A 575720


(2



- N.-,



a






4O I 94-f



Entered, according to Act of Congress, in the year 1847, by
WILLIAM RADDE,
In the Clerk's Office of the District Court of the United States, for the
Southern District of New-York.
a. LUDWIi, PRINTER, 70 & 72 VESaY-BT., N. Y.



THE     TRANSLATOR'S PREFACE.
THE second volume of Hartmann's Acute Diseases will appear
very shortly.
"We have nothing to mention in regard to the mode in which
this work is to be used. It should be read and studied from
beginning to end; that is all.
As this work is intended for practitioners generally, beginners as well as those who are more advanced in our practice,
it may be proper to give a brief explanation of the various
modes in which our medicines may be administered.. We have
nothing to say about the frequency or magnitude of the doses,
as the reader will find that subject fully explained and inquired
into in the body of the work. All that we wish to do in this
place, is to inform the beginner of the various modes in which
the medicines may be given to the patient.
Administration of the pellets.-Two or three pellets may,
be placed upon the patient's tongue, taking care, however, that
the mouth should be well washed previously. If the complaint
should be of such a nature as will evidently require more than
one dose of the medicine, the pellets, seven or eight in number,
may be dissolved in half a tumblerful of water, turning the solution some twenty times from one tumbler into another one
backwards and forwards; the tumblers should be well cleansed
and dried before using them; nothing fuzzy should be left
hanging about them. Never use the same tumbler for two different kinds of medicine. Let not the solution be exposed to
'*



PREFACE.


the light, keep the tumblers covered, and use a separate spoon
for each medicine.
Administration of powders.-If the patient should prefer
taking the medicine in powders, use one drop of the medicine
to about twenty or twenty-five powders; a powder should not
"weigh more than one grain.
Administration of the tinctures.-The tinctures should always be given in water, one or two drops in a tumblerful,
stirring the solution well.
Administration of the lower triturations.-No trituration
below the third should be given in water, but always in onegrain powders.
Hahnemann's favourite mode of administering the remedies
was this: he dissolved a few pellets in a tumblerful of water,
in the manner which has been indicated above, and then mixed
a tablespoonful of that solution with another tumblerful of
water, turning the solution twenty or thirty times from one
Stumbler into another backwards and forwards. This double
mixing is very often required with the tinctures. A simple
mixture of the tincture will frequently be found inefficient,
Swhereas a doubly-mixed tincture has the best effect, provided
the remedy is the true one.
Any medicine which is taken in water should be turned five
"or six times from one tumbler into another, previous to taking
a new dose.


CHARLES J. HEMPEL, M.D.



THE AUTHOR'S PREFACES
TO THE THREE EDITIONS OF THIS WORK,
CONDENSED INTO ONE.
FOR the last ten years the homoeopathic science and art of healing
has been considerably perfected in all its branches; but no work
has as yet been published which furnishes a systematic exposition
of the treatment which ought to be adopted in the different diseases. This omission 'is probably owing in part to the inherent
difficulty of the undertaking, and partly to Hahnemann having remarked that no treatment can be based upon the classification of
diseases as adopted by the old school. I have never despaired of
succeeding in completing a work containing a systematic exposition of the homoeopathic treatment of disease, so much more as the
phenomena which constitute the diseases, as described in allopathic books, are contained among the symptoms obtained by the
provers of drugs, such as: asthma Millari, cholera morbus, fever
and ague, and its varieties. It is the very plan which has been
adopted by the author of homoeopathy, of arranging the symptoms
of a drug in one list, and of distributing them in groups, that has
suggested to me the idea and arrangement of the present work.
I trust I have rendered a service to beginners, by describing the
general diagnostic characteristics of a disease at the commence



AUTHOR'S PREFACES.


ment of the chapter; the more particular indications for the special
remedies have not been omitted.
My remarks on diagnosis, prognosis, etiology, classification,tof
diseases, are necessarily very brief, and may call forth censure on
the part of allopathic physicians. My object has been to furnish
an accurate account of the homoeopathic treatment of disease. As
regards the generalities and the collateral sciences in medicine, I
had a right to expect that every homoeopathic practitioner should
be thoroughly acquainted with them. Some allopaths may find
fault with the distribution of the work; to such critics I have
simply to observe that the distribution of the work has been a
matter of secondary importance, and that my main object in adopting any classification of disease has been to establish points of
reference which would facilitate the use of the work; the treatment
and nature of diseases do not depend upon their classification.
Certain diseases, which are considered chronic by allopathic physicians, haye been transferred to the acute forms of disease;
my reasons for making this change have been stated in treating of
those diseases.
It is more than probable that indolent and indifferent practitioners will avail themselves of this work as a means of avoiding
study and labour. To all such I would repeat the words of Pfeuffer, which may be found in his "Deceptions at the Sick-Bed."
" Every case of disease, in spite of the physiognomic character
which it may possess in common with other diseases, is an individual existence or form, upon which the dogmatism of the
schools will be frequently wrecked.    The power to individualize distinguishes the true physician from the routinier,
whose rules and principles diminish as he advances in his practice."
The present work purports to be the mere outline of a future
system of therapeutics, although such a system can never be made
complete enough to give the beginners fixed rules for the treat,



AUTHOR S PREFACES.


XV.


ment of every case, inasmuch as every case ought to be considered
a distinct affection which has never existed before in precisely the
same form, and for which no remedy can be pointed out beforehand (except a few contagious and miasmatic diseases, such as:
scarlatina, measles, smallpox, purple-rash, syphilis, etc.). This
observation, which has been so frequently repeated by homoeopathic physicians, ought to convince allopaths that their opponents
cannot cure disease unless they possess the power to investigate
the symptoms and the perceptible character of a disease with
great accuracy, which they cannot do without a profound knowledge of anatomy, physiology, pathology, etc. Why then should
homceopaths be called ignorant, as has so often been the case?
According to homceopathy, congestion, fever, inflammation,
constitute the second phasis of a disease, which depends upon a
morbid alteration of the nervous system. Starting from   this
ground I ought to have treated in the first place the affections of
the nervous system; I have preferred preserving the common
division of diseases, in order to avoid all unnecessary and
embarrassing innovations. In describing the symptoms of diseases I have observed the following order: those of the irritable
sphere first; next, those of the reproductive and sensitive sphere;
and, lastly, some affections of the sexual organs, to which the
diseases of females have been added, including the diseases of
the female sexual organs.
The irflammatory affections of the male sexual organs will be
found described in the chapter on blennorrhcea of the male
urethra.
No essential changes have been made in the three editions of
this work, except some changes in the arrangement of the
materials and practical observations derived from my own experience and that of my friends. As regards the fundamental
principles of our art, I can truly say, that I am more than ever
convinced of their truth, and that I cherish particularly the great



AUTHOR'S PREFACES.


principle of selecting a remedy in accordance with the perceptible
phenomena of the disease. I have, moreover, become convinced,
that Hahnemann was right in exacting the most minute examination of a case; although he has modified his original views in
many respects, yet he has constantly insisted with an unyielding
firmness upon the necessity of making a rigid examination.
Homoeopathy would perish, if we were to neglect that most
important part of the treatment.
I have now practised homoeopathy for twenty-eight years, and
my practice has been very extensive. This long period has
afforded me abundant opportunities of becoming aware, that our
knowledge of the internal character. of disease is yet very
imperfect, and that we have not even yet discovered a cor-,,responding simile for every disease.  Nevertheless, I cannot
chime in with the wild innovations of the pretended modern
reformers of homoeopathy. We should prove all things and hold
fast to those that are good; but, on the other hand, we
ought not to abandon a single rule or opinion, without having
become convinced by rigid and impartial investigation, that it is
either useless or erroneous.
F. HARTMANN, M.D.


LEIPSIc, Sept. 21st, 1846.



CONTENTS.
INTRODUCTION.
Fundamental Principle,.....
Proving of Drugs,
Investigation of the Symptoms,......
Causa Occasionalis, Necessity of Investigating the,
Examination of a Case,.....
CLASSIFICATION OF DISEASES.
Diseases belonging to particular Ages,....
"    "     Different sexes,..
"     "     Tradde and Professions,
"   Sporadic,.......
"   Endemic,....
"   Epidemic,.......
"   Annual,...
"   Stationary,.
"   Intermittent,......
"   Hereditary,.
"   Congenital,.......
"   Acquired,........
"   Primary,.....
"Seconday,...


Page
25
26
28
29.  32
32


38
39
S 39
". 40
40'|
40
41.  41
41
41
S 43
S 43
S 44.  44
44



XViii.


CONTENTS.


Page
Diseases, Contagighs...................44
ccMiasmatic,...................44
"i Acute,....................45
" Chronic.....................45
of the Mind,..................47
GENERAL THERAPEUTIC RULES.  50
Different Modes of -Treatment................52
Treatment, Specific,...................52
"c  Prophylactic,,......  52
cc Palliative,..................53
cc Derivative...................56
Empirical,..................57
Isopathic,..................58
Dose, Magnitude of....................60
*Dynamization...................    61
Modus Operandi of our remedial agents,............71
Division of our remedies into antiphiogistics and antipsorics,  74
Repetition of doses...................77-79
Mixing the remedies....................78
Diet, General......................81
FEVER.
GENERAL REMARKS'.
Common Syimptoms of Fevers,...............85
Causes of Fevers.....................86
Critical Phenomena,...................86
Sweat,........87
Rash,........88
" Urine..................... 89



CONTENTS.        XX.
Page
Changeable Urine,               89
Critical Hemorrhage,..................90
Dangerous Hemorrhage in Fevers,............90-92
Critical Discharges from the Bowels,  93
cc Vomiting,                  93
Expectoration...................93
Ptyalism....................,
GENERAL REMOTE CAUSES OF FEVER.  94
Atmospheric Air.....................95
Contagia........................95
Miasmata,.........................95
Passions and Emotions,..................96
Derangements of the Intestinal Canal,............  96
Want of Necessaries,.....................97
CLASSIFICATION OF FEVERS.  97
Fevers, Synochal,.........................97
cc Synochus,.....................98
" Typhoid,.......  98
" Torpor,        a.......... 98
Prognosis........................100
Terminations............................101
Diet,..........................102
Temperature......................103


SPECIAL PATHOLOGY OF FEVERS.
FIRST CLASS.
Synochal Fevers,..............
Pathology..................
Treatment,...............


108
110,



CONTENTS.


Fever of Dentition,.....
Teething, Pathology of,....
Diseases occurring during the period of Teething,
Spasms and Convulsions,....
SECOND CLASS.
Catarrhal Fever,....
"      "     in Children,...
Influenza,...
Grippe,...


Page
115
S116
116
S120


123
S133
135.136


THIRD CLASS.
Simple Rheumatic Fever,


140


FOURTH CLASS.


Gastric Fevers,.
Status Gastricus,
Saburral, Gastric, Bilious Fevers,
Mucous Fevers,....
Status Pituitosus,
Worm Fever,..
Tenia,..
Febrile Conditions resembling Cholera,
Cholera, Sporadic,
"    Asiatic,....
Dysentery,..
"     Inflammatory,
"     Gastric,
"     Bilious,.   151
151.154
S165.   168
172
S179-182
182.184....  187.   202
206.208
209



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CD CD
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CD ~    CD
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E RR A T'A.
Page 47, 11th line from the bottoma-after originate add in psora.
"I 103, 16th cc  cc  c  top-for 250 read 570, and for~ 450 read 770.
14' 4" 17th cc      cc  cc - cc 350  cc 6-703 66  c' 38     700.






INTRODUCTION.
IT is now more than fifty years since homcoopathy
was discovered by the profound and learned Dr. Hahnemann. Its claims and merits are now universally
appreciated, and in spite of the intrigues and invectives of its opponents, it has succeeded in gaining
the rank of an acknowledged science. It owes its
triumph to the fact that the principles of homoeopathy
are generalizations established in the eternal and immutable household of nature. During the first twenty
years of his discovery, Hahnemann was alone in cultivating and perfecting it; but after that peribd he
formed disciples; physicians from the old school, who
at first considered homceopathy a mere creation of the
fancy, became converts to the new doctrine, and, at
the present moment, it is tritunphantly practised in
every civilized country, and not only spreads farther and
farther, but its intrinsic value is likewise being constantly enhanced by new discoveries. This success
could only be accomplished by a mode of cure which
is derived from the laws of nature, and is confirmed
every day by the results of experience. But what will
be the influence and extent of homoeopathy when its
practitioners shall have increased by thousands, and
shall devote all their energies to the development of
their art; heedful of the warning of their master, that
no created spirit can penetrate to the causative principles of nature without substituting in their stead
speculative and hypothetical explanations and opinions
and receding more and more from the paths of nature?
We may certainly hope, without being sanguine, that
after the next fifty years, homceopathy will be far
2



26


INTRODUCTION.


ahead of any other system of cure. Be it remembered, however, that, in order to attain such brilliant results, all homceopathic practitioners ought to devote
themselves to calm inquiry and rigid observation, and
that their efforts in the great cause ought never to
slacken.
However interesting it might be to our readers to
glance in this place over a detailed account 'of the
mode in which Hahnemann gradually arrived at the
discovery and realization of his system, yet we prefer
omitting the relation of facts with which our readers
are abundantly familiar, and confine ourselves to
stating the fundamental principles of hommopathy;
these form a complete system of general therapeutics,
and a correct knowledge of those principles is essential to the proper understanding and appreciation of
the special principles of our treatment- of disease.
The fundamental principle of hommopathy is expressed in these words: " Similia similibus curantur,"
which meaEis, that only such remedies are capable of
effecting a permanent and real cure as affect the
healthy organism in a manner similar to the natural
disease. This fundamental principle of cure was discovered by Hahnemann while he translated Cullen's
Materia Medica (Leipsic, 1790), where his attention
was arrested by the statements about the febrifuge
power of Cinchona. Upon proving this drug on
healthy persons, a state similar to fever and ague was
realized in the provers, beside many other symptoms
which had never been mentioned by any writer before.
From this fact Hahnemann inferred what was afterwards confirmed as a great truth, that medicines are
only in so far capable of curing disease as they realize
in a healthy person a morbid state similar to the natural disturbance of the organism. Led by his experience, Hahnemann established the following rule for
the further development of his system:
Prove the. drugs upon healthy persons, in order to find
out what systems and organs are principally affected
by them and what are the symptoms characterizing



INTRODUCTION.


27


that affection. It is true that the necessity of such
provings had been perceived by single physicians, and
that partial provings have been instituted before Hahnemann; but they were never carried on systematically with a view of obtaining a correct knowledge of
the curative powers of drugs apd applying them to the
treatment of disease according to a fixed general
principle. The road of pure experimentation was soon
abandoned by those physicians as too tedious and too
little productive in brilliant results; their prejudices
were likewise opposed to a systematic proving of
drugs, and Hahnemann is therefore the first who has
proclaimed and demonstrated the necessity of pure
experimentation, who has furnished explicit and abundant rules for the proving of drugs, and. who has furnished to the world the brilliant results of his own
provings, which are the groundwork of homoeopathy
and a beacon-light and model for all homoeopathic
practitioners and pure experimenters.
However laborious and painful the road of pure experimentation may be, Hahnemann never dreaded the
tortures and sacrifices which he encountered on that
road, and, assisted by devoted disciples, he continued
his provings and noted the symptoms which he obtained, with the utmost care. Provers of drugs ought
to employ the greatest discretion and care in observing
the drug-symptoms which they experience during the
period of proving; and they ought moreover to observe
a rigorous diet during all that time, lest the action of
the drug should be impaired and the symptoms should
become impure and untrustworthy. In proving, Hahnemann soon discovered that the drugs had a twofold
effect, which he designates in his Organon by the
terms of primary and secondary, and which had never
been observed before by any physician. Without
entering upon an explanation of that compound action,
which may be found in the Organon and to which we
therefore refer, we content ourselves with simply remarking, in this place, that the primary effect of the
drug is sometimes seen in disease in the shape of a
temporary exacerbation of the original symptoms.



28


INTRODUCTION.


Such an exacerbation, however, is much less frequent
than is supposed. Most of the pretended exacerbations which are recorded in our books have been
noticed by beginners in homoeopathy, who had too
little knowledge of disease and the effects of the
remedies to be able to distinguish a natural from a
medicinal exacerbation of the symptoms; or Hahnemann himself was carried away by his own enthusiasm, and his disciples were either too timid or too
ignorant to correct the errors of his judgment; or the
exacerbation might have been owing to the excessive
magnitude of the dose or the non-homoeopathicity of
the remedial agent. We know that exacerbations
may exist, but they are less frequent now than they
were in the beginning of homceopathy, when every
aggravation of the symptoms was supposed to be
owing to the excessive magnitude of the dose. This
error has frequently proved injurious to the patient
inasmuch as it induced the omission of many things
which ought to have been done and which are done by
the present practitioners of homoeopathy whose knowledge of the course, chances, transitions, and the general characteristics of disease, is much better than that
of their predecessors. It is still more difficult to account for the exacerbation which is said to be produced by the recently-introduced highest potencies.
The proving of drugs affords a twofold advantage.
In the first place the proving physician sharpens his
power of observation and accustoms himself to notice the minutest symptoms of disease, every one of
which ought to be of sufficient importance to the physician to embody it in his record of the case; and, in
the second place, by proving the drug upon himself, he
acquires a true perception of its curative powers, which,
in his person,manifest themselves unbiassed and unmixed with the heterogeneous influences of other medicinal
agents. How different is the.homoeopathic materia
medica from that of the old school, which is a mere assemblage of impure and uncertain effects of drugs as
observed at the sick-bed, and not of one drug at a time,
but every drug being administered in company with a



INTRODUCTION.


29


variety of other drugs, and the whole being adorned
with strange speculative views about the chemical,
dynamic, clinical, mechanical and specific virtues of a
drug. No sort of reliance can be placed upon such
statements. If the materia medica of the old school
is to be used with confidence, it must be constructed
like our own, and, in that case, it will be merged in
homoeopathy; for the homceopathic law is confirmed
in all cases where the pathogenetic effects of our
drugs and the curative results which have been obtained by means of them, are compared with one
another.
The investigation of the symptoms of a disease is the
third fundamental rule in homoeopathy. The importance of that investigation has been urged by Hahnemann with great force, because the proper selection
of the remedial agent, and consequently the success of
the treatment depend upon it. He recommends that
the symptoms of the disease be noted with the same
care and completeness as were the symptoms of the
drug, and that the former be counterbalanced and effaced by the latter. This proposition has been attacked on all sides, and has been strangely misapprehended.  It has been supposed, for instance, that
Hahnemann neglected to take cognizance of the exciting cause, the causa occasionalis of the disease.
The opponents of homceopathyhave frequently charged
that neglect upon our practice; but unjustly so, for
every homoeopathic practitioner knows, that, in many
cases, the proper selection of the remedial agent depends exclusively upon a knowledge of that cause, inasmuch as the symptoms of two entirely different diseases may apparently be alike, and the difference can
only be recognised by tracing the symptoms to the exciting cause. We will illustrate this by a few examples:
We know from experience that Arnica is most useful in diseases resulting from  blows, contusions,
wounds, strains, etc.-A man who has been drenched
to the skin is frequently attacked with a variety of
symptoms corresponding to those of Rhus tox., which



30


INTRODUCTION.


it would be difficult to cure if the exciting cause were
not known.-What physician would not give Cocculus
against a febrile state characterized by flushed cheeks
and nightly sleeplessness, if he knew that home-sickness was the exciting cause?-Fright occasions a
great many symptoms for which we have specific
remedies in our materia medica; Ignatia for grief,
Aconite for a vexed and irritable mood, Opium for
fear.-Ignatia is a sure specific for symptoms resulting from grief and chagrin; Chamomilla, on the contrary, is a specific for the consequences of chagrin,
when accompanied with anger and vehemence.-It
would be a long and difficult business to cure a derangement of the stomach, if the physician did not
know the exciting cause; but it will be readily removed by a dose of Pulsatilla, if it had been occasioned by fat food, especially pork; by Arsenic, if it owes
its existence to a cold in the stomach, to eating cold
fruit, etc.-Physical and mental weakness resulting
from blood-letting, hemorrhage, waking, night-sweats,
onanism, venereal excesses, etc., finds a specific in
China, provided the weakness is the principal suffering, and not a mere symptom of a more general and
deeper-seated disease.-Diseases resulting from want
of exercise, yield to Nux; but could they be cured as
readily if the exciting cause were not known?-Dulcarnara is the specific for diarrhoea, with or without colic,
occasioned by cold, and sometimes accompanied with
swelling of the glands.-A homceopathic physician
who is acquainted* with the pure effects of Chamomilla, Mercurius, Sulphur, China, Valeriana, Iodine, etc.,
will never prescribe those remedies without inquiring
in the first place whether the symptoms have not been
occasioned by the excessive use of those substances,
in which case he would administer suitable antidotes.
-Would it be easy to cure the sufferings resulting
from the excessive use of ardent spirits, if the exciting
cause were not known? It would not, if the physician were ignorant of the exciting cause, and of the
pure effects of Nux vom., which correspond to the
symptoms occasioned by spirituous drinks.



82


INTRODUCTION.


fore. This explains why Hahnemann denied the
validity of allnosological classifications, as a means of
cure, and admitted their use only for the purpose of
collecting the symptoms under one general denomination. In the present work we have retained the
pathological denominations, because we are persuaded
that they facilitate the study of homoeopathy to the
beginner; we have indicated, however, with as much
care as we were able, the specific remedies for the
various groups of symptoms occurring in a disease;
and we expect, therefore, that we be not blamed for
having made this arrangement.
Hahnemann insisted upon every record being taken
in writing, lest symptoms should be forgotten by ihe
physician. An examination instituted by a homceopathic physician is much more minute than an
examination instituted by an allopath; this one
neglects to take cognizance of various exciting causes
which require the administration of peculiar specifics
in homceopathic practice.
"  83. This examination of a particular case of
disease, (says Hahnemann,*) with the intent of presenting it in its formal state and individuality, only
demands, on the part of the physician, an unprejudiced
mind, sound understanding, attention and fidelity in
observing and tracing the image of the disease. I
will content myself, in the present instance, with
merely explaining the general principles of the course
that is to be pursued, leaving it to the physician to
select those remedies which are applicable to each
particular case.
" ~ 84. The patient details his sufferings; the persbns
who are about him relate what he has complained of,
how he has behaved himself, and' all that they have
remarked in him. The physician sees, hears, and
observes, with his other senses, whatever there is
changed or extraordinary in the patient. He writes
all this down in the very words which the latter, and
the persons around him, made use of. He permits


From the American edition of Hahnemann's Organon.



INTRODUCTION.


33


them to continue speaking to the end without interruption,* except where they wander into useless
digressions, taking care to exhort them, at the commencement, to speak slowly, that he may be enabled
to follow them in taking down whatever he deems
necessary.
" * Every interruption breaks the chain of ideas of the person who speaks,
and things do not afterwards return to his memory in the same shape he
would at first have described them.
"~ 85. At each new circumstance related by the
patient or the persons present, the physician commences
another line, in order that the symptoms may all
be written down separately, and stand one beneath the
other. By this mode of proceeding, he will be enabled
to add to that which has, in the first instance, been related to him in a vague manner, any thing he may
subsequently acquire from a more accurate knowledge
of the case.
" ~ 86. When the patient and those about him have
finished all they had to say, the physician then asks
for more precise information with regard to each individual symptom, and proceeds as follows:-He reads
over all that has been communicated to him, and asks
at each particular symptom, for example-At what
epoch did this or that circumstance occur? Was it
previous to the use of the medicines which the patient
has taken till the present time, or while he was taking
them, or only a few days after he had discontinued
their use? What kind of pain, what particular sensation was it that was felt in such or such a part of the
body? Which the precise spot that it occupied?
Did the pain come on in separate attacks at intervals,
or was it lasting and uninterrupted? How long did
it continue? At whathour of the day or night, and in
what part of the body, was it most violent, or where
and when did it cease entirely? What was the
precise nature of this or that particular circumstance
or symptom?
" ~ 87. Thus the physician causes all the indications
which were given in the first instance to be described
to him more closely, without ever appearing, by his
2*



3


INTRODUCTION.


manner of putting the question, to dictate the answer,*
or place the patient in such a position that he shall
have nothing to reply but yes or no to his question.
To act otherwise would only lead the person interrogated to deny or affirm a thing that is false, or only
half true, or even wholly different from that which has
really occurred, according as it may suit his convenience, or for the purpose of gratifying the physician.
An unfaithful description of the disease would then
result, and, consequently, an inappropriate choice of
the curative remedy.
".* For instance, the physician ought never to say-( Did not such or such
a thing take place in this manner?' By giving this turn to his questions,
he puts a false reply into the mouth of the patient, and draws from him a
wrong indication.
"~ 88. If in this spontaneous narrative no mention
is made of several parts or functions of the body, and
of the state of mind of the patient, the physician may
then ask if there is not something more to be said respecting this or that particular part or function, or
relative to the disposition and state of mind,t taking
care, at the same time, to confine himself to general
terms, in order that the person who furnishes the explanation may, thereby, be constrained to answer
categorically upon these various points.
" t For example-Has the patient had an evacuation from his bowels?
How does he pass water-freely or otherwise? How does he rest by day
and by night? What is the state of mind and temper of the patient? Is
he thirsty? What kind of taste has he in the mouth? What kinds of
food and drink are most agreeable to him, and which are those he dislikes? Do the different articles taste as usual, or have they another taste
that is wholly different? How does he feel after meals? Have you any
thing more to tell me relative to the head, belly, or limbs?
a     " ~ 89. When the patient (for it is to him we are to
refer, in preference, for every thing that relates to the
sensations he experiences, except in diseases where
concealment is observed) has thus personally given
the necessary details to the physician, and furnished
him with a tolerable image of the malady, the latter
is then at liberty to question him more specifically if



INTRODUCTION.                         35
he finds he is not yet sufficiently informed on the
subject.*
" For example-How often have the bowels been evacuated, and what
was the nature of the discharges?     Did the whitish   discharges
consist of mucus or faces? Were they painful or otherwise? What
was the precise nature of these pains, and in what part were they felt?
What did the patient throw up? Is the bad taste in the mouth putrid,
bitter or acid, or what kind of taste is it? Does he experience this taste
before, during, or after eating or drinking? At what part of the day does
he feel it in particular? What kind of taste was connected with the
eructation? Is the urine turbid at first, or does it only become so after
standing a while? Of what colour was it at the time of emission? What
was the colour of the sediment? Is there any peculiarity in the state of
the patient when he sleeps? Does he sigh, moan, speak, or cry out?
Does he start in his sleep? Does he snore in inspiration or expiration?
Does he lie on his back only, or on which side does he lay himself? Does
he cover himself up close, or does he throw off the bed-covering? Does he
easily awake, or does he sleep too soundly? How does he feel on waking?
How often does this or that symptom occur, and on what occasion? Is it
when the patient is sitting up, lying down, standing up, or when he is
moving about? Does it come on merely when he has been fasting, or at
least early in the morning, or simply in the evening, or only after meals, or
if at other times when? When did the shivering come on? Was it
merely a sensation of cold, or was he actually cold at the time? In what
part of the body did the patient feel cold? Was his skin warm when he
complained of being cold? -'Did he experience a sensation of cold without
shivering? Did he feel heat, without the face being flushed? What
parts of his body were warm to the touch?T Did the patient complain of
heat without his skin being warm? How long did the sensation of cold, or
that of heat, continue? When did the thirst come on? During the cold
or heat? Or was it before or after? How intense was the thirst? What
did the patient ask for to drink? When did the perspiration come on?
Was it at the commencement or at the expiration of the heat? What
space of time elapsed between the heat and the perspiration? Was it
when sleeping or waking that it manifested itself? Was it strong or otherwise? Was the perspiration hot or cold? In what parts of the body did
it break out? How did it smell? What did the patient complain of
before or during the cold, during or after the heat, during or after the perspiration, &c.?
" ~ 90. All the answers being committed to writing,
the physician      then    notes down      what he      himself
observes in the patient,t and endeavours to ascertain
if that which he observes existed or not when the latter
was in health.
" Nothing is more unpleasant for a physician, than an incomplete or
even incorrect image of the disease. If he have an incorrect impression of
the disease in the beginning of the treatment, he will find it difficult to
correct that impression- while the treatment is going on. He will never be
able to select the proper, remedy, for the disease, and his treatment will
necessarily fail.-HARTMANN.



INTRODUCTION.


