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'I I,... - I ý ll I -.,., - I- ýtý "Y"., ý _ý,, ý.,.' '. ý,,,ý " r.... I,.:._ý I ýý,,-.,.ý,ý v z. - k; %-,, - I, 1. _.,..,.. ý: ý " - ýý',,., I vý,ý..(ý' ý.. "''. -:, ", ý.d L s*4..ý ý 'tj i'- -1.,,;-- I, -.,, ( ý,, ýý,, - ': ';,ý f ", ý -., - - 1ýý, I.::. _ý ý,ý ý -,.. - ", ý,., kký', _..:: -,--I ý., 7- -. ý I -, -- -.1 -.,*. ',, -,,, -.,. I li.".'ý -, I ý,_ý,kf.,, "'i. "... ý, ý, - --)..,ý-j.,-,!-,fý i -,. ý,;._,:I- '_....,ý 1:', 11- I. -. ". i -.:ý -!. r--,,-., 1ý -... I - 1-1 ý(, t." I.. N;-,,. -., 1, ý-ý, ý.,_ g q ý _ý 1 V 11 ý'.1..I, * " V fr&41b.OAK V., / F K ' / lW * C) K, t 4 4 '''C -t K -. 'I t-t I-'!' -HOM(EOPATrHIC MEDICINE. HOM(EOPATHIC PRACTICE OF MEDICINE. cL2 - BY JACOB JEANES, M. D. PHILADELPHIA. PRINTED BY A. WALDIE, NO. 46 CARPENTER STREET. 1838. Entered according to act of congress by JAcoB JEANES, M.DJ, on the 9th day of June, 1838, in the clerk's office of the district, for the eastern district of Pennsylvania. TO CHARLES F. MATLACK, M.D. WHO WAS THE EARLIEST AMONG THE GRADUATES OF THE UNIVERSITY OF PENNSYLVANIA ENGAGED IN THE PRACTICE OF MEDICINE IN PHILADELPHIA, TO ACKNOWLEDGE THE TRUTH OF THE DISCOVERIES OF HAHNEMANN, WHICH ARE GRADUALLY EFFEC'ING A DENEFICENT REVOLUTION IN MEDICINE, THIS WORK IS RESPEQTFULLY INSCRIBED BY HIS FRIEND, THE AUTHOR. ADVERTISEMENT. As it was known to many of the friends of homoeopathia that Dr. Jonas Green and myself were for some time engaged in the preparation of a practical homceopathic work, it may not be improper to inform them, that from the inherent difficulties of combined authorship, that purpose was abandoned: it being mutually agreed that I should carry on the work alone. A renewed reference to the German works in order to cite the cases, &c. in satisfactory detail, and to procure the latest information, in order to "present to the American physician as complete a book of practical homoeopathic medicine as can be done in the present state of the science, necessarily required considerable time. This, together with demandsmade upon my time by the duties of a large circle of practice, will account for any apparent delay in bringing the work before the public. A very small edition of this work is published, as the demand cannot be expected to be very extensive. The price.of the work, therefore, in order to meet the expenses, must be considerably higher than that of books for which the demand is more general. J. JEANES, M.D. Philadelphia, June, 1838. PREFACE. Works of the character of the present volume appear to be advancing in the estimation of the homcopathic physicians of Germany; at least, several books by different authors have appeared there within a few years, and each later one not only increased in bulk by the introduction of additional facts, but also entering into more minute details of the cases which in the earlier works had been merely mentioned. It is only necessary to compare the small pocket volumes of Haas and Glasor with the large work of Ruckert, in order to be satisfied of these facts. No lengthened argument is requisite to prove the great utility of practical works of this kind, to the homoeopathic practitioner; although it must be acknowledged that they are liable to some abuse. This, however, should not prevent us from availing ourselves of what is really advantageous, since there is nothing which is good that is not liable to misapplication; and we might as well deprive ourselves of the advantages afforded by fire, because it may prove destructive of our property, as to refuse other positive good because we may be induced to abuse it. The greatest mischief that can be expected to result from the employment of practical works like the present, is, that indolent physicians will be inclined to prescribe rather according to the name than the symptoms of the disease. But this, when it is brought to the test of examination, shrinks into insignificance: for where a physician is sufficiently indolent to act in this manner, the matter would, certainly, not be much improved if he possessed only the volumes of the materia medica, in which he may without much trouble find a remedy which will meet many of the symptoms of a case, but still so imperfectly, that he would be less likely to make a proper selection than when aided by a proper general guide. 1 2 PREFACE. -It is a great advantage which the homceopathic practice of medicine possesses over all others, that, in novel or undescribed forms of disease, which are much more numerous than physicians are generally aware of, it enables the practitioner to ascertain the proper remedies with tolerable success. This it does by means of the symptomatology of its remedial agents, the investigation of which has been pursued with surprising industry, perseverance, and success. But as the same symptoms (or at least the same so far as regards the import of the words in which they are communicated, and we possess no other medium for their communication than language) are not of equal value under every remedy, there is still considerable risk of the selection of a remedy which is of inconsiderable value compared to another, in the treatment of a given case. It is therefore of no slight advantage to know that cases of the same kind as that which we are about to treat have been cured by such or such remedies. The probability is very great, that among these is to be found the remedy which, of all those with which we are yet acquainted, is the best adapted to our case. Notwithstanding the high estimation in which he very properly held the advantage of being able to select, oftentimes with perfect accuracy, the proper remedy by means of the symptoms, Hahnemann appears always to have recognised the importance of a knowledge of those remedies which had proved most generally or most strikingly useful in those diseases which present a somewhat constant and fixed character. He has, therefore, from time to time, as experience has confirmed the value of remedies in such diseases, not hesitated to recommend them to the attention of physicians. Other physicians having imitated his example in this respect, homceopathic medicine is at length able to present very useful, though far from complete works, based upon experience in practice, and which may serve as guides to the proper remedies for many forms of disease. At the present time we labour under the disadvantage of having to employ, in our practical works, the old names of diseases, which are often applied to complaints which possess PREFACE. 3 very considerable differences in character, although they have some prominent symptoms in common; or they apply to a definition which, being intended to embrace a variety of diseases, presents a combination of symptoms which has been rarely if ever presented in nature, while comparatively few of them are restricted in their application to affections of a fixed and constant character. Therefore, when we mention such or such remedies as being useful in a disease, we do not mean to prescribe for a particular disease, but merely to refer the physician to such remedies as have proved beneficial in cases where the symptoms, which are prominent in the definition, have been present in a violent form. More particular information is, however, communicated by the cases which are accurately drawn from nature.- It is perhaps possible -that a case pf disease may be peculiar, and never have its fellow; but as a general rule, when we find a form of disease in one person, it is most likely that it will be found in some others. This arises from the facts, that the same pathogenetic agent will often produce the same disease in different persons, and that different pathogenetic causes may induce the same or closely similar disorders of the same tissue or organ. Thus, gastric disorder, which arises from the extravagant employment of alcoholic drinks in one person, is very similar to the derangement of the stomach in other persons from the same cause, and may generally be removed by nux vomica. This remedy will also frequently cure the gastric disorder from the use of coffee, and from some other causes. But as all forms of disease in a particular tissue or organ, or all forms of disease arising from the same cause, will not yield to the same remedy, owing to difference of constitution or previous exposure or habit of the patient, the observation of the physician must be constantly exercised, to detect in the varying symptoms the indications which will show one or another remedy to be more appropriate to the case. In observing the number of circumstances and agents which so frequently and powerfully modify morbid action,,the uniformity of this action, at least so far as it is marked by the curative operation of remedies, is sometimes a matter of 1* 4 PREFACE. surprise. Croup furnishes an example of this; for, while it occurs in children of almost every variety of constitution, and appears to be excited by very different causes, it still most commonly yields speedily to the remedies which have been recommended by Hahnemann for its cure. These have proved efficacious, both where this disease has resulted from cold, and where it has been the effect of scarlatina and of measles. As, notwithstanding the difference in the causes by which it is excited, and in the conditions of the systems in which it appears, these remedies exercise such a powerful control over the croup, we must infer that their efficacy arises from a property which they possess of operating powerfully on the tissues involved in this disease. This inference is in accordance with the induction which Hahnemann has drawn from the fact of homoeopathic cure-namely, that the cure happens because the remedial disease, on account of its similarity, seizes in preference upon the same parts of the organisation as have been affected by the previous disease, which therefore cannot operate and is extinguished. The opinion of Hahnemann, which has just been quoted, appears to be a just and legitimate induction from observed facts; and if it localises disease, it has the support not only of the facts from which it has been deduced, but also from those which have been ascertained by the industry of modern pathological anatomists. These also confirm the value of his precepts. For instance, he teaches the necessity of observing all the symptoms of a case of disease, and of selecting as nearly as possible a remedy which is calculated to remove all these symptoms. Now, modern pathological anatomy teaches us, by its dissections, what Hahnemann before observed in the symptoms and progress of disease; namely, that disease of an important organ seldom or never exists alone, but, according to the nature of the morbid action or of the part originally affected, induces, in a particular order or direction, sympathetic diseases in other organs. Although these diseases may exist at first as functional derangements, they may sooner or later produce organic lesions, which will reveal to the anatomist the pre-existence of the disease. As, in a ma PREFACE. 5 chine, a disordered movement in any of its parts must be felt throughout the whole structure; so we can hardly conceive of any derangement of that complicated structure, the human organisation, especially in its more important organs, without consecutive disorder in other parts. Whatever credence or value we may attach to these observations at the present time, it has been only of recent date that they have been considered of much importance, or have attracted much attention; therefore, when Hahnemann published the symptoms produced by remedies tried upon healthy persons, the multiplicity of syinptoms induced by a single remedy was viewed as a matter for laughter and ridicule. But we can now understand, that when a pathogenetic agent deranges the action of any organ or organs, a train of morbid actions in other parts will, in all probability, be the result of this derangement. It is obvious, therefore, that if we possess a remedy which has the power of affecting an important part, we must have from it the symptoms of such affection, and of the consequent sympathetic disorders. The symptoms produced by siuch a remedy must therefore be numerous, and capable of meeting the symptoms which arise from disease of the same parts, induced by other causes. If the localisation of disease is a fact in nature-and the inference that it is seems, as already remarked, to be a legitimate induction from observed facts-it would appear to follow that the remedy which acts positively and immediately upon any tissue is better adapted to the diseases of that tissue, than a remedy which acts indirectly upon it, through its positive action on another organ with which the former is in close relation or sympathy. A knowledge of the actual seat of a disease, of the morbid relations of different organs to each other, and of the seat of the most frequent and powerful impressions of remedial agents, may therefore be of great advantage to the homoeopathic physician. Observation of the operations of remedies in disease, conjoined with experiments with the remedies on healthy persons, ought to be instituted with a view to ascertain the facts in relation to these points. It is true, that in the present state of our know PREFACE. 7 And as false pathology, in, relation to inflammation and bloodletting, has the strongest hold on the minds of the physicians of the present day, this may be selected by way of example. Nearly if not quite all internal lesions of structure, which are not the effects of actual violence, are considered to be the consequences of inflammation; and blood-letting, in one form or another, is viewed as the appropriate remedy. But as we see in external parts, lesions of structure without apparent inflammation, as, for instance, erosion of the cornea in some species of marasmus; and as we observe other external lesions for which, although they are attended with redness from dilatation of the blood vessels, the detraction of blood is by no means beneficial, we may certainly be excused if we view the pathology as false, and the therapeutic views as ridiculous, although the physicians who hold these doctrines proclaim them as those of rational medicine. There seems to be a general belief that blood-letting, in inflammatory diseases, has a rational support independently of that derived from experience of its utility. But no such support can be found. It is true, there have been many speculations in regard to the nature of the morbid actions which constitute inflammation, and in respect to the modus operandi of blood-letting in their cure. None of these, however, have given general satisfaction, and there is no reason to be surprised because they have not. Inflammation exists in vessels and parts which are under the influence of the vital principle, and are unquestionably the result of a modification or innormal action of that principle. The blood-vessels therefore cannot be considered as mere inanimate elastic or inelastic tubes, and any inferences deduced from such views cannot be considered as rational. And as we do not understand any thing of the vital principle but its effects, or in other words, while we can witness the phenomena of life, and while we do not understand its nature or the modes by which it produces these phenomena, we cannot comprehend the nature and true character of the actions which constitute inflammation, since these are some of those vital actions which we do not understand. Neither are we able to 8 PREFACE. explain the modus operandi of blood-letting in its cure, because this is not the same as tapping inanimate tubes, but an operation which, whether it acts beneficially or injuriously upon the disease, does so through its power of modifying the condition of the system; and the why and the wherefore of its action in either manner is no easier to be answered, than why calomel purges, tartar emetic vomits, or cinchona cures an intermittent fever. Local bleeding, that is, the abstraction of blood from the affected part or its immediate vicinity by means of scarifications, leeches, &c., has sometimes proved more useful than phlebotomy, and is preferred for many diseases (though for what reason, independently of experience which many of the self-styled rational physicians are in the habit of decrying, I know not.) Having decided that the disease consists in an inflammation, say of the mucous membrane of the intestines, they direct the application of leeches to the abdomen as nearly as possible over the part which they presume to be affected. It is indeed sometimes really laughable to see these rational practitioners pluming themselves on their exactness in the application of their leeches immediately over the affected spot; and one day directing them to be applied a little higher or Slower, and on the next day a little more towards one or the other side. The matter is ludicrous only because they are rational physicians par excellence; and because what they term local abstraction of blood, although performed within an inch of the affected part, if the distance be measured in a direct line, is, if we follow the continuity of structure, actually performed at the distance of more than one half of the circumference of the body from the inflamed spot. Indeed the skin of the back is much nearer to the affected mucous membrane, in pursuing a continuity of structure, than the skin of the abdomen, which is not only separated from. the mucous membrane of the bowels by muscles and tendons, but also by the cavity of the peritoneum. When such practice is recommended on the ground of its rationality, it is to be rejected; but if recommended and sustained on the ground of experience, it is more worthy of // PREFACE. 9 attention, and should be adopted, if experience proves it to be more efficacious in restoring the sick to speedy and perfect health than any other mode of practice. Experience is the foundation which is claimed for itself by hommopathia. It asserts that it stands upon certain facts, the truth of which can be ascertained by experiment. It challenges an investigation of its facts, but it demands that this should be conducted in the spirit which should govern in all the investigations of natural science-a spirit which is under the dominion -neither of prejudice nor self interest, and which is impartial in its judgment and rigid in the reception and scrutiny of evidence. The doctrines of homoeopathia, which are the mere statements of, or only the fair legitimate and immediate inductions from these facts, are a striking example of the inductive system; that is; "the observation of facts and the embodying of those conclusions that legitimately flow from them." This system of philosophising, which has been strenuously urged by Bacon, is one which has been pursued more or less strictly by men of sound judgment and good common sense in every age of the world. As remarked by Dr. Stokes, "In the writings of Hippocrates you will find the principles of the inductive philosophy. A physician showed Bacon the road to immortality."* But however plain may be the necessity of adhering in matters of science to the strict rules of the inductive system, there is very great danger, unless we are constantly upon the watch against it, of our allowing prejudice, rather than observation and experiment, to decide upon what are the facts in nature, and of our allowing hypothesis to take precedence of fact. The following copious extract from an introductory lecture delivered recently by an estimable and talented medical professor, while in many of its parts it is strongly confirmatory of some remarks already made in this preface, also shows "* Lectures on the Theory and Practice of Medicine. Edition of the American Medical Library, page 7. 10 PREFACE. how fully the lecturer recognises the importance of strict adherence to the inductive system in medicine; and when considered in connection with other parts of the same lecture, exhibits to us in a striking point of view the great necessity of caution against the infraction of those rules, the positive necessity of which we readily admit. "You may receive it as an indisputable truth, that any claim to your guidance in the use of medicines, founded upon an hypothesis assuming to be of universal or even general application, is wholly groundless' and futile. The facts of our science are yet far too limited to enable us to form a general theory of medicine upon the only true foundationthat of strict induction. How is it possible for us to draw from our knowledge of the human system a doctrine explanatory of all its morbid actions, when we are almost wholly in the dark as to the nervous functions, and of the principle of life itself know scarcely more than its existence? We might as well attempt to form an accurate map of a country from our knowledge of a few of its prominent points, while ignorant alike of its boundaries and its interior. Yet so presumptuous is man, that he frequently undertakes the impossible task. With intellectual powers, which, in comparison with-the object, are infinitely feeble, he strives to penetrate the secret counsels of Almighty wisdom. Like the giants of old, he heaps up his mountain upon mountain, and -with audacious vanity hopes to seize upon heaven itself by violence. There is' only one path to truth in science, and that is the straight but narrow and laborious path of observation and experience. It is true that false theories, if without practical bearing, may sometimes be useful as aids to the memory; but when they have relation to human life and happiness, they become engines of incalculable mischief. Systems of medicine, therefore, claiming to be universal in their scope, as they are necessarily false, must be of the most injurious practical influence, and, though often attractive to the inexperienced by their apparent beauty and labour-saving promises, should be discarded as sweetened poisons poured into the very fountain of life. It is a most grateful reflection, that the 12 PREFACE. proportion recover than under the treatment of irregular practitioners in general. Nay, I will go further, and admit that a disciple of Hahnemann may be more successful than a very ignorant and unskilful physician, even though the latter may take rank in the regular corps. But what is the real cause of this apparent success? I have too good an opinion of your common sense to suppose, that you can for a moment be disposed to ascribe it to the infinitesimal doses administered to the patient. Can any one of you possibly believe, that the decillionth of a grain of any medicine kept in the shops, a portion far too minute to be visible to the naked eye, and which the most powerfully magnifying microscope would be insufficient to detect, is capable of producing the slightest impression on the system?" Philosophers, at the time when Bacon lived, were very much in the practice of deducing the facts in nature from their imaginations, opinions or reasoning. It was the desire of this philosopher to correct a practice so little adapted to increase the amount of knowledge, and so well calculated to lead into error. Let us see how far the learned professor, whom we have just quoted, has wandered. from the path of which he approves. We find that he considers it unnecessary to guard the medical class against a belief in the facts of the cure of diseases by remedies which can cause similar diseases, and by the operation of infinitesimal doses, because of the enormity of the former and the folly of the latter fact. From any belief in these preposterous facts the common sense of the students is to save them. Here the lecturer expresses the opinion that the common sense of young men, whose feet have just for the first time pressed the threshold of the temple of natural science, is sufficient to enable them to decide upon what are the facts in nature. All are not possessed of common sense of this kind which introduces them at once to truth in science by some other way than ": the straight but narrow and laborious path of observation and experience." And those who do not possess it will be very likely to doubt its possession by others, especially when they study its bearings, and reflect that if common sense will enable a lad to tell PREFACE. 13 what dose of medicine will not operate, it must also favour him with the knowledge of what dose will operate. And if common sense teaches what dose operates, does it not communicate the idea of some action which constitutes this operation? Or, in other words, does common sense communicate the word operate to the mind of the student, or does it communicate an idea of the operation? If the former, it is an oracle only for the dose; if the latter, the student is able not only to tell by his common sense the dose which will operate, but how it will operate, what peculiar symptoms constitute its operation, &c. It is needless to expend many words on this matter, as it is clear that the lecturer is inconsistent, in first denying more than one path to truth in science, and that a narrow and laborious one, and afterwards recommending a highway so broad and easy as common sense. It is to be hoped that this example may answer the purpose for which it is here introduced, of showing to us, in a prominent point of view, the strange inconsistencies into which we may run, if, while we recommend the Baconian path, we allow prejudice and common sense,* instead of observation and experience, to decide on what are the facts in nature. Whenevei a person, who is unacquainted with the science of medicine, urges the enormity of the doctrine of curing a disease by " the medicine most closely imitative of the disease in its effects upon the system," he is to be excused, because his ignorance of facts in medicine is pardonable. It is not his business to be acquainted with them. And if he talks foolishly, as most men do when they attempt to talk learnedly of those things of which they are ignorant, he only deserves the rebuke; " ne sutor ultra crepidam." But the case is different in respect to the physician whose business it is to be acquainted with facts in medicine. If he is ignorant of these, he is censurable, because his patients and the public may suffer from his ignorance. And if being acquainted with them, he draws erroneous deductions from them in support of error or in opposition to truth, it becomes the duty of 14 PREFACE. others, while they may lament the error, to assume the unpleasant task of exposing it. It is well known that purgatives often cure diarrhea, and that emetics sometimes subdue vomiting. It is not improbable, therefore, that every physician who proclaims the enormity of the principle similia similibus curantur, has been guilty of the enormity of giving medicines for the cure of a disease very similar to that which they produce. What is purgation but diarrhcea or a very similar disease? The explanation that purgatives remove the acrimonious or irritating contents of the bowels, which the previous disease was insufficient to effect, gives them no support. For admitting the supposition of the presence of irritating matters in the bowels, these, when not the ingesta, must be morbid secretions, from disordered action in the secretory vessels which must be corrected before the disease can be cured. It is therefore evident that the remedy which cures the diarrhoea must also cure the disorder of the secretory vessels. Now, that purgatives do act on these vessels, no physician will have the hardihood to deny; and the effect of this action as closely resembles the original disorder, as the purgation resembles the diarrhea. If, then, the cure of a diarrhma is effected by a purgative, is it not a "medicine most closely imitative of the disease in its effects upon the system," which has removed the disease? To the physician who views this subject dispassionately, the enormity of the homceopathic doctrine will not appear so very glaring; especially when, in addition to the matters just mentioned, he recollects the fact, that if a medicine be found to operate positively and decidedly upon any organ, it is very soon experimented upon in various diseases of such organ. Thus, secale cornutum being found to exert a powerful action on the uterus during parturition, it has been tried-in almost every variety of disease of that viscus. And this is done because it does not appear to be a very great enormity to suppose that the remedy should act upon the diseased part. As morbid action in any tissue or organ is mostly known only by the symptoms or sensations produced by such morbid PREFACE. 15 action, and as these symptoms or sensations differ in seat or character as different parts are affected, it may be presumed that, when the same symptoms and sensations appear, the same parts are affected; and that if a remedy produces the same symptoms as a disease, it acts upon the parts affected by the disease. Whether it is more proper to give a remedy which thus acts, or one that operates upon a distant part, is, after all, a matter for experience to decide; and as my own observation and experience are very much in favour of the former, I think it right to recommend the treatment of diseases by remedies which are capable of producing similar symptoms. For the proper modes of proceeding in the treatment of disease on hoimoeopathic principles, the physician is referred to the Organon, which has been translated into the English language. For the prosecution of the practice, the works on the Materia Medica are proper; but as these are not yet translated, the physician can employ Jahr's Manual as a very valuable substitute, until they can be placed in his hands, which I have reason to believe will shortly be done. Before concluding this preface, it will be proper to acknowledge the important aid I have received from the works of Haas, Glasor, and Riickert, in their references to cases. But the cases have all been examined in, and translated from the original reports in the Archiv, Annalen, or other works, except a few which were contained in books that were not in my possession: these I have translated from Riickert's Therapie. To Hartmann's Therapie I have been frequently obliged for information, especially on diseases in relation to which the information to be derived from other sources was very deficient. The plan of this work, though most nearly resembling that of Riickert, is different from his or any other: whether it is preferable, is to be decided by those who shall be acquainted with both. An alphabetic arrangement of the leading articles has not, however, enabled me to dispense with a general index, though it will often obviate the necessity of a reference to the latter. It will be observed that inflamma 16 PREFACE. tions of important organs are, with a few exceptions, treated of in the articles headed with the English names of the organs. The reason why I have chosen the English appellations of these organs is, that they are those which are applied to them by the professors of anatomy in our medical schools. In doing this, and in adopting, except in a few instances, the most commonly employed names of diseases, I have been actuated by the desire of rendering this as convenient a work of reference to the physicians of this country as possible. The abbreviations of the names of the remedies will be readily understood, but those which express the dose may need some explanation. In marks like the following, 2112: the figure on the left of the line designates the number of pellets, and that on the right, the dilution. The mark gtt. means a drop or drops, while gr. means a grain or grains in weight. The number of grains or drops is shown by the figure immediately following; and the second figure designates the dilution or trituration. Thus, gtt. i. 6 expresses a drop of the sixth dilution, or gr. i. 3 a grain of the third trituration. For the valuable remarks and cases which are marked G. or Green, and which are included in marks of parenthesis, I am indebted to Doctor Jonas Green. The cases marked J. are from my own practice. "HOMCEOPATHIC PRACTICE OF MEDICINE. ABORTION. When the symptoms which accompany the process ofabortion make their appearance, the proper treatment consists in the employment of those means which may arrest its progress. The remedies which have been- found most successful in effecting this object, are: chain.,ferr., ipecac., sabin. The physician is often not called until abortion has occurred, or the process is so far advanced that it must ensue. But, even in the latter cases, the administration of the proper remedies for arresting abortion is not improper, as the primary operation of these may expedite the completion of the process and diminish the sufferings of the patient. Where abortion has actually taken place, the treatment must be directed against its unpleasant consequences. The most common and important of these is uterine hemorrhage, which may be sup2 18 ABORTION. pressed by cham., crocus, sabina, secal., calcis carb. Other consequences of abortion or of its accompanying hemorrhage must be.attacked by the remedy adapted to the peculiar morbid condition. Thus, bellad. 2130 has removed debility, paleness, heat in the head and body, palpitation of the heart, thirst, pressing in the head, constriction of the breast and restlessness occurring in a patient after abortion. And bryon. has cured dulness of the head and constipation supervening miscarriage. In many instances, abortions occur in a number of successive pregnancies, and frequently at the same period of gestation in each. In some instances it has occurred in every pregnancy. There must exist, in these cases, a morbid predisposition to abortion. The removal of this predisposition is often within the power of homoeopathic medicine, which is not merely capable of sometimes arresting the process when it has commenced, but can also, and perhaps with even greater certainty, prevent its commencement; except under such circumstances as would generally induce abortion in persons who possessed no uncommon predisposition to it. The remedies employed for this purpose are sabina and secale. Nux v. and cinch., in alternation, were employed successfully in a case, by Hartmann. But in some cases the uterine disorder upon which this predisposition depends, may be sustained in spite of these remedies, by its association with other chronic morbid conditions of the system, and hence other remedies may be requisite. In these instances, when there is a hemorrhagic disposition in the vessels of the uterus, calcis carb., carb. veg., or lycopod., may be indicated; but where there is no evidence of a hemorrhagic disposition, sepia, silex or zinc. ABORTION. 19 Chamomil. Case. In the seventh week of pregnancy, chill, restlessness, labour pains and some bloody discharge; from taking cold. Cham. gtt. i. 2, speedily removed the threatening symptoms. Perfect rest and a repetition of the dose after forty-eight hours completed the cure. Ferrum arrested abortion, marked by fever, labour pains, and some bloody discharge..Ipecac. 2, followed by sabin. gtt. i. 15, effected the same result in a case similar to the one relieved by ferrum, occurring in a woman in whom abortion had occurred in the fourth month in three successive pregnancies. Sabina. Case. To a woman of tender and irritable constitution who had repeatedly miscarried before the third month, sabin. gtt. i. 12, was given as soon as she found herself pregnant, and every month till the eighth the sabin. was repeated. In the fourth month, after violent mental emotion, labour pains without hemorrhage appeared, but were speedily removed by sabin. gtt. i. 9. At the proper period she gave birth to a perfect and healthy child. (In several cases of threatened abortion, at different periods of pregnancy, I have promptly arrested the symptoms by the administration of sabin. 30. G.) Secal. 12, given on the first cessation of the menses and repeated every fourteen days; till the. period at which abortion usually occurred had passed over, has, it is said by Hartmann, prevented abortion in many cases. In a case of profuse hemorrhage after abortion, where the patient appeared almost exsanguine.and excessively debilitated, secale in a low dilution promptly arrested the discharge. The patient fell into a tranquil 2* 20 ANGINA STRIDULA. sleep, from which she awoke after some hours, much refreshed. ANGINA STRIDULA. CROUP. Angina trachealis. Cynanche trachealis. Angina membranacea. " The symptoms of angina membranacea are found reflected in the Materia Medica Pura, among the symptoms which spongia usta and calcis sulph. produce: and I have discovered that these in alternation, and in the smallest dose, cure this fearful disease of childhood.'"-Hahnemann. " Homoeopathia has discovered a very valuable application of the spong. ust. against that fearful disease of childhood termed angina membranacea. The diminution of the local inflammation by the previous use of aconit. is requisite. The collateral employment of calc. sulph. will, sometimes, be found unnecessary." -Ibid. CASE. A boy, et. 8 ann. of tender and delicate constitution, was attacked, after exposure to a current of cool air, with hoarseness, pain in the throat, dry cough with a harsh sound, and at night.febrile heat. He continued to grow worse, with morning remissions and evening exacerbations, till the evening of the 4th day, when he had a severe chill, followed by hot fever. The cough had a deep sounding tone, the voice hoarse and utterance inarticulate. Towards morning perspiration broke out, with a slight abatement of the violence of the symptoms. At noon a new exacerbation so violent, that the parents, who had been deceived by the morning remissions, sent in great haste for Dr. Gross, who saw him towards evening. The ANGINA STRIDULA. 21 child then had the loud shrill breathing characteristic of croup. His head bent back-stupor: violent heaving of the chest in inspiration, with strong action of the shoulder blades. At intervals he raised himself suddenly up, seized with great anxiety whatever was nearest to him in order to obtain support and relieve his breathing: then succeeded dry coughing with a rough stridulous sound, much heat and thirst, though drinking always excited fresh attacks of cough; the pulse was mostly hard, but at times weak and interrupted; the urine red; bowels not open. With the difficulty of the respiration, the countenance became deep red or livid; the carotids pulsated violently: and cold clammy sweat appeared on the forehead and temples. After each paroxysm of coughing, the patient moaned and touched his throat as if pained there: over the larynx a red elevated spot appeared about the size of a penny. Efforts to vomit, and sometimes even vomiting, occurred, especially after coughing. TREATMENT. Cacl. sulph. gr. i. 2. was immediately administered. Dr. G. remained all night with the patient, and observed that in three hours all the symptoms, which in the natural course of the disease must have been aggravated, were evidently subsiding; and in the morning, there was a marked remission. At the end of sixteen hours, tr. spong. ust. gtt. i. 10 was given, and some time after a smaller dose of calc. sulph. On the third day the child was allowed to go out, there being only a slight hoarseness left, which passed off the next day, leaving the child perfectly well. Dr. Rummel cured numerous cases of croup with acon. gtt. i. 24, followed six hours after by tr. spong. ust. gtt. i.; and two days after for the remaining hoarseness calcis sulph. gr. i. 2. He concludes his 22 ANGINA STRIDULA. remarks by observing that so far as his experience goes, the homoeopathic treatment is certain; for all patients submitted to it have recovered rapidly--" I reckon, (says the doctor,) the efficacy of acon., calcis sulph. and spong. to be the most certain that practical medicine can show." Dr. Stapf also says that he has convinced himself, in many very serious cases of croup, of the eminent curative efficacy of the smallest doses of acon., spong. usta and calcis sulph. In the power of these remedies, Dr. Hartmann and all other practical homoeopathists fully concur. Phosphorus proved highly serviceable in a case of croup, where, notwithstanding the administration of the aconit., spong. and calc. sulph. the patient still remained in great danger. Phosph. 3130 was given in alternation with calc. sul. and spong. with an interval of half an hour between the doses. After the third dose of phosph. there was considerable aggravation, followed by some expectoration and speedy relief. "Dr. Gross, who treated this case, remarks that "it was the worst case of croup which he had observed. In all other cases, even those attended with great danger, hlie had always succeeded with the previous medicines." Nearly allied to croup is that disease of the respiratory organs described by Hartmann' and other German writers under the title of Asthma Millari. It is a sporadic disease, and has a-very distinct forming stage: there is no important pain; and the cough, when present, is more dry, dull and hollow, than that of croup, with little fever. This disease depends essentially on a spasm of the lungs, and generally makes its attack in the winter or after taking cold. Some ANGINA FAUCIUM ET ANGINA TONSILLARIS. 23 times the catarrhal symptoms are slight, with attacks of severe suffocation, which intermit; the voice is hoarse, and swallowing difficult. Sambucus is the appropriate remedy when, upon awaking, the patient, with half-shut eyes, can scarcely breathe, must sit up, and then breathes in a very hurried manner with a shrill piping sound, as though suffocating. He throws his arms about; his face and hands become bluish and tumid; he is hot but not thirsty. Whining attends the paroxysm, but seldom is there any cough. Sambuc. in doses of a drop of the diluted juice, has afforded speedy relief. Hartmann also recommends ipec. in repeated doses, ignat., puls., nux, opium and mosch. ANGINA FAUCIUM ET ANGINA TONSILLARIS. Cynanche faucium. Cynanche tonsillaris. Inflammation of the throat. Inflammation of the tonsils. Bellad. is the most important remedy for the treatment of inflammation of the throat and tonsils. When the inflammatory fever is considerable, it should be preceded by aconit. There are, however, many forms of the disease which demand other remedies. Barytes carb. 3130 cured in two days an angina tonsillaris, in which bellad. proved of little service. Cham. is the proper remedy, when the inflammation of the fauces is accompanied by a sticking, burning pain in the top of the throat, with some hoarseness of the voice, tightness of the chest, tickling irritation, and hacking cough. Dulcam. is useful in inflammation of the throat accompanying catarrh. 24 ANGINA FAUCIUM ET ANGINA TONSILLARIS. Ignatia has been employed with advantage when the tonsils were swollen and inflamed, with many small ulcers on their surface; tongue coated with tough white mucus; sticking pain extending to the ears, especially whilst swallowing. Merc. gr. i. 2. Fauces reddened but not swollen: pain in the throat: pain in the parotids and in the muscles on the sides of the neck; frequent hawking up from the fauces of lumps of mucus; fever. Merc. 2112 cured an inflammation of the throat so considerable that it required great exertion to speak or swallow; and attended by salivation. Merc. 1112. Pressing, sticking pain in both tonsils increased on swallowing, and extending to the ears. Tough mucus, with a disagreeable taste in the mouth and throat, causing constant spitting. Bad odour of the breath. Great dryness of the mouth and throat, constant thirst, disagreeable eructation, constipation, hot skin. Merc. In a case where with many of the above symptoms there was a hateful mercurial odour of the mouth. Merc. In chronic and habitual inflammations of the throat, which are aggravated by cool air and worse in the night, with sticking pain on empty swallowing. Nux v. In angina uvularis, and also in a. tonsillaris when this is connected with catarrh. Pulsat. when the colour of the inflamed parts is of a dark instead of a bright red, and there is a varicose condition of the vessels. Also in angina accompanying catarrh. Mangan. acet., rhus and sabad. have also been found useful in angina; sepia is recommended against the disposition to frequent return. ANTHRAX. ANUS. APHONIA. 25 ANTHRAX. Arnica 1.2 has cured this disease in three days. Arsen. Anthrax returning periodically in the spring of the year. Nux v. with the aid of arnica has proved useful. Silex. Case. A woman sixty years of age was affected with an anthrax, which removed nearly the whole of the integuments of the spinal process of the fourth cervical vertebra, accompanied with great and general debility. By means of silex, and daily washing with pure water and dressing with dry lint, the disease was entirely cured in three weeks. ANUS. ANI PROLAPSUS. In a boy ret. 2 ann. after diarrhoea. The prolapsed intestine blackish, painful on being touched, stools only discharged by strong pressure. Merc. effected a cure. Ignatia has also removed the disease. FISTULA IN ANO'. Calcis c., carbo.veg., nux v., sulph., have been employed in this disease with advantage. APHONIA. Loss or imperfection of voice. Inability to speak, in a febrile disease, with some affection of the throat; bellad. 30: in a quarter of an hour the power of utterance returned, then sleep, perspiration and a restoration to perfect health ensued. 26 APHONIA. In another case phos. effected a cure. Hyosc. was found useful in the case of a girl twelve years old, who had been affected with chorea St. Viti, attended with an inability to articulate, as though the vocal organs were paralysed. The next day she was well. Bellad. gtt. ss. 30. and afterwards bryon. gtt. ss. 30. cured a case of hoarseness with inability to speak aloud, from taking cold after measles. Carb. veg. is useful in hoarseness which commonly appears in the morning upon awaking, and is then the worst, also reappearing in the evening: better in warm, but worse in moist, cool weather: aggravated by loud or long continued speaking and by exposure to cold; and sometimes accompanied by considerable tickling in the throat. I have employed this remedy with the most beneficial effects in hoarseness such as -above described, accompanied by pain in the larynx on swallowing. Drosera has speedily cured hoarseness and chronic coug,1, remaining after measles. Dulcam. Hoarseness from taking cold. Manganes effects much good in the hoarseness which accompanies coryza, and which often remains after the latter.has disappeared. Also where hoarseness frequently appears without coryza, indicating an habitual disorder of the larynx. Pulsat. Hoarseness with pain in the throat. Phosph. Sudden disappearance of the voice, only capable of speaking in a whisper, existing in a complicated case of chronic disease, was removed by phosph. 1130, and the other symptoms improved. Sulph. has proved useful in chronic hoarseness from taking cold. Also hoarseness remaining after measles. APHRODYSIA. APHTHIE. 27 Tr. acris has frequently cured, when the voice was so low as scarcely to be understoood. Besides the above remedies, the following have proved useful. Arsen., calcis sulph., lach., merc., plat. sodee mur., spong. APHRODYSIA. Functional disorders of the organs of generation. SATYRIASIS, nux v. cinch., camph. PRIAPISMUS, pulsat. ONEIROGMOS, aconit. acid. phos., conium, pulsat. IMPOTENTIA, with sexual desire but absence of erection, camph., acid. mur., cinch.; I. from excessive venery. acid. ph..; I. from onanism, conium, lycopod., sepia.; I. with erection without seminal emission, magnes. pol. austral.; I. with induration of the testicles; lycopod., graphit., sulphur. NYMPHOMANIA, platin., dulc., verat.; STERILITAS, cannab., calcis carb., phosph. APHTHAE. The following remedies have been found peculiarly useful in aphthous affections. Acid. sulph., borax., sulph. Where the disease is very troublesome in the throat: merc. Where the aphthae are of a dark colour: arsen. (An infant, five or six months old, had been afflicted with aphthe almost from its birth; When I saw the child, it was extremely emaciated, and very fretful both night and day: it had frequent fetid, watery discharges from the bowels, and the secretions from the aphthous surface were so irritating, that they excoriated the nipples of its nurse, and left them in a 28 APOPLEXIA. state of ulceration. By means of acid. sulph. 30, given both to the mother and child, a complete recovery took place in the space of two weeks. G.) APOPLEXIA. A. SANGUINEA. After apoplectic and paralytic affections, there is almost invariably a diminution of the intellectual faculties, and not unfrequently mental derangement. The following case illustrates the most common symptoms of this disease and their treatment. In a plethoric man sixty years of age, of cholero-sanguineous temperament, there occurred, coma, stertor, dilated pupils, froth at the mouth, quivering of the lips and full hard pulse-Bleeding had been resorted to; then ipec. 6. gtt. i. every two hours till three doses were taken, which was followed by vomiting of bile and mucus, and a discharge of faeces and urine. Voluntary motion and sensibility returned. Bellad. was now given to remove the remaining apoplectic condition. For the mental disorder, depraved vision and other symptoms am., stram., hyosciam. and merc. were given, which effected a perfect restoration to health. As a preventive, when premonitory symptoms of this disease occur, acon. is unsurpassed. Schubert recommends in proper cases coffea for the same purpose. Hartmann says, that those remedies, which are most useful in the treatment of the disease act also as preventives: viz. acon., nux., cofea., bellad., ipec., arnica. In the apoplexy of advanced age, bellad. has proved eminently useful, even when administered as the first remedy, though as a general rule it ought to be pre APOPLEXIA. 29 ceded by acon., ipec., arn., coffea, opium, or some other remedy. Haas mentions the case of a person eighty-four years of. age, who was cured by three doses of baryt. acet. ll and 112. Hartmann speaks of baryt. carb. as a useful remedy. Dr. M. Muller recommends am. as a highly valuable absorbent remedy for the removal of the extravasations which so frequently occur in apoplexy. The tr. arnica, gtt. i. 9, to four ounces of water, has been applied externally to the head for this purpose, with the happiest results. A. NERVOSA-characterised, according to Hartmann, as follows: It occurs in sensitive nervous systems, after debilitating causes or depressing passions, is preceded or accompanied by twitching and trembling of the lips and limbs, drawing and pain in the neck, hips and extremities, sinking or distortion of the eyes, contraction of the pupils, interrupted sleep, gnashing of the teeth, ringing in the ears, dysphagia, obstinate constipation, great debility, syncope, a small and commonly a slow pulse, pale sunken countenance, with pointed nose and hollow eyes, respiration not rattling or stertorous. This condition often passes into lethargy, palsy, and mental or other nervous derangements. Mere., bellad., am., coffea, hyos., stram. are the chief remedies. Accompanied by great gastric and hepatic derangement, nux v., iryon., ignat. and ipec. are to be employed according to their respective indications. A. SEROSA is best treated by means of am., ipec., dig. and merc. Lauroceras is mentioned as likely to be a remedy of great utility, and Hartmann recommends carb. veg. 30 ARTHRITIS. ARTHRITIS. When the symptoms of gastric derangement are most prominent, the appropriate remedies will be found among those, which are useful in the removal of disorders of the stomach, premising their use,-when inflammatory fever is present, by the administration of acon. Among these, nux v., bryon., pulsat., ignat., cham., bellad., cinch., antim. crud., and sulph., deserve especial consideration. A. NODOSA. Ledum and staph. are indicated. Schubert mentions that he has derived advantage from aurum, digitalis, bryon.,,nux v. To remove the concretions, Hartmann has successfully used tr. acris, repeated every eight days, till five or six doses were taken. A. VAGA. Pulsat. and sabin. are proper. A. in a chronic form with diminished secretion of urine. sarsap. A. with exacerbation on becoming warm in bed, ledum. A. with exacerbation in the morning, nux v.-in the evening pulsat. A. with exacerbation or first appearance of pain, on moving the affected part, bryon. A. with amelioration of pain by the exposure of the affected part to cool air, pulsat. CHIRAGRA, staph., merc., mgs., magnes. aus. GONAGRA, bryon., coccul., tr. acris, led., cinchon. and puls. When the pain is flying, sticking, puls., coccul. When at the same time the foot as well as the knee is swollen, cinchon. Ledum has been known to cure a case of hard gouty swelling of the knee in less than twenty-four hours. PODAGRA, the foot being swollen and hot, bryon. When the pain is confined principally to the great toe, led., arn., sabin., verat. ASTHMA. 31 When stiffness of the knees, which prevents squatting down, remains, sulph., coloc. or graph. may be indicated. The following are recommended by Hartmann in arthritis, without stating the particular indications for their use. Rhus., dulc., con., spong., slann., stram., guaiac., arsen., chelid., calcis acet., rhododend. ASTHMA, DYSPNCEA, &c. Ambra has been employed with advantage in asthmatic affections, especially in children and in scrofulous subjects. Ammon. c. has operated very beneficially in asthmatic disorders, and especially in those combined with hydrothorax. Arsen. Caseoccurring in a young man from fatigue and exposure to cold. In stormy or moist weather, or from varm and tight clothing, or by change from warm to cold, or by rapid walking, or even by laughing or walking against the wind; paroxysms of constriction of the breast, or loss of breath, which compelled him to stand still. At the same time he felt anxiety and pressure in the breast; was alternately cold and hot. These symptoms began to abate as soon as he began to expectorate a white frothy mucus, and gradually disappeared. If during the paroxysm he entered a warm room, its severity was increased. The disease was of five years' duration, and no medicine had afforded him any relief. Arsen. 6130 in six ounces of water: a table-spoonful daily, had almost cured him, when rapid walking induced a slight relapse. Three doses of arsen. 3130 were given at intervals of eight days, by which he was perfectly cured. 32 ASTHMA. In a man set. 32 ann. Tightness of the breast--he felt as if he never had sufficient air in the lungs. Pain and pressure at the epigastrium as if too much compressed. By every movement, loss of breath with anxiety and debility. The disease was of one year's duration, and was complicated with cephalalgia, gastric derangement, inability to sleep at night on account of cough and dyspnoea, great debility, and anxiety and depression of mind. After a single dose of arsen. the disease gradually disappeared, so that at the end of four weeks he was well, without the aid of any other remedy. Arsen. 5130 cured a case in which the paroxysms appeared mostly at night, and at the farthest every three weeks. Constriction of the breast and trachea, great anxiety, inability to lie down, decline of the symptoms on the occurrence of expectoration-complicated with flatulent colic and abdominal cramps. Arsen. 1130 cured asthma of eight years' duration. Wheezing expiration on lying down at night, constrictive pressure in the breast and trachea, compelling to sit up and lean forward, with anxiety and general sweat, continuing till after midnight; afterwards light slumber interrupted by frequent waking with burning pain or soreness in the breast. Bellad. is useful in some asthmatic affections, especially in irritable constitutions when there is a disposition to convulsions, and particularly in females. In the case of an old man affected with dyspnoea, inability to lie down on account of oppression of the breast; dry cough day and night-vertigo; gastric derangement; and constipation; bellad. proved useful. Bryon. In a case of sixteen years' duration. Asthma occurring towards morning, with inability to lie on ASTHMA. 33 the right side during the paroxysms, relieved by sitting up, but aggravated by walking. Complicated with dyspepsia; alternating costiveness and diarrhoea; and periodic flatulent colic occurring about two or three o'clock in the morning. Bryon. 10, followed in fourteen days by nux v. 20, and continued in alternation in smaller doses, effected a perfect cure in less than eleven months. Cannab. 2130, a dose daily for a week, effected a cure of periodic asthma in a man et. 60 ann. During the paroxysm he had to stand with his body slightly bent forward, at an open window, to prevent suffocation. Nzx v., sulph., sepia; potass. c. had been previously employed with only temporary benefit. Cham. is adapted to the oppression of breast and suffocative attacks from exposure to cold, as also to the asthmatic symptoms accompanying flatulent colic in children. Colchic. has proved useful in asthma. Cuprum. Case in a woman aet. 30,ann. Constant dyspnoea with a sensation as if the clothes were too tight over the epigastrium, shortness of breath on walking fast or going up stairs. Paroxysms commencing generally with singultus. Such oppression at the breast that she could not speak and could scarcely breathe. Face red, tumid, and covered with hot sweat. Respiration rapid, with a whooping sound and almost spasmodic action of the abdominal muscles. When the paroxysms, which endured half an hour or longer, had attained their height violent convulsions occurred. The attacks were excited by fright or grief, and most readily about the commencement of menstruation, which was more copious and longer continued than it had been while she was 3 34 ASTHMA. healthy. When the paroxysms commenced she could not sit up, but had to hasten to lie down. The patient was of an anxious and timid disposition. Cuprum 30, and at the end of four weeks she was nearly well, only at the access of the menses she still had a perceptible disposition to convulsions; merc. gr. i. 2 with return of strength and cheerfulness, as also of the menses to their normal quantity and duration. A paroxysm subsequently occurred from the inhalation of the dust of verdigris, but merc. gr. i. 3. repeated after fourteen days effected a perfect cure. Cuprum has also relieved a spasmodic oppression of the breast in children after exposure to cold. Dyspnoea, short, rapid, superficial respiration, with spasmodic cough, and rattling of mucus in the breast. Pain in the epigastrium on pressure, oppression increased on lying down in the evening. In the paroxysms of coughing, wheezing inspiration. Ipecac. is an important remedy in the treatment of that form of oppression of the breast, in children, which has been termed Asthma Millari. See the conclusion of the article angina stridula. It has also cured a spasmodic asthma occurring at night. It was given every evening for four weeks in the dose of gtt. i. 3. Lachesis. CASE. In a man set. 60 ann. Waking up, after midnight, with oppression of the breast, and slow, difficult and wheezing respiration. He had to rise from bed and sit leaning forward. Lach. 1130 removed the asthmatic affection. Lobelia inf. In the case of a married lady set. 38 ann. the mother of several children. She had suffered since her childhood from dyspnoea, increased by any active exertion, by going up or down stairs, by ASTHMA. 35 exposure to cold, and eating very warm food. Pain in the left lumbar region of the abdomen (also from childhood). Within the last year, constant burning in the stomach and throat, with a sensation of dryness in the latter, as also of a lump in the pit of the throat which impeded respiration and deglutition. Weakness and oppression in the epigastrium with other symptoms of gastric derangement. Urine of a deep red, depositing a copious red sediment. Lob. inf. 416 was given in the evening, and by next morning the sensation of, lump and burning in the throat, together with the dyspnoea, had greatly diminished, and in a few days entirely disappeared. The urine also became perfectly normal in appearance. She has continued well ever since, now more than eight months, without perceiving a trace of the asthmatic symptoms and pain in her left side, which she had experienced from childhood. In the case of an unmarried lady, met. 38 ann. Asthma for four years. Dyspnoea, her breath so short that she could use no active exertion. Dyspncea increased by exposure to a draught of air, by washing her face, either in warm or cold water, by eating food difficult of digestion, or by trifling exertion. Asthmatic paroxysms, occurring most commonly at ten or eleven o'clock at night, next in frequency in the morning; but sometimes at other periods of day or night. The longest interval between the paroxysms was a week; and there never occurred more than two in twentyfour hours. At the commencement of the paroxysms, frequent hacking cough, without expectoration, which became almost spasmodic, and was accompanied by a tolerably copious expectoration of thin, colourless, transparent mucus towards its close. Loud wheezing 3* 36 ASTHMA. or whooping respiration and hoarseness or flatness of the voice when she attempted to speak. Duration of the paroxysms from three quarters of an hour to an hour. Accompanying them there was a sensation of oppression at the- epigastrium extending upwards to the middle of the breast. She felt also a rattling under the middle of the sternum during the attatks. At all times she had an aching pain, which was sometimes also burning and cutting, in the left lumbar region midway between the iliac and hypochondriac regions, with pain of the same character in the back about the lower dorsal vertebra. Pressure at this point increased the pain in the left side, but not that in the back. The pain of the back extended farther to the right side than to the left. Pain in the forehead passing round from one temple to the other; worst in the paroxysms. Urine high coloured, scanty, and speedily depositing a copious, red sediment. Menstruation nearly normal. Appetite good; bowels regular. Lob. inf. 12115 taken at night on going to bed, produced great improvement, but on account of the return of a severe paroxysm, the medicine was repeated at the end of ten days. In a few days more the urine was of normal appearance. The pain left the back. The disposition to violent dyspncea from exposure to slight cold disappeared; she could wash herself freely in cold water without the slightest inconvenience. The habitual dyspncea was removed, so that she could walk in an ordinary gait without being troubled with shortness of breath. But the asthmatic paroxysms continued to recur, but much more seldom and much lighter, and this is the case at the present time. Lob. 6 or 15 always abates the violence of the paroxysms and ASTHMA. 37 shortens their duration. Within the last six months, I have twice had occasion to employ arsen. in her case, for the cure of acute diarrhoea, connected with gastric disorder, the cause of which was unknown. On both occasions which occurred a month apart, the arsen. answered the purpose-for which it was given, but did not appear to alter the asthmatic affection. Although the, case just narrated is not one of perfect cure, yet it appears to me to be still important, since the relief is very great, notwithstanding there exists a strong family predisposition to the disease in this patient. One of her sisters, after suffering for a long time under asthma, died of hydrothorax; and the daughter of another sister had suffered with asthma from her infancy, notwithstanding much active treatment, until about two months since, when she was brought to me by my patient, her aunt. A single dose of lob. inf. 6J15 without any rigid attention- to the diet, effected an almost sudden cure. The child, now about twelve years old, boasts that it can run about as well as its play-fellows. Its general health has also strikingly improved. The symptoms which I have found most strongly to indicate the lobelia, are constant dyspnoea, which is increased by slight exertion, and aggravated so much by slight exposures to cold, as to form a kind of asthmatic paroxysm. A sensation of oppression and weakness at the epigastrium, extending upwards from thence into the breast, with or without pyrosis and cardialgia. A sensation of a lump or quantity of mucus, or of pressure, in the pit of the throat. A pain extending around the forehead from one temple to the other. Pain in the back about the lowest dorsal vertebra. Pain in the left flank. High coloured urine. 38 ASTHMA. In three other cases besides those just mentioned, cures have been effected by single doses of lobelia. In one of these the health remained good at the end of eighteen months. In another the disease recurred after three months, from dissipation and exposure. The other case is of but recent date. One case has occurred where several doses were required, and in this instance the pain in the back, which existed from childhood, did not yield entirely to the lobelia, but was finally cured by mere. gr. ss. 3, in repeated doses. I have had sufficient opportunities to satisfy myself that the dypnoea of phthisis does not always depend entirely upon obstruction or disorganisation of the lungs, but that it often is, in part, of the same character as the dyspnoea above described; for in cases which were complicated with gastric disorder and sensation of weakness at the epigastrium, lobelia has very considerablely lessened the dyspncea, and improved the condition of the stomach. J. Nux v. In a man set. 44. Case of thirteen years' duration. Patient had been under the care of many physicians. Dyspnoea on exercise. Upon attempting to lie down in the evenings, suffocating asthma; he had to leave the bed, and sleep sitting on a chair. Towards morning increased oppression, he could no longer sit, must rise from his chair and prop himself with his hands against a table, and in this position await the termination of an hour-long paroxysm. Sensation of stricture of the chest, and load on the breast; respiration slow, and accompanied with a whistling sound. Violent cough, felt painfully in the head and abdomen. Loss of appetite, disagreable taste in the mouth; flatulent, and acid eructation; nausea, and ASTHMA. 39 dispositon to vomit; distension of abdomen, and pressing pain in the epigastrium; costiveness: hard black stools mixed with blood, and mucus; alternating with most unpleasant diarrhoea with small mucous stools. Bloated, sallow countenance. Fretful and easily excited to anger, with consequent increase of his dyspnoea. Patient had used coffee very largely as a palliative. After several weeks of homoeopathic regimen nux v. 15, with temporary aggravation, and subsequent rapid improvement and perfect cure. Nux v. is most frequently indicated in the asthmas of hysterical and hypochondriacal subjects; in those spasmodic affections of the chest, where turning from one side to the other, or on to the back, sitting up in bed, or getting up, or lying down, produces some relief; in those spasmodic affections of the breast, which are produced by anxious dreams at night; also where there is a sensation as if the clothes were too heavy; and in those which accompany dyspepsia. Phosphor. cured an "asthma siccum" which returned every ten or twelve days with great severity. Pulsat. Case in a woman et. 44 ann. accompanying the cessation of the menses. Cough with little expectoraton, accompanied by retching and vomiting. Periodic dyspncea with loss of breath after coughing. Great gastric derangement, emaciation, debility. Pulsat. 