha 6, every two hours: which, without any further aid, removed the complaint, and completely restored the child. CASE VIII.-Emma D., aged 7 months. July 12th, 1847.-She is brought up by hand: a fine child notwithstanding. Seized this morning with incessant vomiting and purging, which continue unabated up to this time. The ejections both ways are slimy and watery, and very copious. She is thoroughly prostrated by the violence- of the attack, lying in a listless, and dozing way on her mother's lap. Take Ipecacuanha 6, every hour, which entirely and almost instantly, removed the disease. BOWEL COMPLAINTS.-DYSENTERY. 137 CASE I.-Mrs. C., aged 54 years. April 24th, 1847.-Three o'clock, p.m.-Was as well as usual yesterday. At two o'clock this morning, without any assignable cause, was seized with pain in the bowels, followed in a few minutes by violent purging; the promptings, up to this moment, are almost incessant, and since ten this morning she has passed nothing but blood; there are violent gripings, and the evacuations are attended with intolerable straining. Her pulse is small and quick; skin cool; tongue dry; she has incessant craving for cold drinks. Take Arsenicum 6, every hour. 25th.-The first dose of medicine eased the pain; the bowels now act but rarely: when they do, she still passes blood. Continue the medicine, every four hours. 27th.-All the above severe symptoms have entirely disappeared. The bowels are now moved two or three times a day. She feels some nausea after taking anything. Ipecacuanha 6, twice a day. 28th.-She is quite well. CASE II.-Mary Ann D., aged 66 years. October 16th, 1847.-This patient has been ailing the last fortnight, and troubled with irritability of the bowels, The last few days she has got much worse, and at the present time is terribly reduced in strength: she reels in attempting to stand; her breathing is short and spasmodic; and she moans with each inspiration, as much from exhaustion as from the pain of her disorder. She is purged every five minutes, passing blood and slime, with a good deal of straining. She has intense pain in the bottom of the abdomen; is exceedingly thiisty; pulse small and rapid; has aching in all her limbs. Take Arsenicum 3, every hour. 17th.-The bowels began to get better an hour after the first dose of medicine, and she has been troubled only four times in the last twelve hours, on which occasions no blood passed. Within the last hour she has vomited five or six times, bringing up nothing but white phlegm. Take Ipecacuanha 6, every two hours. s 138 BOWEL COMPLAINTS.-DYSENTERY. 18th.-Half an hour after the first dose of medicine the vomiting. entirely ceased, and has not returned. The bowels are still slightly relaxed, and feel tender and sore. Take Mercurius 6, three times a day. With this she got perfectly well, and had no further attendance. CASE III.-Mrs. S., aged 60 years. A very weakly, delicate person; much afflicted with Asthma. December 16th, 1846.-Seven in the evening.-Attacked, three or four days ago, with relaxation of the bowels, which has gradually got worse, and the last twenty-four hours has increased to an intolerable degree, causing her to get out of bed thirty times last night; it has continued to be almost as frequent to-day. Severe pain and griping precede the evacuations, which have been watery up to the last few times; since then they have been composed only of blood and slime. She is extremely prostrated in strength; her tongue is parched and dry, and she suffers incessant thirst; her cough is also very troublesome. Take Arsenicum 6, every hour. 17th.-Noon. There has been no action of the bowels since five this morning. She is free from pain, and has only a little soreness remaining. To relinquish the Arsenicum, and take Phosphorus, every four hours, for severe inflammatory action of the lungs and bronchial tubes. She continued this medicine two or three days, and was then quite convalescent. CASE IV.-James R., aged 2 years. A remarkably irritable, fractious, child. May 24th, 1847.-Has been disordered in his inside some time. Yesterday he became much worse-the irritation of the bowels is nearly constant, and attended with violent straining and purgingscreaming, and drawing up of the legs towards the abdomen. The evacuations are small in quantity, and composed principally of slime. He is very feverish, thirsty, and hot. Take Chamomilla 6, every two hours. 25th.-The same; except that there is not so much straining. Mercurius 12, every four hours. BOWEL COMPLAINTS.--DIARRH(EA. 139 27th.-Amendment as regards the general health: not so hot; but the bowel-complaint still continues: the evacuations recurring every half-hour, and being composed of slime, blood, and fleshylooking substance. Take Arsenicum 12, every two hours. -29th.-One hour after commencing the medicine, the child mended wonderfully. There have been only five evacuations in the last twenty-four hours; and those without blood. Continue the medicine, at longer intervals. With this he quite recovered. BOWEL COMPLAINTS.-DIARRH(EA. HAVING given examples in the last few pages of the satisfactory manner in which Homoeopathic remedies subdue the more violent of the bowel complaints, it will not be necessary to devote much time to the elucidation of their power over diarrhoea, or "looseness of the bowels," which is the simplest, and mildest form of that class of diseases. In many cases also, the same remedies that are used with such success in the two former diseases, are equally applicable in the treatment of the latter. Those remedies are very numerous, and require to be varied according to the varying phases which the complaint may assume. I have retained notes of nearly a hundred cases, occurring in individuals of all ages, and presenting an infinite diversity of symptoms. In the removal of 140 BOWEL COMPLAINTS.-DIARRH(EA. these, a great number of different remedies were necessarily employed. Any attempt to exemplify the treatment of all these varieties would be hopeless: it is also uncalled for, since my object is not so much to teach how Homoeopathy should be practised in any particular case, as to show, on a broad scale, what it is capable of accomplishing. We will therefore dismiss the subject with the quotation of a few brief cases: premising, that the ordinary mode of treatment presents as curious a medley as can well be conceived, of purgatives, opiates, astringents, antacids, diaphoretics, tonics, alteratives, mercurials, &c., used in the most promiscuous and fantastical manner, according as the caprice, custom, education, or other impulse of the prescriber, may chance to suggest. There is, however, one point of difference between the two modes of treatment, which must not be passed over quite so cursorily: I allude to the after-effects of the remedies. It is a well known fact that the different preparations of opium form a constant, essential, and, indeed, nearly the only effective ingredient in Allopathic prescriptions for the cure of diarrhoea, and other bowel-complaints. It is equally well "known, that one of the most unfailing effects produced by that medicine, is obstinate constipation. The necessity thus incurred of administering aperients, and the difficulty often experienced in restoring the bowels to a healthy action, constitute the bugbear of the old system of treatment. The patient's troubles do not end where they ought to donamely, with the subsidence of the disease. He has to undergo a second medication to rectify the errors of the first. It is not enough that he swallow the nauseous draughts prescribed for the original disease: he must needs submit to the still more repulsive process of taking castor-oil, pills, rhubarb and magnesia, &c., for the purpose of arousing the benumbed and stupified powers of his abdominal viscera, to a resumption of their duty. 142 BOWEL COMPLAINTS.-DIARRH(EA. green slime, pass very frequently; and it vomits the instant anything reaches the stomach. This exhausting process has been going on the last fortnight, and has reduced the child to its present almost lifeless state. There is some warmth in the skin, and the pulse is slow, laboured, and somewhat full. A globule of Ipecacuanha to be placd on the tongue; and the dose to be repeated every half-hour. Evening. There has been no return of vomiting, and the bowels have been purged only once since the medicine was begun. It now sucks freely, and is altogether quite another child. Take Cinchona 12, every two hours. 26th.-The little creature is wonderfully changed. Its eyes are wide open, bright, and clear; it sits up on its mother's arm, looks about, and takes notice. He slept well last night; there has beer no vomiting; and the bowels have been relieved only once. He appears merely to be troubled with flatulence. Cinchona, every morning. Sulphur every night. 27th.-Comparatively well: cheerful, hearty, and gaining strength every hour. The bowels are quite regular and healthy. The medicines were continued a few days longer-after which it was perfectly restored; to the no small delight of its parents, who, having previously made up their minds to lose their child, looked upon its restoration, almost in the light of a resurrection. CASE III.-Mrs. I.'s child., aged 2 months. August 26th, 1847.-Was fed in the first instance, and afterwards suckled too much. It has had diarrhoea, off and on, since birth, and at length got so seriously ill, that its mother took it to a physician, who prescribed a compound mixture of chalk, tincture of catechu, and bitters; and a small calomel powder, to be taken twice a week.- The use of these medicines was persisted in for a fortnight, when, the child wasting and still getting worse, it came under my care. It was purged six or seven times in the twentyfour hours, and the last three or four days it vomited every thing it took. To have Ipecacuanha 6, every two hours, till the vomiting ceased. 144 BOWEL COMPLAINTS.-DIARRH(EA. o'clock in the morning with the most excruciating pain in the bowels, followed by violent relaxation. He took various domestic remedies to no avail. The action still continues about every halfhour, attended with so much pain as to bend him double, and cause him to cry out with agony. The evacuations are hot and scalding, and followed by painful straining. He is now very weak. Take Colocynth 12, every half-hour. 13th.-Perfectly relieved in two hours. He slept from ten o'clock last night till five this morning, when the bowels were slightly moved once. He now complains only of some soreness in the late seat of pain, and of weakness. Take Nux Vomica 12, twice a day. Cured. CASE VII.-Mrs. C. D.'s child, aged 9 months. November 11th, 1846.-A fine, healthy girl; but her mother not having sufficient milk to support her, she has, the last two months, been fed occasionally on artificial food. During the same period she has been disordered in her bowels: purged about six or eight times in the twenty-four hours. Her evacuations have a slimy, green, appearance, and are passed with a good deal of straining; and she draws up her legs, and cries out with pain. Take Chamomilla 12, three times a day. 16th.-Perfectly well the last two days. 14I'" IMFLAMMATION OF THE KIDNEYS, AND BLADDER. THE members of the old schoof of medicine test the virtues of their remedies only on the sick patient. Besides the consideration, that the period when a person is labouring under disease is the least appropriate that could be selected for making him the subject of an experiment, it must at once be evident, that such a practice can never lead to exact and trust-worthy results; inasmuch as under such circumstances, it is impossible to distinguish between the symptoms which the remedy might originate, and those which belong to the disease. The physician is thus always in the dark as to the pure healing powers of his remedy. This is one source of the confusion and uncertainty which characterize his operations. It is an essential point in the Homoeopathic system, that all medicines should be tested upon the healthy body before they are applied to the removal of disease. By this plan we ascertain, with the utmost precision, the remedial properties of any given substance, and are enabled to foretel what effect it will produce, when administered to a sick person. It was by a process of this sort that Hahnemann first brought to light the Homceopathic law: it is the basis on which it rests; and on which, after years of toil, its illustrious discoverer erected that imperishable monument to his genius and perseverance-his Materia Medica Pura. T 146 INFLAMMATION OF THE KIDNEYS, Another serious obstacle in the path of old physic, is the custom of mixing a number of different medicines together in the same prescription. The disadvantages of this practice are keenly felt, even by the professors of Allopathy themselves. One of them, Dr. Forbes, declares,* " our system is here greatly and radically wrong. Our official formulae are already most absurdly and mischievously complex, and our fashion is to double and redouble the existing complexities. This system is a most serious impediment in the way of ascertaining the precise and peculiar powers of the individual drugs, and thus interferes in the most important manner with the progress of therapeutics. Nothing has a greater tendency to dissociate practical medicine from science, and to stamp it as a trade, than this system of pharmaceutical artifice." With this confession on their lips, these gentlemen, like parents who at length view even the follies of their children with something like admiration, still adhere to a fashion they condemn. This is the more remarkable, as its relinquishment would interfere in no degree either with their principles or practice, beyond the mere simplification of their prescriptions. So inveterate, however, is the habit, that the prescriber can scarcely bring himself, under any circumstances, to its abandonment. Administering only a few drops of laudanum, he cannot trust himself to exhibit it in pure water, but must needs mystify its action by admixture with syrups and scented waters: forgetting that every medicinal substance, however seemingly simple in itself, possesses a peculiar action of its own, differing from that of every other medicine. If this be true (and who will deny it?) of medicines even of the same class-aperients for instance-what good can reasonably be expected from those compounds, which, consisting of * British and Foreign Medical Review. AND BLADDER. 147 ingredients the most contradictory, are intended also to produce effects the most inconsistent-compounds in which cathartics, diuretics, diaphoretics, and expectorants, are either jumbled together in the same draught, or swallowed almost simultaneously in the multiplied forms of pills, mixtures, and powders! If, under such circumstances, the patient has the good fortune to recover, it is clearly impossible to decide to which of the ingredients employed, any benefit he may have derived should be attributed. The Homoeopathist, on the other hand, never administers more than one remedy at a time; and so escapes all that uncertainty and indefiniteness which surrounds, and to a great extent nullifies, the action of Allopathic medicines. The most prejudicial effect of the errors I have named, is the want of faith they engender in the minds of medical men, as to the healing powers of medicines generally. How else ban we account for the remarkable fact, that with two or three exceptions, the Allopathist possesses no single internal remedy to which he dare confide in the treatment of any acute disorder; but in almost every case falls back upon a totally different, and what he considers a more powerful class of agents-bleeding, leeching, and blistering. These remarks are suggested by the almost total want of correct information, which to this day exists among Allopathists, as to the proper action of the Spanish-fly. It is notorious, that notwithstanding their long acquaintance with this drug as a stimulant to the skin, and their familiarity with the fact that when so employed, it is apt to become absorbed into the system, and exert a powerful action on the kidneys and bladder, they never dream of trusting to it, as the Homoeopathist does, as one of the most energetic, speedy, and certain remedies in active inflammation of those organs. Had they made themselves acquainted, by Hahnemann's AND BLADDER. 149 longing for cold drink; having alternate heats and chills; a rapid, small, hard pulse; and troublesome cough. Take Aconite 3, and Cantharis 3, alternately every four hours. 6th.-He is greatly relieved. The pain in his back is much less; urine clearer, and of lighter color, though still small in quantity; fever abated, and very little thirst. Take Aconite twice in twenty hours. Continue the Cantharis as before. With this supply of medicine he quite recovered; and resumed his occupation on the 10th. CASE II.-C. D., a man, aged 36 years. April 30th, 1848.-Ten o'clock in the evening. For the last three weeks has suffered pain around the back and abdomen. He now complains of severe pain in the right kidney; and pressure in that region almost makes him faint. The pain follows the course of the ureter, implicating the bladder, and causing incessant desire to void urine. The last four days this fluid has looked like bloodand is now very small in quantity. He was very sick this morning, and vomited a little blood. Constitutionally, he is also very ill: is weak and depressed, and has an anxious expression of countenance; his head aches; he is very thirsty; and has no appetite. He has been prescribed for by a medical gentleman, but has derived no benefit whatever from the medicine. Take Aconite 3, to begin with; and follow it after a lapse of four hours, by Cantharis 12; to be repeated at like intervals. May 1st.-He got almost instantaneous relief after the first dose of Spanish-fly. He does not complain at all of the pain in his back. He still feels a dull aching in the region of the bladderbut was not under the necessity of relieving it at all in the night, and only twice this morning. When he did so, the fluid was more copious, and lighter in color. Continue the Cantharis, every four hours. 2nd.-The kidney and bladder are free from pain and irritation, the secretion is healthy, and proper in quality and quantity. He is troubled only by some dyspeptic symptoms, for which he has Nux Vomica 12, twice a day. 150 INFLAMMATION OF THE KIDNEYS, 4th.-Well enough to resume his employment. Has a good appetite, and feels only an occasional aching in the stomach and bowels. Take Sulphur 12, at bed time. Cured. In introducing the following cases, illustrative of the Homceopathic action' of Cantharis' in inflammation of the bladder, it may be useful to the general reader to be informed, that whereas in inflammation of the kidneys, the original disease is situated high up in the loins, and the bladder, if at all effected, is so sympathetically; in the cases now to be related, the bladder is the principal seat of disease, and the characteristic symptoms are referable particularly to that organ. They consist mainly, in pain in the lower part of the abdomen; an unhealthy state of urine; and an incessant, and most distressing desire to pass it. CASE III.-Mrs. M., aged about 40 years. February 14th, 1847.-Has been ill four days, with distressing feeling in the lower part of the abdomen, and frequent desire to void her urine; which causes an intolerable cutting pain as it passes, and contains a thick, yellow, stringy sort of sediment. During the last eight weeks she has been troubled with a pain in the lower right side of the abdomen, considerably increased by pressure, and by motion. She is feverish and thirsty; and has lost her appetite. Take Aconite 3, first, then Cantharis 12, every four hours. 15th.-Afternoon. She is much better, having been necessitated to relieve the bladder only three times since early in the morning; the fluid passes much more easily, and looks clearer; she has some pain in the lower part of the back. Continue the medicine. 18th.-The urine is healthy, and troubles her but very little; her general health also is fast improving. Take Sulphur 12, twice a day; with which she got perfectly well, and required no further aid. AND BLADDER. 151i CASE IV.-William N., aged 28 years. February 17th, 1847.-Has been ill a week with pain in the region of the bladder, attended with frequent urging to micturate; the fluid having a thick, milky, appearance, and causing him much pain in its passage. The pain also extends into the lower part of the back, and passes thence down to the thighs and legs. He is very feverish; and has headache, thirst, and loss of appetite. There is no evident cause of the attack. To take Aconite and Cantharis 12, alternately, every four hours. 19th.-The urinary symptoms have entirely disappeared. His head is also much better: but he complains now of pain extending -from the loins upwards to the shoulders-much increased by the warmth of bed, and by motion. He is liable to rheumatic pains, and this appears to be of that character. Take Bryonia 12, three times a day. 22nd.-Well, with the exception of a little headache. Take Belladonna 12, every night. Cured. CASE V.-P. M., a robust man, aged 38 years. December 15th, 1848.