" t For example-Howhe behaved during the time of the visit. Was he,
irritable, peevish, quarrelsome, hasty, grieved, anxious, despairing, sad
calm, or resigned? Did he appear overcome with sleep, or lost in reverie?
Was he hoarse? Did he speak low? Was his discourse incoherent, or
how was it? Of what colour was the countenance, the eyes, and the skin,
generally? What degree of vivacity was there visible in the face and
eyes? How was the tongue, the respiration, the smell from the mouth,
or the hearing?  Were the pupils of the eyes dilated or contracted?
Did they contract and dilate quickly in light and darkness, and in what
degree? What was the state of the pulse? * What was the condition of
the abdomen? Was the skin moist and warm, cold or dry, upon this or
that part of the body, or was it so all over? Did the patient lie with his
head thrown back, with his mouth wholly or half open, with his arms
crossed above his head; was he on his back, or in what position was he?
Did he raise himself with difficulty? In short the physician is to keep
notes of every thing he has observed that is strange and remarkable."
After having taken down an exact record of the
symptoms of a case, it is essential to investigate the
causa occasionalis, be it a permanently existing, material or an immaterial, dynamic cause, having ceased to
be present. We further require to consider the business
of the patient (whether the disease be occasioned by
it), his moral disposition, mode of life.      We ought to
inquire whether the patient is moderate in eating and
drinking, in his amusements, or whether he has im.
posed upon himself hurtful privations? whether he
has injured himself by venereal excesses? We have
further    to   ascertain   whether     disappointed     love,
jealousy, domestic quarrels, chagrin, grief, abusive
treatment, suppressed vengeance, humbled pride, loss
of property, etc., have been instrumental in occasioning the disease?
A correct knowledge of the hereditary disposition,
age and temperament of the patient is likewise of
great importance. If the patient be a female, the
physician has to inquire into the condition of the
menses, whether the menstrual period is too long or
too short, how    many days the menses flow, whether
they flow uninterruptedly or at intervals, whether they
are copious or scanty, of what colour, whether they
"* The physician examines the pulse, the condition of the heart, whether it
beats normally or abnormally, the chest, the abdomen, and does not neglect
any of the manipulations or instruments by means of which the internal phenomena of the disease are more or less correctly ascertained--HaBTMAXx.



INTRODUCTION.


are accompanied, preceded or succeeded by leucorrhcea? Whether they are accompanied with moral
or physical sufferings, and what are the peculiar pains
and sensations which manifest themselves before,
during, or after the appearance of the menses? What
is the appearance of the leucorrhceal discharge, with
what sensations it is accompanied, whether it is
abundant or scanty, and under what circumstances or
by what causes it is especially excited? Whether the
patient is sterile, or whether she has been pregnant
and how often? Whether she has miscarried? What
was the condition of her breasts, milk, etc.? What is
the strength of her sexual desire? In diseases of
the sexual organs the physician ought always to institute an examination of the parts both internal and
external.
Inquiry ought to be made about the diseases with
which the patient may have been afflicted previously,
both in acute and chronic diseases, especially, however, in the latter, with a view of ascertaining whether
preceding diseases have led to the present malady, or
to what an extent they complicate it. An inquiry
into the previous diseases of the patient sometimes
leads us to a correct knowledge of the disease in
chronic cases, and even helps us in selecting the
remedies which we ought to use in the treatment of
those cases. Although we do not admit that seveneighths of all chronic diseases owe their existence to
the psoric miasm, yet it is undoubtedly true that the
suppression of a previous cutaneous eruption, scabies,
herpes, tinea, scrophulosis, etc. induces a vast number
of chronic diseases which make their appearance
shortly after the eruption had been suppressed, the assertions of many great doctors to the contrary notwithstanding, who pretend that the itch is a mere
external disease which is caused by the acarus and can
be cured by simply destroying that insect by any, even
mechanical means. The homeopathic physician cannot accept such theories, although he may, on the other
hand, feel justified in believing that Hahnemann goes
too far in considering the psoric miasm as a morbific



INTRODUCTION.


principle which is coeval with mankind and has affected
more or less every organismn. One thing is certain, the
influence which previous diseases may have upon the
present one, has to be carefully investigated.
If, in examining a patient, the physician should discover symptoms pointing to the use of a certain drug
which is frequently employed in domestic and allopathic practice, it is the physician's duty to inquire
whether large doses of that drug have not already
been taken. Such drugs are: Valerian, Chamomile,
Mercurius, and mercurial preparations used either internally or externally, Iodine and Iodine ointment,
Sulphur, Opium, China and Quinine, Digitalis, Prussic
acid, Cathartics, etc.
If any, especially an acute disease should prevail,
its character or genius requires to be noticed with
care, inasmuch as it will influence more or less the
character of the disease which we are called upon to
treat and may be a clue to the practitioner for the
selection of the adequate remedial agent.
To institute in every, even trivial case, such a rigorous examination as has been here described, would
involve a useless loss of time and would be very
fatiguing to the patient. Our intention has simply
been to state what sort of an examination should be
made in a complicated case, leaving it to the intelligent and conscientious physician to condense the examination as much as a judicious appreciation of the
case by means of his physiological, pathological and
therapeutic knowledge will permit. A carefully instituted examination is the touchstone of a true artist
in homoeopathic practice.
This is perhaps the best place to say a few words
about the
CLASSIFICATION        OF   DISEASES.
A classification of diseases has not so much value
in reference to therapeutics as to the investigation of
the character of the disease.



INTRODUCTION.


We may divide diseases in reference to the individuality of the patients into
(a.) Diseases belonging to peculiar ages (morbi
aetatum), which may be either acute or chronic.
Owing to the extreme irritability of the childish organism, it is peculiarly liable to spasmodic sufferings; the
reproductive system being principally active in the
child, it must be subject to diseases which are principally seated in the lymphatics; the disturbances which
occur in the reproductive system, maintained and increased by the want of irritability and by the inactivity of the lymphatics, are characterized by congestion to the brain in the form of epistaxis, meningitis,
hydrocephalus, typhoid symptoms'of various kinds,
scrophulosis, helminthiasis, etc. In a more advanced
age, when the vitality of the thoracic organs is developed in a superior degree, congestion of the
lungs is a prevalent condition, inducing a corresponding predisposition to pulmonary diseases; in this age
the sexual organs develope themselves and the passions connected with that development begin to be felt,
and, if satisfied to excess, lead to various diseases
peculiar to this second period of life. The smallest
number of diseases occurs in the period when the
human organism is fully and harmoniously developed.
As man advances in age, the abdominal organs are
principally affected, hence atony of the intestinal
canal, hypochondria, hremorrhoids, gout, etc. are the
principal diseases of that period. Old age, when all
the moral and physical energies of man are on the
decline, is especially predisposed to paralysis of every
kind, deafness, blindness, apoplexy, asthma, paralysis
of the lungs, affections of the bladder, etc. Diseases
affecting the organism during a transition period
(which may be said to occur every seventh year,) are
of a higher importance on account of the development
which the organs undergo'during that period.
(b.) Diseases belonging to the different sexes (morbi
sexus). The difference which prevails in the character and degree of the irritability, sensibility and reproduction of the female and the male organism and



40


INTRODUCTION.


in the physical as well as psychical tendencies of the
two sexes, makes each of them liable to peculiar diseases. Suffice it to mention the various nervous diseases to which women are subject;.the diseases
depending upon the peculiar sensitiveness and irritability of the female temperament; the various diseases
affecting the reproductive system of the female organism, such as tuberculosis, carcinoma, scirrhus, etc.
(c.) Diseases belonging to particular classes and
trades. Rich people, who are accustomed to rich and
luxurious living and spend their life in idleness and
ennui, are liable to derangements of the abdominal
organs and consecutive diseases, such as gout etc.,
whereas the poor are affected with diseases resulting fiom an impoverished reproduction. Tanners are
subject to dropsies; type-founders, miners, potters to
tabes metallica; tailors and workers in wool to
scabies; compositors and printers to oedema of the
feet and varicose conditions; chimney-sweeps to
gangrene of the genital organs; stone-cutters, hairdressers, millers to pulmonary phthisis; washerwomen
to dropsy; literary men who lead a sedentary life, to
diseases of the abdominal organs; mariners and fishermen to scurvy, anasarca, etc.
What has been said in the preceding paragraphs, is
sufficient to show all the essential points which the
physician ought to be informed about in order to obtain a correct knowledge of the origin and course of
the disease, and even the internal changes which characterize it; that knowledge being indispensable to a
sure and successful treatment.
Diseases may also be classed according to the
region over which they spread. We have
(a.) Sporadic (morbi sporadici), or diseases which
depend upon meteoric or telluric miasmata and affect
only single individuals who happen to be predisposed
for such diseases at the time when they are prevalent;
(b.) Endemic (morbi endemici). These diseases are
confined to a definite and often very limited region;
they are distinguished from the former by being de



INTRODUCTION.


41


pendent upon the situation of a place and its surrounding region, upon the climate, the condition of the
atmosphere, winds, soil and water, upon the mode of
life of the inhabitants, food, social life. Every place
may therefore have diseases which are peculiar to it;
it is a remarkable fact that apparently identical diseases which prevail in places not very distant from
one another, require the application of different remedies in the different places.
(c.) Epidemic (morbi epidemici). These diseases
are closely related to the former, with this difference,
that they prevail at periods in a greater or lesser extent of country, and affect all ages and sexes indiscriminately; they depend upon a cause of atmospheric
or cosmic origin, generally upon a miasm which becomes contagious among crowded masses and then
spreads so much more rapidly and over a larger
surface.
(d.) Morbi annui. These are diseases which prevail at particular periods of the year, in the spring,
summer, fall or winter. In the winter inflammatory
diseases are prevalent, whereas the prevalent diseases
in spring are rather of a catarrhal nature. The fall
diseases are characterized by gastric-pituitous symptoms, and those of the summer-season have moreover
a typhoid character. This class of diseases is evidently
affected by sudden changes in the weather.
(e.) Morbi stationarii. It is of great importance to
a physician to know what peculiar character a disease is disposed to assume in a place. This topical
influence modifies the character of the above-mentioned diseases more or less. It prevails during a
shorter or longer number of years, abates gradually,
finally disappears entirely and returns after an indefinite period.
(f.) Morbi intercurrentes. These are diseases which
depend upon causes entirely different from those that
occasion the prevailing disease; but they frequently
ingraft their character upon the latter, and, by so
doing, are apt to transform a naturally mild disease
into a dangerous and malignant one.



INTRODUCTION.


To this classification of diseases we shall add a few
indications which are of great use in examining a
patient. In investigating the symptoms of an epidemic or sporadic disease, it makes no sort of difference whether a similar disease has existed previously.
The previous disease has no sort of influence upon the
present epidemic, which requires to be thoroughly investigated as an entirely new, unknown disease of a
peculiar kind. Hahnemann teaches that even measles,
smallpox, scarlatina, rubeola, etc. are not exempt from
that rule; these diseases depend, it is true, upon the
same miasm, but the form of the eruption only remains the same. In all those diseases there is an
essential difference as regards the systems which are
principally affected, the concomitant symptoms, the
prognosis, and the course and termination of the disease.
The physician frequently requires to investigate two
or three cases of an epidemic disease before he succeeds in obtaining a correct idea of the totality of the
characteristic symptoms which scarcely ever exist together in one case; but even an incomplete knowledge of those symptoms will enable him to administer
a remedy with more certainty than an allopathic
physician could do. However, although he may feel
sure that he has given a remedy which corresponds as
nearly as possible to the symptoms so far as he knows
them, yet he ought to make it his duty to observe
every new case with the same unremitting attention,
in order to finally complete his group of the characteristic symptoms of the disease and to be sure that he
has selected the true specific remedy.
In thus observing an epidemic disease, the general
symptoms, such as loss of appetite, want of sleep,
eructations, etc.,willbe specially and correctly noticed,
and the characteristic particular symptoms of the
epidemic disease will be found to constitute a limited
and rarely-occurring group.  These symptoms all
originate in the same cause, but their totality can only
be known by observing several patients of different
constitutions and temperaments.*
* See Organon, ~ 100-102.



INTRODUCTION.


43


Stationary diseases likewise require a correct and
thorough investigation of all the symptoms which can
only be known by observing a number of patients and
we will often find that the whole group of symptoms
indicates a different remedy from what we might have
selected after a merely superficial investigation of the
disease. This scrupulous investigation is of essential
benefit in intercurrent diseases, where the characteristic symptoms frequently point to the same remedy
which corresponds to the symptoms of the stationary
diseases in that region.
According to their origin, diseases may be divided into
(a.) Hereditary (morbi hereditarii). These are diseases which have existed in a family for generations
past. We have an hereditary scrofulous, haemorrhoidal, phthisical, apoplectic, etc. disposition, which developes itself in spite of the utmost care in removing all
hurtful influences, and frequently leads to the dissolution of the organism, baffling the best directed efforts
of the physician.
If the physician should have reasons to suspect the
existence of an hereditary disposition, he ought to inquire whether any of the ancestors, parents, brothers,
sisters have been affected with a similar disease, or
have died with it. If this should be so, he will be
much better able to express a correct opinion in regard
to the prognosis and to the chances of a cure.
(b.) Morbi congeniti. These diseases generally depend upon malformations with which the individual
was born.
(c.) Morbi acquisiti. These are diseases for which
the patient had no particular predisposition, but which
he brought upon himself by exposing himself for a
length of time to hurtful influences, for example:
taking hurtful beverages and nourishment, indulging
excesses of various kinds which gradually undermine
health, being constantly deprived of the necessary
means of subsistence, living in unwholesome, marshy
regions, or in cellars and close apartments, being deprived of exercise or open air, indulging excessive



44


INTRODUCTION.


physical or mental exertions, being continually agitated by unpleasant moral emotions, etc.
No psoric miasm is required to develope such diseases. According to Hahnemann such diseases disappear of themselves if they have not excited a
chronic miasm.
(d.) Primary diseases (morbi primarii, protopathici).
These are diseases which result immediately from
noxious influences, whereas the secondary, consecutive
diseases (morbi secundarii, deuteropathici,) arise from
a malady which is already existing. This class of
diseases requires no special definition, as their name
indicates their character.
(e.) Contagious and miasmatic, and non-contagious
and non-miasmatic diseases. A contagium, whether it
be originally formed in man or in any other kind of
organic body, in animals or plants, is a material substance, the original and exclusive product of a morbid
condition of the organism and possessing the power of
infecting other individuals of the same kind with an
identical or at least very similar disease and of
spreading in this way to remote regions. A contagium
being dependent upon meteoric and telluric influences,
it is most easily developed in times of war, famine
and inundation, producing hospital, dungeon and yellow fever, typhus, etc.
A miasm, on the contrary, is a volatile deleterious
substance, the chemical composition of which is unknown, which spreads through the atmosphere and
incorporates itself with it with more or less tenacity.
A miasm frequently arises from decayed organized
bodies and from the exhalations of sick persons.
People who are forced to live in such a deleterious
atmosphere, are necessarily exposed to its influence.
Considering the multitude of vitiated exhalations
which are concentrated in many places where people
have to live, it cannot appear strange that the number
of miasmatic diseases should be very considerable.
Miasm and contagium frequently go hand in hand, one
producing the other, as is the case in smallpox.



INTRODUCTION.


The division of diseases into local and constitutional
is without any practical value.  Every physician
knows that the so-called local diseases are much more
speedily removed by internal remedies than by external applications; we need but remind the reader of
syphilis, sycosis, plica polonica, etc. The fearful diseases which frequently break out after the pretended
local affection had been suppressed by externalmeans,
show that this apparently local symptom was a sort
of vicarious concentration of the internal constitutional disease which was held in a latent state as long
as the local symptom continued upon the skin. How
is it possible that a simple ulcer on the finger should
not only remain uncured under the merely external
surgical treatment, but that it should even assume the
dangerous form of a phagedenic ulcer, if it were not
the local vicarious expression for an internal dyscrasia.
It is self-evident that an apparently local affection
which does not owe its existence to an external cause,
must depend upon a coexisting disturbance of various
organs and tissues; the local affection, even if it had
been produced by a merely local external cause, cannot exist for any length of time without affecting the
whole organism, as we see in the case of a burn, a
toothache proceeding from a carious tooth, etc.
The division of diseases into acute and chronic is of
particular importance to us, for this reason, that we
have made that division the basis of the arrangement
which we have adopted in the present work. To
each of those divisions we have devoted a special
volume.
Acute diseases are sudden disturbances of the vital
force, characterized by the greater rapidity with
which they run through their course and by the
powerful reaction which takes place in the vascular
system. In treating such diseases, it is a matter of
course that wherever we know the cause from which
they arise we ought to remove it if we can.
Chronic maladies frequently arise from a disturbance of the vital force, which is seated in the vegeta



INTRODUCTION.


tive system. A concealed dyscrasia affecting that
system is frequently the cause of the obstinacy with
"which those diseases cling to the organism. According to Hahnemann, chronic diseases invade the organism, each in its own peculiar manner, the invasion
being scarcely or not at all perceived in the commencement and gradually overpowering the vital
force, so that it is only able to offer an inadequate resistance, allowing the malady to increase, until it
finally destroys the organism. Starting from the definitions which we have given of acute and chronic
diseases, it will be found easy to draw a line of separation between them, especially if we admit Hahnemann's theory that all chronic diseases derive their
existence from some miasm; a theory, which seems to
be somewhat inconsistent with Hahnemann's previous
condemnation and rejection of all theories and speculations about the essence of disease and the relation existing between it and the changes in the body.
We have already stated above that a number of diseases may exist without depending upon a psoric
miasm, and Hahnemann seems to have had a similar
idea inasmuch as he designates them spurious or improper chronic diseases. He accepted three fundamental forms of chronic diseases: psora, syphilis and
sycosis; from these three fundamental chronic miasms
all chronic diseases derive their origin, seven-eighths
from the former, and the remaining eighth from the
two latter. It is neither our intention, nor is this the
proper place to criticize Hahnemann's views; we may
however remark that the merely palliative effect
which he frequently obtained from his remedies in
chronic diseases, led him to the belief that these diseases depended upon some latent chronic miasm; and
it was indeed ascertained that many of them had been
preceded by itch. Hahnemann was persuaded that
the suppressed itch was the primary cause of those
diseases. Observing that several of them had been
cured by the use of mineral springs, his acute powers
of penetration led him to suppose that the cure had
been wrought by the medicinal substances which



INTRODUCTION.


exist in those springs in minute and greatly divided
quantities. He was confirmed in this view by farther
observations and the successive results of his practice,
and he therefore designated the medicines by means
of which the cure of chronic diseases was effected, as
antipsorics--that is, medicines directed against a chronic
malady. It is now well known, however, that those
antipsorics not only cure chronic, but also a host of
acute diseases, and that they are employed for that
purpose by all homoeopathic practitioners. Hahnemann be praised for having made us acquainted with
such efficient means to relieve the sufferings of our
fellow-beings.
It is an undoubted fact that the inveterate character
of chronic diseases frequently depends upon some
latent dyscrasia which has become rooted in the
organism, and that those conditions have been removed by certain remedies which exercise a specific
effect upon the organs invaded by a psoric miasm. It
is for this reason that the general therapeutic rules
remain the same for chronic as well as any other diseases. If such chronic diseases have,already been
treated with a variety of allopathic medicinal substances, it is advisable that the homceopathic practitioner should let some time elapse before he gives any
medicine to the patient, that the organism may free
itself as much as possible from the various influences
which those drugs have left and may become more
susceptible to the action of our small doses.
According to Hahnemann, diseases of the mind likewise originate. These diseases do not constitute as
distinct a class of diseases as those which have been
indicated above. In almost every disease of the body
the mind is affected more or less, on which account
the state of the mind is to be regarded as an important
feature in the image of the disease. We know from
experience that the condition of the mind in health is
frequently the contrary of what it was in disease. If
a certain group of symptoms indicate two different
remedies, the state of the mind is frequently the only
symptom by which we can decide which of those reme



48


INTRODUCTION.


dies ought to be selected; Aconite, for instance, will
never effect a rapid cure in a person with a calm, even
temperament; Nux will be found very little adapted
to a mild and phlegmatic, or Pulsatilla to a cheerful,
bright and obstinate temper; Ignatia is counter-indicated by an unchangeable mind which is neither
given to fright nor vehemence.
In all chronic diseases it is not only of the utmost
importance to investigate all the physical symptoms,
but the moral and mental condition of the patient
would seem to require our especial attention.* The
physician will have not only to inquire into all the
previous bodily diseases of the patient, but he will
have to make particular inquiries about the disease
which preceded the mental disorder previous to its increasing to a complete derangement. This information can, of course, only be obtained from the family.
If the mental derangement (mania, rage) set in of a
sudden, in consequence of fright, chagrin, abuse of
spirituous drinks, then Hahnemann teaches that it is to
be treated as an acute disease with Aconite, Belladonna, Stramonium, Hyosciamus,Veratrum, Mercurius,
etc., and that the antipsoric treatment, with a properly
regulated diet, ought to be instituted only after the
acute symptoms have been subdued; the antipsoric
treatment is necessary to prevent a new outbreak of
the disease which might easily become a permanent
derangement.
Diseases of the mind which are not yet fully developed and do not arise from bodily affections but
from bad habits, faulty education, immoral conduct,
neglect, superstition or ignorance, may be improved
by kind persuasion, consolations, romonstrance, reasoning; whereas those mental diseases which arise from
bodily diseases, are made worse by such means, and
become more inveterate. A physician ought never to
lose patience or self-control, he ought never to indulge
angry expressions or manners, lest he should lose the
confidence and the affection of his patients, which are
indispensable means of cure.
* See Organon, ~ 217 seq.



INTRODUCTION.


49


There is another class of mental diseases which we
observe in men who have been frequently a prey to
grief, chagrin, insults, attacks of fear and fright.
Those diseases emanate primarily from  the mind,
and the bodily affection is a mere result of the
mental disturbance. If these diseases be recent, they
are most easily removed by spiritual means, such as:
kind persuasion, reasoning, confiding manners, sometimes by a clever deception; the mode of life ought
not to be neglected, of course. Such means are frequently sufficient to restore the normal state of the
mind.
In all cases of mental derangement which can be
cured by homceopathic remedies it is essential not only
to observe a rigorous diet, but to-submit the patient to a
proper treatment on the part of his relatives and
physician. The raving maniac ought to meet a firm
will and a bold and fearless expression of countenance;
the lamenting and disconsolate ought to be surrounded
with silent and sympathizing grief; senseless prattle
ought to be met by silence expressing a slight degree
of attention; disgusting and revolting conduct are to
be left unheeded. The patients ought to be prevented
from injuring or ruining the things around them, without rebuking, or, what would be still worse, punishing or torturing them. The only compulsion to
which the patient is liable, is to take the homoeopathic
medicine, but even that kind of compulsion can be
avoided by mixing the medicine in the beverage of the
patient without his knowing it.
It is a great mistake on the part of the physician or
the attendants of the patients to contradict, censure,
or scold them, or to treat them with yielding timidity;
it would be just as indiscreet to irritate them by derision, and ill-disguised deception. On the contrary,
those patients ought always to be treated like sane
persons, and everything by which their senses or
minds might be disturbed, ought to be carefully removed from their presence.


3



INTRODUCTION.


GENERAL THERAPEUTIC RULES.
We have shown above that the first essential
requisite of a cure is, a thorough investigation of all
the perceptible symptoms of a disease. This investigation is so much more necessary as, according to
Hahnemann, the symptoms which reflect the internal
disease in a visible and tangible form are the only
part of the disease which we can perceive with our
senses and therefore know. If the symptoms are removed the disease no longer exists. We do not entirely admit this proposition as may be inferred from
our mode of examining the patient; but as our object
is not to remark upon Hahnemann's theories, we have
contented ourselves with showing the mode of arriving
at a correct diagnosis and at a knowledge of the
specific means by which the disease will be most permanently and thoroughly cured.
We doubt, however, whether such a cure is possible
in every case. How often is our treatment baffled by
disorganizations which have lasted a sufficient length
of time to produce functional disorders and an excessive irritation of the sensitive sphere; we may mention headache depending upon an exostosis of the cranium; epilepsy, occasioned by tubercles in the brain;
dropsy, by organic degenerations; organic difficulties
about the heart; cardialgia, and chronic vomiting, depending upon tubercles, cysts in the casophagus, or
carcinoma of the pyloric orifice; metrorrhagia, occasioned by carcinoma; haemoptysis, from disorganization
of the lungs, etc.: all such affections are incurable
under any treatment. Under this head belong exhaustion of the vital energies by marasmus, profuse
evacuations, excessive exertions; diseases which set
in with a sudden and overpowering violence,- such as:
hospital-typhus, pest, violent cases of poisoning; and
we may lastly class under this category the unavoidable and permanent presence of hurtful influences,
such as: grief from disappointed love, cares, chagrin,
remorse, living in a climate which is injurious to the
patient, etc.
We have already spoken of the necessity of inves



INTRODUCTION.


53


or gradually increased by rest, and whether they disappear again by motion; whether the symptoms are
most violent in the morning, at noon, in the evening,
night, etc.; whether they are modified by the cool
open air or by warmth; whether a slight, apparently
trivial occurrence, such as nausea, vomiting, a slight
attack of rheumatism, etc., induces great prostration of
strength, obliging one to lie down (we remind the reader ofArs., Verat., Ipec., Sec.), etc. It is of the utmost
importance for the selection of the true remedial agent
that all those points should be carefully considered.
We are frequently led to a knowledge of the specific
agent by considering the relation which it holds to the
peculiar moral or physical disposition, the temperament
or sex of the patient, (Nux vom., Ignat., Puls., Sep.,
Phosph., etc.)
The prophylactic treatment is another species of
treatment which the homoeopathic physician is frequently called upon to employ.
The prophylactic treatment is generally employed
in cases where diseases can be prevented by specific
remedies, for instance scarlatina and hydrophobia by a
few small dozes of Belladonna at suitable intervals;
purpura miliaria by Aconite; varicella and measles by
Pulsatilla; the consequences of chagrin by Chamomilla
(or rather by Colocynth, which is in many cases sufficient to remove the most violent symptoms occasioned
by chagrin); the morbid phenomena resulting from
fright by Aconite, etc.
These few examples sufficiently show that the homoeopathic method of cure is a better prophylactic
method than the method of the old school. We
inquire with much more minuteness into the natural
susceptibility of a patient to this or that disease; our
knowledge of the curative virtues of drugs is not
derived from unfounded theories, but it is based upon
pure experience and careful observation; such things
as spring or milk-cures can never occur in homoeopathic
practice.
The homoeopathic physician acknowledges also a
sort of prophylactic hygiene which it is the business of



INTRODUCTION.


the government to protect.   Under this category
belongs Hahnemann's remark in the preface to Ledum
palustre,* that this powerful substance is frequently
mixed with beer by interested and unprincipled brewers
for the purpose of imparting intoxicating qualities to that
beverage, thus making it very injurious to health.
However strange it may appear to speak of palliative treatment in connection with homceopathy, yet
that treatment is employed under certain circumstances
even by those who have practised hommopathy for
years past. A physician must be very unfeeling if he
would refuse to palliate the troublesome or dangerous
symptoms in cases where they are owing to the
presence of an exciting cause, or when the case is
hopeless and the curative treatment is of no avail.
Every good physician will endeavour to palliate his
patient's sufferings until his death, in all cases where a
cure is out of the question. This rule of conduct,
which is deeply written in the human heart, is not
only true in incurable but also in very painful diseases.
This maxim prevails alike in the homceopathic as well
as the allopathic practice, with this difference, that
in the latter practice palliatives are frequently resorted to for the purpose of subduing a single symptom,
even if the totality of the symptoms should indicate a
totally different remedy, (we merely mention the abuse
which is made of opium, the sudden suppression of
salutary evacuations, the pellentia and exsiccantia in
chronic local affections, etc.)
In treating a case, the hommopathic physician
employs remedies which not only correspond to the
troublesome symptom, but to the whole group. In
palliating acute pain or incurable affections, the homceopathic physician ought constantly to act in accordance with that rule. He will accomplish that palliation by frequently repeating the suitable remedies, for
instance: Belladonna, Chamom., Ignat., Ipec., etc., in
violent spasmodic diseases; Carbo anim., Staphys.,
Thuja, Secale corn., Puls., Bell., etc., in cancer of the
"* See Hahnemann's Materia Medica Pura, by Charles J. Hempel, M.D.



INTRODUCTION.