15 speedily cured the complaint, which was of four months' duration. CASE. In a woman rt. 20 ann. Commencing with first menstruation. The menses regular as to periods of recurrence, but deficient in quaniTy and pale. Dyspnoea increased by motion; worst from evening till two or three o'clock in the morning. Inability to lie 40 ASTHMA. down in the early part of the night from constriction of the larynx; and if she fell asleep she was speedily awakened by a'feeling of anxiety, and must sit up to escape suffocation. Puls. 12 effected a cure in a few days. CASE. In a child aged eight weeks, from retrocession of a rash. Short and superficial respiration, and short hacking cough. Respiration most difficult at night and whilst lying down, puls. 2112 effected a cure. CASE. In a woman met. 22 ann. with suppression of the menses from bathing the feet in cold water during the flow. A painful feeling passing from the stomach into the chest checked the respiration. In three days the symptoms increased in intensity until they had passed into spasmodic asthma, with constriction of breast and sensation of suffocation, accompanied by excessive anxiety, palpitation of heart, coldness of the forehead and hands, and obstinate constipation. Puls. gtt. i. 12, and in a few hours ease. There was an opening of the bowels, a gentle diaphoresis and a pleasant, warmth of the extremities. The night passed comfortably, with considerable sleep. The menses returned, but small in quantity, and in a few days she enjoyed her usual health. At the next period the menses appeared in their usual quantity and quality. Sambuc. n. In Asthma Millari. Stramon. is useful in spasmodic affections of the muscles of the chest, accompanied by twitching in the muscles of other parts. Besides the remedies above mentioned, the following have also proved useful. Calciscarb., dulc., ferr., sepia, spong., sulph., zinc. ATROPHIA. 41 ATROPHIA. Arsen. CASE. A female infant, eighteen months old, had been affected by this disease three months, and was reduced almost to a skeleton; its skin unnaturally white, dry, and like parchment: the eyes sunken, with dark haloes around them, and constantly closed; and the countenance expressive of great internal suffering. The child showed no desire to eat, and if it was forced to take food, this was instantly discharged. It drank frequently, though but little at a time. It commonly laid in a somnolent state, with frequent gnashing of the teeth, and moaning: was restless at night, and seldom had any fiecal discharges; arsen. 30 was given at intervals of ten days, and in four weeks the child became healthy, lively, and blooming. CASE. In a child ten months old. Considerable emaciation; skin dry and wrinkled; lymphatic cords of the neck and throat enlarged; abdomen tumid; five or six diarrhoeal stools daily: feces lumpy, greenish, and consisting of undigested food: constant catarrh; frequent, loose, harassing cough at night, and often in the day: slept much, was obstinate and fretful: little appetite, vomiting of food, much thirst, hot tumid gums, sometimes fever with cold extremities. Bellad. was given, which modified some symptoms for the better, others still indicated danger. Fourteen days afterwards, arsen. 1130 was exhibited, and in four weeks the child had become fleshy and free from any symptom of disease.* CASE. In a child two years and a half old. It had suffered for several months from a disordered state 42 ATROPHIA. of the bowels; stools sometimes white and slimy, then greenish or black: it was reduced almost to a skeleton; skin wrinkled, complexion sallow, abdomen tumid. It would eat nothing for several days before I saw it, but was very thirsty, especially at night. Arsen. 1130 in half an ounce of water, of which one fourth was given in the afternoon. The ensuing night it rested better; the next day took nourishing food and had no thirst: had only one stool daily, and that quite natural in its appearance after the third day; convalescence was steady and sure. In this case there was no repetition of the medicine. J. Cinch. cured atrophia in a child. Great emaciation; ravenous appetite; distension and doughy feel of the abdomen; white pappy stools; whining fretfulness. CASE. In a child. Frequent fluid stools; constant sweat, especially at night; neither appetite, thirst nor cheerfulness; deep, heavy sleep; emaciation; debility; cinch, three doses, effected a cure. Between the second and third doses, ferrum was interposed. Nux v. Case in a child aet. 21 ann. Sallow, bloated countenance; tumid belly with much rumbling therein; alternating diarhoea and costiveness: much thirst; great appetite but with vomiting of the food; emaciation; fretfulness: nux v., gtt. ss. 30, effected a cure in a short time. Rhus. In a child ret. 2 ann. Disease of eighteen weeks' duration. Pale countenance, abdomen tumid and hard, great appetite and thirst, great emaciation; ten to twelve mucous or bloody diarrhceal stools every twenty-four hours; some fever every afternoon. Rhus 5130, repeated every week till three doses VESICA URINALIS. 43 were given, improved the child very much; arsen. 2130 was then given with unpleasant effects. Eleven days after, calcis c. 2130, and gradual improvement resulting in perfect recovery succeeded. Besides the above remedies, the following have also been recommended; baryt., cham., cina., calc., sulph., iodin., magnes. c., petrol., puls. BLADDER. VESICA URINALIS. CYSTITIS. In inflammation of the bladder the fever being a synocha, acon. If it arise from irritation produced by cantharides, camph.; if from alcoholic drinks, nux vom. In many cases of irritation of the neck of the bladder and of the urethra, canth. has been found useful. In inflammation of the fundus of the bladder, when with a constant urinary pressure, which the smallest quantity of urine excites and increases, and every contraction of the bladder is painful, and when the urine must be frequently discharged, the scilla mar., says Hartmann, may be administered with benefit. We should also bear in mind these other remedies: calcis c., sepia, lycop., graph., potass. c. In a case of irritation of the bladder of many years' standing, consisting in a frequent desire to pass urine, and a painful sensation on turning in bed, as though the bladder was falling downwards towards the lower side; attacks of pain, whilst walking, in the region of the bladder, which were relieved by pressure with the hand. Puls. 1130 in twenty-four hours diminished these painful sufferings, and in a few days com 44 BONES. pletely removed them. The patient remained well, when I last saw him, six months after his cure. J. A case is mentioned by Dr. Gross, in which the suppression of the hmemorrhoidal flux by means of medicines, was followed by a disease of the bladder, marked by bloody urination, attended by excessive pain and frequent pressure to -urinate. A restoration of the hammorrhoidal discharge had not lessened the disease of the bladder, for the cure of which Dr. G. gave calcis c., which was followed after twelve days by increased distress in the urinary organs and constant bleedingr from the urethra; and after four days more by the discharge of masses resemblingy uterine polypus. The discharge of these continued for three weeks, and the pieces discharged would have formed a mass of the size of a hen's egg. With the cessation of this discharge there was a disappearance of all symptoms of disease of the bladder. This case reminds us of those which have been termed cancer of the bladder, in which, though there was a discharge of similar masses, recovery has not taken place. BONES. Injuries of the bones fr-om mechanical violence,, like wounds of the soft parts, and under similar limitations with these, are remedied by the recuperative energies of the system when they occur in healthy persons. It is true, that as in the case of wounds, nature may be assisted and hastened in her operations by the removal of foreign bodies from the wound, or the close approximation of its lips by manual -assistance; so in fractures of the bones, the surgical aid which is BONES. 45 requisite for effecting and maintaining the proper adaptation of the fragments to each other, not only hastens the recovery but is generally necessary for the prevention of deformity and the restoration of the full usefulness of the part. In dislocations also, the proper means must be employed for restoring the bone to its proper location. It has been recommended to give arnica after reducing luxations and setting fractures. And it is certain that it is often advantageously employed under these 'circumstances; yet I would recommend the practitioner to observe whether it does not painfully aggravate the strangury. which frequently attends fractures of the large bones of the lower extremities. In two cases of fracture of the bones of the leg, and in one case of fracture of the thigh bone, in which I employed this remedy, the strangury was uncommonly severe, and in the latter case arrived at complete retention of urine, demanding the use of the catheter. Although, in a healthy organisation, the bones may speedily recover from very serious injuries; yet, it is far different in some morbid conditions of the system.. For, where these are present, disease of the bones "4may occur without any violence having been inflicted, or after an injury of a very trivial character. In such cases, if recovery ever takes place, it is mostly after a great length of time, and is generally imperfect, as in most instances great deformity and diminished usefulness of the part are the results of the disease. But it often happens that the disease continues to advance, until by its irritation it exhausts the energies of the constitution, and death puts a period to the sufferings of the patient. It is obvious that the cure of the disease of the bone 46 BONES. must depend in a great measure, if not entirely, upon the removal of the morbid condition on which it depends. A want of the means for effecting this, and perhaps a disposition to overlook its necessity, have induced eminent surgeons to resort to very severe methods of attacking some diseases of the bones; and if these have more frequently aggravated rather than abated the disease, it is a result which was rationally to be expected, because new injuries were inflicted upon the diseased bone at the same time that the morbid condition of the system remained unaltered. Homoeopathia has presented us with means better adapted to remove these conditions, than any we before possessed; and, in consequence, we can treat diseases of the bones with greater success now than formerly. It is true that we have been for a long time in possession of a specific against that one of these morbid conditions which is induced by syphilitic infection. But we sometimes did not succeed in our endeavours to cure, because we employed the remedy in such doses as excited the reaction of the system against it, and we consequently failed to effect the requisite impression on the organisation, which i would have been accomplished by the remedy had it been given in much smaller or much larger doses. We also, by the frequent repetitions of the medicine, often disturbed the curative operations which had been commenced after the first doses, and, if we did not prevent, we sometimes protracted the cure. In those cases where syphilis was superinduced on chronic, morbid conditions of the system, this practice failed on other grounds; for here the specific in proper homoeopathic doses must also fail. The reason of BONES. 47 this is, that as a wound in any part of the body of a person labouring under some morbid operations, will not heal though its lips be brought into accurate coaptation, and it should be otherwise properly treated; so, syphilis and many other diseases attacking persons suffering under other chronic, morbid conditions, cannot be removed by their appropriate remedies, because these cannot induce the same proper curative operations in the unhealthy as in the healthy system. So far as my knowledge extends, Hahnemann has been the first to insist upon the necessity of early attacking the pre-existing morbid condition, instead of urging the employment of the specific for the superinduced disease to an injurious extent. The disease of the bones originating in syphilitic infection, which have been cured by aurum alone, are not to be considered as belonging to this class of complicated diseases, but as a complication of mercurial and syphilitic disease, arising from the improper use of mercury for the cure of syphilis occurring in a previously healthy system. In this disease, when it has not already been abused, mercury is the most important remedy. If before the discovery of the existence of those laws of nature which form the foundation of homoeopathic medicine, we treated an easily recognisable form of disease with a known specific against it, and yet sometimes failed from the causes just mentioned, it is easy to conjecture how much more imperfect was our procedure against that protean morbid condition termed the scrofulous diathesis. We possessed many of the remedies which we now recognise as highly useful against some of its developments, but we had not those certain indications for their employ BONES. 49 possesses great diversity of character. The morbid changes in the disposition constitute a part of the symptoms, and are 'generally of more importance than the natural disposition in the choice of the remedy. A knowledge of the mode in which antecedent diseases have been treated, and of the previous treatment of the present disease, is frequently of great importance, as it shows to us the probable source of some of the symptoms, and hence often leads to the choice of a remedy calculated to afford much relief. It is important also to know what have been the antecedent diseases, not only.when the complaint has been of a syphilitic character, but also when the previous disease has been a cutaneous eruption which has been repelled from the surface by local applications, or has disappeared under the use of drastic cathartics. In these cases that remedy is to be preferred which is capable of doing the most towards the cure of such an eruption as has receded; provided that this remedy has not previously been employed in excess; for example, if the repelled eruption has been psora, sulph., where it has not been previously abused, will -generally be found a highly useful remedy. But as this remedy will seldom of itself effect a perfect cure, the difficulty again occurs in the choice among the numerous remedies which have proved useful in psoric diseases. The exciting cause of disease of the bones is sometimes mechanical violence, and here arnica often proves very beneficial. But however useful it may be, this remedy is incapable of completing the cure, and the difficulty of deciding which of the remedies, that are indicated in the 4 50 BONES. present form of disease, is the appropriate remedy for the present case, meets us but one step later than it does in those cases where the disease has not been excited by mechanical injury. The peculiarities of the symptoms, that is, the time, order and circumstances of their appearance, exacerbations, and remissions, are in many instances the most important guides to the remedy. But in order to ascertain it a laborious investigation and comparison of the symptoms of several remedies are frequently required. This labour, although it cannot be dispensed with, might be considerably lightened, if physicians in recording their cases would state what were the circumstances, symptoms, and peculiarities of symptoms, which characterised the remedy chosen as the one adapted to the case. If we still continue to neglect doing this, we must continue to endure the Sisyphean toil of comparing the symptoms of numerous medicines every time we have occasion to give another remedy, without being able to avail ourselves of any advantage from our previous comparisons, while our labour, but not our certainty, will increase with the growing bulk of our materia medica. The following short index to the remedies for several forms of diseases of the bones may prove useful. It is made chiefly from the cases which follow. The terms applied to the cases are mostly those employed or suggested by the physicians who have treated and recorded the cases. CARIES. Ac. nit., ac.phosph., angust., assa., calcis c., mezer., sepia, silex, sulphur. CARIES SYPHILITICA. Aurum. DISTORTIO SPINALIS. Bellad., calcis c., ipecac., silex, sulph. BONES. 51 SEXOSTOSIs SYPHILITICA. Aurum, bellad., phosph. HYPEROSTOSIS. Arnica, assa, dulc., ledum, lycopod., merc., mezer., rhus, sepia, silex, staphis., sulph. NECROSIs. Ac. nit., ac. phosph., arnica, assa, calcis c., sulph. MOLLITIES OSSIUM. Calcis c. RACHITIS. Bellad., calcis c., merc., assa. SPINA VENTOSA. Assa, mezcr., sil:x, sulph. MoRBUS COXARIUS. Ac. nit., arnica, bellad., bryon., calcis c., lycopod., petrol., sulph., tr. acris. Ac. nit. Caries and necrosis. See cases under assa, sepia and silex. Ac. phosph. Caries and necrosis. See case under assa. Ariica. In a case of hyperostosis femoris, from injury of the thigh by a blow; this remedy produced immediate relief of pain and subsequent abatement of the swelling and suppuration. See case under silex. In a case of necrosis, originating in injury from a fall, arnica greatly diminished the pain. See case under silex. In morbus coxarius, after arnica gtt. i. 6, the pus improved in quality, and there was a general improvement in the health of the patient. See case under sulph. Angustura has been said to have cured caries when given daily in doses of 1 to 6; the'use of coffee being avoided. Assa fcitida. Caries tibiae. In a woman wet. 40 ann., who had been bitten on the leg by an insect six years before. The bite induced violent inflammation which produced ulceration, and finally the bone had become affected. An ulcer on the inner side of the leg over the tibia, two and a half inches long, and 4* 52 BONES. one and a half broad, with indurated margins of livid appearance, offensive suppuration and caries of the tibiae. There was great sensibility in the circumference, and severe pain in the margins of the ulcer on being touched. Assa gtt. 116, was followed by gradual improvement, and by the separation of a small spicula of bone half an inch long, and an eighth of an inch broad. In thirty-six days the ulcer was completely healed. Assa, in alternation with ac. phosph., has cured a caries and necrosis. In another case, assa in alternation with ac. nit. and ac. phosph., after an improved secretion of pus had been induced by sulph., cured a necrosis tibiae. Assa. Spina ventosa tibiae. Hyperostosis tibie. A girl aet. 12 ann. had suffered under a debilitating diarrhoea for three months, when she was attacked with s'evere itching, in the left leg, and the diarrhoea ceased. This itching gradually diminished, but there appeared in its place slight drawing pains in the tibia. On examination, this bone was found very protuberant on the fore part and on the inner side. By the orders of a physician, leeches were repeatedly applied, and embrocations continually employed, but in spite of the treatment the pains increased and the swelling advanced. After sixteen weeks an experienced surgeon pronounced the case a swelling of the bone, and stated that it was near the period of breaking out, to prevent which he directed mercurial inunction. After some weeks, as the disease still kept on increasing, Dr. Hartmann was consduted in relation to its homoeopathic treatment. He found the following form of disease. A swelling of the tibia, greatest about mid-length and forward and on the inner side; BONES. 53 - diminishing above and below, but still so extensive in the latter direction that the malleolus internus could neither be seen nor felt. Over the middle of the swelling was a spot of the size of a dollar, which was somewhat reddened and very sensitive to the touch. The skin over the diseased bone was thicker than the healthy skin, and felt almost like leather. The pain was dull, drawing, boring, worse in rest than in motion; in walking more of a stretching pain which caused her to limp. Countenance pale, turgor vitalis wanting, flesh soft. Appetite trivial, stools natural, sleep often prevented by the pains. She was irritable, depressed and fretful. As adapted to overcome the action of the mercury, and to obviate the debility from the previous diarrhcea, and as answering to the yellowness and flaccidity of the skin, cinch. 2118, was given. It was followed by improvement which continued progressive for seventeen days, in which time the red spot had disappeared. On the twenty-first day, as no advance of improvement had been observed for the last three days, assa 219, which'greatly diminished the swelling. The skin over it became soft and more yielding, and the disposition of the child became cheerful. After thirty-seven days, mezer. 216. The general health of the child improved, and there was considerable diiminution of the pain, though but little of the swelling. After twenty-one days, silex. 21, with the same results. In forty-six days, as for some days there had been a slight drawing and external itching in the diseased part, spiritus sulphuris, after which the drawing and itching disappeared and the swelling of the bone considerably diminished. In thirty-three days, the assa was repeated, and in thirty-one days 54 BONES. the silex. In fifty-one days all that remained of a morbid character was a slight thickening of the skin. Sulph. 6 was given, and completed the cure of this dangerous disease. Aurum. Syphilitic exostosis and caries. A node on the head and nodes on one fore-arm and one tibia. Extensive caries of the palate bones. Discharge of fetid ichor from the nose. Ulceration of the throat; syphilitic rheumatism. Excessive emaciation and debility; night sweats. Ten grains of the first trituration of aurum were well triturated with two drams of sugar. This was divided into eight powders, of which the patient was directed to take one twice every day. The medicine was thus given for ten days with evident improvement. Then, two grains of the first trituration of aurum were triturated with two drams of sugar. This was divided into six powders, of which the patient was directed to take one every six days. In three weeks he was perfectly well, and remained so at the end of three years. Swelling of the frontal, nasal and superior maxillary bones; syphilitic ozmena and rheumatism. Aurum gr. i. 2. In fifteen days entire disappearance of the disease. Bellad. Rachitis. In a child aet. 4 ann. Swollen joints, bent bones, and unsightly large head. Bellad. gtt. i. 24 lessened the disease. Distortio spinalis. In a child et. 4 ann. Incurvation of the spine, (lordosis,) causing great protuberance of the abdomen. Pain in the head, eyes and throat. Strabismus; no fever. Bellad. gtt. i. 16, and in two weeks there was no trace of the disease left. Exostosis. After abuse of mercury. Exostosis on the os frontis, with intolerable pain. Palate covered with deep, gray, painful ulcers. Bellad. 12 proved useful. BONES. 55 Calcis c. Distortio spinalis. In a child aged fifteen months. The vertebra enlarged, the superior dorsal vertebra were bent to the left, and the lumbar towards the right side; with chronic hydrocephalus. Calcis c., ipecac. and silex, effected a cure. Calcis c. effected great improvement in a necrosis of the tarsal bones, in the case of a boy. Shortly after the administration of the medicine there was a separation and painless discharge of a large spicula of bone. Rachitis and mollities ossium. In these diseases calcis c. is remarkably useful. Dulc. 20, then staphis. 20, then rhus gtt. i. 30, two doses, and finally sulph. 3, cured a hyperostosis of the "humerus, with swelling from the shoulder joint to the elbow. The cure occupied eight weeks. Lycopod. 2130, then silex 2124, three doses, then mezer. 2124, and finally ledum, cured a lhyperostosis in the foot of a scrofulous boy eight years of age. Lycopod. has been recommended for caries. - Merc. has proved very serviceable m hyperostosis of the tarsal bones. Mezer. Hyperostosis of the radius of the left forearm. Assa had been previously given in large doses. To counteract this, pulsat. 2112 was given on the sixth day; mezer. gtt. i. 6 on the fourteenth day. On the thirty-first day. silex 2118; on the sixty-second day calcis c. 2130. The improvement both in the local disease and the general health which has been progressive under the previous remedies, continued also to advance after the calcis c. until the joint recovered perfect mobility, the bone had regained its natural size, and a fistulous orifice which existed at the commencement of the treatment, had become completely 56 BONES. cicatrised. The cicatrix was covered with a scurf, which after lycopod. 2130 speedily disappeared. Phosph. Exostosis. Hyperostosis. Exostoses on the frontal, the parietal, and the occipital bones, from the size of a bean to that of a hazel-nut. One of the clavicles of double its proper circumference. Pain in the protuberances on pressure with the finger. Severe tearing and boring pains in the affected parts at night. Phosph. gtt. i. 30, frequently repeated, effected a cure. Sepia. Caries femoris; hyperostosis radii. Fistulous opening, discharging a watery ichor, on the outside of the thigh. A sound introduced into this, after a long progress towards the knee, touched upon a rough carious spot on the bone. At the lower extremity of the radius, enlargement of the bone for a length of four inches; painful on being touched. Sepia 2130, and after six weeks ac. nit. 1130 effected a cure in nine weeks. Silex. Hyperostosis femoris. In a man met. 28 ann. Disease commenced two years before, apparently from a blow on the thigh. Sticking, boring and tearing pain in the front part of the thigh, so severe that he could not sleep at night. The thigh was very much swollen from the knee to the groin. The femur much enlarged. From the fistulous openings nearly a pint of pus mixed with blood flowed mornings and evenings upon the removal of the dressings. The patient was excessively emaciated, and he suffered under a "phthisis pituitosa" and constant heavy sweats. As the pain in this case appeared to be an important symptom, since it had commenced with the disease, and apparently originated from the effects of mechanical injury, and as it had not diminished BONES. 57 through the whole course of the disease, arnica was given. It was followed immediately by a sleep of eight hours' duration, from which he awakened nearly free from pain; and an improvement marked by increase of appetite and abatement of the swelling and suppuration. The improvement continued pr gressive to the tenth day, and on the eleventh, a there appeared to be a cessation to its advance lycopod. 4j28. The improvement again commenced,' and in its course' the phthisis pituitosa gradually dis-i appeared. The cure was completed with silex. Caries ossium digitorum. In caries of the phalanges of the fingers, silex has proved remarkably useful. Where the bone has been already destroyed, it has appeared to hasten its separation, the sore has speedily become clean and rapidly healed. Necrosis. In a man set. 28 ann. who fell from a tree and injured his arm against a stump so severely that four months elapsed before he could again use it. It always remained somewhat painful, and could not be moved with the same ease as the other. Two years afterwards several fistulous openings were formed, through which fragments of bone frequently found a passage. Arnica greatly diminished pain. Silex, calcis c., and spt. sulph. effected a cure. A remaining stiffness of the joints was removed by colocynth. Caries tibiae. The cure of a caries of the tibia, in a boy, was effected by silex, assa., calcis c., mezer., silex repeated, spirit sulph. and ac. nit. Sulph. has proved useful in various diseases of the bones. Distortio spinalis. In a boy aet. 10 ann., arising from a severe blow from a hard substance. The superior dorsal vertebra posteriorly curved, forming 58 BONES. between the shoulders a true cyphosis. The case was at one time complicated with tetanic symptoms, for which cicut. vir. was given, and twenty-four hours afterwards for dysuria, staphysag. These symptoms being removed, the cyphosis, which was only of two months' standing, was attacked with sulph. gtt. i. 9, and in eight weeks the gibbosity had perfectly disappeared. For rachitis, sulph. has been highly recommended. MoRBUs COXARIUs. In the earlier stages of this disease it may be sometimes proper to employ those remedies which are capable of abating inflammation, or of removing those painful diseases of the hip, which are termed ischias or sciatica: namely, aconit., bellad., cantharides, cham., colocynth., mrc., nux v., rhus. In its more advanced stages the remedies which are useful in caries will generally be indicated. But remedies of this class have answered well early in the disease. For instance, calcis carbonas in many doses, removed the coxalgia of a scrofulous child, who, without any previous injury, began to limp, and in walking dragged one foot, but did not complain of pain; the diseased limb was longer than the other, and the foot was always turned outwards whilst walking; pressing the head of the femur towards the acetabulum excited pain. And in another case, three doses of tinctura actis 2130 cured a coxalgia, with inability to stand or walk, in four weeks. The following case from the eighth volume of the Archives of Homoeopathic Medicine, is reported by Dr. Theodore Ruckert. It may be tedious on account of its length, but the case is certainly very interesting. The symptoms, &c. which have influenced the choice ) BONES. 59 of the medicines, I have given as far as they are reported, Amelia T. at. 6 ann., of weakly and tender constitution, and the scrofulous diathesis, had suffered two years before from a species of ozena and caries of the teeth, on which account many of these had to be extracted. Afterwards she was apparently well until her sixth year. On the second of July, 1828, she rode for some hours with her parents in damp, cold weather, and was apparently much chilled. On the following day she complained of pain in her right hip, increased by bearing her weight in walking, which soon became impossible. Many most injurious remedies were applied for its cure, by an old lady, with the natural consequence of an increase of the pain and an aggravation of the inflammation of the hip joint. Advice was now sought from an accomplished alloeopathic physician (who at this time is earnestly acquainting himself with homceopathia), who used different remedial means; namely, leeches, calomel gr. 30, in a short time, with evident sinking of the strength, and in order to raise this again cinchona, bitter extract and aqua laurocerasi were employed, but with constant increase of the disorder, so that the physician at length pronounced her beyond the reach of medical aid. As regards the further development of the disease, it is to be remarked, that about eight days after its commencement, a swelling appeared externally in the region of the trochanter major, which apparently marked the passage of the caput oss. femoris out of the acetabulum. The inflammation and suppuration advanced, accompanied with the most frightful pains; 60 BONES. the child screamed loudly, often for hours, till finally after some weeks, when the limb had already taken a false direction and the femur was luxated, an opening formed itself on the outside of the thigh nearly over the trochanter major, and discharged a quantity of pus. Injections of various kinds were unsuccessfully employed, the child became daily more emaciated and the limb more deformed. Sept. 6th, 1828. In the ninth week of the disease I was called to visit the child and found its condition as follows. It was emaciated in the highest degree, the skin appeared to lie on the bones. Its head was sparsely covered with blonde hair, the greater part having fallen out. The countenance was sunken and pale, the bones of the face prominent, the lips without lively redness. The little patient laid in bed, but desired every hour to be moved into another bed, which could not be accomplished without giving her much pain. Besides she was so peevish and captious that her parents and attendants scarcely knew how to manage with her; they dared not touch her, and every footstep in the room excited her. She had not the least appetite, but complained of no disorder of digestion, and she had a stool almost every day. By close examination of the diseased thigh, I found it in a false direction to the pelvis. The knee was bent and fell outwardly, it was stiff, could not be straightened, and the efforts to accomplish this caused pain. The thigh was elongated. In the region of the foramen ovale a protuberance could be felt, but it could not be accurately examined on account of the too great sensibility of the patient. The right side of the pelvis, when viewed from behind, appeared flattened off, and as if a part of it were wanting. The BONES. 61 opening on the thigh daily discharged a quantity of thin pus, and upon sounding it, which was very difficult on account of the sensibility and obstinacy of the patient, the bone could be felt, yet without roughness. By injecting water it was seen that the cavity was not inconsiderable. Behind on the thigh, on the borders of the nates, as also an inch above the opening, there were soft, discoloured, painful spots. The child complained of severe, sticking pains in the hip and thigh, but still more in the knee, of the affected side. The pains were very troublesome at night, and the patient seldom slept for two hours in succession, she had alternate chills and heats, especially in the afternoons, and then had red cheeks. A spontaneous luxation of the femur, forwards and inwards, was evident; and this together with diminution of the strength of the body, the hectic fever, &c. furnished grounds for a gloomy prognosis. In the most favourable case, though life should be preserved, stiffness of the limb and partial necrosis of the bone were to be expected. On account of the great obstinacy, self-will and peevishness, I chose the arnica, of which on the 7th of September I gave gtt. i. 6, - at the same time prescribing a proper diet according to homoeopathic principles. By the 12th the self-will and peevishness, as well as the pains, had somewhat abated; on the 20th the discoloured spots were opened and discharged some table-spoonfuls of pus. On sounding, the canal was found to pass far inward and upward. By the 26th the pus had become of much better quality, the child ate and drank with satisfaction, had increased in flesh and strength, and sat up much in bed. On this day bryonia 18 was given, 62 BONES. and by the 2d of October there was considerable advance of the improvement. At this time lycopodium 4130 was given in the morning fasting, and by the 16th the limb was more movable, the thigh evidently becoming shorter, and approaching more nearly the natural direction. The child was more cheerful and free from fever. In the early part of November it was free from pain, and tried to walk a few steps while holding on to the bed or a bench. Nov. 15th, acidum nitricum 4130, in the morning fasting, with continued improvement, but with a development of the old disease of the nose, the discharge of very fetid mucus. December. In this month the child was attacked with scarlatina miliaris. Two doses of aconit. 24, on the 5th and 7th, removed the fever, but on the 8th appeared symptoms of angina membranacea, for which spongia 30 was given, and on the following days calcis sul. 3, and pulsatilla 12. December 16th the child was again well and cheerful, went about in the room, but appeared very pale, and was very hard of hearing, a circumstance which had never occurred to it before. A small part of a drop of spiritus vini sulphuratus was given, and in a few days the hearing returned and the colour of the face improved; she began again to go about the room, but with a slight limping. The orifices still discharged much matter, and from the nose there came large lumps of mucus. On the 16th of January 1829, calcis carbonas 30 was given. In this month she was fleshy; and not only went about the room, but skipped and danced with other children. The head of the femur appeared to have nearly attained its natural position, and the thigh was nearly of the same length with the other. BRAIN. 63 In February, from taking cold, there was some increas6 of the disease. On the 8th of March, silex 30 was given in the morning fasting. On the 2d of May spiritus vini sulphuratus. On the 5th of June petroleum 4130. The child constantly well and cheerful ran about in the house and out of doors. The fistulous orifices would sometimes close and then speedily open again. On the 10th of July, from sitting for several hours on a hard bench, she had severe pains in the hip and thigh, &c.; bryonia gtt. i. 18, and by the 21st well and going about. The two upper orifices closed and covered with a scurf. July 23d; phosphorus- 4130, and by the 31st all the orifices closed. On the 29th of November she remained well, and had a perfect movement of the limb. BRAIN. In PHRENITIS, bellad. is generally the proper remedy. It should be preceded by aconit. when the accompanying fever is violent. Where the inflammation of the brain arises from a retrocession of erysipelas, or from external injuries of the head, forming an "ENCEPHALITIS ERYSIPELATOSA," bellad. or rhus will be the appropriate remedy. If it has followed on the disappearance of inflammation of the external ear, pulsat. If such an inflammation threatens to pass into an acute hydrocephalus, mere. will often prevent it. Dr. Gross mentions aconit., bellad., ac. phosph., rhus, merc., hyos:, as having been of service in what the physicians of the old school would term rheumatic inflammations of the brain. 64 BRAIN. In inflammation of the brain, opium has been found useful where there was a soporose condition with stertorous breathing. And stramon. where the gestures of the patients showed that they thought they saw some frightful object from which they would shrink, at the same time shrieking frightfully. CONCUSSIO CEREBRI. Arnica. COMPRESSIO CEREBRI, from effusion, arnica, which has also been applied externally with advantage. PHRENITIS. In a man set. 30 ann. of powerful frame and choleric temperament; from exposure to cold. Sleeplessness, vertigo on sitting up in bed. Frequent and violent delirium; he raved and cried; Would leave the bed, and when held in would show great resistance; tossing about; would not endure the bedclothes. In tranquil intervals he complained of confusion, heaviness and fulness in the head, and of fixed burning and pressing, as also of sticking pain in the head. Eyes wild, rolling, aching, reddened and intolerant of light, pupils contracted; he saw sparks and flames before the eyes. Hearing preternaturally sensitive. Ringing and rushing in the ears. Face hot and red, at times covered with a clammy moisture. Frequent sneezing; pressing in the nose from which at times a few drops of blood flowed. Pulse quick, hard and jerking. Skin hot and dry. Respiration anxious, sighing and at times interrupted; voice hoarse, speech difficult; lips and mouth red, hot and dry. Tongue deep red, and slightly coated with tough mucus; severe thirst; constrictive sensation in the throat and frequent impulse to swallow; nausea and muco-bilious vomiting; singultus; constipation. Urine red and causing a burning sensation in its HYDROCEPHALUS. 65 passage; bellad. gtt. i. 30. In twelve hours considerable relief; he slept some hours the following night. The next day the patient had perfect consciousness; the violence of all the symptoms had abated. On the fifth day for some weakness and confusion of head, white coated tongue, little appetite and costiveness, bryonia gtt. i. 15, and in a few days he was perfectly well. Hyosc. Phrenitis; in a man et. 24 ann. of sanguine temperament. Originating from a fall. After the fall, he walked home to his solitary dwelling, and was found two days afterwards in the following condition. He laid unconscious, with his eyes closed. Tongue covered with a white frothy mucus. Delirium, singing incomprehensible tunes, or murmuring, and sometimes simpering. At times for some minutes still. Movements of the hands as if he would pluck the bed clothes, but was unable; pupils dilated, eyes of dull lustre; face redder than natural, skin dry and harsh; respiration hurried and anxious; pulse uniform, quickened and full. Patient exhibited no sign of pain upon being touched, rubbed or roughly handled. Hyoscyam. gtt. i. 6. In half an hour an aggravation which continued for nearly five hours; but in eight hours perfect consciousness. In twenty-four hours no symptoms of his cerebral affection, but an inflammation of the lungs, which arnica, gtt. i. 6, speedily removed. HYDROCEPHALUS. Dropsy of the brain. HYDROCEPHALUS ACUTUS. In the forming stage, marked by debility, fretfulness, disturbed sleep, and 5 66 HYDROCEPHALUS. gastric derangement, pulsat., bellad., ignat., ipecac., cham. or bryon. may be indicated. In the stage of vascular excitement, Hartmann considers aconit. as indispensable. Bellad. is the next most valuable remedy, but hyos., stramon. or pulsat. may sometimes be applicable. In the more advanced periods of this stage when there is strahismus, disordered vision, anxiety upon raising the head, &c., digit., arnica, rhus, artem., tr. sem. cince., merc., bellad., stramon., hyos. In the last stages where there is stupor, torpor, paralysis, &c., there is but little ground for hope. If the febrile irritation is most prominent, aconit., if the spasmodic, ipecac., bryon., if the soporose condition, opium. When there are frequent convulsions with bending back of the head, frequent smelling of camphor, as often at the least as every five minutes. If after this there is any abatement of their violence, one or two pellets moistened with spt. nit. dulc. laid on the tongue, or constant smelling of spt. nit. dulc. in a phial. Bellad. Case. In a child rt. 4 ann. of a rachitic habit, with swollen joints, distorted bones, and unsightly enlargement of the head. Exacerbating fever, severe headache, &c.; the symptoms clearly showing that condition of the brain which precedes hydropic effusion; bellad. gtt. i. 24. For twenty-four hours aggravation; after the second day the improvement not to be mistaken. Perfect cure, with diminution of the rachitis. CASE. A previously strong healthy child of three years old, (one child of the same parents had died of hydrocephalus, and another had had the disease,) was attacked with fever and pain in the forehead, which HYDROCEPHALUS. 67 under a mild antiphlogistic treatment had so far developed itself as "Hydrops cerebri infantum," that in order to its proper alloeopathic treatment leeches, calomel, &c., would have been necessary; bellad. gtt. i. 24. After the second day the child was perfectly well. CASE. In a girl aged fifteen months, whose elder sister had been treated for hydrocephalus two years before. After she had been ill for a week, during which time she had been treated with calomel, "nitrosum" and "aq. laxativa" in the doses of the ordinary practice, her situation was as follows: Lying with her eyes closed, constantly moaning; she heard nothing, and desired nothing; countenance pale and sunken; skin dry and warm; the nostrils dry; respiration short and rapid; pulse frequent, but the frequency varying; the tongue moist; she drank when she was lifted up and the glass was held to her lips, and swallowed easily, but let her head at once sink again. She frequently tossed the left arm and leg, which she kept constantly elevated and drawn outwards; the extremities of the right side were still, though she yet retained the power of moving them. Urine and fmeces were discharged unconsciously. Bellad. gtt. i. 24 was followed by an abatement of the hydrocephalic symptoms, and a diarrhoea with green, slimy stools. The diarrhoea continuing, cham. gtt. i. 12 was given. Its effect was an almost immediate suppression of the diarrhoea. The relief proved but temporary, and in consequence of relapse bellad. gtt. i. 30 was administered. This was speedily followed by improvement, and in the course of a few days she perfectly recovered. Helleb. 30 has been strongly recommended in those 5* 68 CATALEPSIA. cases where bellad. and bryon. have produced only a temporary mitigation of the disease, or where the symptoms are such as justify the fear that effusion has already taken place, and should it prove inefficient, sulph. 30 or 60. HYDROCEPHALUS CHRONICUS. In a child aged fifteen months. Circumference of the head over the "tubera frontalia" and occipital protuberance, twenty-three inches. Bones of the cranium widely separated. Thin scabs on the scalp of a peculiar odour. Distortion of the spine. Calcis c. 30, ipecac. and silex 1130 were followed by a gradual reduction of the head to the circumference of sixteen inches, and a restoration of the spine to its natural curvature. ~Helleb., arsen. and sulph. in alternation and according as they are indicated by the symptoms, are asserted to have frequently cured chronic hydrocephalus, and even congenital dropsy of the brain, with which, at a later period, general dropsy had become associated. The order of succession in which these remedies were employed was as follows: helleb., sulph., arsen. It is recommended when no urgent symptoms are present, to allow the helleb. to operate without interruption for at least eight or ten days.. CATALEPSIA. It should be remembered by the physician that this disease is frequently simulated, and that the.imposture can be much more easily maintained under the homoeopathic than under the ordinary heroic. treatment. In a case where the attacks occurred every evening, CATARRHUS. 69 commencing with sticking pain in the forehead, vertigo, heaviness of the head, and great languor and debility. The patient would lay entirely quiet; the eyes were half open, and of dull appearance; the upper eyelids twitched spasmodically; the mouth was open; she respired easily, but answered no questions; the warmth of the body was natural; the pulse full, but not frequent; the limbs could be easily moved, and they preserved the given position. This condition lasted for nearly half an hour. Then she began to breathe loudly and with some difficulty; she moved her head; the eyes regained their lustre; she turned herself in bed; she answered questions; the headache was gone; she complained of some difficulty in swallowing; felt very weak, and knew nothing of her recent paroxysm. Stramon. gtt. i. 9 was given immediately after the paroxysm. The next day a return of the headache, but not of the catalepsy, which never again appeared. CATARRHUS. This term is employed to designate that common form of disease which is popularly termed "a cold." The cause to which it is most generally attributed is the action of cold upon the body, either through long exposure to its influence, or through exposure to it when over-heated, or to sudden changes from a high to a low temperature, &c. But however capable cold may be under these circumstances of inducing catarrh, it is certainly not its only cause. The agents, whatever they may be, which produce those epidemic catarrhs which are known by the name of influenzas, 70 CATARRHUS SPORADICUS. are to be ranked among its causes. The number of these must be considerable, inasmuch as the influenzas of different years present considerable diversity of character which can only be accounted for on the ground of a difference in the causes which produce them. But there are other pathogenetic agents than those just referred to, which can produce this disease. The investigations instituted by the cultivators of homoeopathic medicine for the purpose of ascertaining the operation of remedies on the healthy system, teach us that there are many substances which possess the power of inducing catarrhal symptoms. When we consider not only the diversity of the agents, but also the almost endless modifications of their actions by difference of constitution in the production of catarrh, we must suppose that many remedies must be required for its treatment. Experience confirms the truth of such a supposition, for not only the cases of sporadic catarrh, but also the influenzas of different years have required very different remedies: the article which has proved almost specific in one year, proving of comparatively trifling utility in the next. The further consideration of the character and treatment of catarrh can be best conducted under the divisions of sporadic and epidemic catarrh. CATARRHUS SPORADICUS. This is a disease with which the system, in most instances, sympathises but slightly. The catarrhal are the predominant symptoms, and except on account of the inconvenience and discomfort of these, which CATARRHUS SPORADICUS. 71 are rarely so great as to disable the patients from attending to their ordinary pursuits, it would demand but. little attention if it were not that it sometimes awakes into action latent predispositions to disease of the lungs or trachea. As it is mostly of this slight character in its earlier stages, the reactive energies of the system are strong, and the remedies may be given in more rapid repetition and with more frequent change than in most other diseases. But there are sometimes sporadic cases which in their violence and the severity of their accompanying symptoms, equal the most violent forms of epidemic catarrh. In such instances the accompanying symptoms often predominate in importance, and the remedies which operate most decidedly for the cure of these, demand the first consideration. The catarrhal symptoms being of a subordinate character are to be considered in deciding between the remedies which are adapted to the predominant symptoms. As cases of this kind present a great variety of form, a detail of all would be nearly impossible, and of a few would be nearly useless, I shall, therefore, confine myself in treating of the remedies for sporadic catarrh, to those indicated by the catarrhal symptoms. These are the coryza, soreness of the throat, cough, and affections of the voice, and respiration. For the coryza, where it presents any peculiarities, is extraordinarily severe, or does not decline with the other symptoms, see coryza. Under similar circumstances in relation to soreness of the throat, see angina faucium. If the cough is dry, that is, unaccompanied by expectoration, aconit., bellad., bryonia, cina, calcis sul., capsicum, chamomil., conium, drosera, euphrasia, CATARRHUS SPORADICUS. hyosc., ignatia, ipecac., lactuca, lobelia, merc., nux v., pulsat., rhus. When the dry cough is worst through the day, with an intermission of some hours in the evening, nux v. When the cough is dry, (or the expectoration is slight, and only after great exertion,) and worst in the morning, nux v., calcis sul. When the cough is combined with soreness and tenderness in the umbilical region, nux v. When the cough is worst at night, chamomil., capsicum, rhus. When it only appears at night, hyosciamus. When equally day and night, ignatia. When the coryza is uncommonly violent, euphrasia, ignatia. When the dry cough is of a violent and spasmodic character, ending in retching, and vomiting of mucus, followed by great exhaustion, nux v., ipecac., pulsat., bellad., merc., drosera, bryonia. If the cough is dry and spasmodic, and unaccompanied by retching or, vomiting, hyosc., cina, lactuca, conium, ipecac., bellad. A violent shattering, spasmodic cough, which does not permit the patient to get his breath, arising from an intolerable tickling in the upper part of the windpipe which is free from mucus, attacking and awakening from sleep at night, has, according to Hartmann, been frequently cured by belladonna 30. The following remedies are also sometimes indicated in dry cough; calcis carb., sulphur, lycopod., phosphor., sode mur., iodine, spongia, barytes. In cough with copious expectoration, pulsat., dulc., chamomil., bryonia, arnica, stannum, sepia, lycopod., silex, phosphor., graphit, sodce mur., senega. In catarrh accompanied by hoarseness, aconit., antimonii tart., calcis sul., calcis carb., carbo veg., mangan. acet., merc.,phosph., sodce mur., spong., sulph. CATARRHUS EPIDEMICUS. 73 In catarrh accompanied by severe oppression at the breast, with or without shortness of breath, antimonii tart., ipecac., lobelia. The former of these has been for many years employed by some practitioners of the old school in this city for the cure of catarrh; one grain of antim. tart. being dissolved in a quart of water, of which a table-spoonful was given at a dose. And the lobelia I have employed in several such cases with the most striking improvement. For the completion of the cure pulsat., bryonia, or other remedies were in some cases necessary. For further particulars in relation to cough, see tussis, and phthisis. CATARRHUS EPIDEMICUS. Influenza. In the diseases to which this term is applied, it is more frequently the case than in sporadic catarrh, that the catarrhal symptoms are less important than the.other symptoms of disease which appear cotemporaneously with them. As these vary very much in different epidemics it will happen as already remarked that different remedies will be found useful in different years. The remedy which will be most successful in an existing influenza, cannot be accurately known, except from experience in the present invasion. But a knowledge of the remedies which have proved most advantageous in past epidemics may be useful, and I shall therefore briefly state the chief information I have collected on the subject. Camphora, when given in frequent and constantly increased doses has, according to Hahnemann, proved to be a palliative in some of the influenzas of Germany, "but a very valuable one, inasmuch as the disease 74 CATARRHUS EPIDEMICUS. has only a short period of duration (verlauf). It does not indeed shorten the duration of the disease, but it renders it much milder and thus conducts it to its termination without danger." "By nux vomica in a single most minute dose, will this disease be frequently removed in the course of a few hours." Hahnemann. Hartmann found the nux vomica useful in those cases of influenza in which constipation accompanied the disease, but arsenicum where debility, diarrhoea, great thirst and paralytic weakness of the limbs were the most prominent symptoms. Tinctura acris, given about two hours after camphora, proved also very useful. Aconit., agaric., arnica, bellad., bryonia, cinch., merc., phosphor., pulsat., sabadilla, scilla, senega, silex, spigelia, stannum and veratrum have proved useful in influenza. Within a few years the term grippe has been applied in Europe to epidemics which do not appear to differ materially from influenza. The introduction of new names, where there is nothing to determine the applicability of the old or the new term, is to be discouraged, and therefore in introducing the latter here I do not wish to be considered as-adopting it. I only employ it because Dr. Hartmann's treatise, (in his Therapie acuter Krankheitsformen) upon the grippe shows the nature of the treatment required in severe influenza. It is to be remarked that there is not one of the circumstances or symptoms which he considers as belonging to grippe and distinguishing it from influenza, which does not equally belong to the latter. GRIPPE. Another kind of catarrhal fever is the grippe which was prevalent in the beginning of the CATARRHUS EPIDEMICUS. 75 year 1833, which exhibited far greater differences in its appearances than influenza, and also far more dangerous sequelar diseases; for, where disease of the breast was present, after an attack of the grippe a phthisis was almost inevitable, and the patient could but seldom calculate on recovery. In most instances its attacks were sudde6, but in a few cases it developed itself gradually, and an uncommon debility accompanying the catarrhal symptoms, with a heaviness and soreness of the limbs, particularly of the lower extremities, distinguished the disease, with the greatest certainty, from every other kind. This condition of the limbs was frequently associated with headache and a disposition to vomit, and frequently with sorethroat and some hoarseness. The obstruction of the nares was soon very severe and combined with violent tearing pains in the forehead and in the bones of the face, with a sensation of pressure in the rest of the head, vertigo, tearing pains in the ears, &c. The disease moreover possessed many peculiarities, for example, it awakened, in those who were not perfectly healthy, old, slumbering symptoms of disease, and rendered their cure difficult; it attacked the same subject repeatedly, but always in a new form; it frequently continued for a long time with apparently unimportant symptoms, which might be removed by proper remedies but reappeared after the slightest irregularities of diet, often even on the next day; it also readily complicated itself with other diseases, modified their course, and aggravated the evil. Frequent smelling of camphora on the first appearance of the symptoms would suppress the disease, but after a couple of days it still came to complete development. When inflammation of the thoracic 76 CATARRHUS EPIDEMICUS. viscera was present, nux v., after previously administered aconit., always proved useful. Mercurius when repeated every or every other day, was the most adapted to remove the disease or even to destroy it in the germ, especially when, with severe affection of the head, throat and breast, there was a dry, shattering, slowly loosening cough. When the trachea was much irritated or inflamed, so that the acute and violent pain almost prevented speech, and the voice was very much changed, frequent smelling of phosphorus 30 was of service. The disease often appeared in the form of a sporadic cholera, and in these cases the catarrhal affection was unimportant, while the debility was very prominent; here veratrum was always beneficial. When nervous symptoms showed themselves, as was not unfrequently the case, if the patient was delirious (phantasirte), had a wild, staring appearance, and complained of great tenderness of the abdomen, the pulse being full and hard, I gave several doses of aconit. with marked advantage, and conquered the remaining symptoms by a dose of pulsatilla, which also proved serviceable in removing a pappy, insipid taste, with slimy coating of the tongue and loss of appetite, which frequently remained for a long time. The severe pressing pain in the forehead and accompanying cough with easy, mucous expectoration, were removed by bryonia. But when the cough was dry and spasmodic, the headache intolerable and aggravated by every motion, by speaking and by bright light; smelling of belladonna always afforded relief, and in a couple of hours a disease, already bordering on inflammation of the brain, was conquered. The cough which had its exciting irritation in a CEPHALALGIA. 77 rattling as if from a collection of mucus under the sternum, was speedily removed by a.dose of cinchona. The cough which, though accompanied by free expectoration, produced such a soreness under the short ribs that the patient was compelled to press his hands over these parts whilst coughing, always yielded to a dose of bryonia. The obstinate spasmodic cough which frequently tormented the patient for an hour, was often removed by a single dose of hyosciamus, and in a few cases by belladonna. If it was combined with vomiting, that is, if it did not cease until a quantity of mucus was brought up by vomiting, there was no remedy better adapted than conium. But if it appeared always after meal-times and then the food was every time vomited up, ferri acetas was the appropriate remedy. In those cases where the grippe favoured the predisposition to phthisis, and threatened to develope it rapidly, one or two doses of stannum 12 were frequently capable of conquering this incipient disease. Not unfrequently, as was observed by Dr. Gross, obstinate inflammations of the eyes, with subsequent ulceration of the cornea'and great intolerance of light, followed in the train of this disease. Arsenicum proved remarkably helpful against these. Belladonna in frequent doses afforded speedy but not permanent relief. CEPHALALGIA. HEADACHE. Acidum nitricum cured a painful tenderness of the / external coverings of the head, which only appeared! when the patient laid down. Aconitum. Case. In a woman set. 54 ann. o 78 CEPHALALGIA. irritable disposition; from exposure to cold. She was peevish, fretful, and complaining of trifles, and had violent headache, with loss of appetite, and inability to sleep. CASE. Pain in a point on the left parietal bone on every movement and exposure to the air; with pain in one side of the face, and swelling of the lower jaw. Actcea. Hemicrania, when it consists in a severe, tearing, gnawing pain in the right temple, with cotemporaneous boring and cutting pains in the interior of the head; and is commonly most tormenting at night. Arnica. Case. A man et. 35 ann. whilst entering a low door struck his head with such force against the lintel, that he fell back and laid for some minutes completely stunned. He however shortly recovered, and pursued for some days the exciting and laborious sport of hunting. But the pain which at first had not been very severe, increased so much in two weeks, that he sought medical aid; and leeches, embrocations and various other remedial means were employed during many days without relief. He had a pressing pain in the forehead; heat in' the face and head, the rest of the body not being hot; rushing in the ears; contracted pupils; sickness in the morning; thirst, constipation; fever in the evenings, and anxious dreams. He was peevish and irritable. Arnica, gtt. i. 6, caused increased pain for an hour and a half, after which he fell into a comfortable sleep, unattended by dreams, from which he awoke very much improved, and in forty-eight hours was perfectly well. Arsenicum cured a violent pain in the left side of the forehead and in the temple, in a girl et. 15 ann. There was a small spot on the forehead, of a brownish CEPHAIALGIA. 79 red colour, with a black centre, which was painful on being touched. The arsen., in the dose of 1130, was given daily for three days. (In a case of cephalalgia rheumatica occurring to a young-man, and of many weeks duration, where aconit., bellad., and nux had failed, I succeeded in effecting a perfect and permanent cure with arsen. 30 in repeated doses. G.) Aurum has many times removed a rushing and roaring in the head, occurring in hysterical females. Belladonna. Case. In a maiden lady aet. 25 ann. The paroxysms commenced with chilliness over the back and shoulders in the morning on rising from bed. This was of short duration, but left her feeling quite unwell. Not long after the chill, nausea without vomiting occurred, and at the same time severe pressing tearing pain in the whole head, but worst in the forehead, which upon every motion of the body or eyes became intolerable. Every breath of air, opening or closing the door, or a loud footstep, increased the pain. After a time -the pain seated itself entirely in the forehead, on which a hot spot could be felt, and at the same time there was severe aching at the root of the nose. Violent palpitation of the heart, every pulsation being severely felt in the head, and soreness and debility of the limbs, accompanied the paroxysms, which occurred every seventh or fourteenth day. The complaint had existed for eight years, and medical treatment had been always resorted to for its removal. Emetics had been freely employed but without benefit. After having discontinued the use of coffee and all medicines for eight days, bellad. gtt. i. 24 was given two days before the period of the expected paroxysm, at which time an attack occurred, 80 CEPHALALGIA. but so slight as not to compel her to lie down. No other appeared till six weeks afterwards, when there was a severe attack from a long walk. After this bellad. gtt. i. 30 was given, and she remained exempt from her disease. CASE. In a woman ret. 24 ann. The disease was of three years' duration, and had ceased but seldom, and for short periods, notwithstanding much medical treatment. The paroxysms which commenced about four o'clock in the afternoon and continued till three o'clock in the morning, began with burning and sticking in the gums which swelled rapidly and became almost of an exsanguine appearance..After a quarter of an hour, swelling of the upper lip and of the right side of the face, with diminution of the pain in the gums. There then occurred screwing, tearing, pinching and sticking pains, and a rushing sound in the right ear; sticking and boring pains in the right temple; sticking and tearing pains in the whole of the back of the head; and sticking and drawing pain behind the ear and in the swelling of the face. There was great tenderness of the scalp preventing her from lying down at night. The submaxillary glands were slightly swollen, but painful only on pressure. For many years she had been subject to swelling of the glands of the neck. Appetite moderate. Bowels and menstruation regular. Disposition sorrowful. As adapted to the symptoms of the case and on account of its peculiarly beneficial operation on the lymphatic system, as a disorder of this system was apparent,* " The substance of a note by Dr. Schubert who has reported this case in the Archiv fur die homceopathische Heilkurist, may aid in the removal of some misconceptions in relation to homaeo CEPHALALGIA. 81 bellad. was given in the dose of gtt. i. 30 at ten o'clock in the forenoon, after she had discontinued the use of all medicines for some days. There was no change necessary in her diet, but she was recommended to use more exercise in the open air than she had been previously accustomed to do. The next paroxysm after the medicine was rather more severe than commonly. But on the following day it was much slighter, did not attack till six o'clock, and ended in three hours. Every day the attack was lighter. On the fifth day there was none. On the sixth day a slight one. On the morning of the seventh day pulsat. gtt. i. 12 was given, after which there was no paroxysm for four months, when, the disease showing a disposition to return, bellad. was again given and the complaint permanently disappeared. Cephalalgia from exposure to cold, cutting of the hair, or being wetted, accompanied by vertigo and dulness of head, has been cured by bellad. gtt. i. 20. HEMICRANIA affecting the right side and occurring weekly, in a man et. 56 ann. The pain was pressing and stretching, attended by vertigo and weakness of memory. The face was red and tumid; acrimopathic medicine which have found place in this country as well as in Germany. Homoeopathia has been reproached with entirely neglecting to observe what is commonly esteemed by the medical science of the day as particularly worthy of attention, while it merely considers groups of symptoms. This is such an untruth as cannot be asserted by any one who has attentively perused the homoeopathic writings. For this science, besides its attention to symptoms and circumstances which may appear of trivial importance, also considers the character of the disease; whether it is or is not inflammatory, and what tissues, as far as can be ascertained, principally suffer. 6 '*/r ' 82 CEPHALALGIA. nious tears ran from the right eye, the pupil was contracted and the white of the eye discoloured. Intolerance of light; stitches in the right ear, with hardness of hearing. Bellad. 