-Was seized rather suddenly, a fortnight since, with irritation of the bladder, attended with a heavy, dullpain in the lower part of the abdomen, frequent urging to micturate, and the voidance of small quantities of cloudy urine. These symptoms have continued gradually to increase, until to day they became so intense as to be no longer tolerable: he therefore seeks my assistance. The urine is now muco-purulent, passed almost incessantly a few drops at a time, and succeeded on each occasion by nearly as much pure blood. There is also general excitement of the system, indicated by fever, thirst, &c. There is no gonorrhcea. Take Aconite 6, and Cantharis 6, alternately, every four hours. 16th.-He is astonished at the sudden relief he has obtained. The irritation has nearly all subsided. He has emptied the bladder only three times in the course of the day. The fluid still bears much the same characters, and cuts him, as it has done all along, in its passage. Continue the medicines. 152 INFLAMMATION OF THE KIDNEYS, ETC. 18th.-Little or no irritation in any way. Take Hyoscyamus 12, three times a day. 20th.-Return of most of the symptoms, in a mitigated form. Resume Cantharis 12, three times a day. 21st.-Again progressing most prosperously. The fluid more healthy-occasionally a drop or two of blood. Take Cantharis, twice a day. Nux Vomica, at bed time. From this date the restoration of the bladder to its normal condition was steady and uninterrupted. Interchanged with Cantharis, he took, to complete the cure, Nux Vomica, Sulphur, and Calcarea. 153 INFLAMMATION OF THE BRAIN. MANY of the slighter affections of the brain, giving rise to headache, and other symptoms clearly referable to disorder of that organ, are doubtless of an inflammatory character; but active inflammation of the brain, except as it is originated by, and forms a part of, some other disease, is, in adults, comparatively a rare complaint. The injurious effects accruing from the use of ardent spirits, and resulting in delirium tremens, forms no exception to this remark; for besides that the latter complaint is distinguished by other peculiarities, it is pretty well ascertained to consist rather in irritation, than inflammation, of the brain. In children, again, in whom the disease shows itself most frequently and fatally, it is generally traceable to a sympathetic connection with irritation existing in some other part of the body. How rarely do we meet with a case of water on the brain,. unallied with some disorder in the abdominal cavity? Treated Allopathically, there is scarcely any other disease, in which the abstraction of blood by the lancet, cupping, and leeches, is employed so unsparingly. Whether simple, combined with fever, or arising from external injury, it yields with surprising facility to the action of Homoeopathic remedies. Subjoined are the only three distinct cases of the first of these kinds, that have lately come under my observation. U 154 INFLAMMATION OF THE BRAIN. CASE I.-W. S., a hearty young man, aged 20 years. January 28th, 1847.-He has been travelling in the north of England, on business, and caught cold on his journey home about a week ago. At three o'clock yesterday he was seized with shivering and violent pain in the head. He went to bed, (where he now remains,) took two aperient pills which acted freely. At the present time, 4 p.m., he is in the following state: he lies with his neck stretched out and head thrown back on the pillow, from which position he cannot bear to move. He complains of intense pain in the forehead, over the eyes; he cannot tolerate the least light or noisehis brow is knit, eyes red and angry looking. His skin, especially that of the forehead, is hot and dry; pulse 95, full, and hard; his mouth and tongue are dry, and there is incessant thirst. He has no pain in any other part of the body. He is represented as being liable to "flow of blood to the head "-but never had such an attack as this before. Take Aconite 3 directly; then Belladonna 3, every two hours. 29th.-Morning. Some amelioration-head not so hot and painful; thirst not so urgent; pulse same in frequency, but not so hard and throbbing; skin cooler. Take Aconite 3, and Belladonna 3, every three hours. 30th.-He is quite another creature. He exclaims, on my entering his room, and asking how he does, " I am all right now, sir;" his appearance verifies the assertion. A load seems to have been removed from his brain; his countenance is cheerful and animated, and he sits up in bed and converses without inconvenience. His head is cool to the hand, and he complains of no pain beyond a little jarring over the right eye, caused by a slight cough, with which he is troubled. He slept well last night. His tongue is moist, and he suffers but little from thirst. He has some inclination for food. 31st.-He is up, and dining off boiled fowl. Cured. CASE II.-Mrs. S., aged 67 years. A delicate person, much afflicted in different ways. She is more particularly liable tohead INFLAMMATION OF THE BRAIN. 155 attacks, for which she has been repeatedly cupped, leeched, and 11 blistered. She suffered an attack very similar to that under which she now labours, only not so severe, ten years ago, whilst residing at Oxford, and underwent strong depleting measures for its relief; among others, was the application of a blister to the back of the neck, which was kept open a fortnight. March 7th, 1848.-Her head has not been right for the last week, and for three days past it has got much worse. She is now confined to bed, complaining of a throbbing, and hard, aching pain right through the head, from back to front: light and noise distract her; she can get no sleep, and feels as if she would lose her senses. She sees every thing double: the forehead and top of the head are burning hot to the hand. Her pulse is full and hard, and 100 in a minute; she is very thirsty;-her tongue is foul, but moist. She had a shivering fit yesterday, and vomited at the same time. She has taken aperient. and other medicines, used cold lotions, &c., to no purpose. Take Aconite 3, directly; repeat it in four hours. Then commence with Belladonna 3, and repeat it every four hours. 8th.-Very great amendment. She has no pain in the headher forehead is cool-she can bear light without inconvenience. Her pulse is soft, and only 65 in a minute; skin cool; no nausea. Continue Belladonna. 10th.-Still improving. She complains of some epigastric tenderness, and at times slight confusion in the head. Take Pulsatilla 6, twice a day; and Sulph. 12, at bed time, for three nights. 15th.-She visits me at my house, feeling as well as usual. CASE III.-Jane C., aged 5 years. A delicate, fair, and unusually intelligent child; belonging to a scrofulous family. October 10th, 1847.-Has been under treatment two or three days for cold and cough. Last night she was seized suddenly with a train of the most urgent symptoms: high inflammatory fever; intense headache; burning hot skin; insatiable thirst; rapid and throbbing pulse; quick breathing; pain, distension, and excessive tenderness of the abdomen; extreme prostration. Take Aconite 6, every two hours. 156 INFLAMMATION OF THE BRAIN. Evening.-Much the same; except that the head appears more urgently affected: she buries it in the pillow; shuts her eyes; cannot endure the slightest disturbance or noise; nor the admission of the least light. Alternate the Aconite with Belladonna 6, every tyo hours. 1 llth.-The febrile symptoms, that is to say, the heat of skin, and thirst, and rapidity of pulse, have in some degree subsided. The head symptoms still continue, and are, if anything, more urgent and serious; she starts, and screams; is slightly convulsed with the motion of the eyes; keeps tlhem closed against the light; and cannot bear the least disturbance. Her tongue has a yellow and white coating. Complains of a sharp pain in the right side of the chest. Take Bryonia 3, every three hours. 12th.-- Relief in most respects. Takes notice; chats, at intervals; more tolerant of light; head cooler; side easier; skin moist'; not so thirsty. $ 13th.-In the night the-head became again much worse; and there is now threatening of water on the brain: she lies in a state of partial coma-drowsy, heavy, and lethargic; eye-lids half closed; pupils sluggish; screams and starts, without apparent cause; and rolls her head at times. Urine suppressed. Take Helleborus 6,,every three hours. 14th.-Decided amendment. Less lethargic; more cheerful; head cooler; skin soft and perspiring; pulse mild and soft; she opens her eyes, and chats for a minute or two occasionally, but again relapses into a dreamy state. Continue Helleborus. 16th.-Still further and great amendment as regards the head, which appears to be permanently relieved: but she is now exceedingly weak. The tongue, though moist, is still coated; she has a troublesome cough; and is relaxed in her bowels. Take Rhus 12, three times a day. Continuing the medicine two or three days, then Mercurius for profuse perspiration, and lastly Sulphur, her amendment was rapid, and her restoration complete. 157 HYDROCEPHALUS, OR, WATER ON THE BRAIN. THIS name is apt to mislead as to the real nature of the disease, which is generally believed to be essentially inflammatory:-the dropsy of the brain, from which the name originates, being merely the effect of the previous inflammation. Children are more liable than adults to inflammation of the brain. This is easily explained-the head of the child is very large in proportion to the rest of the body, and receives a proportionately large quantity of blood-the circulation is more rapid, and from the proximity of the heart to the head, the blood is propelled to the brain with greater freedom, if not greater force, than in manhood-the nervous system, of which the brain is the centre, is exceedingly excitable in young persons; and, as in them a very intimate sympathy exists between the different parts of the frame, they are so much the more obnoxious to the exciting causes of inflammation generally, and of the brain in particular. A local pain, which, in older persons, would produce no constitutional disturbance, occurring in a child, will throw the nervous system into a state of dangerous excitement. Hence it happens, that teething, and worms, and other intestinal irritants, so frequently act as the exciting causes of Hydrocephalus. The great fatality which attends this disease, added to the insidious manner in which it often creeps upon its victim, renders it especially incumbent upon those who have the OR, WATER ON THE BRAIN. 159 Such an advance as this in the treatment of one of our Smost intractable diseases, would alone have been sufficient to stamp with celebrity a member of the old school; whilst Hahnemann, to whom alone the improvement is due, continues to be calumniated, because, instead of attempting the patch-work renovation of a tissue of errors, he had the genius to conceive, and the boldness to enunciate-a system. CASE I.-I. W., a boy, aged 2 years, of thin, spare habit, and delicate constitution. April 24th, 1846--Has been prescribed for two or three times since the 15th, having been subject to crying fits, and drawing up his legs, as if pained in his stomach: there was a curious convulsive movement of the tongue from corner to corner of his mouth; he also threw his head back, and turned up his eyes, unnaturally. The principal suffering, however, was referable to his stomach. For the relief of these symptoms he had Chamomilla and Bryonia. This morning unequivocal symptoms of water on the brain manifest themselves, in repeated, unnatural, loud, piercing screams; accompanied by a forcible jerking backwards of the head and -shoulders, which effort partially arouses him out of a drowsy stupor, in which he at other times remains: his eyes are sunk; the eyelids half closed, and the pupils contracted; his head is burning hot; cheeks at times flushed; the rest of the body, especially the legs and feet, cool: pulse rather slow, and labouring; his tongue is coated with thick, white, and yellow mucus; and the papillme are prominent: his bowels act regularly. Take Belladonna 6, and Mercurius 6, alternately. 28th.-Four days later. During the first two days there was little or no amendment; on the contrary, the symptoms seemed to gain ground: he became hot and flushed; there was complete insensibility; dilated pupils; rolling of the head, and other convulsive movements-the same unearthly screams, &c. On the third day Helleborus 6, was alternated with Mercurius; from that time a decided improvement commenced, and to-day there has been no 160 HYDROCEPHALUS, screaming; the head is cooler; the eyes less sunken, and look bright, and intelligent; he recognizes his parents, and understands what is said to him. He still lies on his back, and rolls his head, at times; his tongue is cleaning: his bowels act regularly once a day. Continue the same medicines. 29th.-He has slept soundly for the first time during his illness, without any convulsive movement whatever. His head is of a natural warmth: there is no tossing or rolling; no thirst; he may, in short, be pronounced out of danger. Not to tire the reader with further minute details, it will be sufficient to state, that his recovery from this time was rapid and satisfactory.; and that on the 2nd of May he was sitting up, playing with his toys. He continued the Mercurius for a day or two longer; and then had Sulphur to complete the cure. Medical men will recognise in this sketch, one of those alarming and unpromising cases, in the treatment of which, the ordinary remedies hold out not the slightest hopes of recovery. CASE II.-Henry L., a boy, aged 6 years. September 20th, 1847.-Has been drooping some time: the last week so much so, as to induce his parents to take him to a druggist, who prescribed a powder and mixture. He has now all the -symptoms of brain disease, accompanied by gastric derangement: lies doubled up in bed, his knees drawn up to his stomach; cannot bear the abdomen to be touched; is very drowsy and heavy; and when not disturbed, remains constantly in a stupor, with half-closed eyes, and open mouth, When aroused, and also at other times, he starts and screams out in a loud, piercing cry: lis features are sunk; his mouth and nostrils sore, dry, and. black; his tongue dry, contracted, and thickly coated, brown and yellow; the edges and papille being of a deep red color. The skin of the whole body, more particularly of the head and abdomen, dry and hot. He isthirsty, and has no appetite. His bowels are rather relaxed, and the evacuations unhealthy. His pulse beats 125 in the minute, and is hard, and incompressible. He is harassed by a short, hacking cough. Take Arsenicumn 6, every four hours. OR, WATER ON THE BRAIN. 161 22nd.--Much the same, except that the tongue appears to be! cleaning at the edges, and there is not so much thirst. Cpnt. Arsenicum 6, every four hours. 25th.-The symptoms remaining much the same, with some shades only of amendment, he is ordered Helleborus 6, every four hours. 27th.-Decided improvement. Tongue moist, and clearing rapidly; skin cool; very little thirst; pulse more natural, and soft;,his eyes are clear and bright,, he opens them wide, and looks intelligent, and calm; little or no screaming; and he remains awake nearly all day. He continued the medicine, and in a few days was perfectly restored. CASE III.-G. L., a boy, aged 3 years. June 19th, 1847.-Was taken poorly three or four days ago with disordered bowels, and two evenings since fell into the state in which he now remains; namely, drowsy and heavy in the head, which he hangs back over his mother's arm, displaying the greatest repugnance to being moved or disturbed; his brow is knit and frowning; eyelids drooping; pupils contracted; the eye dull, and inexpressive; his head, as well as the body generally, hot and dry; breathing short; pulse 160 in the minute, and throbbing; is very thirsty; cannot bear the least noise, and avoids the light. His tongue is white and thickly coated; bowels still unhealthy and irregular; he is exceedingly weak, his limbs hang about powerless, and he wastes away. Take Aconite 12, and Belladonna 12, alternately, at intervals of four hours. 20th.-Was delirious the greater part of the night, but this morning is wonderfully improved; his skin is perfectly cool; pulse fallen from 160 to 100. He is not nearly so thirsty. His eyes look heavy, and he still frowns, at times. Omit the Aconite, and continue the Belladonna. 21st.-There is an increase of the stupor; but his skin is still cool; pulse rather labouring. Take THelleborus 6, every four hours. x 162 HYDROCEPHALUS, 22nd.-Very considerable amendment: he is comparatively cheerful and lively, and asks for food, which he has hitherto loathed. His tongue is cleaning fast; he has very little thirst. Continue Helleborus. From this time he appeared to recover perfectly; took his food; ran about the house; slept well; and complained of nothing but an occasional headache. On July the 2nd.-He was brought labouring under a temporary relapse: feverish; heavy in head; and frowning. Take Bryonia 3, every four hours. 3rd.-Greatly relieved in every respect. He had another supply of medicine, under the influence of which he got quite well. CASE IV.-M. A. M., a girl, 2N years old. June 17th, 1847.-Has been falling off in health for some time past. Three nights ago, whilst in bed, was very hot and feverish, and poorly the next day. Yesterday she became very ill indeed, lying about the room, complaining of headache, and referring all her suffering to that part. She is now drowsy and heavy; eyelids drooping; eyes sunk deep in their sockets; mouth closely puckered up; cheeks flushed; head and the rest of the body dry and hot; pulse quick and throbbing; tongue coated white, with red projecting papille; she is very thirsty; her breathing is quick, and there is some bronchial cough; the bowels are quite regular. She avoids the light, and is distressed by the least noise; she starts suddenly from her sleep, and screams, as if frightened. Take Aconite 12, every four hours. 18th.-No amendment. Still drowsy; screaming and starting constantly; hot and thirsty. Take Belladonna 6, every two hours. 19th.-Wonderfully relieved: fever and thirst greatly diminished; slept well, and only required a little drink twice in the night; no screams or starts; her tongue is cleaning; the child looks placid and intelligent; she sat up in bed this morning, and chatted to her father. Continue Belladonna, three times a day. OR, WATER ON THE BRAIN. 163 22nd.-Still much better-indeed all but well. She continued her medicine a few days longer; and without the recurrence of any untoward symptom was perfectly restored. CASE V.-E. B., a girl, aged 7 years. January 17th, 1848.-From the description given of her previous health, she has evidently been falling off for some time past; she is now labouriig under premonitory symptoms of Hydrocephalusthe most urgent being referable to the bowels, which are much relaxed, and otherwise in an unhealthy condition. Take Mercurius 6, three times a day. 19th.-Considerably worse: stupid, heavy, lethargic; starts and screams; is hot in head, feverish, and thirsty; her tongue coated -brown, and dry. Take Belladonna 6, every four hours. 22nd.-Still worse: perfectly lethargic,-and unconscious of every thing; she screams and starts terribly; rolls her head; lips, tongue, and teeth, black and dry, and covered with thick, hard, offensive matter; pulse very rapid; skin and head very hot. Take Helleborus 12, Rhus 12, every four hours, alternately. 24th.-Decided improvement in all the symptoms: lips and tongue moist, and cleaning; more quiet and intelligent, and no screaming. Continue the medicines. 26th.-Progressive amendment: tongue and lips clean; head, and Skin generally, cool; bowels act-healthily: she wants food. Continue Helleborus. 29th.-Doing exceedingly well in all respects: sits up in bed, takes notice, and plays with her toys; tongue clean; bowels regular; no thirst; sleeps soundly. Take a few doses of Sulphur. February 1st -Cured. 164 DELIRIUM TREMENS. OF all the vices which meet with their punishment on this side of the grave, there is none to which is attached so sure and ready a retribution as to drunkenness. Decay of health and fortune are its first fruits; and if the wretched devotee be permitted to pass the summer-time of life, premature decrepitude of body, and imbecility of mind, are his autumn gatherings. There is yet another fate that may await himdeath, impatient of his prey, may claim his victim in his midcareer. If he do so, the instrument with which he commonly strikes the fatal blow, is delirium tremens. Though not invariably the result of over indulgence in spirituous drinks, it is so in so large a majority of instances, as to have obtained for it the popular name of the "drunkard's disease." A more awful malady can hardly be conceived. Its most striking symptoms, as its name implies, are delirium, and trembling. The latter shows itself chiefly in the hands; the patient being unable to hold any thing steadily. To give a description of the delirium, would be to depict all the horrors which the human mind, robbed of its reasoning powers, is capable of enduring. "Objects of the most appalling description sometimes present themselves to the patient's imagination; he will be possessed with the idea that he is persecuted by evil spirits, who are on the point of carrying him away, or are preparing to destroy him; or he may fancy he is surrounded by assassins; and cases are DELIRIUM TREMENS. 165 recorded where the unfortunate sufferers actually expired Swhile exerting themselves to the utmost, to ward off the violence they supposed was intended them. Sometimes the most whimsical notions arise: thus a patient will imagine that rats or mice, or other troublesome vermin, are running over him, or near him; that he is employed in drawing ribands from the ends of his fingers, with numberless extravagancies of a similar nature."