55


womb. There are many more examples, all of which
show that the principle " similia similibus," if employed as the rule in the palliative treatment, accomplishes the object of that treatment much better than the
empirical practice of the old school. We invite our
opponents to try our law of cure as a palliative means
in organic malformations, and to compare the results
thus obtained with the results obtained by their ordinary means.
There is another kind of palliative means of which
we avail ourselves in our practice and which have not,
it is true, any homoeopathic relation to the disease, but
by no means interfere with the homoeopathic treatment.
Who does not know that the troublesome dry cough in
tuberculous phthisis is moderated by inhaling the
vapour of warm water, or that spasms of the respiratory organs may be soothed by warm fomentations of
the chest?  Who is unacquainted with the beneficent influence of animal magnetism in asthmatic complaints and spasms? Who does not use warm poultices of milk and oatmeal, bran, or linseed, to soften hard
and painful abscesses, or to cover large ulcerated
surfaces which are very painful and deprive the
patient of his strength? Who does not cover open
abscesses with bands of linen slightly covered with an
ointment of althea? Do we not apply carrot and
potato poultices to painful cancerous ulcers and to bedsores which threaten to become gangrenous? Do we
not bathe inflamed portions of the periosteum during a
long confinement in bed with washes of lemon-juice
and dilute tincture of Arnica? Who does not give
anxious patients; if they should wish to be relieved of
an obstinate obstruction of the bowels, an injection of
tepid water, or milk and water, milk and molasses,
soap-water and linseed-oil, or mere cold water? Do
we not know that in typhus fever great relief may be
afforded to the patient by washing certain parts of the
body with warm vinegar? Have we forgotten the
relief which may be obtained by rubbing with a piece
of flannel limbs that are affected with rheumatism; is
not the pain in acute rheumatism and ascites relieved



56


INTRODUCTIOT.


by friction with warm oil? Are not warm baths excellent palliatives in many cases? Should it be
contrary to our art to apply in many cases of incipient
or perfectly developed encephalitis cold water, snow or
ice to the head, knowing as we do that those applications have a soothing and even curative effect in the
headache occurring in that disease and arising from
violent congestion of blood? Are not gargles of milk
and althea-root boiled together, frequently useful in
angina faucium? Is not the pain in violent inflammation or suppuration of the internal ear relieved by the
vapours of warm milk? Is not the painful otalgia of
children relieved by twisting a sulphur thread around
the external ear? Are not habitually cold feet
relieved by bathing them in cold water? Is not the
agony in croup mitigated by applying a sponge dipped
in warm water to the larynx? *
The derivative method is a particular branch of the
palliative system, and may be advantageously resorted to in many dangerous affections. We may mention the warm oatmeal poultices, the hand and foot
baths with or without salt or ashes, in congestion of
the superior organs and in delirium; dry cupping at
the -pit of the stomach, in oppression of the chest,
anguish  and  restlessness with  an unequal and
spasmodic pulse previous to an acute eruption
breaking out upon the skin; the warm hand-baths in
excessive secretion of milk; the application of warm
vapours to the breasts of the lying-in woman in suppression of the milk; the pitch-plasters between the
shoulders, which were even recommended by Hahnemann in chronic diseases arising from a suppressed
eruption; the recommendation of Hahnemann to wash
the external opposite side of the affected organ with
the medicine which is homceopathic to the symptoms.
-What dangerous symptoms frequently arise from
suppressed sweat of the feet? Is it not proper that
* To these palliative means we may add a current from the magnetoelectric machine, which frequently relieves in a moment's time the most excruciating pain in acute rheumatism, and other kinds of inflammation.
HMPEr iN



INTRODUCTION.


57


the physician should endeavour to restore the sweat
by wrapping the feet in cotton, wool, or wax-linen, or
inserting them in warm sand? There is no doubt that
an illness depending upon a suddenly suppressed cutaneous eruption, whether the suppression be spontaneous or the result of indiscreet treatment, will
be most speedily cured by him who first succeeds in
restoring a similar eruption upon the skin. Who is
not acquainted with the brilliant effects of cold fomentations and the internal use of Arnica in injuries of
every kind, especially those of the head?-Is not the
treatment which we resort to in cases of swoons,
apparent death, suffocation, hanging, freezing, burns,
etc.. of the palliative kind? *
We may here mention another method of treatment
which is subordinate to the homceopathic, and is based
upon a knowledge of drugs obtained ex usu in morbis.
Thus we use Antimonial wine, in drops, against accumulation of mucus in the chest, in the case of little
children; Oleum jecoris aselli against scrofulous complaints and tubercles; Mercurius in syphilis; the biniodide of Mercury in old syphilitic ulcers, and syphilitic diseases generally; Quinine in various intermittent diseases; Sulphur in scabies and heemorrhoidal
affections; Iodine in mercurial herpetic eruptions and
tubercles; Lichen Islandicus in pulmonary phthisis;
Secale cornutum to facilitate labour-pains; the tincture of Cinnamon in metrorrhagia, etc.
We have similar specifics in the homteopathic practice; but we have no right to reject remedies, the specific curative effects of which we only know ex usu in
morbis; the use of such remedies is justified by the fact
of their being specifically adapted to certain forms of
disease. Not every diarrhoea from cold is relieved by
Dulcamara, nor are all catarrhal diseases. Belladonna is said to be a valuable remedy against hydrophobia; but would a homceopathic physician be willing
to use it in practice without first examining its curative virtues? -Colocynthis is known to be an excellent
" Organon of the Speoifio Healing Art, by Dr. Q. L. Rau. Leipsic, 1888.



58


INTRODUCTION.


remedy in colic with dysentery, but will a discreet
practitioner ever use it in such a case without inquiring whether it is specifically corresponding to it?
Rhus is known ex usu in morbis to be a valuable
remedy in many diseases which are aggravated in
rest, and Bryonia in many others which are aggravated
by motion; nevertheless we shall always have to consider whether either of those remedies is specifically
adapted to the existing group of symptoms. The same
remarks apply to Mercury in syphilis, Sulphur in scabies and haemorrhoids, China in intermittent fevers,
Arnica in contusions, Ipecacuanha and Ignatia in
spasms, etc.
We ought not to omit mentioning the law of cure
" equalia oequalibus," or the contagium of a disease
may be employed against it as a curative specific.
This law, which was first discovered and promulgated
by the veterinary physician, M. Lutz, in a pamphlet
entitled the Doctrine of Isopathic Remedies, and published in Leipsic, 1833, has been confirmed by the experience of many acute observers. In making mention of this work in the second volume of the Homcmopathic Gazette, No. 9, page 70, Dr. Gross tells us that
he had made many experiments with isopathic remedies. Since then several cures by means of isopathic
remedies have been reported in the Homeopathic Gazette; but they do not always prove what they are intended to prove, and have appeared to us rather imaginary. There is no doubt that single observations
have been made the basis of the doctrine that the product of a disease is able to cure that disease, and that
this erroneous conclusion has brought into use a number of remedies which do not deserve that name. We
know that contagia are not only capable of subverting
the normal condition of the vital forces, but also of restoring the natural play of those forces (we need but
mention Psoricum, Lachesis, Vaccinin, Morbillin, Variolin); but those remedies have most frequently cured
diseases entirely different from those from whose names
those agents have derived their own. If all diseases
could be cured in this manner the business of a physi



ANTRODUCTION.


59


clan would not be difficult but very laborious, inasmuch as he would have to dynamize the product of
the disease in every single case; for any other it
would be without any value. Cures which are said
to have been effected agreeably to the principle, " equalia aqualibus," are in fact homoeopathic cures;
for the patient is cured by means of a product of that
disease in some other patient, which is dynamized in
the usual fashion.
Inasmuch as we have made mention of the various
methods of treatment of which the hommopathic practitioner may avail himself, we shall now say a few
words of some other methods occurring in allopathic
practice, and comprehended in one or the other abovementioned methods of cure.
Homeopathy knows nothing of the expectant
method. Every manifestation of disease is treated
according to its symptoms, by positive remedies.
Nor does homoeopathy know anything of a particular treatment for convalescent patients. The efforts
of the homceopathic physician are directed against the
disease itself, without poisoning the organism, as is
done in old-school treatment, by excessive doses of
medicine, frequently ingrafting upon the organism an
artificial disease that is much more violent, and lasts
much longer than the natural disease. Homeopathy
does not use any depletory processes; hence the patient is not weakened by homoeopathic treatment, and
there is no necessity for any of those medicines which
are required for the debility consequent upon the employment of the allopathic revulsive treatment. Suffice it to mention the cure of inflammation by repeated bleedings, or the treatment of typhoid fevers with
excitants and a variety of other drugs in large doses,
the use of which is generally followed by a period of
convalescence lasting as long as the original disease;
the treatment of febris pituitosa, which generally
leaves a deranged state of the mucous membranes and
dropsical conditions, etc.
After these preliminary pathological and therapeutic



60


INTRODUCTION.


observations we come to state the fourth cardinal
principle of homoeopathic practice: Give the specific
remedy in a sufficient quantity to excite the curative reaction of the organism, without occasioning any unnecessary aggravation of the symptoms, which would
only serve to impede the cure. According to Hahnemann the hommopathic dose may be ever so minute it
will succeed in improving, curing, or even annihilating the disease. His idea was that the exciting
causes of disease possess only a subordinate and limited power to disturb the organism, but the remedial
agents possess this power in an absolute, and, therefore, supreme degree, at the same time as they are capable of affecting the diseased organ in such a manner
as will restore the harmony of the whole organism. A
few hours after exhibiting his remedy Hahnemann
frequently noticed new symptoms evoked by the
medicine (medicinal aggravation); he therefore concluded that the dose was still too powerful for the
disturbed organism, and was led in the course of
time to carry all his remedies up to the 30th degree
of dynamization. He was rejoiced at witnessing the
effect, the pure dynamis of his immaterial doses, and
the power which even the highest potencies still possessed to cure disease. He even thought that those
highest dynamizations were frequently too powerful,
especially in chronic diseases, and he therefore introduced the method of simply smelling a few pellets
moistened with the medicine. Afterwards he thought
that even olfaction was too powerful for certain delicate organisms, and he advised such patients to dissolve a few pellets of the medicine in half a tumblerful of water, and of taking a tablespoonful every day,
or every two or three days. According to Bcenninghausen's communication in the New Archive, first
and second number, Hahnemann has carried his dynamizations still higher, and since his death the highest
dynamizations have been vaunted in such extravagant
terms that the student of homaeopathy must fairly lose
his senses in that labyrinth of strange and unheard-of



INTRODUCTION.


61


relations. There are as yet no fixed rules for the
magnitude of a dose or the employment of particular
potencies; every physician uses those potencies which
seem to him best, and if he succeeds in curing his patient, he considers that potency the best which has effected the cure, and advocates it as such, upon the ground
of experience. Nothing positive can be said about
a point of doctrine which has given rise to so many
different opinions. It will not do either to contradict
or to blindly believe the results said to have been obtained by other physicians. We ought to verify them
in our own practice, although neither a few successes
nor failures are a sufficient evidence either for or
against the statements and inferences of other practitioners. If it were true that in treating a case of
disease the principal thing is to give the homoeopathic
specific, and that the dose is of minor importance, we
might dismiss the subject without any further remark.
The dose, however, is of some importance, and we
therefore beg leave to express our own opinion in respect to doses, without desiring, however, to bias any
practitioner's mind in favour of our ideas.
In the first place we ought to have a proper understanding of the term dynamization. Hahnemann gave
this name to every attenuation of a drug, which he
considered a development and increase of the power
of the drug, until the material substratum should be
entirely destroyed and the attenuated agent should act
as a purely dynamic power. The term ' dynamization
or potentialization" is certainly the best that can be
applied to the attenuations of mineral and metallic
substances, inasmuch as the process of trituration discloses and developes their latent powers and raises
the drugs to the rank of true curative agents. It is
only by triturating those crude substances that they
become like medicinal agents which, even in their
natural state and divided into very minute parts,
possess so great a power of disturbing the organism
that it is not advisable to use them except highly
diluted. The former substances are dynamized by



62


INTRODUCTION.


trituration, the latter weakened by'dilution. We do
not know very positively how far crude drugs require
to be dynamized before their medicinal virtues are
properly disclosed; but we may suppose that this result is obtained as soon as the triturated substance
manifests the power of morbidly affecting the organism.' Any farther attenuation of the drug would not
be a dynamization but a dilution. If the successive
attenuations of a drug were so many dynamizations,
why does not the dynamic power of the drug increase
by attenuation, whereas Hahnemann thinks that it
decreases. However, our intention is not to criticize,
but simply to state the view which we take of
dynamization and dilution. We understand the thing
differently from Hahnemann, but, if we mean to obtain a rational opinion of the power of his small doses
we have to understand the attenuating process as he
does. He supposed that the dynamic power of ponderable bodies might be excited by peculiar manipulations like that of imponderable substances, and that
the dynamic power of those substances might be
separated from its material substratum and transferred
to a neutral vehicle by means of which it might be
made to act upon the affected organism like electricity,
magnetism, etc. The correctness of the views which
Hahnemann has promulgated about the dynamizing
power of the processes of trituration and succussion,
cannot be denied, nor will it be denied by any one
who is familiar with homceopathic practice, and has
used the 30th, 40th, and 60th potency of Arsenic,
Belladonna, etc., with the same happy results as we
have done in our practice. Latterly, however, the
process of dynamization has been carried much farther
than it ever had been before, and with so much enthusiasm that it is impossible to foresee its ultimate
boundaries. The advocates of the doctrine of dynamization have now become convinced that the whole
secret of the curative effects of one, two or three
pellets is explained by the peculiar mode in which the
medicine has been triturated and succussed. They



INTRODUCTION.


63


carry a remedy up to the 800th, 1000th, and even
2000th potency,* and imagine that those high potencies still produce pathogenetic symptoms.   If this
game, which is particularly exciting to laymen, and in
which physicians become so easily interested, is carried much farther, the end of it cannot possibly be
foreseen, and it may become true what some of our
opponents have said of us, that in homceopathic practice nature triumphs both over the disease and the
physician! We will not decide whether the introduction of the highest potencies has or has not been a
scientific progress; but we confess that those potencies, which we have used in many cases with the
honest intention of testing their real value, have not
answered our expectations as well as theyhave those of
Stapf, Gross, Benninghausen, and other enthusiastic admirers. We still recollect the time when Hahnemann
supposed that all chronic diseases originated in the
use of coffee, until the psora theory furnished him a
new clue for those diseases.  Many homoeopathic
physicians have implicit confidence in the psora-doctrine. They likewise believed in the limit which
Hahnemann had marked out in the preface to every
remedy contained in the first edition of the Materia
Medica Pura as the highest degree of power of which
that remedy was susceptible. And who will deny
that beautiful cures were wrought by these pretended
highest potencies which were supposed to be the most
suitable to the susceptibility of the disturbed organism. But even at that time we frequently succeeded
in curing with a lower potency where the higher had
no effect. No one thought in those cases of ascending
the scale, and an attempt made by Korsakoff to carry
our remedies up to the 1500th potency was rejected
as absurd by those who were satisfied with the results
of their present experience; it was supposed that
those potencies had no curative power whatsoever,
" Baron Gerstorff, one of the provers so frequently mentioned in the
Materia Medica Pura, has told me that Arsenic has been carried up to the
10,000th potency.-HEMPEL.



INTRODUCTION.


and that the patient who was treated with them received no medicine at all. It is but a few years
since the lowest potencies were recommended as the
most suitable in the treatment of disease, and employed by a great number of physicians. What
causes all those changes? Have the drugs become
more powerful? Have the highest potencies been
made or used improperly? Have we obtained a
deeper insight into the spirit of our doctrine? Are.
we desirous of showing to the world that homoeopathy
is yet susceptible of many improvements? Certainly
homceopathy is susceptible of improvement, but it
strikes us that it ought to be effected by a different
road than that of the highest potencies. The probability is, that if Hahnemann had lived and had remained in possession of his vigorous intellect, he would
have made changes in the preparation and administration of our medicines, and would always have recommended the last change as the best. This is our
opinion of the highest potencies; they may afford
advantages in certain cases, but will probably be
superseded one day by a new method of exhibiting
our remedial agents, which will be advocated with
the same enthusiasm by its friends.
As it is impossible that the same dose or potency
should be suitable to all patients, the question naturally occurs: What dose will excite the curative reaction of the organism in a sufficient degree? Every
physician must feel interested in the settlement of this
question, as the dose is of the utmost importance to a
successful treatment. The lowest potencies, the thirtieth, and now the highest potencies, have been successively recommended as the normal doses. But we
are convinced, from the many trials which we have
made with every one of those preparations, that
neither of them can be considered normal, and that
the dose depends in every case upon the susceptibilities
and the reactive power of the patient's organism. In
Rau's Organon the conditions by which the dose ought
to be determined have been accurately described, and
we shall adopt them in the present work, so much



INTRODUCTIOIN.


65


more as the views of Rau on that subject coincide
entirely with our own.*
"* NOTE BY DR. HEMPEL.-Dr. Hartmann's remarks on the highest potencies
appear to me rather superficial. If a man uses the 60th potency with as
much success as he pretends to do, there is no good ground for his being astonished at the curative effects of the 200th or even the 2000th. Dr. Hartman
denies that succussion is a means of developing the dynamic power of a drug;
he thinks that attenuation by succussion is a simple process of dilution. In this
I think he is grievously mistaken. How will Hartmann explain the fact that
adrop of the tincture of Belladonna, when simply stirred in a glass of water, has
frequently no effect, where a few pellets of the thirtieth potency will effect
a speedy cure, or where a cure is effected by that same drop if it be mixed
in a tumblerful of water by turning the solution some thirty or forty times
from one tumbler into another, and then mixing a table spoonful of that solution with another tumblerful of water and turning this second solution again
thirty or forty times from one tumbler into a second one 1 I can affirm that
I have effected many cures with a double-attenuated solution where a simple
dilution of the tincture left me entirely in the lurch. As regards the
highest potencies, I protest both against their exclusive use and against the
injudicious neglect with which many practitioners treat them. 1 have used
them in many violent cases with the most perfect and sometimes with instantaneous effect, and do use them now every day to my entire satisfaction.
I have reported a number of cases in the Hommopathic Examiner where the
curative action of the highest potencies is so evident that no sane man can
doubt it, and in many cases I have obtained results by means of the highest
potencies where the lower potencies had entirely failed, even when administered by skilful hands. A few weeks ago I was requested to take charge of
a lady who had been suffering with consumption brought on by mismanaged
pneumonia. Her most distressing symptom was a hard wheezing cough with
most difficult expectoration; she had a turn every five minutes. This lady
had been treated homceopathically for several months past, and the last medicine that had been given her was crude sulphur, of which she took three
powders a-day, and had already swallowed twenty powders in all. The
patient told me that her cough had been getting worse ever since she had
taken those powders, and that her distress had become so excessive that she
could not take the medicine any longer. Sulphur, however, was the remedy.
J gave her two pellets of the 800th potency in water, a table spoonful every
six hours, and when I saw her again, three days after, her cough was much
less, the paroxysms were much less frequent and less violent. The lady remarked to me, " What a comfort it is to be able to sit without coughing."
In the second number of the Homoeopathic Examiner, Vol. IV., Y have reported a case of neuralgic colic of upwards of three years' standing, which
had been treated for eighteen months by the first homoeopathic physicians of
this city. When I took charge of the patient, she suffered the most agonizing pain from morning till night, and the friends of the patient-a most interesting young lady-had given up all hope of ever seeing her relieved. I
can affirm, as a man of honour, that that patient has not only been relieved
but entirely cured, by the 200th potency of Ipecacuanha. I might adduce the
written testimony of the patient's mother to show that the cure has been
complete; but I forbear on account of the flattering remarks contained in
that paper.
Among other cases where the lower preparations have failed entirely and
where the highest potencies have effected a cure, I may mention the following:-A gentleman of thirty years had an inflammatory rheumatic fever
which was treated allopathically; in the course of the treatment he lost his
appetite, his bowels became affected, and after the treatment had lasted a
whole year he concluded to submit to homoeopathic treatment. His symptoms were: Constant uneasiness about the bowels, excessive qualmishness,
constant desire to evacuate the bowels, which were very sluggish; violent



66


IENTRODUCTION.


The susceptibility to medicinal influences is greatest
in very small children and is at its acme in subjects
entering upon pubescence, a period when the more
noble   developments take place.          These are     epochs
when (as a general rule-Trans.) the organism requires
but minute doses of medicine which ought to be so
much more minute as the medicine has a specific relation to the organ. This observation is likewise applicable to females, who generally require smaller doses.
The constitution of the patient is likewise to be
taken    into   consideration.     Phlegmatic      and   torpid
temperaments require the lower attenuations; sensitive
persons, on the contrary, with a sanguine or choleric
temperament, the higher. Persons whose sensibility
has become obtuse in consequence of the abuse of
spirituous and heating beverages, spices, piquant
dishes, require larger doses of medicine to excite the
necessary organic reaction. This shows that the mode
of life has a great influence on the constitution.
Mental labour, the reading of novels which excite the
imagination, a sedentary and effeminate mode of life,
and long sleeping, increase the sensibility; heavy labour,
country-air, substantial and nutritious food, living in
apothecaries, or tobacco-shops, distilleries, etc., diminish
it.  It is likewise certain that persons who have been
treated with Lead, Mercury, Iodine, Cinchona, Valeriana, and other drugs, and are now suffering with a comshooting pain from temple to temple through the forehead, occasionally a
neuralgic pain in a small circumscribed spot of the left parietal bone; but
his greatest trouble was an abominable coating of the tongue, which was at
least one line in thickness, and had a most horrid appearance; when I saw it
for the first time it positively sickened my stomach. That gentleman enjoyed
for six months in succession the treatment of a distinguished homaeopathic
physician, inder which he got worse instead of better. I cured him with the
200th and 300th potency of Aconite, bowels, head, tongue and all; his tongue
now looks as clean as any man's.
Why should we close our eyes to such facts 1 No honest practitioner does,
but alas! how few are there among us who are honest and devoted inquirers.
Most physicians look upon themselves as accomplished artists, who cannot
learn anything of anybody, and who ought to reject and deride the experience of their fellow-practitioners if it should at all appear strange and some
exertions should be required in investigating and verifying it. IHow an experimental science is to be benefitted by such want of application and by so
much impudent conceit, is difficult to understand. Fortunately the interests
of true medicine are not jeopardized by the neglect of a few men, and, besides, there are plenty of brave men in the homceopathic ranks who will
never shrink from fulfilling their high trust.



INTRODUCTION.


67


plication of the natural disease and medicinal poisoning,
require larger doses than would have been necessary
previous to such a poisoning having taken place.*
Climate has also a powerful influence on the constitution, and indirectly upon the magnitude of the dose, as
we know from experience.
The character of the disease, which we are called
upon to treat, is likewise an important consideration in
the selection of the dose. Erethism and torpor cannot
possibly be treated with the same dose. In a state of
erethism the vital functions are carried on with great
rapidity, and require for their regulation the higher
potencies; in torpor, on the contrary, the vitality is
very much depressed, and requires to be roused into reaction by larger and stronger doses. Inflammatory and
spasmodic affections soon show a favourable reaction
after the use of high potencies, etc.
The magnitude of the dose is also determined by the
seat of the disease, for the greater the sensitiveness of
the affected organ, the smaller ought to be the dose, and
vice versa. In general we may lay it down as a rule,
that affections of the vegetative system, unless they
are of a decidedly inflammatory nature, require larger
doses, as do likewise affections of the mucous membranes.
The intensity with which the drug of its own nature is
prone to act, seems to require a particular consideration
in determining the dose. It is true that in his later
years Hahnemann and the admirers of the highest potencies have overlooked that rule. What a difference
there is in respect to the intensity of action between
Sambucus, Viola-odorata, Verbascum, Leontodon,
Euphrasia, Dulcamara, Crocus, etc., and Belladonna,
Arsenic, Rhus, Phosphorus, Corr. subl., Lachesis, Psoricum, and many more.
Does not the affinity of certain remedies to certain organs require a particular consideration? Undoubtedly  it does.  The more homceopathic the
"* The best means to relieve the organism of the influence of such medicinal poisons, is the hydropathic treatment, which ought to precede the homoeopathic treatment.-HEMPEL.



INTRODt)CTI0N1


69


generally very refreshing, and from which the patients
sometimes wake cured, if the nature of the case admit
ofsucha speedy change. Both the medicinal aggravation and the soothing effect of the remedy are sure
proofs to the homceopathic physician that the remedy
is well chosen. Although that remarkable phenomenon occurs both in acute and chronic diseases, yet it
is seen much more frequently in affections characterized by a morbid excitement of the organic life,
especially when the higher organs are involved, in nervous irritation, spasms of every kind, erethism of the
vascular system, including pure inflammation, erethism
of the lower organs, such as the mucous membrane,
glands, bones, etc. (but much less frequent in the latter), in irregularity of the sleep. Children, in whom
the vegetative system prevails, are especially apt to
sleep after taking the true homoeopathic specific.*
Since it is an established fact that a true homoeopathic specific may either produce an exacerbation
of the symptoms, or a curative sleep,t and we are unable to determine the normal dose which will under
all circumstances occasion those results, we therefore
advise the beginning practitioner not to pledge himself to any dose in particular but to use the whole
scale of potencies to the best of his judgment.
What has been most perplexing to the scepticism of
the old school is the possibility that such small doses
should have any effect upon the organism. This scepticism arises principally from the fact that old school
physicians give their remedies every hour in a crude
state and in large quantities, and have no idea of the
dynamic power residing in a drug. However much
the human understanding may be at a loss to account
for the power of our small doses by any thing known
in science, there is no doubt that the possibility of such
action may not only be conceived according to natu* See reflections on Sleep, which is in many cases a direct result of the
action of homceopathic specifics upon the affected organism; by Dr. E. Stapf,
Archive, Vol.V., No. 3, p. 1..
t See No. 4 of Vol. IV. of Hom. Exam., in the case of typhoid meningitis reported by Dr. Hempel, where this curative sleep set in almost immediately
after the administration of Hyosciamus 30.



70


INTRODUCTION.


ral laws, but that it has been proven by the
universal experience of all homoeopathic physicians.
To cure diseases, both homceopaths and allopaths use
medicines. All those substances which we use as
drugs, must be able to disturb the organism by their
direct action upon it, each in a specific manner. From
a central point the morbid phenomena spread, invading
successively other systems. If we consider the action
of remedies from that position, we perceive at once that
the homceopathic agent is alone suitable in all diseases. It would seem as if we ought to stumble upon
the truth that a medicine and a morbid action both of
which are characterized by the same phenomena,
must primarily act upon the same centre. On giving
a homoeopathic remedy in a sufficient quantity to
produce symptoms, the disease must necessarily be
aggravated; on the contrary, by giving the remedy in
so small a dose that it cannot affect the organism
medicinally, the remedy must necessarily act upon
the vitality of the invaded centre, from which its influence will successively extend over the organs which
are consensually related to the centre; the disease
will therefore be cured without being first aggravated.*
This is no proposition of the pure reason, but one derived from experience after numerous observations
and experiments. Why should we disbelieve a fact
on the ground of its having been wrongly accounted
for, and why should we not do again what we have
done so many thousand times, in order to obtain again
the same good results? We do not deem it necessary
to repeat in the present instance the many striking
proofs which have been offered to the opponents of
homoeopathy, that striking effects are frequently produced by spiritual, or dynamic forces. We will simply
state that if the healthy organism can be influenced
by atmospheric impressions, atmospheric vibrations
upon which the perception of sound and light depends,
and by other imponderable agents, why should it be
denied that an organism invaded by disease can be
* See Ideas on the Formation and Cure of Disease by D. Drechsler of
Diiben, in the Med. Annals of Altenburg, March, 1815.



INTRODUCTION.


71


acted upon by minute doses of highly refined therapeutic agents when it cannot be denied that those agents
possess a dynamic power. We refer the reader to
Hahnemann's beautiful treatise: " How is it possible
that small homceopathic d6ses of a highly attenuated
medicine, should still possess power, great power? "*
We likewise recommend Dr. Trink's excellent treatise
in opposition to Hahnemann: Reflections on Doses,t
and Dr. Gross' reply.
We beg leave here to record our own opinion about
the action of our doses, which is sometimes of long
duration, and sometimes is not perceived at all. Of that
action Hahnemann says in the Chronic Diseases:
"This is not one of those propositions which can be
comprehended; nor do I ask that it should be blindly
credited. I do not comprehend it either, but the truth
is as I have stated. This is a matter of experience in
which I have more confidence than in my own comprehension." The experience which we possess of
the power of the doses, may be deemed sufficient,
and, it is all that we shall know about it for some
time to come. However, we, no more than others,
have been able to resist the desire which is inherent
in the human mind of explaining every phenomenon
which interests man; and inasmuch as it cannot be
denied that the power with which homoeopathic doses
act, is a most interesting and remarkable occurrence,
we have tried to explain it to our mind as satisfactorily
as possible, although we admit that our explanation together with all others, rests upon a hypothetical basis,
having more or less probability in its favour.
It is well known both to allopaths and homceopaths
that the human organism cannot be invaded by a
morbid force, be this either spiritual or material, unless
the organism is in a state of adaptation to that force or
in a state of susceptibility to its influence. This fact
canbe illustrated, by examples. Epidemic scarlet-fever,
erysipelas, measles, etc., do not attack anybody who has
* Materia Med. Pura, by Dr. Hempel, Vol. IV.
t Annals of Horn. Clinique, Vol. III., No. 2, p. 127.
SAllg. hom. Zeit, Vol., p. 43.
9 Chronic Diseases, Vol. I., by Dr. Hempel.