2130, twice given in eight days, effected a cure. Bryonia. Case. In a married woman et. 30 ann. blond, of relaxed habit, and mild, soft and timid disposition. Headache commencing in the morning, compelling her to go to her bed in the early part of the afternoon and arriving at its height in the evening, when she became almost senseless. The pain took in the whole brain, and seemed like a pressing together. She could not endure either noise or light, and became peevish, fretful and quarrelsome. In the afternoons the headache was accompanied by palpitation of the heart, constriction of the breast, nausea and retching. The paroxysms were excited by taking cold, sitting up at night, care or other mental emotions, and were sometimes accompanied by fever. Bryonia gtt. i. 3 administered during the paroxysms procured speedy relief. In a case very similar to the preceding, occurring in a female et. 20 ann. of fretful and quarrelsome disposition. After nux had abated the violence of the paroxysms, two doses of bryonia effected a lasting cure. Calcis carbonas. Case. In a maiden lady set. 20 ann. Dulness of the head. Pain in the forehead as if the head would burst. Hammering headache in the open air. Sometimes humming in the head, with redness of the cheeks. Falling out of the hair. Misty before the eyes especially while reading. Two stools daily and at times diarrhcea. Cutting pain in the abdomen, and pressing pain in the loins in CEPHALALGIA. 83 the menstrual periods. Frequent waking at night; anxious dreams; disposition to complain; want of cheerfulness; calcis carb. 1130 effected a cure. In pressing pain in the upper part of the head, arising in the free air; drawing pain in the forehead with coldness thereof, and nausea; tearing in the right side of the forehead with pain of the part on being touched; calcis c. has been found useful. Carbo veg. Case. Arising from wine drinking and overloading the stomach. Confusion of the head, determination of blood to the head;,indisposition to employment, debility, loss of appetite and sensation of roughness of the mouth and tongue. Cinchona. Case. The scalp on the back of the head felt sore; the roots of the hair were sensitive to the slightest touch. Tr. cinch. gtt. i. effected a cure in thirty hours. Accompanying pain and stiffness in the loins were subsequently removed by bryonia, gtt. i. 3. HEMICRANIA of six months' duration, but with several longer or shorter interruptions, in a girl at. 15 ann. The left side of the head was affected with a most painful sensation as if the brain shook and struck against the skull. It was so severe that she could not keep her head still, but constantly shook it up and down. At the same time there was a sensation as if the skull would burst upwards. The pain was most severely aggravated by motion. The left eye was painful. The left side of the neck painful and stiff. The disposition complaining and depressed. Cinch. gtt. ss. 12 diminished the pain so rapidly that it entirely disappeared in three or four hours. At the end of twelve hours it again returned with its original severity. After twelve hours more, another but 6* 84 CEPHALALGIA. smaller dose of cinchona was given and the headache disappeared, and was not re-excited by active motion. At the end of six weeks there was a slight relapse, which cinchona again rapidly overcame. In hemicrania, cinchona has been recommended when the affected part is sensitive to the slightest pressure. Cocculus has removed headaches accompanied by a sensation of hollowness of the head. It has also proved useful in constrictive or screwing-in pains in the head after eating or exercise, with vomiting or great anxious restlessness. CASE In a woman et. 28 ann. Frequent pain in the forehead with bilious vomiting. Pressure in the stomach. Pain in the right hypochondrium, changing from pressing to sticking upon bending forward; costiveness. Painful hemorrhagic menstruation, and subsequently, hemorrhoidal tumours; debility; sweat; restless sleep; cured by two doses of cocculus, gtt. i. 18, in eight days. Colocynthis cured an arthritic cephalalgia which recurred every afternoon. It has also removed violent tearing headache, accompanied with asthmatic oppression at the breast. Mercurius has proved useful in tearing burning cephalalgia, chiefly affecting the temples. Nux vomica. HEMICRANIA in a man met. 30 ann. of sound but irritable constitution, and of sedentary habits. Shortly after awaking in the morning considerable affection of the head with disgust towards food, drink, coffee and tobacco. Then, sticking or pressing pain immediately above the left orbit, which passed downwards at times into the eye, and was increased by pressure. Intolerance of light, dimness of CEPHALALGIA. 85 sight, and flow of hot tears. All the parts around the eye were hot. At the same time the left nostril was generally obstructed, and the strongest sternutatories would not excite sneezing, which was desirable, because as soon as it occurred, the paroxysm ceased. During the severity of the pain copious sweats broke out, after which he felt worse than before. Sometimes in the commencement of a paroxysm he felt a disposition to vomit. In the paroxysm his thoughts were often confused; and after it the intellectual powers were much affected, and he was forgetful and incapable of much mental exertion. Great sensibility, he spoke unwillingly, and the conversation of others and any noise affected him unpleasantly. The paroxysm continued to increase in severity until towards noon, when it terminated in a short sleep, from which he awoke cheerful and with a good appetite. The paroxysms occurred daily. "This form of disease was very similar to the nervous hemicrania observed in coffee drinkers, and described by Hahnemann. The patient was very fond of coffee, and used it in large quantities; and this might with propriety be considered as the chief source of his disease. He must therefore wholly avoid it. The above symptoms were best adapted for nux v., as this not only produces them, but also possesses the property of exciting the severest disease in the morning hours. Besides, it is one of the chief antidotes of coffee, and it was therefore to be preferred to every other medicine. It was given in the evening in the dose of gtt. i. 24, and even in this dose operated powerfully." (Dr. Wislicenus). The next paroxysm was more violent and of longer duration, but the second was much weaker, and after the third day they had ceased. On the 86 CEPHALALGIA. tenth day, on account of a return of the symptoms in much weaker form, a similar dose was given, and in two days he was perfectly well and remained so at the end of two years. A similar case in a female aet. 35 ann., but attended by severe aggravation of the hemicrania in wet or stormy weather, and by obstinate constipation, was cured by nux v. 3. Nux v. has removed cephalalgia with a sensation of fluctuation in the brain,' pressing pain in the occiput, and pressing beating headache in the morning on mental exertion; after eating, pain in the temples, which was moderated by warmth and increased by wine and coffee; attended by bitter taste in the mornings and constipation for three or four days, and then great exertion to effect a discharge. The patient was passionate, and over sensitive to noise and odours. Also, morning headache, with vertigo, as if the brain moved round in a circle; dimness of sight, and at times unconsciousness; intolerance of light; ringing of the ears; wealdy feeling after eating, eructation, beating and burning in the region of the stomach, and flatulent distension and rumbling in the abdomen. Nux v. has also cured periodic headache; the pains being pressing, tearing or sticking, beginning in the morning, worst at noon, and ending in the evening; in some cases attended with pain in the region of the liver; nausea, retching; eructation or vomiting of bitter fluid, or constipation. Platinum has been successfully employed in the cure of a severe pinching pain in the fore part of the head, especially above the root of the nose; with heat and redness of the face, complaining disposition, and too frequent and copious menstruation. CEPHALALGIA. 87 Pulsatilla. Case.,In a maiden aet. 24 ann. of large and powerful frame, and of a very yielding disposition. In the morning on awaking she had a very severe headache, which at first only affected the forehead, but afterwards the whole head, and produced a sensation as if the head was pressed in a vice; vertigo and heaviness of the head upon sitting up in bed; pain increased by thinking and speaking; great debility; alternating paleness and redness of the face. Sickness and sensation of crawling at the stomach; a constrictive feeling over the breast as if the clothes were too tight; great dryness of the mouth, but no thirst. Disgust of food; frequent transitory shivering over the whole body; weak, scarcely perceptible, slow pulse; over-sensibility of the disposition; she complained continually. Pulsat. gtt. i. 12, given in the forenoon, was followed by a short and slight aggravation, after which there was a progressive improvement till four o'clock in the afternoon, when there was a slight exacerbation, but she enjoyed a good sleep the following night, and was entirely restored to health in forty-eight hours. HEMICRANIA, in a girl met. 8 ann. of a soft and mild temperament and amiable disposition. Pulsating and sticking pain in the left side of the forehead, alternately in the mornings after getting up, and in the evenings after lying down; diminished by external pressure and in the open air, but aggravated in the house, on lying down, and on stooping, or by moving the eyes. The headache continued for many hours, and its cessation was followed by severe pain in the stomach, succeeded by acid or bilious vomiting, after which there were severe cutting pains in the lower part of the abdomen. Pulsat. gtt. i. 6 produced 88 CEPHALALGIA. an- aggravation in the succeeding paroxysm, but the later paroxysms were lighter and lighter, and entirely disappeared by the fifth day. At the end of two months there was no return of this disease, which had been of six months' duration, and had resisted the ordinary treatment. CASE. In a robust woman aet. 32 ann. who had been afflicted for several months by a painful drawing and stinging pain in the left temple which was absent during the day, but recurred at the same time every evening with the sensation of the left side of the crown of the head being lifted up, which deprived her of all rest at night. Accompanying the hemicrania, there was a constant humming and buzzing in the head, tearing pain in the left ear, and in the last six weeks painful metrorrhagia. Both the memory and body had been much weakened by the disease. The pulse was small and 60 in the minute. Disposition mild. A bleeding had aggravated all the symptoms. Pulsat. gtt. i. 3, and in six days the disease had nearly disappeared. A relapse occurred three weeks afterwards from taking cold, when the complaint was perfectly cured by rhus gtt. i. 6. Rhus has cured headache which returned periodically, with intervals of some hours, beginning with stitches in the ears, then in the temples, forehead and root of the nose, and extending to the jaws, with pain in the teeth and gums. CASE. Severe pain in the occiput compelling to lie down; and excited by trouble, or by exercise in the open air. The complaint occurred in a hysterical woman et. 40 ann. and was cured by repeated doses of rhus gtt. i. 6. CEPHALALGIA. 89 Rhus has also proved curative in some cases of arthritic cephalalgia. HEMICRANIA. In this form of cephalalgia rhus has proved serviceable; see the last case of pulsatilla under the present head. Sepia. Hemicrania in a maiden ret. 19 ann. Heaviness and confusion of the head in the morning. Hemicrania with severe tearing, boring and sticking pain; the patient had to close her eyes and press upon them with her hands. During the paroxysms there was' disgust of food. Three doses of sepia 3130 effected a cure. Silex in the dose of 2130 cured a sticking and tearing pain in the head, which extended itself through the bones of the face into the lower jaw and the teeth. Sulphur. Case. A worker in lead and tin had suffered for several years from attacks of a pressing and tearing pain, and numbness of the head, with loss of appetite and sickness at the stomach. Bryonia and nux v. each afforded much temporary relief, but the disease was permanently removed by repeated doses of sulphur 3. CASE In a girl ret. 11 ann. Disease of three months' duration. Pressing pain in the fore part of the head in the morning on awaking and continuing throughout the day, incapacitating the child from learning. After spiritus sulphuris 1110 the disease gradually diminished in violence, and at the expiration of three weeks entirely disappeared. At the end of nine months there had been no return of it. Sulphur has proved useful in the following kinds of headache: in sticking pain in the frontal protuberances, with vomiting of the ingesta; in stitches in the left side of the head with burning in the forehead, 90 CHOLERA. tearing pain through the head, whizzing in the ears and nausea; in drawing and cracking in the upper part of the head extending to the occiput, frequently with nausea. Also in cephalalgia from repelled psora. Taraxacum in the dose of gtt. i. of the tincture, cured a violent headache which only occurred whilst walking or standing. Tr. acris and veratrum have been recommended as useful in hemicrania. CHOLERA. This term has for a long time been applied to a cotemporaneous vomiting and purging, whether of bilious or other matters. Within a few years it has been applied to cases in which these symptoms were not present, but which were the result of the action of a pathogenetic agent which, in a great majority of the cases in which its operation was severe, produced vomiting and purging of a peculiar character. As the latter appears to be a distinct disease, and therefore to require a separate consideration, which is also proper in relation to the cholera of infants, I shall treat of the diseases to which this term is applied under the heads of Cholera Morbus, Cholera Infantum and Cholera Asiatica. CHOLERA MORBUS. This name is peculiarly applicable to sudden and violent attacks of vomiting and purging, arising from the action of cold on the body after long continued exposure to heat, which is a form of the disease that CHOLERA MORBUS. 91 occurs frequently in the summer season, and attacks most generally at night. It is most commonly attended by copious discharges of bilious matter, and its attacks are very frequently invited by over eating, especially of fruits or of vegetables which are difficult of digestion. As there is reason to believe that it is sometimes induced by the epidemic constitution of the atmosphere, though it seldom prevails very extensively, it is to be expected that different remedies will be peculiarly useful in different seasons. This term is also applied by some authors to the vomiting and purging produced by deleterious or poisonous substances taken into the stomach. It is sufficient to remark in relation to the forms of the disease arising from these causes, that the proper treatment consists in aiding nature in the efforts she has already established for the removal of the peccant matters. Or where their removal is rendered difficult by the insolubility and ponderosity of the substance, the exhibition of such remedies as either chemically neutralise it or favour its solution; at the same time that oily or mucilaginous matters are administered for the purpose of involving the poisonous particles and shielding the lining membrane of the stomach and bowels, as far as is possible, from its destructive action. Without the neutralisation or removal of the substance, the vomiting and purging of which it is the exciting cause cannot be suppressed without injury to the patient. But if the cholera continues, after we have reason to believe that the substance which has excited it has been entirely removed from the stomach and bowels, it will be proper to administer those remedies which have been found antidotal to its operations. As a detail of these would be here out of place, 92 CHOLERA MORBUS. I shall now proceed to the consideration of the remedies which have proved useful in those forms of vomiting and purging to which the term of cholera morbus is most appropriate. Arsenicum. This remedy has proved useful in cholera morbus attended by incessant thirst, vomiting of a green matter, purging, pressing pain in the epigastrium, and severe burning in the lower part of the abdomen, with extreme exhaustion and debility. Chamomilla has cured cholera morbus. Cinchona. A case of this disease, occurring in a man set. 81 ann., was cured with cinchona 12. A similar attack, four years afterwards, was removed by the same remedy. Dulcamara effected a cure of cholera morbus arising from "cold drinking," in which, accompanying the bilious vomiting and purging, there was great pain in the abdomen, especially in the umbilical region; burning pain in the region of the stomach; great thirst, and extreme debility. Ipecac. Dr. Zinkthan states that he cured with this remedy, thirty-nine cases of cholera morbus occurring between the first of June and the latter end of September. The disease began with slight chilliness, or even a shaking chill, which was followed by heat of the whole body, but especially of the lower part of the abdomen. The tongue was rather dry and covered with a yellow coating. A sensation of pressure in the region of the stomach preceded the vomiting, which was accompanied by a general sweat, great thirst, and one to three hours after its commencement by bilious diarrhoea. The matters discharged by vomiting were first thin yellow bile; afterwards a bilious, green water of a bitter and acid taste, and CHOLERA INFANTUM. 93 pungent odour. The stools were at first bilious, then mucous with white flocculi, and sometimes some blood. After a time, the vomiting gave place to retching, and the diarrhoea to a most painful tenesmus unaccompanied by any discharge. The breath was short; the urine was small in quantity, and of a dark yellow colour. The pains in the abdomen were very severe. The powers sunk rapidly, the sweats were profuse, and in some cases cramps appeared over the whole body. Ipecac. well triturated with sugar, was given in water every three or four hours, in doses of the eighteenth or thirtieth part of a grain. In most instances in a quarter of an hour to an hour after the first dose there was a striking diminution of the worst symptoms, and in many cases but two and in the worst cases but six doses were required to effect the removal of the disease. Veratrum has proved eminently useful in cholera morbus, even when the patient has become speechless and unconscious, and when corpse-like coldness of the body, excessive debility, cramps, retention of urine and cold sweats, have been present. 'The recorded cases of cures effected by this remedy are very numerous. CHOLERA INFANTUM. Summer Complaint. This disease, which is very prevalent in the great cities of this country in very warm summers, attacks infants from three months to two years of age. Those who are brought up by hand, or are early weaned, or who receive an insufficient quantity of milk from the breasts of their nurses, are most liable to it. But it 94 CHOLERA INFANTUM. is often induced in those who do not suffer under these disadvantages, from food unsuited to the stomachs of infants, and especially from fruits. There is an erroneous opinion very prevalent in this city that the dewberry and blackberry (the fruits of the rubus procumbens and villosus) are wholesome in the summer complaint. That in some very rare instances they may have proved curative is quite possible, but the properties which have rendered them medicinal in some cases, make them injurious in others. It is not on theoretic grounds that these objections' are made to their use, but upon those of experience, as I have more than once had occasion to regret their employment by the parents of infants who were under my care on account of cholera infantum. The physician should be very careful to impress on the minds of the parents, the absolute necessity of withholding all kinds of fruit from infants under two years of age, who are suffering, or have recently suffered, under cholera infantum or diarrhoea, for they are capable, even in very minute quantities, of reproducing the disease. In one case I saw a relapse of cholera infantum apparently induced by allowing an infant to bite upon a slice of apple with its toothless gums. Cholera infantum, though it sometimes rapidly diminishes the powers of the system, and advances with hasty strides to a fatal termination, still more frequently assumes what may be termed a chronic form, and continues for many weeks before it destroys the patient. In many, perhaps a majority of cases, it terminates in symptoms of cerebral disorder resembling those of hydrocephalus, which in some instances appear to arise from a complete metastasis of morbid action; the gastric and enteric disorder CHOLERA ASIATICA. 95 subsiding when the symptoms of disorder of the brain make their appearance. When this metastasis has taken place, death generally follows in the course of twenty-four or forty-eight hours. In this stage, though recovery may not be always hopeless, yet the chance of rescue for the patient is exceedingly slender. In the treatment of cholera infantum, it should be recollected that it frequently happens, after this complaint has continued for a considerable length of time, that the child shows a strong craving for fat meat, mostly ham, or for butter; and that the gratification of this appetite is generally followed by great improvement, or even by rapid convalescence. The following remedies are the most important in the treatment of this disease; namely, arsen., bellad., calcis acetas, chamomil. and ipecac. Of these, bellad. has cured the disease where there was vomiting of an acid, watery fluid and mucus, and diarrhoea with mucous stools. Chamomilla has proved remarkably useful where the diarrhcea was the predominant symptom, and the evacuations were green and slimy. And calcis acetas, in repeated doses, has cured the disease when the discharges were acid. In addition to the remedies above mentioned, the others which have been found useful in cholera morbus and diarrhoea, may often deserve. attention. CHOLERA ASIATICA. This disease is the result of the action of a peculiar pathogenetic agent; and the name has been applied because vomiting and purging, though not its uniform, are its very frequent attendants. 96 CHOLERA ASIATICA. When the action of this agent is manifested by spasmodic muscular contractions of a tonic character, great debility, sunken eyes, blueness of the face, coldness of all parts of the body, hollowness and hoarseness of the voice, great depression and anxiety, burning in the stomach and cesophagus, painfulness of the epigastrium on pressure, cramp pains in the gastrocnemii and other muscles; and there is neither thirst, nausea, vomiting nor diarrhoea; the internal administration of the alcoholic solution of camphor, in doses of one drop repeated every five minutes, at the same time bathing the extremities with the same article, is recommended by Hahnemann and others. But where the spasmodic contractions are of a clonic character, and there are frequent discharges, both by vomiting and purging, of a watery fluid mixed with white, yellow or red flocculi, with unquenchable thirst, loud rumbling in the abdomen, anxiety, sighing and moaning, coldness of the whole body, especially of the tongue, marbled blueness of the hands, arms and face, staring and sunken eyes, diminished sensibility, slow pulse and painful cramps of the limbs; the camphor may be tried as above, but should it fail of affording relief, cuprum 1 or 2130 every half hour until the vomiting and diarrhcea cease, and warmth and comfort return. But no other medicinal agents should be employed at the same time, as these would disturb its operation and prevent its beneficial effects. Similar benefit may be derived from veratrum 1 or 2130 which should be allowed to operate without the administration of a second dose until the improvement from the first dose ceases to advance. When there is severe burning in the stomach, bowels, and cesophagus, great thirst and debility, CHOREA. 97 painful constriction of the breast, burning dejections and great restlessness and jactitation; arsenicum 1 or 2130 is useful. In the stage of collapse, carbo veg., acid. hydrocyanic. and laurocerasus have been found very serviceable. "When after a return of more comfortable feelings the vomiting still continued, ipecac. has been found serviceable, though it is generally of little use when the disease is violent. Dr. Rummell recommends secale in repeated doses of 4 or 6112 when the vomiting has somewhat subsided, but the stools are still unaltered, and every circumstance shows that no bile is poured into the bowels. He states that yellow or green stools speedily follow its employment, and the patient is rescued. In the cholera diarrhoea, acid. phosph., cuprum, phosph., secale and veratrum have proved useful. In the typhus condition which sometimes supervenes on cholera, rhus and bryonia are highly recommended. CHOREA. ST. VITUS' DANCE. A number of different nervous affections have received the appellation of chorea. One of these is an imperfect obedience of the voluntary muscles to the will; so that irreguilar and unintended motions are consequent on attempting to move any part. Another, which frequently accompanies the former, is an in-.voluntary movement of parts independently of any exertion of the will to produce motion. A third con7 98 CHOREA. sists in actual convulsive movements, consciousness and sensibility still remaining, though generally with more or less diminution. To these may be added a fourth, which most probably is the affection to which the name of St. Vitus' dance was originally applied. In this the contractions of the muscles are regular; and running, leaping and dancing are accomplished as if by the exertion of the will; but these exercises are continued by an irresistible impulse, and frequently until the patient is absolutely exhausted. That it may have often depended entirely on an excited imagination, and that it may frequently have been simulated, is undeniable; but that it may exist independently of the imagination, is shown in some persons, who, under the influence of the inhalation of nitrous oxide or sulphuric ether, exhibit this saltatory propensity in a very striking manner. The action of the agents which have just been mentioned, is of short duration, but it is sufficient to satisfy us of the existence of such a morbid condition of the nervous system as will produce all the phenomena which are attributed to this form of chorea. A similar condition of a much more chronic character may therefore rationally be expected sometimes to occur. A case bearing considerable relation to this form of the disease, occurring in a child, and accompanying pertussis, is described under this head. As the cases of chorea here presented are but few, any index to them is unnecessary. And as in most cases more than one remedy has been employed, no attention has been paid to the arrangement of the remedies in alphabetic order. CASE. In a girl; arising from fright. Constant, involuntary movements of the limbs, except during CHOREA. 99 sleep. Cuprum in repeated doses effected great improvement. CASE. Spasmodic movements of the right arm and leg, with inability to extend the hand properly, the fingers being spasmodically bent. Ignatia in repeated doses effected a cure. CASE. Constant twitching of all the muscles. Cured with cinchona 119. CASE. Irregular movements of the side of the face and limbs of the right side, with stammering speech, was cured by cocculus, gtt. i. 9. Case of a girl set. 12 ann.; where the disease had supervened on a nervous fever and lasted for a couple of weeks, and where, with the usual symptoms of intellectual weakness and incapability of properly controlling the contractions of the voluntary muscles, she appeared to consider every thing addressed to her as very ludicrous, and laughed for a long time and loudly; had'a dry cough at night; stools and appetite normal; sleep restless. Hyosciam. gtt. i. 9. Sleep and cough better, the latter looser, and she laughed much less and exhibited a general improvement. On the third day bellad. gtt. i. 12, and the next day she was well. Case of a boy set. 11 ann.; the disease of eleven weeks' duration, in which, in addition to a want of subjection of the muscles to the complete control of the will and the usual mental imbecility, the head was drawn back, the pupils dilated; he laid his hands frequently on his loins, then bent himself back with a painful expression of countenance and distortion of the mouth, as if he was seized with violent pain; constipation and diarrhoea alternating contrary to his healthy condition, he was obstinate and self-willed. Tr. 7* 100 CHOREA. sem. stram. gtt. 1.9 was given and in three days there remained nothing of the spasmodic affection, except a slight trembling of the lower extremities in walking, and of the arms and hands in raising any heavy body. For the morbid condition of the bowels cinch. 1112 was given, and in a few days he was perfectly well. In the case of a girl aet. 14 ann.; supervening on measles, in addition to the symptoms of mental imbecility, and want of perfect control over the contraction of the voluntary muscles, the eyes, the muscles of the face, the arms and lower limbs were in- constant motion, except during sleep, and her utterance was so indistinct that she could scarcely be understood. She had a great number of warts on her hands. Calcis carb. 2118 produced. homoeopathic aggravation -for a day, then a gradual improvement of the disease during forty-five days, when the amendment ceasing to advance, spt. sulphuris 210 was given. The improvement after this was rapid, and in three weeks she was perfectly well. - The warts had disappeared with the disease. Another case, which is mentioned in the Annals, was successfully treated with nux v., calcis carb., lycop., phos., tr. acris. and sulphur. A girl oet. 7 ann. complained of burning and sticking pain in the left arm, which was soon afterwards seized with violent convulsions beginning in the fingers and extending through the whole extremities. On the fourth day the left lower limb was attacked. The neck, even when there Was no paroxysm, was drawn to the right side, so that the face approached the shoulder; after the paroxysms she always felt herself well. The paroxysms came night and day as CHOREA. 101 many as eight or ten in twenty-four hours. Ignatia was given in repeated doses with some abatement of the disease. Cupri. acet. gtt. 1.1 was followed in half an hour by a paroxysm, and in four hours by another, the most severe she had had in her whole illness, which proved to be the last. The girl has since been perfectly healthy. CASE. In a girl ret. 12 ann. Numbness of the left side of the head and of the left arm and lower extremity. Jerking of the head towards the left side and'severe jerking in the left extremities. The attack occurred in church. Next Sunday the attack was renewed. Some hours after the paroxysms, she was well, but weak. Stramonium 9 was given, after which there was no reappearance of the disease for two years, when she was. attacked with tearing pains in the left side of the head and left ear. Some days later similar pain ii the right side of the abdomen, with twitching in the right side of the neck and right ear, and also in the left arm and left side of the head. Pressure on the abdomen diminished the violence of the twitching; and when this ceased, the arm was numb. Nux vom. 30 effected a cure. CASE. Accompanying pertussis in a girl ret. 8 ann. The cough occasional, and moderate through the day, but about ten o'clock at night, after she had slept for an hour, she was awakened by a severe paroxysm of coughing. After this was ended, she sprang out of bed and danced about the room, laughed, sang, struck and bit those present whom she did not know, and behaved herself very improperly. This lasted for an hour, when she laid herself in bed, and slept quietly till morning. After awaking she had but little recol 102 COLICA. lection of what she had done the preceding evening. She had been treated on the old method for some time before she was placed under the care of a homoeopathic physician, but without any improvement. Under the homoeopathic treatment, there was for a length of time no improvement in the paroxysms, but the intervals gradually became longer; at first from twenty-four to forty-eight hours, and afterwards to a week. And instead of striking and biting, she was, during the paroxysm, overflowing with love and tenderness; crocus sat. 211 was then given on the next day after a paroxysm, and the disease never reappeared. The child became more healthy than she had been for a length of time before she had pertussis. The remedies employed previously to the crocus, were stramon., bellad., verat., hyosc., drosera, cuprum, cina, and conium. COLICA. COLICA FLATULENTA. Nux v., cocculus, cham., bellad., cinch., ignat., pulsat., hyosc., colch., phosph., sepia, carb. veg., silex, zinc. CoLICA BILIOSA. Colocynth., cham., nux v., ignat., pulsat., ipecac., bryon., verat., arsen., dulc., sulph. COLICA A CONSTIPATIONE. Nux v., bellad., opium, plumbum, verat., bryonia, staphys., platin., cinch., coccul., sulph., calc. carb., silex, lycop., alum., zinc. COLICA METASTATICA Vel HIEMORRHOIDALIS. NUX V., arsen., bellad., sulph., capsic., ferrum., thuya., pulsat., ignat., coloc., carb. veg., phosph. In this disease it may be sometimes adviseable to give aconite for the removal of the inflammatory action. COLICA. 103 COLICA PICTONUM. Opium, platinum. Arsenicum-Is useful in the hzemorrhoidal colic described under bellad., when the disease has continued for some time, the debility has become great and the pain continues violent. Bellad. Colic with a roll-like swelling in the region of the transverse colon, with rumbling in the tumour; and tumefaction above one of the inguinal rings, receding with crepitus on pressure. The pains pinching and plucking. Such pains are characteristic of the cases suited to bellad. It is also useful in some of those colics which arise from a suppression of the catamenial, or haemorrhoidal discharges, which are frequently accompanied by inflammatory symptoms and by increase of the pain from slight pressure on the abdomen. It is particularly suited to this lind of colic, when there is a spasmodic tension low in the abdomen, with a pressing sensation above the pubis and in the sacrum. Cocculus. Severe pressing pain in the right hypochondrium, increased by coughing or bending forwards. Tearing and burning in the bowels with pinching pain in the stomach, great flatulent distension of the abdomen and constipation. Colocynth-Is a most valuable remedy in colic. In an excruciating attack of this disease, when there was a remarkably great and chronic tympanitis abdominis, it quickly cured the disease; the tympanitis gradually disappeared, and there were no more returns of the colic to which the patient had been previously for a long time subject. In bilious colics it is the chief remedy and is peculiarly applicable where the pain is most severe in a small spot in the umbiliCal region, and appears periodically 104 COLICA. every ten or fifteen minutes or still less frequently; every time beginning with a slight drawing from the sides towards the central point, which grows into a tearing, pinching, boring, &c., and is so severe that the patient cannot restrain himself, but cries out, bites whatever is nearest to him, and writhes like a worm with the agony, which also causes profuse perspiration. Chamomilla is adapted to many of the colics of infancy. To flatulent colic in which the flatus presses against different places in the abdomen, as if it would break through, and there is at the same time a general distension of the prmecordium and hypochondria, pressure to stool, borborygmi, and slight discharge of slimy mucus. Also to bilious colic supervening on violent anger. Cinchona. Flatulent colic low in the abdomen, the pain stretching and pressing, as if the flatus was vainly attempting to force a passage. Cocculus. In flatulent colic, where after the discharge of flatus without relief, more is constantly produced. Ignatia. Flatulent colics, especially nocturnal, in hysterical females. Also in bilious colics from suppressed rage. Nux vom. Flatulent colic in dyspeptics, where there is flatulent distension of stomach particularly after meals. Where the pain is low in the abdomen and there is cutting and sticking pain about the bladder, perinaum, rectum and anus. Pain intolerable in walking, but disappearing whilst at rest. In colica hemorrhoidalis with suppression of urine. It is a very important remedy in colic from constipations, and in those arising from obstructions of the bowels, from intussurceptio, volvulus, &c. CONSTIPATIO. 105 Opium. In colica pictonum and in iliac passion. Plumbum. In colic from constipation or obstruction. Pulsatilla. In the flatulent colics of hysterical females, and in the colics incident to pregnant women, which are accompanied by a frequent desire to urinate. Phosphor. removes flatulent colics which are seated low in the abdomen and are aggravated on lying down. Secale has proved beneficial in the menstrual colics of females, attended by paleness of the face; coldness of the extremities; cold sweat; small, weak pulse, and tearing and cutting pain in the lower part of the abdomen. Also where there is fixed burning pain in the lumbar regions, and pains in the lower part of the abdomen. In males where the frequently recurring colic is combined with pain in the loins and thighs, and with eructation and vomiting. Veratrum. In flatulent colic with cardialgia, flatulent eructation, sickness at stomach, bitter taste, pinching pain in the stomach and painful distension of the abdomen, and constipation. -Zincum. Flatulent colic. Frequent rumbling in the abdomen below the umbilicus and in the left hypochondrium, at times accompanied by pressing pains. CONSTIPATIO. The medicine which is properly adapted to remove the morbid condition of the system, is the proper remedy' for the constipation or costiveness which is 106 CONSTIPATIO. connected with and forms part of such morbid condition. And it frequently happens, that there occurs, within a few hours after the administration of a proper homoeopathic remedy, a stool of more normal character than has appeared for a great length of time: and, afterwards, the bowels continue regularly and properly to discharge the faeces. A list, therefore, which should contain all the remedies that have proved themselves useful in removing constipation or correcting costiveness, would embrace a large proportion of the materia medica. I am unable at present to prepare a list so perfected as to be of utility, which is the less to be regretted, because the collateral symptoms will be found more positive guides to the remedy peculiarly suited to the case, though this remedy must also be adapted to remove the constipation, a fact which can be readily ascertained by a reference to our materia medica. But since constipation and costiveness are frequently the original and predominant symptoms, I shall mention a few of the articles which have most frequently or strongly signalised their power in the removal of these affections; at the same time advising, that it should be borne in remembrance, that however frequently these remedies may succeed under the circumstances just mentioned, or where they are suited to correct the whole disease, of which constipation and costiveness are a part, yet that they must inevitably fail, where they are not so adapted, as these affections, however troublesome, are but subordinate to the general morbid condition. Nux vomica has very frequently been found to remove constipation, and is especially indicated where there is considerable gastric derangement. Where it CONTUSIO. CONVULS]O. 107 has failed, veratrum has sometimes succeeded. So has bryonia in alternation with nux. Opium has removed constipation in several cases. Acetas.plumbi has cured very obstinate constipation. Lachesis has been recommended. Calcis sulph. and sulph. are often useful. CONTUSIO. In contusion, wrenching, straining and all mechanical injuries, arnica montana 30. Hahnemann says that in great and severe contusions the cure will be hastened, when, besides the internal use of a small dose, the affected part is kept moistened for the first twenty-four hours with the following mixture. Dilute alcohol and water, each half an ounce, and five to ten drops of the first dilution of arnica. If some time has elapsed, and febrile symptoms arise, aconite should precede the arnic. Bryonia has sometimes been of service. In a case of injury of the knee from a fall, when the tumefaction and pain were very great, bryonia 30, given twelve hours after the accident, caused, after slight aggravation, a rapid improvement. CONVULSIO. CONVULSIONS. Under this head are included -epileptic, hysteric, and hydrocephalic convulsions, as also those of infancy arising from the irritation of difficult dentition and other causes. Arnica proved useful in the case of a girl wet. 10 108 CONVULSIO. ann. who when two years of age had fallen from a considerable height, and was taken up for dead. The apparent injury of the head was trifling, but violent convulsions speedily took place and were almost constant for four weeks. Afterwards the paroxysms recurred less frequently, but sometimes twice a day for several days in succession, and sometimes did not appear for several weeks. The character of the convulsions remained the same as when they first occurred. They commenced with violent palpitation of the heart, then sickness; the body and limbs on the left side were drawn crooked, and saliva flowed from her mouth. (- She then had convulsions for a short time inwardly, and with these felt a violent itching in the nose, which she rubbed with her right hand." During the paroxysm she retained perfect consciousness. Arnica 5130 was given every sixth day until five doses were taken. At first the paroxysms were more severe, but afterwards gradually diminished in force, and for a short time before the publication of the case had entirely disappeared. Arsen. has been successfully employed in epilepsy. Also in convulsions occurring during dentition, when in the intervals there is constant thirst with burning heat of the whole body, hasty movements and an anxious expression of countenance, and where the paroxysm is of the following form:-First a throwing out of the arms, then complete loss of consciousness, the patient lying as if dead, pale but warm, the fingers and thumb closed; the arms slowly raised and then slowly sinking; after some minutes, motions of the mouth as if the lower jaw was moved about; no appearance of respiration; after a duration of fifteen minutes a conclusion of the paroxysm with CONVULSIO. 109 a jerk of the whole body like a single start forwards with the hands and feet, and a sudden return of consciousness, but with great debility. Aurum has been recommended for hysterical convulsions. Belladonna. Hysteria. A maiden lady met. 32 ann. had suffered under a convulsive disorder for six years, and during the greater part of this time had been treated by many physicians without success, and her last physician, after various efforts to remove the disease, had declared it too inveterate and dependent on organic injuries to be cured. Among the remedial means used were opium, hyosciamus, saffron, cicuta, valerian, musk, prussic acid, flowers- of zinc, sugar of lead, ammoniuretted copper, mercurials, cinchona, the mineral acids, electricity, blisters, cups, issues, &c. But for the last three months she had only employed aperient pills, which merely opened her bowels. The paroxysms, of which she sometimes had six or eight in a day, and which -were very seldom absent for two or three days, were preceded by preternatural vivacity or unconquerable depression and constant fretting. To these premonitions, a violent chill, tormenting anxiety and fear of approaching danger succeeded. These were followed by strong and audible palpitation of the heart, with burning and sticking pain in the heart, and aching pain in the whole breast and throat with a sensation as if she would suffocate. Then, most commonly, loss of consciousness, for a short time, took place along with a violent tetanic convulsion by which the head was bent back upon the neck, and the arms were twisted. When the convulsions ceased, blue spots of the size of a dollar, and resembling ecchymoses, appeared on the 110 CONVULSIO. neck, breast and arms, but disappeared again after a few hours. The menses only appeared every eight or twelve weeks, and then continued but for one day, were sparing, coagulated and black; and when they occurred the convulsions were more frequent and violent. The bowels were costive. Mental emotions of all kinds operated injuriously upon the patient. The treatment was commenced with hyosc. gtt. i. 9, which was followed by a slight improvement, but on the fifth day there was a convulsion, and on' the seventh a still more severe one. Bellad. 1130 was then given, and, the general condition of the patient gradually improved. On the tenth day there was a slight convulsion, and bellad. 1130 was repeated, after which there was no convulsion for thirty-eight days. In this interval pulsat. 5 had been administered, and was followed in eight days by copious menstruation for two days, unaccompanied by any serious disturbance. Bellad. 24 was then given, after which she had no convulsion for fifty days, when after great mental emotion a slight one occurred. Another dose of bellad. was then taken, after which at the end of four months there had been no return of the convulsions; and the patient, whose appearance had been wretched and meagre, had become "a picture of health." Epilepsia preceded by a sensation like the crawling of ants and a numbness about the shoulder joint. In the paroxysm, unconsciousness; face bloated and bluish red; eyes and mouth moved convulsively; red foam before the mouth; the head and upper part of the body drawn forcibly back; stiffness of the whole body, and clinching of the thumbs; violent CONVULSIO. 111 expiration; the paroxysm succeeded by a sensation of load on. the breast. Convulsions, with clinching of the thumbs, in a child aged six weeks, who had cried day and night from the time of its birth. In the paroxysms the face was variously distorted. It had an appearance of laughing in its sleep, from which it often awoke with a piercing cry. Its bowels were alternately costive and loose. It had been previously unsuccessfully treated with calomel and opium in alloeopathic doses. After bellad. 1130 the child became more quiet, and the convulsions ceased. On the eighth day there was a slight attack, when stramonium 1130 was given, and effected a perfect cure. The parents of this infant had lost their eldest child at the same age by convulsions, a circumstance which recalls to my recollection a case which occurred in my own practice. The parents of my patient had lost their eldest child at the age of five months by convulsions. It had appeared to enjoy tolerably good health, except that its bowels were rather costive. When it was of the age just mentioned, the mother was awakened a little after midnight by a clicking sound proceeding from the cradle in which the child lay. Upon examination, the child was found to be in convulsions. A physician was immediately called who employed all the means usually resorted to in such cases, and on the next day was met in consultation by one of the most eminent of our physicians, but notwithstanding all their endeavours to rescue the patient, it died on the third day. The fifth child, who more closely resembled the eldest than either of the others, was attacked, when within three days of the same age as the eldest was at the time of her attack, in 112 CONVUJLSIO. the same manner, at the same hour of the night; and the mother was awakened by the same sound. I was called in and pursued the homoeopathic treatment, and gave hyosciamus, belladonna and other remedies. The convulsions, which recurred very frequently at first, appeared at longer and longer intervals, and at the end of eighteen hours the last paroxysm had taken place. The child never had any more convulsions till seven months afterwards, during the cutting of the first molar teeth, when belladonna showed itself remarkably useful, and the convulsions disappeared. The great difficulty in deciding between the merits of different systems or modes of treatment, consists in our inability to affirm with perfect certainty what would have been the result of the case under a different treatment. Could we, when our treatment has been unsuccessful, place our patients in the same situation in which we found them, and then treat them in another manner, this difficulty would cease. The cases just narrated, appear to me so similar that the second almost resembles a restoration of the first case to the same condition in which the physician found it. There were, however, two circumstances of difference in the two cases which should be mentioned; the one that the sex of the children was different; the eldest being a female, and the youngest a male; a difference certainly not much in favour of the latter. The other circumstance was the greater attention which had been paid to obviating costiveness in the younger child, which, as it was insufficient to prevent the occurrence of the convulsions, can scarcely be viewed as having much influence in producing a favourable issue. It is for the purpose of instituting this comparison that I have introduced CONVULSIO. 113 these cases, and not for that of homoeopathic instruction. For I acknowledge that it was not the best treatment which made such a number of remedies necessary in so short a time, and that had I selected the appropriate remedy at first, no other might have been requisite. But I must plead in extenuation, the necessity of prompt measures in so dangerous a case, in order to prevent incurable organic lesions; and that under such circumstances it is difficult to select the best of the known remedies. J. Calcis carb. Hahnemann speaks of this remedy as having proved very useful in epilepsy, but cautions against any expectation of curing the disease with this remedy alone, when it is not adapted to the cure of all the accompanying diseases of the case. Chamomilla. A child aged nine months had been subject for three months to convulsions of the following form. Stretching itself out rigidly, with incurvation of the back; twitching of the extremities; the thumb clinched; rattling and suffocative respiration; inspiration rapid; face red and tumid; twitching of the eyes and muscles of the face; foam at the mouth; the tongue convulsively moved from one side of the mouth to the other; the mouth at times firmly closed; sweat of the head; paroxysms ending with sleep. Cham. gtt. i. 12 was given, and on the succeeding night there was a paroxysm, but lighter, and the last. The child became perfectly healthy. Convulsions in a child aged eighteen months, marked by sudden relaxation; paleness of the face; distortion of the eyes; closure of the thumbs; slight gritting of the teeth; twitching of the fingers, and rattling breathing, were cured with chamomil. Cna. is useful in the convulsions of infants when 8 114 CONVULSIO. they occur, after a dry spasmodic cough has continued for a long time, and the spasmodic affection is violent in the chest, and attended with twitching of the limbs and involuntary urination. Cuprum. Dr. Kr6tzschmar, in the case of a woman, who had suffered for ten years from convulsions, kept her for a long time free from them by the administration once a week of cuprum 1130. But at length the convulsions again returned; and this remedy proving no longer capable of subduing them, he gave tr. acris 1130, at the same intervals, and again caused a cessation of their attacks. Dr. Gross afterwards tried this practice, and most obstinate convulsions of very different kinds were cured by the cuprum, exhibited in this manner, and returns of the disease happened only in two cases. Hyosciamus. Epilepsia. An otherwise healthy boy of twelve years of age, had suffered for several years from epileptic convulsions which had been induced in early childhood by a sudden fright. The paroxysms occurred twice a day, and were of the following character. Without any premonition of their approach, he fell with a shriek to the earth, jerked his extremities spasmodically, and firmly clinched his fingers and thumb; his face was bluish and tumid; his eyes prominent and spasmodically moved; his urine was discharged involuntarily; he foamed at the mouth; his teeth were pressed together; and his respiration was slow and rattling. The paroxysms lasted for fifteen minutes and ended in a heavy, snoring sleep. Afterwards there was debility and great loss of memory. Hyos. gtt. 1.9 was given in the afternoon after the conclusion of the second paroxysm. A third occurred that evening more CONVULSIO. 115 severe than any of the preceding. It proved to be the last; for three years afterwards there had been no recurrence of the convulsions. The hyosciamus is also a proper remedy in the convulsions of infancy when symptoms similar to those of the above described case are present. Ignatia. Convulsions in a girl aet. 12 ann. which had continued from her sixth year, when they had been induced by partial suffocation, in consequence of the burning of the house in which she resided, and from which she was rescued with great difficulty. The convulsions were preceded by great anxiety and sense of suffocation, and the paroxysms which occurred at nine o'clock every morning were marked by perfect unconsciousness and violent beating of the breast with the right hand, the fingers and thumb of which were firmly clinched, and ended with powerful extension of the body and a deep sigh. Ignatia 5112, given at' six o'clock in the morning, was followed by a convulsion at eight o'clock more violent and of longer duration than any she had previously experienced. The two succeeding days no convulsion appeared. On the third day there were some appearances'of a disposition to a return of the complaint, but the convulsions did not occur. Ignatia 1112 was given, and there was no relapse for four weeks, when after the reception of distressing intelligence she had a slight attack. Another dose of this medicine then given, effected a perfect and permanent removal of the convulsions. Convulsions from fright, in a female. Face alternately red and pale; swelling in the right side like a child's head; involuntary urination. Three doses were given. 8* 116 CONVULSIO. Hysteria in a female ret. 24 ann. when the convulsions arose from agitation of mind, from sudden disastrous intelligence; colour alternately red and pale; mouth full of saliva. Ignat. 12 restored her perfectly. Epilepsy in two boys, one six, the other four years old. In both, face red; pulse full, hard, and one hundred in the minute; eyes staring; convulsions of the extremities, with the thumbs of the younger closed, the thumbs of the elder not; foam at the mouth; on returning consciousness, thirst. In both a single dose of ignatia removed the complaint permanently. Convulsions in a girl rt. 11 ann. Beginning with retching, suffocative attacks; convulsive twitching of the arms, (with perfect consciousness.) Soon afterwards the middle finger of the right hand began to twitch, she stretched it out stiff; her eyes staring; her countenance inexpressive; she seized the finger with the other hand and bent it back as if she would break it off. The twitching then seized the hand and next the arm, then the other arm and both lower extremities, which she jerked about violently. The thumbs were not clinched, but the countenance was distorted. Next, the breast and abdomen were affected, and retching and eructation took place. The paroxysms lasted a quarter of an hour; afterwards she lay senseless and speechless. In two days she had four of them. After cham. had been given with temporary abatement, ignat. effected a perfect recovery. This remedy is peculiarly well adapted to hysteric convulsions. It is also highly important in the convulsions of infancy, which occur about the period of dentition. CONVULSIO. 117 When. these appear suited for, but do not give way entirely to chamomilla, ignatia will sometimes be found to succeed. If this leaves any remnant of the affection, it may sometimes be advantageously followed by bellad. Ipecac. has proved useful in hysterical convulsions with incurvation of the back, distortion of the countenance and sighing respiration. In a case of convulsions attending anasarca, after scarlatina miliaris, where the patient laid unconscious; the face was pale and tumid; the eyes frequently opened and closed; the paroxysms marked by violent twitching of the muscles of the face, and jerking of the extremities, with frequent elevation of the upper part of the body, and succeeded by vomiting. In the convulsions of a child, when there was first a single shriek; then rattling respiration and afterwards rigid extension. -Lachesis. Epilepsia. In a case where the premonitions were coldness of the feet or palpitation of the heart; flatulent distension of the abdomen; eructation; aching and heaviness of the head, and paleness of the face. In the paroxysm, a loud cry and falling senseless to the ground; eyes turned upwards; hands closed; limbs jerking up and down; foam before the mouth, and deep sleep: lachesis effected a cure. Epilepsia in a man mat. 28 ann. Paroxysm every four weeks. The premonitions of attack observed by those about him, were confusion in his actions and thoughtlessness. In the paroxysm, striking back the head; foam before the mouth; clinched thumbs; striking with hands and feet. In the interval, benumbing vertigo, constant headache, heat in the forehead; trembling in the limbs, most on the left side; 118 CONVULSIO. curious dreams. After lach. 3130 the convulsions and the affections of the intervals disappeared: at the end of nine months there had been no return of the disease. Moschus. Convulsions preceded by extraordinary weakness and vertigo. The patient laid motionless with the arms firmly pressed on the body, and then after a few minutes there was distortion of the eyes, with slight twitching of the mouth and nose, the head being drawn back. After a deep inspiration, cessation of respiration for half a minute to two minutes, followed by rapid and laboured respiration and extraordinary beating of the pulse. Then clonic spasms of the abdominal muscles, which always pursued one direction, either from above downwards or vice versa. Finally there were similar convulsive movements in the extremities, beginning in the fingers and toes and afterwards affecting the parts nearer the body. The paroxysms lasted for five or six minutes, and were attended by unconsciousness and insensibility. Two doses of moschus effected a cure. Nux vomica has proved useful in convulsions attended by tonic contractions of the muscles, resembling tetanus. It is useful in the convulsions of drunkards; and also in those of infants attended by constant crying in the intervals and by constipation. It is suited to epilepsies which arise from frequent intoxication, as also when the disease arises from crudities in or acidity of the digestive apparatus, or from worms. Opium. A woman rwt. 25 ann. had attacks in the mornings during which she laid motionless, almost breathless, unconscious and insensible; and had, in the afternoons, hysteric convulsions. A dose of opium CONVULSIO. 119 removed the morning attack, and a dose of stannum the afternoon convulsion. In convulsions alternating with spasmodic breathing, with a general corpse-like coldness. In the convulsions of infants, when the attack occurs at night during sleep, and there is stertorous respiration with open mouth. Epilepsia where the patient laid relaxed, almost breathless, unconscious and insensible. Silex has proved a valuable remedy in epilepsies. Spigelia has removed convulsions attending disease of the heart. Stannum is useful in hysteric convulsions; as also in the convulsions of infants which are renewed at the cutting of every new tooth, and when every new attack is more severe than the preceding. Stramonium has proved useful in convulsions. Sulphur. Epilepsia in a girl aet. 15 ann. Sleepiness, then stretching and stiffness of the limbs; after two minutes closing of the eyes and biting of the teeth together; clinching of the thumb; jerking about over the floor till she came against the wall, &c. After the paroxysm weeping of the eyes. The extremities so rigidly extended that they could not bebent. The disease had continued: for four months, and the paroxysms which endured for ten or fifteen minutes had become so frequent that she had six hundred and thirty in twenty-one days. There were no con-vulsions at night Sulphur 2130 was followed by a single paroxysm, after which the disease disappeared. STr. acris has been useful in different forms of convulsions; see cuprum. In a case of hydrocephalic convulsions where belladonna and nux vom. were administered without 120 CORYZA. success; tr. acris was followed by an aggravation which continued for several hours; then by a sleep of two hours, on awaking from which there was a perfect restoration of consciousness, and in three days a complete recovery. Veratrum. Hysteria, where the paroxysms were preceded by distress, depression and anxiety, and in which, with syncope and general relaxation, there was spasmodic trembling of the eyelids; the eyes turned upwards; the jaws firmly closed and the limbs flexible. In addition to the above remedies, the following are also deserving of attention in the treatment of convulsions; namely, carbo veg., cocculus, graphite, lycopod., magnes. carb., magnes. mur., sepia, silex, soda, sodce mur. CORYZA. Cold in the head. This disease, although generally described as a superabundant secretion of mucus in the nostrils, is sometimes, and especially in its earlier stages, accompanied by a sensation of dryness or obstruction in the nose. The former of these symptoms may arise from a suppression of the secretory process; and the latter may be produced by the inflammation and turgescence of the lining membrane, or from accumulations of tough and viscid mucus. In the treatment of coryza, nux v. is very useful in the early stages when it enters with an inflammatory character, the nose is dry and there is but little secre ,I// CORYZA. 121 tion of mucus. Pulsatilla is serviceable in those forms of the disease where but little inconvenience is experienced by the patient in the open air, but where upon entering a warm room and in the evenings he is tormented with a troublesome obstruction of the nostrils. It is also useful when, after the violence of the inflammatory action has abated, there is a constant discharge of mucus from the nostrils with soreness of the margins of the nares. Sambucus has rapidly cured coryza in infants where the nostrils were completely filled with thick and tough mucus, and there was a consequent difficulty of sucking at the breast. Euphrasia and ignatia have also proved beneficial, and the latter is peculiarly adapted to coryzas attended by dull pain in the forehead and occurring in hysterical females. The lobelia has frequently cured this disease very speedily when it has commenced with' a copious fluid discharge from the nostrils. Coryza sometimes assumes a chronic form, and in the worst cases can scarcely be distinguished from ozena, which consists in an ulcerated condition of the lining membrane of the nostrils. Arsen. In the case of a woman aet. 42 ann. who had been for a long time afflicted with constant burning in the nose; alternating obstruction and discharge of fluid mucus which was of an acrimonious quality, and caused a scurfy ulceration of the skin below the nares. Purging, medicinal teas, &c. had been long employed without relief. Two doses of arsen. 30 effected a radical cure. Ipecac. In the case of a man wet. 25 ann. affected with constant obstruction of the nares and loss of smell, and with dry spasmodic cough. Disease of two months' duration. One twentieth of a grain of 122 122 DELIRIUM TREMENS. ipecac. thrice repeated at intervals of twenty-four hours effected a perfect cure. Pulsat. In a female vet. 18 ann. Copious discharge of an offensive puroloid matter of a yellowish green colour from the nose, with swelling, but without perceptible ulceration of this part. IDyspepsia. Confusion and heaviness of the head, which was worst in a warm room and in the evenings. Deficient, menses, which were of too pale a colour and occurred with too long intervals. Pulsat. gr. i. 9. effected a perfect cure, Sulphur. In two cases, in scrofulous children, sulphur cured a serous coryza with ulceration of the skin beneath the anterior nares. DELIRIUM TREMENS. Mania a potu-Horrors. The popular appellation of "the horrors" is remarkably well applied to this disease, in which the hallucinations are almost always of a disagreeable and frequently of a frightful character. The patient often imagines that the walls of his room are falling upon him, and he will stand in a painful position for a great, length of time using all his strength to prop them up: or he sees the room filled with vermin and reptiles, which swarm over his person: or he sees thousands of imps watching to do him mischief: or he hears voices from every direction, reproaching him, and calling him by every bad epithet: or unseen persons are seeking to murder him or to take him to prison. Even when the hallucinations appear to the attendants to be of an amusing and ludicrous character, -they are DELIRIUM TREMENS.13 123 far from being so, to the patient. lie may- see armies of pigmies march about the floor and scale the furniture, he may describe their uniforms and-, the pompous airs of their officers, he may distinguish the blazonry of their banners, and point out the evolutions of the Lilliputian host; but he do'es not do these things -with the -feelings of a merely curious or amused spectator. It is against him that this visionary array is formed; or the slightest offence on his part may direct its vengeance towards him, and the warriors, though diminutive, can torment with a thousand new means of annoyance and injure him with weapons which are novel in warfare. He either seeks to flee away from the danger, or to deprecate the resentment of the generals by the most conciliatory expressions. He is constantly bathed 'in perspiration, and a trem-ulous motion of the hands is almost, always present, and there is often a violent trembling of the whole frame. He is constantly- watchful and constantly engaged, according to the nature of his hallucinations, which sometimes change in rapid succession, and at others continue of the same character for hours together. Though constantly in' fear, he is not always devoid of courage, and will sometimes. attack his imaginary foes. The disease continues either until the patient expires worn out by continual agitation, exertion and watchfulness, or until a long continued sleep, (generally induced by medical means,) occurs as the first symptom of the abatement of the disease, and is followed by an almost perfect restoration of health. In some of the fatal cases a coma occurs shortly before death. The hallucinations which have just been described, are connected with complete deceptions of some of 124 DELIRIUM TREMENS. the senses; and in many instances one sense will correct the mistakes of another. Thus I have frequently seen a patient stoop to pick up money, which he saw lying scattered over the floor, and after endeavouring for some time to grasp a piece with his fingers, relinquish his object as impossible of attainment. One poor fellow remarked that it was "the funniest money he ever saw in his life, for his fingers would meet through it." In another case I saw the patient firmly convinced by the sense of feeling that he had money in his hand, until on looking for it there he could not see it. Although delirium tremens is a consequence of the excessive indulgence in alcoholic drinks, yet it is not a direct effect of these. It arises, on the contrary, from their sudden discontinuance, and appears to be a reaction of the system against their primary operation. But it should be remembered that this primary operation is that which occurs from excessive quantities of these drinks, and that we only find this reaction after a violent debauch, or in persons who have for a length of time drank to excess, and who were in consequence rather in a state of constant stupefaction than of exhilaration. The observation of these facts will enable us to perceive that the curative action of moderate quantities of brandy or other alcoholic drinks, in mania a potu, is perfectly homceopathic. For the primary effects of these quantities being of a stimulative, while the reactions against these effects are of a sedative character; the operations produced by the brandy may supplant the existing morbid actions, and the reactions of the system may effect a cure. But as very minute and excessively large doses of medicinal substances have DELIRIUM TREMENS. 