* This is a picture of the disease in a severe form; but it presents, itself in every shade of violence, from the slight bodily indisposition, mental depression, and watchfulness, which mark its first stage, up to that point which terminates in raving madness and death. It is fortunate when the medical man's assistance is sought in the earliest stages of the complaint, since it is then that his services are of most avail. When it has been neglected and allowed to become confirmed, especially in habitual drunk. ards, the prognostication is generally unfavorable-always doubtful. The treatment of delirium tremens under the old system, notwithstanding that it appears to have found something like a point of general consent in the use of opium, is nevertheless, in some respects, involved in difficulties. The disease is supposed to consist rather in irritation than in inflammation of the brain. Whilst in some cases the symptoms of the latter state are unequivocal, and in many others it is very difficult to distinguish clearly between those two conditions, in both, bleeding is supposed to be requisite. The difficulty consists in determining when it should be adopted, and to what extent it should be carried. Imagine an inexperienced man called upon to decide this knotty point, with the following passage for his guide. "In young and vigorous subjects, and where there exists evidence of * Dr. 1-I. M. Carter, Cyclopadia, Practical Medicine. 166 SDELIRIUM TREMENS. local determination, a single moderate bleeding from the arm, or the application of leeches to the temples, or behind the ears, may prove useful; but the bleeding should never be large, and very seldom will it be proper to repeat it; while generally speaking, it should be rejected, as a practice which has too often done mischief, and has not unfrequently destroyed the patient."* That man must be endowed with uncommon visual acuteness, who could see his way clear by the light of such a rule; and possessed of more boldness than discretion, if, to obtain the doubtful benefit of bleeding, he would be content to incur the fearful risk attached to that operation. Without decrying the unquestionable power of large doses of opium in this disease, my experience leads me to believe, that all the good which it can achieve, may be obtained quite as effectually, and much more safely, by this and other medicines, in Homoeopathic quantities. It has fallen to my lot to treat eight or nine cases since I embraced Homoeopathy. The two most violent out of the number terminated fatally; but it is a remarkable fact, that in both those instances, from the intervention of Allopathic advice, opium was administered in large doses. In one case the patient fell into a profound stupor, from which he never awoke. In the other-after sleeping for some time, he suddenly roused up, fell back in a convulsive shudder, and expired in a moment. What might have been the result, had the Homoeopathic treatment been continued, it is of course impossible to determine-but this is certain, that up to the time when the change of treatment was adopted, one of the cases was progressing so favorably, as to hold out some hope of a successful issue. * Cyclopaedia, Practical Medicine. DELIRIUM TREMENS. 167 CASE I.-Mr. F., aged 36 years. Dark hair, florid complexion. His occupation leads him to drink large quantities of wine, and other stimulants. March 22nd, 1848.-I received a note this morning, whilst dressing, requesting my immediate attendance upon this patient, who, it was represented, was " awfully nervous, and going out of his mind." I found him in bed, in a state of much excitement and agitation. He had been drinking hard for a week previously; had felt poorly two or three days, and yesterday.was taken very unwell. He has hardly had a moment's sleep the last two nights; he is afraid to close his eyes, for as soon as he does so, he starts up in terror. His look is anxious; and his eye, glistening, quick, and restless; he is constantly jumping up in bed, for no purpose, and suddenly lying down again, being unable to remain in one position more than a minute or two together. His hands tremble like an aspenleaf; his skin is hot, and perspiring; pulse quick, and thumping, but easily compressible; his tongue is white, and foul; and he is very thirsty. He has already taken Calomel and Colocynth pills, saline medicines, and a dose or two of Opium, with no other result than that just described. To remain in bed, and take Nux Vomica 3, every hour. Nine o'clock in the evening.-He relates, that after the, second dose of the medicine, he felt an extraordinary change come over him: all his nervousness vanished as by a charm, and he became perfectly calm and composed. He took some light nourishment, dressed himself, and went out and attended to some business, on which he was occupied several hours. After this he returned to bed, where I now find him, free from excitcment, and to all appearance well. To take two or three doses more of the medicines, at longer intervals. Cured. CASE II.-T. C., aged 50 years. A compositor: dark complexion, irritable temper. May 24th, 1848.-Ten o'clock, night. Has been addicted to Sdrinking many years. In his struggles to conquer this unfortunate propensity, he has several times taken " the pledge," and become a 168 DELIRIUM TREMENS. teetotaller; but, sharing the fate of too many others who contend with a long indulged appetite, he relapsed into his former habits, and is now in the eighth week of his intemperance. He began to feel the ill effects a month ago: became queer and inconsistent in his actions and conversation; irritable, impatient, and unsettled in temper; he lost his appetite; and got restless and disturbed nights. The last ten days, getting more and more lost, he has not been able to attend to his business; and to day is in bed, exhibiting in a severe degree, the symptoms of delirium tremens. He gets no sound sleep-dozing only in snatches of a few minutes at a time, and awaking in " fits of madness." He fancies there are a number of persons in his room, when only his wife is present; at times-he does not know her, and mistakes one person-for another; imagines he is in another place than his own house; is constantly talking about building; sees curious houses moving about his bed room; and betrays other oddities, which it would be useless to name. His pulse is quick and full; skin hot; he is very thirsty; and his tongue is dry and parched. There is not much trembling; but he is exceedingly weak, and his movements are unsteady. Take Opium 3, every two hours. 25th.-Noon. Eight hours after the first dose of medicine, he fell into a sound sleep, in which he remained the greater part of the night, and awoke an altered person: his mind calm and collected; his nerves quiet; his thirst abated; his skin cool and perspiring; and his pulse steady. He got up about nine o'clock, and walked some distance to his office; not to do any business, but for the purpose of" showing himself." His wife asserts that he has not had so good a night as the last, nor been so comfortable in the day, as he is now, for a considerable time past. To live moderately, and take a few doses of Nux Vomica. Beyond this he received no medical attendance. CASE III.-C. J., aged 29 years. A stout, muscular man. May 2nd, 1847.-6 p.m. At intervals indulges to excess, and is always stupid for a day or two after. He got drunk yesterday, and to day has complained of headache, and loss of appetite, and has not been able to go to his work. He has been restless, getting in 170 DELIRIUM TREMENS. 6th.-There has been little or no wandering since yesterday. At eight in the evening there was a slight return of the tremor of the limbs, which lasted half an hour. Take Belladonna 3, every six hours. 7th.-He is quite calm and collected; there is no wandering; he takes food; sleeps well; and is altogether so far restored as to require no further attendance at his own abode. He took Nux Vomica, for two or three days longer; gradually recovered his strength of mind and body; and was discharged. Cured. CASE IV.-W. D., aged 30 years. A shoe-maker. For years past an habitual drunkard. The effects of his intemperance have been gradually developing themselves in tremblings of the hands, unsteady speech, irritability of temper, loss of appetite, and frequent empty vomitings in the morning. January 31st, 1848.-The foregoing symptoms have become much aggravated by "a drunken bout" of several days duration. He is now in a pitiable condition: one seldom sees a man so thoroughly altered in mind and body. He is restless and agitated; twisting and turning about in every direction. He cannot utter a sentence correctly, and his lips tremble as he speaks. A general tremor pervades his whole body; he gets no sleep, and if by chance he drops off for a few moments, he is tormented by horrible dreams. He is confused and dizzy in his head: exceedingly irritable and excitable in temper. He is very thirsty; his tongue is " as dry as a chip," and he is forced to keep it constantly moistened to enable him to speak or swallow. His stomach rejects every thing he takes; and he has an accumulation of phlegm in the chest and throat, which he is unable to expectorate, and by which he fears he will be suffocated. His pulse is small, rapid, unsteady, and compressible. His skin is covered with a clammy perspiration. Take Nux Vomica 3, every two hours; Opium 3, at bed time. The next day, February 1st, he attends at my house, infinitely relieved. He slept pretty well during the night. Has vomited only once, and that slightly; is much more steady in his limbs and hands; and more calm and comfortable in mind. DELIRIUM TREMENS. 171 His tongue is moist, and he is not so thirsty. Pulse more regular, and less frequent, but still small and weak. He has taken a little light food. He continued the remedies two days longer-taking the Nux Vomica less frequently; and left my care better than he had been for a considerable time previously. 172 APOPLEXY. THIS disease is usually divided into two stages, viz.: the premonitory or threatening stage, and the actual seizure. Neither of these is constant. The former may pass off without leading to an apoplectic attack: the latter may supervene without any forewarning. Respecting the predisposing. and exciting causes of these two conditions, and the -exact state of the brain at the time, there is the utmost uncertainty. The fact that it is customary to quote almost every circumstance or condition of life, physical as well as moral, as favoring its development, and the general admission that it may originate equally in the most opposite conditions of the brain, so far from throwing any useful light upon the subject, do but prove that our nearest approximation to the truth amounts to nothing more than conjecture. Under such contradictory circumstances, one would have expected medical men to hesitate before they adopted with unquestioning faith, any particular mode of treatment not regulated by unerring rules; or, at least, to have insured that it should be of such a character, as, if misapplied, it should lead to no injurious results. Yet what is the fact? Why, that the Allopathist, notwithstanding his incapability of determining whether the attack consist in the rupture of a vessel, serous effusion, a congested, or an exhausted APOPLEXY., 173 state of the brain-never doubting the propriety of the step, but almost as a rule-resorts at once to the abstraction of blood. This custom, it is true, has, within the last few years, owing to the spread of more correct views on the subject of apoplexy, received something like a check; yet, from the operation of a variety of causes, so little has this alteration of opinion influenced the general practice, that bleeding may still be pronounced the universal remedy. It must not be supposed from these remarks, which are aimed at the indiscriminate adoption of a routine and hazardous practice, that Homoeopathy, any more than Allopathy, pretends to cure every apoplectic patient; on the contrary, it is well known that there are many cases, (as for example, where, from the rupture of a vessel a large quantity of blood becomes effused and presses upon the brain,) in which all medical treatment must, from a physical necessity, prove unavailing. In an instance of this kind, the two systems, as far as relates to a cure, are on an equality; but as far as they affect the duration of the patient's existence, there is this difference -that bleeding, by its weakening operation, hastens the final catastrophe, while the nature of the Homoepathic remedies renders it impossible that they should ever exercise such a tendency. Again, if the case be not one of effusion, but of debility of the brain, or an enfeebled state of the general circulation, then bleeding, being in no case a cure for such a condition, instead of acting beneficially, can only increase the existing evil. Here also Homceopathy enjoys a decided advantage. Coming lastly to the premonitory or threatening stagethat stage in whiclr medical treatment, judiciously applied, may be really serviceable-the difficulties which attach to bleeding again present themselves. We can at the best only make a guess at the state of the brain, and cannot therefore APOPLEXY. 175r subject, but jproceed at once to detail a fewillustrative cases; first of the threatening stage, and then of the apoplectic attack. CAsE J.-W. H., aged 50. A carman, very steady and temperate in his habits. June 13th, 1847.-Seized yesterday, at two o'clock, whilst loading his cart, with dizziness and staggering, which caused him to hold by a post to prevent falling. He recovered himself a little and attempted to drive, but had not proceeded many steps before he fell two or three times onto his hands, and when he got up could not stand without support. He became confused in his sight, and could scarcely distinguish the road. He has now a general aching in the head, with a sensation of lightness and swimming, as soon as he moves; his forehead is unnaturally hot, his pulse slow and throbbing. He has a little stitch in the right side under the rib; no thirst; tongue moist and clean; bowels regular light causes him no inconvenience. Take Nux Vomica 6, every four hours. 14th-.He is so much better as to be able to walk to my house, a short distance from his own, without assistance. He began to mend in the afternoon, and now has a slight headache with a little dizziness at times. There is also occasionally a singing in the right ear. He has a better appetite to-day; his bowels have acted healthily, and he has no pain in the side. Continue the medicine. 17th.-Much better still, although there is yet a little dizziness when he stoops or walks fast. Feels very weak. Take two doses of China 3, six hours apart; then Sulphur 12, two doses, at the' same intervals. 19th.-He can stoop to tie his shoes; is cheerful; nearly as active as usual; and in other respects, well. Repeat the medicines. 21st.-He has simply a momentary return of swimming, once or twice in the day. Take Conium 6, twice a day. Cured. 176 APOPLEXY. CASE II.-W. D., aged 31. Stout built and florid complexion. He works at a furnace. Is very temperate. He has been liable to dizziness, off and on, for years, and has been bled for it. He has now been suffering a month, and is forced to leave his work in consequence. June 29th, 1847.-He complains of a hard, thumping, plunging pain in the head, attended with dizziness and swimming. He is worse lying down, when everything seems to run round, and he sees sparks flying about before his eyes. His sleep is disturbed and unrefreshing. His appetite lately has been very bad. His pulse is not much accelerated. He thinks bleeding would do him good. Take Aconite 2, directly; six hours hence Belladonna 12, and repeat it three times a day. July 2nd.-Better. He still feels worse in bed, especially on waking; the pain is now chiefly at the back part of the head. Take Bryonia, three times a day. 5th.-Great improvement. He has slept soundly the last three nights. He has no dizziness or swimming, and his eyesight is clearer. He feels very weak, and has still no appetite. Take China 3, once a day. 7th.-Head seems quite right. He feels stronger, and his appetite is returning. Continue. 10th.-Had a slight return of headache for about two hours, yesterday-otherwise quite well. CASE III.-I. D., a baker, aged 41 years; by no means robust, though generally in the enjoyment of pretty good health. September 21st, 1848.-Has felt queer and confused in the head, and in other ways getting out of order for the last week. He went to a medical man, a day or two ago, and had some aperient medicine which did him no good. Yesterday he drank a little more beer than usual, and this morning is unable to go to his work. Though perfectly sober, he is led here staggering and reeling exactly like a drunken man; he appears to have lost nearly all command over his movements; the left side partakes most of the APOPLEXY. 177 paralytic affection; the- arm hanging powerless by the side, and the,leg being scarcely more obedient to the will. It is with great difficulty he can sit in his chair without -being held; he hangs his head; speaks thickly and indistinctly; and breathes spasmodically; is thirsty at times; and dry in the mouth; is very sleepy. Opium 3, every two hours. 22nd.-He feels altogether better; walks more steadily, can raise his left arm; his head, though still feeling tight and " cased up," is comparatively cool, clear, and light. He complains of epigastric tenderness, and is troubled with unpleasant, flatulent eructations. There is also some bronchial irritation and cough. He perspires at times very freely. Nux Vomica 6, every six hours. 23rd.-Still progressing favorably; but little unsteadiness in his gait; he can see to read, and speaks quickly and distinctly. He complains, yet, of heaviness, fullness, and pressure in the head, aggravated into pain when he coughs. Is tight in the chest, and coughs a good deal; acid risings in the throat; pulse full and compressible. Bryonia 6, three times a day. 25th.-Rapid amendment. Has no pain in the head, which feels cool, clear, and comfortable. His chest is easy, and his cough does not trouble him. His stomach is much better, and tongue clean. There is a little wavering in his step occasionally, and he still feels weak. Take Rhus 12, twice a day. Subsequently to this he had China and Sulphur; and resumed his employment in a few days. CASE IV.-H. M., a married woman, aged 50 years. Tolerably stout, and generally in the enjoyment of good health. February 5th, 1847.-Has felt heavy in the head at times for the last fortnight: about four days ago she was seized with a heavy dizziness, as if she had received a blow on the head: this passed off, and she felt pretty well till three hours ago; when, sitting at 7 178 APOPLEXY. work with her needle, she felt again as if she had been struck violently on the right side of the head. Without falling from her seat, she lost all consciousness; her head fell on one side, and her breathing became stertorous. This condition lasted some hours, when she gradually revived, and found that she had lost the use of the right arm, leg, and foot. The head now feels like a dead weight, and there is some pain at the top of it. i Her pulse is full and hard; skin hot; she vomited as soon as she came too; though, at her dinner, which was taken some hours before the attack, she had eaten nothing indigestable. Take Nux Vomica 3, every four hours. 6th.-An astonishing amendment: her head is nearly well, feeling only some heaviness at the back part. The use of the leg and arm has returned to a great extent. Continue the medicine. 7th.-Still further improvement: has almost recovered the entire use of her limbs. She had a slight threatening of a return of the attack to-day in a feeling of faintness, and numbness in the tongue, and deep-seated pain in the head. Take Lachesis 12, three times a day. She continued this medicine three or four days, when, feeling perfectly well, further medical attendance was not considered necessary. CAsE V.-A.'Y., aged 70 years. A man of herculean stature, robust of his age; stout, plethoric, and accustomed to take large quantities of stimulants. April 28th, 1847.--Was seized in the middle of the day with severe pain in the head; followed in a short time by paralysis of the right side of the face, and numbness and partial loss of power in the right arm. On visiting him at eleven o'clock at night, he presents the above condition; with the exception that the pain in the head has subsided into a heavy, confused sensation. He is sitting up in his chair, speaks rationally and collectedly, but his articulation is con APOPLEXY. 179 siderably impaired. The mouth is completely drawn to one sidebut the paralysis does not extend to the tongue. He complains of a sense of fullness and thickness about the throat. His head is preternaturally hot; his pulse is firm, regular, and a little accelerated. Take Nux Vomica 6, every four hours. 29th.-The head is much relieved; it does not feel so heavy and confused, and, is also cooler to the hand. In other respects he is much the same, and does not feel particularly ill. Repeat the medicine every 6 hours. It is useless to particularize this case, further than to say, that he continued the Nux Vomica once in twenty-four hours, for a week or ten days longer, that from the first the muscles of the face, as well as the arm and hand, gradually recovered their tone; and that at the end of about a fortnight there was scarcely any trace of the attack remaining. Since then he has had a severe attack of dysentery; from which also he perfectly recovered, and has from that time up to the present, enjoyed excellent health. 