INTRODUCTION.


not yet had those diseases; we frequently see one or two
individuals in a family where either of those diseases
prevails, remaining free from the disease, but they are
attackedby it when the disease occurs a second time and
and when the organisms of those individuals are more
susceptible to it than they were during the first invasion
of the epidemic. Not all persons who expose themselves to the contagium of itch or syphilis, will be infected by it; such an infection will only take place in
persons whose organisms are predisposed to the reception of the miasm. If the predisposition of the organism were not necessary to its infection by a contagium, how could we account for the fact that of ten
persons who are bitten by a mad dog, only two or
three become affected with hydrophobia.
A sick organism is much more vividly affected by
external disagreeable impressions than an organism in
a state of perfect health, which may be left entirely
undisturbed by those impressions. The sick organism
being so easily irritated by the least disturbing causes,
it requires on the other hand very little to affect it
favourably. It is upon this fact that we account for
the efficiency of homeopathic doses. The homoeopathic agent and the morbid force disturbing the organism
in a similar manner, their disturbing influence must
be directed primarily against the same central point
in the organism, and, in disease, that central focus must
therefore be readily influenced by the homceopathic
agents, so that the natural irritation will be easily,
thoroughly and permanently counterbalanced and effaced by the artificial influence.
Although Hahnemann has shown that the inherent
power of a drug is only properly developed by the dynamizing process, yet we believe that the real dynamic force of the remedial agent begins to act only
when it meets the central focus of the disease, to
which the homceopathic agent conjoins itself as the
seed does to an appropriate soil; if that central focus
be not met, the dynamis of the homoeopathic agent
remains in a latent state and the disease goes on increasingly; or else the remedy may develope its own



INTRODUCTION.


73


pathogenetic symptoms, which become engrafted upon
the disease without any benefit to the patient. This
takes place in cases where the remedy is not homceopathic to the disease, where it covers a few symptoms
only without corresponding to the fundamental character of the disease, or where the dose was too powerful
or the patient's sensibility too great.
To avoid either of those results the homceopathic
physician ought to possess a perfect knowledge of
disease, in order to be able to distinguish essential
from accidental symptoms, but he ought likewise to
possess a complete knowledge of the symptoms of our
drugs, in order to be sure that the remedy he selects is
the true homreopathic specific. If those conditions are
fulfilled, the curative reaction of the organism will
seldom fail to be excited in such a degree as will leadto
the restoration of the patient's health in the most expeditious and safest manner.
We, no more than Hahnemann, comprehend how
medicines can act for so long a period; and yet we
sometimes let them act much longer than Hahnemann
did, and sometimes we give them more frequently,
even the antipsorics, than he advises in the Chronic
Diseases. On that subject we beg leave to record our
opinion as follows:
It has already been mentioned that the action of the
homceopathic agent is seen most brilliantly when it
bears directly upon the central focus of the disease,
which must always occur when the remedy is the true
homeopathic specific. If the remedy be homaeopathic
to the disease, the organic vital forces will be powerfully roused in opposition to the heterogeneous influence
of the drug. The vital reaction being once excited
and having succeeded in overcoming the artificial disturbance, it does not at once compose itself to a state
5f rest, but it continues active until the normal condition of the affected organs shall have been restored.
It is for this reason that the curative reaction sometimes
continues for weeks and months, provided the remedy
was perfectly homoeopathic to the disease. The curative reaction lasts much longer in a chronic than in an
4



74


INTRODUCTION.


acute disease; the former being more deeply rooted
than the latter. The duration of the curative reaction
may be illustrated by the vibrations of a musical cord,
which continue long after the cause which excited
them has ceased. It may likewise be illustrated by
the fact that a long and progressively increasing disease may be excited by a momentarily existing cause
ceasing the moment after its influence upon the organism has been established.
As regards Hahnemann's views about the selection
of the remedy, they have been considerably changed
by experience. He thought that the medicines which
he had proved first were more suitable to acute and the
so-called antipsorics to the chronic diseases." Experience however, which is the safest guide in medicine,
has convinced Hahnemann and all homceopathic physicians that such a division of our remedies into
antiphlogistics and antipsorics is not founded in
Nature, inasmuch as the antipsorics are frequently
used in acute diseases, such as Phosphorus, Acidum
phosp., Carbo veg. in cholera morbus, and the antiphlogistics in chronic, such as Chamomilla in cardialgia, Acidum hydroc., Verbascum in chronic affections
of the larynx. Hahnemann being convinced that his
former views on that subject required modification,
he incorporated a number of his first remedies in the
second edition of his Chronic Diseases.
In regard to the treatment of Chronic Diseases we
refer to some observations which have been communicated in the second number of the eighth volume of
the Archive, p. 33, and which are still valuable to
the practitioner. We there read: " Every physician
knows that chronic affections in their incipient stage
are so little troublesome to patients that they do
not consult their physicians until, after a very gradual and sometimes scarcely perceptible development, the affection breaks forth in an acute form,
acute rheumatism, acute gout, etc. Although these
* By antipsorics Hahnemann understands those remedies which he proved
after the discovery of his psora theory and which are contained in the
Chronic Diseases.



INTRODUCTION.


75


acute-chronic affections depend no doubt- upon a
chronic miasm, yet it would not be advisable to treat'
them with antipsorics from the very commencement, for
this reason, that the antipsorics frequently occasion
a considerable aggravation of the symptoms in the
first two weeks, which it is very difficult to counterbalance by other remedies. The vehemence of the acute
attack ought in the first place to be allayed by a
remedy which does not properly belong to the class of
the antipsorics, and after the disease has been reduced
again to its former condition, then the antipsoric treatment ought to commence. After having instituted a
number of experiments in regard to the best mode of
treating chronic diseases, we have adopted the following views in reference to that subject: Do not begin
the treatment of every chronic disease with an antipsoric, but sometimes with one of the former remedies,
especially when the disease had been successfully, and,
as may hence be inferred, specifically treated with
one of those remedies previous to the antipsorics
being known. Among them     the principal are the
polychrests, some of which are equal to the antipsorics in the treatment of chronic diseases; we may
mention Belladonna, Nux, Rhus, Staphys., Asa., Dulc.,
Mezereum, Sarsap., Ars., Coloc., Hepar, Anac., Clem.,
Puls., Ignat., etc..
The reviewer of my first edition objects to the last
proposition and would like to see it altered. Numerous experiments, however, have convinced me that my
opinion is not altogether incorrect. Even before me
many physicians have objected to any rigorous line of
demarcation being drawn between antipsorics and the
remedies for acute diseases; they have proposed that
remedies should be administered with reference to the
symptoms independently of that division. I propose
the same thing, viz. that no remedy which has been
known to act as a specific curative in a given disease,
be discarded until we know a substitute for that
remedy which will act still more specifically.
* Dulc., Mez., Sarsap., Ars., Coloc., Hepar, Anac., Clem., belong to the
antipsorics.-HEMPEL.



INTRODUCTION.


It is an acknowledged fact that antipsorics are the
best remedies for disorganizations and such affections
as could not be cured by any of the non-antipsoric
remedies, or when these are not indicated in the present case. In all such cases, the treatment ought to
be commenced with Sulphur, the best preparation being the tincture of Sulphur, one dose a-day for 4, 6 or
8 days in succession, provided the Sulphur is at all indicated by a few or more symptoms, or the patient has
a distinct recollection of having had the itch. The
Sulphur may be continued until several symptoms
make their appearance which the patient has not yet
felt on any former occasion. After the action of the
Sulphur has been distinctly perceived, it ought to be
discontinued, and, as soon as the Sulphur has ceased
to act, the patient ought to be given another antipsoric
which is most homoeopathic to the symptoms. This
will act with so much more certainty and success
after the Sulphur has been given. This second antipsoric has likewise to be repeated, but less frequently
than the Sulphur; the frequency of the repetition has
to be left to the judgment of the physician. If a wellchosen antipsoric should not act as well as the physician had a right to expect, he then may again recur
to a few doses of Sulphur to secure a more favourable
reaction, and afterwards give the next suitable antipsoric; in this way the Sulphur may have to be repeated two, three or four times during an antipsoric
treatment. In spite of this truly scientific proceeding
in the treatment of inveterate diseases, especially when
disorganizations have already occurred, the physician
sometimes fails in accomplishing anything, and the
disease goes on in its course. Under these circumstances the dose has to be increased, which is sometimes the only means left to benefit the patient.*
In the treatment of acute diseases, success depends
entirely upon the proper selection of the homceopathic
agent; but there are cases in which the ordinary
specifics have no effect. This deficient action of the
* Under these circumstances the most marked success has been obtained
from the highest potencies.-HEMPEL.



INTRODUCTION.


77


remedial agents frequently depends upon an impoverished vital force, or upon an excess of vital energy
in one or the other part of the disturbed organism,
owing to which the curative reaction is either entirely
or at least partially prevented; in such cases the patient is first to be mesmerized, after which the homceopathic specific, which would not act before, will become a most efficient agent. Sometimes the want of
action depends upon a latent dyscrasia having been
excited by the acute disease, which requires a suitable
antipsoric to be again reduced to a latent state. Sulphur is generally the best antipsoric to be employed
for such purposes, it removes the symptoms which had
appeared in company with the acute disease, or, at any
rate, it restores the original character of the acute
disease, and enables the previously employed remedy
to exhibit its full action.
The following observations relative to the treatment
of acute affections may conclude our general remarks
about the homoeopathic treatment of disease. If no
change of symptoms occur two, or at most four, hours
after the dose has been taken by the patient-provided
the dose was of sufficient magnitude-this is a certain
sign that the remedy is not homoeopathic to the disease,
and that another more suitable remedy requires to be
selected. But if an improvement commences a few
hours after the taking of the first dose, if the consciousness becomes freer, the sleep is more quiet, the skin
moist, no other, dose or remedy ought to be given until
the improvement ceases.
In acute diseases where life is in the most imminent
jeopardy, the medicine may be repeated every fifteen
minutes, half hour, hour, or every two, or three hours,
provided the physician is sure of having selected the
proper remedy. This fiequency of repetition is especially admissible in inflammatory affections, asthmatic
complaints, typhoid fevers, dysentery, cholera and diseases of a similar kind, etc. The attenuation ought, of
course, neither be too high nor too low.
We now come to mention the fifth fundamental
principle of homceopathy, which is just as important as



78


INTRODUCTION.


it is characteristic of our practice; it is this, that no
more than one remedy at a time ought ever to be given.
By mixing several remedies together, in old school
fashion, the peculiar effects of each are easily disturbed, or even neutralized, or a compound effect results
from that mixture which it is impossible to determine
a priori, and which we can only ascertain by proving
the mixture upon the healthy organism. - This, however, will probably not be undertaken as long as there
are simple remedies left of which the physiological
action upon the organism remains yet to be ascertained. If the homoeopathic physician were to recommend, in company with the homcoopathic agent the
use of herb-tea, herb-bags, fomentations, injections
or ointments composed of medicinal herbs, he would
commit the same mistake which we censure in oldschool practice, and he could not rely upon the effect
of the small homceopathic doses.
Some homceopathic physicians have tried to mix two
remedies, one of which seemed homoeopathic to one
portion of the symptoms, and the other to the remaining portion; but the results did not answer their expectations, and all good homceopathic physicians were
soon convinced that such a course would have occasioned the ruin of true homceopathy, and would have
degraded our practice far below the practice of the
old school.
It would be as pernicious both to our patients and
practice, to mix our remedies, as it is useful in many
complicated cases, to use two remedies alternately
at suitable intervals. This alternation may be much
more rapid in acute than in chronic diseases. In
the former the power of a dose is soon spent, in the
latter, on the contrary, the functions of the organism
are either carried on naturally, or they are too slow or
even entirely suppressed. We will illustrate this by a
few examples.
Scarlet fever and purpura miliaris are frequently
found complicated; to the former corresponds Bellad.,
to the latter Aconite, both of which remedies may be
given in alternation every three hours, to the great



INTRODUCTION.


repetition by rules. For instance, it is necessary to repeat the dose if the first dose diminishes the violence,
without changing the character of the disease, and if
the violence of the attack ceases to diminish after a
time. If a second dose effects no farther change but
simply prevents the disease from returning to its former
violence, this is a certain proof that the organism has
become accustomed to the influence of that medicine.
If, however, that same medicine continues to be indicated, in that case a lower potency requires to be administered, and to be continued until reaction has
evidently set in, which ought not to be disturbed by
another dose. If the reaction should cease before the
cure is effected, in that case either the same or another
more suitable remedy has to be administered.
It is universally conceded that the dose ought to be
much less frequently repeated in chronic than in acute
diseases where the vital process is carried on much
more rapidly than in the former, and where, consequently, the vital powers are much more speedily exhausted. The repetition of the dose cannot be determined by fixed rules, and has to be left to the tact and
judgment of the physician; of course he ought to
possess the talent to judge with discretion. If highly
sensible and active organs are affected, the dose will
have to be repeated more frequently, because its power
will be spent much more rapidly, as is the case in inflammatory and typhoid diseases. In such diseases the
effects of the remedy are perceived very soon, and the
dose admits of a speedy repetition. If the effects are
not soon perceived, we may conclude with certainty,
that either the potency or the remedy was badly
selected. In chronic affections the effects of the
remedy ought to be perceived in forty-eight or at
latest in seventy-two hours; if they are not, the
remedy is either not homceopathic to the disease or
the potency was not adapted to the susceptibility of
the organism.
If by repeating the dose an essential change is
effected in the symptoms, this change may be considered a proof that the medicine is no longer homceo



INTRODUCTION.


81


pathic to the disease; if circumstances permit, the
exhibition of a new remedy may be delayed twentyfour or forty-eight hours; if the change of symptoms
should indicate danger, a new remedy ought to be administered immediately. The dose ought not to be
repeated when the disease passes into a new stage,
for instance, in scarlatina, after the disease has assumed a new form by metastasis; in croup, when the
disease has passed from the inflammatory stage to that
of effusion; * in smallpox, when the suppurative stage
has commenced, etc. These new forms of the disease
require new remedies, which are to be repeated if
necessary.
It is advisable, however, especially in chronic diseases, not to continue the same remedy tdo long, even
if the dose be changed,-lest the organism should become accustomed to its influence, which cannot be
useful in the treatment. Instead of repeating the
same remedy too often, it would be better to select
another remedy which should be as nearly as possible
homceopathic to the disease, and to repeat this remedy
at suitable intervals, after which the previous remedy
may again be given. We do not admit with Rau that
in acute cases the higher potencies are more suitable
on account of their action being more speedy and
shorter in such cases; for it is known by experience
that the higher potencies act more intensely and
longer than the lower, that they excite the curative
reaction of the organism much more tardily than the
lower potencies, and are on that account much better
adapted to the treatment of chronic diseases.
The last fundamental principle in homceopathic
practice is the diet and mode of life. This is of the
utmost importance, considering the smallness of the
dose, which ought to be regulated by the intensity and
general character of every case. The strictness of
the homceopathic diet is appreciated even by the old
school; it is estimated even beyond its merits, for our
"*It is asserted by some pathologists, that what has been hitherto considered
different stages of croup, are four distinct varieties of that disease, each of
which requires a special treatment, and has no connection with any of the
other varieties.-See Horn. Examiner, Vol. IV., 5.
4*



INTRODUCTION.


cures are attributed to it exclusively. There is no
doubt that everything which might exercise a medicinal influence upon the organism should be carefully
avoided during homceopathic treatment, lest the action
of the small doses should be impaired.  Chronic
patients particularly should be submitted to the most
rigorous diet, inasmuch as their disease is frequently
maintained and even aggravated by faults of diet or
other artificial influences which might be avoided. A
rigorous diet is sometimes even sufficient to restore
the organism without any medicine; at any rate the
susceptibility of the organism to the action of the
remedial agent is heightened by keeping the organism
free from all stimulating and disturbing influences.
Every intelligent physician will at once perceive that
not every patient can be submitted to such a rigorous
diet, and that a man of sixty years for instance, who
has been in the daily habit of taking coffee, tea, wine,
brandy, or of smoking tobacco and using snuff, cannot
be suddenly deprived of those things without detriment
to his organism. Hahnemann allowed smoking and
snuff; he forbade wine, brandy, and coffee, with great
severity. This seems to be inconsistent, and leads us
to suppose that in a more advanced age we may except some other things besides tobacco from the general rule of abstinence. But let the homeopathic
physician beware lest he should be too lenient in prescribing a proper diet to his patients, and let him be
mindful of the proverb: Give him an inch and he will
take an ell.
In acute diseases the diet ought still to be much
more rigorous than in chronic, and the more so the
greater the danger and the more rapid the course of
the disease. The physician will not find it difficult to
enforce that rigorous diet in acute diseases where the
patient has scarcely any desire for anything, and the
attendants are of themselves convinced that the strictest diet is of the utmost consequence. If the patient
does not wish to eat anything, nourishment ought not
to be forced upon him; on the other hand he ought to
be allowed to quench his thirst, for which purpose the



INTRODUCTION.              83
patient will generally prefer cold water; he may
drink this without fear, provided he does not drink too
much of it at a time. When -the instinct of selfpreservation has again been awakened, the internal
sense of the patient is for him such a sure guide in
regard to those things which he ought to eat and not
to eat, that the patient should not be refused anything
without very cogent reasons.



FEVER.
GENERAL REMARKS ON FEVER.
~ 1. According to Hahnemann, the symptoms of a
disease are the only portion of the disease of which
we can take cognizance. This is accomplished by
means of our senses. The internal nature, the essence
of a disease, cannot be known with certainty; it can
only be conjectured.  Hahnemann considered the
usual names of diseases as collective names for very
different conditions of the affected organism; according to him those names are of no value in the treatment of disease.  He considered fever a purely
dynamic disturbance of the vital force, affecting both
its action and sensibility, and being most distinctly
perceived in the vascular system. The principal characteristic of fevers is the changeable nature of their
symptoms. Reil (On the Diagnosis and Treatment of
Fevers, sec. ed., Vol. I., ~ 24,) says: " Any classification
of disease is the work of man, which Nature does not
always confirm; on this account we are unable to
draw a definite line of demarcation between fevers
and those diseases which are not fevers." Von Hildenbrand expresses the same idea in the following words:
"Logica definitio febris dari non potest." The great
difference which prevails among febrile diseases, and
the frequent changes occurring in the symptoms of
the different kinds of fevers, make it very difficult
to offer a definition of fever that will be applicable to
all its varieties. We are not prepared to believe with
Eisenmann, Henle, and others, that the spinal marrow
is the focus of every fever; we believe, however, that
it is that focus in all cases where spasmodic symptoms
of any kind form the commencement of the fever, and



FEVER.


85


the fever is not seen in a distinct form, except after
the spasmodic symptoms have been removed. When
spasms occur, the spinal and cerebral irritation is
evident; but it would be improper to assert that, because such an irritation exists whenever the febrile
paroxysm is accompanied with spasms, the spinal
marrow must be the primary seat of every fever.
This cannot be admitted as long as we do not possess
more data to base such a doctrine upon; for the allopathic physician such an admission would be especially hazardous, inasmuch as it would mislead him in
his treatment.
The homceopath needs not to embarrass himself
with a definition of fever; he is satisfied with Hahnemann's view, which neither injures nor benefits the
treatment.
~ 2. The common symptoms of fever which have to
be regarded as a reaction of the organism against the
morbid cause, are: Increased frequency of pulse and
breathing, not depending upon an accidental cause,
such as fast running, but upon a disturbance of the
vital principle. Increased warmth of the patient,
although the temperature of the surrounding air is the
same as before the attack; orgasm of the skin, which
becomes warm, hot, d'ry, turgescent, and exhibits a
vivid red colour; bright redness of the tongue and
mucous membrane of the mouth; vivid and glistening
redness of the eyes, etc.. Excessive desire for drinks,
with dryness of the mouth; diminution of the secretions and excretions, strong odour and high colour of the
former. Alternation of warmth and coldness, sometimes at regular intervals.  The above-mentioned
complaints are accompanied with a general sick feeling
of the organism, headache, weariness and debility of the
limbs, arrest of the animal functions, increased sensitiveness of the organs of the senses, delirium, spasms,
great restlessness, and in general various kinds of disturbances indicating a powerful excitement of the
organism.
However, the pathognomonic symptoms, which have
been mentioned in the preceding paragraph, would
furnish but a very imperfect diagnosis if the physician



86


FEVER.


did not possess the requisite talent to put a proper estimate upon the concomitant symptoms.
~ 3. In treating fevers it is of impor'ance to the
homoeopathic physician that he should know the causes
of the fever, the local symptoms, the type, duration
and period of the paroxysm; he should know whether
the fever is continuous, remittent, intermittent, or alternating--that is, whether it occurs alternately with
morbid conditions of another kind. The proper appreciation of these characteristics is of great importance to the selection of the remedy, which can only
cure the fever if the group of symptoms which characterizes the fever is likewise peculiar to the remedy;
in proportion as the remedy corresponds more minutely
to all the peculiarities of the disease, the cure will be
effected so much more rapidly and permanently.
~ 4. We ought not to pass unnoticed the critical
phenomena which are observed in fevers. Although
we do not, and owing to our different treatment, cannot attach as much importance to them as the physicians of the old school do, yet the homoBopathic
physician ought not to neglect studying the phenomena
by which a crisis is generally characterized, inasmuch
as they may occur to -him just as well as to an allopathic physician, and he might be misled in his treatment if he did not know them. It is not advisable to
endeavour to establish such critical changes by artificial means, for this reason, that we are ignorant of
the mysterious processes which Nature, untrammelled
and unbiassed by treatment, establishes in disease for
the production of such changes. But suppose we
knew both the process which Nature adopts in their
realization, and the operation of the remedy which is
intended to bring about a similar result, in that case
it would nevertheless remain a proceeding of highly
questionable propriety to substitute an incomplete and
often dangerous crisis, obtained by artificial means, in
the place of those critical changes which indicate a
favourable but frequently insufficient or even powerless reaction of the organism against the disease.
We do even believe that those critical changes may
be greatly moderated, or even subdued, by homoco



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87


pathic treatment, without the curative action of the
drug being diminished in the least. Those changes,
when fully developed, frequently constitute peculiar
diseases, which the physician is called upon to treat
and to remove. This being our view of a crisis in
disease, we shall treat the subject a little farther in
detail, and shall, at the same time, mention the therapeutic measures to be adopted when a crisis occurs.
~ 5. Critical symptoms in fevers are: excessive
debility, chills, increase of heat, orgasm, vertigo,
illusions of the senses, oppression, twitchings of
the muscles, or even subsultus tendinum, delirium
and  cold sweats, accompanied    by an unequal,
often  even  intermittent, double-beating, frequent
pulse; these symptoms can only be considered critical
when they occur spontaneously, without having been
occasioned by hurtful influences at a period when a
crisis may naturally be expected, and the vital forces
are not depressed. If we had it in our power, by
establishing such a crisis, to restore in the patient the
sensation of a full return of health, it would be foolish
not to excite such a short-lasting struggle, and to maintain it until it should have accomplished its object.
Very frequently, however, a crisis remains incomplete,
the organism makes renewed and ineffectual efforts to
complete it, and the result of this struggle is, in many
cases, the transfer of the disease to a noble organ,
whereby life is not only endangered but frequently
terminated. A crisis is a dangerous occurrence in
other respects; owing to the general erethism of the
organism, the crisis may easily be disturbed, in consequence of which the organism may relapse into the
original disease, and, being already exhausted by the
first attack, would be much more dangerously prostrated by the second. We will now proceed to a more
detailed consideration of the critical phenomena.
~ 6. We believe, with others, that a critical sweat is
a decisive sign of the equilibrium of the organism
having been restored in fever, when the sweat is preceded by several cold creepings over the skin or itching of that organ, when it is accompanied by a soft,



FEVER.


undulating pulse, a warm, soft, moist skin with a reddish tinge, when it covers the whole body uniformly,
is neither too profuse nor lasts too long in proportion
to the intensity of the fever; when the violence of the
symptoms abates during the breaking out of the sweat,
and the patient feels relieved. Generally, that sweat
occurs as a result of the homoeopathic specific, and
ought not to be disturbed in any way. The medicine
should be stopped, the patient should be covered
neither too warmly nor too slightly, he should
remain in the same temperature, and keep perfectly
quiet. If the breaking out of the sweat should have
been prevented, or the sweat itself arrested in any
manner, and if, in consequence of that suppression,
new symptoms should have made their appearance,
in that case the physician needs not to expect anything
of the equilibrating influence of the sweat, and has
at once to exhibit one of the following remedies in
accordance with the symptoms:-Puls., Dale., Acon.,
Chain., China, Mere., Phosp. ac., Sulp., and several
others. If the sweat be too copious, if the patient
feel exhausted while it occurs, and other alarming
symptoms set in, the medicine has not been well
chosen, and another remedy has at once to be adminisl ered, either for the purpose of terminating the sweat
or transforming it into one of a favourable kind. The
remedies which may be used for that purpose are:
Stannum, Sulphur, Mere., Acid. phosp., Arsen.,Phosph.,
Ipec., Bryonia, Verat., Lycop., and some others.
If the symptoms which indicate the probable occurrence of a critical sweat, should be complicated by an
anxious restlessness, oppression of the chest, panting
breathing, short cough, pains in the limbs, alternation
of shuddering and sweat, etc., these symptoms may be
considered the precursors of a rash which, if the symptoms should be too violent, may frequently be prevented by Acon., Ipec., Bryo., Ars., Mere., each remedy to
be administered in accordance with the indicating
symptoms. Sometimes, however, it may be deemed
advisable to favour the outbreak of the sweat, this result may be accomplished by Puls., Bryo., Chain.,



FEVER.


89


Arsen., Acid. phosp., Rhus, Staphys., and Sulphur,
according as each remedy may be indicated.
~ 7. The critical urine is likewise seen in homceopathic treatment and is a so much more favourable
symptom than critical sweat as it is not accompanied
with phenomena denoting a violent irritation of the
organism. It has been frequently observed that a
critical urine makes its appearance even after the
most minute doses of a homceopathic specific, showing
that the reactive powers of the organism are constantly engaged, during- a well-regulated treatment, in removing the disease and that these favourable critical
changes are not accomplished by large doses of medicine. The precursory signs of a critical urine are:
slight burning and pressing in the urinary passages,
weight, drawing and tension in the lumbar region,
increased desire to urinate, increased dryness of the
skin, and increase of thirst, all these being symptoms
which do not necessarily require a change of remedy.
At first the urine exhibits a light cloud on the top and
in the middle of the chamber; the cloud lowers itself
more and more day after day, it increases and gradually reaches the bottom of the vase, where it forms a
white, slimy, yellowish, flocculent sediment, or one
which is light, coherent and somewhat elevated in the
middle. The sediment is so much more decisive as it
settles more speedily after the emission of the urine
and is more copious; it is the more dangerous the
longer the urine remains turbid. In general a changeable urine is a very dangerous symptom, as it shows
a deficient reaction of the organism.
The following remedies may be used in cases of
changeable urine, provided the other symptoms correspond: Canthar., Colocynth., Digit., Sassap., Acid. sulp.
and phosp., Dulcam., and others; when the urine
deposits a mucous sediment which does not reach the
bottom of the vase: Puls., Ant. cr., Natr. mur., Acid.
"nit., Dulc., Nux v., Senega, Sulp., Sassap. Urine with
purulent sediment might be treated with Canth., Sep.,
Acid. nitri., Puls., Lycop., Clematis and others, [also
Mercurius, Cannabis, and Uva ursi.-HEMPEL.]



FEVER.