125 been proved to produce very similar operations, differing oftentimes only in danger and intensity, and as in this case only an antipathic operation can be expected from either of the extremes, a difficulty occurs in determining on the proper dose. What this may be I cannot pretend to decide with certainty. I have seen a sound sleep and perfect recovery follow speedily after,the administration of a little more than half a gill of brandy, but I am inclined to the opinion that a much smaller dose would often prove more satisfactory, as the stimulative operation of the remedy would be of shorter duration. Before dismissing the subject of the treatment of mania a potu with brandy, it may be proper to remark, that some physicians object to it on the ground that it favours the maintenance or operates as an encouragement of the habit of indulging in the use of intoxicating drinks; and they therefore resort to opium or other medicines to effect Atheir object. This is a practice which I have pursued myself until very recently; but as almost every patient I thus cured, speedily resumed his bad habits, I cannot see the utility:of pursuing this'course on these grounds, and if the brandy effects a more speedy'cure, it is certainly to be preferred. As regards the operation of infinitesimal doses in mania a potu I cannot speak very highly from my own experience. In all the instances in which I have tried them, I have not found so marked a beneficial operation as to induce me to refrain from a treatment under which, notwithstanding I have had many cases of the disease to treat, I have never yet lost a patient. It is not,on account of a want of effect from the infinitesimal doses that I have thus far been dis 126 DELIRIUM TREMENS. satisfied with their operation in delirium tremens; on the contrary, I have seen very decided effects: for instance, I have seen from opium 3 a powerful antipathic operation closely resembling the effects which I have seen from twenty grains of opium, though of shorter duration. But it has been on account of a want of satisfactory operation; and I suspect that the same disappointment has been experienced by others, as Hartmann recommends the employment of moderate quantities of brandy along with the infinitesimal doses. It may properly be urged that the medicines exhibited were not the adapted homoeopathic ones; and this I freely admit to be true. At the same time I doubt whether any one of the remedies which have been recommended in mania a potu is adapted to the peculiar condition which exists in this disease. They may be partially suited to it, and in some instances successful, but the recorded cases are not marked by such accuracy of detail in relation to the progress of the cure as to exhibit the curative operations of the remedies in a very striking light. The following brief statement of most of the recorded cases exhibits to view the remedies which have claimed the chief confidence of homceopathic physicians. In a fully developed case, nux v. afforded no relief. Opium 316, given in the morning, produced in the afternoon sleepiness; and at night the patient slept from ten o'clock till five o'clock the next morning, when he awakened well. In a man who intoxicated himself more frequently with beer than brandy, nux v. in repeated doses effected a cure. DIARRHEA.1 127 In a case where the patient imagined one half of his body to be cut off, two doses of stramon. 30 effected a cure. One case was cured by bellad. gtt. i. 30 in water, every two hours. A case was cured by calcis carb. when nux v. had proved inefficacious. -Hartmann recommends nux v. in the early stages, in which he also thinks tr. coffea crud. is often an indispensable remedy. This he gives in the dose of gtt. i. 2. After the disease is fully developed, opium. Hyosciamus has also been recommended. DIARRH(EA. Acid. nit. completed the cure of a nightly diarrhoea with offensive stools containing undigested matters, in which much improvement had been already effected by sulphur. Acid. phosph. has proved useful in chronic diarrhoea, as also in cholera diarrhoea. Antim. crud. In serous or watery diarrhoeas. And where there is alternating diarrhoea and costiveness in old persons. Arsenicum. In serous or watery diarrhoeas with speedy exhaustion and violent pain in the bowels. It is also the remedy entitled to the most confidence in the diarrhoeas of infants suffering under atrpphy. Bryonia is useful in diarrhoeas where there is little pain, but much debility; and the stools containing undigested aliment are voided shortly after the patient has eaten his meals. * Calcis acet. In the diarrhoeas of consumptive 128 DIARRH(EA. persons, and also in those of scrofulous children. And in diarrhoeas with acid discharges. Calcis carb. In a case of diarrhoea, attended by violent pain in the head and back, with severe cutting pain and sensation of coldness in the abdomen; this remedy effected a perfect cure. Chamomilla is applicable when watery and slimy stools are preceded by cutting pains, below the umbilicus, which disappear after the evacuations. Also in the diarrhoeas of infants during dentition, when the stools are green and watery, and unattended by pain. Also in the diarrhoeas of infants, with acid discharges. Cinchona is serviceable in the chronic diarrhoeas of aged persons. Also in diarrhoeas in which the aliment passes off undigested immediately after meals or at night. Also in diarrhoeas where there is great emaciation, debility, and night sweats. In these cases the cinchona may sometimes be employed advantageously in alternation with ferrum: Colocynth. has proved useful in violent and debilitating mucous diarrhoea. Cuprum is an important remedy in the diarrhoea which attends Asiatic cholera. Dulcamara is recommended for those watery diarrhoeas which occur in the summer season and mostly attack in the night. Also in diarrhoea from taking cold. Case in a woman set. 20 ann. from taking cold. The disease was of several months' duration, and had resisted the ordinary treatment. It was worst at night, when the stools were extremely frequent and accompanied by a violent cutting pain about the umbilicus; nausea, vomiting, cold sweats and smarting DIARRH(EA. 129 at the anus as if from the application of salt. The faeces consisted of a greenish yellow matter. Dulcamara in the dose of the thousandth part of a drop of the juice effected a perfect cure in less than twentyfour hours. CASE. In a man aet. 31 ann.; cause unknown. Disease of three years' duration. The diarrhoea worse at night, and attended with severe cutting pain about the umbilicus; great and constant thirst; smarting at the anus as from Cayenne pepper; and a considerable prolapsus of the rectum. The stools consisted in a great part of blood. Succus dulcam. gtt. i. was given, and by the fourth day the disease had entirely disappeared. The man afterwards continued well. SHyosciamus. In diarrhoea, unaccompanied by pain, where the discharges are involuntary, and the patient is almost unconscious of their passage. Ferrum met In watery and mucous diarrhcea which are unattended by pain. Also in diarrhoea with great emaciation, debility and copious night sweats. Jalappa cured a diarrhoea with bloody stools and severe pain in the bowels, in an infant. Lycopodium has been recommended in diarrhoea occurring during pregnancy, when there is a sallow tint of the skin. Magnesice carb. In the diarrhoeas of infants attended by an acid odour of the stools. Also in diarrhoea occurring in infants where the stools are frequent, green, watery, and accompanied with discharges of flatus, and much crying. Mercur. In serous diarrhoea with acrimonious discharges and consequent burning and itching at the anus. In a diarrhoea of three years' duration in 9 130 DIARRHCEA. a child of four years of age, with passage of undigested aliment with the faeces, and extensive prolapsus ani; this remedy effected very great improvement. J. Nux vom. In watery diarrhoea with cutting and drawing pains passing from the lower part of the back into the thighs. Oleander, In diarrhoea attended by the discharge of undigested aliment. Petroleum. In a case of chronic diarrhoea of four years' duration, in a man,et. 29 ann. He had from six to ten stools in twenty-four hours. The fweces were watery and yellow, and caused a sensation of burning at the anus. These were preceded by severe cutting pains in the abdomen, which were abated by bending forward; then a severe pressing to stool occurred. The pain ceased after the stools, but great debility ensued. The appetite was poor, and animal food disagreeable to the patient. There was frequent nausea; and sometimes vomiting of a green and bitter fluid occurred. After eating, the patient felt a load at the stomach. Petroleum 18 was given, and in eleven days the stools had become perfectly natural. Phosphorus has proved itself to be a valuable remedy in the diarrhoea which accompanies Asiatic cholera. It has also cured chronic diarrhoea, attended by the discharge of undigested alimenrt with the faeces. Pulsatilla. In watery or mucous diarrhoea, especially when there is a constant variation in colour of the discharges. Rheum. In watery diarrhoea with acidity of the discharges. Rhus. In diarrhoea attacking after midnight, the stools preceded but not followed by pain in the DIARRHCEA. 131 abdomen. The faeces somewhat consistent. Rhus is also useful in diarrhoea with green bilious discharges, and worse at night. Secale in repeated doses was found by Dr. Rummel of great use in the diarrhoea of Asiatic cholera, when there was no appearance of bile in the discharges. I have repeatedly employed this remedy in the diarrhoeas of children, when the faeces were watery and whitish, and have found very great advantage from its use. I employ it in doses of 4 or 513, or in doses of about one twentieth of a grain of the first trituration, given every two hours until three doses are taken. J. Sulphur. In nocturnal diarrhoea preceded by cutting and twisting pain in the bowels; the stools occurring frequently, and the faces being of pappy consistence and slimy. Also, in diarrhoea with thin, white, slimy and most offensive stools, and worse at night. Also, in the watery diarrhoeas of infants during dentition. Also, in nocturnal diarrhoea with violent tenesmus after the stools. CASE-of several weeks' duration, in a man at. 55 ann. Attacks commencing a couple, of hours before day-break with severe pain in the bowels. After a considerable time a discharge of very offensive flatus took place. About day-break the patient had three or four stools in quick succession. The discharges continued to take place through the forenoon, but did not occur in the afternoon or early part of the night. The faces were very offensive, of a brown colour, watery, but causing a sensation of burning during their passage, and so acrimonious as to occasion such an excoriation of the parts about the anus as caused him great pain in sitting. Sulphur 1130, given in the 9* 132 DYSENTERIA. latter part of the afternoon, was followed by a diarrhceal stool before bed time; but the attack the next morning was much less severe; and afterwards, the recovery though gradual was steady, and in the course of a few days the stools had regained their normal character. J. Veratrum is a most important remedy in the diarrhoea of Asiatic cholera. It is also useful in some forms of nocturnal diarrhoea. DYSENTERIA. DYSENTERY. Flux. Bloody flux. It has been recommended to commence the treatment of dysentery, when it is accompanied by considerable inflammatory fever, with the administration of one or two doses of aconit. Whether this precaution is either necessary or useful, is somewhat doubtful, for it is certain that many of the worst forms of dysentery have been speedily cured, by the appropriate remedies, without the previous employment of the aconit. Of the remedies employed for the cure of dysentery, merc. is one of the most important, and has been used in the most simple of its preparations in doses varying from gr. i. 2 to 1130. It has also been employed in the form of merc. sublim. corros. in the thirtieth dilution. The homoeopathic aggravation or commencing improvement, should be seen soon after its administration; and when aggravation occurs, it should be followed by improvement in less than four hours. If this does not happen, it is most probable that mere. is not the appropriate remedy. I have, DYSENTERIA. 133 however, sometimes thought it useful, when mere. has not procured marked relief in four hours, to follow it with a dose of mere. sublim. corros., especially when the symptoms have been similar to those of the following case. A man at. 40, ann., was attacked by an autumnal, epidemic dysentery, and had suffered under it until the sixth day without medical aid, when he presented the following symptoms: namely, violent cutting, pains in the abdomen, which diminished in violence whilst he laid quiet in bed, but became intolerably severe when he had to rise to stool. The tenesmus was excessively violent, "as if all the bowels would be pressed out;" and the discharges were of mucus mixed with blood. The tenesmus increased after the discharges, and on rising from the close-stool, but gradually lessened after he had laid down in bed. The discharge corroded the anus and caused painful burning. The disease was worst at night, and had continued, from the first, to increase in intensity, and on the last night the patient had to rise almost continually to stool. He was exceedingly debilitated, and his pulse was very frequent and weak. Mercur. gr. i. 2 was given on the evening of the sixth day, and a few dysenteric stools occurred that night. On the following morning he was free from his dysentery, but had to keep his bed from debility. On the morning of the eighth day, cinch. gtt. i. 9 was given to remove the weakness under which he suffered. The next day he felt well, and afterwards had no relapse, To some cases, presenting symptoms similar to the above, arsenicum is also adapted; but it is most particularly useful when the symptoms present a malignant character, and the stools, though not 134 D YSENTERIA. excessively painful, consist of "degenerated and offensive masses," which are sometimes discharged involuntarily; and there are nausea, and bilious.or mucous vomiting, putrid taste, putrid odour of the breath, hemorrhages, petechie, aphthe burning hot skin, clouded urine with a cadaverous odour, sunken countenance, and torpid or soporose condition. Acid. sulph., cinchona and nux vom. may also be indicated in dysentery of this character. In dysenteries, where the progress of improvement is slow, or where, after some improvement, there is a disposition to relapse, acid. nit., petrol. or sulphur. may be indicated. In dysenteries attended by great heat, redness of the face, thirst, tormina and tenesmus; the discharges consisting of scybala, with blood and mucus; nux vom. In dysenteries produced by marsh miasmata, especially when the accompanying fever assumes an intermittent character, cinchona will frequently be found to be the proper remedy. In cases where the improvement after merc. has advanced slowly, verbascum, in the dose of one twentieth or one fiftieth of a drop of the tincture, formed by a mixture of equal parts of the juice of the plant and of alcohol, has, in several instances, appeared to operate very beneficially. In addition to the remedies already mentioned, the following have also been found useful: namely, bellad., cham., colchicum, colocynth., dulcamara, pulsat., rhus, sulphur. DYSPEPSIA. 135 DYSPEPSIA. Difficulty of digestion. Among the symptoms which mark the existence of those forms of morbid action which impair the energies of the stomach, and consequently unfit it, in a greater or less degree, for the proper performance of its important functions, are, innormal sensations in the region of the stomach; eructation or vomiting of the ingesta, or of flatus, acid fluid or other morbid secretions or products; nausea and disordered taste. And as the diseased action most generally extends itself to the intestines, the symptoms of gastric derangement are frequently attended by those of enteric disorder, among which, constipation and diarrhoea are the most common and striking. It is my object in this place, to give a brief but useful index to the remedies adapted to the most important of these symptoms. I shall do this in the order in which they have just been mentioned. OF THE MORBID SENSATIONS. One of these is pain in the stomach, (gastrodynia,) which presents numerous varieties of form. I shall, however, include all, as sufficient for the present purpose, under four heads: namely, pressing, constrictive, sticking and gnawing pains. Pressing pains, which are very analogous on the one hand to the sensation of fulness and weight, and on the other to the constrictive pains, are adapted to carbo veg. when worse on lying down; to lycopod. when the pressure appears to come from both sides; and to bellad., baryt., cinch., magnesice carb., petrol., phosph. 136 DYSPEPSIA. Constrictive pains, in their lightest forms, most closely resemble the sensation of tightness, and in their worse forms constitute cramps or griping pains of the stomach. To these arsen., baryt. acet., bellad., -calcis carb., carbo veg., cocculus, magnesice carb. and phosph. are adapted. - Sticking pains to bryonia when the pain is increased by every step; to phosph. when greatly aggravated in the evening and at night; and to bellad. and ignatia. Gnawing pains; arsen., bellad., mezer., nux vom. The other morbid sensations are those which, although they are in general highly disagreeable, yet cannot be termed pains. Of these-: The sensation of pressure is adapted to calcis carb. in those cases where the pressing is most severe when the stomach is empty. The sensation of heat or burning to arsen., bellad., carbo veg., cinch., mezer., lobelia, lycopod., nux vom. and phosph. Sensations of fulness and weight, to baryt., bismuth., carbo veg., ignatia, nux vom. Sensation of distension of the stomach, to bryonia. ERUCTATION, when flatulent, may be adapted to bryonia, calcis carb., carbo veg.; when of the ingesta, to ignatia; when of an acrimonious fluid, to acid. sulph.; when saline, acid and acrimonious, to sepia; when acid and bitter, to calcis carb., magnesice carb., nux vom. and phosph. VOMITING is adapted to arsen., baryt. acet., bellad., calcis carb., digitalis, lobelia, ipecac., nux vom., phosph. Of these, arsen. is adapted when the vomiting causes an increase of the pain; calcis carb. or nux vom. when the ejected matters consist of the food and bitter mucus; petrol. when of a green and bitter fluid; DYSPEPSIA. 137 phosph. when the vomiting of a transparent, acid fluid occurs in the evening or night; lobelia when the food is vomited up soon after the meal. NAUSEA. Carbo veg., cinch., cocculus, digitalis, lycopod. MORBID TASTE. When acid and bitter, petrol.; when acid, nux vom., ignatia; when putrid, nux vom. CONSTIPATION. Alumina, arsen., baryt. acet., bryon., calcis carb., carbo veg., cinch., graphit., ignatia, nux vom., sodce carb., sodce mur. DIARRHOEA. Calcis carb., digital., nux vom., petrol., phosph., pulsat. There are some other guides to the choice of the remedies which it may be proper to indicate; namely, when the cause of the dyspepsia has been mechanical injury in the region of the stomach, as from a violent blow, bryonia will probably be the proper remedy; when the disease has arisen from eating fat food, fresh pork; &c., pulsat.; when it is attended by a sensation of oppression or tightness of the breast, lobelia, lycopod., nux vom. Acid. sulph. has been recommended, by Hahnemann, as a valuable remedy in dyspepsia of long continuance, when there is frequent eructation of an acrimonious fluid. Alumina has been recommended as being sometimes useful in dyspepsia, attended by obstinate constipation. Arsenicum is a valuable remedy where there are sensations of great heat and gnawing pain in the stomach; especially when these symptoms arise from a cancerous condition of that organ. CASE. Scirrhus of the stomach in an old woman. 138 DYSPEPSIA. Constrictive and burning pains in the epigastrium and in the back; the epigastrium tense, and painful on pressure. Daily vomiting of the ingesta, either immediately or some hours after eating, with increase of the pains. Tongue clean; mouth dry; thirst; sunken abdomen; constipation. Emaciation, debility and sleeplessness. Arsen. 30, in numerous doses, at long intervals, removed the most distressing of these symptoms for a long time. Aurum removed an indescribable aching sensation, and great accompanying restlessness and mental depression, in a case where nux vom. had cured the most of the dyspeptic symptoms. Baryt. carb. is often useful, especially in persons of a scrofulous habit, when a very light meal excites sensations of great fulness and weight in the stomach. Baryt. acet. Case. In a man set. 77 ann.; arising from repelled tetter. Dyspepsia of six months' duration. Most violent cramps in the stomach, burning in the region of the stomach, retching, vomiting of the ingesta, constipation enduring from twelve to fourteen days. General emaciation and swelling of the lower extremities. Baryt. acet. 18, after previously administered nux vom., catised a reappearance of the tetter; and, together with a dose of sulphur and one of conium, removed the most important symptoms, so that the patient, after some weeks, could leave his bed and take a sufficient quantity of food and drink without inconvenience, and had natural stools. Belladonna is adapted to some obstinate forms of cramp of the stomach, to which chamomil. appears to be suited, but affords no relief. The indications for the employment of the belladonna are, a gnawing DYSPEPSIA. 139 and pressing or a spasmodic stretching pain in the epigastrium, which compels the patient, from time to time, to bend himself backwards and to hold his breath; or when the severe pain produces insensibility or syncope; or when it always attacks during dinner. CASE. In a young lady set: 19 ann. otherwise healthy. Disease of five years' duration. Upon exposure to cold, or from wetting the feet, or from eating flatulent food, and especially at the menstrual periods; attacks of the following description. Violent sticking and pinching pain extending from the epigastric into the umbilical region. Anxiety, and a feeling as if the entire abdomen was knotted together. Great tendency to syncope, and a cold feeling of the whole body. Nausea, offensive eructation, and sometimes vomiting. Pressure of the abdomen and bending forward afforded some relief. The eructation relieved her more. Her countenance was pale; her mouth dry; hands cold; and pulse small, hard and slow. The paroxysms endured from ten minutes to half an hour, and left her for some hours exceedingly weak and uncomfortable. After a dose of belladona, there were symptoms of an approaching paroxysm which did not fully develope itself. These occurred for three days in succession, but afterwards she remained well until the next menstrual period, which occurred five days too early, when slight paroxysms appeared. A dose of sepia was then given, and the next menstruation occurred at the proper period, without any return of the disease. A year afterwards no relapse had happened. Bismuthum is remarkably useful in most obstinate dyspepsia, especially when accompanied by severe 140 DYSPEPSIA. pressing pain, or by a sensation of weight and indescribable discomfort. Bryonia is useful in the milder forms of gastrodynia, when this begins whilst or immediately after eating, and is accompanied by a sensation of swelling of the stomach. -Also when there is considerable costiveness, and an increase of the pain during motion, and decrease whilst at rest. Or where the gastric affection is accompanied with pressing pain in the temples, forehead and back of the head, as if the bones of the cranium would be pressed asunder. Also where the above symptoms are present from mechanical injury in the region of the stomach. CASE. In a robust washerwoman met. 40 ann. Disease of three weeks' duration, and incapacitating her for her employment. By every movement, especially by every step, and worst by every mis-step, a sticking pain in the epigastrium, and passing, as she said, from thence out of the left side. Whilst lying down she felt well and had no pain any where. She could not sleep later than three o'clock in the morning. The food had its proper taste, but as soon as she had eaten, she felt a disposition to vomit. She had a flow, of water into the mouth. There was frequent flatulent eructation after eating. She was of passionate temper. With the severe pain she perspired freely. Her menses had occurred in order fourteen days before. All the other circumstances were natural. Hahnemann, who records the case, gave sue. rad. bryon. alb., gtt. i., and on the next day the patient was able to resume her employment, and on the succeeding day was perfectly well. Calcis carb. Hartlaub has found this remedy useful where there was a sensation of severe pressure 142 DYSPEPSIA. only every second or third day. Two doses of carbo veg. 30 effected a permanent cure. Chamomil. is adapted to dyspepsia, in persons not disposed to violent outbursts of passion, which owes its origin to severe vexation; and when there is a severe pressing pain as if there was a stone in the stomach; anxiety and shortness of breath, worse at night, and sometimes associated with a beating pain in the crown of the head, which compels the patient to sit up. The gastrodynia moderated by drinking coffee. Cinchona. Case, occurring after parturition and whilst nursing. Disinclination for food and drink. Pressing in the stomach, heart-burn, flow of water into the mouth, and retching after eating. Languid and sleepy in the day time. Small stools discharged slowly. Pulse weak and small, sallow countenance. Yellowness of the eyes. Cinchona gtt., i. 6, and afterwards cinch. gtt. i. 12, effected a cure. Cocculus is useful when with the gastrodynia there is a pressing and constrictive pain throughout the whole abdomen, which is relieved by discharges of flatus or by nausea and a flow of water into the mouth, but no burning sensation attends. Digitalis is useful in dyspepsia attended by nausea, vomiting, bitter taste, loss of appetite, thirst, diarrhoea, pain in the forehead and great weakness. Graphites is useful in great debility of the digestive organs attended by costiveness. Ignatia. Case. Much mucus in the mouth, and an acid taste of the saliva. Loss of appetite for food, drink and smoking tobacco; eructation of the food: singultus; burning in the stomach; slight sticking in the epigastrium, which is very sensitive to pressure, DYSPEPSIA. 143 and in.which there is a sensation of weakness and emptiness. Ignatia is useful where there is a sensation of heaviness of the stomach, with sticking pains in the region of its cardiac orifice, and costiveness. Also in those forms of dyspepsia which arise from care and grief. Ipecac. is sometimes serviceable in dyspepsia when there is nausea and vomiting, the latter is accompanied by a sticking pain in the epigastrium, and on the cessation of vomiting a severe aching of the stomach. Lobelia inflata. Case in a married lady et. 38 ann. Accompanying chronic dyspnoea. Sensation of weakness and oppression at the epigastrium, and extending from thence into the chest. Burning in the stomach, and a sensation as if there was a burning lump in the pit of the.throat, which appeared to impede swallowing and respiration. In swallowing, it seemed as if at this point something rose up to meet the food and obstruct its descent into the stomach. Frequent eructation of acid fluid with sensation of burning. Frequent vomiting of the food after meals, especially after eating warm food..She "had not known what it was to be without heart-burn for one hour, for the last year." Her urine was high coloured, and deposited a copious red sediment. She had for a long time been subject to pain in the left lumbar region of the abdomen. Lobelia 416 effected a gradual but perfect removal of the whole train of her dyspeptic symptoms. In numerous cases besides the above, I have succeeded in removing the dyspeptic symptoms by the employment of the same remedy. The chief indica 144. DYSPEPSIA. tions for its use are---the sense of weakness and oppression at the epigastrium, and at the same time some oppression at the breast. But the nearer the approach of the symptoms has been to those of the above case, the less have I been disappointed in my expectations of a strikingly beneficial operation of the lobelia. There are, however, some cases where, although the symptoms of pectoral oppression are very trifling, yet this remedy operates satisfactorily. In a case of this kind, which I have but recently treated, and which occurred in a fat and robust man about 45 years of age, who complained chiefly of a copious haemorrhoidal discharge and consequent debility, and a sensation of tightness in the epigastrium and some acidity of stomach..1 at first gave him nux vom. without any apparent abatement of his disease, and subsequently some other remedies with the same want of success. At length he complained of some oppression at the breast, for which I administered lobelia 516. The following day he informed me that he felt new life and vigour, and that the pectoral, gastric and hoemorrhoidal disorders had all disappeared. Since that time, now about two weeks, he has remained free from them, and also from a feeling of want of power in the anus and rectum which was exceedingly uncomfortable to him while at stool, and to which he had been subject for many years. Lycopodium. Case, in a young woman who had suffered under the complaint for six months. Gastrodynia occurring in the mornings after she had been up for an hour or two, continuing throughout the day, and only ceasing on her becoming warm in bed at night. It was worse in the open air, and after eating flatulent food; and caused a sensation as if the DYSPEPSIA. 145 stomach was strongly pressed from both sides. A kind of cramp of the breast, almost preventing respiration, accompanied it. At times there was nausea, or tearing pain in the lower part of the abdomen, or pressing pain in the forehead with some vertigo. Stools regular. Menstruation, after cessation for one period, had continued after the next period almost uninterruptedly for fourteen days, was tolerably copious and attended by pains in the abdomen and back. The gastrodynia would continue to recur every day for eight or fourteen days, and would then cease for some days. Lycopod. 3130 completely removed the disease in the course of four weeks, and at the end of a year there had been no return of it. Lycopod. is also useful where there is burning pain in the region of the stomach. Magnesice carb. is useful in dyspepsia, with pressing and constrictive pain in the region of the stomach and frequent acid eructation. Mezereum is recommended where there is a gnawing and burning pain in the stomach. Nux vom. may be said to be the most important remedy in the treatment of dyspepsia. In those forms of the disease which owe their origin to the abuse of coffee or alcoholic drinks, it is generally applicable. As also where there is a sensation of weight in the stomach, and such a feeling of tightness about the epigastrium that the-patient imagines his clothes press against it too firmly; these symptoms aggravated after eating, or by drinking coffee. Also where there is tightness of the chest, causing difficulty of respiration or even asthma-these symptoms appearing when the patient first awakes in the morning. Or where the following symptoms are present: 10 146 DYSPEPSIA. namely, nausea; flow of water into the mouth; eructation of acid and bitter fluid, either with or without burning heat; vomiting of food or mucus; retching; palpitation of the heart, with anxiety; acid or putrid taste; constipation, or alternating constipation and mucous diarrhoea; flatulent distension of the abdomen; sometimes hemicrania; sometimes pressing pain in the forehead. Also where the pain is relieved by bending forward, by external warmth or by vomiting. Also where the pain is gnawing. Petroleum. In a case of dyspepsia, attended by diarrhoea, with acrimonious discharges, where the appetite was poor; and there was a dislike of all kinds of meat, but especially of fat meat; thirst; bitter and acid taste; nausea, and pressing in the stomach after eating; sometimes vomiting of a green and bitter fluid; sensation of coldness, and severe cutting pain in the abdomen. Phosphorus has been found useful in dyspepsias in which there was a constriction of the cardiac orifice of the stomach, in donsequence of which the scarcely swallowed food was brought up again into the mouth. It has also cured, where, besides the sensation of constriction and pressure in the stomach, there was a frequent eructation of a bitter, acid fluid, particularly after eating, and frequently recurring diarrhoea. Also where with these symptoms there was vomiting of a transparent acid fluid in the evening or at night, and acid eructation. CASE. In a man aet. 48 ann. Burning, sticking and pressing in the stomach constantly, but worse a couple of hours after eating. Similar aggravation often occurred late in the evening or at night, and disturbed the sleep. The burning sensation rose into DYSPEPSIA. 147 the throat. There was in the stomach a constant sensation of fermentation. Sometimes there was vomiting of water, at other tihes acid eructation. Stools occurring too seldom, always hard, and passed with effort. Burning in the rectum, at times debility. Nux vom. and sulphur effected no improvement, but after phosph. 1118 there was an increase of appetite, gradual diminution of the gastric disorder, and an increase of strength. The stools became regular and of the proper consistence. For a slight relapse at the end of three months, phosphor. 3130 was given, which completely removed the disease in eight days, and at the end of twenty-two months there had been no return of it. Pulsatilla is useful in dyspepsia accompanied by nausea and vomiting. Also where the disease is attended by diarrhoea and sensation of tightness or pulsation at the epigastrium, the pain and fulness of which are diminished after eating. This remedy is strikingly beneficial in many cases of dyspepsia, arising from eating fat meat, fresh pork, fried food, or rich pastry. It is often useful in dyspepsia accompanying deficient menstruation. Sepia. Case in a young man who had suffered for several years under dyspepsia of the following form, for which he had been treated in the common mode without success. About noon and in the evening he was tormented with a constant rising of an acrimonious, saltish and acid fluid, which had depressed his spirits and rendered him almost weary of his life. Sepia 1130 was dissolved in eight ounces of water, and the patient was directed to take half an ounce every night on going to bed. The first dose produced such an aggravation, of the complaint that the patient 10* 148 DYSPHAGIA. discontinued its use for three days. Afterwards the improvement was steady, and in two months the health was completely restored. Sodce carb. and sodce mur. are frequently useful in dyspepsia, attended by obstinate constipation. Besides the above remedies, ipecac., rhus, stannum, staphisag., sulphur and numerous others have, at times, proved useful in dyspepsia, but the particular indications for their employment have not been so satisfactorily laid down by practical writers as to render it expedient to enter into any details respecting them in this place. DYSPHAGIA. Difficulty of swallowing. Difficulty of deglutition occurs as a symptom of angina and hydrophobia, and is to be removed by the remedies which are appropriate to the diseases which it accompanies. But it sometimes occurs as a consequence of some disease less perfectly known, either of the oesophagus or of the cardiac orifice of the stomach. And as the dysphagia may, in many of these instances, depend upon the same disease, the following cases may sometimes furnish aid'in the selection of the remedies in future practice. CASE. Frequently, difficulty of swallowing liquids; constantly, great difficulty in swallowing more solid food. The patient could only eat bread crumbled in milk, or bread with a large quantity of slightly salted butter. At night there was eructation of the half digested food. Bellad., hyosc. and cicuta were'given without benefit. Cantharides gtt. i. 30, repeated at the end of fourteen days, effected great improvement. DYSPHAGIA. 149 The cure was completed with phosphor., sulphur and lycopodium. (CASE. Apparently rising from a contraction of the oesophagus near the cardiac orifice of the stomach. This disease'occurred in the person of a young man, about 25 years of age, by occupation a baker, and of very temperate habits. He came under my notice as a patient in October last, and presented the following symptoms: viz., much general debility of body arising from inadequate nutrition, attended with a corresponding dejection of mind. His nervous irritability was such, that he seldom enjoyed a comfortable night's repose, and never rose from his bed refreshed and strengthened to renew his daily toil. But the most alarming symptom, and one which threatened him at no very remote period with starvation, was the difficulty he experienced in passing food into his stomach, which had been gradually increasing- for three years past.. He could not, at the time I first saw him, swallow an ordinary draught of water or any other fluid, nor was he more successful when he attempted to swallow small portions of solid food. He fortunately discovered, although neither fluids nor solids in small portions could be forced into the stomach, but. were arrested before they entered this organ, that by continuing to swallow his food as well as he could, until the oesophagus was filled, and then by taking as much water into his mouth as he was able, and afterwards making strong voluntary attempts at deglutition, he could succeed in forcing the arrested mass into his stomach. These voluntary exertions were attended with much pain at the time they were made, and left the lower portion of the oesophagus sore and tender for some time afterwards. 150 DYSPHAGIA. In this manner the patient had subsisted for many months, during which the difficulty of swallowing was gradually increasing. In the mean time he had consulted one of the most eminent practitioners of the old system, and had submitted to the Thomsonian treatment, but without receiving any relief. Fearing that ere long his powers of deglutition would be unavailing, and that a lingering death from inanition would ensue, he sought my advice. I have treated him exclusively upon homoeopathic principles, unaided by any mechanical means, and have been abundantly satisfied with the result. The remedies used in the early part of the treatment were bell., ars. and nux v., which soon produced a marked degree of improvement in his general, health, allaying his nervous excitement, restoring his natural sleep, and recruiting his physical energies. I subsequently gave him carb. v. and petrol. in alternation, which acted more locally and enabled the patient to swallow his food with less difficulty. He is now (March 20th) able to eat thickened milk, mush and milk and other similar preparations with facility, swallowing them completely, without painful effort; bread and butter, meat, &c., also pass into the stomach with very little effort, and every day his condition is improving. There is every reason, therefore, to believe that a perfect cure will be effected. Green.) CASE. Sensation of a lump with a burning feeling at the pit of the throat, with the sensation of something rising to meet the food and obstructing it in its descent towards the stomach; occurring in a patient suffering under dyspepsia and dyspnoea. The dysphagia, together with the other diseases, were -cured with lobelia. J. EAR AND HEARING. 151 EAR AND HEARING. OTALGIA. In aching of the ears; bellad., chamomil., digitalis, merc., nux vom., pulsat., rhus and spigelia have proved. successful remedies. OTITIS. In inflammation of the ears, it is some"times proper, where there is considerable fever, to commence the treatment with aconit. But this is not often necessary, and therefore the remedies which act most powerfully on the affected parts, should generally be employed at. once. Of these belladonna is most useful in otitis interna, especially when this is combined, as it very frequently is, with inflammation of the brain. Pulsatilla is most generally the proper remedy in otitis externa, in which merc. and nux vom. have also proved useful, and the other remedies which have just been mentioned as successful in otalgia, are deserving of attention. OTORRH(EA. When suppuration has taken place, and there is a chronic discharge of pus or puroloid matter from the ear, the remedies must be such as are capable of removing the disease of the system on which this otorrhoea depends. There are, however, some cases in which the local affection is the only striking symptom of the existence of a morbid condition of the system. In a case of this kind in a child set. 3 ann., who had suffered with a fetid otorrhcea for several months, the discharged fluid being of such an acrimonious character as to cause excoriation of the skin of the ear and also of the skin over the angle of the jaw, and attended with itching or some other sensation in the ear, which induced the child to bore it with its fingers uritil the ear would bleed; digitalis 152 EAR AND HEARING. effected a perfect cure in the course of a few days, and at the end of six months there had been no return of the complaint. Belladonna, pulsat. and merc. have proved serviceable in ottorrhoea, and the last of these remedies has been reported as having effected the removal of a polypus of the ear. DYSEC(EA. Imperfection or difficuity of hearing, which is popularly termed, "hardness of hearing," exists in every degree of intensity, from inability to perceive some very low sounds, to perfect deafness. It may arise from obstruction of the external meatus by concrete cerumen, polypus or foreign bodies; from imperviousness of the Eustachian tube; from injury or destruction of the membrana tympani, or of the small bones of the ear, or from other structural lesions of this organ. But it perhaps owes its origin more frequently to a partial paralysis of the auditory nerves, than to any defects in the structure of the ears. Proceeding, as this disease does, from such a variety of causes, it is necessary that the physician, before commencing its treatment, should carefully inspect the ear and enquire into the circumstances and history of the case. For where the dysecoea depends on obstruction of the meatus externus, medicines cannot be expected to do much good, because they cannot, except in the cases of polypus, effect the removal of the obstructing bodies; and when the dyseccea arises from destruction of parts, it must be to a considerable extent incurable. The cases which are capable of being improved by medical means, are those which depend on a present morbid action in some part of the ear, or on a loss of power in the auditory nerves; and the chances of success are much diminished if not EAR AND HEARING. 153 entirely destroyed, when the patient has been subjected to the operation of puncturing the membrana tympani, which frequently injures the ear to such an extent that recovery of the hearing becomes nearly hopeless. The following statements in relation to the homoeopathic treatment of dysecoea, though very unsatisfactory, are all that can be presented at the present time. It is to be hoped that homceopathic physicians who have treated this affection successfully, will publish their cases in such detail that a judgment may be formed of their value and a more accurate knowledge may be obtained in regard to the operations of remedies in correcting defects of hearing. Calcis carb. has proved useful in several cases of dyseccea. In two cases, the secretion of cerumen, which had been previously deficient in quantity, was increased in amount after the employment of this remedy. One of these was in a woman et. 41 ann. The dyseccea of the right ear commenced in her childhood during an attack of natural small-pox; the left ear was at times also affected. There was a sound in the ears resembling the driving of wagons, and almost constant cephalalgia. Calcis carb. 3124 effected great and permanent improvement of the hearing. Petroleum cured a case where calcis carb. had been previously employed with advantage. And in the case of a man aet. 29 ann., where ringing of the ears, the secretion of a concrete cerumen, cephalalgia and hemorrhage of the gums accompanied the dysecoea, this remedy completed the cure which had been commenced by silex. The following remedies are also mentioned as 154 ERIUPTIONES CUTANEIE. having been advantageously employed in the treatment of dysecoea; bellad., graphit., ledum, pulsat., spigelia. ERUPTIONES CUTANEIE. Under this head are included most of those cutaneous diseases, (with the exception of Rubeola, Scarlatina and Variola,) which having been successfully treated on homoeopathic principles, are recorded in the works to which I have had access. The terms papulm, pustules and vesicles, are employed in their usual meanings; namely, papulesmall inflamed elevations of the cuticle; pustulessmall elevations on the skin containing pus; vesicles -small elevations of the cuticle containing a transparent fluid whether coloured or not. The term crusts, as here employed, is generally a literal translation of the German word kruste, and is applied most frequently to those scabby coverings of the diseased skin which appear to be formed by. the concretion of effused fluids. It may, however, sometimes be applied to irregular layers of morbid cuticle. The term scale, a literal translation of the German word schuppe, is applied sometimes to a thin coating of the diseased skin, formed by the concretion of effuse fluids; but it is also applied to a lamina of morbid cuticle. The term scurf, a literal translation of the word schorfe, is applied to furfuraceous desquamation of the cuticle. The most of the names of cutaneous eruptions which occur here, have been applied by the physicians who have reported the cases. To many of 156 ERUPTIONES CUTANEJE. Eruptions forming crusts; arsen., bellad., clemat., conium, mere., rhus: brown crusts; ac. phosph.: brownish yellow; lycopod.: yellow; cicuta, rhus: yellowish green; sulphur: whitish gray; graphit. Eruptions forming scales; bryon., lycop., sulphur. Eruptions forming scurf; alum., arsen., baryt., bryon., bovist., conium, graphit., lycop., sulph. Eruptions of syphilitic origin; mere. Eruptions, papular; calcis carb., calcis sulph., cicuta, ledum, sepia, sulphur. Eruptions, pustular: arsen., baryt., bellad., calcis carb., graphit., mere., rhus. Eruptzons, vesicular: arsen., bellad., bryon., bovist., cicuta, dulcam., rhus, sulphur. PSORA. Sulphur, carbo veg., sepia, tr. acris. RHAGADES. Bryon., calcis carb., calcis sulph., sepia, sulphur. TINEA CAPITIS. Baryt., belladonna, calcis carb., graphit., lycopod., oleander, phosph., rhus, sepia, staphys., sulphur. ZoNA. Cingulum. Herpes zoster. Shingles.Arsen., graphit., pulsat., rhus. Acid. phosph. E. c. A moist, tetter-like eruption on the red of the lips, the cheeks, and about the angles of the mouth. The lips raw in some places, and in others covered with thin brown crusts, and bleeding underneath. The affected parts of the cheeks covered with thick yellow scurf. Ac. phosph. is mentioned by Hartmann as useful in some cases of crusta serpiginosa. Aconitum. Urticaria. Face blood-red. Body covered with the rash. Every time the bed clothes were thrown off, severe chill. Pulse hard and frequent. Thirst. Oppression at the breast, with short, quick ERUPTIONES CUTANEAE. 157 breathing; difficulty of speaking; hoarseness. Sensation as if a ball stuck in the throat, preventing speaking, and impeding respiration. Headache; constipation; dry hot skin; great anxiety; debility and trembling. Aconit. 5124, in the morning, followed by nux v. 2130 in the evening, effected a cure. Alumina. E. c. A moist, scurfy tetter on the temples, at the edge of the hair, and some very small spots of the same on the fore-arms. Elephantiasis; lepra arabum. Dr. Hering, to whom we owe all the information which we possess in relation to the homoeopathic treatment of this disease, found alumina one of the most valuable remedies in the swelling of the face; and that, in some cases, the tubercles diminished under its use. Arsenicum. Pemphigus. In a man aet. 48 ann. Vesicles on the body and extremities containing a bloody fluid. Fever, headache, diarrhoea, restlessness. Urine burning, and like bloody water. No sleep for eight nights; for, on lying down in bed, there was severe burning in the skin and a sensation as if hot water flowed through his veins. Large hemorrhoidal tumours of the size of walnuts, pain burning and sticking. Arsen. 30, with speedy relief. The hoemorrhoidal tumours also rapidly diminished. Small ulcers. In a woman et. 60 ann.; disease of several months' duration. Small ichorous ulcers over the whole body, the face excepted. Burning itching, which compelled scratching, although aggravated by it. Worse in the cold, and least troublesome when warm. The sores sometimes healed up in places, but fresh crops soon showed themselves. All ointments irritated. The patient became more and more 158 ERUPTIONES CUTANEXE. emaciated, was dyspeptic and debilitated. Arsen. 30 cured the disease perfectly in fourteen days. Ulceration, with formation of crusts. In a man aet. 43 ann. After a severe chill, an eruption of small, red pimples, the tops of which became filled with a clear yellow fluid: these burst, and their acrimonious discharge corroded the healthy skin, causing the formation of large crusts, under which there was a continued effusion of matter. The ulcers were confluent and covered the face, neck, breast, fore-arms and hands, and caused an intolerable burning pain which prevented sleep. Patient had a saline taste in his mouth, little thirst, dirty-yellow coated tongue. Diarrhoea; stools yellow; cloudy, yellow, urine. Debility. He was dispirited and peevish. Disease of three months' duration. Arsen. 30 effected a cure in ten days. Vesicular eruptions. Between the scapulae a red spot, the size of a dollar, beset with small vesicles, which burned intolerably, especially at night; sulphur was followed in five days by no relief, but by the appearance of a similar eruption over the epigastrium. Arsen. 30 was next given, and afforded relief in two hours, and in ten days effected a perfect cure. Gangrenous vesication. Arsenic. is a valuable remedy in this form of disease; though in some cases acid. mur. may be preferable. This remedy has been highly recommended in herpes zoster, by Dr. Trinks. It has proved useful in crusta lactea, and is said by Hartmann to be indicated in crusta serpiginosa, when the eruption extends itself rapidly, and the itching and burning appear to be very great, but are lessened by warmth, especially in bed. ERUPTIONES CUTANEXE. 159 A case of pustular eruption on the face, in the region of the beard, accompanying a pustular eruption of the scalp, forming crusts: with great falling out of the hair, and a dead appearance of what was left, was slowly cured by arsen, and rhus in alternation. Arsen. proved useful in two cases of chronic desquamation of the cuticle of the nose. Elephantiasis; lepra arabum. Dr. Hering has employed arsen. with strikingly beneficial results in this disease, for the superficial ulcerations on the balls of the toes and soles of the feet, from eroding vesication, with loose, skinny and unevenly torn margins; foul, yellow ground, red only on the circumference, itching and burning severely, especially at night, and attended with biting, pinching pain. Also where ulcerations of the fingers were attended by burning pain. The tubercles always diminished after arsenic., and sometimes disappeared. Urticaria. Arsen. has been recommended in chronic urticaria. Barytes. Tinea capitis humida, with swelling of glands of the neck, has been cured by baryt. acet. Pustular eruption on the neck, changing into an itching scurf. Baryt. acet., dose repeated in four weeks, effected a perfect cure. Belladonna. Erysipelas of the face, with severe headache, vertigo, intolerance of light, incessant cold shivering, thirst and vomiting. Pulse full and frequent; bellad. gtt. i. 24. For six hours, aggravation, then gradual relief. In nine days the cure was perfect. The patient had been twice before attacked by the disease, and on one occasion had suffered under it for four weeks. 160 ERUPTIONES CUTANE-E. In another case, in a woman ret. 56 ann. who had suffered under repeated attacks of the disease, which under the ordinary treatment endured for eleven days, and under domestic remedies for a still longer period, the cure was perfect by the sixth day after taking bellad. 18. Vesicular eruptions. Bellad. has been found useful in some forms of vesicular eruption, and one case is recorded in which this remedy effected the cure of a gangrenous vesication on the right leg, accompanied by swelling of the foot, pain in the stomach, nausea and vomiting. Pustular eruption. Bellad. has proved useful in pustular, papular and crusty eruptions of the face in children. Tinea capitis. In some forms of tinea capitis, bellad. has been employed with advantage. Bovista. E. c. Red spots, with furfuraceous desquamation of the cuticle. E. c. small, crowded, red elevations of a raw, scurfy appearance, and secreting a transparent fluid on the backs of the hands, and occurring every winter. Bryonia. In a vesicular eruption on the face, where after the bursting of the vesicles there was desquamation. Disease originally crusta lactea, and of many years' duration. Two doses of bryon. at an interval of two weeks, effected a cure. Erysipelas of the joints, with increase of pain on motion, has been relieved by this remedy. In furfuraceous tetter of the eyelids bryon. has been recommended. Rhagades. In the treatment of chapped lips, bryon. has proved useful. ERUPTIONES CUTANEIE. 161 Calcis carb. has proved useful in some forms of papular eruption on the face. Tinea capitis. In a case, with ophthalmia, costiveness, sour sweat and peevishness. T. c. In a case of moist tinea capitis, with glandular swellings in the neck; thick, swollen lips, and pale, bloated face; a single dose of calcis carb. gtt. i. 30 effected a cure. T. c. This remedy has also been found useful in dry tinea capitis. Rhagades. Calcis carb. gtt. v. 12, mixed with five ounces of water, and locally applied, cured the painful chaps which appeared in the hands of a brick-maker whenever he worked in wet clay. Calcis sulphuret. in repeated doses, at long intervals, cured a crusty eruption on the ears; the eruption mostly dry; moisture only in a few spots. It has also proved useful in pustular, papular and crusty eruptions of the face, and in moist tinea capitis. In erysipelas it has proved a valuable remedy. Urticaria. In a constantly recurring nettle rash on the hands and fingers, calcis sulph. was very useful. Rhagades. On the palm of the left hand a semicircular spot with deep fissures and chaps, frequently bleeding, and attended with burning, and on being touched, sticking pain. Carbo veg. In psora, carbo veg. has been employed with advantage after sulphur. Urticaria. Carb. v. has been recommended for chronic urticaria. Cicuta virosa. Papulm of the face. Dark-red, crowded papula, attended with.burning pain during the eruptive process; continuing for some days and then desquamating. Disease of sixteen years' duration. 11. 162 ERUPTIONES CUTANEJE. Two doses of cicut. viros., the first gtt. i. 2, the second gtt. i. 4, at an interval of twenty days, effected a perfect cure in thirty days. E. on the face forming crusts, in a girl et. 16 ann. Every year, from her eleventh to her sixteenth year, the disease attacked her in September, and endured for a long time. The eruption began with a scabbiness about the left angle of the mouth. The diseased surface poured out a yellowish water, which rendered sore the parts which it touched, and excited burning pain. These sores secreted a similar fluid, which concreted into honey-yellow scabs and formed a thick crust The left side of the face, the whole chin, and a large part of the skin below the chin were affected. In both nostrils yellowish brown scabs were observable. The sub-maxillary glands were swollen and painful. One twentieth of a drop of the succus cicut. vir. with improvement till the ninth day. On the eleventh day cicut. vir. gtt. i. 1, with rapid improvement. On the twenty-fifth day, cicuta vir. one thousandth of a drop, and by the thirtieth day there was not a trace of the disease, and it never appeared afterwards. Vesicular eruption succeeded by crusts. In a child oat. 1 ann. Vesicles containing a transparent colourless fluid, breaking and then pouring out a fluid, which dried into thick yellow scabs forming crusts, the sores extending themselves in such a manner that many of the crusts were of large size. The eruption occupied the skin around the mouth and the cheeks, but was worse on the chin. Cicut. vir. 1130. In two weeks well. J. Clematis erecta. Vesicular eruption, succeeded by crusts. See rhus. ERUPTIONES CUTANE1E. 163 Conium mac. E. c. Inr a female ret. 20 ann. who in earlier life had suffered from eruption on the head and glandular swellings. It was on both fore-arms, and began at points from which it extended itself until it occupied surfaces of four by eight inches. The skin had a porous, highly red, raw appearance, was somewhat swollen, and exhibited in places depressions and furrows. There were sore spots, from which a tough clammy lymph and, at times, some blood exuded. This lymph dried into a white scurf. On the margins of the eruption, under the apparently sound skin, small glandular tumours were to be felt, which gradually became red, and were finally involved in the disease. The itching was excessive, especially in the evenings. Conium gtt. i. 1, every eight days, and sue. conium gtt. i. twice given, perfectly cured the disease in eight weeks. E. c. described as a severely burning, biting, moist tetter of the hands and fore-arms, which had resisted a great variety of treatment. Con. mac. four doses in three weeks. The first, sue. conium gtt. i.; the second, coniumn gtt. i. 6; the third, gtt. i. 18; the fourth, gtt. i. 24. In six weeks well. A number of homoeopathic remedies had been previously used without much success. E. c. with crusts. A female aet. 26 ann. had, from her childhood, some spots of the size of a hand on her body, covered with crusts. Con. mac. in the same doses as in the preceding case, but given in the course of two weeks, effected a perfect cure. Dulcamara. Pemphigus. In. a boy aged thirteen months. Vesicles of the size of peas, seated on an inflamed base, and containing a transparent yellow fluid. 1 Upon breaking, eating sores were formed, 11* 164 ERUPTIONES CUTANEIE. which discharged a clear red ichor, which, after some days, formed a thick brownish red scab, painful on being touched. After some days the scabs fell off leaving bright red spots. The whole body, but chiefly the back and extremities, was covered with it. The face only was free from it. Emaciation, loss of appetite, thirst. Slimy, brown, diarrhoeal stools. Urine of strong odour, cloudy and causing itching and pain in the parts which were wetted by it. But little sleep; restlessness. Dulcam. In a few days well. Herpes pudendi. Dulcam. has been spoken of as being,'of inestimable worth in suppurating moist tetter about the pudendum." Urticaria. The eruption every time preceded by a sensation of sticking, as with needles, through the whole abdomen, and accompanied by severe itching; and after scratching, by burning. Dulc. gtt. i. 24 speedily cured the disease. Urticaria, with fever, bitter taste, slimy coated tongue, nausea and vomiting, pressing pain in the epigastrium, diarrhcea, dark, cloudy urine, and pains 'in the limbs. Graphites. Scurfy tetter on the skin below the nose. The affected parts itched severely, and discharged an acrimonious ichor, which formed a thick scurf. There was also a pustular eruption over the whole body, and sticking pain in the anus before the stools. Tetter on the arms, hands, face, ears, calves of the legs and thighs. There was a thick, whitish gray crust formed by exuding lymph, under which the skin had a red and sore appearance. Severe biting, itching, tooth and ear-ache at night. Stiffness and ERUPTIONES CUTANE1E. 165 immobility of the affected parts, with swelling of the glands. After phosphorus, graphit. 12 effected a speedy cure. Herpes zoster, zona, &c. Graphit. 3130, three doses, one every other day. Crusta lactea. Scurfy, ulcerated nose and lips, with some itching. Tinea capitis. Graphit. 30, every ten days a dose, cured a tinea capitis, but an erysipelas of the face then appeared. T. c. Graph. 2130, five doses, one every week, cured a case of tinea capitis humida, which chiefly affected the top of the head, and was accompanied by itching and a falling out of the hair. Elephantiasis; lepra arabum: "It frequently improved the leprous spots or their remaining traces, especially coppery, annular, elevated blotches in the face, coppery tubercles on the ears, also the callous ulcers of the feet, which arise from eroding vesication." Hering. Bucnemia. Elephantiasis. Barbadoes leg. In this disease graph. "has more influence than most other remedies." Ibid. In vesicular erysipelas of the face, graphit. has been found very useful. Ledumn has aided in removing pimples and bloodboils from the forehead and other parts. In a case of dry, scabby tetter of the face, with burning pain in the free air, and a burning and stretching sensation on moving the muscles of the face. Mere. had been previously used with advantage, and two doses of ledum 15 completed the cure. Lycopodium. E. c. A furfuraceous tetter, with -plaiting of the skin about the mouth, which disap 166 ERUPTIONES CUTANEIE. peared for four months after sulph. 3130, but again returned, was permanently removed by lycop. 2121. E. c. Tetter on the face, neck and calves of the legs, in a girl et. 9 ann. The patches mostly of the size of a dollar, with distinct margins, level with the skin, of a brownish yellow colour, but with points redder than natural, and scaly desquamation. After graphites these spots became redder, and at length formed matter; they also spread and not only itched as before, but produced burning, sticking pain; lycop. 2130. In three days, improvement. In three months, well. E. c. Tettery eruption on the legs; somewhat moist, with deep fissures; thick, straw-yellow crusts; severe burning pain; especially at night. Crusta lactea. Lycopod. has been recommended for this disease. Tinea capitis. Lycop. 1130 cured a moist tinea capitis, and soreness about the genitals, and upon the thighs, in a child aged ten months. Lycop. has been found very useful in those cases where the whole of the back and parts of the front of the head are -covered with thick crusts, from under which there is discharged, especially during the night, a lymphatic, bloody or puroloid matter; and there is tumefaction of the glands of the neck and throat, disagreeable odour of the head, pale, sickly countenance, the face spotted with small pustules, the ears involved in the eruption, and discharge of pus from the ears. Mercur. acet. 4 cured an eruption over the whole body, but worse on the arms; consisting of itching pustules, which burned severely after scratching. Mercur. E. c. In a child aged four months. ERUPTIONES CUTANEJE. 167 Eruption began on the head, and extended from thence over the whole body. Face covered with a dirty yellow crust, from under which a stinking moisture exuded. Intolerable itching. Eyes surrounded with scurf, red and weeping; intolerance of light; small pustules on the conjunctiva. E. c. syphilitica. In a child who had received the syphilitic infection from its nurse. Skin covered in some places with pustules, in other places with tettery patches; the pustules while advancing were painful, and itched while drying up; some were confluent, forming either dry spots with furfuraceous desquamation, or raw surfaces secreting an acrimonious fluid. When any of the patches cicatrised, a fresh eruption appeared in their vicinity. Face and scalp free from the disease. Itching in all the affected parts, increased in bed. The conjunctiva was reddened, the lower eyelid swollen, with a yellow crust on its edge; the falling off of this crust exposed to view many small ulcerations. Mere. aided by mezer. effected a cure. Mere. gr. i. 8 cured an extensive tetter, in which a sensation of burning was excited on its being touched. Nux vomica. Urticaria. Nux v. is a valuable remedy in this form of cutaneous disease. For a case of febrile nettle rash, in which it was serviceable, see aconit. In a case where the febrile excitement was unimportant, but nearly the whole skin was covered with large blotches of the eruption, attended with troublesome itching; the face very red, but without the peculiar appearance of urticaria. Nux v. speedily subdued the disease. J. Oleander cured a red, raw tetter on the skin before 168 ERUPTIONES CUTANE1E. the ear, accompanied by a secretion of a fetid moisture behind the ear. Tinea capitis. The eruption affected only the hairy scalp, itched excessively, after scratching there was burning; sometimes the eruption was scaly, at other times moist. It appeared as if there was an effusion of serum under the whole scalp. Oleand. gtt. i. 3 effected a cure in a few days, though the disease had existed for many weeks. Petroleum has been employed with advantage in the treatment of itching tetter on the scrotum and perineum. Phosphorus. In tetters on the neck and breast, consisting in light-brown, irregularly formed patches, which are slightly elevated, somewhat rough to the touch, and at times itching. Tinea capitis. Phosph. cured a case attended by dry desquamation. Pulsatilla. Erysipelas. Hartmann recommends pulsat. in erysipelas, when inflammation of the external ear has taken place, and rhus has ceased to operate. Caspari found it useful in an erysipelatous inflammation of the foot. Hordeolum. Pulsat. has been recommended as useful in this disease. E. c. arising from indulgence in fat food. Zona. Pulsatilla is mentioned as one of the remedies applicable to this disease. Rhus tox. Erysipelas, pustulosum, bullosum vel vesiculare. Rhus tox. is one of the most important remedies for this form of erysipelas, and will frequently, if not generally, remove it without the aid of any other remedy, and by a single dose. Sometimes another remedy has been found necessary to ERUPTIONES CUTANEJE. 