180 INFLAMMATION OF THE EYE. THE beautiful mechanism of the eye, and the admirable adaptation of its different parts to the performance of their several functions, is too well known to need description. All these different parts are at times the seats of disease. Those which attack the inner portions of the organ-the optic nerve, crystalline lens, &c.-are for the most part of a painless, and chronic character, and often result in blindness: such are cataract and amaurosis: whilst those which affect the outer and anterior membranes, are of an active and exceedingly painful kind, but do not so often interfere permanently with the enjoyment of vision. By far the most common of these is opthalmia, or "inflammation of the eye." It is not necessary to enter into a minute detail of its symptoms. It will be sufficient to state, that the most constant are redness, more or less intense, of the white of the eye, pain and great intolerance of light, and a preternatural flow of tears, or a discharge of matter. These are commonly attended, like severe affections of other important organs, with constitutional derangement, such as fever, thirst, and headache. There is perhaps no other disease, with the ordinary treatment of which, in its general principles, the world at large is so well acquainted. Cupping, leeching, blisters, fomentations, &c., are the universally acknowledged remedies. The second of these in particular, holds here undisputed sway, and the INFLAMMATION OF THE EYE. 181 abolition of its employment in this one disease, would go very far towards banishing the leech from the list of remedial agents. There is however one drawback upon its indiscriminate use, which exercises considerable influence over the public mind, and, although not acknowledged by the profession, is beyond a doubt, well founded: I allude to the popular fear, lest the abstraction of blood by leeches should weaken the eye. There can be no question, that the withdrawal of blood under any circumstances, has a tendency to produce weakness of the system generally, and especially of any organ which may at the time be diseased. That being the case, it follows of necessity, that the application of leeches for the relief of inflammatory diseases of the eye, must leave its vessels in a debilitated condition, and more liable than they would otherwise be, to put on diseased action at a future time. This is peculiarly the case as regards children, in whom these diseases rarely show themselves except as concomitants of scrofula. Indicating, in the highest degree, a want of constitutional stamina, this taint, as strongly interdicts the employment of debilitating measures for the removal of any local complaint. Unfortunately for the Allopatlhist, all his remedies for active inflammation are of that description; and, as a necessary consequence, in treating scrofulous opthalmia, he finds himself, like Garrick between Comedy and Tragedy, or Macheath in the Beggars' Opera, distracted by contending claimants: the eye requiring depletion; the constitution, tonics. To overcome the difficulty he adopts both classes of remedies; and, endeavouring to amalgamate things so palpably incongruous, he fails in the attempt, and is only successful in accomplishing-nothing! Homceopathy, also, has its difficulties, but they arise from the inherently intractable nature of the disease, and not from any incongruity of the remedies. These, while they act directly upon the local malady, at the same time invigorate the general health. Witness the following cases. 182 INFLAMMATION OF THE EYE. CASE I.-Mrs. W. aged 34 years. Spare, delicate woman. June 16th, 1848.-The left eye has been inflamed three weeks. Getting considerably worse, she went about a week ago to one of the opthalmic hospitals; where, at different times, she was cupped on the temple, leeched, had the eye scarified, and took a good deal of medicine. From all this she obtained no relief whatever. She is now suffering intensely, not only from the disease of the eye, but also from sympathetic pain in the forehead and other surrounding parts. She is much disordered in her general health, being feverish, hot, and thirsty; having no appetite, and feeling exceedingly weak. The eye itself is so excruciatingly painful on the least admission of light, that I can get only a momentary glimpse at it; it is then discovered to be intensely red; and there is a constant discharge of tears. Take Aconite 6, and Belladonna 6, alternately every four hours. 19th.-Wonderfully better in every respect. She has no pain either in the forehead or eye. She can open the eye with comparative facility, and suffers but very little inconvenience from the light; it is very much less inflamed, but being now able to examine it deliberately and completely, two small ulcers are detected on the cornea. Aconite and Mercurius 12, alternately, at longer intervals. 21st.-Amendment still uninterrupted: suffers no pain, can open the eye freely, see well, and attend to her household matters. There is but slight redness remaining on the conjunctiva, and the ulcers are fast disappearing. Her health has greatly improved; all the constitutional disturbance has subsided. She has a good appetite, and is fast recovering her strength. Sulphur 12, at bed time, every night, for a week. She got perfectly well without further medical attendance. CASE II.-C. C., a boy, aged 21 years. A weak, sallow looking, scrofulous child. Had a severe attack of inflammation of the lungs a year ago, for which he was repeatedly leeched, &c., and has ever since remained exceedingly delicate. February 2nd, 1847.-He has now been ill about eighteen hours. The left upper eye-lid is inflamed, and so much swollen as to pro INFLAMMATION OF THE EYE. 183 ject out considerably beyond the level of the face; it is also much elongated, and entirely overlaps and hides the lower lid, so as to render it impossible to get a view of the eye itself. The other eyelid is also red, and partially swollen; and the eye is injected and intolerant of light; to avoid which he hangs his head down as low as possible. There is a discharge of thick, yellow matter, from both eyes, but most copious from the left. He has a cold, cough, and running at the nose; and a good deal of fever and thirst. Take two doses of Aconite 6, then Belladonna 6, every two or three hours. 3rd.-The left eye is considerably relieved: the right one is now much worse; the eyelid swollen as large as a walnut. Take Aconite 12, and Mercurius 6, alternately, at four hours intervals. 4th.-Much improved in both eyes. Continue the Mercurius. 5th.-Rapid amendment: swelling and discharge very much abated. 6th.-Both eyes nearly wide open: he sits up and looks cautiously at the light. There is a small ulcer on the cornea of the left eye, and some redness of the conjunctiva. The chest symptoms and fever have increased since yesterday, and an attack of acute bronchitis has supervened. Take Aconite 6, every three hours. 7th.-The constitutional symptoms abated: not so much heat and fever. Resume Aconite and Mercurius 12, alternately, every six hours. 1 lth.-From the former to the present date his amendment has been most satisfactory; his eyes may be said to be well, even the ulcer has quite healed and disappeared. He is pretty free from the other disease, having only a loose cough. He has been takinog Belladonna and Mercurius. CASE III.-E. W., aged 6 years. A thin, fair, somewhat delicate girl. February 24th, 1847.-Her left eye has been inflamed three days, and is now intensely red. She cannot bear the least light, INFLAMMATION OF THE EYE. 185 even its partial restoration possible. He cannot bear the admis'sion of the least light; there is a copious discharge of tears; lie has intolerable pain in the temple and forehead. Take Aconite 2 directly, and follow it by Belladonna 6, every four hours. 5th.-He is already greatly relieved; there is not nearly so much pain, and the redness of the eye is considerably diminished. Continue the medicine. - 7th.-He is still mending, and has Mercurius 3, to be taken three times a day. 9th.-His amendment is rapid: he suffers but little, and can open the eye slightly, without inconvenience. Take Sulphur 12, twice a day. From this time to the 28th, he had Mercurius, Sulphur, and Calcarea; and at the latter date, was better than he had been for a considerable time previous. He had another attack, about ten months later, and found equally speedy relief from the same kind of treatment. CASE V.-G. W., aged 38 years. Has been ill four days; is liable to inflammation of the eyes, and has had much trouble in getting them well, being generally under the necessity, among a variety of other remedies, of applying a good many leeches. March 29th, 1847.-The present attack is confined to the left eye, which is very red, painful, and intolerant of light, and discharges a large quantity of water. There is also an ulcer just on the edge of the cornea. Take Aconite 3, directly; and follow it by Belladonna 3, every four hours. April 1st.-Considerably better: the eye and forehead not so hot, and the redness has greatly subsided. Take Mercurius 12, three times a day. 3rd.-Wonderful amendment. The ulcer has quite healed. There is no inflammation of the cornea, and but very slight of the conjunctiva. He can bear light and is able to attend to business. Continue the medicine. 2 A 188 LYING-IN FEVER. which flow from it, as so many processes, for the safe and healtchy performance of which nature almost invariably makes ample provision, the plea for the administration of medicines vanishes: where there is no disease, remedies are unnecessary. A practical observance of this principle cannot fail to be attended with the happiest results., Unimpeded in her operations by meddlesome interference, nature is always adequate to'effect the contraction of the womb, the secretion of the milk, and the action of the bowels, in the manner best calculated to secure the safety and comfort of the patient. There are, however, certain diseases-often beyond our control in their origin-which, in spite of all our care, will occasionally attack women after their confinement. The most frequent and formidable bf these are, puerperal or lying-in fever, and inflammation of the breasts. The former, though termed a fever, is known to be essentially an inflammatory disorder, affecting together, or separately, the womb and its appendages, and the bowels. It is distinguished by exquisite pain and tenderness in the lower part of the abdomen, and by general constitutional disturbance. It appears to de"ive some especial modification from the peculiar condition of the patient at the time, since it has always proved so much more extensively and rapidly fatal, than attacks of inflammation occurring in women under other circumstances. This fatality, added to the interesting. situation of the patient, has always caused it to be regarded with feelings of deep apprehension-and most naturally so, for at no other period, surely, do disease and death appear so untimely, as when they visit woman in this her hour of greatest joy; when a new tie is added to the cords that bind her to life; and, in the birth of her offspring, she herself, seems to commence a new existence. IPp:: 'ýortidoate to this interest have been the exertions of LYING-IN FEVER. 189 medical men, to discover means of encountering the disease successflly- Their endeavours have hitherto been attended with very discouraging results: its treatment still forms one of the opprobia of medicine. The following resume of the different modes of treatment adopted by different parties, proves that there is not a single remedy on which even those who advocate their employment, can depend with confidence. Dr. Marshall Hall says, " I would observe in the first place, that nothing can be trusted to to save the patient, but the most ample blood-letting, and that nothing should preclude the use of this remedy but the actual existence of the state of sinking." Dr. Ferguson remarks, " The abdominal pain that occurs in puerperal fever, is accompanied by two very different states of the constitution; one in which little or no depletion is borne, another in which relief is obtained only by very large evacuations of blood. While I admit this, I am equally certain, that large bleeding has not been borne in this country, generally speaking, during the last twelve years." Dr. Blundell says, " Emetics have been highly spoken qf, For myself, I have no confidence in curing the disease with this remedy. The oil of turpentine has been highly recommended by Dr. Brenan and others. I have tried it in four cases, but which by no means verify the high encomiums bestowed upon it. Mercurial preparations have also been recommended. It is said, if you could get the mouth sore, the patient would be safe. I am sorry to say that a patient to whom I gave this remedy died in the usual umanner, although the system zwas brought under its influence. Digitalis has been -recommended: I have tried it without any good effect. Ice has also been recommended: I have tried it but without success." Dr. Churchill says, " After full depletion the next most LYING-IN FEVER. 191 and painful recollection of the dismay I felt at the occurrence. To assert that these disheartening events will never happen in Homceopathic practice, would be unwarrantably presumptious, but in affirming that where they now occur fifty times, when Homceopathy shall have become general they will not occur once, I am simply uttering a prediction, founded upon and sanctioned by daily experience. The following cases in support of this assertion are selected from many others, principally on account of their brevity and the simplicity of the treatment. CASEL.-Mrs. A., aged 21 years. December 8th, 1847.--Was confined with her second child five days ago. In the evening of the third day she was seized with rigors, and pain in the lower part of the abdomen. Yesterday morning her then medical attendant thought it necessary to bleed her, but faintness speedily supervening, only a small quantity of blood was obtained. He also prescribed pills, a mixture, and a sleeping draught at bed time. This morning, (the patient being no better, but the reverse,) ten leeches were ordered to be applied to the abdomen, and fourteen more this afternoon. Called to visit her for the first time at 6 o'clock this evening, I find her in ihe following condition: she is lying in bed on her back with her knees drawn up; she has, at the present moment, hot fomentations on the stomach, and is besides smothered in flannels, shawls, and bed-clothes. She complains of incessant thirst, to quench which she is allowed only warm liquids, which are instantly vomited, and her medicine shares the same fate. Her mouth is clammy; tongue brown and dry; pulse small, hard, and 130 in the minute; skin very hot; breathing short and quick; head confused. Placing my hand on the lower part of the abdomen, and making gentle pressure, she flinches and cries out with the pain; the least movement, or cough, also greatly aggravates her suffering. The abdomen is much distended; the lochia have ceased; the bowels have been relieved to-day. 192 LYING-IN FEVER. The fomenting flannels, and other extra wraps are removed, and only a comfortable amount of clothing retained; the curtains are thrown back, and a free circulation of air admitted. She is to drink cold toast-water, -and barley-water, and take Aconite 3, every hour, till amendment manifests itself, - then every two hours. 9th.-Noon. Without witnessing it, one could hardly credit the change that has come over this patient since yesterday bvening. Her condition, as just described, was then most alarming: to-day there is hardly a trace of disease. - After the second dose of medicine she fell into a calm, refreshing sleep, which continued some hours. She has now but very little pain in the abdomen, even on pressure. She moves freely from side to side, and from one part of the bed to another; there has been no return of vomiting; her thirst is quite allayed, the mouth is cool and comfortable, and the tongue moist: the skin is of a, natural temperature, and the pulse reduced to 100. Her countenance, yestcrday pinched and contracted and expressive of distress and' anxiety, is now expanded, cheerful, and smiling. Continue the medicine at longer intervals. 10th.-Passed an excellent night, and to-day, with t1he exception of a little weakness, feels quite well. Omit the medicine, and take gentle nourishment. Cured. C..sE 11.--Mrs. F. A tall, dark young woman, of sanguine temperament, aged 21 years. July 1st, 1847. Was delivered of a five months' child at four o'clock yesterday morning. There was adherent placenta which required manual assistance for its removal. She was.doing as well as usual till noon to-day, when there was a severe shivering fit. This has been succeeded by sharp pain in the region of the womb, and terrible constitutional excitement. There is a rapid, tumultuous pulse (140 in a minute): Her skin is burning hot; she is intensely thirsty; has racking headache and intolerance of light and noise. Her breathing is quick and her countenance flushed. The abdomen is exceedingly senisitlve to the touch, particularly over LYING-IN FEVER. 193 the right side of the womb. There is a dark lochial discharge. She has had another shivering fit this evening. Take Aconite 3, and Belladonna 3, alternately, every hour. 2nd-After the fourth dose of medicine all the symptoms abated, and the amendment having been progressive ever since, she is now wonderfully better. Complete calmness of system has succeeded to the previous alarming excitement. There is but little tenderness in the abdomen; scarcely any headache; the breathing is quiet; the skin -cool; pulse 105, soft and regular; she is composed and placid, and speaks cheerfully. Continue the medicine. at longer intervals. 3rd.-Doing remarkably well. She sits up in bed without inconvenience; has no pain in the abdomen; no headache; no thirst; pulse natural. There is some stiffness about the back of the neck and shoulders. This was removed by a dose of Bryonia. Cured. CASE III.-Mrs. R., aged 30 years, dark complexion, irritable, sanguine temperament. May 4th, 1847.-W-as confined three days ago, with her second child. She had an excellent time, but ever since has had occasional chills creeping over her. This morning her feet and legs became cold, and, nearly at the same time, severe and cutting pains attacked her in the lower part of the abdomen. This point is now exquisitely tender to the least touch; and coughing, attempting to move in bed, or to breathe deeply, increases the pain to an intolerable degree. She lies upon her back perfectly quiescent, looks dull and depressed, and heavy about the eyes, though naturally of a. remarkably vivacious disposition. Her pulse is greatly accelerated; she is thirsty; complains of headache; milk is secreted, but there is but very little lochial discharge. The bowels have acted this morning without medicine. Take Aconite 3, every two hours. 5th.-The pain is nearly gone. There remains some tenderness on pressure just in the region of the womb; but the original pain has almost entirely subsided; as have also the constitutional 2 B 196 LYING-IN FEVER. 21st.-Pulse 95, soft, and more equable; very little thirst; skin cool and perspiring; countenance, hitherto anxious and shrunken, is now expanded and placid.- The milk begins to be secreted, and the dischairge is more free and less offensive. 22nd.-Much the same. Still some pain on deep pressure over. the left side of the womb. She now perspires profusely at times, and feels exceedingly weak. Take Mercurius, every six hours. 23rd.-Convalescent. Debilitated. Takes light nourishment, and Cinchona 3, twice a day. Cured. This is a specimen of a class of cases-unfortunately but too numerous-which more than any other, embarrass and baffle the Allopathic practitioner. Violent in their onset, and attended from the first with symptoms of great debility, they entirely preclude the loss of blood. In the absence of other means capable of arresting the disease, it runs its destructive course unchecked, and in a few - hours hurries the unhappy patient out of the world. Besides the one above related, I have treated several other cases of the same character, Homceopathically, and have had the satisfaction to see them all recover. 197 -INFLAMMATION OF THE BREAST. MoRE protracted and painful, though fortunately less dangerous, than the last named disease, -inflammation of the breast, is one of the most harassing attendants upon a lyingin. Like puerperal fever, it too commonly owes its origin to injudicious interference; consisting, in this instance, in the outward use of stimulating applications, and in the internal administration of strong medicines. Both of these-the former by producing local irritation, the latter, general disturbance-tend to interrupt the natural and healthy secretion of milk, and so lay the foundation of subsequent disease. Cases will, however, present themselves, in which, from unavoidable causes, the breast cannot be relieved of its accumulated milk, and the consequent developement of inflammation becomes inevitable. Medical assistance is then necessary, in order to check the inflammation, and prevent theformation of abscess. The frequent occurrence of "bad breasts" too plainly attest the inadequacy of leeches, poultices, and purgatives, to effect that object., Not so with Homoeopathy; employed early in the disease, its remedies are most effective. Unless neglected, and far advanced, I have never yet met with a case, which Aconite, Belladonna, and Bryonia failed to arrest; and in those cases in which the formation of matter could not be averted, the same remedies have rendered that process comparatively painless, by allaying the general -fever, and moderating the local inflammation. 