~ 8. In febrile diseases hemorrhages are favourable
symptoms and may be considered critical even by
homosopathic physicians, when the hemorrhage proceeds from an organ which is not injured by it, such
as the nose, womb, anus, or if the hemorrhage take
place in young, vigorous, plethoric subjects, affected
with inflammatory diseases, and the congested organ
be relieved by it from the excess of blood. Hemorrhage frequently takes place in subjects who have become plethoric by the abuse of spirituous drinks or in
whom the choleric temperament predominates; or in
persons in whom an habitual hemorrhage which is
usually left to  nature, has been suppressed by
accidental causes. We frequently see hemorrhage
taking place in exanthematic fevers. If the hemorrhage be too violent and exhaust the patient, if it
proceed from the nobler organs, the lungs, stomach,
bladder, if the blood itself be decomposed, in all such
cases the hemorrhage loses its critical character and
ought to be considered a dangerous symptom characteristic of a special form  of fever and requiring
specific remedies.
Epistaxis or hemorrhage from the nose rarely occurs
suddenly; it is generally preceded by more or less
characteristic complaints, such as: heat, redness, puffiness of the face, red, running eyes, scintillations and
flashes before the eyes, headache, especially in the
temporal region, vertigo, humming in the ears, itching
in the nose, throbbing of the temporal arteries and the
carotids, distension of the veins, illusion of the senses
and delirium; all these symptoms denote a congestion
of blood to the head. If the physician is able to remove
those symptoms by suitable remedies why should he
not do so; since he cannot know beforehand whether
the hemorrhage from the nose will be of a critical nature,
why should he delay treatment until the hemorrhage
has actually occurred? According as the constitution
and temperament of the patient, the exciting cause, the
concomitant symptoms, the time of day, etc., require,
he may use Aconite, Bellad., Nux, Crocus, Carbo veg.,
Cham., Arnica, Pulsat., China, Mere., Ranunc. bulb.,



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91


Secale, Sulphur, or some other remedy. If those
symptoms should have been occasioned by a remedy
which had been given a little while previous, in that
case they have to be met by a suitable antidote.
If the hemorrhage from the nose has already set in,
then one of the following remedies is indicated and
ought to be selected in conformity with the existing
symptoms: Aconite, China, Arnica, Bryon., Pulsat.,
Ignat., Crocus, Bellad., Carbo veg., Sulphur, and a few
more. If the hemorrhage from the nose continue, and
great weakness, fainting fits, collapse and-other symptoms of depletion make their appearance, it is perfectly
proper, even for a homceopathic physician, to make cold
water applications to the genital organs. If the
blood be entirely decomposed, Kreosot, China, Conium,
Rhus, Arnica, Carbo veg., Ferrum acet., Nitri. acidum
and Acidum sulphuricum may be of use, each remedy
to be given in accordance with the concomitant symptoms.
A similar treatment is adopted by the homceopathic
physician in congestion of the womb and hemorrhage
from that organ. The congestion of the womb is
recognised by the fulness, tension, uncomfortableness,
the dull and painful drawing along the groin to the
ossa pubis; by the peculiar tension in the lumbar
region; by the sensation as if the os sacrum had -not
sufficient firmness. These symptoms are frequently
accompanied by a burning warmth in the internal
sexual organs, by a pressing in those organs as if
every thing would fall out; the lips of the vulva are
tumefied and there are occasionally symptoms of
nymphomania. The symptoms of congestion of the
uterus occur most frequently in those fevers which
arise from the sexual organs; hence they occur most
frequently during confinement, after suppression of
the menses, or when the sexual organs are very
iritable, or the uterus and vagina are varicose.
Symptoms of congestion of the uterus may likewise
occur when disturbances of organs which have a
Sympathetic relation to the sexual system, are accompanied by febrile symptoms involving the uterine



FEVER.


system by sympathy, for instance affections of the
breasts, or of neighbouring organs, in gastric and
hammorrhoidal fevers, or in fevers depending upon congestions in the portal system. It is scarcely necessary
to state that the exciting cause of the disease and the
disease itself have to be considered in selecting a
remedy, nevertheless we may direct the attention of
the practitioner to the following remedies when the
congestion of the uterus is characterized by the above
mentioned symptoms: Belladonna, Hepar sulp., Plat.,
Sulphur, Mercurius, Nux, Bryon., China, Ipec., Crocus,
Murias magnes., Calcar., Carbo veget., Sabina,
Ferrum, Secale corn., Ignat., and Thuja.
If the hemorrhage is inconsiderable or if it occurs
at the regular period of the catamenia and affords
relief to the patient, she does not require any new
remedy; but if the hemorrhage should increase to a
metrorrhagia, the following remedies deserve particular consideration: Crocus, Cham., China, Ipec.,
Platina, Ferrum, Millefol., Hyosc., Stramonium,
Bryon., Ignat., Sabina, Secale corn., Sulphuric acid,
Phosp., Calc. carb., Nux mosch., Ratanhia (and the
tincture of Cinnamon,-HEMPEL). It is always understood that each remedy should be administered in
strict accordance with the symptoms.
The so-called critical hemmorrhoidal flux is likewise
preceded by symptoms of congestion which determine
the remedy to be selected; these symptoms are: pain
in the small of the back as if it would break, and as if
there were no power in it; desire to evacuate the
bowels and bladder; burning and itching of the anus
and of the hamorrhoidal tumours. If those symptoms
occur in fevers, the following remedies may be employed: Nux, Bellad., Ars., Sulphur, Mercur., Ferrum,
Ignat., Pulsat., Phosp., Lycop., Caps., Carbo veg., Acid.
mur., Acid. sulp., and Acid. nitr. A very troublesome
and exhausting symptom in congestion of the anus, is
the excessive burning pain of the hrmorrhoidal
t umours. That pain is generally caused by an inflammatory condition of the swollen tumours. I have frequently succeeded in relieving it, at least for a few



FEVER.


93


moments, by repeated smelling of Aconite, without
disturbing the action of the principal remedy.
In flowing hsmorrhoids the above mentioned remedies require to be principally employed.
~ 9. As regards the critical discharges from  the
bowels (critical diarrhoea), these ought never to be left
unnoticed in the selection of a new  remedy. It is
impossible to point out with unerring certainty those
remedies which will prove the most efficient in those
various kinds of diarrhoea for which the organism
may be predisposed by a variety of diseases, especially
diseases of the abdominal organs. Nevertheless we
will mention some of theprincipal remedies, reserving
to us the privilege of speaking of them more in detail
when we shall treat of the special treatment of
diseases.
~ 10. The same remarks which we have offered on
the critical diarrhoea, apply to the so-called critical
vomiting. This change which is considered critical
by allopathic physicians and which is ushered in by a
dirty coating of the tongue and a tensive oppression
in the preecordial region, by frequent eructations, inclination to vomit, nausea, great restlessness and
anxiety, frequent shuddering and cold sweat, and an
irregular and intermittent pulse, requires the employment of a specific remedy. This symptom occurring
"mostly in gastric, bilious, and pituitous affections, for
which Nux, Bryon., Pulsat., Antim. crud., Colchicum,
Hellebore, Platin., Secale corn., Cuprum, Veratr., Tart.
emet., Ipec., Arsen., Asar., are the best remedies, it is
not to be wondered that precisely those remedies
should be so efficient in arresting the vomiting
together with the disease.
~ 11. An increased secretion of mucus in the lungs
after an inflammatory or catarrhal affection cannot
always be prevented, even under the best treatment.
That secretion is owing to the morbid condition of the
mucous glands, occasioned by the previous inflammation. No matter what shape or colour the expectoration  may assume, ball-shaped, thick, coherent,



94


FEVER.


yellowish-white, or whether it be considered critical
or otherwise, it will be necessary to remove it by
suitable remedies, lest a chronic affection, weakness,
etc., should be entailed upon the lungs or trachea,
which must necessarily be the case if the expectoration
is suffered to remain too long. Puls., Dulc., Squilla,
Senega, Ipec., Bryon., Stannum, and others, are the
principal agents for the removal of such an expectoration.
~ 12. Critical ptyalism is one of the least frequent
phenomena occurring in fevers. It is seen in several
kinds of typhoid fever, smallpox, rash or quinsy, and
in other diseases where glandular organs are affected.
The precursory symptoms of ptyalism are said to be
pain behind the ears, difficulty of swallowing, confluence of saliva in the mouth, other excretions being
suppressed for the time. Those symptoms indicate
one of the following specifics:-Bellad., Hepar sulp.,
Sulphur, Mercurius, Dulcan., Acidum nitri., Tart.
emet., Cantharides, and others.
The critical changes which have been enumerated
in the preceding paragraphs may generally be considered favourable if they occur at a period of the fever
which has the character of a critical period, if they are
accompanied by an essential alleviation of the symptoms, or if they do not depress the vital energy; or
lastly, if the critical reaction of the organism cannot
be ascribed to other causes. Under homceopathic
treatment that critical commotion of the organism
may be occasioned by too large a dose of the homceopathic specific, and would not have occurred if the
dose had not been too large.
~ 13. It is just as important for a homoopathic as
it is for an allopathic physician to know the general
remote causes of fever; without that knowledge it is
scarcely possible to establish a correct diagnosis, and
to treat the disease successfully.
The exciting causes of fever are very various;
constitution, sex, age, mode of life and occupation,
the natural evolutions of the organism, may be such



FEVER.


causes; physical exertions, injuries and wounds, internal inflammations, suppurations and ulcers, etc.,
may likewise occasion fever.
Fevers may be caused by external influences not
depending upon any innate morbid disposition; such
fevers are a kind of poisoning of the organism, and
may be considered epidemic and contagious. Such
external influences are:
(1.) The atmospheric air. In spring, for instance,
when the weather is liable to sudden changes, and a
warm atmosphere frequently alternates with rain,
wind and cold, catarrhal and rheumatic *fevers are
predominant; in the summer, when the energy of the
body is depressed by hot and sultry weather, and the
digestive and assimilative powers are weakened, the
organism is predisposed for bilious and gastric fevers;
in the fall the sudden succession of warm days and
cold nights predisposes man for pituitous, typhoid,
putrid, and other kinds of dangerous fevers; in the
winter season, fevers have generally an inflammatory
character, occasioned by the cold, dry, raw, and cutting air. Epidemic malignant fevers generally cease
in that season. An atmosphere filled with electricity,
gases, and with the vapours arising from marshes, is
likewise favourable to the occurrence and development of fevers. If the weather which generally prevails in the different seasons, deviate greatly from its
usual state, the character of the fever is, of course,
correspondingly modified. Lastly; fevers are more or
less influenced by the stars, which affect organized
bodies either directly or indirectly, by means of
causes or conditions controlled by the influence of the
heavenly bodies. The state of the weather, for instance, which has the greatest influence on the animal
organism, is regulated by the heavenly bodies. Who
does not know the influence of light, heat, sun and
moon, upon all organic beings?
(2.) Contagia and Miasmata. Among these may
be numbered poisonous influences arising from decaying plants and animals, exhalations of plants and
animals in close rooms, becoming deleterious on ac



FEVER.


count of not being replaced by fresh air. If one man
in such rooms is attacked with fever, all the others
are. It is an established fact, that the first cases of
fever are occasioned by the epidemic miasm; but in
the patients who are first attacked with the epidemic
fever, a contagious principle is afterwards engendered
capable of propagating the disease, so that contagium
and miasm support one another.
(3.) Passions and emotions, fright, anger, joy, intoxication, disturbance of the mind by anxiety, surprise,
etc., and in general violent concussions of the body,
may occasion fevers. Anger may occasion a bilious
fever and inflammation of the brain; silent grief
about disappointed love may bring on a slow typhus,
and the most malignant fevers may be caused by fear,
anxiety, fright, constant. care and despondency.
(4.) Derangements of the intestinal canal, produced
'by overloading the stomach with things which are not
hurtful in themselves; but especially by taking improper food and drinks, large portions of drugs, etc.,
may occasion fevers. Fevers may be excited by eating a piece of fattened goose, duck, or pork, or by eating a certain kind of fish, or rather the spawn of that
fish, such as sturgeon, barbel, etc.; also by eating crabs
and lobsters, oysters, clams, and mussels; by spices,
herbs, roots, mushrooms; barberries, juniper-berries,
bitter almonds, unripe fruit, may likewise excite a
febrile sensation in the organism. Can the morbific
power of spices and of the pastry prepared with spices
be denied? Although we are by no means opposed to
the moderate use of wine, or of a well-fermented and
pure beer, and cannot chime in with those who condemn those beverages as injurious to health, yet
we do not hesitate to denounce any abuse which is
made of them, as well as the use of hot, spiced wine,
or beer mixed with stupefying and heating herbs. All
such beverages have a tendency to produce disease.
Who is not acquainted with the febrile conditions
which may be excited by the abuse of China, Mercurius, Sambucus, Valerian, Chamomilla, and other
remedies?



FEVER.


97


Want of those things which are necessary to sustain
life.
~ 14. The general division of fever into classes
is of no essential value to a homceopathic physician,
as that classification depends principally upon the
arbitrary disposition and the individual views of
physicians. All fevers, without exception, have been
classed according to that part of the system which is
the primary seat of the affection, or according to their
type and course; such a classification is both incomplete and insufficient in practice. In one word: there
is no isolated form of fever; every fever affects
primarily one or the other organ, the brain, the
spinal marrow, the ganglionic system, the lungs, the
abdominal organs, the skin, the mucous membranes of
the air-passages, etc.; hence every fever is one of a
different kind, the difference being founded both in the
nature of the affected organ and in the character of the
fundamental affection. Owing to the great variety of
the febrile symptoms, it is impossible to class fevers
according to determinate forms. The only classification possible is one of the general phenomena occurring
in the various kinds of fever. Every particular group
of those phenomena can easily be named by the
physician for his own gratification and that of the
attendants of his patient, and can easily be classed
provided the organ which is affected, and the manner
in which it is affected, are considered. It is scarcely
necessary to state that the treatment ought not to be
based upon the mere name.
According to their characters, fevers might therefore
be divided into
(a.) Synochal, sthenic, inflammatory, arterial (Synocha; synochal reaction, according to Canstatt). This
kind of fever is characterized by great heat, glowing,
hot, and dry skin; accelerated, full, hard, tight, sometimes subdued pulse; distinct beating of tlhe carotids,
and temporal arteries; bright-red, frequently whitecoated, and mostly dry tongue; hot breath and hot
mucous membrane of the mouth; great thirst; delaying or suppressed stool; bright-red, fiery and burning
5



98


FEVER.


urine, depositing a sediment. Violent restlessness;
painful sensation of debility; frequently the patient
experiences violent headache, especially in the occiput,
sleeplessness, delirium, sensibility of the organs of
sense. Glistening eyes. The phenomena of the fever
scarcely ever remit.
(b.) Synochus (erethic reaction according to Canstatt). This is a form of fever occupying a middle
rank between synocha and typhus, without inclining
to either side except when the fever lasts any length of
time, or when the fever patient is constantly exposed to
hurtful influences, in which case the erethic form may
pass over either into the synochal or the typhoid. Erethismus is characterized by moderate heat and a slight
exhalation from the skin; the pulse is full, accelerated, but neither hard nor tight; the tongue is slightly
coated and moist; thirst is moderate; the alvine evacuations are not entirely suppressed; the urine exhibits a
slightly reddish tinge. The general strength of the organism is but slightly affected by this febrile form, which
is moreover characterized by distinct intermissions.
(c.) The typhoid form is a peculiar affection of the
nervous system, disturbing the equilibrium  of the
vital energies which is maintained by the nerves. In
real typhus the functions of the brain and nerves are
entirely prostrated; the strength of the patient fails
visibly and there is a tendency to disorganizations and
to decomposition of animal matter. Typhus is characterized by irregular and violent manifestations, and
by illusions of the senses, muscular debility, exhaustion, but neither paralysis nor complete prostration.
Canstatt considers typhus as a variety of synocha
and synochus. According to him there is another
distinct form of fever, which we on the contrary consider as a termination of one of the preceding forms;
this is
(d.) Torpor. Torpor is characterized by a collapse
of all the organs; pale, cold, dry skin which is liable
to break; dry and cracked mucous membrane of the
mouth; frequently a disagreeable, pricking heat of the



FEVER.


99


skin, or else cold, clammy sweats; colliquative sweats
and diarrhoea; collapse of the features, faint eyes;
sudden emaciation; pulse frequent, quick, empty,
small, easily compressible; hemorrhage, petechiae,
ecchymosis;   speedily increasing  prostration  of
strength; excessive muscular debility, tremor, subsultus tendinum, delirium, paralysis. There is a striking
opposition between the objective and the subjective
symptoms; for instance, the patient's tongue is dry
and yet he is not thirsty; his skin is cold and yet he
complains of a glowing heat; illusory strength, etc.
With respect to their type, those different forms of
fever may be divided into continuous, remittent, or intermittent, irrespective of their fundamental character.
Continuous fevers are such as exhibit the same
phenomena during their whole course and rage with
the same intensity from the commencement of the disease to its crisis. Fevers are called remittent when
they exhibit, it is true, the same phenomena during
their course, but with a periodical increase and decrease of intensity. Intermittent fevers are such as
are characterized by remissions of a definite or indefinite length, during which the patient sometimes
appears perfectly healthy.
Fevers may likewise be divided into sporadic, endemic, epidemic, and still other classifications might
be established, which, having no practical value, are
here omitted. We content ourselves with recalling to
the minds of our readers what has been said page 41
about the influence of the permanently prevailing, endemic or epidemic character of disease in a certain
region upon any of the above mentioned forms of
fever; this influence deserves the closest attention in
the selection of a remedial agent and is greatly concerned in the ultimate result of the treatment.
~ 15. To establish a prognosis in fevers, is not so
very easy, inasmuch as the momentary indications,
which are frequently deceptive, are by no means
sufficient; a prognosis which is to be well founded and
to bear the highest character of probability, must be
based upon a correct estimate of all the circumstances



FEVER.


and of the whole image of the disease, upon a careful
consideration of the constitution, disposition, age and
external condition of the patient, of the state of the
weather, of the season, and the simple or complicated
character of the fever; a good deal of discretion is required to establish a good prognosis. Although it is
impossible to foretell the issue of the fever at the very
commencement of the disease, inasmuch as the practitioner cannot possibly foresee all the hurtful influences
which may complicate the course of the disease and
interfere with the treatment: yet the homoeopathic
physician, confiding in his therapeutic law by virtue of
which the well-chosen homoeopathic specific will act
directly upon the focus of the disease and excite a
corresponding curative reaction in the organism, is
enabled to prognosticate with tolerable certainty the
termination of the disease, provided the above mentioned conditions of a well-founded prognosis are
fulfilled.
The prognosis is generally favourable, when the patient has a vigorous constitution and has led a regular
mode of life; when the pulse is regular, soft, not too
frequent; when the breathing becomes freer and more
regular; when the nervous system is but little affected
and the expression of the countenance is natural; when
the general and especially the muscular strength is
good; and, lastly, when the secretory and excretory
functions are not interrupted.
The prognosis is unfavourable when the constitution
of the patient has been weakened by former excesses
or by violent diseases, when, therefore, the strength of
the patient must be greatly prostrated and the reaction
very deficient; when the pulse is very frequent, weak,
and irregular; when the nervous system is violently
affected, the patient is delirious, and the hands and
tongue tremble; when there is subsultus tendinum,
floccitation, hiccough. It is likewise an unfavourable
symptom, when the patient remains extended on his
back without ever changing his position, or when he
settles downward in his bed. Unfavourable symptoms
are likewise: general apathy; involuntary emission of



FEVER.


urine and involuntary alvine evacuations; retention of
urine; complete alteration of the expression of countenance (hippocratic countenance); convulsions; loss
of sight; dropping of the lower jaw; irregular breathing when there is no particular affection of the chest;
hurried, superficial breathing, interrupted by occasional
sobs; difficult deglutition, or a noise when swallowing,
as if the swallowed substance fell into the.stomach;
cold extremities, with cold clammy sweats, etc.
There remains to be stated, that the occurrence of
only one unfavourable symptom does not constitute an
unfavourable prognosis, but the prognosis is unfavourable when several of the aforesaid phenomena occur
simultaneously.
~ 16. Fevers may terminate in three different ways.
These terminations are, (a,) recovery; (b,) passage
into another disease; (c,) death. The fever terminates
in health when it runs through its course regularly,
when the critical changes occur regularly, are duly appreciated by the physician, and are not disturbed by
external pernicious influences; when the constitution
of the patient has not been weakened by other causes
and the more important organs have not been disturbed. We frequently notice the fact, that patients
who recover from a fever, feel better after the fever
than they did before. The fever passes into another
disease when the favourable conditions which have
been mentioned in the preceding paragraphs, do not
occur. Either the whole character or only the external form of the disease is changed; or else the disease
invades a totally different part of the organism (metastasis), or it assumes a new form by metaschematismus.  Death is to be prognosticated when the
functions of a noble organ have been disturbed, in
consequence of inflammatory affections, disorganizations (a cure is frequently effected under those circumstances, by homoeopathic treatment), suppuration,
gangrene, or in consequence of a complete prostration
of strength, and consequent cessation of the organic
functions.
~ 17. It would be a foolish undertaking to indicate



102


FEVER.


a general method of treating fevers according to homeopathic principles; it would be a useless filling up
of space, inasmuch as no physician would venture to
prescribe a single remedy without having carefully
examined the group of symptoms to which the remedy
is required to correspond. It is almost superfluous to
remark that a cure according to homoeopathic principles cannot be effected unless the pathogenetic effects
of the remedial agent are entirely similar to the perceptible phenomena of the disease. Ebermaier says,
in his Clinical Pocket-Manual: "Those physicians
have been most successful in the treatment of fever
who have employed the simplest methods of cure, no
matter how frequently the epidemic diseases, the
habitual morbid influence of a region, and the methods
of treatment may have changed." Is there a simpler
and at the same time more natural method of cure
than homoeopathy, which accomplishes so much with
simple means specifically adapted to each single case.
An important object in the treatment of fever is a
suitable diet, which we mention here generally, and to
which we shall refer in our chapters on the special
treatment of fever. The physician will have to exercise his own discretion in adapting it to the wants of
the patient in every single case. Fever patients generally use but few things, but every thing which the
patient ought to do and not to do, requires to be carefully stated.* The first thing which the physician has
to attend to, is the patient's habits; these have to be
duly considered in prescribing a diet for the patient.
The patient ought not to be removed from a bed to
which he is accustomed, nor ought he to be transported
into a different bedchamber; if he has been accustomed
to quiet, let quiet be preserved; if he has lived amidst
noise and prefers it, let him continue the enjoyment of
it; if the patient has favourite drinks, such as brandy,
wine, coffee, etc., the physician has to consider the age
of the patient, and the length of time during which
those beverages have been his favourite and habitual
* See Dietetic Rules for the Sick, etc., by Dr. F. Hartmann, Dresden and
Leipsic.



FEVER.


patient; if the eyes be very much inflamed and sensitive to the light, or if the light increase the irritation of the brain, the room ought to be kept
dark.
Inasmuch as the doors of the sick-room require to b&
closed in order to prevent currents of air, it is important that the air should be occasionally renewed by
opening the windows or by some other mode of artificial ventilation. This renewal of the air requires to
be repeated in proportion as the room is lower and
smaller.
~ 18. The nourishment which we permit our patient,
likewise depends upon the nature of the fever. The
fever patient having generally no appetite for any
solid food, we need not apprehend that he will aggravate his sufferings by an error in diet; nevertheless
it is important that whatever nourishment the patient
does take, should be carefully selected. If he should
express an irresistible desire for one or the other kind
of nourishment, the demands of nature must be carefully observed, and the patient must neither be flatly
refused what he desires to have, nor ought he to be
persuaded to take more of it than he wants. The
fever patient generally desires such kinds of food or
beverage as will palliate his sufferings; the substances
which the patient desires, are not so much medicinal
as necessary to satisfy a want. If the cure of the disease should be retarded by the moderate enjoyment
of those things the damage will be easily repaired or
even outweighed by the new energy imparted to the
vital forces by the homoeopathic remedial agent, and
by the refreshing delight and invigoration which the
patient experiences from enjoying the desired food or
beverage.The fever patient eats only when he is hungry, and
no more than is necessary to satisfy his appetite. The
general rule, however, is, that the patient ought to eat
little and only light food.  The patient will not
frequently desire warm food; if he should desire any,


* See Organon, ~ 265 and 266.



FEVER.


105


he may take a little warm panado, or a light broth
with grits, barley, rice, sago, salep, oatmeal, oatmealcake. If the fever be not very violent, the broth may
be a little stronger, and the patient may even be permitted a dish of light meat, venison, poultry, which is
not too young, a piece of delicate beef, in company with
either of the above vegetables. In proportion as the
fever decreases, and the appetite of the patient returns, he may be allowed green vegetables, such as:
cabbage of various kinds, savoy, cauliflower,, peas,
carrots, green beans, soft-boiled eggs, and the abovementioned dishes of rice, barley, etc., with the yolk of
an egg, may likewise be allowed.
The best kind of food in every stage of the fever is
undoubtedly fruit. Among the apples, Spitzenberg,
pippins, and love-apples, are undoubtedly the best for
the patient, especially when prepared as a marmalade;
he may likewise eat pears, prunes, either fresh or
dried, stewed and preserved without spices; sweet
cherries, grapes, strawberries, peaches, apricots,
oranges, figs, melons, pineapple. Of course all those
various kinds of fruit ought to be enjoyed with moderation, lest the saccharine matter which they contain
should accumulate in too large a quantity and give
rise to flatulence, which might become very troublesome and increase the fever. In erethic fevers, with
disposition to diarrhoea, the physician will have to be
very cautious in recommending the use of fruit; in
many cases that use will have to be interdicted
entirely.*
~ 19. The beverage of fever patients who frequently
suffer with burning thirst, deserves particular consideration. It is inexpedient to give the patient no other
but warm drinks, for these do not always quench his
thirst. But it would be just as improper to give the
patient iced water or other icy-cold drinks; a medium
temperature is the best; let the drinks which the
patient takes be cool, but neither warm nor icy cold.
* Raw fruit of any kind is hurtful in most cases offever, and ought never to be
allowed. I have seen violent relapses into bilious and intermittent feveroccur
in consequence of the patient having eaten a piece of raw apple.--~HEiP;r.
5*



106


FEVER.


The reviewer of the first edition of this work disapproves of water which has not been drawn fresh from
the well; he thinks that fresh water is the best beverage for the patient, and will refresh him most, provided it is given by the spoonful. Fever patients
sometimes will require more than a spoonful of a
drink, in which case the icy-cold water would not be a
suitable drink. The water which the patient drinks
in the winter-season ought to have been standing in a
warm room for several hours. If the physician' were
to permit his patient the unlimited use of icy-cold
water, and the patient should die, this sad result might
be attributed to the use of that liquid, whereas the
use of moderately cool water will not be hurtful to
the patient, if the homoeopathic remedy have been
otherwise well selected. The use of icy-cold water,
which is insisted upon by cholera patients, is in their
case an exception to the rule, which cannot be made a
law for all fever patients. It cannot be decided beforehand when and how much the patient is to drink;
this depends upon the violence of the fever and upon
the wants and desires of the patient; it would evidently be cruel to let the patient suffer thirst. If the
patient be deprived of his senses, and the dryness of
the lips and tongue and the frequent licking indicate
an intense thirst, the attendants ought frequently to
offer the patient drink. When the patient is thus
panting after a little refreshment, he may occasionally
be given a teaspoonful of a mixture of orgeat and the
juice of cherries, mulberries, or sweet oranges. This
compound is extremely refreshing, and does not injure
the effects of the medicine. It is proper never to
allow the patient too much drink at once, but little at
a time and frequently.
The best drink is pure spring water. This is the
best drink to quench the thirst. If the patient should
get tired of the pure water, it may be boiled (which
ought especially to be done if the water cannot be had
pure), after which it is to be cooled again, and a slice
of toasted bread or rusk to be soaked in it; or the water
may be boiled together with the toast, and afterwards



FEVER.


107


filtered through a piece of linen. This liquid may be
sweetened with sugar, raspberry, cherry, althea, mulberry, or apple-juice; the yolk of an egg may be
added, or a refreshing lemonade may be prepared out
of it by dropping a few drops of the juice of an orange
or that of fresh grapes into the liquid. Whether
lemonade made of lemon-juice can be allowed depends upon circumstances, and has to be left to
the decision of the physician. Decoctions of dried
apples, cherries, and prunes, are likewise pleasant and
allowable.
Th6 next drink, after water, is boiled milk, which
cannot be used, however, in all kinds of erethic fever,
without injuring the patient. The same observation
applies to buttermilk, which, although generally
pleasant and useful, yet has to be used with great
caution in gastric and pituitous fevers. The patient
may likewise use the so-called white German ale.*
Oatmeal gruel, rice, and barley-water, and other
slimy decoctions of a similar kind, are likewise very
agreeable; also decoctions of both fresh and dried
fruit, orgeat made of sweet almonds; malt-drink, prepared by pouring over three or four tablespoonfuls of
malt a quart or three pints of boiling water; and various other decoctions.
Moreover, the patient may use broth, a light warm
beer without spices, an infusion of roast and ground
cocao, chocolate without spice, and an infusion of
althea, with or without a little liquorice.
~ 20. Mental and physical quiet is an important
requisite for the successful treatment of fever. The
patient has to be on his guard against vehemence, or
against emotions of any kind, on which account it is
advisable that no one but the necessary attendants
should have access to the sick-chamber. Hope and
confidence are the only emotions which exercise a
soothing influence on fever patients.
~ 21. Quiet sleep being very desirable to the fever
* This is beer made of pure malt, which has fermented in the open air;
"it is a mild and pure beverage, and does not affect the brain. The patient
may use it diluted.-HEAMPEL.