169 complete the cure. The other remedies which have been found most serviceable, are bellad., calcis sulph., graphit., carbo an. and cantharides. I shall adduce only one of the many cases of the beneficial operation of rhus in vesicular erysipelas, which are recorded by homceopathic writers, asmore would occupy space unnecessarily. A woman cat. 48 ann., of arthritic habit and choleric temperament, who had once before had an attack of vesicular erysipelas of the face, in the progress of which her life was considered to be in great danger, and the cure of -which, by the common system of treatment, occupied eight weeks; was three years afterwards again severely attacked by the same disease. Rhus gtt. i. 30 produced a slight aggravation; but an improvement in 'some of the symptoms was perceptible in twelve hours. In forty-eight hours the disease was cured; with the exception of a slight debility, which disappeared in a few days. Pemphigus chronicus affecting the face, neck and extremities. Large vesicles seated on an inflamed base, and containing a sero-puroloid fluid, which dried into thick, brown scabs or formed superficial ulcers. After healing, the, cicatrices remained blood-red, shining, harsh like paper, scaly and insensible. Zona. Rhus has been recommended in this disease. E. c. In a boy et. 8 ann. who, when a month old, had been attacked with a scurfy eruption of the scalp, and in whom the disease had advanced until, the whole fore part of the head, the forehead, and right side of the face, were covered with a thick, moist crust, from beneath which there flowed an ichorous matter of intolerable odour. The crusts sometimes fell off, showing the raw, uneven and discoloured 170 ERUPTIONES CUTANERE. skin, but they were soon reproduced. On the body and extremities the skin was raw and scaly, and in many places covered with crusts like the face. Severe biting itching in the affected parts, especially towards evening, at night, and when warm. Rhus gtt. i. 2 left in four weeks but slight traces of the disease. In four months, in which time four doses were given, a perfect cure was effected. E. c. White vesicles, succeeded by thick, yellow crusts, beneath which a yellow, corrosive, burning pus caused great pain. Sores slowly drying up. The disease appearing every spring. E. c. in a boy rat. 10 ann. Disease of several years' duration, diminished in the summer and increased in the autumn. The upper part of the thigh nearly covered with a scaly coating (crusts?) from under which a yellow, corrosive ichor was discharged. Sometimes the scales fell off, showing a raw, moist surface, covered with many small vesicles, which upon bursting discharged a yellow, corrosive fluid, that caused the same disease in the parts with which it came in contact. New scaly coating was soon reproduced. On the haunches, arms and back were groups of crowded vesicles. The affected parts itched excessively when warm, especially in bed. Swelling of the inguinal and axillary glands. Patient debilitated and emaciated. Staphys. gtt. i. 30 produced an aggravation without much subsequent improvement. Clemat. erect. gtt. i. 6 effected a considerable diminution of the disease, but after fourteen days the disease showed a disposition again to advance. Rhus gtt. i. 9 with great improvement. After twenty-one days the affected parts were moistened with the following mixture. Tr. rhus toxicod. gtt. i., aq. purae. gtt. c. ERUPTIONES CUTANE1E. 171 In twenty-one days more there was not a trace of the disease. Crusta serpiginosa. Rhus has been found useful in this disease. Tinea capitis. Thick crusts over the whole scalp, from under which there flowed a greenish coloured pus. Severe itching at night. Sarsaparilla. Crusta serpiginosa. This disease, like crusta lactea, attacks young infants. It begins with a vesicular eruption on the cheeks, just in front of the ear, and over the parotid glands. The vesicles, which are seated on a red base, burst and discharge a considerable quantity of an acrimonious serous fluid, which irritates the adjoining skin and produces on it the same eruption. This fluid dries into small, superficial and dark coloured crusts which alternately fall off and are reproduced. The disease spreads itself over the whole face, and sometimes affects the eyelids, but never the eyes. It sometimes invades the hairy scalp and may attack the back, hips and extremities, and even retain possession of these parts when it has disappeared from the face. There is severe itching, and frequently great debility and emaciation. Sarsap. is a very valuable remedy in this disease, and has been recommended for those cases in which the child is very peevish and fretful; when the eruption is seated on an extensive inflamed base, the crusts separate themselves from the skin on exposure to fresh air, and the tender new skin becomes fissured and chapped. The remedies mentioned as adapted to crusta lactea may also be useful in this disease. The following have also been found serviceable. Acid. phosph., calcis 172 ERUPTIONES CUTANEIE. carb., cicula vir., clematis erecta, conium, graphit., ledum, lycopod., sodca mur., sulphur. Sepia. E. c. Sepia cured an eruption resembling psora, and appearing over the whole body, but worst on the extremities, with severe itching in the evening. E. c. Tetter on the face and back of the hands which itched severely, especially in the evenings. There flowed from the chapped skin a yellowish lymph, which dried into crusts. Skin hard like parchment; ground and circumference of the tetter red. E. c. Sepia has been very serviceable in moist, itching, burning tetters; in crusta lactea, and in tinea capitis humida, with ichorous discharge. It has also aided in the cure of some cases of psora., Elephantiasis. Lepra arab. Sepia proved a valuable remedy, and was peculiarly advantageous in the cure of the ulcerations consequent on erosive vesication. Prurigo pudendi. The labia swollen, inflamed and covered on the inside with small papulae or pustules, which secreted a puroloid fluid. The itching excessive; aconit. 30, and after twenty-four hours sepia 3130. In four days no trace of the disease. Staphysagria. Tinea capitis. Moist eruption on the right side of the head, with indescribable, offensive odour. Pustules on the neck, swelling of the glands of the throat. Sulphur. Psora. In the treatment of psora, sulphur is one of the most important remedies. Given either in the lower or very high dilutions, it has cured this disease without the aid of any other remedy. But in many cases it has been insufficient to complete the cure, and therefore other remedies have been ERUPTIONES CUTANEIE. 173 required. Among those which have been found most useful as adjuvants of the sulphur, are carbo veg., sepia and tr. acris. Some cases are also recorded in which benefit appears to have been derived from lachesis. Herpes squamosus on the forehead, was cured by sulph. 3 in ten days. Herpes miliaris. Small vesicles containing a serous fluid, united in groups on an inflamed base. The groups, from the size of a dollar to that of the hand, formed separate circumscribed, irregular spots, between which the skin was healthy. Eruption chiefly on the extremities. Burning, itching, and either moist or covered with thin white scales. Herpes crustaceus. (Impetigo of Willan.) On a circumscribed red base, small crowded vesicles, discharging a puroloid lymph, which dries into thick, yellowish-green crusts. These crusts frequently fall off, and new ones are reproduced on the moist, slightly elevated, bluish-red spots. Burning and itching, chiefly affecting the face. E. c. Sulphur 2 cured a dry furfuraceous tetter. E. c. A moist, itching tetter extending over the whole face, thickest over the nose and around the eyes, also here and there on the swollen eyelids, and attended by great intolerance of light, much weeping, itching and smarting of the eyes, and swelling of the glands of the neck, was cured by two doses of sulph. 2, given at, an interval of seven days. E. c. supervening vaccine disease. Eruption somewhat resembling the vaccine vesicle, but assuming a tetter-like appearance. Sulph. 1130 was very serviceable, and the child, who had been previously unhealthy, became quite well. 174 ERUPTIONES CUTANEtE. E. c. Eruption in large wheals of small vesicles containing yellow pus, which dried away forming scurf. The wheals surrounded with a red space. Severe itching. Small, red, itching points on the fingers. E. c. Small tubercles of the size of poppy seeds on the extremities: on the superior extremities extending from the wrists to the shoulders, attended with itching. Tinea capitis. Sulphur has proved serviceable both in moist and dry tinea capitis, but most in the latter. T. c. In an infant. Thick, bark-like, straw-yellow crusts on the upper part of the head; a thick, yellow puroloid matter flowing from beneath them. Many separate, red pustules, with yellow tops, on the body. Nocturnal diarrhoea, with greenish stools, preceded by screaming and twisting. Restlessness, sleeplessness, emaciation. The sulphur was administered both to the mother and infant. Crusta lactea. In a female child set. 2 ann. Disease commencedwhen the child was six months old. The skin had been previously healthy. The eruption began on the body and extremities, and for the last three months has been extended over the whole face, so that the cheeks, forehead and eyelids were covered with the eruption, which consisted of small, white vesicles, that on breaking extended into each other and formed crusts. The itching, especially in the evening, was very severe. The skin was very sore for a considerable extent from the orifices of the nose. The eyes were glued together with matter in the mornings. Considerable opacity of the cornea in both eyes. Sulph. 3 was followed by great improvement. ERUPTIONES CUTANE}E. 175 After six weeks, sepia 30 was given, and in six weeks the child was well and cheerful. Rhagades. Sulphur has proved useful in chapping of the hands. Viola tricolor. Crusta lactea. This disease chiefly attacks infants between two and ten months old. It commonly appears first on the cheeks and around the mouth. The affected parts become hot, red, tense, swollen and glossy. The child is restless, and rubs the affected parts against every object which it can reach. The eruption consists of small pustules of the size of a pin's head, which are filled with a thin, transparent yellowish lymph. These soon burst, and the effused fluid forms thick, yellowish-brown crusts. Under these a puroloid secretion continues itself. New pustules arise and become confluent with the old. When the disease extends to the forehead it sometimes induces inflammation of the eyes, with opacity of the cornea and swelling of the eyelids, or complete psorophthalmia. During desiccation the urine is cloudy and has the odour of cat's urine. Viola tricol. is one of the most valuable remedies in the treatment of this disease, but others may be demanded. The following have been useful. Arsen., aurum., carb. veg., calcis sulphuret, dulcam., lycopod., rhus, staphys., sulph., tr. acris. Vinca minor. gtt. i. cured a chronic, moist, strongly smelling eruption on the head, in the face, and behind the ears. Plica polonica. In one case, tr. vine. min. gtt. i., every eight days a dose, cured this disease. In another case vine. 28 proved itself useful. Zincum cured tettery, raw, itching spots on the hands, with bleeding of the gums. 176 EYE AND VISION. EYE AND VISION. The diseases of the eye, and the defects of vision, of which I shall treat in the present work, will be included under the following heads, and in the order in which they are here mentioned: viz. ophthalmodynia, ophthalmia, leucoma, fungus hematodes oculi, cataracta, amblyopia and amaurosis. OPHTHALMODYNIA. Severe pain in the eye frequently occurs without any apparent inflammation; is sometimes increased by light, as in ophthalmia, and sometimes. recurs periodically. Where it is connected with an intolerance of light, conium, ignatia and spigelia are the best remedies. In a case, in which periodic ophthalmodynia of the left eye was the consequence of too great exertion of the eyes in reading and writing, the paroxysms commencing every day at six o'clock in the morning, and terminating about noon; the pain sticking and boring, increased by moving or opening the eyes, and after a time extending to the top of the head; pupils contracted; eyes glassy and dull; bright spots before the eyes; the upper eyelid dependent, as if paralysed; spigelia 30, given soon after the conclusion of a paroxysm, was followed, after a few minutes, by a renewal of the "pains, but not in their greatest severity, which endured only for twelve minutes, when she fell into a quiet and refreshing sleep, from which she awakened very much refreshed. After the preceding paroxysms she had been unable to sleep. The next day the 1! OPHTHALMIA. 177 paroxysm commenced an hour later, was incomparably lighter, ceased earlier, and left much less debility. On the third morning it was quite unimportant, and in a few days every trace of. the disease had vanished. OPHTHALMIA. Acid. nitric, is frequently useful in syphilitic ophthalmia from metastasis. Acid. sulph. can sometimes be advantageously employed in chronic ophthalmia. Aconit. has been highly recommended by Dr. Stapf in ophthalmia which has been occasioned by the irritation, of foreign bodies in the eye, the cause of the inflammation being carefully removed. Even when the inflammation thus originated has continued for some time, and has become modified by the morbid condition of the system, he often prefers first administering the aconit., and then following it by the remedy which is the best adapted to correct the constitutional disorder. Where there is a morbid condition of the system, which has supervened on psoral, disease, he recommends sulphur, and where there is the scrofulous diathesis, calcis carb. Arnica proved beneficial in a case of ophthalmia arising from contusion. Arsenicum. Case in a girl ast. 14 ann. Disease of two days' duration. The conjunctiva appeared as if sprinkled with blood. The pain was burning, and so severe that the patient could neither sleep nor eat. There was violent fever and great thirst. Arsen. 24 was given at four o'clock in the afternoon, and by 12 178 1EYE AND VISION. the next morning the disease had entirely disappeared, and the patient remained well. CASE. In a girl ret. 10 ann. She had suffered under a scrofulous ophthalmia of the right eye for more than four years, and had been treated with leeches, vesicatories and other derivatives, eyewaters, ointments, &c. without benefit. For six months all treatment had been discontinued, but there was no improvement. The eye almost always closed; the edges of the lids somewhat reddened, the upper lid somewhat swollen and dependent. It was impossible to examine the condition of the eye closely, for upon attempting, with every precaution, to open the lids, there was severe sticking pain and a gush of tears. Of the eye nothing was to be seen during the momentary separation of the lids but a red, uneven, fungoid mass. The child had, according to the statement of the mother, been unable to see with that eye for three years. The pains were severe, burning, sticking or cutting, accompanied by great intolerance of light, aggravated upon exertion of the sound eye, especially in the evening. Nov. 23d, 1830, arsenicum 2130. From the third day the intolerance of light gradually abated, and by the eighth day she could open the eye in the clear daylight. The eye presented then the following appearances. The conjunctiva, and perhaps the external layer of the sclerotica, completely degenerated, and consisting of loose, raw flesh, similar to very red cellular membrane, in which were the enlarged blood-vessels proceding from the centre of the cornea; the border of the cornea was set with deep little ulcers, and the lamella of the cornea appeared to be separated by an infiltration of purulent fluid; OPHTHALMIA. 179 here and there on the cornea whitish gray cicatrices of old ulcers, besides two open ulcers. The cornea so perfectly opaque that not the slightest trace of iris or pupil could be seen through it. No more medicine was given till the 19th of January, 1831, by which time the improvement had so far progressed that she could read large print with the right eye, though there was still a slight opacity of the cornea. Crocus 9, then given, was followed by rapid improvement. But for fresh inflammation from taking cold, bellad. was administered on the 30th Jan., which effected a speedy removal of the inflammation. On the 25th Feb, tr. euphras. undilut. 210, which produced a rapid improvement. By March llth there were only two or three small specks on the cornea, and these not in the axis of vision. For improvement of general health and prevention of relapse acid. nit., spt. sulph., petroleum and silex were given, and she remained perfectly healthy. CASE. In a girl set. 6 ann. who was subject to ophthalmia on the slightest exposure. Vessels of the conjunctiva dilated; on the cornea the cicatrices of old, and some fresh open ulcers; pains, smarting, sticking and burning; intolerance of light; gushes of tears so acrimonious as to make the cheeks sore. Eyelids swollen, edges reddened, cilia adhering together with matter. Arsenic. effected a perfect cure in ten days. CASE. In a woman. Severe sticking, followed by burning pain upon every movement of the eye. Intolerance of light. Antiphlogistics, &c. had proved of no service. Bellad. did not alter the disease. Arsenic. cured it in a few days. Bellad. has been highly recommended in catarrhal, rheumatic, arthritic and scrofulous ophthalmia. 12* 180 EYE AND VISION. CASE. In a man set. 38 ann. From exposure to a draught of air. At first tearing and drawing pain over the right eye. Then, sticking, burning and pressing pain in the right eye, with intolerance of light, contracted pupil. Flow of acrimonious tears. Itching of the eyelids. Bellad. gtt. i. 30 effected a cure. CASE. Scrofulous inflammation of the eye in a girl aet. 3 ann. Eyes slightly reddened. Some of the vessels of the conjunctiva much distended. Two small superficial ulcers on the left cornea, and one on the right. Great intolerance of light and flow of tears. Bellad. gtt. i. 6 was followed by such improvement that in six days the redness and ulceration had disappeared. Some intolerance of light remained, which was removed by ignatia. CASE. In a woman et 52 ann. Pain in the forehead. Distension of the vessels of the conjunctiva. Dilated pupils. Intolerance of light. Heat and tickling sensation in the eyes. Fever. Rapid pulse. Little sleep,.owing to the pain in the eyes; and dreams upon falling asleep. Bellad. 30 was followed by increase of the headache for four hours, but afterwards by such improvement that the patient slept uninterruptedly for six hours on the following night. The disease continued afterwards to decline gradually, until it entirely disappeared. Calcis carb. This is a very valuable remedy in scrofulous ophthalmia. An instance of its beneficial operation is mentioned under fungus hematodes oculi. Chamomil. has been recommended as a useful remedy in ophthalmia, accompanying catarrhal fever. " Ophthalmia neonatarum." A case is recorded of the cure of purulent ophthalmia in a very young infant. There was swelling and redhess of the eyelids, OPHTHALMIA. 181 with copious mucous secretion, so that they could scarcely be opened. The eyes very much inflamed. The cham. was employed in the dose of 2112. Cinchona. Ophthalmia, with periodic exacerbations. In a girl of scrofulous habit, subject to ophthalmia. Eyes painful, weeping, and sensitive to strong light. Sensation as if there was sand under the lids. Conjunctiva slightly reddened. Inward pressing pain in the eyes and lids. Exacerbations at eleven o'clock at night. Cinchona gtt. i. 12 produced an aggravation of the succeeding paroxysm. The next day the eyes were well, and there was no subsequent return of the disease. Colocynth. in repeated doses, effected, in the course of eight days, the cure of an arthritic ophthalmia, in which there was burning and cutting pain in the right eye; copious discharge of acrimonious fluid from both eyes, and constant violent cephalalgia, with determination of blood to the head. Conium is a valuable remedy in scrofulous ophthalmia. It is also recommended where there is great intolerance of light, either without any or with very slight apparent inflammation of the eyes. Digitalis has been recommended in catarrhal ophthalmia. Euphrasia. Case in a child aged six months. Eyelids swollen and 'adherent; eyes inflamed; discharge of bloody mucus from the eyes. Other instances, in which euphrasia has been advantageously employed, may be seen in cases under the following remedies; arsen., merc., spigelia. Graphit. has proved useful in scrofulous ophthalmia. -Mercur. cured an ophthalmia, with ulceration of cornea, surrounded with an extensive opaque margin. 182 EYE AND VISION. It also cured an acute ophthalmia, with burning, smarting pain, worse in the open air, and a sensation as if there was a foreign body beneath the lids. The disease affected all the members of a family. CASE. In a boy ret. 7 ann. who had scrofulous enlargement of the glands in the neck. The conjunctiva of the right eye reddened in spots, with burning pain and some intolerance of light. The tarsi reddened, and a thick, honey-yellow scurf on the lower tarsus; slight adhesion in the mornings, with some slimy matter in the angles. Distended vessels passing from the external canthus towards the cornea. Mercurius gr. i. 9 produced a gradual improvement for several days. On the seventh day, a relapse, from taking cold. Tinct. euphrasia gtt. ss. brought temporary improvement, which was succeeded by a relapse, probably from cold, and the formation of a hordeolum. Digitalis gtt. i. 15. On the second day, the pain, hordeolum and morning adhesion had disappeared. Dulcamara gtt. i. 12. In five days the eruptive crust on the tarsus had entirely disappeared. No return of the disease at the end of six months. Magnesia. Case. Redness of the conjunctiva, with distension of the vessels; heat and burning in the eyes; lids swollen and red; the Meibomian glands secreted much slime, so that the lids adhered in the mornings and required frequent wiping; great intolerance of light. Tumefaction of the nose, upper lip and glands of the neck; the openings of the nose full of scurf. After a great length of time in the treatment, in which pulsat.,. bellad., bryon., mercur., aur. fol., rhus, ignatia, sulphur, carbo veg., graphit., calcis carb., phosph. and soda had been employed, OPHTHALMIA. 183 and the intolerance of light had almost ceased from opacity of the cornea, magnesia 3124, without producing any obvious homoeopathic aggravation, caused'a great improvement and considerable advance towards transparency of the cornea. In about six weeks afterwards acid. nit. 3130 was given, and produced a perfect cure, with restoration of the transparency of the cornea. Nux vom. has been recommended for catarrhal ophthalmia. Pulsatilla has proved useful in ophthalmia, attended by much weeping and mucous secretion from the Meibomian glands. Rhus cured an ophthalmia, attended with extensive cedema of the eyelids and face. Sepia has proved useful in scrofulous ophthalmia. CASE. Chronic ophthalmia, in a child set. 4 ann. Ophthalmia, with vesicles on the eye, which suppurated, opened of themselves, and left afterwards a clouded spot. Great intolerance of light. Eyelids became adherent in the night. Severe pain in the eyes. After sepia 1130 the inflammation disappeared, yet silex 1130 was afterwards exhibited for the completion of the cure. Spigelia has been recommended for arthritic and rheumatic ophthalmia. The following case is styled one of rheumatic ophthalmia, by Dr. Rummel who reports it. Ophthalmia of fourteen days' duration. The right eye was strongly reddened, the vessels of the sclerotica much distended and of a bluish red, and the cornea so clouded, especially in its lower segment, that the form of the pupil could not be clearly discerned, and every object appeared to the patient to be involved in 184 EYE AND VISION. a mist. Severe pain of the eye, especially on moving it. A feeling of heavy pressure, which extended itself to the bony parts of the orbit, especially towards the temple. Eye not very sensitive to the light, apparently because the rays cannot pass readily to the retina through the opaque cornea. Sulphur 112. In twenty-four hours no change; then spigelia gtt. i. 30 which was followed by great improvement. After forty-eight hours spigelia 2130 was given. The eye next day was free from pain, but an ecchymosis had formed in the internal angle; the opacity of the cornea as great as ever. Tinct. euphrasia undilut. gtt. i. In forty-eight hours the opacity was entirely removed. This case, previously, had been treated, in other similar but less violent attacks, with leeches, blisters, mercurials, derivatives, &c., and had generally required three or four weeks for its cure. Sulphur. Case in a man of robust constitution, who had been subject, for a long time, to frequently recurring, slight ophthalmia, which, until the last attack, had always disappeared of itself. On the last attack, therefore, the patient at first paid but little attention to it for many days, but as it gradually became worse, he called in a physician, who found, on examination, a considerable ulcer on the cornea. After the inflammation had been abated by local applications, the ulcer was moistened several times a day with the tincture of opium, and began, under this treatment, to cicatrise slowly. But after taking cold, the eye was seized with a violent inflammation. Leeches, local applications, and purgatives, containing calomel, were freely employed. Speedy, but temporary relief followed the use of the leeches, and the inflammation remained unabated. Under these I/.' / OPHTHALMIA. 185 circumstances, the attending physician called Dr. Gross to see the case. He found the left eye apparently larger than in its healthy state, and its coverings extraordinarily tumefied. The albuginea was blood red from the distension of its vessels. The cornea was clouded as if covered with fine dust, and the ulcer, which had once been nearly cicatrised, was considerably more extensive and deeper. Most violent pressing pain in the eyes, which was excessively aggravated by motion of the eyelids and by light. The pain then extended itself through the whole head, where it also became excessively severe. Sulphur gr. i. 2 was given towards evening, and "the result was favourable beyond expectation. Early in the morning of the following day we visited our patient again, and found, to our astonishment, no trace of the previous inflammation. He had laid down to sleep at his usual time, and not once through the night had- his rest been disturbed, while the preceding night had been passed almost without sleep, and under tormenting pain. He awoke in the morning strengthened and refreshed, was surprised that not a sensation of yesterday's pain remained, and scarcely believed his own perception, when, on looking in a mirror, he found the diseased eye similar to the healthy. He saw and felt himself perfectly recovered, as if through a miracle. Only the presence of the ulcer on the cornea betrayed the preceding morbid condition; but this had already assumed a more favourable appearance, and cicatrised in a few days afterwards. With this last ophthalmia disappeared at the same time all the earlier disposition to this form of disease." Scrofulous ophthalmia in a girl aot. 17 ann. The 186 EYE AND VISION. edges of the eyelids were tumid and ulcerated, the cornea deformed with spots, and, independently of these, the vision was so clouded that the patient could not see small objects, and large ones appeared enveloped in smoke and mist. The general health was also considerably impaired. Sulphur, calcis carb., silex, phosphor. and lycopodium were given in succession without any apparent result, except that after the sulphur, there appeared to be for three days some trifling amendment. "This observation led me again, after thirty weeks of ineffectual treatment, to the employment of sulphur. My patient now took tinctura sulphuris 1130 twice a week. After the eighth dose, there was a perceptible aggravation of the disease which forbade a continued employment of the remedy. Now appeared many other new affections; among others, pustular eruptions, warts, yellow spots on the skin, tetter-like scurf, here and there on the body, pains in different parts, restless sleep, &c. These continued for about eight days after the discontinuance of the remedy, when a positive improvement appeared; the new affections diminished first, and afterwards the original disorders, which were so completely conquered in the space of six weeks, that I could pronounce the patient perfectly healthy. The eyes were without spots, and the vision perfectly restored, so that the patient ventured, against my will, to try fine embroidery, which she could never before accomplish. But no bad consequence ensued, and she afterwards remained well." Dr. Julius Aegidi. LEUCOMA. FUNGUS HXEMATODES. 187 LEUCOMA. Opacity of the cornea, with existing inflammation of the eye, is best treated by the remedies which are calculated to subdue the ophthalmia. For a leucoma which remains after the removal of the inflammation, euphrasia and cannabis appear to stand highest in the estimation of homoeopathic physicians. FUNGUS H1EMATODES OCULI. The following case is reported in the seventh volume of the Archiv fur die homoeopathische Heilkunst, by Dr. Ernst Stapf, the able editor of that work.' A girl -et. 10 ann. who had suffered from her infancy under painffil tumefactions of the sub-maxillary glands, and other scrofulous affections, was attacked in the beginning of May 1827 with an ophthalmia, which very speedily produced a considerable opacity of the cornea of the left eye. Physicians and a celebrated oculist were consulted, and leeches, purgatives, derivatives, eye-waters and eye ointments of different kinds, were employed, and the directions of the physicians were followed with the greatest accuracy. But in the course of a four months' treatment the disease had continually advanced. "On the second of September she was placed under my care. I saw the girl then for the first time, and learned the circumstances which -have just been narrated, from her very intelligent mother, and found upon investigation the following form of disease. The left eye was but slightly inflamed, yet the cornea was much clouded, the pupil was elliptic, the vision very much 188 EYE AND VISION. weakened; she saw every thing as through a thick mist and with indistinct outlines. The right eye, on the contrary, was in the highest degree inflamed; the eyelids swollen, red and ulcerated; a thin, acrimonious, puroloid matter, which corroded the cheeks, together with tears, flowed constantly from the angles of the eyes. There was great intolerance of light,< the slightest ray of which increased the severe burning, sticking and boring pains in the interior of the eye. The eye-lids were firmly closed, often matted together, and itched and burned painfully. She required-the eye to be constantly covered, and when with great exertion she opened it for a few moments in the twilight she asserted that she could distinguish nothing; every thing flowed chaotically together, like dark clouds. A momentary view (which was all that could be obtained, from the closure of the lids on account of the severe intolerance of light) showed the eye chemotically reddened, and the cornea covered with ulcers and spots. The general health of the child was impaired. The body was considerably emaciated; the face bloated and pale; the appetite diminished; bowels irregular, at one time constipation, at another diarrhoea; the urine whitish; sleep restless, interrupted, full of dreams; the glands tumid and painful; the disposition depressed, peevish, irritable." As all medicinal applications had already been discontinued for some days, bellad. 1130 was given, on the second of September, and by the ninth the inflammation and intolerance of light had so far abated as to admit of an examination of the eye in the twilight. The albuginea was very red, and there were ulcers on the cornea, on the lower segment of which, "a peculiar, dark-red, tumid spot appeared, which upon close 190 EYE AND VISION. mitted by the physician. The cornea of the left eye "was entirely clear and bright. The improvement continued progressive till the middle of April, at which time both eyes were perfectly clear excepting a leucomatose cloudiness of the spot which had been the basis of the fungus. On the twentieth of this month calcis carb. 2118 was given. It was followed,by increased sensibility and weeping of the eye and painless swelling of the sub-maxillary glands. These appearances gave place after a few days to improvement, and by the middle of June the glandular swellings had nearly disappeared, the leucomatose spot was almost imperceptible, and did not impair the vision in the least degree, both eyes were clear and bright, and the previously sickly and scrofulous child was a picture of health. The following case is reported by Dr. Muhlenbein, in the same volume. A girl aet. 5 ann. complained of sticking pain in the left eye, dimness of sight, intolerance of light, at times, stitches in the head, more on the left side, also severe pain in the right leg and hip, so that her walking was interrupted; she was frequently feverish. The appetite was weak, bowels irregular, the urine frequently dark, the sleep often restless. In the first days of the disease, the child screamed on account of the severe pain in the left eye. Then a red point developed itself deep in the interior of the left eye. There was a constant and copious flow of tears from the eye; the albuginea was most reddened on the side towards the nose; the pupils were dilated, the vision of the left eye entirely lost; the iris was permeated by enlarged blood-vessels, and had thus become of a dark brown colour. The patient was CATARACTA. 191 seen by several physicians, who pronounced it a fungus hmmatodes of the eye. A good and experienced surgeon, who saw the child, confirmed this judgment, and stated that he had met, in his own practice, with five cases of the disease, and that all had terminated fatally, whether extirpation of the eye had been performed or not. Bellad. gtt. i. 26 was given, at intervals of a week, until four doses were taken. Then nux vom. gtt. i. 30, three doses in eleven days. Afterwards bellad. gtt. i. 30 was given at various intervals for nearly a year. During this time there had been a gradual abatement of the disease; nux vom. gtt. i. 30 was then given. The child could then see the light, and objects moving before it, without.being able to distinguish them with the diseased eye. It was sent to school, but sometimes whilst reading there was a return of the sticking pain in the diseased eye. Afterwards euphrasia gtt. i. Then bellad., many times repeated; then aconit.; then cinchona for an intermittent fever. The treatment occupied more than three years, the fungus had diminished to a point, 'but full vision was not restored to the eye. The child became remarkably healthy. CATARACTA. Conium has been recommended for cataracts which arise from contusion of the eye. Magnesia carb. 30 and tr. cannabis, in alternation, at intervals of eight days, and in drop doses, produced evident improvement in "cataracta capsulolenticularis" of both eyes. Phosphorus. In a case where inflammation of the eye had been induced by a fragment of flint which 192 EYE AND VISION. flew into the eye whilst striking a light.. The removal of the flint was followed by ease for some hours, when there was a return of the ophthalmia which resisted the usual antiphlogistic means for ten weeks, and produced such opacity of the cornea that the iris was invisible. In thirty days, under the use of crocus, bellad., nux vom., euphrasia, spigelia and calcis carb., the leucoma had so far diminished that the lens could be seen, presenting a colour very similar to that of a "cataracta glaucomatosa." About this time, from change of the weather and other. causes, there was an increase of the ophthalmia. Phosphor. 30 was followed by speedy relief of the pain, more normal appearance of the lens, diminution of the opacity, of the cornea, of the intolerance of light, and of the dilatation of the pupil. After the period of the operation of phosphorus had passed over, silex 3130 was given, and in a short time every innormal appearance, except a small spot on the cornea, where it had been punctured by the flint, was gone. Pulsatilla. Cataract of a light gray colour, of six months' duration. Ophthalmia of many years' standing, with inversion of the few remaining eyelashes of the upper lid, and much weeping. She could distinguish large objects at the distance of four steps. Removal of the inverted cilia produced a temporary abatement of the inflammation, but in a few days it again returned, when pulsat. gtt. i. 3 was given, and by the seventh day there was only a gray spot in the middle of the lens, and the patient saw every thing as if enveloped in a light mist. Tr. cannabis gtt. i. produced still farther improvement, and opium gtt. i. AMBLYOPIA. 193 6 completed the cure; the lens having become perfectly clear and transparent. Sulphur. Case. Incipient cataract and amaurosis. A man met. 20 had psora which was cured by external applications. He some time afterwards felt at times a tearing pain in the left eye and a slight itching of the skin. Eighteen months after he had psora, on closing the right eye to ascertain the visual power of the left, he was alarmed to find that he was entirely blind of this eye. On examination: the pupil of the /left eye was dilated and immovable, and there was a slight opacity in the middle of the lens. The eyelids and conjunctiva were somewhat reddened. The vision was almost entirely lost; only when the hand was held close before the eye he could dimly and indistinctly distinguish the fingers. After sulphur 216 an eruption occurred on the face and arms; and at the same time there was an improvement of the vision. The sulphur was repeated at various intervals for nearly two months, when the skin was clean, the eyes clear and bright, and the vision restored. In the case of a woman aet. 60 ann.; sulphur 30 followed in two weeks by tr. acris cured a "tolerably far advanced cataract." AMBLYOPIA. Depraved vision. Diplopia. Double vision. In a man et. 30 ann. of robust constitution and otherwise healthy. The complaint of four weeks' duration. In the clear daylight he saw every thing as if through a mist, and objects frequently appeared doubled. Dark spots frequently floated before the right eye. In the morn13 194 EYE AND VISION. ing and evening twilight, he could see nothing with the right eye, which exhibited no other abnormal appearance than that it was duller than the left, and its pupil constantly somewhat dilated. Bellad. gtt. i. 15 effected considerable improvement in the course of twelve days. At the expiration of this time, pulsat. gtt. i. 12 was given, and at the end of eight days there was no trace of the disease. In a woman ret. 52 ann. The disease, which was of between three and four years' duration, had commenced at the period of the cessation of menstruation. Sometimes double vision, and a play of colours and mistiness before the eyes, in which were sticking pains. Great dimness of sight. In a dull light there was slow but very great dilatation of the pupils. Bellad. 2130, repeated after seven days, restored her sight in the course of two weeks. In a case of double vision, where, in attempting to read, the letters appeared to turn, and had an iridescent halo around them, a similar halo appearing around the flame of a candle. Intolerance of light; sometimes burning in the eyes; dilated pupils; pain in the forehead immediately over the orbits. Cicuta effected a cure. Dr. Schubert states that repeated experience has taught him that the hyosciamus nig. is a valuable remedy in double vision and strabismus. He considers the latter affection to be a consequence of the diplopia. Marmaryge. Bright coruscations before the eyes. In a case complicated with dyspepsia. On closing the eyes, an appearance of sparks of fire before the eyes. The pupils were dilated. The patient saw every thing as if through a thick mist The flame of AMAUROSIS. 195 a candle appeared very large, and surrounded by a bluish red halo. Belladonna removed most of the symptoms, and the cure was completed with nux vom. In a man et. 50 ann. Appearance of fiery circles and balls before the eyes, with almost complete blindness of the left, and diminished vision of the right eye; copious flow of tears from both eyes. The cornea of the left eye was dull and clouded, and the pupil of a whitish gray. The disorder of vision had been preceded by inflammation of the eyes. Pulsat. 3 effected great improvement in the course of ten days. Euphrasia gtt. i. completed the cure. In a case where this symptom (marmaryge) was present, spigelia effected a cure. See ophthalmodynia. AMAUROSIS. Belladonna has been recommended for incipient amaurosis, especially where the disease appears suddenly, or after inflammation of the eyes; and the patients still see objects, but always as if enveloped in a dark mist, and, at the same time, black or many coloured points or spots float before the eyes. Cinchona. In the case of a man et. 50 ann., who was an intemperate brandy drinker. At the distance of a few steps he could perceive only the outlines of objects. A printed page appeared to him as a black surface with white borders. Pupils dilated; very little contraction produced by sudden and strong light: The interior of the eye appeared smoky. He saw somewhat better in the morning than some hours later. Complicated with debility, dyspepsia and disturbed sleep. Tr. cinch. gtt. i. 1, repeated after two 13* 196 EYE AND VISION. weeks in the dose of gtt. i. 2, effected, in four weeks, a perfect cure. Merc. Incipient amaurosis. In a woman et. 30 ann. Dimness of sight; pain in the eyes; intolerance of light; temporary blindness. Almost constantly before the right, and sometimes before the left eye, black spots, like flies moving about. Sometimes a cloud before the eyes. Constant weeping. Merc. gr. i. 12 effected, in two weeks, a removal of the whole disease, with the exception of the troublesome flow of tears, which yielded in a short time to tr. euphrasia gtt. i. The disease had been advancing for a year. Phosphorus. Incipient amaurosis. In a boy aet. 9 ann. Almost perfect inability to read, even when a book was held close to the eyes, in clear daylight, and as little ability to distinguish other objects. Improvement commenced within a few days after the administration of phosphorus 10; and continued progressive until vision was perfectly restored. Ruta. Incipient amaurosis. In a linen-weaver aet. 29 ann. Diminished power of vision. He could see the threads in the web but indistinctly, and could no longer read. In viewing near objects there was a mistiness before the eyes, which thickened into a perfect cloudiness when he endeavoured to look at more remote objects. The disease had been severe for only a week. Tr. ruta gtt. i. was given, and improvement soon took place. In the course of sixteen days the vision was perfectly restored. Sulphur. Incipient amaurosis. In a woman at. 48 ann. The disease had commenced with severe tearing pain in the left forehead. Afterwards it appeared to her as if small fibres depended from the AMAUROSIS. 197 upper eyelids. At a still later period the eyes had become painful and constantly clouded, and she was only able to distinguish large objects. The conjunctiva was slightly reddened. In ten days after tr. sulphur gtt. i., the disease was almost entirely removed. A case of almost perfect amaurosis of one eye, complicated with incipient cataract, was cured by repeated doses of sulphur. See Cataract. In that form of amaurosis in which the blindness appears every evening, continues throughout the night, and disappears in the morning, and to which the name of hemeralopia has been applied, bellad., hyosc., pulsat., and verat. have been found useful. Four cases are recorded, in each of which a single dose of belladonna perfectly removed the disease. It was employed in the third, sixth and ninth dilutions; the sixth being used in two of the cases. The following symptoms were present. In the daytime, even when it was cloudy, perfectly good vision. After sunset, almost perfect blindness; and the flame of a candle appeared only like an irised circle. All the other functions normal. The pulsatilla was useful in a case where there was deficient menstruation, and the hemeralopia was accompanied by a sensation as if the eyes were firmly bound by a handkerchief. The veratrum was usefiul in the case of a boy set. 10 ann. The hemeralopia was combined with diarrhoea, which was troublesome at night. Many other remedies had been previously employed without success. 198 EYELIDS. EYELIDS. Paralytic weakness and consequent hanging down of the upper lids. Sepia, spigelia, veratrum, zincum. Spasmodic closure of the eyelids. Hyosciamus, chamomilla. Painful cramp of the eyelids, worse at night. Crocus. Psorophthalmia. Arsenicum, belladonna, bryonia, dulcamara, spigelia, staphysagria, sulphur. Hordeolum. Pulsatilla. Staphysagria is useful where there are tubercles on the margins of the eyelids, and an inflammatory condition of the Meibomian glands, which causes adhesion of the lids at night. FEBRIS. Fevers will be here treated under two heads. Under the first, the continued and remittent fevers; and under the second the intermittent fevers. FEBRES CONTINU1E ET REMITTENTES. In applying to fevers the specific terms, bilious, typhus &c., I do not wish to be considered as viewing them as expressive of certain determinate diseases, or as calculated to guide with accuracy to the proper treatment. Each of these terms is applied to fevers of widely different origin, and which present a great diversity of symptoms, and require very different FEBRIS. 199 remedies. But since they express (though rather vaguely) certain general symptoms or circumstances of disease, they may be employed as guides to those remedies which have proved useful where these symptoms or circumstances have been present; from among which remedies the one adapted to the other symptoms of the individual case may be selected. It is to be regretted that the present classifications of fevers are so imperfect, that they can aid but little in the selection of the appropriate remedies; and it is much to be desired that careful and observant physicians would publish their accurately recorded cases of fever, in order that the means may be afforded for a more satisfactory classification, the difficulty of selecting the remedies lessened, and the certainty of cure increased. Febris biliosa. Aconit., antim. crud., et tart., arsen., asarum, aurum, bellad., bryon., cham., cinch., coccul., digital., ignat., ipecac., mere., nux v., pulsat., scilla, staphysag., sulphur, tarax., verat. F. catarrhalis. See catarrhus. F. inflammatoria. Aconit., bellad., bryon., nux vom. F. nervosa. Acon., ac. mur., ac. phos., arnica, bell., bryon., cinch., coccul., hyosc., nux vom., opium, puls., rhus, sulph., zinc. F. puerperalis. Acon., arnica, arsen., bell., bryon., cham., hyosc., ipec., mere., nux vom., plat., puls., rhus. F. putrida. Ac. phosph., ac. mur., arsen., bell., cinch., hyos., ipec., nux vom., opium, rhus. F. typhus. Acon., ac. phosph., arsen., bellad., bryon., cham., cinch., coccul., conium, cuprum, digit., hell. nig., ipec., ignat., mere., nux vom., opium, pulsat., rhus, sulph., stram., verat. FEBRIS. 201 This remedy is considered by some practitioners to act best in the lower dilutions. That it acts well in those dilutions is proved by both the above cases. It is frequently adapted to typhus fever when there is diarrhoea, foulness of the mouth, great debility and stupid insensibility' It has also proved useful where there was slight muttering; picking the bed-clothes; harsh, dry, burning hot skin, and dry tofigue. Aconitu9n. In inflammatory fevers, especially when they are accompanied by local inflammation, aconit. is the remedy which should generally be first exhibited. It frequently effects a removal of the disease; and where it fails to do this, it generally moderates the fever, and appears to place the system in a better condition for the operation of the remedy which is adapted to the local affections or other symptoins of the case. Hartmann considers it sometimes necessary to repeat this medicine at intervals of six, eight or ten hours, and recommends a dose of a higher dilution, when the preceding dose has much diminished, without entirely overcoming the fever; and of a lower dilution when the fever, after some hours, shows no diminution. Hahnemann remarks that in inflammatory fevers, "after twelve or sixteen hours' operation of the aconit., a homoeopathic remedy for the remaining symptoms is often necessary, and that after this, there will seldom be occasion for a repetition of the aconit." This remedy has been sometimes advantageously employed in the treatment of puerperal fever. Antimoniumn. Both the ant. crud. and tart. are sometimes indicated in bilious fevers where there. is vomiting and diarrhcea, combined with cutting pains in the abdomen. The ant. crud. sometimes cures FEBRIS. 203 In puerperal fever it is often a valuable remedy, as may be understood from the following case. A woman aet. 36 ann. was suddenly attacked, after violent mental agitation, on the sixth day after parturition, in the following manner. Severe chill through the back and extremities, with great heat and redness of the face; the abdomen was somewhat tumid, and excessively painful on the slightest touch; pains, resembling labour pains, every quarter or half hour, with pressing down towards the vulva and anus, and every time a discharge of fetid black blood in lumps. Fever, which gradually increased in violence, but was attended by coldness of some parts, particularly of the extremities; burning heat and redness of others, especially of the head, and partial sweat of the warmly covered parts. Violent pain in the forehead, increased beyond endurance by motion or speaking. Distressing sensation of dryness in the mouth, with tolerably clean, high red, yet entirely moist, tongue, on which the papillae were remarkably prominent. Only moderate thirst, swallowing rendered somewhat difficult by stricture of the oesophagus. Frequent small diarrhceal stools, and frequent discharge of small quantities of straw-yellow urine. Shattering cough, with rattling in the trachea, which excited the severest pain in the abdomen, increased discharge of blood, and sometimes involuntary urination. Short, quick, noisy respiration, with evident constriction of the chest. Delirium of the wildest kind. Sleeplessness, anxiety, tossing about. The first eight hours she saw every thing doubled, and of an immoderate lustre. At the end of this time, every thing appeared bright red; after some hours more, purple; and still later, an amaurotic condition of the eyes supervened 204 FEBRIS. and she complained of being in a perfectly dark place, though the apartment was well lighted. The pupils were widely dilated. In this condition she was found by the physician. No medicinal treatment had been resorted to; all other proper attention and care had been bestowed on the patient. He administered bellad. 24, and in half an hour afterwards the patient fell into a soft sleep, out of which she awakened, at the end of two hours, much improved, and in the course of sixteen or eighteen hours she was well, with the exception of some debility. Bellad. is also useful in bilious fevers, where they are accompanied by inflammatory affections of the fauces, or roseolous or erysipelatous eruptions. F. typhus gravior. Case of a lad after three weeks' treatment with medicines in large doses. No sleep. Raves (phantisirt) with closed eyes; either answers no questions, or answers them improperly or hastily, and with few words. Respiration quick. Pulse sixty to seventy in the minute, and weak. Tongue dry, gray in the middle, and of a dirty yellow on the sides. Lips dry, and covered with brown crusts. Speech somewhat lisping. Face pale, sunken, and covered with cold sweat. No appetite. Constipation. Urine bright yellow. Before urination, moaning. Hands dry as parchment. Bellad. gtt. i. 30 with rapid improvement. Bryonia is an important remedy in the treatment of fevers which are accompanied by much hepatic or gastric derangement, especially when the latter is marked by those peculiarities which, when they are present in dyspepsia, furnish indications for the employment of bryonia in the treatment of that disease. FEBRIS. 205 And when pain at the epigastrium, which is much increased by every movement and by pressure, is so severe as to induce the suspicion that inflammatory action is developed in the stomach, forming an acute gastritis, in which disease bryonia is often useful. And in cases where such fevers are accompanied by sticking pains in the joints, arising after or aggravated by every movement. It is a valuable remedy in puerperal fever, and is indicated "where the disposition is dull and depressed, and there is sticking pain in the region of either of the ovaries, increased by the slightest pressure or motion, with painfulness of the thigh on the affected side, especially on motion." It is useful in some forms of bilious fever, and has proved strikingly so in that complication of hepatic and gastric derangement with inflammation of the lungs which has been termed pneumonia biliosa. CASE. In a woman ret. 44 ann. Severe headache. Vertigo on sitting up. Head burning hot; face red and tumid. Tongue with a dirty coating. Taste bitter; constant severe thirst. Vomiting at first of bile, afterwards of a bitter water, of disagreeable odour. The vomiting causes great pain in the left side, where severe stitches were produced by every inspiration, and by coughing. Constipation. Violent palpitation of the heart. Sticking pain in the limbs. Hands swollen. Increased heat of the skin. Pulse rapid, full and hard. Every trifle vexes her. She believes she must die, and desires only to be freed from the painful vomiting. Bryonia gtt. i. 12 with speedy and rapid improvement. Chamomilla. F. arising from vexation or anger, or vexation and fright. 206 FEBRIS. In bilious fevers, especially when arising from the above causes. It is indicated where there are heat of the face and eyes, with prominent redness of one cheek; dry lips and continual thirst; cotemporaneous coldness of the limbs; vertigo, with pain in one side of the head, or a pressing heaviness in the forehead; bitter, bilious taste in the mouth, which is communicated to the food; nausea, and even vomiting, the ejected matter bitter; yellow, slimy coated tongue, the coating generally woolly, thick, and more yellow towards the root of the tongue; eyes red, lids swollen, and adhering together in the morning; appetite very trifling, often entirely gone; distension of the abdomen, especially in the hypochondria, with a sensation as if it was too full, and pressed up towards the breast, causing not only discomfort, but a feeling of anxiety; pressing in the stomach, colic pains, and watery stools; restlessness, peevishness, irritability; sleep interrupted by starting, tossing about, and attacks of anxiety. Depression of spirits; heaviness and fatigued feeling of the limbs. Chamomill4 afforded speedy relief in a puerperal fever, where there was great restlessness and nervous excitability; suppression of the secretion of milk in the breast; diarrhcea, with white stools; immoderate lochia, with pains in the back resembling labour pains; headache, and oppression of the breast. Cinchona. F. Case in a weakly woman et. 65 ann. Disease of four days' duration, presenting the following symptoms. Confusion of the head; vertigo on sitting up in bed. Sleep light, restless and unrefreshing. Yellow colour of the skin and eyes. Loss of appetite. Bitter taste. Bitter eructation. Nausea. Yellow coated tongue. FEBRIS. 207 Slight thirst. Fulness and pressing in the epigastrium. Tightness of the breast. Diarrhoea; stools white. Urine dark-red. Great debility. Sorrowful and peevish. Cinch. gtt. i. 12 with great improvement. A few remaining symptoms, and among these constipation, were removed by bryonia. F. From the valuable properties of cinchona in the cure of intermittent fever, arising from exposure to marsh miasmata, it is worthy of attention in the remittent fevers, which spring from the same source. In a form of fever, intermediate between a remittent and quotidian intermittent, caused by exposure to the marsh miasmata of a southern port, but first developed on the arrival of the patient in this city, (a very common circumstance with whole crews in the latter part of summer,) cinchona, in the dose of one fiftieth of a grain, effected very great improvement. J. F. nervosa vel typhus. Loss of appetite; great thirst; clayey taste; tongue and lips black and chapped; yellow, watery diarrhoea; cough, with expectoration of mucus; sleep quiet but unrefreshing. Cocculus. F. Case after vexation. Chamomilla had been previously employed. Pain in the head and teeth. Rushing in the ears. Yellow-coated tongue. Dryness of the mouth without thirst. Disposition to vomit, with eructation of disagreeable odour. 'Disgust to food. Painful fulness of stomach, with difficulty of respiration. Stitches in the region of the liver, between the scapulm, and in the loins. Nipping pain in the abdomen. Soft yellow stools, creating a sensation of burning at the anus. Great debility. Numbness of the hands. Redness of the face. Burning in the feet. Skin hot, with constant chilliness. Anxiety and fear of death. 208 FEBRIS. F. CASE. Severe pressing headache, especially in the forehead. Dimness of sight. By every movement vertigo, and a sensation as if the eyes were drawn out of the head. Nausea. Slight appetite. Much thirst. Burning in the breast and throat, with sulphurous taste and dryness of the mouth. Constipation. Trembling of the whole body. Little sleep. Anxiety. Sweat on the slightest motion. Nux v. had been previously administered without the least advantage. After cocc. gtt. i. 12 the improvement was immediate, and the recovery rapid. Coffea has been recommended for puerperal fever, accompanied by preternatural excitability of the nervous system. Colocynthis. F. puerperalis. Case. -After vexation. Head hot. Face and eyes red. Yellow-coated tongue. Pulse full, hard and quick. Skin hot and dry. Abdomen painful on being touched. Constipation. Cessation of the lochia. Delirium, alternating with sleep with half open eyes. After colocynth. 2|30 rapid recovery. Digitalis. F. with constant nausea, frequent vomiting, great bitterness in the mouth. Diarrhoea. Loss of appetite. Thirst. Vertigo. Pain over the eyes. Little sleep at night. Anxiety. After digit. gtt. i. 15 the recovery was rapid. Hyosciamus is indicated in typhus fever by the following symptoms. Lively delirium, with various phantasies. Over-liveliness and complete sleeplessness. Restlessness. Trembling of the hands on motion. Twitching of single muscles or of the whole limb. Picking at the bed-clothes. Inclination to spring out of bed. Heat and redness of the face. Eyes red, staring and sparkling, with alternately FEBRIS. 209 dilated and contracted pupils. Puroloid matter on the edges, and in the angles of the eyelids. Rushing or ringing in the ears. Dysecoea. Tongue dry, harsh, and with a brown coating. This remedy has proved serviceable in some forms of puerperal fever. Ipecacuanha. F. Headache, particularly in the forehead. Pale, sallow countenance. Dry lips. Thick, slimy, dirty-yellow coating on the tongue. Fetor of the mouth. Eructation, nausea, vomiting of the ingesta, with much retching. Bitter taste; every thing tastes bitter. No appetite. Much thirst. Pain, Spressing and sense of fulness in the stomach. - Cutting pain in the abdomen, increased by pressure. Putrid, fetid stools, preceded by cutting pain in the abdomen. Cannot sleep on account of heat and thirst. Pulse small, hard and intermitting. Lycopodium. F. typhus. Where the patient is quarrelsome upon awaking out of sleep, and exhibits much ill nature, and the bowels are constipated. Mercurius. F. typhus. Where there is vertigo. Fulness and.confusion of the head. Incapability of thinking. Severe pressing pain in the head, especially in the forehead and top of the head. Rushing in the ears. Thick, dirty-yellow, slimy coating of the tongue. Disgusting, putrid, slimy taste. Nausea, retching; vomiting of bitter mucus. Great sensibility of, and painfulness in the epigastrium and about the umbilicus. Burning heat of the skin. Yellow, diarrhoeal stools. Or where there is putrid, bitter taste, with clean tongue. Great sensibility of the epigastrium, pain and tumefaction in.the region of the liver; pain increased by pressure. Constipation. 14 210 FEBRIS. Or where there is bleeding of the gums, very dark urine, and frequent greenish-yellow stools. Nux vomica. F. synocha. Nux vom. is sometimes indicated in inflammatory fever after one or more doses of aconit. F. case. Vertigo. Pressing pain in the forehead. Dulness of the eyes with yellowness of the whites. Dark yellow coating of the tongue.. Bitter acid odour of the mouth., Eructation of a bitter, acrimonious, yellow fluid. Cough, with retching to vomit. Dislike for food. Much thirst. Burning sensation in the oesophagus. Attacks of violent pain in the right side of the chest with difficult respiration. Constant pressing in the regions of the liver and stomach, which are much tumefied. Burning pain in the umbilical region. Ineffective pressure to stool. Much dark yellow urine. Soreness as from great fatigue in the limbs. Sleepiness. Awaking in fright out of anxious dreams. Biting heat of the. skin. Small, contracted pulse. F. in consequence of great heat of the weather and exertion. Frequent chilliness. Much heat. Considerable thirst. Disinclination for food. Bitter or putrid taste, especially in the morning. Tongue white, or white and moist in front, and yellow and dry towards the root. Loss of appetite. Constant nausea. Eructation bitter, or of the taste of the ingesta. Vomiting of the ingesta. Pressing in the epigastrium. Small watery or slimy stools, the latter with soreness of the rectum. In some cases constipation. General relaxation and debility of mind and body. Depression of spirits. Little sleep, or sleep interrupted by anxious dreams. The headache mostly in the forehead, though in some cases a pressing FEBRIS. 211 pain through the whole head, or in the back of the head, accompanied by vertigo and confusion. In some cases great heat and redness of the face, with coldness and chilliness of the rest of the body. F. typhus. In the forming stages, or even after its complete developement. F. puerperalis. Case. Disease commenced on the third day after parturition and after purgative and diaphoretic treatment. On the ninth day after parturition it presented the following.symptoms. Severe burning pain through the whole abdomen, increased by motion or touch, even by the weight of light bed-clothes. The abdomen very hot. Frequently, a burning, cutting in the umbilical region, which compelled bending of the body, and generally accompanied by eructation. Nausea, and vomiting. No stool for three days. Suppression of the lochia. Urine small in quantity. Skin dry, like parchment, and burning hot. Thirst moderate, and mostly for cold drinks. Pulse full and hard. Face red. Tongue and lips. dry, the former with a dirty-yellow coating towards its root. The mammae painfully distended: yet the child sucked with satisfaction. Short, dry cough increasing the pains. Countenance expressive of great anxiety. Constant restlessness. Very shortly after the administration of nux v. gtt. i. 30, and an enema of lukewarm milk, the patient fell into a refreshing sleep, which lasted for two hours, and out of which she awoke almost well. The injection had remained with her during the whole time, and soon after waking she had a normal stool. In two days she was entirely well. Pulsatilla. F. from wet clothes. Vertigo. Eyelids inflamed, swollen, and secreting much puro14* 212 FEBRIS. loid matter. Bitter taste. Vomiting of, bile and mucus. Diarrhcea, with thin mucous stools. Before vomiting, tearing pains in the abdomen. Constant chilliness. Stitches in the right ear. Febrile heat and red tumid face. But slight thirst. Laying as if insensible, with the eyes directed constantly on the same object. Debility. Aconit. 2124 and after twelve hours, pulsat. 2115. The first day some return of appetite; the most of the second day out of bed; the third day at work. F. from eating pork. Eructation. Vomiting. Rumbling in the abdomen. Epigastrium painful on pressure. Fever. Restless sleep. Debility. F. In a child aged eighteen months. Eructation. Loss of appetite. Dulness of the eyes. Changing redness of the cheeks. Full pulse. Exacerbation in the evening. Pulsat. gtt. i. 12. Well in ten hours. F. typhus. Pulsat. 18 was employed with advantage. It was given whenever weeping and wringing the hands occurred. F. puerperalis. When the countenance of the patient is expressive of her mental and corporeal sufferings, the disposition is mild, and there is over excitability of the nervous system. Sudden suppression of the lochia with a feeling of fulness and burning in the internal organs of generation. Paroxysms of heat with anxiety. Nocturnal anxiety. Palpitation of heart and sleeplessness. Under these circumstances severe thirst does not counter-indicate this remedy, provided there is diarrhoea with copious discharges. In cases where the lochia are suddenly suppressed by violent mental emotions, or by taking cold, pulsat. will frequently be the proper remedy to prevent the formation of a puerperal fever. FEBRIS. 