198 INFLAMMATION OF THE BREAST. The following cases are illustrative of both these points. CASE I.-Mrs. A., aged 21 years. Delicate, fair complexion, light hair; confined a fortnight, with her first child, and troubled ever since with tender nipples. November 13th, 1848.-Taken in the night with shivering, and severe pain in the right breast. Visiting her at three o'clock in the afternoon, I find her in bed, labouring under intense bodily excitement, in addition to the local disease. Her pulse is exceedingly rapid; she has incessant thirst; her skin is hot and dry; her head aches and throbs violently, causing her to bury it in the pillow, and keep the eyes closed. Her breathing is hurried, sobbing, and irregular, and she has aching pains in every limb; whilst the affected breast is much swollen and distended, and very painful, and tender to the touch, but particularly so on the outward side, where there is considerable hardness of the gland, and a deep-red blush on the skin. Take Aconite 3, and Belladonna 3, alternately, two hours apart. 14th.-Amazingly relieved. The constitutional excitement has entirely subsided. She is sitting up in bed, composed and cheerful; pulse calm; skin cool; no thirst. There is but little tenderness in the breast; the redness has disappeared; and some hardness constitutes the only remains of this severe attack. Take Bryonia 12, three'times a day. 15th.-Perfectly well. o CASE II.-Mrs. S., aged 30 years. Fair, delicate, light hair. Has been confined three weeks, and troubled with excoriated nipples, for which she has taken Chamomilla, &c. September 17th, 1848.-The left breast became irritable and painful three days ago. Yesterday these symptoms increased considerably, and to-day she is in bed; being bodily ill with fever, heat, thirst, headache, and loss of appetite. The breast is much enlarged, painful, throbbing, and burning; red and inflamed on the skin, and hard in the substance of the organ, towards the chest bone. Take Aconite 6, every three hours. 200. INFLAMMATION OF THE BREAST. " to disperse the milk," but instead of that effect, it produced heat and erysipelatous redness of the skin. The whole gland is inflamed, tumefied, and painful; and there is a hard lump, about the size of a large egg, on its outer side. The patient is confined to bed, with fever, thirst, and headache. Take Aconite 3, three doses; then Belladonna, three doses. 20th.-Redness nearly all disappeared. The breast is not so tender, it does not throb so much, but the hardness still continues. Better in health; no fever or thirst. 21st.-Well in health: takes light food; the breast causes butlittle inconvenience, yet the lump remains; and there are appearances which lead me to suspect a rather deep-seated abscess. This suspicion proved to be correct. The matter gradually made its way towards the surface; and was discharged at the proper period. The inflammation was kept under by appropriate remedies; the abscess was small, and caused but little pain or inconvenience; and at the end of a few days she w.as about as if nothing had happened. CASE V.-Mrs. M. A. M., aged 29 years. A large, strong woman. January 20th, 1847.-Was delivered of her second child seven weeks ago. Three weeks since she had a shivering fit, which ushered in an attack of inflammation of the right breast; this yielded speedily to a few doses of Aconite. She remained well till the 11th instant, (nine days ago,) when she again had chills, followed by pain and hardness of the left breast. She endeavoured to subdue it by fomentations and aperient medicines. Failing in this, and the pain, enlargement, and induration continuing to increase, she seeks my advice this morning. She complains of a throbbing, darting pain in the diseased organ, which is hot and inflamed on the surface, and in the centre the gland is hard, round, and about the size of a large orange: evidently in that condition which immediately precedes suppuration. She is feverish and thirsty, and has lost her appetite. Take Aconite 3, directly; then Bryonia 6, every six hours, and apply bread poultices. INFLAMMATION OF THE BREAST. 201 II 21lst.-There is-much less of the shooting pain in the breast; but the hardness remains the same. She has lost the fever and thirst, and feels altogether much more comfortable. Take Mercurius 12, and Bryonia 12, alternately, twelve hours apart. 29th.-In the interval since the last date has felt little or no pain: the breast is larger, has become Qedematous, and matter has evidently formed. She has had Mercurius and Hepar Sulph. 31st.-The matter rapidly approaching the surface. In making an incision, a considerable quantity of healthy pus is discharged. February lst.-The breast discharging slightly. Feels -quite well. Medical attendance discontinued. 202 CONVULSIONS. " CONVULSIONS " is one of that mysterious order of dis$eases called thle "spasmi," or spasms. In the same category is included epilepsy, hysteria, St. Vitus' dance, tetanus or locked-jaw, and hydrophobia, as well as some others which are not so distinctly characterized. The true spasmodic or convulsive diseases are exceedingly frightful to behold, and never fail to excite the terror of the non-professional spectator. Nothing, for instance, can be more alarming to witness than an epileptic fit in an adult, or an attack of convulsions in a child., In both cases the whole body is thrown into the most violent contortions. Every limb and muscle is seized with spasmodic contractions or jerkings; the head and face become turgid and bloated; the eyes averted and fixed; the breathing interrupted and irregular; and the lips covered with foaming froth. The wonder is, not only how the patient can survive such a convulsion of the system, but how it happens that in that convulsion he should sustain so little injury. Deadly as the contest appears to be, nature, especially in adults, generally triumphs; the convulsion, exhausted by its own efforts, subsides; the patient falls into a sound sleep, and awakes unconscious of the fearful struggle in which he has been engaged. These diseases are scarcely less mysterious than appalling. How rarely can we assign any thing like a definite cause for an attack of epilepsy, hysteria, or convulsions! 204 CONVULSIONS. care must be taken, lest the child be brought into that state of exhaustion in which convulsions are very apt to occur firom an exactly opposite cerebral condition. The writer of this article (Dr. Locock) saw a plethoric child of a year old, cupped to fainting, during a severe convulsive attack, and no sooner had the faintness subsided, and the child was left bleached, with a depressed fontanelle, than a second and still more violent convulsion took place, from which it was with extreme difficulty recovered." In this paragraph we have an instance of the life of a child being as much jeopardized by the remedy as by the disease. One would think that the risks engendered by the latter were sufficient, without adding to them the hazards originating in unscientific treatment. Other means commonly adopted, are baths; ice and cold lotions to the head; mustar'd poultices to different parts of the body; blisters, calomel, purgatives, &c. The Homceopathic treatment will be best seen in the following cases. CASE-I.--E. B., a female child, aged 2- years. Was brought from the country a month ago in perfect health. Since then she has fallen off in strength, but betrayed no distinct sign of illness till yesterday, when she became hot and feverish. June 14th, 1847.-Two hours and a half ago she fell into a strong convulsive fit, which continues at this present moment in all its violence. The whole body is affected, but one side chiefly: her head is thrown forcibly backwards, the face being fixed in an oblique position towards one side; the, limbs are rigid, the hands being firmly clenched, and the toes drawn towards the heels; every part of the frame is strongly convulsed, and thrown into violent jerks, which affect principally the head, neck, arm, and leg of one side, together with the muscles of the face and mouth, from which latter there is a constant discharge of foam; the eyelids are CONVULSIONS. 203 forced wide open, the eyes are averted and staring, and the pupils irregularly dilated; the whole countenance is frightfully distorted, Nboated, congested, and livid, as though she was undergoing strangulation. Her breathing is most irregular, and spasmodic, at times entirely suspended, until another spasmodic expiration ensues. Her pulse beats tumultuously, (200 or more in a minute,) the skin is burning hot, especially on the head. It is scarcely necessary to state that there is complete insensibility. She has been in a warm bath some time, without any mitigation of the symptoms. Having my pocket case of medicines with me, I immediately-forcing the clenched teeth a little asunder for the purpose-give three globules of Belladonna, and sit down to watch the effect. In fifteen minutes -its beneficial action is strikingly evident: the general rigidity of the body begins to subside; the arms and legs, previously as stiff as a piece of wood, gradually relax, and become perfectly moveable; the eyelids from time to time droop as if falling asleep; the breathing becomes more calm and regular; the lips resume their natural color; the head and skin remarkably cooler. I repeat the dose, and at the end of another half-hour have the satisfaction of seeing the little creature relieved from the grasp of her fearful enemy. Partial consciousness returns: she drinks a little milk and water, grasps my finger when placed in her hand, and in short is coming quite to herself. I leave another dose of Belladonna, to be administered in a few hours. 15th.-She is brought to me, comparatively, though not quite, well. There is a little contraction and rigidity in one wrist; some restlessness; she starts at any sudden noise; is a little hot and thirsty. Take Aconite 12, every six hours, alternately, with Chamomilla. She was brought once more, had a repetition of the medicine, and was thoroughly restored. Had I treated this case according to the old system, I should instantly have opened a vein in the neck, and-here I must have stopped-it is true I might have applied ice to the head, and mustard poultices to the feet and legs, but as to internal remedies, the 206 CONVULSIONS. door was shut against their admission: the attempt to force medicine down the child's throat, would, in all probability, have caused instant death, Not so with Homoeopathy: it is always possible to get the globule, if not on the tongue, at least within the lips, and that is sufficient-it instantly melts in the saliva, and becomes absorbed into the system. CASE II.-E. H., a fine boy; 18 months old. June 16th, 1847.-He is cutting his double teeth, and has been a little disordered in his bowels the last few days. About twenty minutes ago he became violently convulsed, in which state he still remains; every part of the body, arms, legs, and.back, are thrown into rapid and violent jerks; the head is twisted on one side; every muscle of the face, especially those of the mouth, working violently, and causing frightful distortion of the features: the eyelids are fixed wide open, the eyes averted, and the pupils widely dilated; the foam rushes backwards and forwards between his lips, as it is drawn into and expelled from the mouth by his spasmodic breathing. The veins of neck, face, and forehead, are swollen and turgid. His pulse is beating with a throbbing stroke, and too tumultuously to be counted; the skin is burning hot, and bathed in -a profuse perspiration, probably from his having been just taken %out of a warm bath. I pass three globules of Chamomilla between the teeth, instantly. 'Ten minutes after, the limbs relax, the breathing becomes deeper and more regular, the skin cooler. He now remains in a general itremor through the whole body, like a child recovering from a fright. I lance the gums, give a dose of Belladonna, and leave another to be administered in the night. 17th.-He slept soundly, and is brought to my house this morning, perfectly well. CASE III.-William N., aged 15 months, was never ill before. April 21st, 1847.-Has had five fits within the last sixteen hours; the last having gone off about an hour since. They are described -as coming on with violent convulsions of the arms and legs, and body generally, frothing at the mouth, blackness of the face, very CONVULSIONS. 207 irregular breathing, and rattling of phlegm in the throat, as though he (,ould be strangled. They last about a quarter of an hour, and!av-e him drowsy and insensible in the intervals. He is now lying in that condition, with frowning brows, flushed face, hot skin, quick pulse. He starts at times, and screams, and becomes suddenly excited, but instantly relapses into his former condition. Take Belladonna 12, directly;; and repeat it every two hours. 22nd.-He had three more fits of a mitigated kind before eleven o'clock last night, since when they have not returned. He is drowsy and lethargic; but not so feverish, hot, and thirsty, as previously. Repeat Belladonna 12, every four hours. 23rd.-There has been no convulsion: he is in every other respect greatly relieved: he slept well; is cool and comfortable in skin; wakeful and collected in mind; he watches the other children about the room, and even makes feeble efforts to join in their amusements. There is occasionally a little starting and restlessness; the bowels have all along acted regularly. Continue the medicine at longer intervals. 24th.-On waking from a sleep yesterday afternoon, his mother found him warmer in skin, and his face covered with a red erup. tion. To-day it has made its appearance on the legs and arms, and proves to be measles. There is but very little febrile action, and all cerebral excitement has vanished. He had a few doses of Pulsatilla. The skin disease ran its course favorably, and he recovered rapidly without encountering any drawback. CASE IV.-B. S., aged 18 months; a beautiful boy, but somewhat pulled. down by the irritation of teething. July 2nd, 1847.-He is now cutting his double teeth, for which his gums were lanced this morning. He was much disordered and purged in his bowels all yesterday. In the middle of last night, now nine hours ago, he was seized with a violent fit, convulsed in every limb; jerking of the head and face; foaming at the mouth; the'eyes wide open; the face of a ghastly Color; the skin burning hot; breathing irregular, and accompanied with a rattling in the 'hroat. This lasted half an hour. He had another at two o'clock 208 CONVULSIONS. in the morning,' and again at half-past six, from which he is now, at nine, just recovering; he is in a perfectly stupid, insensible state, showing no signs of consciousness when undisturbed; but if touched, he starts and becomes slightly convulsed for a moment. I gave a globule of Chamomilla 3, immediately, and ordered it to be repeated in an hour; then. to take Belladonna 3. He revived much, then slept calmly for some time, but at noon there was a slight return of the convulsion, which lasted about five minutes. On visiting him shortly after, I found him greatly improved, indeed quite a different child from what he was in the morning. He is, however, still suffering much from purging of the bowels, which is almost incessant, and attended with pain, griping, crying, and drawing up of the legs, and insatiable thirst; he grasps at a cup of cold water, and drinks it down with the utmost avidity. Take Aconite, directly;.then Arsenicum 12, half a globule every hour. At four in the afternoon he is reported as better in the bowels, as well as in every other respect. 3rd.-Dressed, sitting up, looking intelligent, and comparatively lively and cheerful. No appearance of fits, but the bowels still continue much disordered, the evacuations slimy, and at times mixed with blood. Take Mercurius Solubilis 12, every four hours. 4th.-The bowels rather better, but still relaxed. Take Arsenicum 12. He got subsequently Chamomilla and Sulphur for the diarrhoea, which, though rather obstinate, yielded entirely to these medicines, and he recovered without any recurrence of the convulsions. CASE V.-N. V., a girl, aged 2 years; delicate, small of her age, and large headed. Has previously shown a tendency to convulsions; is liable to relaxation of the bowels. August 23rd, 1847.-Nine in the evening. She was sick this afternoon: about two hours and a half ago, was seized with slight convulsive movements of the arms, and the eyes became fixed, this state of things gradually increased to a decided convulsion of the whole body, but affecting the- right side most strongly; the mouth ERYSIPELAS. 211 four members of the party had expressed as many different opinions. One recommended the application of a solution of zinc-another found nitrate of silver infallible-his neighbour advocated puncturation of the skin-whilst the fourth extolled the superiority of long incisions.* These four gen"tlemen, though affording a fair specimen of the prevailing diversity of opinion, by no means represented all the existing modes of treatment. In opposition to this diversity, there is no disease, on the treatment of which, Homoeopathists are more decidedly unanimous. Hahnemann and his followers, in testing the virtues of medicinal substances, have discovered some medicines of surpassing efficacy in subduing erysipelatous inflammation. Foremost among these stands Belladonna; and scarcely inferior to it is the Rhus Toxicodendron. We venture to affirm that no medical man, however strong his prejudice against Homoeopathy, can witness the effects of these medicines without being struck with admiration at their power in mitigating the virulence, and arresting the progress of the disease. CASE I.-John D., aged 26 years. A carpenter; very temperate; naturally of a delicate constitution. He caught a severe cold about three weeks ago, from sleeping in a damp, newly-built house, and has not been well since. He had at first pains in the limbs, especially in the back, for which he was cupped. Continuing to get worse, he took to his bed, got a dispensary letter, and was attended by one of my colleagues. A week ago he came under my care, and was attended Allopathically till to-day, when, failing to make * "Some Surgeons make the incision a foot long; but others make half a dozen incisions, each an inch in length; some doing it all at once; and others, as,,Mr. Lawrence waggishly said, " by instalments."-Elliotson's Lectures. 212 ERYSIPELAS. any impression on his disease, and other symptoms of an alarming nature supervening, the dispensary letter is relinquished, and Homoeopathic treatment adopted. May 7th, 1847.-He presents the following deplorable condition: he is thoroughly prostrated; lies on his back unable to raise him'self in bed; has general pain in all his limbs; is feverish, thirsty, and complains of severe headache; his pulse is small and faltering, and beating 130 in a minute; his tongue is thickly-coated, dry, and cracked; he has a harassing cough; pain under the chest bone, and rapid breathing; his bowels are relaxed, and he has frequent vomiting. There is general tremor of the limbs, and at times wandering delirium. In the midst of all this erysipelas manifests itself. It first attacked the posterior part of one of the shoulders, and then spread to the back of the neck and head, creeping round to the face on both sides, and meeting on the forehead and nose, where it has risen into a large blister. The parts last named, as well as the eyelids, are intensely red and swollen, so that the eyes are entirely closed, and the whole face terribly deformed. There is also a large patch of erysipelatous inflammation on the lower part of the back, reaching across from hip to hip, and extending downwards on to the thighs; it is here of a bright red color, and its margins are elevated, and exactly defined. At one o'clock in the forenoon he takes the first dose of Homoeopathic medicine-Rhus Toxicodendron 3; to repeat it everytwo hours. Eight o'clock in the evening.-There is already a more favorable state of things: his pulse from 130 has sunk to 110, and is more firm and steady; skin soft and warm; tongue more moist, especially at the edges; he is more collected in his ideas, and speaks in a firmer tone. Though coughing a good deal, and complaining of pain in his chest, he breathes more regularly, and does not appear to be so much oppressed with phlegm. 0 Continue the medicine. 8th.-Considerable further improvement in the general aspect of the case. There is altogether more power; he is less delirious, though still wandering and incoherent at times; there has been no vomiting since yesterday evening, and the bowels are quiet; pulse only 100; tongue moist; breathing easy; expectoration copious and 214, ERYSIPELAS. as to puzzle me, (though well known to me,) in tracing her identity. The skin is of a deep red color, and the swelling has entirely closed the left eye, and rendered the upper lid treble its natural thickness. The gum of the upper jaw is also swollen and, inflamed, and,there is a hardness just in that spot, threatening the formation of an abscess. The saliva flows freely from the mouth' The constitutional symptoms run high: her pulse is rapid; skin hot; tongue coated and dry; she is thirsty; complains of severe headache; and gets no sleep. Take Aconite 6, every four hours. 