SYNOCHAL FEVER.


patient, all unnecessary attendance in the sick-room
ought to be avoided, nor ought the frequent closing
and opening of the doors to be tolerated. The patient
ought to rest upon a mattress, and be covered with a
light quilt.*
~ 22. Cleanliness and proper clothing deserve great
attention in fevers. However much the bulk of men
may be prejudiced against washing the hands and
face of a fever patient with tepid water, this is no
reason why the homceopathic physician should conform to that prejudice. After being washed with
tepid water the patient feels invigorated and refreshed.
If the exhalation from the skin be very considerable, it
is even necessary that the whole body should be
washed with tepid water every three or four days,
observing the precaution, however, to dry the body
immediately. The cure is promoted by a frequent
change of linen; if the patient perspire a good deal,
his linen ought to be changed several times a-day,
always observing the usual precaution. The patient
ought never to have on too much covering, lest an
unnecessary perspiration should be induced. In order
that the patient may not be obliged to have his breast
constantly covered with the bed-cover, and may be
allowed to keep his arms upon the cover, he ought to
wear a vest over his night-shirt, which is to be made
of cotton in summer, and of wool in the winter.
SPECIAL PATHOLOGY OF FEVERS.
FIRST CLASS.
FEVERS AFFECTING PRINCIPALLY THE CIRCULATORY
APPARATUS.
~ 23. Synochal or sinple inflammatory fever.
A better knowledge of human diseases and an almost boundless experience have convinced modern
physicians that a pure synochal fever either does not
* The Germans are in the habit of using feather-beds as a covering, which
ought not to be tolerated in the sick-room, except when the patient complaus of excessive cold, in which case a very light feather-bed may be used.



SYNOCHAL FEVER.


109


exist, or at any rate that it does not exist long without
affecting a special organ, and that it occurs especially
as an accompanying symptom of inflammation. Not
being an idiopathic disease, it is not subject to any fixed
therapeutic rules. We have long meditated on the
subject whether a pure synochal fever ought to be mentioned in a work on pathology. In treating of the
special diseases we found ourselves frequently obliged
to repeat certain general remarks, and we therefore
concluded to devote a few pages to the pathology and
treatment of that class of fevers, in order to be able to
refer to that chapter whenever occasion should require.
The synochal fever occurs not only as an accompanying symptom of inflammatory diseases, but also in
young, vigorous, plethoric subjects, after wounds,
burns, etc., in the shape of a febris irritativa, and as
such requires the attention of the physician. The
simple, benign, acute, ephemeral fever requires no
medical treatment, except when the fever assumes a
different form in consequence of the reaction of the
organism having been interrupted by the indiscreet
conduct of the patient. Another fever arising from
an irritation of the organism, is the fever of dentition,
which is more closely related to a synochal fever
than is any other kind of fever.
According to Schcenlein the synochal fever is of the
species of phlogosis; he places it under the head of
arteritis and phlebitis. Our opinion is that Schcenlein's view is confirmed only in a few cases, and that
the synochal fever is scarcely ever sufficiently developed to deserve the appellation of either arteritis
or phlebitis.
All the symptoms of an inflammatory fever show
that the irritable sphere is principally affected, the
heart and the blood vessels are irritated, their power
being apparently increased, and the temperature of
the body being considerably elevated. The nervous
system and the digestion are less affected, hence it is
that the sensations of the patients are correct, definite
and clear, and that he is fully conscious of his complaints and feels his sufferings intensely. When the'



SYNOCHAL FEVER.


cerebral irritation is considerable from the very commencement and the delirium is more continuous, thereis ground for apprehending a typhoid fever.
The fever commences with a violent chill, followed
by continual heat, the pulse is hard, full, accelerated,
not easily compressible, the tongue is dry, slightly
coated, and the skin is dry; the dulness and heaviness of the head, which exist in the commencement of
the paroxysm, soon pass into an aching and pulsating
pain, especially in the forehead; the face becomes
red,- hot, the eyes shining, and, in sensitive subjects,
the erethism increases even to spasms and delirium.
The breathing is hurried, anxious, the breath hot and
dry; the arteries throb, the secretion of urine is diminished and the urine itself is red and fiery; the
thirst is excessive. The restlessness and anxiety increase, alternating with interrupted slumber and stupor. The appetite disappears, but the heat and dryness of the mouth occasion an increasing desire for
cold water. Perspiration affords relief, but the skin
is generally dry and hot. The symptoms are worse
in the evening; their violence begins to abate after
midnight, and is least in the morning.
A general inflammatory fever seldom exists without some local inflammation, especially when there is
a congestion of blood to a special organ in the commencement of the disease, in which case the pulse is
contracted, small, but hard. These fevers are frequently accompanied by bleedings, especially from the
nose, which, however, afford a good deal of relief.
Synochal fevers seldom last long unless they have
become complicated by the supervention of some
other affection, or have passed into a different form of
fever; they frequently terminate after a short duration by a critical sweat, and a turbid urine depositing
a sediment.
~ 24. The prognosis of an inflammatory fever is favourable. Such a fever is never fatal of itself. It
may become so, however, by passing into another disease or by terminating in exhaustion, which is the
case when the fever becomes complicated with in



SYNOCHAL FEVER.


111


flammation of a noble organ, of the veins or arteries,
6r when a typhoid condition supervenes. In giving a
prognosis the physician has to consider the peculiar
character of the disease in the case of his patient,
and the individuality of the latter.
Among the exciting causes we may notice the following: the tendency to epidemic diseases and the
peculiar character which diseases are disposed to assume, more particularly in spring and winter when
north-westerly winds prevail; the excessive use of
stimulating and heating food, producing a corresponding excess of animal life; suppression of the activity
of the skin and of other secretions, echauffement, violent exercise, abuse of spirituous drinks, contagia,
wounds, burns, dry and cold air, not to forget violent
emotions, such as fright, fear, chagrin, anger; or the
violent irritation which children suffer during the period of dentition.
~ 25. In treating these fevers we have, in the first
place, to consider their character and course. At the
commencement of the fever, it is not very difficult to
select a remedy. The business of the physician is to
allay the fever before the local inflammation has
developed itself. There is no better remedy to allay
the fever than Aconite. The physician is scarcely
ever sent for during the chill, as it is supposed that
this chill, which sets in suddenly and without any precursory symptoms, is a merely transitory symptom the
end of which ought to be awaited first before sending
for a physician. If the physician were sent for during
the chill, it would not be advisable that he should
administer a remedy before the second stage has made
its appearance; for in that stage it is much easier to
select a remedy, inasmuch as the symptoms of the
case have become more numerous and more characteristic. In general it is not advisable to exhibit the
homoeopathic remedy during tI chill, as we have
abundant evidence of the fact that, by so doing, the
disease is considerably increased.
The essential sphere for the action of Aconite are
the erethic fevers, the inflammatory erethisms of the



11              SYNOCHAL FEVER.
vascular system, and the first stage of catarrhal,
rheumatic, and traumatic inflammations; hence that
sphere extends from the simple ephemeral erethisms
up to the synocha, and from the simple catarrhal
and rheumatic fever up to the most intense phlogosis, without any marked local affection. Aconite
is a true universal remedy, our most charming antiphlogistic, superior to venesection, leeches, and
cupping it cures without depletion, and in a much
shorter time than those violent means which weaken
the organism and reduce its vital energy. Any one
who is acquainted with the physiological effects and
the true character of Aconite, must certainly know
from experience that Aconite can only do good in the
sphere of action which we have assigned to it, provided the dose is proportionate to the susceptibility of
the patient's organism and the intensity of the disease.
Aconite is a specific remedy in inflammatory fevers
with congestion to the chest or head, the pain which
the patients suffer, appears intolerable to them, they
are exceedingly nervous and restless; this is especially
the case with young, lively, plethoric subjects leading
a sedentary life. Aconite is especially useful in fevers
which are occasioned by raw north-westers or by a
current of air, and which are characterized by the
following symptoms: great general heat, especially
about the head and face; vivid redness of the cheeks,
great thirst, stinging, beating headache and excessive
painfulness of the whole head, vertigo and nightly
delirium, restlessness, moaning, anxiety, tossing about
in consequence of the limbs feeling bruised and paralyzed; alternation of chilliness and dry, burning heat,
with shortness of breath and dry, hacking cough; intolerance of noise, ill humour, despondency even unto
weeping; glistening eyes, roaring in the ears, great
irritation of all the senses; dryness of the lips, mouth
and tongue; hasty *ed tremulous speech, burning unquenchable thirst, bitter taste with empty eructations
and with a qualmish feeling in the pit of the stomach;
scanty secretion of a highly-coloured, hot urine.
The dose should be adapted to the age and constitu



SYNOCHAL FEVER.


113


tion of the patient. In the commencement of the disease, and in young and delicate patients, the higher
attenuations  are  sufficient; full-grown, vigorous
patients, and the later periods of the fever, require
stronger doses, sometirhes even a drop of a lower attenuation. This kind of fever generally resolves itself into a sweat, which is extremely salutary and
beneficient in those affections, and is so much more
decisive as its appearance has been speedily induced
by the homceopathic agent. It is highly improper to
elicit the sweat by artificial heat, whether externally
or internally applied. The best means to cause the
sweat to break out is a suitable dose of Aconite, which
may be repeated at proper intervals and whose action
may be assisted by giving the patient as much cold
water as he desires. If the sweat breaks out, and the
urine becomes more watery, the fever is broken and no
farther medication is required.
If the synochal fever be merely an accompanying
symptom of a local affection, our first duty is to moderate the fever, unless we know a remedy which covers
both the fever and the local affection. Even in most
of these cases, Aconite is the principal remedy, corresponding both to internal inflammations and to inflammatory cutaneous diseases. We refer the reader
to the second division of the first volume, where both
classes of diseases are treated in detail.
There are several other remedies, besides Aconite,
which may be used for the cure of synochal fever, but
they are much less important than Aconite, and can
only be employed when the fever assumes a particular
form from the commencement, when it is not very violent, when the orgasm is confined to certain regions,
and when secondary symptoms occur. The principal
remedies, next to Aconite, are: Bell., Bryon., Mercur.,
Canthar., Cham., Arnica; other remedies which have
been placed in the same category with the preceding,
do not properly belong here, as they are given in diseases where the fever is merely a sympathetic affection.
Belladonna is th principal remedy, and ought to be



SYNOCHAL FEVER.


given after Aconite, in cases where the cerebral system is principally affected, and the following symptoms
occur: burning heat, especially of the head and face,
the latter being red and puffed; strong, quick, full
pulse, violent burning thirst, intense delirium, especially at night, vertigo and aching in the forehead as
if it would burst; red, shining eyes, anxiety and restlessness, and tendency to start.
Bryonia is indicated when the orgasm of the blood
is principally confined to the organs of the chest, accompanied with great erethism of the vascular and
nervous system; burning, dry heat mingled with chills,
violent thirst, headache as if the whole contents of the
head would issue through the forehead, anxious sleep,
disturbed with moans, short cough and oppression of
the chest. In a synochal fever of that sort gastric
symptoms frequently supervene and change the synocha to a synochus; for many complications of that
kind Bryonia is likewise the specific.
Mercurius acts similarly to Bryonia, with this difference, that it is not so much indicated by local symptoms as Bryonia, and it is principally required in inflammatory fevers characterized by erethism of the
nervous system, a disposition to profuse sweat, an
accelerated, irregular pulse, and excessive thirst with
desire for icy-cold water.  These symptoms are
accompanied by dulness of head, and a pressure in the
parietal regions from within outwards, undulations and
beatings in the sinciput. The supervening gastricbilious symptoms likewise indicate a complication or
rather the transition of the pure synochal into a gastric
fever, for which Mercurius is likewise a specific.
Cantharides are indicated in violent burning fever,
especially at night, with accelerated, strong pulse,
general redness of the skin, violent thirst and dryness
of the mouth, accompanied by painful sensations in the
right side of the body, great anxiety, delirious talk about
business, etc.*
Neither Cantharides nor Chamomilla can be said to
* Especially when there is a frequent desire to urinate.-HEMPEL.



FEVER OF DENTITION.


115


be indicated in pure inflammatory fevers; the fevers
for which those remedies are indicated consist rather
of attacks of heat having the character of a synochal
fever; the fevers indicating Chamomilla are characterized by heat mingled with occasional chills, by
bright redness of the cheeks, tremulous and anxious
palpitation of the heart, great irritability of temper and
excessive sensibility of all the senses, etc. Chamomilla corresponds especially to those fevers which have
been occasioned by anger anti chagrin (giving first,
however, a few doses of Aconite), and are generally
accompanied by spasmodic symptoms.
Arnica corresponds only to such inflammatory fevers
as have been occasioned by contusions, tearing of
muscles, and wounds of any kind; the violence of
the orgasm requires in the first place to be moderated
by Aconite.    If the injuries are very considerable,
dilute tincture of Arnica may be used externally, in the
shape of a wash or a poultice.
~ 26. Fever of dentition.
The cutting of teeth is no disease of itself, but a
natural occurrence in the period of evolution. It is a
stage in the physical development which marks at the
same time the commencement of the intellectual life
of the child. At that period the child begins to utter
articulated sounds and to exhibit signs of rationality.#
Life, in this period, is liable'to the same dangers as in
the other periods of development. If the irritation
produced by the cutting of teeth be very violent, which
will generally be the case when several teeth are cut
together, a febrile condition is induced resembling so
closely a synochal fever that we deem it expedient to
speak of it as belonging to that class of diseases. In
order not to scatter the various ailments occurring
during the period of dentition, through separate parts
of this work, we shall describe them all in this chapter.
" The great French philosopher, Charles Fourier, author of the Doctrine
of the Universal Association of Capital, Labour and Talent, says, in his great
work on that subject, that the period of dentition is the time when the soul
truly conjoins itself to the body; previous to that time the organism merely
vegetates and exists from the same general vital principle that sustains the
life of the planet.



FEVER OF DENTITION.


Not all the morbid phenomena occurring during the
period of dentition, are directly occasioned by the rupture of the gums; these phenomena as well as the
teething itself are developments which belong to one
another, and are characteristic signs of a new period
of life upon which the child has entered; the child's
individuality becomes more marked and the child is
less dependant on the mother. Upon reviewing the
whole life of man we will find that every new period of
life is characterized by'striking bodily phenomena, in
which not only the nervous system but also the mind
is interested more or less, in such a manner, however,
that neither the physical nor the mental phenomena
can be said to be either essential or accidental, primary or secondary.
The same remark applies to the cutting of teeth
and to the phenomena accompanying that process.
These phenomena are at times of a nervous, at times
of a febrile nature, sometimes they are mixed. But
whether nervous or febrile, they, as well as all other
infantile diseases, are easily recognised by the parents
or the physician, and the symptoms are generally so
well marked that it is much easier to select a specific
remedy for the diseases of children than for those of
full-grown persons, which may partly be owing to the
children's mode of life being much more simple than
that of full-grown persons.
The phenomena of teething occur in the period
from the fifth to the fifteenth or sixteenth month.
The border of the jaw which requires to be pierced,
gradually enlarges and becomes indented as it were,
the child's mouth fills with water, the hand is frequently and quickly carried into the mouth, or hard substances are pushed into it to bite them, the mouth is
hot, the child does not like the inner mouth to be
touched, utters frequent and sudden cries as if in distress; the gums are swollen, whitish, especially so
along the edges, as if a tooth were shining through,
they become hot and painful. These symptoms are
most frequently accompanied by diarrhcea, which, however, is a natural derivative means, and the best pre



FEVER OF DENTITION.


is most easily subdued by a few doses of Coffea cruda,
This remedy may however remain without any effect
if the mother or the child should have been in the
habit of using coffee as their daily beverage. In such
a case Aconite and afterwards Chamomilla would deserve the preference. A flow of saliva, loose stool or
diarrhoea, which generally accompany the cutting of
teeth, do not require any treatment; those symptoms
disappear as soon as the cutting is accomlplished.
Children in whom the irritation consequent upon
dentition, continues for a long time, and who lose
strength or flesh in consequence of it, are relieved by
a few doses of Calc. carb., which ought to be given at
tolerably long intervals; this remedy is generally sufficient to remove all the troublesome symptoms accompanying teething without any other remedy being
required afterwards.
Teething is sometimes accompanied with a febrile
condition, appearing and disappearing at intervals,
and constituting a sort of synochal fever, the paroxysms
of which recur every day. This is the real fever of
dentition, and deserves especial consideration when it
occurs in plethoric, fleshy children, in whom it inclines to become a local affection. This fever is
treated as every other affection, except that the successful treatment of that fever requires the utmost regard to the irritability etc. of the patient, which is
uncommonly increased at that period of life. All the
diseases which occur during the period of dentition, as
well as the morbid phenomena accompanying dentition,
require the utmost care on the part of the practitioner.
All that the physician can do is to subdue the irritation of the various systems, and the disease is thus
frequently cut short in the most striking manner.
Aconite is the best remedy, by means of which that
irritation is accomplished. In general, this remedy is
of great importance in the diseases of infancy, where
the least vascular erethism is easily increased to a
synochal fever, on account of the greater activity prevailing in the vascular system previous to the development of the organs being accomplished. No remedy



122


FEVER OF DENTITIOTC.


toms: extension and rigor of the whole body, occasionally interrupted by spasmodic jerks through the
arms; constant spasmodic motion of the facial muscles,
in which the lips and eyelids are involved.
We have to mention one other remedy which is
frequently indicated against epilepsy, especially when
the fit was occasioned by fright, and consecutive fear.
The Opium fits-for that is the remedy-commence
with a convulsive, spasmodic trembling of the limbs,
which is interrupted only by jerks of the body and
twitchings of the limbs, accompanied with a croaking
scream, and giving way, after a while, to a soporous
state, during which the child snores with an open
mouth, and from which the patient cannot be roused.
The Opium fits only appear at night; this is characteristic.
Besides the above-mentioned remedies, the following
remedies may be used for epilepsy, which will be
described in detail when we come to treat of that disease: Cina, Rhus, Arsenic, Cuprum, Calc. carb.,
Causticum, Arnica, Hyosciam., Stram., Cicuta, Secale
c.. Stannum, Zincum, and others.
There is another kind of epilepsy to which those
children are liable who are nursed by females addicted to the use of spirituous drinks. That kind. of
epilepsy likewise occurs during the period of dentition.
It yields to a few doses of Nux, provided the nurse
abstains from the use of spirits, or, if this should be
impossible to her, weans the child. That kind of
epilepsy is perhaps more dangerous than any other,
because the organism of the child is entirely ruined by
the vicious habits of the nurse. Nevertheless, the
physician is bound to attempt a cure, and, if Nux
should be of no avail, he may try Arsenic. It would
seem as if a delicate creature like woman could not
be guilty of such conduct, were she even born in the
meanest hovel. We thought so until we were convinced of the contrary by actual facts. Not malice,
however, and rarely habit or the love of vice, induces
the misconduct which we here censure; the liquor is



CATARRHAL FEVER.;


123


generally drank for the purpose of procuring the child
rest and sleep; it is the success in accomplishing this
which leads to the vicious habit.
Children who are brought up without the breast are
liable to another kind of epileptic fit. This is generally
induced by overloading and deranging the stomach.
If the precursory symptoms are: inclination to vomit,
retching, the vomiting ought to be brought on by
tickling the velum pendulum palati and the fauces,
after which the patient ought to be given a few teaspoonfuls of black coffee, followed by Ipec., Puls.,
Bryon., Nux, or any other suitable remedy.
SECOND CLASS.
FEVERS, AFFECTING PRINCIPALLY THE MUCOUS MEMBRANES.
~ 29. Catarrhal fever.
An intense irritation of a greater or lesser portion
of the mucous membranes induces a febrile state.
The symptoms of that febrile condition are those of a
catarrhal fever which may be principally seated in
the mucous membranes of'the respiratory and reproductive, or else in the genital and uropoitic system.
Generally speaking, we understand by catarrhal fever
an affection of the respiratory organs. It is a sort of
synochus of the lighter kind, continuous and remitting,
and commencing towards evening with a slight chill,
rather resembling a creeping over the bones, accompanied by a soft pulse which is not very much accelerated, thirst, restlessness, and sometimes great lassitude. In company with this fever the mucous membrane of the throat, chest, nasal, maxillary and frontal
cavities appears more or less inflamed. At first the
mucous membrane thus irritated does not secrete any
fluid, or only a watery, acrid humour, which is afterwards transformed into a viscid, thick, slimy substance; the tongue, at the same time, exhibits a white
coating, the smell is gone, the taste altered, the digestion is disturbed, the urine is red, turbid, generally depositing a profuse, slimy sediment, and a dull aching



CATARRHAL FEVER.


pain is experienced in the head, especially in the frontal cavities.
The irritation sometimes extends over themucous
membranes of neighbouring organs, or even of the
whole organism, occasioning a variety of unpleasant
and painful sensations, and increasing the intensity of
the fever. The conjunctiva is red and turgid, the eye
is either dry or secretes an abundance of tears, and is
very sensitive to the light. The affection of the mucous membrane lining the nasal cavities is characterized by creeping and frequent sneezing, and by an
aching pain over the eyes (coryza). Sometimes the
affection extends to the larynx and trachea, causing
an alteration of the voice, roughness and hoarseness;
the affection of the tracheal mucous membrane shows
itself by the oppressive breathing and the dry cough.
~ 30. A catarrhal fever may be caused by a sudden
suppression of the perspiration by a current of air, by
a sudden change of temperature, or by a dry, sharp
and cold air. Most of those fevers which depend
upon a contagious miasm, generally commence with
a catarrhal fever; catarrhal fevers may be occasioned
by contagia, and occur principally at times when the
measles and whooping-cough are prevalent among
children; they may likewise occur in consequence of
the respiratory organs having been irritated by violent
inspirations during physical exertions, such as dancing,
screaming, singing, running; and lastly, they may be
caused by the inhalation of acrid vapours, especially
in individuals who are very sensitive to external atmospheric influences, and had been frequently affected
with catarrh before.
~ 31. In simple catarrhal fevers the prognosis is favourable. They are frequently cured spontaneously
by an increase of perspiration and the discharge of a
turbid, clayish-looking urine; the local affection, however, lasts somewhat longer and disappears only
gradually through the secretion of a profuse, thick,
yellow, inoffensive mucus. The secretion of that
mucus is to be considered a favourable crisis. A catarrhal fever is least dangerous when the inflamma



CATARRHAL FEVER.


125


tion affects the nasal mucous membrane only; the
prognosis is more doubtful when the mucous membrane* of the lungs and larynx is involved; in that
case there is danger of the local affection increasing
to an inflammation of those organs, or of disorganizati6ns being induced by careless treatment. A violent
catarrhal fever is to be treated as a pure synochal
fever; the local irritation increases of course in proportion to the intensity of the fever. A catarrhal synocha is a continuous fever, characterized by great
heat, restlessness, thirst, and a full, tight, hard pulse,
without any mucous discharge.
~ 32. Slight catarrhal fevers get well of themselves
in a few days with good care, leaving at most only a
mild fluent coryza. None but very sensitive patients
send for a physician in such cases. Some cases of catarrhal fever are so mild that individuals of a robust
constitution are not even obliged to be confined to
their rooms, but are able to attend to their business as
usual. Such patients have been known to get well
by taking a glass of grog or punch in the evening;
this would excite perspiration in the night, which was
kept up next morning by remaining in bed a little
longer than usual, and was found sufficient to restore
the equilibrium of the functions. A glass of grog is
no homceopathic remedy, of course; we allude to it
merely as a palliative means which has been successfully used in a great many cases of mild catarrhal
fever.
The danger increases if the local irritation and consequently the fever be more intense and the mucous
discharge more difficult. In such cases the local irritation requires our principal attention in selecting a
remedy; -whereas the febrile symptoms are the most
important if the local irfirftion have an inflammatory
character. The homceopathic physician should be on
his guard in this, as in every case, against being
carried away by one or two symptoms instead of carefully observing the whole group. This kind of routine
or symptomatical treatment, which is justly condemned even by the old school, is unfortunately practised



CATARRHAL FEVER.


by more than one among our ranks; but it is a mischievous mode of treatment, and accomplishes in a
round-about way, by a variety of remedies, what one
single remedy would have done if selected in accordance with the whole group of symptoms. All good
homceopathic physicians will agree with us that the
symptomatic method would be the grave of homceopathy, and will not blame us for not giving a detailed
description of the treatment which ought to be pursued in every little variety of a disease; we shall furnish general indications for the selection of the proper
remedy in every case.
One of the principal remedies against catarrhal
fevers is Aconite, especially when they are occasioned
by a cold, by dry and cold weather, north-westerly
winds or by a current of air, and when the following
symptoms occur: Creeping chills with burning skin,
hot forehead, great thirst, especially in the evening, accompanied with a sensation of dryness and scraping,
slight burning and soreness in the throat, especially
in the region of the larynx, or extending even through
the whole chest, inducing continual turns of a short,
dry cough, which is rather rough and hollow in the
night, and interrupts the sleep; this is moreover disturbed by vivid fancies, especially after midnight.
Another remedy, which is frequently indicated, is
Nux vomica; it corresponds to the following symptoms:
inclination to chilliness, erratic shiverings, as if passing
over the bones, now in one, now in another part of the
organism, mostly during motion, alternating with
flushes of heat, coming on in the afternoon and increasing progressively. These ailments are relieved by
remaining quiet, near a warm stove. They are sometimes accompanied with a scraping sensation in the,
pharynx, which is particulary experienced in the morning hours, and induces a roughness of speech obliging
the patient to hawk frequently or to cough. One
of the characteristic symptoms of Nux is the titillation
which is caused by the scraping sensation below the
larynx; the scanty expectora'ion of tenacious mucus,
the light scraping cough in daytime, less in the night,



CATARRHAL FEVER.


127


and more frequently in the morning hours, are likewise characteristic of Nux. - Nux is likewise the principal remedy when the dry, wearing cough is accompanied with a painful feeling as if bruised in the
umbilical region, which is moreover sensitive to
pressure.
Conium maculatum, middle attenuations, is the best
remedy for fevers characterized by the following symptoms: internal dry heat with much thirst, great lassitude, scraping, itching, and creeping in the throat,
inducing an almost uninterrupted dry cough with titillation. The urine is whitish and turbid, the sleep
unrefreshing, disturbed by many anxious dreams; the
patient dreads every little noise or talking on account
of the sensitiveness of the head, which is either excited
or aggravated by it.
Dulcamara corresponds to catarrhal fevers which
have been evidently caused by a cold, by a sudden suppression of the perspiration, and are characterized by
roughness and hoarseness of the throat, cough with
mucous expectoration, violent fluent coryza, great
heat, dryness and burning heat of the skin. In many
cases of epidemic catarrhal fever Dulcamara is likewise indicated by a dry, rough cough.
Drosera is one of the best remedies in catarrhal
fevers, when the patient is attacked with a sensation
as if all his limbs were bruised and paralyzed, and
when the usual catarrhal symptoms are accompanied
with frequent shudderings over the whole body, cold
hands, and hot countenance. The catarrhal symptoms
indicate Drosera when the larynx is principally affected, when there is hoarseness, cough excited by a sensation of roughness and scraping in the fauces; sometimes the inmost parts of the chest are irritated.
Euphrasia is to be employed in catarrhal fevers,
when the chilliness is more frequent than the heat,
when the heat is merely an incidental symptom, and
when the following symptoms occur: inflammatory
irritation of the mucous membranes of the eyes,
lachrymation, photophobia, nightly agglutination, heat



CATARRHAL FEVR-o


in the head, and painful sensation as if the head were
bruised, sensation as if the skull would burst, frequent
fluent coryza, painfulness of the inner nose, sneezing,
violent cough with expectoration, especially in the
morning.
Similar symptoms indicate Mercurius sol.; it is no:t
always easy to decide which of the two remedies, Euphrasia or Mere., is preferable; a sensation of fulness
in the head, pulsations in the head reaching as low down
as the nose, general heat to which the chilliness is mere'ly incidental, indicate Merc. rather than Euphrasia.`
Mezereum     may be employed against the following
group of symptoms: violent fever consisting of alternate chills and heat, the chill being more violent out of
the bed, the heat more violent when the patient is in the
bed, great sensitiveness to cold air, acrid discharge from
the nose, cough arising from      a burning irritation in
the larynx and trachea, and difficulty of throwing off
the mucus.
Every observing practitioner is acquainted with the
go )d effects of Chamomilla in catarrhal fever, especially when the following symptoms prevail: synochus,
both the chilliness and heat being moderate; the chilliness consists of slight chills which are experienced
only in certain portions of the organism, generally in
those parts which the patient uncovers; hence, the
chills are frequently experienced when the patient lifts
the cover of his bed; sometimes the chilliness and heat
are mixed: while one portion of the body feels cold as ice,
the other is burning hot, the heat being principally felt
on the cheeks. The sleep is, of course, disturbed by
the febrile condition; starting from sleep as if in af* Such colds are very obstinate in this region of our country. When the
nose has not yet commenced running and feels swollen internally, Hahnemann advises Nux as a preventive. f the Mercurius be required, one dose
of Mere. 200, will be found to be sufficient in some cases; in others, however,
we have to use Mercurius 3, in powders, one every three hours. My rule
then is, to continue these powders until every vestige of the cold has disappeared, which sometimes requires 10,15, or even 20 powders in succession. To
speed the cure the patient ought to live as low as possible, on gruel, weak
tea, toast, etc., and avoid all stimulating dishes. The saying, " Feed a cold
and starve a fever," implies a vulgar and foolish practice.--HEPEL.