213 Rhus. F. typhus. Hahnemann mentions in his introduction to rhus, that this remedy, in alternation with bryonia, cured a typhus, which ravaged those countries of Europe which were most visited by the war in 1813, 'and that of one hundred and eightythree patients with this disease, under his care in Leipzig, not one died; while thousands " were allowed to go home to their fathers" under the ordinary modes of treatment. F. typhus. Case. Vertigo on movement. Severe headache, as if the brain would press out. Incapability of thinking clearly. Eyes very sensitive. Roaring' in the ears, with dyseccea. Sensation of dryness in the mouth. Great thirst. Tongue brown and dry. Loss of appetite. Constipation, with ineffectual pressure to stool. Urine dark coloured and hot. Tightness of chest. Little sleep, frequently interrupted by dreams. Patient spoke much of fire, was very anxious and fearful, and would frequently endeavour to spring out of bed. Pulse rapid, small and unequal. Bryonia without improvement. Rhus 30. In three hours striking remission, and in four days able to go out. F. typhus. In the typhus fever which sometimes succeeds the Asiatic cholera, rhus has been found a most valuable remedy.. F. puerperalis. When with irritability of the nervous system, a slight vexation aggravates the disease, and after the lochia have become colourless, they suddenly become bloody, even to such an extent as to be coagulated. - Stramonium. F. typhus. With anxious delirium, and deceptions of sight and hearing. Or where there is continual delirium, the patient at one time singing 214 FEBRIS. or whistling, at another, talking as if with persons who are absent. At other times, disposed to spring out of bed, in order to run away or to go to his employment. F. typhus. Case. After several days' treatment with calomel in large doses, vesicatories to the neck, leeches, &c. Patient could neither see nor hear. Pupils widely dilated, eyes insensible to strong light. Patient would utter a few words interruptedly. After twenty-four hours' discontinuance of all medicines, his condition was unchanged, except that suppression of urine was added to his other symptoms, and he would sometimes lay, for a short time, in a soporose condition, with loud stertor and open mouth. True sleep he had not. Stramon. gtt. i. 3. Shortly after taking it, he fell asleep: slept for two hours, awakened sensible, and could see, hear and speak, though indistinctly. Rapid improvement followed. FEBRES INTERMITTENTES. The selection of the proper remedy for every case of intermittent fever is very difficult, and much experience is requisite to the attainment of tolerable certainty. This, according to Dr. Hartlaub, is best attained by a close study of what he terms "the opposite relations of the constituents of the intermittent. paroxysm, i. e. of the chill, of the. heat, and of the thirst; the sweat being of less importance." The meaning of this expression can best be understood by reference to arsen., capsic., carbo veg., cina, cinchona, ignat., ipecac., nux v., pulsat., sabadill., verat., under each of which are described the forms of intermittent fevers adapted to it. The indications, which he con FEBRIS. 215 siders to be of the next importance, are those furnished by the other symptoms which accompany the paroxysm, and those which are present in the apyrexia. "The latter," says Hartlaub, "according to my experience, play a very subordinate part, especially when they are. chronic disorders, which, though they may be of great importance in themselves, are not so great in relation to the fever; for this can be cured and these previous disorders still continue. When, indeed, as frequently happens, the symptoms which first appear with the fever, and accompany the paroxysm, continue through the apyrexia, they demand much greater attention, and necessarily so, when the paroxysm is not peculiarly marked, as in the simplest form of intermittent fever, which consists in chill without thirst, heat with thirst, and sweat. "It is very surprising, that in a disease which appears under so many forms, the type should appear to be of no particular importance in the treatment. With all the medicines which I have employed, I have cured quotidians and tertians; -with many of them also quartans; only I have found arsenic, more frequently preferable in quartans, and pulsat. in quotidians. Yet whenever the symptoms have been sufficiently characteristic to determine the indication, I have been guided by these, without any reference to the type, and in this way I have succeeded well. "As to the importance of the time of day at which the access of the fever occurs, I have had no certain experience, because most of the intermittents, which I have treated, have had more or less of an anticipating type, and also the time of access always changed. It is, indeed, very probable, that the observation of 216 FEBRIS. the time of day may be of use in the selection of remedies in many cases. Of the dose.-Hartlaub gives from one to five, at the highest,.ten pellets of 30. Only of ipecac. he has frequently given gtt. i. 3, in relapses after cinchona, with success. Other practitioners speak favourably of the employment of some of the remedies in the lower dilutions. Respecting the time of administering the remedy.Hartlaub adopts and confirms the view of Hahnemann, that the medicine should be given immediately after the cessation of the paroxysm; he says, that he "has never allowed the medicine to be taken immediately before the paroxysm, and where it has, at times, happened, through the forwardness of the patient, he had almost always seen a violent paroxysm to ensue." But he admits that medicines, given as long as six hours before the expected paroxysm, frequently operate satisfactorily. A rule supported by men of such close observation and great experience, is entitled to the highest respect, yet it may be proper to remark, that medicines given just before the time of the expected paroxysm, have at once arrested the disease. In one case I have even seen the remedy administered during the paroxysm with highly satisfactory results. Of the number and repetition of doses.-It is scarcely necessary to remark, that in the homceopathic treatment of intermittent fever, a single dose is given. It. has, indeed, been recommended by an anonymous writer, to give four doses of ipecac. in the apyrexia, FEBRIS. 217 at longer or shorter intervals, according to the length or shortness of the intermission, and to administer a dose of nux vom. in the next apyrexia. But this plan of treatment partakes of the character of rude empiricism, and though it may sometimes succeed, yet it must more frequently fail, and cannot present the same approximation to certainty of success, as a treatment based upon the close adaptation of the remedy to the case. Though, for these reasons, not disposed to recommend, I have still considered it proper to mention this practice, as the writer who proposes it asserts that it has proved very successful, and as the repetition and succession of remedies are subjects which demand the close observation and investigation of homoeopathic physicians. But where the disease is so far subdued by a remedy, that it is absent for seven or nine days, and then returns in a lighter form and with the same character, a repetition of the medicine is proper. According to Hartlaub, in such cases the same remedy, once or twice repeated, "conquers the disease quickly and for ever.", He also considers it proper to repeat the remedy once experimentally, in those cases, where, after its administration, the character of the disease is changed, but still not essentially altered, and the chill, heat and thirst are more moderate than before, especially when it has been chosen with full conviction of its adaptation, and no other remedy is known which promises more certain success. Of the process of curee.-After the administration of the homoeopathic remedy, the paroxysms may at once cease to return, and this sometimes happens even in inveterate cases of from six to eighteen 218 FEBRIS. months' duration. Or a much weaker paroxysm, a mere shadow of the preceding, may appear, and then no more; and this happens most frequently. Or, as less frequently happens, the fever ceases after two, three or four paroxysms, each weaker than the preceding. Or a paroxysm more severe than any of the preceding occurs, and after this' no other; but this is not of frequent occurrence. Or finally, as sometimes happens in fevers of some considerable duration, there is no appearance of the disease for seven, nine or more days, and then very slight, regular paroxysms of the same or nearly the same character. Of the time during which we should wait for the operation of the medicine.-It is the opinion of Hartlaub, that this should be only sufficient to ascertain the effects of a remedy, and whether a cure has been effected. The length of time necessary for this purpose can be inferred from whatý is said in the preceding paragraph in relation to the process of cure. Of relapses. These sometimes happen, but far less frequently than under the ordinary mode of treatment, and, the patients usually enjoy good health in the interval, which is seldom the case after the suppression of intermittents by large doses of cmnchona or quinine. In the preceding remarks, as also in the following pages, I have drawn largely on the treatise of Hartlaub, because this is the best which I have met with on intermittent fevers, and his statements appear to be the result of close observation and extensive experience. Chill without, and subsequent heat, with thirst, .~,. FEBRIS. 219 indicate nux vom., cina, ipecac., sodc mur., carbo veg. and cinchona. Chill and subsequent heat, both with thirst: capsic., sode mur., nux vom., cinch., bryonia. Chill and subsequent heat, both with little thirst: pulsat., arsen., sabad., sodce mur. Chill and subsequent heat, without thirst: ignat., carb v., capsic. Coldness and heat in alternation: nux vom., lobel. inf. Chill and heat intermixed: sabad. Heat, with coldness of some parts: nux vom., cinch., ignat. Heat, antecedent to the chill: capsic. Chill and subsequent sweat: verat., thuya. Chill remarkably weak: arsen., cham. Heat and subsequent sweat: cinch. Chill alone: verat., sodce mur., arnica. Heat alone: valerian. Heat burning: arsen., bryon., pulsat. Chilliness in the heat, or sweat on motion: nux vom., rhus. Chill increased by drinking: nux vom. Cold sweat following the heat:' capsic., verat. Thirst before the chill: nux vom., cinch., capsic., arnica. Thirst, in the chill: capsic., ignat., carbo v., sodc mur., nux vom., thuya, rhus, bryon., cina, verat., cinch., lob. inf.,ferri acet., mezereum. Thirst, only between the chill and heat: cinch., pulsat. Thirst, throughout the paroxysm: nux vom., arsen., lob. inf. Thirst continues in the apyrexia: sodce mur., cinch., nux vom. 220 FEBRIS. Aconitum. F. i. Quartana. F. i. Case cured by four doses of aconit., given in the apyrexia. Severe chill, succeeded by dry, glowing heat, with great anxiety and oppression.. F. i. Case where the paroxysms observed no regular period; cured by aconit. 2124. Slight chilliness, succeeded by heat, with hot, red cheeks, headache and loss of appetite. F. i. quartana cured by two doses of aconit. 2124. In the evening, chill, succeeded by heat of ten hours' duration. Antimonium crud. F. i. where with but little thirst there is a heavily coated tongue, bitter taste, with eructation and loss of appetite. Aranea diad. in the first, second and third dilutions, has many times cured intermittent fevers. Arnica. F. i. where before the chill there is great thirst, with much drinking. In the heat, thirst, with moderate drinking. Arsenicum. F. i. Tertiana, quartana, quotidiana. Morning and evening fevers. Frequently in relapses after cinchona, and in anticipating type. F. i. Chill without thirst; then heat with thirst, and then sweat. F. i. Chill and heat, both without thirst. * ACCOMPANYING DISORDERS. Before the chill.-Vertigo, syncope, benumbing headache, severe stitches in the left side of the-breast. Drawing here and there in the abdomen and back; yawning and stretching. FEBRIS. 221 In the chill.-Anxiety; headache; flying, stitches in the head and bones of the limbs; drawing, tearing pains in the head and arms; nausea, or vomiting of bilious matter; coldness in the abdomen; oppression at the breast; pressing in the loins and epigastrium, and disordered respiration; pains in the back and limbs; gaping and stretching. Between the chill and heat.-Debility and sleep. In the heat.-Delirium; confusion and heaviness of the head headache; anxiety; vertigo on rising up; sallow, bloated face; bitter taste; tongue white and dry; nausea; pressing pain in the region of the liver; left hypochondrium hard and painful on pressure; fulness and tension of the upper part of the abdomen; pressing and burning in the epigastrium, extending into the left hypochondrium; hard, distended abdomen; oppression of the breast; severe stitches in the left side of the breast: redness of the skin. After the paroxysm. Pressing pain in the forehead. Sleep with frightful dreams. In the apyrexia. Anxiety, excitability, fretfulness; vertigo; confusion; pressing and beating pain in the forehead; paleness of the face; dry, slimy mouth; white coated tongue; no appetite; much thirst; eructation after eating; nausea; pressing in the stomach; tension and distension of the hypochondria; distended abdomen. Stretching and cutting pain in the abdomen; undigested matters in the stools; oppression of the breast in the free air; drawing, sticking, stretching pain in the breast and spine; pain in the back; drawing, tearing pains in the arms and head; great debility; cold, clammy sweat. Belladonna. F. i. Quotidiana, tertiana, quartana. 222 FEBRIS. F. i. quotidiana, with violent headache, and vertigo; redness of the eyes; nausea; vomiting; constipation; shaking chill or mere shivering; without subsequent great heat. F. i. Case. Great thirst and headache; trembling chill; heat, with mental wandering, and little sweat. F. i. tertiana, with great thirst and toothache. F. i. quartana, with cotemporaneous swelling of the glands of the throat. Bryonia. F. i. Tertiana. Quotidiana. F. i. tertiana, attacking in the morning. Chill preceded by vertigo, with pressing in the head, accompanied by stretching and drawing in the limbs, much thirst and disgust for food, Heat first alternating with chill, then burning, with unquenchable thirst, and then profuse sweat. With the fever there entered an irritating, dry cough, with stitches in, and tightness of the breast, increased by motion. F. i. tertiana, with headache, gastric disorder, rheumatic pains, increased by motion, and inclination to costiveness. F. i. quotidiana. Every afternoon a severe shaking chill for many hours, attended by intolerable outward-pressing headache, particularly in the forehead, increased by motion: therewith, great thirst. After the chill, very weak, without increased heat, or at most only in the head. Sleep at night restless and unrefreshing. Cantharides cured an intermittent fever accompanied by catarrhus vesica et urethrae and swelling of the penis. FEBRIS. 223 Capsicum. F. i. Quotidiana. Tertiana. Frequently in relapses after cinchona. F. i. Chill with thirst, then heat with thirst, and often at the same time with sweat. In one instance much cold sweat succeeded the heat. In some cases thirst also precedes the chill. F. i. Chill with thirst, then heat without thirst, with sweat. F. i. Heat, then chill with thirst. ACCOMPANYING DISORDERS. In the chill.-Headache, much spitting; mucous vomiting; large, painful swelling of the spleen; pain in the back; at the beginning of the chill, tearing through the back, loins and knees exceedingly violent, and such headache and confusion that the patient cannot keep up. Intolerable tearing pain in the limbs. In the heat.-Headache; sticking in the head; disagreeable taste; cutting in the abdomen, with ineffectual pressure to stool; pain in the breast; pain in the loins; tearing in the lower extremities. In the apyrexia.-Ashy colour of the face; little appetite; tumefaction of the spleen; drawing pains, now here, now.there, in the body, worse in the fresh air; swelling of the feet; constant chilliness and coldness. Carboveg-. F. i. Tertiana. Quotidiana. Quartana. Frequently in very long continued (one, two years) fevers, and in relapses after cinchona, F. i..Chill with great thirst, then heat with less, or no thirst, or with thirst only at its beginning. The chill not always severe, though frequent shaking 224 FEBRIS. chill; it is often preceded by coldness of the feet. The heat is at times combined with redness of the face, at times with sweat. F. i. Chill without thirst, then heat with thirst. ACCOMPANYING DISORDERS. Before the chill.-Beating in the temples; tearing in the teeth and in the bones of the limbs; cold feet. In the chill.-Debility. In the heat.-Vertigo; headache; redness of the face; dimness of sight; nausea; pain in the breast, stomach and lower part of the abdomen; oppression of the breast; much pain in the lower extremities. In the apyrexia.-After the paroxysms, headache; want of appetite; region of the stomach tumid, and after eating, painful; sleep little and disturbed; debility, paleness and emaciation. Chamomilla. F. i. Slight chill, but long continued great heat, with thirst, confusion of head, and frequent affrighted starting up. Cina. F. i. Quotidiana. Tertiana. Relapses after cinchona, and in procrastinating type. F. i. Chill without thirst, then heat with thirst, and after this, or before it is at an end, sweat. Sometimes sleep during the sweat. F. i. Chill with much thirst, then great heat with some sweat. F. i. Thirst only in the cold stage, and after the paroxysm vomiting once or twice. ACCOMPANYING DISORDERS. Before the chill.-Disposition to vomit; drawing in the limbs. 226 FEBRIS. In the apyrexia.-Headache; confusion of the head; pain in the scalp; yellowness and sallowness of the face; dull eyes; want of appetite; tongue in many cases clean; ravenous appetite at night; thirst; after eating, sense of fulness in the stomach, and drowsiness; pressure as from a stone in the epigastrium; nausea; constipation; diarrhoea, with prolapsus ani; cough, with difficult expectoration; swelling of the feet; trembling from debility; want of sleep. Cocculus. F. i. Evening shaking chill, with previous shivering and blueness of the nails. In the apyrexia.--Vertigo; dull headache; depression of spirits; want of appetite; general weakness. Drosera. F. i. Tertiana. F. i. Chill with headache. Fever with disposition to vomit. F. i. Type not mentioned, with cotemporaneous pertussis, cured by repeated doses of drosera. Severe chill with cold face, and pale, ice-cold hands and feet, and bilious vomiting. Heat, with severe pressing, beating headache,, and spasmodic, shattering cough. In the apyrexia, gastric disorder. Ferrum acet. F. i. Tertiana. F. i. First headache and pressing in the forehead, followed by a severe, long continued chill with increased headache and much thirst, then moderate heat and sweat. In the paroxysm.-Bitter taste; loss of appetite; constipation; yellow colour of the face; great debility. In the apyrezia.-Slight headache. FEBRIS. 227 Hyosciamus. F. i. Quotidiana. Quartana. F. i. quartana. Case of three months' duration in which cinchona had been used in large doses without success. There was a dry, hacking cough at night, disturbing the sleep. Hyosc. gtt. i. 3. effected a cure both of the cough and fever. F. i. quotidiana epileptica, arising after anger. Every afternoon spasmodic drawing in the calves of the legs, speedily followed by spasmodic affection of the stomach, then insensibility and severe epileptic convulsions enduring for half an hour. Heat with moderate sweat, heaviness of head and vertigo ended the paroxysm. In the apyrexia.-Great debility, saw wheels or circles of fire before the eyes. Dryness of mouth. Frequent singultus. Ignatia. F. i. Quotidiana. Tertiana. Fevers of anticipating type. F. i. Chill with- thirst, then heat without thirst. The chill may or may not be attended with external coldness; it is frequently very severe, with shaking and tossing of the limbs. In one case the sensation of coldness appeared to extend from the abdomen. The thirst, which was often very great, was commonly at the commencement of the chill. The heat may be accompanied by coldness of the feet and internal shuddering, and at the same time redness of the cheeks. ACCOMPANYING DISORDERS. In the chill.-Nausea; vomiting of food, bile and mucus; paleness of the face; pain in the back; paralytic weakness of the lower extremities. 15* 228 FEBRIS. In the heat.-Delirium; vertigo; headache; beating headache; red cheeks; pain in the back; tearing pain in all the bones; sometimes sleep. In the apyrexia.-Apathy; pressing in the head; tearing in the forehead; paleness of the face; whitish tongue; dry lips; little or no appetite; pressing pain in the epigastrium; pain in the abdomen; ineffectual pressure to stool, hard stool; oppression of the breast; pain in the back; heaviness and pain in the limbs; debility. Ipecacuan. F. i. Quotidiana. Tertiana. Mostly relapses after cinchona, and in those cases in which it does not conquer the disease it removes the nausea and vomiting. The dose must, sometimes, be repeated. F. i. Slight chill; mostly of short duration; often only a chilliness or shivering, without thirst; then strong heat with thirst; and after this, sweat, mostly copious. The sweat may be wanting. ACCOMPANYING DISORDERS. Before the chill.-Drawing in the back. In the paroxysm.-Headache; dulness; gastric disorder; nausea and vomiting; oppression, constriction and tightness of the breast; cough, with stitches in the breast. In the apyrexia.-Disagreeable taste in the mouth; bitter taste of the food; much spitting; want of appetite; after eating, vomiting; great debility; want of sleep. Lobelia inf. F. i. quotidiana. Attack at 10. h. A. M. In a man set. 49 ann. Severe coldness, alternating with flashes of heat till 12 Ai., when the heat, FEBRIS. 229 which was moderate, became more constant, but alternating with slight chilliness, continuing till evening. Profuse sweat at night, slept during the sweat as usual. Thirst great from the first chill and during the whole of the hot stage, but worst in the chill. Respiration short, anxious, laborious and wheezing, with sensation of tightness of the chest. Sensation of oppression and weakness, principally at the epigastrium, but extending thence through the whole breast. Tickling in the pit of the throat, with frequent hacking cough. Severe headache, extending round the forehead from one temple to the other. Loss of appetite, both in the paroxysm and apyrexia. Tongue white, scaly coated on the right side, but clean on the left. Great debility. Lobelia inf. 15115, given at 31 h. P. M. during the paroxysm, produced. considerable relief of the oppression of the respiratory organs, and the next day there was a very slight paroxysm, of short duration; the third day and afterwards no more. F. i. quotidiana. Attack 12 o'clock M. Two cases attended with great sallowness of countenance and loss of appetite, both in the paroxysm and apyrexia. F. i. In a child aged eighteen months, who had an intermittent fever of six weeks' duration, suppressed the previous autumn by sulphate of quinine, and in whom it reappeared early in the summer. Lob. inf. 116, shortly before the expected paroxysm, prevented its recurrence. The next day nux vom. was administered. The child, in a few days, acquired- a much brighter complexion, and became more animated than it had ever shown itself before. No return of the fever. J. 230 FEBRIS. Menyanthes. F. i. with coldness in the abdomen. Mezereum. F. i. Tertiana. F. i. Severe chill for several hours, with coldness of the body, icy coldness of the hands and feet, and thirst. After the cessation of the chill, sleep for many hours, with sweat. In the apyrexia.-Great paleness of the face; dull, pressing headache; want of appetite; distension and hardness in the region of the spleen, with pressing pain; sensibility to cool air; general weakness. Nux vomica. F. i. Quotidiana. Tertiana. Morning, afternoon and evening fevers. F. i. Chill, with or without external coldness, and without thirst;- then heat with thirst, and with or without subsequent sweat. The chill is often trifling, a mere chilliness; but more frequently it is severe and long continued, a shaking chill, with chattering of the teeth, and blueness of the nails. It may be preceded by internal and external coldness of many parts in succession, and gaping. The heat is mostly great and long continued; at times accompanied by cold sweat of the face. The thirst begins oftentimes with the heat, at other times it developes itself gradually. The sweat in the heat is sometimes partial, as on the head and neck. F. i. Chill (shaking chill) with thirst, then heat with thirst and sweat. The thirst is sometimes observed before the chill and through the whole fever; often only before the chill, and not in it, and then again in the heat. The coldness is increased after drinking. The sweat begins with the heat, or after the heat has continued for some time. FEBRIS. 231 F. i. Alternation of coldness and heat. F. i. Heat cotemporaneous with coldness of the extremities. It is a frequent peculiarity of all these forms, that chilliness or chill is produced during the heat and sweat by the slightest movement.. ACCOMPANYING DISORDERS. In the chill.-Pain in the loins. In the heat.-Headache; -vertigo; redness of the face; vomiting of water, bile, mucus and the ingesta; red urine; pain in the breast. In the apyrexia.-Headache; pain in the forehead as if the brain would fall out; vertigo; salivation; bad taste in the mouth; acrimonious taste of the food and drink; acid eructation; want of appetite; dislike of food; much thirst; after eating, pressure, and constantly some pain in the epigastrium; pain in the abdomen; movement upwards in the abdomen; flatulent distension, with anxiety; costiveness; after urination, pressing in the bladder; drawing in all the limbs; weakness in every degree. Immediately after the chill.--Rushing in the head. Opium. F. i. Quotidiana. F. i. Severe shaking chill in the forenoons, then sleep, with heat and subsequent sweat; after awaking, headache and general debility. Pulsatilla. F. i. Quotidiana. Tertiana. Quartana. Evening fevers and relapses after cinchona. F. i. Chill without thirst; then some thirst, (drinking once or twice,) and then some heat without thirst. F. i.. Chill with dryness of the mouth, without 232 FEBRIS. much thirst; then great and long continued heat, with little thirst; afterwards a slight sweat. F. i. Chill; then burning heat with thirst; afterwards a slight sweat. ACCOMPANYING DISORDERS. In the heat.-Vertigo; much headache; pain in the left side of the abdomen. In the apyrexia.-Bitter and putrid taste in the mouth; want of appetite; hard, red tumefaction, first of one and then of the other breast in' alternation, with beating and sticking pains; great debility; little sleep. Rhus. F. i. Tertiana. Tertiana duplicata. F. i. tertiana duplicata. Beating pain in the temples, and slimy mouth; then chill, extending from the sacrum and thighs over the whole body, with pain in the right hip and calf, as after fatigue, and tearing in the left leg, with thirst; then general warmth, with chilliness by every motion, and then sour sweat. There was, besides, sallowness of the face; ringing in the ears; hardness of hearing; stoppage of the nostrils; sleeplessness. F. i. tertiana with urticaria, (erysipelas?) which disappeared after the paroxysm, and left, during the apyrexia, only a burning and redness of the eye. Sabadilla. F. i. Quotidiana. Tertiana. Quartana. F. i. Chill with little or no thirst; then heat with little thirst, and then sweat, which may be considerable and long continued. F. i. Chill, with intermixed heat; little thirst, and chillitess throughout the apyrexia. FEBRIS. 233 F. i. Daily, and also at night, yet more severely every other day; twelve to eighteen paroxysms of shaking of all the limbs, as in the most severe shaking chill, so that the patient cannot stand, and can scarcely speak without- a feeling of chilliness,, but with external coldness; then heat, with some thirst and with sweat. ACCOMPANYING DISORDERS. In the chill.-Pain in the upper ribs; dry, spasmodic cough; tearing in all the limbs and bones. In the heat.-Yawning and gaping. In the sweat.-Sleep. In the apyrexia.-Want of appetite; troublesome, pressing distension of the stomach; pain in the breast; cough; weakness; chilliness. Sambuc. F. i. In a case where, throughout the apyrexia, there was profuse, debilitating sweat. F. i. In a case where there was an excruciatingly painful sensation of pinching in both mammae, but most in the left, during the chill; the sambucus removed this symptom, and abated the violence of the succeeding paroxysms. J. Sepia. F. i. quotidiana, with cotemporaneous pertussis; fever attended with very great thirst. Sepia cured the fever, and abated the cough. Sodcamur. F. i. Mostly in tertian fevers, with anticipating paroxysms, also in quotidian fevers, and.in such as, attack now at this now at that time of the day or night, frequently in very inveterate cases, and in relapses after cinchona. 234 FEBRIS. F. i. Chill with little or no thirst; then heat with much thirst. Sometimes great thirst appears when the chill is pretty well over, and continues in the heat. F. i. Chill, with (at times very great) thirst; then (mostly great) heat, with (mostly very great) thirst. The thirst often continues throughout the apyrexia. F. i. quotidiana. Slight and short chill, without any thing else. Sweat partly during the heat, and partly after it. ACCOMPANYING DISORDERS. Before the chill.-Headache. In the chill.-Sticking headache; short breath; pain in the back, (continuing in the heat); tearing in the bones; gaping and sleepiness. In the heat.-Indescribably severe, tearing, sticking, beating headache, frequently in the forehead, which is, at times, present in the chill, and frequently continues after the paroxysm, throughout the whole apyrexia. In one case, where, after severe chill, almost no heat ensued; the headache appeared to take the place of the heat. Confusion in the head; pain in the back; tearing in all the bones. In the apyrexia.-The above mentioned headache; immediately after the heat, long continued headache; weakness of the eyes; bilious colour of the face; white coated tongue; bad taste; bitterness in the mouth; great thirst; little or no appetite; pressing as from a lump in the stomach, with tumefaction in the region of the stomach; pressing in the epigastrium, with pain upon pressure; costiveness; short cough; no sleep at night; sleepiness in the daytime; debility. FEBRIS. 235 Staphysagria. F. i. Evening chill, without subsequent heat. F. i. tertiana, with scorbutic affections. Sulphur. F. i. quotidiana. Chill now in the forenoon, now in the afternoon; previously to the chill, thirst with much drinking. Thirst also in the heat. Vertigo; much headache; bitter taste; great debility; night sweat; cutaneous eruption with much itching. Thuya. F. i. Paroxysms of chill, with external and internal coldness and sweat, without heat. In some cases, thirst during the chill. Valeriana..F. i. without a cold stage, only heat with-thirst and confusion of the head. Veratrum. F. i. Quotidian. Tertian. F. i. Chill, then warm sweat, which soon changes into cold. F. i. Severe shaking chill; then heat with some thirst and some sweat. F. i. Chill with much thirst; then alternate chill and heat, and then heat alone with thirst; afterwards sweat. F. i. Chill at night, without any thing else, as a remnant of other forms of fever. ACCOMPANYING DISORDERS. In the chill.-Vertigo; nausea; intolerable pain in the loins and back. In the heat.-Delirium, redness of the face, and constant slumber. GASTRITIS. 237 mained adherent in the opening, until after the fiftieth day. On the sixtieth day the wound was unclean, of a bad odour, and again bled a little, but the tumour had greatly diminished, as also had that on the left hip. By the eightieth day the improvement had advanced much farther, which advancement was attributed by.the patient to a common adhesive plaster, which had been applied to gratify him with an idea of active local treatment. By the ninetieth day, there only remained an indurated cicatrix. The induration gradually diminished, and at the expiration of four months had entirely disappeared. For other cases of this disease, see fungus haematodes oculi; in the article on the eye and vision. GASTRITIS. Inflammation of the stomach. It has been recommended to commence the treatment of acute gastritis with the exhibition of repeated doses of aconit., following this with the remedy which is best adapted to the remaining symptoms. The medicines which are most likely to be demanded, are bryonia and nux vom., but others may sometimes be required. For instance, when the fever approximates to a typhus, or where the burning in the stomach has been considerable from the commencement of the attack, arsenicum, euphorbium, ranunculus or cantharides may be necessary; the arsenicum is particularly important under these circumstances, when there is a rapid sinking of the strength. If the thirst is great, and there is difficult deglutition of fluids 238 GONORRHCEA. from spasmodic affections of the muscles of the throat, accompanied by a sensation of burning rising in the throat; hyosciamus, stramonium, cantharides or belladonna may be indicated. In the only case which I find recorded, the practice of first administering the aconit. does not appear to have been pursued. Arsenicum gtt. i. 30 was first given, and after twelve hours, colocynthis gtt. i. 30, which was repeated after sixteen hours. The symptoms were severe burning pain in the epigastrium, where not even the pressure of the shirt could be borne. All the ingesta immediately vomited up. Pulse small and rapid. Anxious restlessness. GONORRH(EA. In the treatment of gonorrhoea, it is generally considered proper to give the remedies in the lower dilutions. The medicines which have been found most important in this disease, are cannabis, cantharides, mercurius, petroselinum and thuya. Of these, the thuya is indispensable in the gonorrhcea of sycosis; the petroselinum is particularly useful where the urinary pressure is very frequent; the cannabis, cantharides, mere. or thuya, when the disease is attended with chordee, and cannabis or mercurius when there is phymosis or paraphymosis. But it should be understood, that the usefulness of these remedies is not confined to those cases in which the symptoms, just mentioned, are present. It has been recommended to give aconite when the disease is attended by chordee, and the inflammatory action is violent, and to follow this, in suitable GUMS. 239 cases, with sulphur. But it is most probable that this will prove a useless waste of time, inasmuch as the inflammation is the consequence of a specific irritation, and but little or merely temporary benefit can be expected from any remedy which is incapable of diminishing that irritation. In addition to the remedies above named, acid. nit., capsicum, copaviae balsamum, cubebm, ferrum, ledum, petroleum, pulsatilla and stramonium have been found useful. In gonorrhoea glandis, mercur., sodm mur., cinnabar, mezereum, sulphur and thuya have been recommended. (In a case of G. glandis, which was of several months' duration, and had returned, after a temporary suppression by means of astringent lotions, and was complicated with enlargement of one of the testicles, I effected a permanent cure with two or three doses of cinn., given daily. Green.) GONORRHOEA MUCOSA. Gleet. In those chronic forms of gonorrhoea to which these terms have been applied, the preceding remedies will often be found useful. But some of the following will be frequently necessary. Acid. nit, conium, lycopod., sepia, sode mur., sulphur. GUMS. - In inflammation, and tumefaction of the gums, acon., bell., cham., puls., nux vom.. A fungus on the gums, of the size of a walnut, was cured by two doses of staphys. In swelling of the gums, calcis sulph., mere., nux 240 HEMORRHAGIA. vom., sulph., agar. and alum. may be used according to the indications of each particular case. In cases of retraction of the gums from the teeth, mere., carbo veg., calcis sulph. and acid phosph. are recommended. When the gums become spongy, mere., tereb. Where there are frequent and troublesome discharges of blood from the gums, carb. v., mere., nux vom., acid. phosph., sodwe bor., tereb., and arsen. are worthy of attention. HEMORRHAGIA. Hemorrhages. Under this head will be contained all the most important hemorrhages, in which the blood finds an exit from the body, except those arising from wounds which require the application of the proper surgical means for their suppression. In internal hemorrhages, whether into the cavities of the body or into the texture of its organs, our knowledge of the means, which will arrest its progress, is very limited, and must probably remain so, from the concealed character of the disorder. But it appears probable that where the hemorrhage arises from mechanical injury, arnica may sometimes check its progress. And where the internal hemorrhage is not of such a nature as to lead to the inevitable destruction of life; this remedy has the confidence of many homceopathic practitioners, as an.agent capable of expediting the absorption and removal of the effused blood. I shall treat of hemorrhages in the following order: OPFITHALMORRHAGIA. 241 ophthalmorrhagia; epistaxis; hmmatemesis; hamoptysis; metrorrhagia; hamaturia. OPHTHALMORRHAGIA. Bleeding from the eyes. CASE. In a child three weeks old, whose parents were healthy. It had suffered for two weeks from a violent diarrhoea; could not open its eyes on account of swelling of the lids, which adhered together. When the lids were forced apart, blood was seen on the eyes and inside of the lids. Blood flowed continually from the eyes, but most freely when the child cried. Rash on the body, but most on the cheek, where the cuticle was wanting, which probably arose from the copious discharge of blood from the eyes, (from an acrimonious quality of the discharge?) Chamomilla gtt. i. 12 was given. In about an hour a beneficial sleep occurred, which continued for three hours. It awoke much improved. Stools speedily improved in quality and became less frequent. The swelling of the eyelids and hemorrhage somewhat diminished. On the third day bellad. 30 was given, and in two days the eyes were perfectly well. CASE. In a child six weeks old, of unhealthy parents. Deprived of the breast at two weeks; was fed upon biscuit broken into coffee, and for drink had coffee with milk. For two weeks the child remained tolerably well, but after this time, restless sleep, constipation, ischuria and other affections. In the sixth week, frequent flow of blood from the eyes; tumefaction of the eyelids, which were not so much swollen but that the child could partially open the eyes. The vessels of the sclerotica were dilated, and 16 242 HEMORRHAGIA. when the eyes were held for a length of time open, small, bloody points appeared on the eyeball, which gradually enlarging, became drops, which then ran down. Eructation after eating; flatulent colic; conS stipation for two or three days; when a stool occurred, the faeces were hard, discharged with great straining and accompanied by prolapsus ani. Nux vom. 30, Swith the necessary alteration of diet. In three days the child was well, and remained so. EPISTAXIS. Bleeding of the nose. Aconit. is indicated where there is general plethora, and increased excitement of the vascular system. Arnica has at times proved serviceable. Bellad. When the hemorrhage awakens out of sleep at night, and is accompanied by determination of blood to the head, and when it is excited by stooping, or strongly blowing the nose. Bryonia is useful under very similar circumstances to those in which bellad. is useful, and is especially indicated where the epistaxis arises from sudden suppression of the menses. Cina is serviceable when the epistaxis is symptomatic of worms in the bowels. Cinchona. When the hemorrhage appears to arise from relaxation of the vessels. Crocus. Where there is determination to the head. In a case where a thick black blood flowed in a stream, and the patient was so reduced, that he fell from one fainting fit into another. Crocus 1.6 stopped the epistaxis in a minute. It is also useful when the hemorrhage starts with violence, and the blood is of a bright red colour. HEMATEMESIS. 243 Moschus. -Hartmann says he has conquered the most severe hemorrhages from the nose with moschus 3. Nux v. When the hemorrhage occurs in the morning, or where there is great cephalic congestion. It is a proper remedy where there is a flow of venous blood from the nose. Pulsat. When the hemorrhage attacks in the evening, or before midnight. Rhus. Under circumstances similar to those in which bellad. and bryon. are useful. In addition to the articles above mentioned, cham. and ignat. have also been recommended as suited to some cases. And where the disease frequently recurs, the following remedies have been found useful in removing the tendency-to return. Sulph., ambra, graph., secale, sepia, lycopod., acid. nit., phosph., silex, carbo veg. HEMATEMESIS. Melaena. Morbus niger. Vomiting of blood. This disease is generally preceded by gastric or hepatic derangement, or both, and frequently requires a succession of remedies, in order to remove the morbid conditions from which it springs. CASE. In a man met. 60 ann. Vomiting of black blood in large quantities. Great debility. A burning feeling in the region of the stomach. Pulsation at the epigastrium, and anxiety. The slightest movement excited nausea. Loss of appetite; great thirst. Stools of black, coagulated blood. Cinchona benefited but little. Arsen. 2130 produced a steady and gradual improvement. After fourteen days the pulsation and 16* 244 HEMORRHAGIA. burning feeling at the epigastrium continued the same. Calcis carb. improved it very much, and carbo veg. completed the cure. Another case, in a man met. 50 ann., was treated successfully with nux v., bellad. and stannum, and the patient felt better than he had done for years. After some years, the disease reappeared, and these remedies only operated palliatively. The patient was rescued by treatment with the antipsorals. CASE. A woman met. 72 ann., of arthritic habit, subject to erysipelas of the face and frequent dyspeptic symptoms, was attacked with vomiting and purging of blood in pitch-black masses. Her countenance was sunken; epigastrium painful and tumid; pulse weak and small; extremities cold. Ipecac 416 was given. In a quarter of an hour slight vomiting, and a stool of the same kind as before. But afterwards she felt easier, and on the next day was still better. Ipecac. was repeated. On the next day there was a return of0 a cough and dyspncea, to which she was subject; her tongue and throat were dry, yet she had no thirst. Bellad. 2130 was then given. The dryness of the tongue and the sensation of pressure at stomach disappeared. Subsequently for the debility, cinch. 2112 was exhibited, and she speedily recovered. CASE. A woman Aet. 50 ann., with whom the catamenia had ceased for years, was attacked with burning in the abdomen; and a return of the catamenia; and subsequently with a vomiting of blood. A drastic cathartic, administered by a quack, produced copious stools of blood. Ipecac. 3130, in a dram of water, was given in the dose of ten drops every three hours. With every dose she felt herself better, and ' HIEMOPTYSIS. 245 the vomiting soon ceased. After two days cinch. 2130, and speedy restoration of strength. Nux v. is an important reniedy in this disease when it occurs in plethoric habits and there is a tendency to constipation, or where chronic affections of the stomach have long preceded it. Arnica mont. in strong robust constitutions of sanguineo-choleric temperament when the discharge consists of a dark fluid blood, and the patient complains of a bruised feeling in all his limbs. Hyosciamus is a valuable remedy in hematemesis, where the discharged blood is of a bright red colour. A case of melena was treated successfully with aconit. 30, and nux vom. 3130. For remaining dyspeptic symptoms, pulsat. was afterwards given. Veratrum 3112 cured vomiting of'black blood. Besides the above named remedies, the following are mentioned by Hartmann. Millefol., canth., mezer., phosph., sode mur., cicuta, sulph., lycopod., zinc. HAEMOPTYSIS. Spitting of blood. Aconit. " Where a sensation of motion, or bubbling in the breast, and of fulness and burning, with palpitation of the heart, anxiety and restlessness precede and accompany the htemoptysis, in which the blood is brought up at intervals, and in large quantities by hawking, the pulse is weak, thread-like and scarcely perceptible, and the countenance pale and anxious, aconit. is the proper remedy, and should be repeated as soon as the beneficial action of the first dose ceases. When the aconit. causes a cessation of the hemorrhage, but the accompanying symptoms still remain, ipecac. may be given." (Hartmann.) d 246 HEMOpRHAGIA. Arsenic. When the anxiety, the motion or bubbling, and the palpitation of heart, still continue, after the treatment just mentioned, or where these are worst in the middle of the night, awaken the patient from sleep, and a burning heat extends itself over the whole body, and the patient feels compelled to sit or even to stand up, arsen. 1130 should be given. But this medicine should not be repeated without an intervening remedy between the different doses, as its immediate repetition is not attended in this disease with the same advantage as is observed from it in some other diseases. The preceding remarks are derived from Hartmann, and the caution which he suggests against the repetition of the arsenic., without the intervention of some other remedy, is confirmed by a case in my own practice. CASE. In a man set. 24 ann., who had been unhealthy for more than a year, and for the last three months had daily expectorated more or less blood. When I first saw him, he was almost continually coughing, -and expectorating freely blood somewhat florid in its appearance. The vessel into which he spit, contained at least half a pint of this blood, which, though thick, did not appear to have much tendency to coagulate. The cough was convulsive, and of a very shrill sound, resembling the crow of a hen (kikikikih). The strength of the patient was much reduced, his appetite much impaired, his pulse weak and feeble, and his sleep at night very much interrupted, if not entirely prevented by his cough. Although he had been taking medicines up to the time at which I saw him, I did not hesitate to administer immediately arsenicum 2130, though with such small hope of being HLEMOPTYSIS. 247 able to afford him much relief, that I gave him permission, in case he did not, in a few hours, experience some relief, to continue the employment of some pills, which were probably of an anodyne character. It was evident that these pills afforded no positive benefit, yet I thought it probable, that he might experience inconvenience from the sudden withdrawal of an opiate to which he had been for some time accustomed. At my visit, the next forenoon, his mother remarked, that he now slept without moaning, which he had not done for three months until the last night. In the course of a few hours after taking the arsenicum, he had felt a little better, and had not taken his pills. His cough and bloody expectoration, though less frequent, still continued. On this account I repeated the arsen.; but the effects were far from satisfactory. Neither on the next, nor the two following nights, did he rest as well as he had done on the first night, and he was, besides, troubled with pains in the epigastrium, the right hypochondrium, and about the lumbar vertebra, It was not until the fifth night that he rested as well as he had done on the first night. The hmmoptysis gradually diminished, but did not entirely cease till after the tenth day. By the fourteenth day, his appetite and strength had considerably improved, and his cough was much less shrill. The spute appeared to consist of a white, opaque mucus. The improvement then continued progressive till the end of the fifth week, when his cough became more convulsive, shrill and frequent, and continued for two days to grow worse, when the arsenicum was again administered. For two days he suffered, but not so severely, from similar pains to those which he had after the second dose of this 248 HEMORRHAGIA. medicine. But he afterwards improved so rapidly, that by the eighth week week he was able to ride out. The improvement afterwards continued to advance, but at intervals of one or two days or a week he would cough up small quantities of a dirty white, or pale yellow mucus, or mucus mixed with pus, showing plainly the existence of a small abscess which discharged its contents thus seldom. He has now driven my carriage for eight months, and was exposed both in the night and day to the severe weather of last winter, and has continued to improve in his general health, though the abscess continues occasionally to discharge small' quantities of matter. As the chief pain of which he complains, and that is neither constant nor very severe, is in the right hypochondrium, and as, on several occasions, the discharge of the matter appeared to have been excited by leaning forward and pressing his side against his arm while this rested on his thigh, as also from the quality of the matter discharged, which nearly resembled a pasty mass which I once found adhering to parieties of a cavity in the liver. I have considered it to be most probable that a small abscess of the liver has opened a passage through the diaphragm and into the lungs. There are other circumstances which confirm this supposition, namely; some time before the attack of haemoptysis, he had for two months a diarrhoea, with copious bloody discharges from the bowels. At the end of this time, he had an attack of violent pain in his right side, and cough, which was pronounced by the physician who --attended him, to be a pleurisy. He was treated by bleeding, blistering, &c. During the treatment, the hemorrhagic diarrhoea ceased. After some time the HAEMOPTYSIS. 249 pain in the side abated, but he began to expectorate matter, and continued to do so for a considerable length of time before the expectoration became hemorrhagic. The inferences which I deduce from these facts, are: that the hemorrhage from the bowels was either directly or indirectly connected with the abscess of the liver; in other words, that the blood was effused in the cavity of the abscess, and passed from thence either by a direct opening or through the hepatic ducts into the bowels; or that the hemorrhage was, like the hsemorrhoidal flux, sympathetic with the disordered condition of the liver; and that the pleuritis was the consequence of the extension of the abscess to the pleura. That it was not a metastasis of diseased action appears evident from the fact, that there was no diminution of the diarrhoea previously to or in the early stages of the inflammation of the pleura. But it ceased during the treatment, and its cessation was attributed by the patient to the application of a sinapism over the right hypochondrium. It is almost certain that the temporary suppression of the hemorrhagic tendency was effected by the agency of some of the remedies at that time employed, and it is quite possible that the sinapis may possess this power. I have been thus minute in the detail of this case, because, while it exhibits the powerful curative action of the arsen., it may, when compared with other cases, guide to a more accurate knowledge of the pathological conditions in which this remedy is applicable. I have only to add, that during the eight months, in which the patient has been in my employ, I have used several other remedies for the completion of the cure, but without any very striking effects from any but the acid. phosph., which caused 250 HEMORRHAGIA. the disappearance of a light, white, flocculent sediment from this fluid. Three or four times there has been a slight return of the hemorrhage, which has always yielded speedily to the arsenicum. It is proper to remark, that from the latter doses of this medicine, the same unpleasant circumstances did not occur, as from its first and second repetitions, a circumstance which should, perhaps, be attributed to the improved state of his health, and the consequent more powerful reaction of the system against the pathogenetic operations of the medicine. J. Arnica. Not only in cases of hoemoptysis, from mechanical injury, to which it is peculiarly adapted, does arnica operate very beneficially. But it is also useful when fluid blood of a dark colour is discharged without much exertion or cough, and there are stitches, burning, motion, agitation or bubbling, and constriction in the chest; palpitation of heart, debility, and at times syncope. Also where a frothy, bright-red blood, sometimes mingled with small coagula and mucus, is thrown up by a slight cough, the irritation to which is felt under the sternum. Belladonna is a good intermediate remedy in hemoptysis attended by the greatest exhaustion and a continual tickling irritation to cough, which is felt in the trachea, especially when the following symptoms are present. Great shortness of breath, with a constant short cough, anxiety, restlessness, strong and rapid pulsation of the heart, burning heat, great thirst and symptoms of determination of blood to the head. Crocus has proved useful in hamoptysis. Digitalis proved serviceable in hemoptysis from HAEM0PTYSIS. 251 being much overheated, and uhconnected with any peculiar feeling in the breast. Ferri acet. Where there is a jaundiced tint of the skin, considerable dyspncea, especially at night, slight cough and expectoration of pure blood, though not in large quantities, ferri acet., in the lower dilutions, is useful. Ledum. In a case of a cachectic young woman of choleric temperament. The attacks of hemoptysis, of which she had had several, were suspended, after the ordinary treatment, for six, eight or twelve weeks. In the attack, for which she was homceopathically treated, her respiration was short and oppressed; she had constriction of the breast, which was increased by every movement; loud, hollow-sounding cough, which caused a painful sensation of shattering, and was attended by the expectoration of large quantities of bright-red blood; violent beating headache; tumid face, alternately red and pale; tinnitus aurium and dysecoea; tickling in the trachea; soreness under the sternum; constipation; sensation of fulness in the upper part of the abdomen; cedema of the feet and legs; troublesome drawing in the limbs whilst lying still; sensation of great heat through the whole body, alternating, with moderate perspiration; rapid, full pulse; general debility-and depression of spirits. Aconit. and nine hours afterwards a dose of ledu'm were administered with such good success, that on the following day there was no hemoptysis, and by the third day the patient could perform her household duties. A year afterwards there had been no return of the hemorrhage. Ledum is also useful, where, with a severe cough, there is a copious discharge of bright red-blood; a 252 HEMORRHAGIA. wheezing and rattling sound in the trachea, and a fixed burning pain in some spot in the breast. Millefolium. Case. Every evening a sensation of motion in the breast, which was followed by a flow of warm blood into the throat and from the mouth; then cough, with bright-red, bloody expectoration. Great debility. Millefol. gtt. i. 3 suppressed the haemoptysis, and cinchona 6 removed the debility. "Pulsatilla cured a hamoptysis which returned every three months after the cessation of the menses. Incessant cough and expectoration of thick black blood, most at night; tightness of the breast; stitches in the left side of the breast; continually cold feet. Rhus. In the case of a man et. 60 ann., who had suffered for many years from frequent attacks of hbemoptysis. His last attack, which had endured for three weeks, when he placed himself underhomoeopathic treatment, had not been in the least benefited by the ordinary treatment. When he coughed, there was a feeling of warmth rising out of the breast, and expectoration of a quantity of bright red blood, and, at the same time, a painful feeling in the lower part of the breast, just above the epigastrium. The hemoptysis occurred generally four or five times a day, and if it intermitted for a day, which seldom happened, it was much worse on the next day. Sometimes the discharge amounted to apint. During the absence of the hemorrhage, he had a feeling of peculiar weakness about the heart, as if it were in a tremulous movement, combined with anxious oppression at the breast, and these feelings were the most sensible immediately after the haemoptysis. Although food had its proper taste, he had no appetite, and the eating of even a small quantity caused a sensation of METRORRHAGIA. 253 pressure in the epigastrium. He complained of heat and sweat, and was disposed to chills. He was costive, weak, and emaciated. Rhus gtt. i. 12 was followed by a violent paroxysm of coughing, and a considerable discharge of blood. The hemorrhage did not subsequently recur. Fourteen days afterwards cinchona was given on account of the debility. The patient remained well. In addition to the reniedies above mentioned, the following have also been found useful; namely, acid. sulph., drosera, lycopod., plumbum, potassce carb., stannum, carbo veg., phosphor., ammonia carb., calcis carb., sepia, magnesice carb., sabina, bryonia, dulcamara. METRORRHAGIA. Hemorrhagia uterina. Uterine hemorrhage. Uterine hemorrhage differs in its character and treatment according as it happens in the unimpregnated or gravid uterus, or immediately after parturition. I shall, therefore, treat of it under the divisions of M. menstrualis, M. gravidarum, and M. lochialis. METRORRHAGIA MENSTRUALIS. It frequently occurs that instead of the proper menstrual secretion, an actual hemorrhage takes place at the menstrual periods. The fact is to be ascertained by the coagulation of the discharge, which never happens in perfectly healthy menstruation. The quantity of the discharge may be but little greater than in the. healthy condition, but it is generally more profuse, and mostly recurs every two weeks or even oftener. As the hemorrhage arises from a morbid performance of the function of secretion, it is not surprising that it should be accompanied with considerable pain. As far as my experience extends, this is always the case. 254 HEMORRHAGIA. Bellad. Hemorrhagic discharge at. the period of menstruation. Blood bright red. Also when the metrorrhagia occurs after heavy lifting, with pain in the lower part of the abdomen; pulse full and hard. Bryonia. In a case where there was constant bloody discharge for some months, but every three weeks a true metrorrhagia. By the eighth day after the bryonia, the discharge had entirely ceased, and menstruation was afterwards normal. Cham. At the time of menstruation, discharge of large black coagula. Crocus. Continual discharge of black, fetid blood. In a case where the discharge consisted, sometimes, of thick, black blood, at other times, of black coagula, and at times of a bloody water. Croc. gtt. i. 1 effected a cessation of the discharge, but the menses recurred too copiously every two weeks. Platinum gr. 1.2, then given, was succeeded by normal menstruation. In a case from over exertion in dancing and the use of stimulating drinks during menstruation; excessive uterine hemorrhage. Patient exsanguine in appearance, and fainting on being moved. Blood black and fetid; croc. gtt. i. 3. In an hour and a half diminution of the hemorrhage and continued improvement. In two of the above cases there was a sensation of motion in the umbilical region as if there was some living thing there. Ferrum. In a case where a metrorrhagia commenced during menstruation, and continued for- a long time. The discharge ceased in one night after a dose of ferrum. MIETRORRHRAGIA. 255 Ipecac. gtt. i. 1 cured a metrorrhagia which had continued for nine months in an unmarried female. Secale corn. In several cases where there was a hemorrhage from the uterus every two weeks, distinguished from the menses by coagulation. Attended with pains in the sacrum, pains shooting down the thighs, and bearing down pains in the lower part of the abdomen. Secal., in the lower dilutions, has generally benefited very much. Also in cases of chronic metrorrhagia attended with the same pains. Under the operation of the secale, the pains often entirely subside some time before the complete cessation of the discharge. In the case of a married woman where the hemorrhagic action occurred every two weeks, conception took place shortly after the suppression of the hemorrhage by the secale, and gestation was normal throughout. J. METRORRHAGIA GRAVIDARUM. This form of uterine hemorrhage is a symptom of the commencement or progress of abortion. The remedies are, therefore, those which are most capable of, arresting that process, and will be found under the article abortion.,The judicious practitioner will understand that these remarks do not apply to the profuse hemorrhages of advanced pregnancy, which arise from placental presentation, and are, fortunately, not very frequent. But little is to be expected from medicines in these cases, where every thing depends on the skill and judgment of the obstetric practitioner. METRORRHAGIA, LOCHIALIS. In the rapid and formidable hemorrhages which so frequently occur after parturition, it is unsafe and inexcusable to delay, for any considerable length of time, that manual assistance, which, if timely afforded, may save the patient H.EMATURIA. 257 stiffness of the joints. The bright red blood continually flowing, but most during the spasms. The pulse slow, weak and intermittent. Ipecac. Where the hemorrhage only occurs on motion, and there are cutting pains about the umbilicus, and pressure towards the uterus and anus. Chill, and coldness of the body, whilst there is a sensation of internal heat, rising towards the head. The ipec. should be frequently repeated. Platinum. -In similar cases to those which are adapted to bellad., except that the blood is dark and thick, or even coagulated. In addition to the above, cinch., ignatia, mag. pol. aus., nux vom., millefol.,ferrum and rhatania deserve attention. HIEMATURIA. Hemorrhagia urethralis, vesicalis et renalis. Bloody urine. Under this head I include all the hemorrhages which find their exit from the body through the urethra. It is true that we sometimes find, when the lesion is in this canal, that the blood flows away independently of urination. But even in urethral hemorrhage the discharge of blood is more or less combined with that of the urine. I shall therefore include this under a term, which, although it may not be exactly appropriate to all its cases, yet is so to many of them, especially those where the hemorrhage is so slight that the discharge only takes place on attempting to urinate, or where the performance of this function excites the hemorrhagic action, and the urine is in consequence mixed with and followed by a discharge of blood. 17 * 258 HEMORRHAGIA. Arsenicum effected the cure of bloody urination, complicated with pemphigus and hemorrhoids,. See arsen. in the article Eruptio cutan. Cannabis. A frequent pressure to urinate at night, with the discharge of small quantities of urine, and, at the last, of a few bloody drops; was cured by cannab. gtt. i. 3. Cantharides is an important remedy in hematuria, and is useful not only when the hemorrhage arises from disordered action in the vessels of the bladder, but also when it springs from those of the kidneys and ureters. In a case where there was severe burning pain in the bladder and urethra during urination; and after it, with severe cutting and burning pain and continual effort, the discharge of many drops of blood. In a case of hsematuria after a gleet; where after connection, there was a continual discharge of blood, with severe cutting and burning, as well whilst urinating as at other times. Ipecac. Case. In a woman wt 50 ann., after exposure to cold on a journey. Debility, vertigo and confusion of the head. Violent pain in the loins. Sensation of warmth in the abdomen. Towards evening, severe pain in the umbilical region and in the region of the bladder, with urinary pressure. Soon afterwards, discharge of severely burning urine, which was mixed with blood. At night frequent discharge of blood, coldness of the extremities; heaviness of the head; nausea, and inclination to vomit; pressure in the epigastrium; a cure was effected with ipecac. gtt. i. 2. Lycopod. In the case of a man who had suffered under a severe hmematuria for two months, large H EMATURIA. 259 coagula being deposited from the urine, complicated with obstinate constipation and almost perfect paralysis of the feet. Three doses of lycopod. 30, one every three days, effected a cure. Mezereum has frequently proved useful in hwematuria. Millefolium. In a case where, at intervals of four or six weeks, there were pains in the region of the left kidney, with chilliness. Considerable discharge of blood through the urethra, with painful pressure during its passage. The attacks continuing from five to eight days and then ceasing. Thuya and lycopodium both produced transitory improvement. The fourth of a drop of tr. millefol. effected a cure. Pulsatilla has been serviceable where there was hmematuria with symptoms of the descent of renal calculus into the bladder. Mercur. In a case where there were burning pains at the mouth of the urethra, increased by urination; cutting pain below the umbilicus, extending itself into the loins, at night; scrotum drawn up, penis diminished in size; continual chilliness; pressure in the epigastrium after eating; haematuria with burning at the mouth of the urethra; frequent rumbling in the abdomen; drawing through both testicles, extending to the abdominal rings: cramp and numbness in the right thigh, and in the right hand. Pulsatilla removed the pain, and merc. cured the hematuria. Uva ursi has proved serviceable in hoematuria, as have also the following remedies; scilla, calcis sulph., zincum, sulphur, calcis carb., conium, phosphorus. 17* HEMORRHOIDES. 261 the size of the last phalanges of the fingers, and of a dark blue colour; the stools accompanied by burning pain, and discharge of blood; pain of the back and limbs; carbo veg. effected a permanent cure. Calcis sulph. has been found useful in hemorrhoidal affections. Ignatia is often of great service in the treatment of hemorrhoids. Lobelia inf. proved useful in a case of hemorrhoids. See lob. inf. in the article Dyspepsia. Nux vom. is very useful, in both bleeding and blind hemorrhoids, especially where these arise from indulgence in the use of spirituous liquors or of coffee; as also where they are induced by mental exertion, sedentary habits, foreign bodies or worms in the rectum, or pregnancy. In a case occurring after parturition, where the stools occurred only every three or five days, were hard and dry, and discharged with violent pressure, attended with a sensation of inaction, and an increase of the sticking pains in the rectum. With the stools, a discharge of pure blood, or of bloody mucus. At the anus, a hard, round, bluish-red roll. Constant pain in the lower part of the back, increased by motion. Tr. nux vom., given in repeated doses, effected a cure. In a case of venous hemorrhoids, nux vom. 21 effected a cure. Petroleum. Case. In a man, who had suffered under the following disease for fifteen months. Loss of relish for food, and, though at times a sensation of hunger, inability to eat much. Nausea after eating. Constant rumbling in the bowels, and a sensation as if the abdomen was empty and hollow. A short HEMORRHOIDES. 