20th.-Erysipelas spreading ovei the other side of the face, closing both eyes: and extending also backwards, and involving the ears and subjacent parts of the neck. Constitutionally, she is considerably relieved; having not so much thirst, nor heat of skin; the pulse being softer, and less rapid; and the tongue not so dry. The whole head and face now appears nearly twice its natural size, and feels so heavy that she has not power to lift it from the pillow. There is a little discharge issuing from under the upper lip, as though an abscess had burst. Take Belladonna 3, every three hours. 21st.-The inflammation and swelling have subsided in a remarkable degree. She can open her eyes freely, and the face is nearly restored to its usual size. The disease is now confined to a faint blush on the sides of the neck, and under the chin, and a considerable tumefaction of the ears. Pulsatilla 12, every four hours. 23rd.-Still a little tenderness on the back part of the head. All the parts previously affected are quite well, with the exception of the gums, which remain tender and swollen. It scarcely need be said that the constitutional symptoms have improved in equal proportion. Take Mercurius 6, three times a day. 26th.-She calls to report herself perfectly well. All traces of the disease have disappeared, and she complains only of a little debility. Take a few doses of Hepar Sulphuris. ERYSIPELAS. 215 CASE III.-H. D., aged 18 years. A servant girl. August 27th, 1848.-Was taken ill five days ago, at her situaýion, with symptoms of fever. She had shivers, heat, headache, thirst, pains in her limbs, &c. She was attended by a medical gentleman, who prescribed for her several times, but continuing to get worse, she was brought home the day before yesterday. Twenty-four hours since, erysipelas first made its appearance on the left cheek, which Vpart it now completely covers, and has passed over the nose to the opposite side, and partially occupies the forehead. The inflamed parts are intensely red, and considerably Selevated above the surrounding skin. She is exceedingly ill, presenting all the signs of low fever, such as prostration of strength, delirium, intense headache, hot dry skin, rapid pulse, incessant thirst, and thickly-coated, brown and dry tongue. Take Aconite 3, and Belladonna 3, alternately, every four hours. 28th.-Constitutionally much better: skin soft and cool; tongue moist; less thirst and headache. The erysipelas spreading more completely over the face, and forming at numerous spots into blisters, or vesications; both eyes entirely closed by the swelling of ~ the lids, and surrounding parts. i Rhus Toxicodendron 6, every three hours. 29th.-A decided check to the eruption: it has not extended since yesterday, is less vivid, and the blisters are drying up. Her health is better. The fever has subsided. Resume the use of Belladonna. 30th.-Wonderfully better. Both eyes quite open, and she has 'been reading. The eruption fading rapidly, and her health improving in proportion. \31st.-Perfectly well as regards her health. The skin peeling off he face. A dose of Hepar Sulphuris. Cured. CASE IV.-E. S., a florid, plethoric young lady, aged 11 years. July 8th, 1848.-Had erysipelas some years ago. She came home uch heated by a run, two or three days since. Yesterday morning sphe awoke very ill; had shivering, headache, and thirst, with pains n her bones; and at the same time a red spot made its appearance 216 ERYSIPELAS. on one cheek; this has now spread over the nose, and invades the other side of the face. The redness is intensely vivid; and the parts are swollen and very painful. The constitutional symptoms run unusually high. Her pulse is very rapid; skinburning hot; mouth and tongue dry and parched with thirst; splitting headache. Take Aconite 6, and Belladonna 3, alternately, four hours apart. 9th.-The inflammation has extended on to the forehead, and lower down on the cheeks, but it is not nearly so vividly red. The fever still runs high. Continue the medicines. At two o'clock she becomes delirious, and excessively restless. i Pulse 140, full, and hard. Take the medicine every hour. Nine in the evening.-She has been quite calm since four o'clock, and is now much better. The fever and thirst have greatly abated, and she feels quite another creature. '10th.-Wonderfully better. Constitutional excitement has all vanished. The eruption is spreading no further, and is getting paler and less swollen. Continue Belladonna, at long intervals. l1th.-Dressed and down stairs; wanting food, and in other respects convalescent. 12th.-Playing about the room with her sisters. She is quite well. The skin is peeling off, and shows -no other trace of the disease. CASE V.-M. H., aged 30 years. A coal porter by occupation. May 3rd, 1848.-Has had pains and swelling in his ankles the last fortnight. He is now confined to bed. Both legs are cover d with erysipelatous inflammation, from the feet to above the knies; they are intensely red, burning hot, swollen, and painful. Hie is feverish and thirsty; has no appetite; tongue white and coated; ias headache; and gets very little sleep. Take Belladonna 3, every four hours; preceding it by two doses of Aconite 6. 5th.-The lower half of the limbs are covered with vesicles, o small blisters. T Take Rhus 3, every four hours. ERYSIPELAS. 217 'ith.-No extension of the disease; but on the contrary the 1swelling and inflammation have considerably subsided. His health is much improved. Continue the medicine. 9th.-He is so much better as to be able to attend me at my house; the vesicles have dried up, and left a scaly condition of the skin. There is still some puffiness about the top of the foot and the ankle. Take Hepar Sulph. 12, three times a day. He has the same on the 12th, and is discharged cured. I have notes of a host of other cases which occurred in almost every form, in every degree of intensity, and in persons of all ages. A sufficient number are here detailed to show, that in those of the most formidable character, Homoeopathic remedies may be relied on with more unfailing confidence than can be awarded to sulphate of zinc,' nitrate of silver, punctures, or even Mr. Lawrence's instalments." In treating the foregoing cases the use of external applications was omitted. Experience, both in Allopathic and Homoeopathic practice, has satisfied rne that their operation is decidedly detrimental. Those cases which are attended with the formation of vesicles, generally run the most rapid and favorable course. The employment of cold lotions, &c., while they exert no beneficial influence over the disease, either locally or constitutionally, prolong its duration, by preventing its natural termination in vesication. 218 SCARLET FEVER. IT is customary to include under the head of " eruptive fevers," the names of a considerable number of affections; but as the greater part of them are merely symptops attendant upon other disorders, and possess none of the distinctive characters of the true exanthemata, beyond the mere discoloration of the skin, it appears more correct to restrict the term to small-pox, scarlet-fever, and measles. Between these there are certain points of resemblance, which not only prove their 'close pathological affinity, but also as strongly distinguish them from every other family of diseases. They are all highly infectious; chiefly incidental to the period of childhood; and are attended with a uniform eruption on the skin; they run a defined course; and for the most part appear but once in the same individual. The first of these diseases, notwithstanding that it does occasionally present itself, is so fast succumbing to the power of vaccination, as to warrant one in anticipatifg its complete extinction, when that preventive shall be more universally adopted. On this account, and not on account of any inefficacy in Homoeopathy to control its symptoms, it has "not been thought necessary to give it a separate notice, or to swell this volume with any illustrative cases.* k Living under the benign influence of vaccination, persons of the present day, have but an inadequate conception of the fearful 220 SCARLET FEVER. symptoms, suddenly assume the most alarming aspect, and baffle all our remedial efforts. In other instances, after the disease has run its course without any untoward circumstance, and the patient seems to be beyond the reach of its influence, one of its unfortunate sequeloe, especially kidney disease and dropsy, may overtake him, and not only subject him to much suffering, but even place his life in jeopardy. These contingencies, at all times troublesome, are much her presence: she immediately observed, " I cannot take that disease, for I have had cow-pox." This little incident rivetted the attention of JENNNE. Young as he then was, he dwelt with deep interest on a communication thus casually made to him by an uninstructed peasant, and foresaw in some degree the vast consequences which might result from so extraordinary a fact." Having achieved no mean reputation, both as a physician and as an author, in the old school of medicine, HAHNEMANN, wearied and disgusted with the uncertainty, and want of fixidity of principle every where prevalent in that system, had relinquished the practice of his profession, and betaken himself to the occupation of translating foreign works into his mother tongue. W "Whilst engaged, in the year 1790, in translating into German the Materia Medica of the Scotch physician, Dr. Cullen, his attention was so much attracted by the various, and apparently incompatible properties attributed to peruvian bark by that author, that he was induced to try the effects of that substance upon himself. He was in perfect health at the time, but to his astonishment, he found that repeated doses of decoction of bark produced in him febrile symptoms, bearing great resemblance to those of a certain kind of intermittent fever, known by the name of ague. As bark had long been known as a specific for the cure of ague, his sagacious mind suspected that something more than mere accident had caused this substance to produce symptoms so nearly resembling those of the disease which it cured. This phenomenon made upon * Concise View of Ilommopathy, Dublin. SCARLET FEVER. 225 CASE III.-E. L., aged 12 years, A fair, rather delicate girl. June 9th, 1847.-Was brought home from school yesterday. She has been languid some days. The eruption displayed itself this morning, with vomiting, and other severe symptoms. The skin is intensely red, and burning hot; her throat is very sore; she cannot swallow even a little liquid without much inconvenience. She is very thirsty, and requires something to moisten her mouth every five minutes; her tongue is red, and dry at the tip, and covered with a thick, white, coating in the centre. Her pulse is 140 in the minute, and very full and hard. She complains much of pain in the head, which she keeps buried in the pillow, and is quite unable to raise. All these symptoms mark it as a very severe attack. Take Aconite 6, and Belladonna 6, alternately, every four hours. 10th.-Suffering much with her throat; but otherwise doing very well. Pulse rapid, and much fever. Continue the medicine. llth.--She sits up in bed, and looks cheerful. The eruption hasnearly disappeared from the face. The body and limbs are still intensely red. The skin is not so hot, and the pulse less rapid; tongue quite clean, but very red throughout; the glands in the throat are still swollen, but not so much inflamed, nor is there any ulceration. She swallows more easily. Take Belladonna 6, every four hours. 12th.-Altogether greatly better. The constitutional symptoms all rapidly subsiding: she has an inclination for food. The eruption still out, but not so vivid. Belladonna, at bed time. 14th.-She feels well. The eruption has disappeared; the skin is peeling; her throat is quite well. To take light food, and discontinue medicine. CASE IV.-E. B., a girl, aged 4 years. June 25th, 1847.-Has been poorly a day or two-languid, lying about the house, and unwilling to move. Yesterday morning the scarlet eruption came out all over the body. There is burning heat in the skin, and general fever of a severe character. Her 2F 226, SCARLET FEVER. throat is swollen both outwardly and inwardly, impeding the swallow so much that she can only get down a drop or two of water at a time. She had a dose of Aconite last night; and to-day is to take Belladonna 6, every four hours. 26th.-The throat is greatly relieved. The swelling is much less, and she can swallow without much difficulty. The eruption keeps well out. She complains this afternoon of pain in the stomach. Take Pulsatilla 12, directly; to-morrow resume the Belladonna. From this time she progressed most favorably; and to day, the 29th, she is up, and about the room, appearing well, with the exception of weakness. The eruption has disappeared, she has no fever, and the throat is quite well. CASE V.-M. A. B., a girl, aged 13 years. Sister of the above. July 5th, 1847.-She got up with sore throat yesterday morning. Felt very poorly, went to bed again, and in the evening the eruption made its appearance. It now covers nearly the whole body. Her throat is very much swollen, preventing her swallowing anything. The constitutional symptoms run high-much thirst, fever, and headache. Commence with two doses of Aconite; then take Belladonna 12, every four hours. 7th.-Her throat is greatly relieved: she can drink with ease. There is not nearly so much fever and heat. She is altogether doing remarkably well. There are two children next door, laid up with the same complaint, and suffering dreadfully with throat affection. They are treated the old way, with leeches, poultices, &c. The child continued the Belladonna two or three days longer, and was then convalescent. CASE VI.-C. R., a lad, aged 15 years. August 16th, 1847.-Taken poorly two days since. He is now in bed, exceedingly ill. The eruption appeared yesterday: it is well out. The skin is dry, and burning hot; he has high fever; extreme headache and thirst; his tongue is dry, parched, and SCARLET FEVER. 227 brown in the centre. His throat is greatly inflamed and swollen,. so that he can neither turn his head, nor swallow, without much pain and difficulty. Take Aconite 6, and Belladonna 6, alternately, every four hours. 17th,-The eruption is out vividly over the whole body. The general excitement of the system has much abated: there is less thirst, heat, and headache; the throat, though still sore, is less painful and swollen. Continue Belladonna. 18th.-Great amendment in every" respect. The throat, which threatened to be severely affected, now causes but little inconvenience. Continue the medicine. 19th.-Still progressing most favorably. The eruption has nearly disappeared. The throat is well; and in every other way he may be pronounced convalescent. Take a few more doses of Belladonna. Cured. I have notes of several successful cases of a more dangerous kind than those here detailed. They were of a typhoid type: attended with extreme prostration of strength, and severe head symptoms;-stupor, screaming, slight convulsions; ulceration of the throat, lips, nose, &c. Recovery from these cases being always slow, the treatment was necessarily protracted and various. Their recital, though interesting in a medical point of view, would occupy more space than can be afforded them. I have, likewise, records of a considerable number of cases of dropsy, following scarlatina. Under Allopathic treatment this is always a most troublesome, frequently an intractable symptom. I have never seen a case, unless it had been neglected, and allowed to attain a very aggravated state, which did not yield readily to Cantharis, Arsenicum, Digitalis, &c. 228 MEASLES. THIS disease forms the third and last of the eruptive fevers we proposed to notice. Less severe and fatal than scarlatina, it is yet at times, on account of its complication with inflammation of the respiratory organs, a serious and troublesome complaint. There appears to exist a direct and unaccountable connexion between it and hooping cough, since, in numberless instances, no sooner does the child emerge from the one, than it lapses into the other. This sequence, together with inflammation of the eyes and disease of the ears, originating in a debilitated and scrofulous state of the system, often causes more trouble and anxiety than the primary disease. SThe same objections which were urged against the ordinary treatment of scarlet fever, obtain with even greater force in measles. In this disease the patients are less able to bear depleting remedies, on account of the greater tendency which the eruption manifests to " strike inward " and implicate some important internal organ. Unable to subdue inflammatory symptoms (especially in children) by any other than depletory measures, the Allopathist is compelled, when those symptoms present themselves, either to suffer them to pursue their destructive course uninterruptedly, or, by depleting, to incur the still greater risk arising from exhaustion. The subsequent cases, presenting some severe examples of the complications in question, show, also, with what facility, remedies, applied in accordance with an immutable law of MEASLES. 281 9th.-Loud bronchial breathing, rapid and confined to the upper 'portion of the chest. The lower portion dull in percussion, and respiration. In other respects very ill. Take Phosphorus 12, every two hours. 10th.-Amazing relief in every way. The breathing comparatively calm and regular; the skin cool, soft, and perspiring; its eyes are bright, and it sucks freely. Continue the medicine, at lengthened intervals. 1 lth.-Still improving, but there is a violent spasmodic cough. Take Belladonna 12, three times a day. From this period the child recovered rapidly, and without interruption. CASE IV.-Mrs. B.'s child, a boy,.aged 18 months. November 12th, 1847.-The eruption has been out twenty-four hours, pretty fully, but of rather a dark color. He is now labouring under the symptoms of acute inflammation of the lungs, viz.:short rapid breathing, burning skin, insatiable thirst, and rapid pulse. The head is likewise implicated: he is drowsy, heavy, and lethargic; the pupils are closely contracted, and the scalp is very hot; the eyes are inflamed, and the eyelids swollen; the mouth is foul; the gums ulcerated; and the lips covered with glutinous saliva. Take Aconite 6, every two hours. 13th.-The inflammatory symptoms much less urgent: the skin not so hot, nor the breathing so difficult. The head much the same as before. The eruption still showing, but faintly, and of a dark color, Take Aconite 6, and Bryonia 6, alternately, every four hours. 14th.-The inflammation of the- chest apparently subdued, the breathing being deep and natural in frequency; the skin not particularly heated, and the pulse less frequent. The head symptoms are now the most prominent: he is drowsy and lethargic, taking no notice when not aroused, and when disturbed, immediately relapsing into his former state. The eyes are clear, the pupils contracted. The pulse quick and full. Take Cuprum Acetat 12, every four hours. 233 ACUTE RHEUMATISM. A MODERN writer has stated it as his-opinion that " medicine has been, and still continues to be, so conjectural and uncertain, that our astonishment at the anxiety with which empirics have been sought after and followed, is much diminished."* Every one who reflects on the subject, must acknowledge the correctness of this observation. It is beyond dispute that the most powerful perpetuating cause of quackery is the lamentable uncertainty which characterizes the prevailing system of medicine. When men of the highest acquirements in the profession, are found diametrically opposed to each other in matters both of opinion and practice; when we see every school of medicine propounding its own favorite dogmas; almost every teacher starting, as a stepping stone to popularity, some new and fanciful, theory, and every medical man not only differing from his neighbour, but even himself losing to-day his own identity -of yesterday, can it be wondered at that the public should lose faith in a system, fruitful only in such instability and change, and award to the ignorant, but more consistent pretender, that confidence which should be monopolized by the educated and qualified practitioner! * T. J. Pettigrew, Esq., on the Superstitions of Medicine and Surgery. 2G; ACUTE RHEUMATISM. 