CATARRHAL FEVER.


129


fright, and shrieking while sleeping, are characteristic indications for Chamomilla, especially when those
symptoms occur during the period of dentition. The
catarrhal irritation is principally perceived in the mucous membranes of the respiratory organs, nose, and
frontal cavities-hence, the violent dry cough, especially at night, occasioned by a constant titillation in
the larynx, accompanied with hoarseness and rattling
of mucus in the trachea. When this cough, arising
from a titillation in the larynx, exists only in the night,
it is generally relieved by Hyosciamus. If it continue
night and day without change, Ignatia is the best
remedy.
Among the symptoms of Hepar sulphuriswe discover
a catarrhal fever, characterized by internal chilliness,
and ill humour, or heaviness in all the limbs. This
remedy is on a par, and constitutes a group, with Euphrasia and Nux; it is most frequently indicated when
the mucous membrane of the eyes is affected, when the
patient experiences a painful pressure in the eyes, when
the conjunctiva looks puffy and red, and the lids are
swollen. Hepar is likewise indicated when the respiratory organs are affected, the patient suffers with a moist
cough and rattling of mucus in the chest,when the cough
is accompanied with an intense pain in the larynx and.
roughness of voice, and when the patient complains of
weakness of the chest which scarcely allows him to
speak. The vascular and nervous systems are-but
moderately irritated.
Lachesis is said to cure a kind of catarrhal fever
characterized by heat, fulness of the head, drawing in
the teeth and facial bones, glistening eyes as when one
feels exhausted, irritable disposition, restlessness, malaise, some discharge from the nose. We have used
this remedy with success in a few cases, when, after
the slightest and scarcely perceptible cold, a violent
fluent coryza would set in with sneezing, confusion
of the head, great warmth in the internal parts of the
forehead, hot nose, and genleral disagreeable warmth
over the whole body, with great heat of the hands and
feet. In using Lachesis for those symptoms, we have
6*



CATARRHAL FEVER.


1,31


ward evening; the heat appears only by dint of
coughing, and then'becomes excessive and continues
all night, even after the cough abates.
Rhus is likewise useful in those fevers when the
titillation and cough are not felt in the larynx, but in
the bronchial ramifications, when the cough shortens
the breathing and is especially violent in the morning,
thereby preventing the patient from falling asleep
again. In general Rhus is indicated when the catarrhal affection extends over a large extent of the
bronchial ramifications. As regards the fever, this
remedy corresponds to Pulsatilla, except that the
evening exacerbation is characterized by a predominance of heat, drawing and stretching in the limbs,
and slight creeping chills.
Bryonia corresponds to catarrhal fevers accompanied by cough, which produces retching, and sometimes vomiting of the ingesta, with sensation as if the
chest would fly to pieces, and with profuse, violent
fluent coryza, and pain in the forehead which is relieved by pressure upon the forehead; the right side
of the body is colder than the left, and the patient
complains of great thirst.
Ammonium carbonicum should be resorted to in
catarrhal fevers characterized by hoarseness and profuse fluent coryza, especially when an acrid, burning
water flows from the nose; by morning cough with
titillation or retching, and with alternation of chilliness and heat. Causticum may be used when a sensation of soreness and excoriation is experienced in the
trachea (All. hom. Zeit. XXVI. 93).
Sepia is indicated in catarrhal fevers where the
chilliness is continual and occurs upon every movement in the warm room; the heat is merely incidental; the Sepia catarrhal fever is moreover characterized by a nightly spasmodic cough, which increases
even unto vomiting and suppression of breath; sneezing, violent fluent coryza, ulcerative pain in the occiput
and drawing in the hips and thighs are likewise
present.
Among the remedies which we have so far indicated



CATARRHAL FEVER.


133


chronic catarrhs, the last of them principally, when
the expectoration seemed loose and yet could not be
thrown off:-Tart. emet., Drosera, China, Dulcamara,
Stannum, Manganum, Carbo veg., Iodine, Bromine,
Amm. mur. According to Goullon, Lycopodium corresponds to those obstinate catarrhs where a lemoncoloured and frequently bitter phlegm is thrown off,
accompanied by a violent tearing beating pain in the
frontal cavities, with afternoon or evening exacerbations.
It is well known that catarrhal fevers frequently
unite with gastric or typhoid symptoms, inflammations,
and cutaneous eruptions; in such cases the remedy
has to be chosen in accordance with the symptoms of
that affection which are most marked.
~.33. Catarrhal Fever in Children.
We ought not to omit mentioning, on this occasion,
a catarrh or catarrhal fever of children which can only
be observed by the physician, but cannot be investigated by questioning the patient. The pathology and
treatment of this fever do not differ essentially from
the one above described. It is characterized by sneezing, running of the nose and eyes, cough, hoarseness,
and in small children rattling arising from the mucus,
which they have not strength enough to throw off.
Aconite, two or three doses a-day, is the principal
remedy when the following symptoms occur: burning
heat of the whole body, accelerated pulse and breathing, dry, short cough, the infant screaming sometimes
as if it would manifest pain. If the heat be less
marked, the cough loose with constant irritation in the
air-passages, and if rattling be present, we know of
no better remedy for those symptoms than Antimonial
wine, one, two, or three drops a-day; this remedy frequently removes the symptoms more rapidly than
Chamomilla, which is likewise indicated. In catarrhal
fevers, Euphrasia suits children frequently better than
full-grown persons, the profuse running from the nose
being frequently accompanied by a considerable redness of the whites of the eyes, lachrymation and slight



134


CATARRHAL FEVER.


agglutination. As regards other remedies, we refer to
those indicated for the catarrhal fever of full-grown
persons, reminding our readers particularly of Belladonna and Pulsatilla.
The dry coryza is still more troublesome than the
fluent; the former hindering the infant's taking the
breast and causing it to scream and to be restless. This
condition arises from the suppression, in consequence
of cold, of a fluent coryza, causing a disagreeable
dryness of the nose, which brings on the difficulty of
taking the breast. This affection frequently lasts a
long while, becomes worse in warmth, and decreases
in the open air, where the running from the nose is
generally restored. It befalls not only small, but even
larger children, inducing a habit of breathing with an
open mouth.
The trouble is frequently removed by rubbing the
dorsum of the nose with a greasy substance, such as
hen's grease, almond oil, or thick cream; or by causing
the vapour of warm milk to pass into the nose. Inasmuch as the trouble is chiefly owing to the nasal
mucus not being secreted in a sufficient quantity, it is
certainly a good plan to replace the natural mucus by
an oily substance, say almond oil, with which the inner
walls of the nose may be lined by means of a fine
feather.
If this palliative means should not be sufficient to
remove the trouble, an internal remedy will then have
to be resorted to, and will have to be selected in accordance with all the concomitant symptoms. A
small dose of Nux will prove the best, if the dry
coryza increase in the evening, accompanied by great
dryness of the mouth, whereas the fluent coryza prevails in the daytime. Other physicians pretend to
have removed the trouble by repeated doses of
Sambucus. In some cases, where the obstruction of
the nose was accompanied by a profuse discharge of
mucus, Chamomilla proved curative; Dulcamara is
the best remedy when the dry coryza increases in a
cool and decreases in a warm temperature. Carbo
veg. deserves consideration in obstinate cases, with



INFLUENZA.


135


evening exacerbation; Graphites, when great debility
and prostration prevail.
If the dry coryza set in while the children are still
at the breast, or if the mother be affected with it, the
latter may take the medicine alone.
~ 34. Influenza.
The influenza is not an indigenous disease with us
(in Germany); the grippe still less so; when the
cholera appeared amongst us, both affections frequently appeared in company with it, and have ever since
become stationary diseases, the grippe at least. Both
grippe and influenza are varieties of a catarrhal fever,
being subject to the same therapeutic rules as the
fever, and every other disease. For the benefit of beginning homoeopathic practitioners we here record our
experience of the treatment of those affections; what
we shall say is derived from the most careful observation.
The influenza, like every catarrhal fever of a certain
degree of violence, commences with striking debility
and drowsiness; subsequently shiverings and even
chilliness over the whole body make their appearance.
The usual catarrhal symptoms are: sensitiveness of
the eyes, lachrymation, pressure in the eyes, with
slight redness; aching pain in the forehead, fluent
coryza, in some cases dry coryza; short turns of dry
cough, which fatigues the chest, are not wanting;
they are accompanied with want of appetite, and a
white-coated but dry tongue; dryness of the throat,
and afterwards a dry, burning heat, with great thirst.
Many cases of influenza, especially those which are
characterized by constipation, are often relieved by a
dose of Nux in a few hours, provided the dose was
proportionate to the intensity of the disease and the
patient's individuality; sometimes, however, Arsenic is
more suitable, especially when debility, diarrhoea,
great thirst and a paralytic sensation in the limbs are
the prominent symptoms. Causticum has been found
very useful, which was followed a few hours after by
Camphor. Both those remedies were administered by



GRIPPE.


olfaction. Of the latter remedy Hahnemann remarks: *
"If the Siberian influenza attack one of us (in Germany),
and the heat have already set in, Camphor may be
used as a palliative, on account of the disease having
but a short run; it is an excellent palliative when administered in frequent and progressively increased
doses. Camphor does not shorten the course of the
disease, but diminishes its violence, and removes all
danger until its termination."
~ 35. Grippe.
Another species of catarrhal fever is the grippe,
which prevailed at the commencement of the year
1833.t The symptoms of grippe are much more varied
and complicated than those of influenza; and the
disease, when invading the organism suddenly, was
much more dangerous, and sometimes led to fatal results. If a patient, whose chest was affected, had an
attack of the grippe, consumption was generally the
result of that complication; in very few cases only it
was possible to save the patient's life. Generally, an
attack of the grippe came on suddenly-in a few cases
only the disease developed itself gradually; it was
distinguished from any other catarrhal disease by an
unusual lassitude, heaviness and a bruised feeling in
the limbs, especially the lower. At times this prostrate
feeling of the limbs was accompanied with headache
and an inclination to vomit, at times with sore throat
and some hoarseness. Sometimes the dry coryza became very violent, and was accompanied with a
violent and frequently intolerable tearing pain in the
forehead, affecting the facial bones, with pressure in
the remaining portion of the head, vertigo, otalgia,
painful swelling of the parotids, etc. The disease had
many peculiar features, for instance: in persons who
were not entirely well, it would excite the former
symptoms which had become latent, thus making the
cure so much more difficult; it would attack the
"* See Hahnemann's Materia Med. Pura, by Charles J. Hempel, M. D.,
Vol. I., preface to Camphor.
t See All. hom. Zeit.,V ol. I., p. 187, etc.; also, Archiv, Vol. XIII., 2, p. 88.



GRIPPE.


137T


same person several times, but always under anotber
form; sometimes it would last a considerable while in
a mild form, but the symptoms, although easily yielding to suitable remedies, would be excited again by
the least error in diet, sometimes even the next day.
Another peculiarity of the grippe was its tendency to
unite with other diseases, modifying their course and
aggravating the whole condition. Dr. Bosch (see
Hygea, XIX, p. 328), found that fetid sweats and
erysipelatous eruptions constituted critical phenomena
in grippe, and therefore proposes to designate the disease as a febris erysipelacea epidemica.
As soon.as the first symptoms of the disease made
their appearance, it was an easy thing to suppress it
by smelling a few times of Camphor; after some
time it broke out, nevertheless. This was not the'
case in an epidemic grippe which broke out afterwards,
and for which the first attenuation of Camphor taken
internally proved the most sovereign remedy (see All.
hom. Zeit. XXV. 61). When an inflammatory condition of the thoracic organs was a predominant
symptom, Nux was always found an excellent remedy
after Aconite. Mere. sol. or Mere. vivus was preferable when the head, throat, and chest were violently
affected, and when a dry, racking cough, which afterwards became loose, was present; when the patient
complained of pains in the pleura, with profuse sweats
which did not afford him any relief; when the condition of the liver exhibited inflammatory symptoms,
the pain being rather dull, and the pulse not very
hard; a few doses of Mercurius a-day were sufficient
to remove and even to suppress the disease in the very
beginning. Phosphorus was the best remedy when
the trachea was irritated or inflamed, and when the
intense pain prevented speech, or when the voice was
very much altered.
Sometimes the disease assumed the form of sporadic
cholera; in that case the catarrhal symptoms were
inconsiderable, but the debility so much more marked.
Veratrum was the specific for that group of symptoms.
If, in the course of the disease, typhoid symptoms set



GRIPPE.


in, as was frequently the case in the later periods of
the epidemic; if the patient became delirious, had a
wild, staring look, complained of great sensitiveness
of the abdomen, with a full, hard pulse, Aconite was
given with great effect; the remaining symptoms
yielded to Pulsatilla. This remedy frequently removed the papescent, insipid taste which sometimes
remained a long time, accompanied with slimy coating
of the tongue and want of appetite.
An exceedingly distressing symptom in that disease
was the violent pressing, aching pain in the forehead;
this pain, together with the accompanying cough, and
the loose and slimy expectoration, yielded to Bryonia,
which was likewise the principal remedy when the liver
was distended, and the region of the liver was painful
to the touch, or when the pain was excited by coughing
or taking a deep inspiration. Bryonia was also the
specific remedy for the cough when it readily excited
vomiting, or occasioned a pain in the epigastric region
(in which case Bryon. and Nux were equally indicated),
and a pain as if bruised under the short ribs, obliging
the patient, while coughing, to press his hands against
the region where this pain was experienced. Bryonia
was given alternately with Carbo veg., in a form of
grippe with which old people were sometimes attacked,
and which was characterized by great distress in the
chest and coldness of the limbs; this form frequently
terminated fatally in paralysis of the lungs. Ift the
cough was dry, spasmodic; if the headache became intolerable, if it was increased by walking, talking, bright
light, movement; if* the patient had a staring look, and
saw all sorts of fanciful images on closing the eyes,
Belladonna was the remedy; and after using it for a
couple of hours, the symptoms, although bordering
upon encephalilis, had disappeared.
Rhus was indicated if the grippe had come on in
consequence of getting wet, and the attack was characterized by oppressive anxiety, frequent turns of involuntary, deep breathing, restlessness of the body, and if the
patient was constantly changing his place of rest.
Sabadilla was the remedy when the grippe took the



SIMPLE RHEUMATIC FEVER.


141


duration and the commencement of the crisis are not
always marked by definite periods. Schcenlein does
not recognise any rheumatic fever; he terms the
rheumatic affection acute rheumatism, which is distinguished from a rheumatic fever by the greater
violence of the local affection, interesting the attention
of the patient and the physician more than the fever;
in acute rheumatism the redness and swelling occur
more frequently than in rheumatic fever, especially if
the affected part be near the surface of the body.
The pain in acute rheumatism is more acute, more
seated, the fever is more violent, and strictly continuous. It is undoubtedly improper to draw a marked
line of demarcation between a rheumatic fever and
acute rheumatism; if such a thing were possible, the
hommopathic treatment would not be affected by such
a division.
~ 37. These fevers depend principally upon atmospheric changes, which generally communicate to those
fevers an epidemic character. They occur frequently
at the end of winter, at the commencement of spring,
and during the damp and wet fall weather. Exciting
causes are: getting wet to the skin, exposure to a
current of air, repelled perspiration, etc.
~ 38. In most cases the prognosis is favourable as
long as the disease remains a simple rheumatic fever.
The prognosis is less favourable when the fever is
accompanied with inflammation of important internal
organs, or when the articulations of the spinal column
are involved. The prognosis is likewise unfavourable
when the fever lasts a long time, and the pericardium
or the heart itself is involved in the disease; or when
the fever settles upon the brain, and, in general, when
the local affection easily changes its seat.
~ 39. The treatment of these fevers is just as varied
as that of any other disease; it depends in every case
upon the characteristic symptoms of the disease.
Aconite is required only in very few cases. According
to our experience it ought to be given when the fever
is intense; when the inflammation, hot swelling, redness, and intense pains in the affected parts increase



SIMPLE RHEUMATIC FEVER.


rapidly; in such a case Aconite is always indicated
by other accompanying symptoms, such as: intense
dry heat, burning dry skin; full, accelerated, not hard
pulse; great thirst, flushed face, or else alternate redness and paleness of the face, anxiety and restlessness,
moaning and tossing about, sleeplessness, or else sleep
disturbed with anxious dreams. For such a group of
symptoms, the lower attenuations of Aconite, frequently repeated, will prove the best remedy.
Rheumatic fevers which are characterized by such
symptoms, belong rather to the class of acute rheumatism, whence it appears that Aconite is indispensable
in that disease.
Bryonia is superior to Aconite when the nervous and
vascular erethism is accompanied by tearing, tensive,
stinging pains in the red and shining swelling of the
articulation, becoming insupportable during movement
and during the night's rest. This remedy has likewise
to be repeated in such fevers, the repetition being proportionate to the violence of the fever which had remained after the exhibition of Aconite.*
Belladonna is a specific in rheumatic fevers when
the brain and nervous system are greatly irritated, and
the rheumatic pains wander from one part to another;
swelling and light redness are always present, and the
burning, stinging pains in the affected parts are most
violent at night and when the parts are touched ever
so lightly; if the patient should go to sleep, he is frequently roused by startings of the affected parts, or a
painful drawing in the limbs prevents him from falling
asleep. Belladonna is an excellent remedy when the
nape of the neck, the spinal column and the small of
the back are involved, when those parts are painful,
stiff and swollen, when the rheumatic affection prevents every movement of those parts, and movement
occasions the most violent pains; one knee-joint is
likewise affected, the patient has to keep it bent and
"* A great rival of Bryonia in inflammations of the serous membranes is
Cantharides, especially when there is a frequent desire to urinate. In rheumatic inflammations where Bryonia is indicated and will not help, Cantharides ought to be given, and if neither be sufficient alone, they ought to be
given alteraately.-HrEMmnL



SIMPLE RHEUMATIC FEVER.


143


quiet, the least movement making the pain intolerable
to such an extent that it will extort shrieks from the
patient. (When these symptoms occur Bryonia may
be used when the fever approaches more to the erethic
form.) The rheumatic fevers to which Belladonna
corresponds, are sometimes accompanied with tearing
pains having the character of an ache, and proceeding
from the inmost parts of the bones, or else darting
like an electric shock towards the neighbouring articulation, where they occasion a dull pressure, which is
relieved by counter-pressure, aggravated by motion,
and increases in intensity during the night. The fever
has generally the form of a synocha: violent burning
heat over the whole body, strong, full, accelerated
pulse, a good deal of thirst, loss of appetite, accompanied by a tensive, aching pain in the forehead, with
pressure from within outward, the pain being increased
by moving the head; the urine is turbid and deposits
a reddish sediment.
There is one remedy which has been too little used
heretofore in rheumatism: it is Colchicum. It deserves
especial consideration at a time when rheumatism is a
prevailing disease, and is of still greater importance
when the rheumatic influence prevails in the transition periods from winter to spring, fall to winter, or
during a damp and cold, foggy weather. This remedy
has been principally used in the chronic forms of rheumatism and gout, probably owing to the limited number of febrile symptoms which we possess of that drug.
In a case of synochal rheumatic fever where Aconite
seemed to be required, but was given without the least
benefit, we were induced to exhibit Colchicum alternately with Aconite every three hours. The result
was brilliant beyond belief. Since then we have used
"Colchicum on several occasions, and have noted the
following symptoms as indicative of its use: the
fever is a continuous remittent fever, with afternoon
exacerbations; the patient, during the exacerbation,
complains of a progressively increasing dry heat over
the whole body, accompanied with palpitation of the
heart and thirst, sweat breaking out upon the skin



144


SIMPLE RHEUMATIC FEVER.


suddenly, and disappearing as suddenly; lancinating
pains in the affected parts, increasing with the fever,
being most violent in the night, abating in the morning, when they generally wander to some other part
which becomes inflamed rapidly,, whereas the part
just left by the pain exhibits a simple pale swelling,
which disappears entirely in the course of that day.
For such symptoms we give Colchicum, third attenuation.
Mercurius is the remedy for rheumatic fevers.which
are characterized by the following group of symptoms: constant alternation of chilliness and heat,
or internal heat accompanied with a continual chilly
creeping over the affected parts; these parts have to
be moved all the time, either on account of an internal
uneasiness in the parts, or on account of the drawingtearing pains which are experienced in them. A characteristic indication for Mercurius is profuse sweat
which affords no relief, rheumatic pains in the head,
limbs and joints, which are especially violent at night,
the slimy coating of the tongue with slimy or saltish
taste in the mouth, complete aversion to any kind of
nourishment, great painfulness of the region of the
liver, the epigastric region and the pit of the stomach,
frequent evacuations of green mucus, accompanied
with tenesmus.
The remedies which we shall now mention, correspond rather to those rheumatic fevers which belong to
the class of the erethic fevers, the rheumatic pains being indeed continuous, but the inflammation of the
ligaments, tendons and synovial membranes, being less
intense.
First in rank is Rhus toxicodendron. It is indicated
by tensive, drawing and tearing pains in the limbs,
which are most violent when the patient is in a state
of perfect rest, accompanied by a sensation of numbness in the affected parts, and as if they had gone to
sleep, this sensation being especially experienced in
those parts upon which he is lying; the pains are felt
during the paroxysm of chilliness; the chilliness alternates constantly with the heat through the whole



SIMPLE RHLEUMATIC rbEvR.t


is the specific remedy, which requires to be repeated
more or less rapidly according to circumstances.
The Arsenic rheumatism sets in with peculiar symptoms which are frequently so confused that the physician is easily led astray by them, and is exposed to the
danger of misapprehending the disease, unless the
general character of the prevailing sickness reveals
the real character of the attack. We find for instance
paroxysms of anguish without any previous cause, accompanied with pressure and burning in the pit of the
stomach, stitches in the side, tension and fulness of the
abdomen; after a shorter or longer interval those
symptoms are followed by a shivering, and, after
quenching the thirst, by real chilliness, which is afterwards accompanied by a drawing and a burning tearing in the limbs, preventing the patient's resting upon
those parts, but being relieved by warming or moving
the affected part. After some time a dry, burning
heat with anxiety supervenes, during which the rheumatic pains become more violent, and which is accompanied with great thirst. A characteristic symptom of Arsenic is that the pains abate as the sweat
breaks out, whereas in other rheumatic fevers, for
which other remedies are indicated, the sweat affords
~o relief.
There is another kind of sub-inflammatory fever
which is characterized by drawing, tearing pains, sensation of lameness or numbness, the tendons, ligaments
or bones, are principally affected, there is no swelling,
night exacerbation; the spinal column and the head
are involved in the attack, the pains extend like labour-pains from the small of the back into the thighs,
making the least movement impossible, and the night
intolerable: such an attack yields to Chamomile.
Dulcamara is closely allied to Rhus as a remedial
agent in rheumatic fevers. It deserves a preference
over Rhus, if the fever was not occasioned by wet,
but by a sudden retrocession of sweat in a draft of air
or some other kind of exposure. A peculiar exciting
cause is not always required to make the exhibition of
Dulcamara necessary; the exhibition of that remedy



SIMPLE RHEUMATIC FEVER.


Euphorbium, when the pains are tearing or sticking,
with sensation of pressure; they are aggravated by
rest, relieved by movement.
Carbo vegetabilis, when the pains are drawing,
tearing, with sensation of lameness, and arrest of
breathing, characterizing the affection of the chest,
flatulence.
Mezereum for tearing, drawing, and tensive pains
in the long bones, with night exacerbation, and especially if Mercurius in allopathic doses have been previously given for syphilis. This latter indication applies
likewise to Carbo vegetabilis.
Valeriana is excellent in rheumatic fevers, when
the joints are principally affected. There are other
remedies for rheumatic fevers, which we do not mention on account of the little use which has been made
of them in practice.
The most frequent metastasis occurring in rheumatic
fevers is to the pericardium; as we shall treat of that
affection more in detail hereafter, we content ourselves with barely mentioning in this place the principal   remedies for it, viz., Belladonna, Spigelia,
Arsenic, Cannabis, Bryonia.
Rheumatic as well as catarrhal fevers may exist
simultaneously     with other acute affections, complicating them and making the use of other remedies
beside those here mentioned necessary; frequently,
however, one of the above-mentioned remedies is likewise indicated by the complication of the symptoms.*
"* An interesting remedy for rheumatic fevers, which Hartmann has omitted to mention, is Guajacum. In the second number of the Examiner, Vol.
IV., we have recorded a most remarkable case of rheumatism which Dr.
Schellhammer cured by two doses of Guajacum. The symptoms were:
violent stitches in the outer side of the right calf, which soon extended as
far as the right ankle joint, and became so violent that the patient fell down,
and was, since that period, no longer able to walk. By mismanagement, the
patient was reduced to the brink of the grave, until Schellhammer effected
a complete cure. When Schellhammer was called, the symptoms were:
violent tearings and lancinations in the whole of the affected side, extorting
constant shrieks day and night; cough, with expectoration of fetid pus;
aversion to food; nausea and vomiting every morning; swelling of the limb,
it was drawn up, stiff and immoveable; interstitial distention and softening of the tibia and tarsus; hot skin, tongue coated, vehement thirst.HEMPEL.



151


FOURTH CLASS.
GASTRIC FEVERS.
~ 40. The fever is a continuous remittent, the digestive apparatus being principally affected; the fever
differs according as it depends upon overloading the
stomach, morbid action of the mucous membrane of
the stomach, disturbed secretion of bile, or derangement of the whole intestinal canal. This fever is
generally ushered in by premonitory symptoms which
may be successfully combated by homceopathic remedies, thus preventing the fever altogether. The fever
commences'with violent heat, restlessness, oppression
and anxiety; the patient feels ill and weak, complains
of violent headache. Frequently, but not always,
the epigastric region is sensitive, especially when
touched, and the following symptoms are present:
coated tongue, eructations, disagreeable taste, vomiturition and nausea, increased alvine evacuations, or
else constipation; dark, brown-red, saffron-coloured
urine, sometimes depositing a sediment, want of appetite, increased thirst.
We shall offer the following classification of those
fevers, which has no reference to the seat, course, and
terminations of the disease, for these are frequently
modified by epidemic or the prevalent morbid influences; nor has it any reference to the intensity of the
fever, which may be of an inflammatory or even
typhoid character.
~ 41. Status gastricus, biliosus et pituitosus; gastroataxia saburralis, biliosa et pituitosa, of Schcenlein; a
gastric condition without fever. Premonitory symptoms
of a gastric, bilious, and pituitous fever.
This condition is characterized by the following
symptoms: pressure and fulness in the region of the
stomach, inclination to vomit, constant disagreeable
eructations, bitter or slimy taste in the mouth, dryness
of the mouth or confluence of saliva, aversion to food,
coated tongue, debility; weight and drawing, or else
an aching pain in the region of the forehead; also, in



152


GASTRIC FEVERS,


the limbs, altered complexion, restlessness, low-spiritedness, coldness of the hands and feet. All these
symptoms are distinct indications of a derangement
of the digestive functions.
Persons whose digestive powers are naturally weak
are predisposed to such a state, which may be brought
on by over-eating, by heavy or spoiled food, unwholesome drinks, bad, damp air, great heat, anger, chagrin,
grief, etc.
It is not difficult to treat that affection homceopathically, provided the exciting cause is known. The
proper and timely use of remedial agents shortens the
course of such diseases, and prevents their running
into corresponding acute affections.
If the gastric derangement be evidently owing to
overloading the stomach, the best medicine is fasting.
The patient ought to content himself with a little
water-gruel, and afterwards take some black coffee.
If the stomach have been deranged by fat meat or fat
food of any kind, with rancid taste and eructations,
the patient ought to fast and take Pulsatilla; in a few
hours he will feel better, especially in the stomach.
If the gastric derangement be characterized by
eructations tasting of the ingesta, by nausea, loathing, inclination to vomit, Nature is frequently competent to relieve itself; but the efforts of Nature, which,
if unassisted, are frequently unsuccessful and tormenting, can be facilitated by tickling the velum pendulum
palati, fauces and pharynx, with a long feather; if
anything should remain in the stomach, a little black
coffee is sufficient to carry it off by the route of the
intestines.
If the stomach should have been overloaded to such
an extent that the power, or even the inclination, to
throw off the contents spontaneously should have been
suppressed, occasioning great pains in the epigastric
region, the dynamic irritability of the stomach is
restored by swallowing a spoonful of black coffee at
successive intervals, after which the contents of the
stomach, were they ever so excessive, will either be
thrown off by the mouth, or carried off by the rectum.