263 hemorrhoidal tumours; severe periodic colic pains in the whole of the lower part of the abdomen; frequent retching without vomiting; a severe spasmodic pain extending from the region of the right kidney, in the course of the ureter, towards the pudendum, so that it was very similar to the pain attending calculus. Still later, appeared the following symptoms; a short, dry cough in the evenings, which caused pain in the region of the bladder and urinary pressure. Strangary; by the constant painful urinary pressure, which was. combined with a prickling sensation, only a few drops of bloody urine could be discharged; whatever she eat was rejected after half an hour, by vomiting, attended with more or less pain; pulse frequent; disposition restless, fretful, and peevish, the spirits depressed. These symptoms disappeared in the order of their appearance after one twentieth of a grain of sulphur; but this disappearance was preceded by a considerable homoeopathic aggravation of the pain. In a case attended by vertigo, cephalalgia, and weakness of memory; nausea, and disposition to vomit after eating; colic pains, and a sensation of pressure in the region of the liver; deficient appetite; increased thirst; pain in the loins, and lower part of the back; itching about the anus; debility. The bowels were open twice in twenty-four hours; the stools hard, discharged with much painful exertion, and attended by the descent of venous hemorrhoids, which sometimes burst. After aconit. gtt. i. 12, sulphur gr. i. 3 was given, and effected a cure. The following remedies have also been found useful in the treatment of hemorrhoids; bryonia, cantharides, capsicum, chamomilla, cuprum, ferrum, HEART. 265 doses, aided by two doses of aurum, effected great improvement. In a case of carditis, arising from exposure to cold. After a sleepless night, chill in the morning, followed by permanent pain in the left side, great anxiety, syncope, intermitting pulse, palpitation of heart, "asthma siccum," and much thirst; two doses of aconit., and afterwards single doses of pulsatilla and cannabis, effected a perfect restoration of the health in the- course of seven days. In a case of palpitation of the heart which, though not constant, still recurred very frequently; aconit., in repeated doses, aided by sulphur; effected a cure. Aurum. In a case of palpitation of heart, where this.took place paroxysmally several times a day, and was accompanied by anxiety, and constriction in the breast. In a case where there were violent, irregular pulsations of the heart, and constriction of the chest, which supervened on a rheumatic fever, aurum proved of great use. Bryonia cured a case of carditis, attended with great anxiety, restlessness, and continual pressure in the breast. Phosphorus proved useful in two cases of palpitation of the heart, where the symptoms justified the suspicion of organic derangement of this organ. It was repeated with advantage after a month. In a case where palpitation of the heart was very troublesome whilst sitting, and accompanied by shortness of breath; phosphorus 2130 effected a cure. Pulsatilla. In the case of a female affected with pressing headache, which disappeared on motion; dyspepsia; frequent chilliness; coldness of the hands, 266 HEART. feet, and tip of the nose; timidity and peevishness; heaviness, pressure and burning in the region of the heart; paroxysms of palpitation of the heart, with dimness of vision, vanishing of the senses, and trembling of the limbs; the paroxysms attacking without premonition, but most frequently after mental agitation, and often in the night; pulsatilla in alternation with aconit., and both in repeated doses, produced great improvement. Rhus. In a case where there were severe stitches in the left side of the breast, which threatened to stop the breath, occurring especially on quick movement, in standing and whilst walking; ceasing and again recurring; painfulness of the part on pressure; trembling of the heart; pain and numbness in the left arm, especially during rest, and sensation of crawling in it on motion, or from friction; painful sensation of stretching in the pectoral muscles of the left side, worse in rest; frequent chilliness; deficient appetite. Rhus 3124 effected a cure. Spigelia. The following case, related by Dr. Giuseppe Mauro, of Naples, is from the tenth volume of the Archiv. f. d. h. H. " Gatano Delfrate, a boy set. 12 ann., from his birth strong, robust, and of great muscular strength, which he had exerted from an early age in gymnastic exercises, was attacked, during a residence in Marseilles, with an inflammation of the heart, for which he was alloeopathically treated. Although he was relieved from this acute disease, yet his strength appeared to be considerably diminished, and after many months an elevation of the ensiform cartilage appeared, without any discoloration of the superincumbent skin. By and by, the four last true ribs and HEART. 267 the sternum became elevated, and he often felt a palpitation of heart, which would not permit him to pursue his accustomed exercises. The vertebral column was likewise distorted. During two and a half years, in which he was treated by Roman physicians, he had become so much worse, that he could not stir in bed without being attacked by the greatest tightness of breast. He could only sleep with his head elevated by three pillows, and he could only lie on his right side. When the ear was applied over the heart, a sound, similar to that of the purring of a cat, was perceived. The cheeks and lips were sometimes bright red, and at other times perfectly pale. The carotids pulsated with a tremulous movement. At times he felt stitches in the region of the heart. His appetite was. very trivial, and he had scarcely any thirst. A slight exertion at stool produced immediate syncope, and he became disposed to faint in a moderately warm room.. By speaking he felt himself very much oppressed, the respiration became very short, and the redness of the cheeks and lips much increased. He was very easily affected by cold, which produced a 'lingering coryza, that rendered the orifices of the nose sore. From time to time he suffered under a fever which was considered to be of a rheumatic character. He had been treated with the preparations of iron, hyosciamus, valerian, and similar remedies. "The patient was seen by several other physicians, one of whom pronounced the disease to be an organic defect of the heart, probably an enlargement, by which the sternum and ribs were elevated, and the circulation interrupted. He moreover considered the disease to be incurable, and that a phthisis or 268 HEART. hydropic affection would end the life of this unfortunate being. Another declared it to be an 'excrescenza fissa.' A third thought it to be an 'excrescenza vegetante.' And a fourth decided that it was either an aneurism of the aorta or a polypus. "On the first of February I gave to the patient spigelia 3130 on the tongue. Dr. Trasmundi and the father laughed, and believed that this was only a preparatory dose, since they conceived it to be impossible that this should have any decisive operation. "I cautioned them against being alarmed, if, during the first hours, the palpitation of the heart, the redness of the cheeks and lips, and the other symptoms should be increased. Five hours after taking the medicine, he became very restless, and much oppressed at his breast, so that, although two additional pillows were placed under his head, he felt no relief. The redness of the cheeks and lips was increased, without the subsequent paleness. The restlessness and anxiety were great. The powerful strokes of the heart appeared as if they would shatter his ribs and sternum, and he could not sleep for a moment. His weeping mother cursed all medicine, and wished he could free himself from the remedy he had taken. But the lad encouraged his mother by reminding her of my presage. "The next day I found all quiet in the house; the lad had slept well through the night, even without the pillows, and he asked my permission to eat something, which I allowed to him. He dressed himself, which he had not done for more than a month, and walked sixty steps about the room, at three trials, without fatigue. The next day I permitted him to ride in a carriage, and by and by he moved about in HERNIA. 269 the fresh air, without feeling anxiety or fatigue. After five days I found myself in the house of the patient with Dr. Trasmundi, who, after examining the patient, said; 'I see that he is actually better; both the palpitation of heart, and the well observed noise, like the purring of a cat, have vanished, and the ribs and sternum have become less elevated.' On which I remarked to him that his evidence was of double worth to me, since, although he was not directly an opponent, yet he was not disposed to see an improvement where there was none. "From day to day the patient became better, went into company, sang, and played on the harpsichord, and performed all business like a healthy person. "On the 25th of February, there was deceptive vision, all objects appearing to lie remote. Hyosciamus 3112 produced a homoeopathic aggravation, and cured the visual disorder. "On the 14th of March, calcis carb. was given on account of the acrimonious coryza. After this remedy, the coryza and all the other symptoms were so far overcome, that no one any longer, thought of an organic lesion of the heart or the neighbouring parts. The ribs and sternum had completely returned to their natural situation." HERNIA. Cases of hernia are stated to have been cured by aurum, cocculus, magnesias carb., nux vom. and opium. Of these, nux vom. appears to have been the most frequently successful. The remedy of next importance is cocculus. 270 HYDROPS. Cases are also recorded of the spontaneous reduction of strangulated hernia after the employment of nux vom. Other cases are recorded in which the operation of this remedy appeared to favour the reduction. While it is very proper to endeavour to effect the cure of hernia by homceopathic remedies, the case is different with respect to strangulated hernia. The strangulation is an accident of very great danger, and the destruction of the patient, or injury as much to be dreaded as death itself, may speedily result from it. And while we believe that nux vom. has caused spontaneous reposition, we may still doubt the propriety of its exhibition, except in very early stages of the strangulation, when the symptoms are not very urgent, because hernia most frequently owes its origin to chronic morbid conditions of the system, and therefore nux vom. must frequently fail. And as the disease does not allow time for the beneficial operation of the remedies which are calculated to remove these chronic morbid conditions, it is most probable, that the safest practice, in the present state of our knowledge, is to treat strangulated hernia by the usual methods. HYDROPS. Dropsy. This disease is often associated with organic lesions of one or more of the abdominal or thoracic viscera, and although pathological anatomy may be unable to demonstrate such lesions, in all cases of fatal dropsy, yet the symptoms have most frequently pointed to the existence of functional derangement in the organs just HYDROPS. 271 mentioned. But both organic lesions and simple functional derangements may exist without the presence of dropsy, and, indeed, frequently if not always precede, for a considerable length of time, the appearance of the latter disease. It is not my object to attempt any explanation of the nature of this connection between visceral disorder and dropsy, but merely to state the facts and point out some of the most obvious inferences which may have a practical application. As most of the visceral lesions, which we find inducing or accompanying dropsy, are, in the present state of our knowledge, of an incurable character, it will be improper for the practitioner to give very great encouragement to the friends of the patient, even when remedies appear to be operating in a very salutary manner. For although the visceral derangement may be merely functional, and therefore of a remediable character, yet as we have no certain marks by which to decide that it is unconnected with organic lesion, the latter may exist and lead to the disappointment of hopes which have been prematurely and rashly excited. This connection of visceral disorder and dropsy should also induce us not to bestow too much of our attention on the latter disease, to the neglect of the other symptoms which are frequently of primary importance. This is a mistake which is frequently made; and those means which promise to remove the symptom, which is the most troublesome and afflicting to the patient, the hydropic effusion, are sought after with avidity. That remedies thus employed, which are incapable of abating or removing the morbid actions which are the primary source of the 272 HYDROPS. effusion, should only produce temporary palliation, and oftentimes not even effect this, is only what might rationally be expected, and what daily experience proves. Before proceeding to speak of the remedies which have proved useful in dropsy, it is proper to remark, that in the homceopathic treatment of this disease, all articles of diet which possess a strongly marked diuretic property, should be forbidden to the patient. Arsenicum. Case, in a man of strong and robust frame, addicted to the use of spirituous liquors, and whose employment was of a sedentary character. He had felt himself very much debilitated and oppressed at the breast for several weeks. His appetite was gone, he had pains in all his limbs, became incapable of pursuing his business, and was at length confined to his bed. The whole body swelled, and an ascites, together with painful cedema of the feet, afforded grounds for a gloomy prognosis. The pains in his limbs were so severe that he dreaded to be moved on account of them. After a dose of ledum, perspiration, which had not appeared for a long time, again took place, and his skin became moist; the pains in his limbs diminished in violence. The improvement continued progressive till the eighth day, when it was interrupted by an impropriety of diet. Bryonia then obviously advanced the improvement, and arsenicum gtt. i. 30 removed the dropsical effusions which had already been, in some measure, lessened by the previous remedies. A number of other cases are recorded, in which the arsenicum appeared to produce great improvement, and some cases where it, aided by other remedies, effected perfect cures. 274 HYDROPS. purpose, but the disease again recurring, digitalis, in large and in small doses, failed to produce any benefit. In cases of ascites, benefit has been derived from the repetition of the digitalis as soon as there was a cessation of improvement from the preceding dose. Anasarca, occurring after scarlatina, has been cured by digitalis. Dulcamara. General dropsy in-a child. Face bloated, body and limbs swollen; great restlessness at night, on account of heat; urine deficient in quantity, and of a disagreeable odour; diminished appetite; thirst; flatulent eructation; costiveness and debility. Disease, the consequence of an intermittent fever. Dulcam. gtt. ss. 21 effected a cure. Dulcamara is adapted to anasarca when it arises from a sudden suppression of the perspiration induced by exertion, from exposure to cold and moisture. Helleborus was of striking ttility in a case of hydrothorax occurring in a man st. 57 ann. The urinary secretion, which had before been nearly suppressed, was restored. Cinchona, brypnia and sepia, completed the cure. The patient had been previously treated by an alloeopathic physician, without any success. In a case of anasarca occurring after scarlatina miliaris. Hydropic effusion in the cellular tissue; patient could not sit up; lay in a lethargic condition, and was fretful when aroused; loss of appetite; scarcely any secretion of urine; paleness of the face; helleborus gtt. i. 12 effected a cure. Helleborus 1130 cured, in the course of three days, ascites in a child. This remedy often affords speedy relief in the HYDROPS. 275 dropsies which occur after scarlatina, whether these assume the character of ascites or anasarca. Lactuca virosa effected a rapid recovery in a case of ascites with anasarca. Ledum operated very beneficially in a case of dropsy, attended with pains in all the limbs, and dryness of the skin. See, case under arsenicum. Lycopodium given in alternation with bryonia, has been productive of benefit in dropsy. In a case of ascites with cedematous swelling (anasarca) of the lower extremities, and lower part of the back. The patient, a man Eet. 37 ann., had been several times tapped, and the quantity of fluid discharged was very great. The intervals between the operations had diminished from six to four weeks. Two weeks after the last tapping, the patient considered himself as much distended as ever, and was anxious for the operation to be again performed. At this period I was desired to attend him. I found him with pale sunken countenance, great emaciation of the superior extremities, and great hydropic tumefaction pf the lower limbs, and of the penis and scrotum. His appetite was good, but his bowels were obstinately costive; active cathartics producing small and unsatisfactory discharges. He was subject to attacks of colic in the latter part of the afternoon, which continued till nearly bed-time. The urine, about a pint in twenty four hours, of a dark colour, and depositing a copious red sediment. His tongue was smooth, and of an unpleasant dark red colour. The pulse one hundred and four in the minute. His disposition, which in health had been rather irritable, appeared to be altered by his disease so that it had become of a more mild and patient character. I gave 18* 276 HYDROPS. him lycopod. 3124, and afterwards he had no return of his evening colics. In the course of a day or two his bowels were open, and the intervals between the stools became gradually shorter, so that in the course of eight or ten days, he had at least one stool every day. The fmeces were at first of a clay colour, but gradually passed through various deepening shades of yellow to a brown colour in the course of three or four months. The discharge of urine increased in quantity, reaching, in two or three weeks, to nearly a quart in twenty-four hours; the quality of this fluid also improved, the colour becoming lighter, and the sediment disappearing. The dropsical effusion abated in the inverse order of its appearance. The cedema of the privates, which had appeared latest, vanished first, and was followed by the anasarca of the legs and back. The diminution of the ascites commenced later, and only progressed until about half of the fluid was removed from the abdomen. The pulse gradually fell to eighty-four in the minute, and the tongue in the course of three or four months had become of a proper colour. When I state that the changes above mentioned were gradual, it is not to be understood that their progress was steady. On the contrary, about the fifth week it was evident that the improvement fromn the lycopodium had ceased. Cinchona, and afterwards mercurius, produced but little important change. Lycopodium, again given, produced a fresh advance of the improvement, but for a more brief period and to a more limited extent than before. About the end of the third month, there was a cessation of all improvement. The tumefaction of the abdomen rather increased, than diminished, the urine again became high coloured, a copious sediment HYDROPS. 277 was again formed in it, and the quantity diminished to a pint. A number of remedies have since been resorted to with only temporary improvement or without any marked effects, except that the urine has again become clear, and the pulse falls sometimes of late, below eighty-four in the minute. I have now had the patient under my care for nearly six months. He now goes up and down stairs without assistance, his tongue is of the natural colour; he has had no return of his colic, but has been subject for some time past to a load at his stomach after eating, continuing from fifteen minutes to half an hour; his flesh has considerably increased in bulk and firmness, and there is no hydropic effusion except in the abdomen. J. Mercurius is adapted to hydrothorax supervening scarlatina, where there is violent oppression of the breast; short, rapid and difficult respiration; heat and sweat over the whole body; anxiety; continual, short, dry, shattering cough; necessity of lying with the head elevated considerably, or of sitting up. Mercurius is also adapted to ascites and anasarca, when these are dependent on hepatic derangement. Phosphorus cured two cases of frequently recurring swelling of the face, with cedema of the hands and feet. Prunus spinosus has been recommended as a remedy in general dropsy. Rhus has cured some cases of dropsy occurring after scarlatina. Sambuci nig. cort. intern. proved powerfully diuretic in a case of general dropsy. Though the swelling was somewhat diminished, the improvement was only of brief duration. 278 HYSTERIA. ICTERUS. Solanum nig. proved useful in a dropsy occurring after intermittent fever. HYSTERIA. The following are among the most important.remedies for hysteric affections. Ignatia, aurum, bryon., ipecac., pulsat., cinchona, veratrum, valeriana, sepia, silex, sulphur, tr. acris, acid. nit. For the remedies which are adapted to those cases in which the hysterical disorders are so violent as to induce convulsions, see Convulsio. ICTERUS. Jaundice. Arsenicum. Dr. Gross mentions a case of jaundice which was dependent upon an incurable disorganisation of the liver, where arsenicum proved more beneficial than any other remedy; and he expresses the opinion, that had it been employed in an earlier stage of the disease, it would, probably, have effected a perfect cure. Belladonna has repeatedly cured jaundice in children; and in the same disease, but of a more obstinate character, occurring later in life, it has aided in the cure. Calcis carb. cured a jaundice, which returned periodically, attended with obvious tumefaction of the liver; habitual costiveness; grayish white stools, and dyspepsia. This remedy was given daily, for some time, in the dose of gr. i. 3, and afterwards in the higher dilutions and at longer intervals. ICTERUS. 279 Carbo veg. proved very useful in a case of jaundice, complicated with psora and ischuria. Chamomilla is often adapted to jaundice which arises, from transitory causes, as, for example, improper diet, mental emotions and exposure to cold. In the case of a man aet. 30 ann. After great vexation, which, as he was of a quiet disposition, he chiefly concealed, he had a severe chill. Afterwards, loss of appetite; a sensation, whilst walking, as if the stomach was falling down; dirty yellow coating of the tongue; much mucus in the mouth, especially in the mornings, when considerable quantities were thrownoff; at the same time a nauseous, unpleasant taste; nausea; bowels costive; urine of saffron yellow, large in quantity, and frequently discharged; the face, eyes and hands perfectly yellow; debility and evening chill. Chamomil. 9, followed the next day by pulsatilla gtt. ss. 12, and in two days more by nux vom. 5130, effected a perfect cure in the course of twelve days. Cinchona. In a case where aconit. had been previously given in order to moderate the fever, and where, besides the yellowness of the skin, there was loss of appetite; pain, upon pressure, in the region of the liver; tumefaction of the abdomen; the faeces but slightly coloured; two doses of cinchona removed the disease. Digitalis. In a case of jaundice attended by severe cephalalgia; nausea; mucous vomiting; debility; loss of appetite; dark brown urine; chalk white faeces; thirst, and full slow pulse; digitalis gtt. i. 15 was followed, in thirty-six hours, by six stools, each stool more yellow than the preceding, and gradual restoration of health. 280 INCUBUS. LEUCORRH(E A. Mercurius is an important remedy in jaundice. Nux vom. Judging from the reported. cases of cures, this remedy is the most important in the treatment of jaundice. The cases to which it is adapted, have, in addition to the yellowness of the skin, some or most of the following symptoms. Loss of appetite. Nausea or vomiting, especially after eating. Pressure or pressing pain in the stomach. Tongue coated. Disagreeable taste. Constipation or costiveness. Faeces white and hard. Pulsatilla has been employed in the treatment of jaundice; but, in the reported cases, nux vom. has generally been also used. Sulphur has been recommended as a valuable remedy in jaundice. In addition to the above mentioned remedies, the following have also been recommended; acid. nit., bryonia, dulcam., ignatia, ipecac., lycopod., magnes. mur., sepia, sodce mur. INCUBUS. Nightmare. Where this disorder frequently appears, the following remedies will often be found useful; aconit., ammonice carb., bryonia, bellad., ignatia, guaiacum, nux vom., opium, sulphur. LEUCORRH(EA. Fluor albus. Whites. Aconit., in repeated doses, has sometimes proved serviceable in leucorrhcea. Alumina. In a case where the discharge was of a 282 LEUCORRH(EA. Copaiva bals. has been stated to be a good remedy in fluor albus arising from gonorrhoea. Iodine. Dr. Mauro states that iodine has proved a very important remedy in leucorrhoea, and that by a single dose of iod. 3130 he had cured this disease, though of many years' duration, in a woman ret. 50 ann. Lycopodium. When the discharges of a yellowish matter are sudden, and preceded by a cutting pain low in the abdomen; the patient is dyspeptic and often affected with sudden flashes of heat in the face, though this is pale. Mercurius. Two doses of mere. 12 cured a leucorrhoea. Nux vom. When the discharge consists of a fetid yellow mucus, and the leucorrhoea is complicated with cephalalgia, colic, distension of the abdomen, and constipation. Pulsatilla. When the discharge consists of a thin, acrimonious mucus, and is attended by a burning sensation in the vagina; sorrowfulness and depression of spirits. Sepia. In a case where, with a copious discharge of thick, yellow, acrimonious matter-throughout the day, there was fulness, heaviness and tension of the abdomen, and continual downward pressure in the sides; sepia proved very useful. (In a case of leucorrhoea of two years' standing, characterised by pain in the back, an increase of the discharge from exercise;. the matter of a light yellow colour and unirritating quality. I administered sepia with entire success. Green.) In addition to the remedies above mentioned, the following have also been recommended. Acid. nit., LIVER. 283 arsen., bellad., bovista, conium, carbo veg., ferrum, graphit., ignatia, mezereum, petroleum, platinum, sabina, silex, sodce mur., stannum, staphys., sulphur, thuya. LIVER. HEPATITIS. As the inflammatory fever, which accompanies this disease, is generally very considerable, it is mostly proper to commence the treatment with repeated doses of aconit., and then, according to the circumstances, to employ either bryonia, nux vom., mercurius, or any other remedy which is adapted to the case. Belladonna is adapted where there are pressing pains in the region of the liver, which extend themselves as far upward as the shoulder; distension of the epigastrium, and intolerable tension across the abdomen immediately above the umbilicus, with difficult respiration and anxiety; determination of blood to the head, with confusion of the head, dimness of sight and the vertigo of approaching syncope; great. thirst; agonising restlessness; sleeplessness. Bryonia has been frequently employed after aconit., with satisfactory results. In the case of a boy aet. 14 ann., of strong frame, and irritable disposition, who had been ill for eight days, and gradually becoming worse. The region of the liver extremely painful on being touched; tongue dry, with a dirty brown coating; taste bitter; face red, and hot; heat and dryness of the surface of the whole body; sensation of violent internal heat interrupted by slight chilliness; sticking pains extending 11 284 LIVER. upwards from the region of the bladder; cutting pains in the extremities, which were very severe on motion; pulse hard and frequent. The patient had drunk plentifully of chamomile tea (matricaria chamomilla) and had afterwards a severe diarrhcea, which had ceased after the discontinuance of the tea. In twenty-four hours after aconit. 4 24, the pains had diminished, the skin was moist, the pulse normal, and the heat absent. Bryonia 4130 was followed by rapid convalescence, and in six days the patient was able to resume his usual employment. Chamomilla is adapted to hepatitis, especially when this disease owes its rise to violent anger or exposure to cold; but it is proper to precede its employment by a dose of aconit. Lycopod. In a case of hepatitis complicated with pneumonia, arising from walking in the open air soon after recovery from an attack of pneumonia, which had been treated with aconit. 3130 and bryonia 3130. Dry cough, with stitches in the breast, which impeded respiration and speech; yellowness of the eyes and face; burning and sticking in the region of the liver, in which the slightest touch could not be borne without screaming; the patient lay easiest on his back, and could not lie on either side; tongue with a yellow coating; nausea; cephalalgia; heat, thirst; much sweat; pulse small and frequent. After aconit., nux vom. and merc. had been employed without obvious amendment; lycopod. 2130 changed the condition essentially in twenty-four hours, and in eight days the patient was perfectly well. Mercurius is one of the most important remedies for hepatitis, but in the reported cases, nux vom. or bryonia has most commonly been previously used. LIVER. 285 In a case arising from exposure to cold. Severe sticking, burning pain. in the convex part of the liver, extending to the spine, and increased by sneezing, cough, deep inspiration or pressure; liver greatly enlarged, and protruding below the ribs; great tension of the praecordia; frequent vomiting of bile; flatulent eructation; tongue with a white coating, and moist; taste acid and bitter; great thirst; constipation; urine burning and high coloured; face swollen and red; warmth of the skin moderate; pulse small and hard. After aconit. gtt. i. 24, mercurius gr. ss. 12 was given, and effected a cure. Nux vom. This remedy is generally employed in the treatment of hepatitis. Dr. Schubert states that he cured seven cases of this disease, which were accompanied by considerable gastric derangement, with nux vom., followed by mercurius. He details the following case. CASE. In a woman ' t. 30 ann., of sanguineocholeric temperament. In the region of the liver, which was tumid, the patient felt stretching and severely sticking pains, which were increased by every inspiration and cough; external pressure could not be endured, and she could lie only on her back; respiration short, difficult and painful; excessive soreness in the region of the stomach; violent pain in the right shoulder joint; general heat; frequent, light sweat; pulse rapid, full, and somewhat hard; sleeplessness from pain, &c.; cramps in the feet, and in the right gastrocnemius muscle; severe thirst, especially at night; little appetite; after eating, pressure in the stomach; eructation, with taste of putrid eggs; nausea and bilious vomiting; twice in the day, diarrheal stools; cloudy red urine, speedily depositing a q86 LUNGS. lateritious sediment; peevish and quarrelsome. Nux vom. gtt. i. 30 effected considerable improvement in twelve hours. On the second day the patient complained only of pressure in the stomach after eating, and of outward pressing pain in the region of the liver, which was still tumid. Mere. gr. i. 2 was then given, and in a few days the disease entirely disappeared. In addition to the above remedies, the following have been mentioned as worthy of attention in acute hepatitis; antimonium, cinchona, pulsatilla. HEPATITIS CHRONICUS. In those forms of morbid action in the liver, which are termed chronic hepatitis, sulphur, soda, magnesia mur. and lycopodium are the remedies most frequently indicated, though the following are mentioned as likely to be sometimes useful; ammonies mur., antimonium crud., bellad., carbo anim., potassce carb., sodce mur. LUNGS. Some diseases in which the lungs are considerably or principally affected, have been already considered under separate heads, as, for example, catarrh and asthma, and others will be thus considered. Therefore I shall treat in the present article only of inflammation of the lungs. PNEUMONIA. PLEURITIS. Aconit: is the most important remedy in inflammation of the lungs, and is employed advantageously in nearly all cases. If it should fail to remove the disorder entirely, it will generally abate its violence, and diminish the accom MAMM E. 289 face tumid, and of a brownish red; pulse hard, small and intermittent; violent palpitation of heart; skin hot and dry; urine of a deep red colour; tongue rough and dark coloured; thirst considerable; bowels not open for two days. Bryonia gtt. 1.12 was followed by an increase in the violence of the symptoms for some hours, and then by a gradual abatement. The next day she was free from fever, had no pain, and could take a long breath. The bowels had also been open. By the following day she was well. MAMMIE. The Breasts. The breasts of females are very liable to inflammation, but especially so after parturition, during lactation, and at the time of- drying up the milk or weaning the child. It may arise from not applying the child to the breast sufficiently early, or neglecting to resort to other means for relieving the mamma from the accumulated milk. Drawing off a portion of this fluid will often remove the inflammation in its early stages. A variety of contrivances have been resorted to for this purpose, but none of them are superior to the mouth of the infant when this is perfect, and the nipple is properly developed and free from disease. But where the infant cannot perform this office, the mouth of an older person, where one can be found willing to undertake it, is next to be preferred. But there are cases where, from soreness or malformation of the nipple, or other causes, we must resort to other means. In the employment of these, especially of some of later inven19 290 MAMMXR. tion, where the vacuum is formed by means of an air pump, care must be taken that too much force be not applied, for serious injury may possibly be inflicted on the lactiferous ducts. Indeed, but little force should ever be applied; for much often defeats us of our objects, and frequently the mammae will relieve themselves without any external aid. In the case of a woman where, instead of nipples, there was a concavity as if the nipples were inverted, I thought it proper to endeavour to draw off some of the milk by artificial means, though there was a slow exudation of this fluid. Suction, instead of increasing the flow, suspended it, and I was obliged to desist. The natural discharge proved sufficient, for in the course of a few days, the pain disappeared, and the secretion soon ceased without any unpleasant consequences. When the milk does not flow of itself, or is not yielded to gentle suction, diseased action is already present, and the remedy is not forcible suction but the employment of those means which will remove the disease. For although retention of the milk may induce morbid action, it is itself more frequently a result of disease induced by taking cold, or other causes. Under these circumstances, we find a general hardness of the breast; the lactiferous vessels feel like knotted cords, in which the patient experiences sensations of tension and pressure. As inflammation advances, the surface of the breast becomes more or less reddened, the tumefaction and hardness increase, and are accompanied by severe lancinating and burning pain, and general fever. The most important remedy in these cases, before the inflammation has become very violent, is bryonia, but where the MAMMILLAE. 293 She suffered also from cough; shortness of breath; great debility and amenorrhoea. The disease of seven weeks' duration. Silex 30, keeping the sore clean by frequent washing, and the use of a dry bandage to support the breast, produced rapid improvement. In eight days the breast had resumed its natural size, and become soft, but several weeks elapsed before the breast was entirely healed, and the general health fully restored. GALACTIRRHWEA. When the milk is too copiously secreted and runs freely from the mamme, without suction on the nipples, and the discharge is so great as to induce debility and emaciation, the following remedies are recommended; calcis carb., phosphorus, aconit., rhus, belladonna. AGALACTIA. When there is a suppression of the secretion of milk, or where it is deficient in quantity, pulsatilla and zincum are recommended as remedies which are likely to be indicated. In those cases where, although the secretion of milk is proper as to quantity, and the health of the mother and infant apparently good, yet the latter refuses to take the breast, Hartmann highly recommends cina and mercurius. SCIRRHUS MAMMIE. See article Scirrhus. MAMMILLJE. The nipples. The nipples are very liable to become sore, the soreness varying in degree from simple abrasion of the cuticle, to such deep ulceration as destroys them. This soreness appears, sometimes, to be the result of 294 MAMMILLE. irritation from the mouth of the child, and in some "of these instances to be the effect of the acrimonious secretions in the mouth of the infant while it is suffering from aphtha. In other cases, the soreness partakes of the character of a tetter, and is dependent on a morbid condition of the system. But whatever may be the form or cause of disease of the nipples, it most generally inflicts great torture on those whom it affects. In its more simple forms, and where, it exists independently of constitutional derangement, moistening the nipple, whenever the infant is removed from the breast, with a wash formed by mixing two drops of tincture of arnica with a teaspoonful of water, will frequently be sufficient to remove the disease. Every time before applying the child to the breast, the nipple should be washed with lukewarm water. When this treatment does not remove the pain entirely, in forty-eight hours, it is recommended by Hartmann to administer sulphur 1130. He also remarks, that, at times, calcis carb., lycopodium, sepia or graphit. is indicated in the beginning; these indications being decided by the accompanying symptoms. The graphit. is particularly useful when the inflammation is considerable, and approaching an erysipelatous character, or where the patient has been subject to scrofulous eruptions on the skin, or to tinea capitis, and when she still complains of itching of the scalp, with much furfuraceous desquamation. CASE. In a woman with her fourth child. At the commencement of lactation, the nipples became sore, and were deeply chapped. The chaps frequently bled, and burned like fire. There were also such deep fissures at the base of the nipples and in the MAMMILLA. 295 areole, that there was cause to apprehend the loss of the nipples. For several weeks the disease was treated, with washes, ointments, and plasters, from the most successful of which she experienced only temporary relief, and from some of the others considerable aggravation of her sufferings. These being laid aside, a small part of a drop of spt. vini sulphurat. was given internally. Frequent washing of the nipples with pure, lukewarm water was also recommended. In three days there was a diminution of the burning pain, and a cessation of the bleeding from the fissures. In four weeks the fissures were completely healed, but a slight degree of soreness remained, which increased in the fifth week, and in the sixth week a number of small vesicles appeared on the nipples. Graphit. was then given; the vesicles dried up, and soreness disappeared entirely. In four weeks there was not a trace of the disease. She had nursed her child during the whole course of the treatment. CASE. The nipples sore, tumid, hard and inflamed. This case was treated "antipathically," by the' same physician who afterwards treated it homceopathically. The pain caused by applying the child to the breast was so great, that it was applied as seldom as possible. Owing to its consequent imperfect nourishment, the infant sickened and died. Previously to the death of the child, the right breast of the mother had inflamed and suppurated. This had healed, but many knots were left in it, as also in the breast which had not suppurated. After the death of the infant, the soreness of the nipples disappeared, but the indurations remained. Four months afterwards, the patient became pregnant. In the third month of gestation, 296 MENSES. she felt a drawing in the indurations, which more and more frequently returned, and at length changed into pain. At the end of the fourth month, the breasts were turgid, and so sensitive that the slightest touch excited pain. The nipples and areole were ulcerated, and covered with straw yellow scales, from beneath which there exuded an acrimonious fluid. In the affected parts there was severe itching at night, and scratching caused burning pain. In the fifth month, the disease had become so troublesome, that the physician was called to visit her. He gave her a small dose of tinct. sulphuris, and in two days the sensibility of the breasts began to dimi.ish. By the ninth day, the indurations were smaller and less painful, and in seven weeks after the administration of the sulphur, the nipples were nearly well, and the breasts without pain. The smaller indurations had disappeared, and the larger had lessened very much in size. Graphit. was then given, and in eighteen days the indurations had entirely disappeared, and the right nipple was perfectly well, but the left nipple was still covered with scales, and ulcerated. Lycopodium was afterwards given, and in the course of four weeks the disease was completely removed. At the proper period, she was delivered of a child, and suckled it without the slightest return of her old complaint. MENSES. AMENORRH(EA. Emansio mensium. "The circumstances which most commonly attend the first commencement of the menstrual secretion, are: determi 298 MENSES. as fright, grief &c., &c., is known, the remedy which is most useful in removing the effects of such cause, may be the proper one for the case. But if much time has already elapsed, such remedy will frequently be found inefficient, and the indications for the remedy must be found in the existing symptoms. Cocculus is often the best adapted remedy, when, at the period of menstruation, instead of the menses, there are abdominal cramps, and especially when there are combined with these, constriction of the chest; anxiety; sighing and groaning; paralytic weakness, the patient being unable to speak aloud, and the limbs relaxed; convulsive movement of the limbs, and scarcely sensible pulse. Cuprum or cupri acetas, when the typical paroxysms consist in most intolerable abdominal cramps, which extend themselves into the breast, and produce nausea, retching, and even vomiting; at the same time the limbs are also affected, and convulsions similar to the epilepsy are produced. Besides the remedies above mentioned, the following are worthy of recommendation; valeriana, platin., bellad., ignat., magnes. arcticus, mezer., digital., pulsat., magnes. carb. and mur., sulphur, zinc., silex, lycopod., graphit., acid. nit. MENSES IMMODICIE. What is generally termed immoderate menstruation is seldom a real increase of the menstrual secretion, but a true hemorrhage; the proper remedies for which will be found under the head of Metrorrhagia menstrualis. The same remedies are worthy of attention, when (if this is ever the case) the menstrual secretion is morbidly increased. MENSES DIMINUTE. Where bad health accompanies a diminished, or uncommonly small menstrual NEPHRITIS. 299 secretion, the remedies already mentioned for retention or suppression of the menses, deserve attention. DYSMENORRHCEA. Where menstruation is accompanied, by pains, shooting from the back into the thighs, and by bearing down pains in the lower part of the abdomen, resembling labour, or after pains, secale cornut. is indicated. I prefer the lower dilutions of this remedy for the greater certainty of effect, though they are sometimes productive of considerable temporary aggravation. In this form of morbid menstruation, the periods are too frequent, and the discharge is mostly, if not always hemorrhagic, as is exhibited by the fact of the coagulation of portions of it. The other remedies for metrorrhagia menstrualis are therefore worthy of attention in most forms of dysmenorrhoea. J. NEPHRITIS. Inflammation of the kidneys. Aconit. is proper to abate the violence of the inflammatory fever. Belladonna. This remedy is adapted where there are spasmodic sticking and burning pains in the back, in the region of the kidney, which extend themselves in the course of the ureters, to the bladder, and pain in the lower part of the abdomen, increased by pressure; high coloured urine in small quantities;, anxiety; restlessness; constipation. Calcis sulph. is often indicated when the symptoms above mentioned are present. Cannabis is recommended, when a drawing pain, as from soreness, extends from the kidneys to the 302 NEURALGIA; thirst. Pulse full and hard. Disease of three days' duration. Colocynth. was followed, after a brief homoeopathic aggravation, by comfortable sleep, and the next day he was perfectly free from his complaint. A year afterwards he was attacked with the same disease, but was at once treated with the colocynth. with the same success as before. Conium cured a severe neuralgia of the face, which consisted in tearing pain, passing, with electrical rapidity, through the right side of the face, and returning every two to five minutes. The remedy was given every day, for some time. Mezereum. N. facei. In a man ret. 25 ann. Six or eight paroxysms in a day, of pressing, pinching, spasmodic pain in in the superior maxillary bone of the left side, extending upwards into the eye and temple, and downwards to the ear, teeth and shoulder. Paroxysms induced by entering a warm room or eating warm food. Mezereum gtt. i. 6 produced an aggravation of the complaint for a day or two, then entire disappearance of the pain for a day. After it again returned, chamomilla removed it for some time. In eight days it again returned, when mezereum 2118 perfectly cured it, and a year afterwards there had been no return of the complaint. Phosphorus. N. facei. In an otherwise healthy and robust man met. 30 ann. Disease of eight years' standing. Origin, taking cold. Vertigo on rising from bed, for which many bleedings, purgatives, &c., had been employed without benefit. Itching over. the temple and whole left side of the face. Face tumid and pale. Dull tearing in the left cheek, and dull drawing in the left upper jaw, to the root of the nose; pain and stitches in the left cheek, from the NEURALGIA. 303 jaw towards the ear. Pain throughout the entire left side of the face on opening the mouth. Phosph. produced homoeopathic aggravation for two days. In fourteen days he was well. No return at the end of a year. Spigelia. N. facei. Dr. Gross states that he cured several cases of neuralgia facei, of recent origin, with spigelia 30. But that, in a case of considerable duration, in a man of fifty years of age, this remedy moderated, for a time, the violence of the paroxysms, but could not remove the disease. In this case, the pain was paroxysmal and excessively violent, and affected the whole left side of the face, but raged most violently in the zygomatic bone and the parts bordering on the orbit. The patient could not endure (in the paroxysms) the slightest touch on the affected parts, nor the slightest motion of a single limb. The left side of the nose, and the left half of the upper lip, were tumid and shining. After the spigelia, he employed, in succession, calcis carb., lycopod., sepia, baryt., phosph., and concluded the cure with graphit. 30, because, after every change of weather, there was a morbid sensibility of the parts which had been affected. After the graph., there appeared on the left side of the face an erysipelatous affection, which disappeared in a few days, as also did every trace of the neuralgia. In several cases of neuralgia facei, I found the spigelia of great service. In the case of a young lady who had suffered, at times, under this complaint for more than a year, the most violent paroxysms coming on towards evening, pulsatilla produced temporary abatement of the suffering. Spigelia speedily removed it. After some weeks there was a return of 306 ODONTALGIA. bed; increased by cold drink; swelling of the cheek and neighbouring glands. O. digging and gnawing in carious teeth, increased by drinking coffee, and worst at night; gums swollen and burning. O. grumbling and drawing in carious teeth, worst after eating and at night. 0. nightly, before the return of every menstrual period. 0. beating, most severe at night, especially in a warm bed; cheek red and slightly swollen; sweating of the scalp; severe thirst, and sometimes swelling of the sub-maxillary glands. A form of odontalgia frequently occurring in women and children. Cinchona. 0. beating, most violent after eating and in the night; the slightest touch aggravates the suffering, though firmly pressing the teeth together, relieves. Paleness, emaciation, diarrhoea, night sweats. Similar odontalgia, from the abuse of cinchona, was relieved, in one case, by arnica, in another by pulsat., two remedies which answered less to the beating odontalgia than to the collective symptoms. Coffea crud. 0. beating, occurs frequently in coffee drinkers, and requires for its relief aconit., cham., ignat., nux vom. or pulsat., according to the circumstances of the case. 0. beating; the exhibition of the signs of suffering disproportionate to the actual pain, and known to be so by the patient herself. In a lady who did not use coffee, coffea cr. 6 afforded relief in two minutes. After five minutes, for remaining sensibility in the previously affected parts, ignatia was given, and followed by the speedy disappearance of this symptom. 310 ODONTALGIA. evening and night, especially when warm in bed, or after eating. Frequent flatulent eructation; uterine hemorrhage. In one case it supervened on the repulsion of podagra from the great toe by means of external applications, and was speedily removed by the sabina without a return of the disease in either form. Sepia. 0. beating and sticking, extending to the ear, and through the arm to the fingers, in which there is a sensation of crawling. Affections of the respiratory organs, and swelling of the cheeks and sub-maxillary glands, frequently accompany it. It most frequently occurs in persons who have a yellowish colour of the face. 0. beating; of pregnant females, but the improvement seldom commences till after several hours, it then, however, continues for a long time. Silex. 0. beating, similar to those of sepia, only that in the cases for silex, the periosteum of the lower jaw is swollen, and the pain is more in it than in the teeth, and the patient cannot sleep at night, on account of general heat. Mostly, there is a diseased condition of the skin, owing to which every trifling wound becomes an eating sore. Spigelia. 0. drawing and tearing, in all the teeth of the upper jaw, especially the incisors, twitching with electrical rapidity through the crown and root of a tooth into the jaw, most in the day-time. Lukewarm drinks relieve; hot and cold aggravate. Teeth sensitive to the cold. 0. beating, with a form of neuralgia facei; there is burning and tearing in the jaw; the face is pale and bloated, with yellow areole around the eyes. The patient also suffers from pain in the eyes; fre ODONTALGIA. 311 quent urinary pressure, with small discharge; severe palpitation of the heart, and frequently a sensation in the breast like the purring of cats; chilliness and great restlessness. Staphysagria. 0. gnawing; in a carious molar tooth, with drawing pain along the front teeth, and upwards towards the eye; worse in the morning; increased by eating and chewing; in the free air and by cold drink; relieved by warmth. Gums bleeding easily. 0. paroxysmal; all food and drink excited most intolerable pain; chewing was impossible. Sulphur. 0. drawing; increased by warmth, evenings and nights, with sticking in the back part of the head, or with drawing and sticking through the tooth and head. 0. jerking, stitchlike; in carious teeth in either jaw. 0. beating; arising from the suppression of cutaneous eruptions by means of external applications. In the cases adapted to this remedy, the gums are swollen, and suffer the beating pain as well as the teeth. There is, commonly, great sensibility of the tops of the teeth; determination of blood to the head, with beating headache, especially of evenings; red and inflamed eyes and nose; stitches-in the ears; frequent ineffectual pressure to stool; pain in the loins; restlessness in the limbs; sleepiness in the daytime; chilliness, &c. Tr. acris. 0. beating; without fever. Gums painful, easily bleeding; tearing pain in the muscles of the face, and in the eye and ear. Veratrum. 0. beating; accompanied by swelling of the face; cold sweat of the forehead; nausea or 312 OZ2ENA. bilious vomiting; weary feeling of the limbs; sinking of the powers, even to syncope; coldness of the whole body, with internal heat and unquenchable thirst for cold drink. OZ/ENA. Alumina, in repeated doses, cured a case where there was a discharge of a thick, yellow and fetid fluid, especially in the mornings. Also, at times, of large, firm, yellowish green lumps of dried matter. Stoppage of the nose. Sometimes copious bleeding of the nose. Loss of smell. Pain at the root of the nose and in the frontal sinuses. Paleness of the face. Costiveness. Tetter on the backs of the hands and fingers. Aurum has been productive of much benefit in obstinate stoppage of the nares, with crusts from ulceration, in scrofulous children, especially when the eyelids were red and inflamed, and hordeolum frequently occurred. In a case where thick, yellowish green matter, partly fluid, partly dried into firm lumps, was blown from the nose; there was a constant disagreeable odour from the nose; loss of smell; stoppage of the nares; aurum, in repeated doses, proved useful. Phosphorus: Case, in a man et. 22 ann., supervening the cure of tinea capitis by means of ointments. Chronic inflammation and great enlargement of the nose. The mucus dried into hard crusts, which, when softened by snuffing up warm water, could be expelled by powerfully blowing the nose. After bryonia had somewhat improved the general OZENA. 313 health, phosphorus 30 was given, and in fourteen days the disease had disappeared. Rhus. 'A case is mentioned where an ozena, existing at the same time with a tinea capitis, was cured by. rhus 30. Sepia. In a case of ozena, which appears to have originated from taking cold. After washing the head in cold water, whilst heated in warm weather, a severe beating pain attacked the forehead, and, subsequently, the ozena appeared. Scabs were formed in the left nostril, of extremely offensive odour, and sometimes so large, that they must be drawn back through the posterior nares and thrown out of the mouth, which excited vomiting. After belladonna, the pain in the forehead diminished, and the discharge became greener and. more moist. Sepia was next given, and effected a perfect cure in six weeks. In a case of ozena, of several years' duration, supervening a disease of the scalp, near the crown of the head, which had left a space of the size of a dollar, with an irregular, uneven surface, over which the hair grew sparsedly scattered, although the rest of the scalp was well covered with hair. The patient frequently discharged from the affected nostril, large masses of scabs or crusts. His breath had a peculiarly offensive odour, and he complained of constant lassitude and weakness. Phosphorus produced temporary improvement. Sepia, afterwards given, effected the same thing, but to a much greater extent, and for a longer period. For some time he ceased to discharge the scabs, his breath lost its offensive odour, and he experienced a very great improvement in his general health, a circumstance which was obvious to others in his greater animation of countenance and improved 314 PARALYSIS. complexion. But the disease afterwards returned, though not with its original violence. Sepia again lessened, but did not entirely remove it. The qase has now been for several months under treatment. J. The following remedies are also worthy of attention. Assa, antim. crud., cantharides, cina, conium, mercurius, mezereum, nux vom., ranunculus bulbosus, sulphur, thuya. Where the ozena is of syphilitic, sycotic or mercurio-syphilitic character, the remedies which are adapted to these diseases will be proper. PARALYSIS. Arnica. In a case of paralytic weakness of the extremities, especially of the hands; temperature and sensibility normal; arnica was given. After the cessation of its operation, nux v., and subsequently sulph., and again arnica, with restoration to health. Belladonna. In paralysis, occurring after apoplexy. Two cases, the one in a woman met. 45 ann., reported by Dr. Bigel, (Arch. 5, 2, 32), the other in a man mat. 42 ann., reported by Dr. Bethmann, (Arch. 14, 1,, 133), are remarkable for the similarity of their circumstances in regard to the previous condition of health, time of attack, symptoms, operation of the remedy, and cure. Both patients were of a sanguineo-choleric temperament, and had been for a long time subject to headache, constipation and rheumatic pains of the limbs. Both were attacked about an hour after midnight with apoplexy, in consequence of which there was an PARALYSIS. 315 entire loss of sensibility and of the power of motion in the right side of the body. In both all the organs of sense were weakened, there was inability to speak, and the mouth was distorted. Both had convulsive movements of the muscles of the unparalysed side; a constant flow of saliva from the mouth; much thirst, and difficult deglutition. In both, the eyes were red and prominent, and the face tumid. The pulse in th1e man was full and hard, (voll und hart), in the woman it was elevated and full (eleve et plein.) The intellectual faculties of both were perfect, and they felt the bitterness of the present and the future in all its force. To the man, bellad. 2130, and to the woman, bellad. gtt: i. 24, was given. In the former, the aggravation commenced in less than fifteen, and in the latter, in less than thirty minutes. In both it lasted about thirty minutes, then each fell into a sleep, which was accompanied by a general sweat, and both awoke much improved, and capable of speech and motion. The man had some pain and heaviness in the head, which left him the next day; the woman some heaviness in the left side of the head, and some lively pain about the umbilicus, both of which symptoms disappeared the next day, after a free discharge from the bowels. Bryonia. Paralysis, with numbness of the lower extremities, which did not feel as if they belonged to the patient, and were emaciated and cold. Costiveness. Cocculus. Paralysis in a robust child ýet. 8 ann. Sudden without known cause. Loss of voluntary 316 PARALYSIS. motion, with numbness and sleepiness of the extremities of the right side. Cocc. gtt. i. 9. In three days restored to health and remained so. Paralysis after apoplexy. After.the beneficial operation of rhus, cocc. completed the cure, but the sensibility of the. affected parts did not return till after fourteen days. Paralysis of the left arm and foot; the patient could not move the fingers or toes. Arm and leg entirely flaccid and powerless, yet not insensible; felt a particular coldness in them. Face somewhat tumid and red. Difficult respiration. Inclination to costiveness. Cocc. gtt. i. 9, and later gtt. i. 6, afforded, together with a dose of rhus 15, the most relief. Paralysis of the, left side, which was completely immovable. Sinking of the intellectual powers, so that what happened was not observed. Urine discharged unconsciously and involuntarily; stools had to be forced; cedematous swelling of the feet. Cocc. gtt. i. 12, and after eight days gtt. i. 9, effected an important improvement, and almost the complete removal of the concomitant symptoms. Coccul. has been recommended as very useful in paraplegia. Coccul. 5112, repeated after some days, cured a paralysis of the right side, after apoplexy; the right arm and thigh perfectly paralysed, but the fingers and toes capable of motion. Ferri murias. Paralysis of the shoulder joint. Lachesis. Paralysis of the left side. In one case very useful in alternation with rhus. Ledum. Paralysis connected with rheumatism of the hip joint. Lycopodium. Almost complete paralysis of the feet, 318 PARALYSIS. - Patient laid on his breast (the only endurable position.) The head was drawn back so that the occiput nearly touched the vertebrae of the back; face pale, sunken, distorted and covered with cold sweat; the dorsal vertebrae were distorted; on bending and examination of the hlmbar vertebre, there was crepitation, as if the articulation was interrupted. In the region of the sacrum, there was a great tumefaction of the bone, the touching of which as well as of the rest of the spine, excited excessive pain. The patient screamed continually from severe pain. The lower extremities were perfectly paralysed. Dysuria and blood red urine. Constipation so obstinate that enemata could induce no feculent discharge. No appetite; emaciation; constant fever, with evening exacerbation; great thirst; sleep, but little, restless and full of frightful dreams; strong jerks throughout the whole body. Rhus 1130 produced great amendment. This medicine was repeated every eight days, till the cure was complete. This remedy proved very useful, in a case of paralysis of the arms, with diminished sensibility. Stannum. Paralysis, with sensibility. Stannum aided by stramon. and belladonna effected a cure. Sulphur and sodce murias cured a case of paralysis with involuntary discharges of faeces and urine. Sulphur removed a paralytic weakness of the lower extremities, attended with pain in the hips and sacrum at every step. Tr. acris. Paralytic weakness of the right side, of three years' duration. Vertigo; difficult passage of the urine and faeces; cramp in the right foot; face pale; emaciation. Tr. acris 2130, repeated in two 320 PARTURITIO. Magnet. pol. arct., as also sepia, have been reported to have proved highly beneficial in paronychia. PARTURITIO. PARTURITION. The object of the introduction of the present article, is only to mention the remedies which are adapted to some of the morbid conditions which occur during or shortly after parturition. Some of the most important of the diseases, which attack after delivery, are elsewhere treated of in this work. See Febris puerperalis, Peritonitis, Mamme, Phlegmasia alba dolens, Metrorrhagia lochialis, &c. Where, during labour, the pains are weak, or entirely cease, pulsatilla may be indicated. When the pains are " too violent and stormy," nux vom. is proper. For after pains, when the patient is in a state of great excitability, coffea or. chamomilla. When the patient is of a mild, soft disposition, but is very excitable, and disposed to be readily alarmed, pulsatilla. If the after pains are combined with a slow metrorrhagia of thick, dark coloured blood, and consist of sharp, cutting pains in the thighs, organs of generation and sides, extending towards the sacrum, crocus; but when the metrorrhagia consists of coagulated blood, which is discharged at the same time that the. pain is most violent, chamomilla is the proper remedy. When after pains are accompanied by a sensation of pressure to stool, and the spasmodic pains are felt most in the regions of the uterus and bladder, nux vom. will frequently relieve them in a few hours. Hartmann considers the arnica as the most valuable and almost specific remedy for after pains. i s PERITONITIS. 321 For convulsions, attacking during labour or after delivery, the following remedies have been recommended; hyosciamus, chamomilla, cicuta, ignatia, belladonna. For contusion or laceration of the sexual parts, arnica; if the injury is inflicted on the external parts, washing them with a weak infusion of arnica flowers or mixture of tr. arnicme and water. When the bowels are not open by the fourth day after delivery, enemata, which do not contain active medicinal articles, may be employed, and nux vom., bryonia or opium, according to the circumstances of the case, may be used to correct the disposition to constipation. Where there is troublesome diarrhoea, dulcamara, hyosciamus, rheum or antimonium crudum may be indicated. PERITONITIS. Inflammation of the peritoneum. In this disease, as in most other inflammatory affections of important organs, it is generally considered proper to commence the treatment with aconit. This practice, however, has not been uniformly pursued, and the very satisfactory result of a case, which appears to have been one entitled to the appellation of puerperal peritonitis, treated by belladonna alone, shows that the aconit. is not always indispensable. For the case alluded to, see belladonna in the article Febris. Bryonia is a valuable remedy in puerperal peritonitis. The following case, in which it was 21 PHLEGMATIA ALBA DOLENS. 323 improvement, and bryonia 5130 was given in the morning. A rapid improvement, without any previous homoeopathic aggravation, took place, and in the afternoon, the patient was dressed and sitting up in a chair. Two more doses of bryonia 3130 were required for the completion of the cure. Hyosciamus is stated to have succeeded in the cure of a case of peritonitis, where belladonna had failed. PHLEGMATIA ALBA DOLENS. Milk-leg. For this complaint, which fortunately is not of very frequent occurrence, a considerable number of remedies have been recommended, viz.: aconit., arnica, arsenicum, belladonna, bryonia, calcis carb., chamomilla, cinchona, lycopodium, mercurius, nux vom., pulsatilla, rhus, sulphur, veratrum. Of these, belladonna, arsenicum, rhus and bryonia, appear to be of the most importance, though arnica has been recommended as peculiarly adapted to its incipient stages. PHTHISIS PULMONALIS. Consumption. This term is applied to those diseases in which, with considerable cough and more or less expectoration, there is emaciation, hectic fever, &c. SAs these symptoms proceed from very different disorders of the organs of respiration, it is obvious 21* 324 PHTHISIS PULMONALIS. that phthisis embraces a number of distinct diseases, the duration, violence and curability of which must be expected to differ widely. Such is also the fact, and while some of them may yield, eten in advanced stages, to appropriate remedies, others, while yet in an incipient form, are almost beyond the reach of the curative means at present in the possession of medical science. A brief review of some of the most common forms of phthisis may be useful. I shall, therefore, treat of this disease in a concise manner, under the divisions of catarrhal, apostematous and tubercular phthisis. Catarrhal phthisis may be defined to be, a disordered condition of the mucous membrane of the windpipe or lungs, in consequence of which there is an inordinate secretion of mucus, or a secretion of puroloid mucus or of pus; frequently ulceration of this membrane; hectic fever, emaciation, &c. It includes, therefore, those diseases which have been termed chronic catarrh, chronic laryngitis, and chronic bronchitis. It is generally supposed to arise from a catarrh induced by cold, or by the operation of other pathogenetic agents, as the miasm, which induces influenza, &c. But as a catarrh, in a healthy subject, has only a limited duration, the recuperative energies of the system being capable, even when unaided by the operation of remedial agents, of effecting its removal, just the same as these energies have the power of healing a wound, it follows, as in the latter case, that if healing does not take place, this must'happen because these energies are either already impaired or in some manner counteracted. A wound may be kept open by irritating applications, or fresh violence continually inflicted; or it may PHTHISIS PULMONALIS. 