235 tism is a highly inflammatory disorder; yet, says Dr. Elliotson, "we shall find it (the blood,) buffed and cupped. But there is no danger from this circumstance; for if we go on bleeding, we may find the blood buffed and cupped, till we have got nearly all the blood out of the body." An instance of this 'sort came under my own observation some years ago. I was called to visit a patient, in conjunction with a young physician, who had been attending him three weeks, and had verified Dr. Elliotson's words almost to the letter; The patient was reduced to the lowest ebb, by repeated venesections, and on my enquiring upon what grounds this had been done, the doctor brought forward a basinful of recently drawn blood, and pointed triumphantly to its strongly marked cup-shape, and thickly buffed coat, as an undeniable justification of his treatment. How much further this draining might have been carried, but for the intervention of a little advice suggested by greater experience, it is impossible, to determine; but it shows to what a broken reed those practitioners trust who use the lancet in this disease. Equally uncertain and indefinite is the rule for employing other remedies. Some rest all their hopes on mercury; others on the use of bark; colchicum has a band of admirers; iodine another; some trust to salines; some to purgatives; and, recently, a thick covering of wadding has been extolled, as the most effectual means of relief. It is, however, in the treatment of chronic rheumatism, that quackery finds its strong-hold. Unrestrained in these cases by the severe and dangerous symptoms which attend the disease in its acute form, the empiric finds time and scope for the exercise of his ingenuity in devising, and of his perseverance in applying, his remedies; and the patient, too well aware of the uncertainty which attaches to regular practice, submits himself a willing victim to his irregular adviser. Without asserting that in doing this he chooses the lesser 236 ACUTE RHEUMATISM. evil, it may be questioned whether he does not select the least painful; for, among the external remedies most in vogue, are, bleeding, cupping, leeching, blisters, setons, mustard-poultices, liniments, embrocations, and acupuncture! The quack may be the less successful practitioner of the two: he is certainly the most merciful. These remarks are not intended to convey the erroneous impression that Homoeopathy encounters no difficulties in curing rheumatism. On the contrary, it must be confessed that under the best treatment that can be brought to bear upon it, there is that about it, which renders it, at times, an exceedingly obstinate and intractable disease. But between the two modes of treatment, there is this great and essential difference, that, whilst Allopathy is uncertain, unscientific, and haphazard in its principles, painful in its practice, and, on that account, often unsuccessful in its results; Homceopathy,even when unsuccessful, has the sting of failure removed, by the consciousness of having acted on fixed and philosophical principles, and of having added nothing to the sufferings of the patient, by the torturing character of its remedies. That a cure should result from the latter, where failure had attended the former, is what one would naturally expect, and what experience proves to be the case. CASE I.-G. M., a man, aged 32 years, January 16th, 1848.-Some years ago was confined eighteen weeks with this disease. He is a smith by trade, and much exposed to sudden alternations of heat and cold. He caught cold a few days ago, and the present attack has been creeping on ever since. Both ankles and wrists, and the left knee, are much swollen, red, and so exquisitely painful and tender, that he cannot bear the least touch, or movement, of those parts. He lies on his back like a person paralysed. He gets no sleep: his pulse is full and ACUTE RHEUMATISM. 237 r'pid; skin hot and dry; the breathing short and quick, and Sattended with a good deal of cough and expectoration. He is very thirsty; his tongue is foul; he has of course no appetite. He has taken aperient medicine without benefit., Aconite 3, every three hours. 17th.-Diminution of the febrile symptoms: the limbs as painful, and as much swollen as before. The right knee is now implicated. Take Bryonia 3, alternately with the Aconite, every four hours. 19th.-Very great amendment. The ankles and right knee are comparatively well. The left wrist and hand, though weak and puffed, admit of free motion. He has had some sound sleep during the last two nights, but wakes in a profuse perspiration: he has but little fever or thirst. Take Mercurius 12, every four hours. 22nd.-He has progressed most satisfactorily since the last date. He retains but little trace of his complaint. The limbs are restored to their natural appearance. He suffers no pain; the perspirations have ceased; he has no fever nor thirst; his tongue is clean, and he has a good appetite. The chest symptoms, spoken of in the first instance, have entirely disappeared. Continue Mercurius, three times a day. 25th.-Quite convalescent. At times has some dragging pains across the shoulders. Take Rhus 12, twice a day. He required no further aid. CASE II.-Mrs. D., aged 30 years. January 18th, 1848.-Is suckling a child two months old. She keeps a shop, in a damp situation, and is much exposed to draughts of cold air. Was seized three days ago, with shiverings, and other symptoms of a cold, which resulted in the present severe attack of rheumatic fever. She is confined to bed: the knees, left arm, and shoulder, are the parts most affected. They are hot, dry, and swollen, (especially the knees,) red, and so intensely painful as to 238 ACUTE RHEUMATISM. render her incapable of bearing the least motion, and entirely preclude sleep, night and day. She is very thirsty; complains much of headache; her pulse is rapid. Take Aconite 3, every four hours. 21st.-Some subsidence of the fever: in other respects not much amendment. The pain has extended to the back, completely pinioning the arms, and rendering her as helpless as a child. Take Aconite 12, and Bryonia 3, alternately, every four hours. 24th.-The febrile symptoms have much abated. She is also more free from pain; gets a good deal of sleep; has but little thirst; no headache, and altogether enjoys great relief. Her skin is bathed in moisture. Take Aconite 3, every night, at bed time; and Mercurius, every four hours in the day. 26th.-Progressive amendment. Continue the medicines. 29th.-Is entirely free from pain: has no fever. Her only complaint now is weakness. She had previously suffered severely from two protracted attacks of this disease, and was, on that account, the more gratified at her rapid recovery on the present occasion. CASE III.-Henry P., aged 36 years. Has had three previous attacks of rheumatic fever. By each of the first two was confined fifteen weeks, and eleven weeks by the last. September 26th, 1848.-He has now been ill a long time, though not sufficiently so to keep him from his work, and during the whole period under medical treatment at a dispensary. Five days ago the symptoms assumed so aggravated a form as to compel him to take to his bed. He has been taking colchicum, iodine, Dover's powders, &c., without benefit. The pain now occupies the right hand and wrist, left foot and knee, and the back of the neck. These parts are swollen, hot, tender to the touch, and intolerant of the least motion. He is feverish and thirsty; has headache; full, hard pulse; and a short, hacking cough. Take Aconite 6, and Bryonia 3, alternately, four hours apart. 240 'LUMBAGO. this to Homoeopathic treatment. Bryonia, Nux Vomica, Rhus, &c., infinitely surpass, in their effects, any thing I was ever able to accomplish by Allopathic remedies. The following cases bear me out in this assertion. CASE I.-Mrs. W., aged 33 years. September 15th, 1848.-Six o'clock, evening. Had a chill a month ago, and ever since has felt pains flying about different parts of the body. Three days ago she became much worse, and at the present time is confined to bed, and rendered entirely incapable of moving, by a distracting pain across the loins, extending, also, round to the hip, groin, and down the left leg. She is feverish, hot, and thirsty. There are also some pains of a more mitigated character in both arms. Take Aconite 3, directly; Bryonia 3, every two hours afterwards. 16th.-At ten o'clock last night the pain began to abate, and has continued to do so, and she is now comparatively easy and comfortable. She can move without difficulty, and has lost all the feverish symptoms. Continue Bryonia, every six hours. 18th.-Up, dressed, and has felt no inconvenience the last two days, beyond a little aching in the loins yesterday evening. Pulsatilla 12. Cured. CASE II.-Mrs. S., aged 45 years. Has now been ill three days. September 1st, 1847.-She has had two previous attacks of the same complaint, for which she was bled twice, and cupped once. The present one is quite as severe as either of the former. She is in bed, lying on her back, quite unable to move, and screaming out with pain when she attempts to do so. The pain extends across the loins, and down the left leg. She has had no sleep the last two nights, and is thirsty and feverish, and feels altogether very unwell. Her messenger was sent to me with the request that I would go and bleed her: I preferred sending her Bryonia 3, to be taken every two hours. 9.2 SCIATICA. has used oil to the back, and taken Friar's balsam inwardly, to no purpose. His sufferings are now, to use his own expression, "dreadful." Take Bryonia 3, every two hours. 19th.-Already greatly relieved: he has not half so much pain as yesterday. He can get out of bed, and stand upright with tolerable ease. Continue the medicine. 20th.-Continued amendment. He is now, with the exception of some stiffness in the back, comparatively well. He had Nux Vomica, and resumed his work a day or two after. SCIATICA. GENERALLY considered to be inflammatory rheumatism of the sciatic, or large nerve of the thigh, is, on the whole, a more painful, and obstinate affection than that of which we have just been speaking. When suffered, by neglect, to become confirmed, there are, indeed, few, if any diseases, which entail upon their victims a greater amount of suffering and inconvenience. Like other forms of local rheumatism, it receives, at the hands of the Allopathic practitioner, much the same kind of treatment as lumbago. ACUTJS RHEUMATISM. 243 "The Homceopathic mode of dealing with it will be seen in the following cases. CASE I.-Mrs. B. aged 36 years. A stout woman, of dark complexion, and excitable temperament. June 14th, 1848.-Has been poorly the last week, with dyspeptic symptoms, and pain in the left hip and leg. This pain, the last two days, has increased to an intolerable degree. It commences at the posterior part of the hip, passes round to the groin, down the back of the thigh to the knee, (where it is very severe,) and thence to the heel. It becomes excruciating at times, especially so when she is warm in bed; on that account she is forced to get up, but can neither sit, stand, nor move, without great anguish. In the course of the night, and again this morning, she was seized with paroxysms of fainting and crying; she has no appetite, and feels nauseated. Take Chamomilla 3, every two hours. 15th.-Wonderfully relieved: she walks briskly from room to room, and says she does not feel a tithe of the pain she did yesterday. She hbad some sound sleep in the night. Continue the medicine. 17th.-She walks to my house from the City, a sufficient proof, alone, of her amendment. She retains little or no trace of her ailment, but thinks it safe to continue the medicine a day or two longer. Cured. CASE II.-Mrs. M. A. E., aged 23 years. February 10th, 1847.-She got wet ten days ago, and has ever since been troubled by occasional pains in the left leg. The day before yesterday she was exposed to cold damp air, and was seized in the evening with shivering, followed by severe pain, extending down the posterior part of the limb, from the hip to the knee. Pressure over the nerve, as well as movement, causes excessive agony. She is also suffering from all the symptoms of a cold. Take Dulcamara 12, every three hours. 2445 TIC-DOULOUREUX. THERE is nothing so intolerable to the mind as the idea of prolonged pain. In anticipation, death appears preferablein realization, the instinctive love of life, alone renders it endurable. Hence the dread engendered by the name of tic-douloureux. Its associations are those of agonizing pain, and indefinite duration-incurableness. Like other popular impressions, this is doubtless exaggerated; but, like them, it has truth for its foundation. There is no disease which has so often been put to the "rack," without the secret of its cure being elicited. Rolling on from age to age, and gathering in its course, the accumulating wisdom of successive generations, Allopathy finds itself still unable to remedy the ache of a nerve-twig! Whence this immobility? Why is it that the art of curing diseases remains now where Hippocrates left it two thousand years ago? " He used purgatives in great variety, and administered them with great freedom; he prescribed. diuretics and sudorifics; he drew blood both by the lancet and the scarificator; he applied cupping glasses; he administered injections, and inserted issues; he made frequent use of external applications, such as ointments, plasters, liniments, &c."* What more does the physician of eighteen hundred and forty-nine? Hippocrates knew little or nothing of anatomy, physiology, botany, * Dr. Bostock's History of Medicine; Cyclopadia Practical Medicine. 246 TIC-DOULOUREUX. chemistry, materia-medica. What does not the physician of the present day know on all these subjects? The question recurs with redoubled force, why, with the aid of all this borrowed light, does the practice of medicine remain station.. ary amid universal progression? We look in vain for an explanation in the history of other sciences-they afford no parallel. Astronomy, geography, mechanics, natural philosophy-the sister branches of the medical art which we have just enumerated-all these, though they may have been insignificant in their beginnings, and- obscure in their birth, yet have they, from age to age, continually and steadily advanced, expanding into maturity, and winning for themselves the lofty position we now see them occupy in the temple of learning. The secret lies in this-that while those branches of knowledge are based upon an accurate comprehension of natural laws, and from thence derive an onward tendency as irresistible as the truth from whence they spring, the science of medicine, as at present constituted, involves no such law-has no foundation in correct principle-and, on that account, is as incapable of advancement,-as a rootless tree is of growth. The necessity for a natural and universal therapeutic law, is keenly felt by the most enlightened disciples of Allopathy,* and no where is its absence more apparent, than in the ordinary mode of treating tic-douloureux. Its history is the history of medicine-uncertain, vacillating, fruitless: an unending circle of experiments, leading to endless disappointment. It would be a task of more time than profit to enumerate all the remedies-from division of the nerve, down to the hop-pillow-that have been essayed for removal of this disease. It is more interesting to know that the three * "Things have arrived at such a pitch, that they cannot be worse. They must mend or end!!"-Dr. Forbes.-British and Foreign Medical Review. TIC-DOULOUREUX. 247 remedies most confidently used by the Allopathist are essentially Homceopathic in their action: Arsenic, Belladonna, and Stramonium. If there is any one disease, on the treatment of which Homoeopathy would be content to rest its claim to superiority over the old system, that one is tic-douloureux. No where is the practical advantage resulting from the guidance of a permanent and recognized law more strikingly manifested, because, no where is it more successfully applied. So rich is Hahnemann's Materia Medica in remedies for this disease, that, judging from my own experience, I question whether the most confirmed cases may not be greatly mitigated, if not entirely cured, by their steady employment. In more recent cases, and those of an inflammatory, and rheumatic character, their efficacy is often truly magical. CASE I.-Mrs. A., aged 25 years. Plump, and generally healthy. November 16th, 1846.-Has been suffering from the present attack three months, during the whole of which period she has been under medical treatment. It seized her an hour after her confinement, and the gentleman who attended her, had her under care a month. Failing to get relief, she subsequently consulted three other medical men, but with no better success. All sorts of remedial devices were tried-she had two teeth extracted; blisters were applied to the cheek, and behind the ear; blood was repeatedly drawn by leeches; mustard poultices, liniments, and fomentations, were brought into requisition; besides creosote, camphor, and laudanum, as applications to the gums, teeth, and ear; and internal remedies were administered in corresponding quantity and diversity. Having attended her some years ago, she is induced, almost in despair, to come a considerable distance to seek my advice. She describes the pain as being of a tearifig, piercing kind, occupying the right side of the face and head, affecting the ear, jaws, teeth, and cheek-bone. She gets short intervals of ease, 248 TIC-DOULOUREUX. after which the pain returns with redoubled violence. The gums are inflamed; the face puffed; the teeth tender. Her health is bad; she is weak, feverish, and thirsty; has a foul tongue, and no appetite. Take Aconite 6, and Mercurius 6, alternately, every four hours. 17th.-The constitutional fever, and inflammation of the gums much abated. She can now, for the first time during her illness, close the teeth with tolerable ease. Take Mercurius 6, every four hours. 19th.-The pain ceased at seven o'clock yesterday evening, and has been felt but slightly since. Slept well for the first time these eleven weeks. Continue the medicine, every six hours. 20th.-Have been some pains felt at long intervals, particularly in the ear. They are, however, so trifling, in comparison with what she before suffered, that she " does not mind them." Phosphorus 6, a dose every six hours. 23rd.-Has felt a slight pain the last three evenings, from seven till nine o'clock. Cinchona 3, every eight hours. 28th.-Has had no pain the last three days; is altogether much improved in health. A few doses of Sulphur. Cured. CASE II.-F. R., aged 29 years. Dark complexion, weakly constitution. November 24th, 1846.-Ten days ago had a cold, for which he laid in bed, and took some medicine; got better, and resumed his business. On Sunday morning (this being Tuesday,) he was seized with distracting pain in the left ear, from whence it extended up the face to the temple, and across to the eye. It still continues unabated, with violent fits of exacerbation. The whole side of the face is hot, tense, and exquisitely tender to the touch, especially in and about the ear, where, also, there is a strong pulsation. He is distressingly prostrated in strength, being as powerless as an infant; he is propped up in bed; his head thickly enveloped in flannels; his voice, naturally full and powerful, is weak and puerile; and he TIC-DOULOUREUX. S249 utters constantly a low whine or moan; exhatstion and sleeplesskess have rendered him lethargic and heavy, and he is distressed by light and noise; his pulse is rapid and jerking; tongue dry and coated; and he is very thirsty. Directly he was taken ill he sent for a medical gentleman, who has attended him up to this time. He has been rather violently purged; is at present taking powders and a mixture, which. cause him to perspire,; he is also using an embrocation to the face and throat, and occasional fomentations. Take two doses of Aconite; then Belladonna 3, every four hours..,25th.-Fever, thirst, and heat abated: slight remission of the pain; still terribly exhausted; no sleep. Take four doses of Arsenicum 6, one every hour; then Phosphorus 3, every two hours. 26th.-An hour after the first dose of medicine the pain became lulled, (especially in the temple,) and he fell into a sound sleep; he now has occasional pains, of a subdued character, in the ear, and angle of the jaw. He has taken some nourishment; his voice has recovered its tone; and he is altogether another creature. Is still weak, and perspires in his sleep. Continue Phosphorus; and take Mercurius 12, at bed time. 27th.-Entirely free-from pain: much restored in strength and spirits; sat up an hour yesterday evening, and intends doing so to-day. From this time his recovery was rapid.- He had Mercurius and Sulphur, and, after a few days, went into the country. CASE III.-Miss C. 0., aged 26 years. Pale and rather delicate. July 31st, 1847.--Has been a martyr to: face-ache for years. Has had seven or eight teeth drawn, and submitted to a great deal of medical treatment, without gaining any permanent relief. The present attack (the most severe she has ever had,) has tormented her a fortnight. She gets short intervals of ease from the free use of laudanum, inwardly, and locally applied. Until yesterday the pain was on the right side; the left is now affected; it extends from the ear under the chin, to the teeth and gums, which are inflamed and swollen, causing a copious flow of saliva, and entirely 21 TIC-DOULOUREUX. 251, pain is increased to such an agonizing degree as almost to drive her Smad. She is then forced to lie on a sofa, or pace the room, with ' hot things applied to the face, to mitigate the pain. It occupies the lowerjaw principally. She has been under the care of a physician, who has prescribed a variety of remedies, without affording the slightest ease. He told her he could mitigate, but not cure, her malady. She had, first of all, Mercurius; then Arsenicum, in alternation with it; and got complete ease in the course of three days. About twelve months after this period (having left the neighbourhood,) she had another attack, and consulted a medical gentle. man of the old school. He attended her a fortnight, but failing to make any impression on the disease, she was induced to send to me for a packet of the same powders she had a year before. I sent a dozen Mercurius. She got complete ease in twenty-four hours, and has been perfectly well ever since. CAsE VI.-Mrs. W., aged 27 years. March 27th, 1847.-Has been afflicted a fortnight. The attack comes on every morning at seven o'clock, and lasts three or four hours. It occupies the right temple, the eye, eye-brow, and cheek bone; and is of -a tearing kind, and exceedingly agonizing at times. She has some decayed teeth, but the pain does not appear to be connected with them. The face is exquisitely tender to the touch when the pain is on. Take Cinchona 3, every two hours. 23rd.-This morning the pain is much mitigated. 24th.-Hardly any remains of the pain. Feels "quite different." Continue, for a day or two longer. Cured. FEVER. 253 "books for the convenience of description. Practically they are unimportant. The symptoms distinguishing the different -classes, are often so commingled as to render it impossible to separate them, and say under which head any particular case should be-placed. We will, therefore, not attempt to -draw on paper, a line of demarcation which does not exist in nature. There is no theoretical question in medicine more obscure than the nature of fever, nor a practical one surrounded by greater diversity of opinion, than that of its treatment. To the Allopathist this must ever be the case. His treatment of a disease is regulated by the notion he may entertain of its nature. The one being unfathomable,-the other cannot but be uncertain and unstable. Thus, Dr.,Clutterbuck, and those who agree with him, observing in most cases of fever a good deal of head affection, believe it to consist essentially in inflammation of the brain, and employ such measures as they deem best calculated to relieve that condition-those measures being comprised, principally, in the different forms of blood-letting. Others, again, disciples of the French physician, Broussais, (whose opinions prevail extensively in this country,) finding in many cases of fever unequivocal signs of mischief in the bowels, regard it as originating, in disease of those organs. These, disregarding the head, direct their attention, almost exclusively, to the removal of what they consider to be the cause of the disorder, and accordingly apply leeches by tens, twenties, and fifties, to the abdomen. To the Homceopathist the hidden source of a disease, though doubtless a subject of deep philosophical interest, is not a question- which influences him materially in his practice. Nature having vouchsafed to him the light which the symptoms throw upon the internal operations of the disease, he deems it safer to walk by this light, than to be continually hunting after that, which, no doubt for wise purposes, has 254 FEVER. hitherto been kept from his view. So, in his treatment of fever-uninfluenced by his inability to fathom the occult moving powers of the disease, but studying carefully all the symptoms-awarding to each its own weight, and attaching to no particular one an exclusive degree of importance-he selects such remedies as are calculated to include the whole circle of symptoms within its sphere of action. The result is that his treatment insures an amount of success, such as is sighed for in vain by those who direct all their attention to one particular organ, or class of symptoms, and entirely overlook, or take but little account of the rest. The Allopathist treats a symptom--the Homoeopathist a disease. A minute examination of the multifarious plans of treatment adopted by the Allopathists, would be an endless and useless undertaking. There is, however, one practical observation connected with this subject, of too much importance to be passed over in silence. I allude to the pernicious custom which prevails so generally, of giving purgative medicines in fevers. Some adopt it to a very great extent. Dr. Elliotson, for instance, insists upon the bowels being purged two or three times every day, and to effect this, advises the administration of five, ten, or fifteen grain doses of calomel, followed by castor-oil or senna, and this action is to be kept up from day to day. Many medical men do nothing more than give saline aperients. Others, and perhaps the majority, use them more sparingly. When we consider that in almost all fevers, if there be not absolutely inflammation of the lining membrane of the bowels, at least a strong tendency to it exists; that one of the most troublesome symptoms is relaxation, arising from this inflammatory condition and that we comparatively rarely see a fatal case of fever, where death may not be attributed mainly to the exhausting effects of incurable diarrhoea, we cannot but believe that the use of purgative 258 FEVER. 15th.-The relaxation has increased, with griping and some tenesmus. In other respects he is better. Take Arsenicum 12, every four hours. 16th.-The diarrhoea ceased with the first dose of medicine. Continue the medicine, every six hours. 18th and 20th.-Progressing favorably. Rhus 12, twice a day. 23rd.-Sitting up, dressed, and enjoying food. CASE IV.-Miss R., aged 22 years. Pale and delicate. September 16th, 1847.-Has been ill of typhus fever three weeks at Islington, where she was attended by a medical gentleman of the old school, but continuing to get worse, she was yesterday removed to her sister's home, in this neighbourhood. She is now so ill as to induce me to give a very qualified opinion as to her ultimate recovery. She has been taking a good deal of opening medicine. There is extreme prostration of strength: she sinks low down in the bed, on her back; her breathing is so short and rapid, that she cannot articulate the shortest sentence without stopping two or three times to gasp for breath. Her pulse is very rapid, (140,) and faltering; skin hot; she is intensely thirsty; her tongue is coated, dry, and cracked. There is trembling of the limbs; tenderness in the pit of the stomach, and over the whole of the abdomen. The bowels are much relaxed; every thing runs through her as she swallows it. She is delirious in the night, and gets little or no sleep. Take Aconite 12, and Arsenicum 12, alternately, every four hours. 17th.-Great amendment already. Many of the worst symptoms are entirely removed, and the others are much mitigated. Continue the Arsenicum. Aconite at long intervals. 18th.-Amendment still rapid: diarrhoea and abdominal tenderness disappeared. Her pulse is 100, soft, and round; her skin cool; tongue moist and- cleaning; slight thirst; sleeps well. To-day, for the first time, has enjoyed a little light nourishment. Take Rhus, three times a day. 20th.-She sat up three hours yesterday; enjoys food, and isquite convalescent. AND CONSUMPTION. 261 sources-ignorance, or knavery. Ignorance-inasmuch as any one, totally unacquainted with medicine, may be supposed not to know that consumption is incurable. Attempting, under such circumstances, to perform an impossibility, no one can mistake the proper position of such a man. Knavery-inasmuch as, the man who, knowing as every medical man must know, that genuine consumption is notoriously incurable, shall yet attempt to persuade the public that he possesses the wand whose magic touch shall stay its progress, can be influenced by no higher motive than a desire to impose upon his patients for his own advantage. With any thing so impure and unholy, Homoeopathy holds no fellowship. A cure for consumption is a boon which has hitherto been withheld from our race, and should it ever be bestowed, we are bound to believe that some purer medium for its communication will be selected, than is to be found among these greedy worshippers of Mammon. Leaving the future to the disposal of her own designs, it is certain that as far as the cure of consumption is concerned, the past presents nothing but a blank. Nor can this excite our astonishment; for when we consider the peculiar structure and function of the lungs-their spongy texture and unceasing motion-and bear in mind their condition in the progress of decline, it certainly does appear to approach very near to a physical impossibility, that under such circumstances they should ever be restored. But though unable to attain to the higher prerogative of cure, we are not, therefore, doomed to an impotent inactivity. The scarcely less important work of prevention and retardation invites our exertion. Here Allopathy and Homoeopathy come again fairly into competition, and it is to their respective capabilities that we wish now briefly to direct the reader's attention. In order fully to appreciate their differences, it is necessary to bear in mind two things. 262 SPITTING OF BLOOD, First-that consumption, in all its stages, is an inflammatory disease: and secondly-that notwithstanding this inflammatory condition, it is as undeniably a disease of general debility. With these two propositions before us, we are in a position to understand the embarrassing situation of the Allopathic practitioner, when called upon to treat a patient labouring under either the premonitory, or more advanced symptoms of consumption. He finds himself (to speak somewhat figuratively,) face to face with a patient, who presents to him on the one side, the flushed cheek of inflammation, to relieve which, (if true to his principles,) he must in some way or other withdraw blood: and on the other side, the pallid cheek of exhaustion, which imperatively forbids the use of any debilitating remedy. The alternatives are, death according to nature, and death secundem artem. That an assertion so startling, but at the same time so true, may lose none of its weight, by resting solely on my unsupported authority, let us hear what Dr. Law, of Dublin, says on the subject in his article, in the Cyclopedia of Practical Medicine. "We would only observe, that the causes which call a tuberculous diathesis (consumptive tendency,) into operation, are such as have the effect, either directly or indirectly, of debilitating the energies of the constitution; and that, therefore, though hemoptysis (spitting of blood,) be a complication with which we cannot tamper, but which we must meet with decision, we cannot but regret the dilemma in which we are placed, by a symptom requiring a mode of treatment, which we have reason to apprehend may have the effect of increasing that condition of the system which has given rise to the original disease." This, expressed in rather an abstruse and mystified manner, put into plain language, amounts to the declaration, that in treating spitting of blood " with decision,".(by which is meant bleeding, AND CONSUMPTION. 263 &c.,) we go the proper way to increase the disease on which thati symptom depends! This is certainly a curiously inverted mode of- cure; and was it not too notorious, that in expressing his own opinion, Dr. Law does but echo that of all his brethren, we might have attributed it to the well known influence of Hiberniaii air in originating a curiously inverted mode of reasoning on matters in general. What, after this, does the reader suppose is the plan of treatment usually adopted in these cases. Surely, he exclaims, they do not bleed! Let us see. This is Dr. Elliotson's advice-" On the immediate occurrence of hemorrhage (bleeding,) from the lungs, it is right to treat it as inflammation; to bleed in the arm freely." Dr Law, (whom we have just quoted,) says,-" In an attack of active hemoptysis, general bleeding, proportionate to the vascular organs, and to the strength of the individual, must be employed." Dr. Copeland in his Dictionary of Medicine, remarks,"If the patient be robust or young, if he have not suffered long from pulmonary disease, and if the hemorrhage has not been very great, blood-letting ought to be immediately performed in the arm, from a large orifice, until an impression is made on the system, or faintness ensue." We might quote the same opinion, varied only in expression, till the list of writers was exhausted; the practice, in short, is universal. If it be a first attack, the bleeding is plentiful-if it occur subsequently and repeatedly, as it often does in the course of consumption, then the bleeding is more moderate, and is performed by the cupping-glass and the leech, instead of the lancet-but however employed, and to whatever extent, the tendency is still the same; it debilitates the patient, and so hurries on the fatal catastrophe it is intended to avert. We have hitherto omitted to mention 264 SPITTING OF BLOOD, blisters, antimony ointment, embrocations, &c., which are applied to the chest, and which, by their painful action, still further exhaust the patient. Such is, in part only, the Allopathic mode of treating spitting of blood and consumption. Let us now examine how Homoeopathy deals with these cases. Consulted in the first dawn of the disease, she can either entirely arrest its progress, or keep it at bay for an unlimited time; and at a later period, when it has attained a firmer hold, and a cure becomes hopeless, she can check its advance, and by the removal of those distressing symptoms which surround the disease, and constitute the patient's severest trials, can assuage his sufferings, and smooth his passage to the grave. The symptoms here alluded to, are, the local pain in the chest, and constant harassing cough; the fever, thirst, and exhausting perspiration; the vomiting, loss of appetite, and wasting diarrhoea. A few words will explain how this good is effected. The reader has already learned that Homoeopathy cures inflammation of the lungs without drawing one drop of blood, or employing any of those other painful means on which Allopathy relies. The remedies which accomplish this object are equally available in subduing the inflammation which attends upon consumption. Checking this inflammation, we allay the cough which it originates, prevent the hectic which consumes the patient's frame, and at the same time ward off the draining night-sweat, which is its natural outlet. For the vomiting, loss of appetite, and diarrhoea, when they are the products of disease, Homoeopathy finds prompt relief in the use of appropriate remedies; and to prevent them, when, as more frequently happens, they result solely from the administration of large quantities of nauseous and irritating 266 SPITTING OF BLOOD, 15th.-Improving. Phosphorus 6, three times a day. From this time his recovery was rapid. He went to business on the 22nd, but, having a little suspicious cough remaining, he was advised to go into the country. After a month's absence he returned, looking as hearty and robust as usual, and has continued so ever since. CASE II.-A dark, large built man, aged 35 years. An engineer. February, 1847.-Has been wasting in flesh, and getting weak for some time past. He had a cold in the first instance, and has ever since been troubled with a severe cough. This morning he spat up a considerable quantity of fresh blood. His pulse is quick and small; breathing short; skin cool; no particular thirst. He has a pain through the chest, under the left collar-bone. The breathing sounds are imperfect and dull in that spot. He took a few doses of Aconite; Phosphoric Acid; and Carbo Vegetabilis. The spitting of blood ceased; the cough gradually subsided. His general health improved rapidly, and at the end of three weeks he felt perfectly well, and has remained so up to this time. CASE III.-A young, single woman, aged 19 years. October, 1848.-Has been ill five months; nearly the whole, of the period under medical treatment. She has all the symptoms of consumption-wasting; great debility; chilliness in the afternoon, succeeded by heat, thirst, and flushed face; loss of appetite; hot skin; small, quick pulse; night-sweats; a pain through the chest, on the left side, under the collar-bone, extending to the back; a hard, distressing cough, with yellow expectoration; inability to lie on the affected side. Auscultation detects distinct crepitation in the seat of disease, dulness on percussion, and bronchophony. She has taken a good deal of opening medicine. The bowels are much relaxed, and the abdomen very tender. She took Arsenicum, Mercurius, Phosphoric Acid, and Carbo Vegetabilis. The action of these medicines was most striking and gratifying. At the end of a month she considered herself, and really appeared AND CONSUMPTION. 267 to be, quite well. All the above symptoms had vanished; she had regained her strength and spirits, and resumed her usual occupation. There was still a slight cough, and the sounds of the chest, "though not healthy, had greatly improved. At this time she was forced to remove to a distance; I'am, therefore, unacquainted with her subsequent history. CASE IV.-A young woman, aged 20 years. Always delicate. September, 1848.-Has been troubled with a slight cough, and losing flesh for some time past. Has now been confined to bed three weeks. 'Has had no regular advice. The system is in a state of high excitement-general ebullition. She is exceedingly exhausted; cannot sit up in bed a moment without fainting. She is feverish, thirsty; has headache; rapid breathing; short, hacking cough; has a pain on the left side, passing through the chest, under the collar-bone, and preventing her resting on that side. There is distinct mucous rale in the upper and posterior portion of the right lung, with bronchophony: loud breathing in the left. She gets particularly hot and flushed in the evening, and perspires profusely towards the morning. Looking at the case in all its bearings, I did not feel justified in holding out the least hope of her recovering sufficiently to leave her bed. In this I was happily mistaken: not only has she left her bed, but for months past has been in the enjoyment of tolerable health; so good as to admit of her venturing out once or twice to visit me. Under the action of Aconite, Arsenic, Phosphoric Acid, Carbo Vegetabilis, Kali, and some other medicines, varied according to symptoms, she rallied rapidly; regained her appetite, and with it her strength. She is now looking plump and well, and though there remains a cough, with some unhealthy sounds in the chest, I am not without hopes of her ultimate restoration. - CASE V.-A young female, aged 17 years. Formerly stout and plump, and still looking'fat, though sallow, in the face. October, 1848.-Has been labouring under symptoms of consumption the last nine months; under treatment the whole time, 270 SPITTING OF BLOOD, ETC. Her symptoms have varied greatly in the interval-at one time better, at another worse, now spitting blood, again relieved, and so on; but, on the whole, so great has been the comfort derived from the medicines, that she has never been able to go more than a week or ten days without them. She walked the distance of a mile to visit me six weeks ago; since then I have not heard of her. CASE VIII.-A man, aged 39 years. June 7th, 1848.-Ill two years. Eighteen months under medical treatment. Spat blood two months agQ; now in rapid decline. Short breath; coughs yellow matter; is hoarse; wastes; perspires at night; feverish; no appetite; diarrhcea; hectic. Upper part of left lung completely disorganized: much pain in that part. He had Phosphoric Acid, Mercurius, Kali Carbon, Lachesis, &c. From these medicines he derived immediate and great relief; so much so, that he really began to flatter himself with the idea of a complete restoration. His cough became less distressing; the pain ceased from the chest; his appetite returned; his strength rallied; he could lie on his left side, which he had not done for eight months previously. In this way he went on for the space of about six weeks, when, from particular circumstances, he was forced to leave my care. He died about a month after. November, 1850.-It is satisfactory to be able to state that five out of the eight foregoing patients are still living; and that in the majority of them, disease has made but little, if any, progress since their cases were recorded in the first edition of this volume, nearly two years ago. 2 74 INJURIES. His restoration was rapid and uninterrupted. He applied Arnica Lotion to the scalp; and took inwardly, Arnica, Belladonna,'and Sulphur, for the removal of some lingering tenderness in the brain. CAsr II.-E. C., a female, aged 50 years. April 7th, 1847.-Eighteen hours ago was knocked down, and in her fall came in contact with an iron fender, which bruised her frightfully across the lower part of the back, where she is swollen and tender, and completely discolored. One of her legs is also seriously bruised, and much swollen. The ear which received the blow is considerably damaged. She is in bed, suffering much pain in all the injured parts, as well as from general fever, thirst, and headache. Take Aconite 3, directly; then Arnica 12, every four hours; and moisten the bruise with Arnica Lotion. 8th.-Wonderfully relieved: nearly all soreness gone out of the bruises, and she is free from fever. Continue the same treatment. 9th.-Still improving. Continue. 10th.-Up and about her house. Simply some discoloration. Cured. C.sE III.-I. C., a boy, aged 9 years. May 13th, 1847.-Fell down yesterday evening whilst at play, and str-uck the left eye, violently. The lid is immensely swollen, not only filling up the socket, but projecting out fi-om the face, in the form of a large, round tumour. The upper lid hangs down, completely overlapping the lower one, and rendering it impossible to get a sight at the eye. The whole of this part of the face is deeply discolored. Take Arnica 12, every four hours; and apply Arnica Lotion to the injured part. 14th.-The swelling has almost entirely disappeared: there is only a little puffiness in the upper lid; the eye is wide open,-and fortunately uninjured. Continue the Arnica Lotion, a few hours longer. Cured. IU