325 become the principal point on which the morbid conditions of the system develop their actions, and other parts which before exhibited many symptoms of suffering, may show these fewer in number, or less violent. This latter circumstance occurs from the derivation of morbid action, which is the same as its metastasis, except that in the former the morbid action is invited to the part which becomes affected, and in the latter it is either repelled from the part, which becomes free, or its seat is changed from unknown causes. Of the laws of derivation and metastasis we know nothing, except their existence, and some of the circumstances which invite or attend their operation. A catarrhal affection, which, in its beginning, has not been uncommonly severe, may be maintained by unadapted remedial agents, which have been administered for its cure, but which, instead of aiding, may counteract the curative operations of the system. Or, it may be sustained by a morbid condition of the system, and the mucous membrane of the lungs become the prominent seat of morbid action, from derivation or metastasis. Morbid conditions, which frequently develop morbid actions in the lungs, may arise from the retrocession, either forced or spontaneous, of cutaneous diseases; or, what is probably the same thing, the disease of the lungs may proceed from sympathy with some other suffering organ, or may exist as a necessary result of the disorder of another part. The light which this knowledge throws upon the treatment proper to be pursued in catarrhal phthisis, shows us that we are rather to employ those means which will overcome the primary constitutional dis 326 PHTHISIS PULMONALIS. order, than such as would operate remedially in the catarrhs of persons who labour under no chronic, morbid condition of the system. Therefore when the disease is maintained by constitutional derangement which arises from the repulsion of cutaneous eruptions from the skin, those remedies which have been termed antipsorals will generally be indicated. Where syphilitic disorder is the maintaining cause, the antisyphilitic remedies should be used, but where these have been already abused, as is mostly the case in syphilitic phthisis, which rarely appears until after the throat and nares have been for some time effected, resort must be had to the remedies which are useful in the complications of venereal and medicinal disease. As already remarked, catarrhal phthisis often exists cotemporaneously with disorder of some other organ. It frequently does so with disorder of the stomach, forming a disease to which Dr. Wilson Philip has applied the name of dyspeptic phthisis. "Drunkards," says he, "at that time of life which disposes to phthisis, frequently fall a sacrifice to this form of the disease, and those who have been long subject to severe attacks of dyspepsia, and what are called bilious complaints, are liable to it They are not simultaneous affections, for the one always precedes the other. In by far the majority of cases, in which both the lungs and digestive organs are affected, the affection of the digestive organ precedes that of the lungs." According to my observation, many of those cases, which are termed chronic bronchitis, are justly entitled to the name of dyspeptic phthisis, as they depend upon cotemporaneous disorder of the lungs and of the digestive apparatus, particularly of the stomach. In the treatment of dyspeptic phthisis, we ought PHTHISIS PULMONALIS. 329 five days. Urine small in quantity, and blood red. Glands of the throat swollen. Pain in the loins. Constant chilliness, with much thirst. Debility. Local, debilitating sweat of the breast, at night. CASE. Severe cough, especially in the morning, with yellowish puroloid expectoration, and. rattling in the breast. Fulness, and beating in the head; little appetite; constant thirst; stools hard, occurring only once in three or four days. Menses too frequent and deficient. Frequent coryza. Debility. After beneficial operation of calcis carb., lycop. completed the cure. A similar case to the above, except that the menses were too copious, and accompanied by a debilitating leucorrhcea in the intervals, and that there was a bitter taste; *the expectoration greenish and fetid; stitches in the right side, above the region of the liver, by deep inspiration, and by coughing; night sweats; was cured by calcis carb. Carbo vegetab. Phthisis apostematosa. In this form of disease carb. veg. has proved advantageous in a number of cases. Cinchona is sometimes useful when frequent hemoptysis is succeeded by frequent cough, and purulent expectoration. Dulcamara. Case, from frequent exposure to cold. Constant cough; expectoration, tinged with bright red blood; breast internally and externally painful; fever, with exacerbation; circumscribed redness of the cheeks, with paleness of the rest of the face; great thirst; sweat; emaciation; debility; constipation; pain in the loins; flatulent distension of the abdomen; flatulent eructation. Dulcamara removed the phthisical symptoms. The constipation, pain 330 PHTHISIS PULMONALIS. in the loins, and flatulence, were removed by bryonia. Ferri acetas. Phthisis, from neglected inflammation of the lungs. Tickling in the upper part of the trachea, with constant incitement to cough, and copious greenish purulent expectoration, with streaks of blood, and putrid nauseous taste; difficult respiration; rough, hoarse, and scarcely perceptible voice; face sallow, with circumscribed redness of the cheeks; pale lips and tongue; mouth ulcerated; colliquative diarrhoea, causing soreness of the anus; debility; emaciation. Ferri acetas gr. i. 6 removed most of the alarming symptoms, and pulsat. 12, ten days afterwards, completed the cure. Calcis sulph. A tincture of this medicine, prepared in the same manner as the spiritus sulph., has proved very useful in suppuration of the lungs. Lachesis. In a case of phthisis, supervening on inflammation of the lungs, which had been treated by blood-letting. Short, hacking and straining cough, frequently exciting vomiting. Difficult expectoration of small quantities of mucus, which was sometimes thin, at others tough, and at times in thick, round little lumps. Cough only in the daytime, worse after walking in the open air, and after speaking, which appeared to create dryness, and thereby to excite coughing. A tickling in the epigastrium induced the cough; at the same time there was soreness under the ribs, and in the trachea. Shortness of breath; debility. Nausea, and want of appetite in the forenoon. Lachesis, in repeated doses, effected a cure. Laurocerasus. Phthisis, with incessant cough, and very copious expectoration of gelatinous sputa, spotted with blood. PHTHISIS PULMONALIS. 331 Ledum. Phthisis apostematosa. Cough, with stitches in and above the region of the liver; expectoration of large quantities of fetid, greenish matter. Emaciation. Lycopodium. In a case where the patient could not speak more than two words at a time, and these in a very weak and low voice. Cough day and night. Copious expectoration of puroloid matter. Hectic fever, and clammy night sweat. Lycopodium 1|12 effected a cure. Phthisis, with purulent expectoration and clammy night sweats, supervening on typhous pneumonia, has been cured, in several instances, by means of lycopodium. NOTE. In a case of chronic cough, with hemoptysis, and other phthisical symptoms, lycopod. nearly removed the whole. Calcis carb., administered afterwards, renewed the disease from which the patient was not rescued. In a case of liver complaint, where lycopod. had done much good, the subsequent administration of calcis carb. was productive of unpleasant effects. Phosphorus. In a case of shattering cough with trembling of the limbs; throat raw, and dry; hoarseness; internal soreness of the breast; sputa yellow, purulent, of saline taste, especially in the morning and evening; the patient could scarcely speak a word without being interrupted by a short, tormenting, hacking cough; tearing, and stitches through the whole breast, in which there were sensations like hammering, and fermentation; constant chilliness, worse towards evening, and then interrupted by flying heat; copious sweat; restless jactitation at night. Phosphorus effected a cure. 332 PHTHISIS PULMONALIS. Phosphorus has proved very useful in a number of cases of phthisis, in which (as will be generally found to be the case with every remedy,) it was incapable of effecting a cure by itself, and other remedies had to be called in requisition. Potassce carb. In a case where, with violent cough, there was an expectoration of a yellow matter, most in the morning. Soreness, and stitches in the breast, and soreness under the short ribs of the right side, on pressure or coughing. Shortness of breath. By lying on the right side, drawing pains under the short ribs of the left side; tearing pain in the knees, legs and feet, increased by rest. Sleep restless after midnight. The potass. was, in this case, several times repeated. Potassce nitras. In a case attended with excessively painful stitches in the breast, which obstructed the respiration, and were accompanied by anxiety and oppression, the potassae nit. proved to be a very valuable remedy. Samnbuci cort. intern. In a case where there was constant cough, with copious expectoration of a saline taste; pain in the breast; dyspncea; cedema of the feet; circumscribed redness of the cheeks; emaciation. Tr. samb. nig. cort. int. gtt. i. daily, for six days, and afterwards the same dose every other day, until six or more doses were taken, produced great improvement. Afterwards, an infusion of hedera terrest., with milk and sugar every morning, was allowed, and in a short time the patient was well. CASE. Cough night and day, with copious expectoration; the sputa of a nauseous, sweetish taste; pale, sallow countenance; great emaciation; rapid, small pulse; burning palms; much thirst of after PHTHISIS PULMONALIS. 333 noons; strong night sweat; tongue somewhat coated; no appetite. Tr. cort. int. samb. nig. gtt. i., at first every three, and afterwards every-four days. In three similar cases, recovery after six, eight or twelve doses. In dry cough, with difficult expectoration, this medicine was of no use. Sepia has been recommended for apostematous phthisis. Silex. In a case where there was shattering cough, excited by tickling in the throat, especially troublesome at night; difficult respiration; purulent expectoration; weakness in the joints; stiffness and debility of the limbs; silex 3130 completed the cure which had been commenced with calcis carb. CASE. Violent cough; expectoration of green, purulent masses; emaciation; debility; fever in the forenoon. After the fever had been previously lessened by repeated doses of cinchona, silex 3130 completed the cure. Stannum. In a case where there was cough day and night, with copious mucous expectoration; great emaciation, though the appetite was good; rapid, small pulse; burning palms, especially of afternoons; great morning sweat; tongue red; debility; diarrhoea; stannum gr. i. 6, four doses, one every eight days, effected a cure. CASE. Violent cough, sometimes dry, with difficult expectoration, sometimes loose, with copious and easy expectoration, which was sometimes composed of watery, thin mucus, sometimes of thick and tough; at others, was in yellowish green masses of a saline, sweetish taste. Cough worse, and expectoration most copious, at night. Oppression and soreness of the breast. Voice hoarse. The trachea felt constantly 334 PHTHISIS PULMONALIS. raw, and there was always tough mucus in the larynx. Loss of appetite; great debility; restless sleep, interrupted by frightful dreams. Fever every evening from six to nine o'clock; hot palms; dryness in the mouth, yet moderate thirst. Pulse small and frequent; sweat night and morning, of a musty smell. Emaciation; frequent call to urinate, discharges small; urine sometimes colourless, at others, dark coloured. Cinchona was given with little or no benefit. Stannum gr. i. 6 with very great improvement; in eighteen days there was nothing of the disease remaining, except a peculiar beating, pressing pain in the left side of the breast, and a slight hoarseness, which yielded entirely in three days to bellad. gtt. i. 24. CASE, Cough, with expectoration of large masses of a yellowish matter, of disgusting odour and taste. Dyspncea; emaciation; cured by stannum. P. mucosa. P. dyspeptica. Cough; tickling and rattling in the breast; aching in the epigastrium, worse on inspiration; acid eructation, with sensation of rawness in the cesophagus; dyspnoea; debility. P. with violent cough, especially in the morning, frequently ending with retching and vomiting of the food. Cough excited by lying on the right side. Expectoration lumpy, sometimes white, at others yellow. Emaciation; debility; great dyspnoea. Case occurring after grippe. A number of other cases cured by stannum are recorded; in many of these the expectorated matter was of a disagreeable, sweet, or putrid taste. Sulphur. In a case where, with violent cough, especially at night, there was a copious expectoration of a yellowish green matter, smelling like putrid eggs; great improvement was produced by spiritus 338 RHEUMATISMUS. shoulder joint, extending down to the elbows; and in the neck. The affected parts were swollen, red and almost immovable; pain worse at night, as also in motion; constipation; urine scanty, and red. R. inf. Sticking, drawing and pinching pain, with swelling of the knees. R. Pain in the back, either in the loins, or between the shoulders, or under the shoulder blades. R. inf. et chronicus. The forms of rheumatism which are adapted to bryonia, are generally those in which the pains are increased by motion, are worse at night, and accompanied by sleeplessness and constipation. Calcis carb. R. Knee swollen, bluish red, pain on every motion. Even in rest, a stretching and frequently a sticking from the patella inwards. Complicated with too frequent and copious menstruation, and leucorrhoea. R. in the hip of a scrofulous child. Calcis sulphuret. R. inf. of the ankle, worst at night. Chamomilla is adapted to acute rheumatism, when the pains are drawing or tearing, more in the tendons, ligaments and bones, worse at night, and constant in the same parts, which are not swollen. The fever begins rather with chilliness, than with a proper chill, which is followed immediately with a burning fever, with moderate thirst. R. Tearing pain, extending from the tuberosities of the ischium, down through the bones to the soles of the feet. Slighter in motion, worse in sitting, intolerable at night. R. of hip joint. Nightly pain in the thigh, and weakness of the whole limb. RHEUMATISMUS. 339 Cinchona. R. Attacks of pain, excited by touching, or slightly moving the affected part, and then gradually rising to the most fearful height. Colocynth. R. of the hip joint. Dulcamara. R. Severe sticking and pressing pain in the arms and back at night. Better from motion. R. Tearing pains in all the limbs. Ignatia. R. Pain, resembling that from excessive labour, with momentary relief by lying on the affected part. Lycopodium. R. chroriicus, combined with cephalalgia, dyspepsia, dyspnoea, &c., &c. Drawing pain in the loins. Cramp, and tearing in the whole back, especially while sitting. Renewed by rainy weather and storms. Diminished by warmth. Stretching and tearing in the joints of the upper and lower extremities. Stiffness of the limbs, and coldness of the feet. Mercurius. R. where copious sweating does not relieve. R. Drawing and sticking in the lower limbs, worse at night than in the day, and increased by motion. Constant feeling of coldness in the affected parts. R. of the hip joint, with severe sticking pain increased by motion. Nux vomica. R. acutus et chronicus. When the patient is very passionate, and there is over sensibility to or abhorrence of fresh, cool air; also where the pains appear or grow worse after eating, or are increased by mental exertion. R. of the loins. R. of the hip; when this is accompanied by pain 22* RUBEOLA. 341 hip joints; when these ceased, tearing in the right arm, always worse at night; arm powerless, painful on motion and numb; one finger spasmodically and constantly closed; costiveness. Tr. acris. R. Severe tearing pain in the joints, shooting thence along the bones. Not altered by movement or rest; excessively increased by cool air; much moderated or entirely subsiding in a warm room, or on becoming warm in bed. Disposition fretful and peevish. Thuya. R. Tearing and beating pain in the shoulder, and extending from thence into the fingers. Increase of pain on' letting the arms hang down, and in a warm bed. Amelioration by motion, in the cold, and by sweat; worse at night. Depression of spirits. Veratrum. R. Pain, as if bruised, in the shoulder joint and extending to the wrist; could not bear the arm touched; worse by covering; better by rising and moving about; worse in stormy weather. Exacerbation about four o'clock in the morning. In addition to the above mentioned remedies, the following have also been found useful. Ledum., mangan. acet., mezereum., spigelia. RUBEOLA. Morbilli. Measles. In this disease aconitum is a most valuable remedy. It generally abates the violence of the fever in such a manner, that the measles run their course without much inconvenience or danger. But there are cases which will require other remedies. Thus, where 342 RUBEOLA. retrocession of the eruption has taken place, belladonna or pulsatilla may be proper, the former especially when the disappearance of the measles, from the surface, is attended by delirium or by pain in the bowels. Where particular symptoms, which attend this disease, are uncommonly violent or dangerous, or where other important symptoms accompany it or appear during its course, those remedies are indicated which are best calculated to overcome these symptoms. Hence, when the affection of the lungs exceeds its ordinary limits, and passes into pneumonia; bryonia, cannabis, or some other of those remedies which prove most useful in pulmonary inflammation, will be required. When the laryngeal affection, which usually communicates a hoarseness or flat roughness to the attendant cough, passes into angina stridula, the remedies for croup must be employed. Where the patients have been previously troubled with worms, and the measles have developed considerable morbid action in the bowels, marked by unquenchable thirst, violent and frequently recurring colic, and the vomiting of worms, cina will be proper. As regards the sequelae of measles, drosera has been found useful for the hoarseness and chronic cough often left by this disease. Chamomilla, ignatia, nux vom., for harsh, dry cough. Belladonna, cina, conium, hyosciamus, for spasmodic cough resembling pertussis. Cinchona, mercurius, pulsatilla, for mucous diarrhoea. Sulphur for hardness of hearing. SCARLATINA. 343 SCARLATINA. Scarlet fever. The ordinary division of scarlatina into S. simplex, S. anginosa, and S. maligna, is not here adopted, because it cannot be advantageously applied in directing the homceopathic treatment of the disease. A much more important division, in this respect, is into the form adapted to belladonna, and that adapted to aconite. Some physicians have considered these forms to be two distinct diseases, arising from different contagions. Others consider them merely modifications of the same disease. I adopt the latter opinion, and agree with Hartlaub in the statement, that "the latter, to which the terms scarlet rash and purpura miliaris have been applied, is to be viewed only as a modification or peculiar form of scarlatina, which yields neither in fatality nor in its consequences to the original form." In the form of scarlatina, in which bellad. is the proper remedy, the eruption is of a bright red, like the shell of a boiled crab; the redness disappears for a moment on pressure with the finger, but rapidly returns. The redness shades off gradually into the whiteness of the adjacent parts. It becomes alternately of a paler and a deeper hue, and almost every moment it diminishes or increases its extent. The reddened skin is even and shining smooth, and the redniess first affects the face, neck, breast, hands and feet, and extends thence to the rest of the body. The fever and the eruption appear together, and endure, in the milder cases, for three or four days, and in the severer ones for seven days. The eruption never disappears 344 SCARLATINA. suddenly, but gradually declines with the fever, which is the more violent in proportion as the eruption is the more extensive. The reddened parts do not sweat, and if there is moisture on the skin, it is on the white parts. A general sweat sometimes follows the disappearance of the redness. To this succeeds desquamation of the cuticle. In the form adapted to aconit., the eruption is of a purple or brown red, in spots with distinct margins. The redness does not disappear on pressure with the finger, and the reddened parts are thickly sprinkled with small, dark red papulke, which are perceptible to the eye and the finger. The eruption is generally on the covered parts, and especially about the flexures of the joints. The fever and eruption have no definite duration, but may continue for weeks. The eruption sometimes disappears suddenly, with increased danger, and commonly with a speedily fatal issue. The mildness or severity of the disease is not connected with the extent of the eruption. Only the dark red spots sweat. This form of the disease may attack the same person oftener than once. For this form of disease, the aconit. must sometimes be repeated at intervals of four or six hours. At times it is necessary to give coffea crud. 3, for the abatement of excessive sensibility to the pains; and not unfrequently these remedies are required in alternation. Intermediate forms of scarlatina (considered by those physicians who affirm the existence of two diseases, as a complication of these, viz. of scarlatina with purpura miliaris) frequently occur, and present great difficulty in the treatment. It has been recommended in these cases to give the aconit., first SCARLATINA. 347 as there was great stupor, aconit. and coffea were given in alternation every four hours. External swelling of the neck was removed by merc. 1112. Great debility, occurring during desquamation, by cinchona 1130. Rhus. Scarlatina. Dark redness from the head to the toes, with innumerable vesicles, containing a yellowish fluid; burning heat; great thirst; coma, with starting up, as if affrighted; dysuria; constipation. After rhus there was a satisfactory improvement. Sulphur. Scarlatina in a girl aet. 9 ann. On the fourth day, much sleep; starting; opening wide the eyelids; distortion of the eyes. The eruption had suddenly disappeared; the pulse was small and quick; skin dry, but not hot. Sulphur 1150 produced speedy improvement. Scarlatina. Bright red eruption over the whole body. Skin hot. Incessant delirium. Tongue dry, chapped, cinnabar red; here and there covered with brown slime; stoppage of the nose; dysphagia; constipation; pulse quick, small and hard. SEQUELLE OF SCARLATINA. Tinea capitis humida. Rhus, calcis sulphuret. Tinea capitis sicca. Calcis carb., sulph. Scrofulous enlargement of the glands of the neck have been removed by cinch., bellad., calcis carb., silicea, but have more frequently passed on to suppuration, in the furtherance of which calcis sulphuret has proved itself the most useful. Hydrops. Arsenic., helleb. nig., digital., rhus. SCIRRHUS. 349 induration. Belladonna gtt. i. 20 every forty-eight hours, for two weeks, and a dose of arsenicum every four days, for some time afterwards, together with the local application of a weak infusion of belladonna, by means of a sponge, effected a perfect cure. Belladonna is also very useful in scirrhus of the mammae. Conium. In the case of a woman st. 22 ann. Five years before, she had been struck on the left breast, and afterwards a scirrhus had formed in this spot, which had grown slowly until it had at length attained the size of a walnut. It was seldom painful, but immovable. At times, there was an itching in the skin over it, which was not discoloured. The disease appeared not to affect the general system in the least. With reference to the originating cause of the disease, conium maculatum was prescribed, because this answers well for glandular indurations which arise from mechanical injury. Soon after taking the medicine, the patient felt some stitches through the scirrhus. A considerable diminution of the tumour could be perceived on the next day, but the improvement soon ceased to advance. Chamomilla gtt. i. 3 was then given, and was followed by peculiar exacerbations and remissions. In the evening, the scirrhus would be larger, and somewhat painful, and in the mornings smaller and movable. These changes continued to occur for ten days, and during this time the tumour had diminished in size. At the end of fourteen days the improvement ceased. A number of other remedies were for some time tried, which exhibited no action on the induration. The physician therefore considered it most advisable to employ local applications, and he directed some drops of the 350 SCIRRHUS. tincture of conium, prepared from the fresh expressed juice of the plant, to be rubbed in, every evening, over the induration. Under this treatment the scirrhus entirely disappeared in the course of eight days. This remedy has also been found useful in cancer of the lip. Magnesice murias. removed scirrhous induration of the uterus. Nux vom. proved useful in cancerous ulceration of the lips. CASE. A man had a scirrhus of the size of a pea on the middle of the lower lip, which was removed by a surgeon by, means of repeated applications of caustic. But afterwards there appeared at each extremity of the lower lip, adjoining the angles of the mouth, eroding ulcerations, with elevated, uneven margins of a white colour, pale red ground, and discharging a thin fluid, without any perceptible bad odour. The patient had a constant flow of saliva, which every one who trod in it with a bare foot pronounced "very sharp and biting." His disposition was passionate, but at the present time depressed, and he asserted that his disease and his unfavourable circumstances had taken away from him all desire of life. Nux vom. gtt. i. 18 was given, and was followed by great improvement. On the sixth day, conium mac. gtt. i. 21 was given, and by the tenth day the disease was completely removed. * Phosphorus proved very useful in excessively painful and hard indurations in both mammae, unaccompanied by inflammation. Sepia has proved beneficial in scirrhous indurations of the cervix uteri. // l, SCROFULA. SINGULTUS. 351 This remedy removed a cartilaginous and frequently bleeding scirrhus of the lower lip. Silex. A scirrhous induration, commencing at the left angle of the mouth, and involving nearly the whole of the left cheek, was removed by silex 6130, dissolved in two ounces of water, of which a tablespoonful was given every other day. This prescription was once or twice repeated. This remedy also removed a cartilaginous induration, with a deep fissure, which was seated in the upper lip. SCROFULA. Many developments of scrofulous action are presented under other heads. It is merely necessary to remark in this place, that sulph., calcis carb. and barytes are among the most valuable remedies for the enlargement of the lymphatic glands of the neck, in scrofulous subjects. SINGULTUS. Hiccough. Bellad. cured a hiccough which at first had appeared every year; later, at shorter intervals, and continued for two or three days. Before, it had always been cured by musk, in large doses, but, at length, it would not yield to the largest. After the cure, by a single dose of belladonna, it did not again return. In the case of a man, bellad., and afterwards bryonia, cured a hiccough, attended by retching and vomiting, of forty-eight hours' duration. 354 SYNCOPE. SYPHILIS. SYNCOPE. Fainting. Cases are recorded in which aconit., moschus, nux vom. and veratrum, have proved useful in syncope. SYPHILIS. Lues venerea. Venereal disease. Before proceeding to mention the remedies which have been found most useful in the treatment of syphilis, it will be proper to remark, that homceopathic physicians do not approve of the treatment by caustics, &c., of the local diseases. Hahnemann objects to it, as depriving the system of what is necessary for its relief in its diseased condition, and as taking away from the physician the indices which mark the presence and extent of that condition. In support of the former argument, against such local treatment, it is only necessary to mention the circumstance of the great relief which is sometimes experienced from heavy, oppressive and despondent feelings, and even from pains, on the appearance of chancres or other local affections. In support of the latter argument, the opinions of allceopathic physicians might be quoted, but this is unnecessary, as every physician, who believes that the chancre is only a symptom of constitutional disorder, will at once perceive its propriety. Acid. nit. is useful against primary as well as secondary syphilitic ulcerations of the mouth and throat, and also in those which appear in the parts just mentioned, from the abuse of mercury. TESTES ET CHORD.E SPERMATICAE. 355 Acid. phosph. has proved useful in mercuriosyphilitic disease. Aurum has been employed, with strikingly beneficial results, in secondary syphilis. Lachesis has been recommended for secondary syphilis. Mercur. has been employed in single and in repeated doses, in various dilutions, with complete success, for the cure of chancres, buboes, and seconddary symptoms. The mercurius solubilis appears to be generally preferred. Thuya has proved serviceable in some cases of secondary syphilis. TESTES ET CHORDAE SPERMATIC1E. Testis inflammatio. From injury, has been cured with aconit. followed by arnica. Inflammation of the testicles, from contusion, has also been rapidly removed by pulsatilla. Clematis and nux v. have also proved useful. Testis induratio. Lycop. gtt. ~ 18, graphit. gtt. ss. 18, and sulphur 2115, in this succession, cured induration of the testicles, with impotence. Clematis has proved useful in induration and sensitive, enlargement of the testicles. Testis tumefactio. From injury, arnica. From gonorrhoea, mercur, pulsat. Swelling of the testes, from the latter cause, may be relieved,.while acute, by alternation of aconit., with the proper remedy for the gonorrhcea. Testis dolor. Zinc, calcis carb., lycopod. 23* 356 TETANUS. Hydrocele. Graphit., silex, rhododendron; from bruise, pulsat. Circocele. I have seen temporary removal of the enlargement of the spermatic veins of the left testicle, forming a moderate circocele, by acid nit. under circumstances to excite the suspicion that, in this instance, it only operated palliatively. In this case the affected testicle hung lower than the other. In some cases of circocele, this remedy may possess certainly curative powers. J. TETANUS. Aconit. In the case of a boy affected with trismus, (locked jaw); frequent alternation of redness and paleness of the face, and distortion of the eyes; aconit., twice given, effected a cure. Angustura has been recommended for trismus and opisthotonos. Arnica. In a case of trismus, with opisthotonos, arising from a wound in the leg, after the violence of the disease had been abated by mercurius, the cure was completed with two doses of arnica, 2112. Belladonna "is adapted to many of the premonitions of tonic spasms; to these belong, partial spasms; shivering and trembling of the limbs; gastrodynia; spasmodic, constrictive sensations in the epigastrium, which are accompanied by shortness of breath, and an anxious, distressing feeling in the breast, drawing and stiffness in the neck and spine, spasmodic contractions in the tongue, difficult deglutition, yawning, vertigo and stupor. When these symptoms advance, dimness of sight, distortion of the face, and trismus, TETANUS. 357 or spasmodic difficulty of deglutition, also appear. When belladonna is adapted to trismus, the following symptoms, especially in the cases of infants, must be present; sudden starting and drawing together of the body and limbs; slight, twitching motions; strabismus; inability to swallow; finally severe spasms; anxious, spasmodic respiration; dilated pupils; motionless, staring eyes; involuntary discharges of the feces." Cicuta virosa is a valuable remedy in tetanus, especially when this disease presents itself most strongly in the form of trismus, but there is, at the same time, general tetanic rigidity. The recorded cases in which it has proved serviceable, have. all originated in immediate irritation of the brain or spinal marrow, from injuries inflicted on the head or back. Ignatia. In a case of opisthotonos from fright, (hysteria?); in which the head was drawn powerfully back by tonic spasms; the countenance was livid; pupils dilated; respiration laborious; deglutition of fluids difficult; ignatia effected a cure. Ipecacuanha is a remedy well worthy of attention in tetanus. Mercurius has proved useful in trismus. Nux. vor. In the case of a girl set. 12 ann., from being wetted, and taking cold. Severe spasmodic affections, first in the limbs, and afterwards extending to the back, which became so rigid, that the patient had the appearance of a person suffering under tetanus; the lips were blue, and the respiration difficult. Nux vom. 2130, effected a cure. Rhus cured what might be termed a chronic opisthotonos from injury received by falling down TUSSIS. 359 cough, with the shrill tone of a hen, (kikikikih), and an almost complete loss of breath; cough dry, or attended only by a slight expectoration of transparent mucus; paroxysms enduring from thirty to forty-five minutes, and ending with convulsive symptoms of short duration and a sleep of two minutes; no cough until the period of the next paroxysm; arsenicum gtt. i. 30 was given shortly after a paroxysm. The next day the attack occurred an hour later, and was more severe than. usual, but there was afterwards no return of the complaint for three months, when it again made its appearance, and the arsenicum, in the same dose, removed it in the same manner as before. Previously to the employment of the arsenicum, the following remedies had been tried; moschus, ipecac., calcis sulph., cina, ignatia, stannum, nux vom., cinchona. From none of these, except the last, was there any beneficial operation; this, however, suspended the disease for one day. A repetition of the dose did not suspend, but in some measure modified the disorder. Belladonna is useful in some forms of spasmodic cough, especially when these attack at night. Bryonia. In a case of chronic, spasmodic cough, worse after meals and in the evening, at which time it was accompanied by vomiting; the bowels costive; bryonia gtt. i. 4 effected a cure. Capsicum is useful in some kinds of cough which are most severe in the evening and at night. Carbo veg. has frequently proved useful in chronic cough, with slight expectoration. Chamomilla. In a case where the cough attacked in the morning, and in the evening gradually disappeared after lying down in bed; before the attack, 362 UTERUS. by an intolerable tickling through the whole breast; there was, during the paroxysms, undulating inspiration, and before them anxiety; iodine 30, given every third day, proved very useful. Ipecac., repeated every two or three hours, has been found not only of advantage in removing the catarrhal symptoms, which sometimes remain after the cure of the spasmodic cough, but has also been found capable of subduing some forms of pertussis itself, and is applicable where the short, severe and shattering jars of coughing follow so rapidly and incessantly on each other that the patient can scarcely breathe, every inspiration appearing to excite renewed coughing. Efforts to vomit are frequently combined with these symptoms. Lactuca vir. has proved useful in pertussis, especially where the paroxysms have been preceded by anxiety. Ledum has been employed in pertussis. Lobelia inf. has proved useful in pertussis, In addition to the remedies above mentioned, the following have also been recommended; ambra, antitimonii tart., arsenicum, calcis carb., hyosciamus, laurocerasus, nux vom., pulsatilla, sepia, sulphur, veratrum. UTERUS. The Womb. HYSTERITIS. METRITIS. Where inflammation of the uterus attacks with a severe chill, followed by violent fever, Hartmann recommends that aconit. should be given, but does not consider it to be VARIOLA. 365 On the third day of the aunt's illness, I was called to visit her, and notwithstanding I had reason to believe that it was a variolous fever, yet as the symptoms appeared to indicate the nux vom., I administered this remedy. On the next day the variolous eruption had made its appearance, and as, at this period of the disease, a spontaneous abatement of the fever was to be expected, any mitigation which appeared was to be attributed to this cause, and not to the operation of the remedy which had been given. The eruption was very copious, in fact, as much so as it could be to retain the character of a distinct small-pox (variola discreta). I did not procure the vaccinin until the second day of the eruption, when I administered to her several pellets wetted with a high dilution of this article, which produced no evident change. On the fourth day of the eruption, as she complained very much of burning and soreness of the skin, the pocks presenting all the appearances which would justify the belief- that they would run the course which they usually do in pretty severe cases of variola in persons who have not been protected by previous vaccination or variolation; the vaccinin was again given. The next day the patient informed me, that shortly after talking the medicine, the burning in the skin had very much abated, and that she had passed a tolerably comfortable night. After this, the pustules rapidly dried up in the manner of varioloid, and, in a few days, had all fallen off from the skin. A question occurs, whether the vaccinin had any influence over the disease; and in favour of an affirmative answer, the fact of the relief which followed so speedily on the employment of the remedy, 366 VARIOLA. may be urged. But against this, and in support of a negative reply, it may justly be argued, that relief should have followed after the first administration of the remedy, if it possessed the power attributed to it; and that the relief, when it did occur, happened at the very period of the eruption at which it often takes place in those forms of variola which occur in persons possessing a partial protection against this disease from previous variolation or vaccination, to which, of latter years, the term varioloid has been applied, and of which the drying up and earlier disappearance, instead of the ordinary maturation of the pustules, are the most distinctive features. The only reason why the latter arguments are not fully conclusive in my mind, is the fact, that I have never, in any other instance, seen a case in previously vaccinated or variolated persons, in which the eruption was so copious, run the course of varioloid; but, on the contrary, always to maturate and decline in the same manner as variola occurring in persons without any previous protection. While attending on the aunt, I had an opportunity to observe that the vaccinia ran its regular course in her nephew, only that I did not see him at the period of the greatest perfection of the areola, but from what I saw myself and learned from the parents, this was perfect. Two days after the formation of the areola, the child had a convulsion which ushered in a variolous eruption, which became very copious, filled at the proper time with a yellow puroloid fluid, burst, encrusted, and ran the complete course of a perfect and copious distinct small-pox.. In this case, as the child had just passed through the vaccine disease, the scab VARIOLA. 367 of which was still on its arm, it appeared to me a work of supererogation to administer the vaccinin, and therefore it was not given until the third day of the eruption. As the mother of the child thought it appeared to be a little easier after the remedy, this was several times repeated, but as the disease ran the course of variola, 'not much value can be attached to the supposed observation of greater ease after its use. This case appears, at first view, to militate still more strongly than the former against the supposition that the vaccinin possesses the property which has been attributed to it. For, in the present case, notwithstanding the presence of the vaccine scab on the arm, the disease advanced, and afterwards, in spite of repeated infinitesimal doses, pursued an uninterrupted course through regular maturation and decline. But a decided inference against the powers of the remedy, deduced from these facts, would be improper, for the case stands upon peculiar, though, I believe, not solitary grounds, and would of itself equally justify the conclusion that vaccination affords no protection against variola, since, notwithstanding the vaccine disease had just completed its full course and in the proper time, a copious variolous eruption occurred and also ran its full course. From a review of the facts of the case, it will appear probable, indeed almost certain, that the infant contracted the disease from its sister at nearly the same time that the aunt was infected from the same source; and that as the infant was vaccinated on the same day in which the aunt was attacked with the variolous fever, that it was on the eve of sickening with the same disease at the moment of vaccination. The only objections to these conclusions are, that 368 VARIOLA. the child might have been exposed to other sources of the infection than that afforded by its sister, or that it might have contracted the disease from its aunt. But no other exposure of this kind was known of or probable; and in respect to infection from the aunt, it is to be observed, that, as variola, when received by infection, appears to require an interval of eleven days between the exposure to the infection and the appearance of the eruption, it must follow, that if the child contracted the disease from her, it must have done so on the first day of her fever, the possibility of which is very doubtful; and then, what is highly improbable, the variola must have advanced pari passu with the vaccinia. Agreeably to my own experience and all that I have heard of the experience of other physicians, which I am able at present to call to mind, vaccination, when performed upon persons residing in the same apartment with a person suffering under variola, even as late as the second day of the eruption, has always, when it produced the vaccine disease, prevented the small-pox at that time. Though there may be some cases where the vaccination being performed at a much later period after exposure to the infection, vaccinia has been followed by variola as in the present case. The most justifiable conclusions therefore appear to be, that the child received the infection from its sister, that the variola was delayed in its appearance by the intervention of the vaccinia, and that there was a perfect arrest of the advance of the former during the progress of the latter disease. Whether the variola was not, in all probability, rendered milder, although not prevented by the vaccinia, is a question which I shall not at present If VARIOLA. 369 discuss; though I think it most probable that it would be answered affirmatively by most physicians who possess an extensive knowledge of both diseases and their relations to each other, and who are, at the same time, acquainted with the highly malignant character which variola generally assumes, of later years, in persons who have received no partial protection from previous vaccinia or variola. If vaccinia, besides its well established power of procuring either perfect immunity or partial protection from variola, is also capable of arresting and possibly of modifying this disease in the middle of its course, it would be improper for the physician, who knows the powerful operation of infinitesimal doses, to positively deny, from the present evidence, the possession of some controlling power in. vaccinin thus administered, over variola; or to assert that the apparent relief from its employment in the case of the infant was only illusory. I may, perhaps, be justly charged with prolixity in tle above details and arguments, but would plead in extenuation of the fault, my anxious desire that as all our medical knowledge, which deserves the name, is to be derived from accurate observation and close investigation of individual cases; that in the trials of this, as well as of every other remedy, in variola as well as every other disease, we may subject our cases to the most rigid scrutiny, so that we shall neither suffer ourselves to be misled, nor aid in misleading others. 24 372 VERMES. of intestinal worms, we have the most convincing evidence of their powerful operation upon the human stomach and bowels. The knowledge of these facts enables us to perceive more distinctly than we have hitherto done, what are the uses and what have been the abuses of vermifuge remedies. In the first place, viewing the worms as a consequence and not a cause of the disease, we can understand, that as the symptoms usually observed when worms are present, arise from the gastro-enteric disorder, and not from the worms, and as these symptoms may exist without the presence of these animals; that vermifuge medicines will often remove the symptoms attributed to worms, without the appearance of these in the discharges. Under these obviously more correct views, we shall neither be led into the error of supposing, that notwithstanding there have been no worms discharged, still they must have existed, and that as the symptoms have disappeared, they must have been killed and digested; nor shall we fall into the still more ridiculous mistake of considering the altered excretions of the bowels as the fragments of these animals. In the next place, we can understand that as the vermifuge medicines have a decided action upon the stomach or intestines, they must each, according to the peculiarity of their action, be capable of subduing some of the disorders of these viscera, especially when these disorders originate in the viscera themselves, as they are very likely to do from errors in diet, and not in constitutional derangement. That as these remedies are, in fact, prescribed against certain symptoms which experience has taught us they are capable of removing, the actual cures from VERMES. 373 their employment may be numerous. But as no one remedy can be expected to cure more than a small proportion of the derangements of these viscera, if proper attention be not paid to the selection of the remedies, as adapted to the peculiar forms of these disorders, it will frequently happen that mischief, instead of benefit, will result from their employment; even when they effect the destruction and discharge of the worms. For if the pathogenetic operation of the remedy be not such as to supplant and subdue the previous disease, the system has been unavailingly submitted to a new disorder, and its energies having thereby been impaired, it cannot as well resist the advances of the old disease. And it probably has arisen from the observation of the injurious effects which ensue from the removal of worms by medicines which are not adapted to overcome the disease which allows of their existence; that many physicians have considered worms to be rather beneficial than otherwise, and that they act as a species of "scavengers" by consuming matters in the bowels, which, but for them, would prove prejudicial to the health. How far worms may perform the part thus attributed to them, or whether it really belongs to them, I shall not attempt to decide; but even admitting that they are useful, I can see no propriety in withholding the treatment which is proper for their removal, because, they are themselves an evidence of a disordered state of the alimentary canal which ought to be corrected, and the correction of which will be attended by the disappearance of the worms. It is probable that the morbid conditions are different which favour the existence of the different kinds of intestinal worms; that one form of disorder * VESANIfE. 375 may also be sometimes useful; asarum, cicuta, digitalis, silex, stannum, veratrum. VESANIYE. Insanity. The disorders of the mental faculties being so numerous and varied as to forbid, in the present state of our knowledge, any classification which would prove of much service to the homoeopathic physician, I shall attempt no other arrangement than that which exhibits, under each remedy, the cases in which it has effected cures, and those in which, although other remedies have been used, it has been evidently useful. Aconit. In those cases where there is a superstitious belief in a fixed day of death, whether this belief is founded on presage or presentiment, aconit. is a most valuable remedy. The important influence which a fixed idea of this kind may exert on the general health of the body, and the fatal results which it may produce in debilitated conditions, are already known to the profession. But as the following unfortunate case, which is related by Dr. Gross, stands in strong contrast in its issue with those which are afterwards detailed, I consider its insertion in this place to be proper. CASE. A young, blooming and well formed woman had purchased, while yet a girl, a "planet," which was to inform her of her future destiny. Among other things, the "planet" foretold that she would die in her first childbed. As she was then quite young, although she believed the presage, yet she did not allow it to trouble her at that time. She was ~0 VESANILE. 377 was given, and in the course of two hours all these appearances vanished, and the thoughts of death had given place to cheerfulness. CASE. In a woman ret. 20 ann. In consequence of a superstitious presentiment as to the day of her death. As the ominous day, to which she looked forward with great anxiety, approached, she was attacked with fever and delirium. Bleeding produced no improvement, and the patient at one time broke out into laughing, and at another into weeping delirium; rose out of bed at night, and endeavoured to climb up the wall or to escape from the apartment; but lay in the day time dull and torpid. Aconit. was given, and by the next visit the patient could understand the questions addressed to her, and answered them with motions of her head. In the course of two days, consciousness was completely restored, she ate, spake and slept, but a nervous fever developed itself, and confined her for nearly two months. After her recovery, on being asked in what manner she had become sick, she answered, "in a right stupid manner." (Attomyr.) Arsenicum. In the case of a man set. 32 ann.; the following form of disease recurred periodically; at first, at intervals of six months, but afterwards every third month, and finally every four weeks. After bleeding and a foot bath, the paroxysms had always disappeared in from four to eight days. When attacked, he could not sleep, but constantly tossed about in bed, where he became covered with sweat. At length he could continue no longer in bed, but must--, rise and go about on account of an indescribable but dreadful internal anxiety which allowed him no rest, but drove him about from place to place. Frequently, * 378 VESANIXE. he could not restrain himself from weeping and wailing. At these times it was very unpleasant to meet his acquaintance, because he believed he had unconsciously injured them, and therefore he would ask pardon of every one. He would fall at the feet of his wife, and entreat her not to be angry at him, although he did not know that he had ever injured or offended her. At the same time, he felt a great heat in his face and head. His pulse was eighty in the minute, and rather weak. Arsenicum 30 was given, and in a short time afterwards he fell asleep, slept through the whole night, and awakened well the next morning. In four weeks there was a recurrence of the disease; the arsenicum was again given with the same success, and two years afterwards there had been no return of the complaint. Aurum proved useful in a case of religious melancholy, from compunction of conscience for misdeeds, which was characterised by great anxiety, weeping, praying, anxious and frightful dreams, feeling of great debility, emaciation, morning sweat and painful menstruation. Belladonna. This remedy, according to Hartmann, may prove useful in melancholy, when this disease is occasioned by disorder of the abdominal viscera, and there are, at times, spasmodic affections of the muscles of deglutition and of the bladder. But it is more frequently applicable in idiotic conditions, especially when there are rapid alternations of merriment and sorrow; or of continual babbling and obstinate silence. It may also be indicated in mania when there is uncommon muscular strength. CASE. A gentleman, after great mental excitement, combined with grief and fright, was suddenly VESANIJE. 379 attacked with mania, characterised by the following symptoms: Fearful, anxiety; seeing of ghosts and devils, who threatened to murder him; fear of death; black hounds would seize him; he knew nobody; trembling in his body and limbs; pulling at his teeth with his fingers; biting, spitting, and striking about; great muscular strength in his fits of raving; it appeared to him as if he was raised up by a rope; he saw every thing doubled; the right upper eyelid hung down as if paralysed; copious sweat, of a strong, almost urinous odour. Belladonna gtt. i. 30 was given, and in a quarter of an hour he fell into a sleep which continued for six hours. He awoke with full consciousness, but health was not completely restored; there was still fear and anxiety, and he was tormented with fantastic appearances in every direction. This continued for three days to alternate with a comatose condition. At the end of this time, opium gr. i. 3 was given, and in twelve hours he felt himself free from his disease and cheerful. In six days he was able to resume his business. Conium. A melancholy young woman speedily regained her cheerfulness and vivacity under the use of conium 3130, dissolved in six ounces of water, of which a spoonful was taken daily. Dulcamara proved useful in a case of mania. Helleborus is recommended for quiet melancholy. In a case in which the intellectual disorder had been removed by stramonium, but great depression of spirits and sorrowfulness remained, the helleborus niger completed the cure. Hyosciamus proved highly advantageous in the case of an infant, who laid in an idiotic condition and passed its stools and faces involuntarily. 380 VESANIE. This remedy, aided by veratrum and pulsatilla, cured a case of melancholy accompanying amenorrhoea, arising from fright. The disease was characterised by fear; endeavours to escape out of the house; fear of being poisoned or sold; belief of being bewitched. Ignatia is recommended for melancholy arising from care, grief or mortification, and where there is a love of solitude, and constant thought on the unpleasant circumstances which have induced the disease. Lachesis. "A young man, from too intense study, had become insane, and fallen into an extraordinary talkativeness, which did not correspond with his temperament, and discoursed incessantly in the most chosen expressions, yet passed rapidly from one subject to another, and thus discussed the most heterogeneous matters. He, at the same time, treated those about him with a kind of hauteur and great distrust. I gave him lachesis 2130 with the result, that he discontinued his discourses, and returned to his ordinary behaviour. Only there still remained an inordinate appetite, and an irritability of disposition, which would not permit him to endure contradiction, and he also exhibited a peculiar formality in his manner towards others." Gross. Nux vom. A young man, when nineteen years of age, became insane from over exertion of mind, &c. At that time he was alloeopathically treated, and after a year restored to health. A year after his cure, he had a relapse in the same month, and under the same circumstances as those of his first attack, which was characterised by some of the same symptoms. He was chilly and fretful in the mornings; his countenance was gloomy and perturbed; he was anxious VESANIE. 381 about his situation; had complete loss of appetite; white coated tongue; bitter, and acid taste; flow of water into the mouth; disposition to vomit; frequent pressure to stool, with small discharges of nearly natural fieces; no thirst; in the left side of the abdomen a sensation of great weakness, which appeared to extend from thence to the head, and disqualified him for any employment; he unwillingly spoke a word; felt extremely weak and relaxed; trembled in his limbs; had continual chilliness; paleness of the face; was very restless and excited; could not sleep, although he was much fatigued; he at times talked irrationally, and was very passionate. Nux vom. gtt. i. 30 was given, and in a few hours the disease entirely disappeared. CASE. In a man mat. 56 ann., of large and robust frame, who had been for fifteen years a postilion, but had left this active business under mortifying circumstances. In consequence of a great change in his mode of life, as he formerly moved continually in the open air, but now spent his time sitting in his room, as well as from the disagreeable recollections which still continued to operate upon him, he fell into a kind of melancholy. For this he was alloeopathically treated by a respectable physician, but without any success. When seen by Dr. Ruckert, who reports the case, the following symptoms presented themselves. His countenance was much perturbed, his eyes were red, and alternately dull and wild. He spoke little, but that little evinced a morbid care; he believed, for example, that he must freeze from insufficiency of fuel, or, that he and his family must perish from hunger, that something bad would happen to the absent, that he would never 384 VESANI E. else than great anxiety at her heart. She exhibited extreme fearfulness; trembled in her limbs; her face was red; pulse small and weak. On the next day after platinum gr. i. 2, her condition was very much improved, and by the third day she was perfectly well, and remained so at the end of eighteen months. CASE. In a girl wet. 19 ann. She talked almost incessantly, sometimes of actual circumstances, and sometimes irrationally. She laughed, sang, danced and wept, distorted her countenance, and gesticulated with her hands. She adhered obstinately to her ideas without becoming raving. She had no desire for food, but of what was offered to her she ate with haste. Platinum produced a very beneficial change. A remaining disposition to silence and great reserve was removed by sepia. Pulsatzlla. In the case of a woman aet. 19 ann. who was naturally of a lively and cheerful disposition. In the eighth month of her first pregnancy she became gloomy, mistrustful and reserved. She frequently sat still and folded her hands, laid them on her abdomen and sighed. To the questions of her affectionate husband and of her mother she gave no other reply than "there is nothing the matter with me." At times she had heat of the face and thirst; she had no desire for food; felt herself very weak, had pain in her limbs, and was unable to sleep. She often sought for things in wrong places, or knew not where she was. She talked incongruously, especially at night, when she would go out, because, as she stated, "the black men would injure her." After the paroxysms she had no recollection of them. Belladonna 30 was given, and for forty-eight hours she was quiet, and felt and slept well. At the end of this 386 VESANI.E. savage beasts and black dogs; heat, and at times redness of the face; staring appearance of the eyes; anxiety and thirst; sorrowfulness; weeping, and thoughts of death; organs of speech as if paralysed, he stuttered and stammered much before he could speak a few words; frequent coldness of the body, and constant coldness of the feet; restless sleep; pulse irregular, quick and small. Stramonium 15 cured him perfectly in twenty-four hours, and he afterwards remained well. Sulphur. In a case of melancholy, with suppressio mensium, occurring in a woman ret. 45 ann. who had experienced several attacks of the same form of disease, which had always disappeared without treatment in six or eight days. But the last attack continued for several weeks, when medical aid was sought. Her countenance was pale, and exhibited the peculiar features of melancholy; her eyes were dull. She complained of headache and a sensation of pressure in the head, and of pressure in the epigastrium. She was very anxious and concerned about her situation; thought she must starve, and often walked about the room wringing her hands. She was often seized with violent anxiety, which impelled her to run away, which she was unable to do from the watchful care of her family. Pulsatilla 7112 produced no improvement in four days, when tr. sulphuris 7115 was administered. In nine days the melancholy had entirely disappeared. There was afterwards a slight renewal of the complaint, for which, it being considered by the physician as belonging to the primary operation of the medicine, no remedy was given. In a few days this also ceased, and about the thirtieth day after the administration of VESANIE. 387 the sulphur, menstruation took place and continued for four days, after which she remained well. CASE. A woman Eet. 26 ann. of quiet, tranquil temperament, strong frame, brown hair; two weeks after the birth of her third child, was attacked with mental derangement, and three weeks later, when Dr. Tietze was consulted, presented the following symptoms. She mostly sat still, did not speak, and when much pressed with questions, only answered very briefly. She was morose and peevish. But at times she wept and complained, and her mien was expressive of care and uneasiness. She was often oppressed with blasphemous thoughts and ideas, from which she could not free herself. This rendered her, for some time, anxious for the welfare of her soul. She would after a time again seat herself and cease to speak or weep. Her countenance was pale and expressive of anxiety. If, for a short time, she felt better, the countenance became more cheerful. She frequently complained of headache; had aversion to employment, and indifference to her household concerns; yet she cared for her child, and still nursed it, though the breasts did not appear to afford a sufficiency of milk; complained of great debility. Appetite and sleep good. In the early part of the disease she became vexed, and, contrary to her usual habit, was excited and violent. Belladonna caused a temporary improvement. Veratrum, which was next given, was productive of no benefit. Tr. sulphuris 5115 was followed by marked improvement; the disease would disappear for days and again return Cocculus 5112 was next given, but with little advantage. Then lycopodium 5118, after which she was quite well for fourteen days, when the Febris Febres contin. et remit Febres intermittentes Felon 0 0 Fistula in ano Flux. Fluor albus Fungus hoematodes Fungus hoemat. oculi Gastritis Gohagra Gonorrhaea Grippe Gums INDI PAGE S. 198 S.. 198 S. 214 S.. 319 S. 25 S.. 132 S. 280 S. 236 S. 187 S. 237 S. 30 S.. 238 S. 74 S.. 239 Inflammation of the Testes - Uterus Influenza. Insanity. Jaundice Kidneys, inflammation of the Lepra arabum. See Eruptiones. Leucoma. Leucorrhcea. Liver Locked jaw. Lordosis. See Bones. EX. PAGE * 355 362 S73 375 * 278 299 * 187 280 * 283 356 Hamatemosis Hematuria Hamoptysis Hamorrhagia Hoemorrhagia oculi Hamorrhagia uterina Hnmorrhoides Headache Hearing Heart. Hemicrania. See Cephalalgia. Hepatitis Hernia Herpes. See Eruptiones. Hiccough 0 0 0 Hordeolum * 0 0 Hydrocele 0 0 Hydrocephalus Hydrops flydrothorax. See Hydrops. Hyperostosis. See Bones. Hysteria. 6 0 Hysteritis 0 0 S 243 * 257 S 245 * 240 S 241 * 253 S 260 S77 S 151 * 264 S 283 * 269 S 351. 198 S 356 S65 S 270 Lues venerea Lungs Mammm Mammillm Mania a potu Measles Melena Menses Metritis Metrorrhagia Milk-leg 0 Mollitdes ossium. Morbilli a Morbus coxarius Morbus niger S... 354 S*. 286 S... 289 S.. 293 S... 122 S.. 341 S... 243 S.. 296 S... 362 S.. 253 S... 323 See Bones. S.. 341 58 S.. 243 Icterus. Impotentia. Incubus. Inflammation of the Bladder _ - ~Brain - Ear - Eye - Fauces - Heart - Kidneys Liver - Lungs - Peritoneum - - Stomach * 278 362 * 278 27 4 280 43 - 63 151 0 177 23 0 264 299 a 283 286 0 321 237 Necrosis. See Bones. Nephritis Neuralgia Nightmare Nipples Nose Nose, bleeding from the Nymphomania Odontalgia Oneirogmos Ophthalmia Ophthalmodynia Ophthalmorrhagia Opisthotonos. See Tetan Otalgia Otitis Otorrhcea Ozcena 6 0 S. 299 300 S. 280 S. 293 - 304 S. 242 S. 27 S 305 27 S 177 S. 176 S. 241 lus. S161 151 -. 151 S. 151 S 312 314 S 314 Palsy Paralysis Paronychia Parturitio Pemphigus Peritonitis Pertussis Phlegmatia alba dolens Phrenitis Phthisis pulmonalis Piles... Plrif;ti'o IND PAGE. 319 S. 320. 157 S. 321. 361 0. 323 *. 53 0. 323 *. 260 9 QR EX. Swallowing, difficulty of. Sycosis... Syncope... Syphilis.... Testes.... Tetanus.... Tic doloureux Tinea capitis. See Eruptiones. Toothache... Trismus. See Tetanus. Tussis..... Tussis convulsiva Urticaria. See Eruptiones. Uterine hcemorrhage Uteri prolapsus Uterus..... PAGE ~ 148. 352. 354. 354 ~ 355. 356 300. 305 358. 361 253. 363 362 Plica polonica. See Eruptiones. Pneumonia... Podagra.. Priapismus... Psora. See Eruptiones. Psorophthalmia Purpura miliaris Rachitis. See Bones. Ranula... Rhagades. See Eruptiones. Rheumatismus Rubeola..... Satyriasis... Scarlatina... Scirrhus.... Scrofula.... Singultus.... Small-pox.... Spina ventosa. See Bones. Spermatic chords *. Sterilitas..... St. Vitus' dance. 286 30. 27 198. 343 335. 336 341 27 343. 348 351. 351 364. 355 27. 97 Variola.. Venereal disease. Vermes. Vesani.. Vesica urinalis Vision. Voice, imperfection of the Warts and Corns Whites... Whitlow Whooping-cough Womb... Worms.. 364 S. 354 S. 370 S. 375. 43 S. 176. 25 S. 389 S. 280 S. 319 S. 361 362.. 370 Zona. See Eruptiones. 'r'i tN. -,: UIVESIY O r''C/5't it, 1< fi -71 i4i -t44-- "N' N/,' (Y. ~ t~'''~'~.'ig~"' '- 7'' ''4 '' 'N H' '4'el ''~''1''j "I.4" * '' It