GASTRIC FEVERS.


153


If those means should be insufficient to remove the
contents of the stomach, or if, after their removal,
loathing, nausea, inclination to vomit, should remain,
these symptoms yield to Antimonium crudum.*
If the gastric derangement be occasioned by some
dynamic cause, violent emotions, etc., the treatment
differs. If any of the above-mentioned symptoms of
gastric disturbance arise from violent chagrin, a small
dose of Chamomilla is sufficient to remove them. If
those symptoms and the still continuing chagrin be
accompanied by chilliness and coldness of the body,
Bryonia alba is the remedy.
Gastric disturbances arising from violent fright and
chagrin, are entirely removed by Aconite within the
space of three or four hours.t
Gastric derangements frequently occur in persons
who are constantly bowed down by grief and chagrin,
other morbid symptoms beside those of the gastric
affection being likewise present. An indispensable
requisite for a permanent cure is the removal of the
causes which have brought on the disease.         The
humane physician will do all in his power to cheer up
the patient, and to afford him every opportunity for
rational amusement. If these conditions can be fulfilled, which is not always possible, owing to the limited means of the patient, Ignatia amara will be found
sufficient to remove the trouble about the stomach; if
one dose should not be sufficient, another one may be
taken in two hours, either weaker or of the same
strength.
If the gastric symptoms arise from  taking cold, or
from exerting the mind or body immediately after a
meal, were it even moderate, Nux vomica is the best
remedy. If those symptoms owe their origin to coldness of the stomach, occasioned by a cold drink or
* Especially if there remain a taste of the food in the mouth; Nux
vomica is in many cases superior to Antimony. The spasmodic vomiting of
mucus, which sometimes remains for hours after the contents of the overloaded stomach have been thrown off, is stopped by Nux vomica.-HEMPEL.
t The most prominent symptom of a gastric derangement, arising from
violent chagrin, is sometimes a deep sopor, from which the patient can only
be roused by shaking him violently; this condition yields to Opium 18.HEMPEL.
7*



154


GASTRIC FEVERS.


fruit, Arsenic and sometimes Pulsatilla are the best
remedies; a gastric derangement which is characterized by a good deal of flatulence, and arises from eating cabbage, and other kinds of food containing watery
particles, yields to Bryonia.
If the usual symptoms of a gastric affection be accompanied by the gulping up of an acrid acidity from
the stomach, or if the acidity exist without the other
symptoms as a        chronic affection, which is usually
termed heartburn, Nux is the best remedy, provided it
corresponds to the remaining symptoms; for chronic
heartburn, Sulphuric acid is perhaps more frequently
suitable, provided all the accompanying symptoms
correspond.
The above-mentioned symptoms, denoting a disturbance of the gastric functions, may all be brought on
by the fault of the patient; but they may also occur
as a sporadic or epidemic disease while the patient is
under treatment for some chronic affection. Under
those circumstances the above-mentioned remedies
have to be employed, but in as weak doses as possible,
lest the treatment of the principal chronic affection
should be entirely interrupted.*
~ 42. Gastric fevers; saburral, gastric, bilious fever.
We have alluded to the precursory symptoms of
"* There are other symptoms, and also other remedies, for gastric affections,
which Hartmann has not mentioned. We recommend Calcarea carb., Carbo
veg., China, Capsicum, for acidity of the stomach and heartburn, each of
those remedies to be chosen in accordance with the symptoms.
Carbo animalis is an excellent remedy for sour stomach, with scalding sensation in the throat.
Lycopodium for acid risings from the stomach, constipation, cuttings from
the liver to the epigastrium.
Arsenic for burnings in the pit of the stomach, oesophagus and pharynx,
with constrictive or suffocative sensation in the throat, and constant thirst;
or for sensation as if the stomach were torn to pieces.
Digitalis for excessive debility in the region of the stomach as if this
would die; accompanied by irregular pulse.
Ignatia for great weakness in the epigastric region, with a burning
pricking.
Spigelia for a strange sensation of weak soreness in the pit of the stomach;
the patient cannot bear the pressure of the clothes; this pain is frequently
accompanied with soreness of one eye-ball, and pain on turning it or looking
down; twitchings in the lid, sensitiveness to light.
Lachesis for excessive rolling of wind from the stomach upwards.
Nux vomica for gastric derangement arising from abuse of coffee or spirituous drinks.
Mere. for soreness as of an abscess in the pit of the stomach.-IIEMPEL.



155


GASTRIC FEVERS.


those fevers in the preceding paragraphs. If the precursory symptoms be not relieved, and the gastric fever
become fully developed, then the fulness and pressure
in the region of the stomach increase, that region becomes distended, although it remains soft and is not
sensitive to pressure; it is filled with gas, as may be
ascertained by percussion, accompanied with inclination to vomit, rising of fetid air, sometimes vomiting
of food and tenacious, bile-coloured mucus; the tongue
is covered with a thick crust of dingy-yellow mucus,
the abdomen is soft, the bowels are either constipated&
or else the patient discharges a quantity of fetid stool,
consisting of badly-digested food. A peculiar kind of
headache is almost always present, a sort of pressure
in the forehead, commencing in the frontal sinus and
thence spreading over the orbital region; general feeling of debility; wretched, disfigured appearance, with
yellow tinge of the whites of the eyes; the chilliness
is more or less violent, succeeded by heat and dryness
of the skin; the pulse is irritated, quick, soft, sometimes intermittent, or at any rate unequal, the urine is
turbid, smells like horse-urine.
If the bilious symptoms be particularly prominent
(in which case the fever is called febris biliosa, or in
the language of the older physicians, causus) all the
symptoms are then generally more violent, the heat is
very great, there is great burning and turgescence of
the skin, the restlessness and the thirst are great, the
patient has a great desire for sour drinks, and the
prevalence of the bilious symptoms is visible all over.
The tongue has a lemon-coloured coating, which becomes gradually brown, taste and eructations are bitter, the patient vomits a greenish, bilious matter, the
bowels are confined, or else there are yellowish, green
or brown discharges from the bowels, the countenance
looks livid, and somewhat jaundiced; these symptoms
are sometimes accompanied by sensitiveness, hardness,
tension, warmth, burning in the region of the liver and
stomach; the urine is dark-brown, tinged with the
colouring matter of bile, the pulse is frequent, full, intermittent or double-beating.



GASTRIC FEVERS.


157


extremities are cold, the pulse is frequent, wiry, small,
the urine is brown, decomposed, emitting a strong ammoniacal odour, the patient becomes delirious; involuntary discharges of faeces and urine, sopor, and the
usual typhoid symptoms set in. Death rarely takes
place by local disorganizations, inflammation and ulceration of the mucous membrane of the stomach;
death is more frequent by the gastric fever passing into typhus, and paralysis taking place in consequence.
Should a chronic inflammation and subsequent suppuration of the mucous membrane of the stomach set in,
the physician's attention will necessarily be directed,
by the obstinate duration of the gastric symptoms, to
such a process of disorganization having commenced;
and he will find that the fever, which gradually increases again, has become a slow, chronic, secondary
affection, depending upon the incipient degeneration.
In most cases the prognosis is favourable; the complication with typhoid symptoms makes it more doubtful. The convalescence is generally very short.
~ 44. The homoeopathic treatment of simple gastric
fevers is generally very easy, and, in most cases,.successful. The lighter forms of those fevers, such as
saburral fevers, frequently terminate in two or three
days. The following remedies deserve a preference
in the treatment of those fevers: Puls., Bryo., Nux
vom., Ipec., Tart. emet., Antim. cr., Chamom., Coloc.,
Acid. phosp., and Arsenic.
What we have said of the treatment of the premonitory gastric state, is likewise applicable to the simplest kind of gastric fever, the saburral fever. The
same remedies will generally be found sufficient.
Pulsatilla is a specific remedy in that affection when
the patient is out of humour and disposed to weep, and
when the following symptoms are present: great chilliness, absence of thirst, aversion to food, especially
warm, meat, bread, milk and tobacco; slimy, sour, bitter taste, eructations, vomiting of food, pressure at the
stomach, and sensation as if the food were in the intestines undigested, rumbling in the abdomen, nightly
green stools, restless night sleep, disturbed with dreams.



GASTRIC FEVERS.


Pulsatilla is adapted to individuals with excessive venosity, when a throbbing is experienced in the pit of
the stomach, when the patient is periodically affected
with stinging pains in the stomach, and the fever exacerbates in the forenoon. Pulsatilla is likewise suitable in that form of gastric fever, which was designated by the older physicians as a febris gastrico-venosa. If a sense of illness, debility, a chilliness in the
body, and a want of appetite, should remain after the
exhibition of Antimonium crudum, these symptoms will
yield to Pulsatilla; the symptoms remaining after Antimony may likewise indicate Nux or some other
remedy.
Nux vomica is especially suitable to irritable, lively, plethoric and hypochondriac individuals, whose digestive powers have been weakened by mental exertions, a sedentary mode of life, abuse of coffee and
spirituous drinks. Nux is likewise indicated when the
gastric fever arose from a violent commotion of the
mind by surprise, fright, quarrelling, etc., and the
proper specific was not at once resorted to, allowing
the fever time to establish itself in the system. If the
gastric disease was occasioned by frequent chagrin,
and the symptoms occasioned by those mental disturbances do not yield to the specific remedy, Nux ought
to be employed (Pulsatilla rivals Nux under those circumstances). Nux may likewise be administered for
the following group of symptoms: considerable heat
in the face, burning heat in the eyes, dry lips, great
thirst, violent lancinating pain in the forehead or hemicrania, brownish or slimy coating of the tongue, acid
taste in the mouth, nausea, tension and distention of
the region of the stomach and of the abdomen, with
fulness and pressing towards the chest, oppression of
breathing, anxiety, violent, spasmodic pains in the
stomach, with sensation of griping and tearing away,
rumbling and pinching in the abdomen, constipation,
flatulence, yellowish tinge around the nose and mouth,
general restlessness, great sensitiveness of the organs
of sense.
If there should be an excessive tendency of the vital



GASTRIC FEVERS.


159


action upward and downward, with vomiting and
diarrhoea, cutting pains in the whole of the abdomen,
with fetid flatulence and discharges of undigested
food, Antimonium crudum is the best remedy even in
the most obstinate and dangerous cases. Ipecacuanha
corresponds more to a gastric derangement brought on
by general causes, such as: weather, etc. (in opposition to a gastric derangement occasioned by specific
influences, such as: fat food, etc.), when inclination
to vomit is present, or when the nerves of the stomach
are excessively sensitive and irritable, and the introduction of the least quantity of food into the stomach
brings on the vomiting.
Remedies that affect the healthy organism in a
similar manner, must necessarily correspond to similar
morbid conditions; this is especially the case with
remedies which antidote one another. It is for this
reason that Tartarus emeticus, which antidotes both
Ipec. and Puls., is a useful remedy in gastric fevers.
This remedy deserves a preference when the following
symptoms make their appearance: great drowsiness
with the fever; reddish, itching rash on the trunk,
especially the chest; violent vomiting and nausea day
and night, yellow-brown diarrhoeic stools, with excessive cutting in the bowels.
Bryonia is a distinguished remedy in gastric fevers,
which depend upon a double cause, cold and chagrin.
It is indicated when the gastric derangement is accompanied by great febrile heat, mingled with slight chills,
great debility, nightly exacerbation of the symptoms,
when the patient is irritable and out of humour, and
complains of a pressing pain in the forehead from
within outward. These symptoms are accompanied
by dry mouth and tongue, violent thirst, desire for
acidulated drinks, pressure at the stomach, stinging in
the liver when touching the region of that organ, or
when coughing and taking a deep inspiration; empty
retching, continuing for some time, and gradually increasing to a bilious vomiting after a good deal of
hickuping (this shows that Bryonia is a good remedy
in bilious fevers), accompanied with pinching, cutting



GASTRIC FEVERS.


colic, constipation being sometimes present Bryonia
deserves consideration when the gastric fever is complicated with rheumatism, and when the synochal
fever threatens to assume a typhoid character.
Colocynth is on a par with Bryonia. It deserves a
preference when the gastric fever was brought on by
a fit of indignation, by deep mortification in consequence of humiliating treatment, and when it is accompanied with sleeplessness, violent heat, with a hot,
dry skin, and a full accelerated pulse. The colocynth
fever is likewise characterized by a pressing pain in
the forehead, which is more violent in the recumbent
posture than in walking. The gastric symptoms are
not as intense as those indicating Bryonia. If vomiting be present, it is copious, and the ingesta are
thrown off; the colic is generally very violent, is
occasioned by eating the slightest quantity of food,
and generally consists in a violent cutting, with chilliness and tearing in the lower limbs, and frequent
yellow-greenish diarrhceic stools. Colocynth is an
excellent remedy, not only in gastric, but also in
bilious fevers.
Acidum phosphoricum is an excellent remedy in
such fevers, when they arise from grief, deep and
gnawing sorrow, anxiety and care, and are accompanied by great restlessness, a pushing and tumult in the
blood, and profuse sweats. The fever generally consists of alternate chilliness and heat, strong, irregular
pulse, and extreme apathy. The pressing headache is
likewise present, but more in the vertex than in the
forehead, and is accompanied with a sensation as if
the brain were bruised. The whites of the eyes are of
a dingy yellow, the eyes are faint, without lustre,
sunken, surrounded with bluish circles, and making the
face look pale and sunken. The thirst is greater than
the appetite, which is constantly accompanied with
nausea; after every meal the patient experiences a
painful pressure in the pit of the stomach which is increased by contact. Characteristic indications are
the burning in the abdomen with sensation as if it
were distended, especially in the umbilical region,



GASTRIC FEVERS.


161


and the discharges by the rectum of white-grey
mucus.
One of the principal remedies in gastric fevers, and
indeed in many other affections of the mucous membranes, is Arsenic. It is indicated by an excessive
prostration of strength which is by no means proportionate to the intensity of the other symptoms, by great
dry and burning heat, and panting for drink; a number
of other symptoms which do not generally belong to
gastric fevers: such as tearing, burning pains in the
extremities, spasms, pressing headache, loss of appetite, evanescent sweats, anguish, etc., are likewise
present and, by a process of metaschematismus, invade
other parts and internal organs. Arsenic deserves
especial consideration when the gastric symptoms are
accompanied with violent burning pains in the stomach
and pit of the stomach, swellipg and pain of the liver
and spleen, meteorism.
The following remedies which are likewise useful
in some forms of gastric fever, will be spoken of more
in detail in the subsequent paragraphs: Veratrum,
Belladqnna, Cocculu's, Mercurius, Staphysagria, Digitalis, China, Taraxacum, Asarum, Ignatia, Colchicum.
~ 45. If the bilious symptoms be the most prominent, Chamomilla is a principal remedy, especially if
the fever originate in violent chagrin or vehemence
and be characterized by great general heat, burning
of the face and eyes, violent thirst, bitter bilious taste
in the mouth, vomiting of a substance which is bitter
as bile, thick, yellow coating of the tongue, tension of
the abdomen, and the hypochondria, colicky pains in
the abdomen accompanied with rumbling, watery,
green, yellow evacuations, startings as if in affright,
tossing about during sleep, sallow, yellowish complexion, excessive irritability and sensibility to pain,
painful pressure at the stomach as from a stone, with
shortness of breath and anguish. Only in case Chamomilla should haye been used as a tea previous to the
arrival of the physician, it ought not to be administer



162


GASTRIC FEVERS.


ed as a remedy.*  In such cases Coffea, Ignatia, Nux,
Cocculus, Pulsatilla are better indicated.
Ignatia is preferable to Chamomile, when the bilious
fever has arisen from concealed chagrin and when the
usual Chamomilla symptoms are moreover accompanied with silent grief and shame. If the fever was
occasioned by chagrin with indignation, Staphysagria
is the remedy. Staphysagria is likewise indicated
when the disease commenced with fainting fits.
Mercurius deserves especial consideration, when the
gastric-bilious condition is accompanied with frequent
diarrhoeic stools of green mucus which is sometimes
acrid and streaked with blood, the discharges being
almost always preceded by a painful pressing in the
rectum and an anxious tremor with colic; the patient
is moreover affected with a jaundiced colour of the
skin, yellow-coated tongue, bitter taste and eructations, desire for sour things, great sensitiveness of the
region of the liver which is painful and distended, the
urine is dark and has a putrid smell.
China deserves consideration in cases of debility occasioned by the use of cathartics and emetics,,(it will
therefore have to be frequently employed in gastric
fevers which had been treated in the usual old-school
fashion) and when the following group of symptoms
occurs: Dulness and want of clearness in the head,
vertigo when raising the body, tearing headache,
especially at night; restless, unrefreshing sleep, claycoloured, yellowish tinge of the skin, and whites of
the eye; yellow coating of the tongue, dry lips, want
of appetite, bitter eructations and taste, retching and
pressure at the stomach, oppression of the chest,
frequent whitish or greenish-yellow stools, emission of
fetid flatulence, which affords no relief; dark red
urine, slight thirst, great debility, disposition to be
vehement and out of humour; enlargement, and induration of the liver and spleen.
"* As a general rule; but there are cases of bilious fever or bilious colic
where Chamomile tea has been used without effect, and where the homoeopathic preparation of that drug effected a cure. Such cases have occurred
in my practice at any rate.--HEMPEL.



GASTRIC FEVERS.


163


If the gastric and bilious symptoms be accompanied
with violent cutting pains in the abdomen which
appear at intervals and seem to proceed from flatulence; if there be an entire want of action in the
rectum, constipation or else greenish-yellow diarrhoea
with loud rumbling and frequent emission of flatulence; if the abdominal pains be so violent that the
patient is on the point of losing his senses, and the
body becomes cold; if the patient have an anxious,
irritable, hypochondriac mood: Veratrum album is
frequently the best remedy.
~ 46. We sometimes meet a peculiar form of gastric
fever, which was formerly termed febris venoso-gastrica. This kind of fever is almost always preceded
for a time, often even for years, by the symptoms of
predominant venosity and abdominal plethora, which
is easily increased by an error in diet, or by other
hurtful influences, and, in that case, gives rise to febrile
phenomena and to derangements in the digestive and
the portal system. The fever is obstinate and remitting, the patient's countenance is red and puffed, he is
anxious, out of humour, melancholy, the bowels are
slow, the tongue is coated, the appetite is gone, there
is nausea, changed taste, without, however, any
evidence of undigested food having remained in the
intestinal canal, the pulse is mostly hard, small, not
frequent, the urine is either not altered or else dark
and smells like horse urine, there is not much sweat,
and sometimes the sweat is cold. After the fever has
lasted about a fortnight, the patient discharges a considerable quantity of fetid, bilious, or slimy substance;
these discharges relieve the patient and generally break
the fever. We have already mentioned that Pulsatilla is
a chief remedy in such fevers; but Digitalis is likewise
recommended. It is especially suited to individuals
with sanguine temperament and soft, flabby muscles,
slow pulse, weak stomach, nausea, bitter mouth in the
morning on waking, vomiting of the ingesta, spasmodic
griping, tearing pain in the stomach, sensitiveness of
the pit of the stomach to pressure, vertigo, aching pain
in the forehead over the eyes, great debility as if one



MUCOUS FEVERS.


165


chagrin, especially when the circulation and the functions of the liver were disturbed by those causes.
Aconite is particularly indicated by violent chills followed by a general dry and burning heat, hard, full,
bounding, accelerated pulse, great thirst, and a general
profuse sweat succeeding after the heat.
If typhoid symptoms should set in, or if the fever
should become a real typhus, the remedies which will be
more particularly described in the chapter on typhus,
such as Bryonia, Belladonna, Rhus tox., Phosphorus,
Arsenic, etc., require to be used. Arsenic is suitable
even in purely gastric fevers when the following
symptoms are present: blackish, diarrhoeic stools,
accompanied with violent colic, vomiting, great internal burning heat, dry lips and tongue, unquenchable
thirst, excessive debility and prostration, great anguish,
nightly restlessness, burning and beating in all the
blood-vessels, clammy sweats, apoplectic symptoms.
"The diet requires to be carefully regulated, of
course. However, errors in diet need scarcely to be
apprehended, as the patients have an aversion to food,
especially warm food. The best beverage is fresh
water, in a very few cases some other drink may be
given.
~ 48. Mucous fevers, erethism of the mucous membrane of the intestinal canal.
This fever is essentially a catarrhal affection of the
greater portion of the mucous membrane of the chylopoetic canal; sometimes the mucous membranes of
the other systems and organs are likewise affected.
The precursory symptoms which sometimes set.in a
long while before the fever breaks out, are: loss of
appetite, flat taste or entire absence of taste, white.
slimy coating of the tongue, loathing, great repletion
of the stomach, irregular evacuations, pale countenance and debility, and other symptoms which have
already been mentioned among the precursory symptoms of gastric fever.  All those phenomena are
generally mild, sometimes the patient feeling rather
comfortable, chilly. As a general rule the develop



MUCOUS FEVERS.


of a tenacious, albuminous, thready mucus, by the
coating and the peculiar colour of the tongue, by the
mildness of the fever, with a pulse which is but
slightly or not at all accelerated, and by the absence
of pain in the ileo-coecal region, of the characteristic
typhus evacuations from the bowels, of enlargement
of the spleen, etc.
Predisposing causes are: youthfulness, female sex,
scrophulosis, worm affections, disposition to chronic
blennorrhcea of the abdominal organs, especially the
stomach. The outbreak of the disease is favoured by
wet and cold or damp summer weather, and by confining one's self to a vegetable diet, consisting principally of indigestible, heavy food; these causes are
often sufficient to make the fever epidemic.
The course of the disease is always slow; in the
most favourable circumstances it lasts a fortnight,
sometimes much longer, as the patient is liable to relapses and temporary aggravations. As the disease
progresses, the symptoms frequently change; sometimes the increased secretion of mucus spreads over
the mucous membrane of the whole abdomen, the
respiratory, urinary, and genital organs; or the fever
assumes the so-called typhoid character, with muttering delirium, humming in the ears, dull and stupid
feeling of the head, hardness of hearing, subsultus
tendinuim, grasping at flocks. Very often a rash, in
the shape of white crystal-coloured vesicles, makes its
appearance, accompanied with profuse, fetid, exhausting sweats. Sometimes aphtha form in the mouth
with fetid, cadaverous smell from the mouth, and
ptyalism; the aphthae may even affect the mucous
membrane of the whole abdomen, as may be inferred
from the existing tenesmus and the shreds which are
discharged from*the rectum.
The disease is rarely complicated with other diseases; in young, plethoric individuals, however, the
mucous membrane may become inflamed and ulcerated.
Post-mortem examination has shown the following



MUCOUS FEVERS.


results: the mucous membrane of the chylopoetic canal
is covered with thick viscid mucus, the mucous membrane itself is interstitially distended, of a dingy grey
colour, reddish, and softened to such an extent that it
can be pulled off or even wiped off, like pap; the
criptae mucosae are enormously enlarged, distinctly
visible; some parts look as if the mucous membrane
had been cut off, without redness, swelling, or interstitial distention about the edges.
The prognosis is not unfavourable even when the
disease is perfectly developed, or the treatment has
been neglected.  Slimy diarrhoea, supervention of
typhoid or putrid conditions, with rash and aphthe,
discharge of decayed worms make the prognosis very
doubtful. Recovery is generally characterized by the
following appearances: mild sweat (a rash making
its appearance which afterwards scales off), strawcoloured urine, with a thick clayish sediment, and calm
sleep, but it is almost always slow, and the patient is
greatly inclined to have relapses. Death either takes
place by the formation of aphtha3 covering the mucous
membrane of the abdominal and respiratory organs
and becoming gangrened, or in consequence of the
non-appearance or the retrocession of the rash, or by
paralysis of the abdominal nerves causing meteorism,
involuntary discharges of cadaverous stools, small,
weak and trembling pulse, and sopor, or lastly the
brain may become paralyzed.
~ 50. It is of great importance in this disease to
employ suitable remedies before the fever is fully developed; this will frequently enable us to cure the
patient in a very short time, whereas, if the precursory
stage be neglected, the disease becomes very obstinate.
The principal remedies for the precursory symptoms
of mucous fever are: Pulsatilla, Amrfonium muriaticum, Nux vomica, Ipec., Mere., Dulc., Ignat., Staphys.,
Senega.
Pulsatilla deserves a preference over every other
remedy in individuals of a flaccid, lax, venous-lymphatic constitution, who, by eating too much fat and



MUCOUS FEVERS,


169


rich food, have brought on a total want of appetite,
flat, slimy taste, coated tongue, chilliness, ill humour,
and a want of muscular tonicity.
The physiological effects of Ammonium correspond
perfectly to the symptoms of the status pituitosus. For
centuries past Ammonium has been recommended for
those morbid phenomena which it produces in the
healthy organism in the most striking manner. White
slimy coating of the tongue, constant hawking, occasioned by a quantity of viscid mucus in the throat; a
disagreeable, pappy taste in the mouth, with confluence of water, aversion to food, loathing, empty
eructations, gulping up of bitter, sour water, malaise
and warmth in the stomach, discharge of glassy,
tenacious mucus by the rectum, etc., indicate the use
of Ammonium.
Nux vomica is suitable when the patient has been
irritated by chagrin, and when the following symptoms
occur: dry tongue, coated with white mucus, disposition to acidity of stomach, dyspeptic symptoms after
every meal, heartburn, distention of the pit of the
stomach, constipation, dull and obtuse feeling about
the head. Dulcamara is recommended when the fever
has heen occasioned by a cold, and when it is characterized by the following group of symptoms: flat, soaplike taste, great thirst, dryness of the tongue, increased
secretion of saliva, aversion to any kind of food, dingy
white coating of the tongue.
Another distinguished remedy is Mercurius, which
corresponds both to the precursory symptoms and to
the disease itself, when it has reached a certain degree of development. Mercurius is indicated by the
following symptoms: increasing diminution of appetite, tongue coated with white mucus, excessive and
painful dryness.in the throat when swallowing, putrid
taste and smell, loathing and nausea, tearing burning
pains in the temples, pressure and tension in the pit of
the stomach, in the region of the stomach and liver,
regurgitation of an acrid fluid into the mouth, turbid,
slimy urine depositing a sediment, irregular evacuations, with frequent tenesmus, pale, livid, yellowish
8



MUCOUS FEVERS.


countenance, debility, want of irritability; characteristic symptoms are: thick coating of a dirty mucus on
the tongue, flat, pappy taste as of soap, great desire
for piquant dishes, dryness of the mouth and throat,
sluggish stools or else constipation, or diarrhceic stools
of fetid mucus, great mental and physical prostration.
In the commencement of the disease, Ignatia is
sometimes useful, especially when the symptoms are
changeable, and when the following group of symptoms occurs: great indolence, inclination to lie down,
weight and pressure in the forehead, pain in the pit of
the stomach, alternate redness and paleness of the
face, dry and chapped lips, white-coated tongue, flat,
insipid taste, great aversion to food and drinks, regurgitation of a hitter substance, frequent discharges
of white mucus; sudden flushes of heat over the
whole body are frequently present, with small, accelerated pulse.
Staphysagria may likewise prove useful in the first
commencement of the disease, and competes with
Ignatia when the disease has been occasioned by
moral emotions. But even in the highest degrees of
pituitous fevers, Staphysagria is an excellent remedy,
even when typhoid and putrid symptoms have made
their appearance. The attending physician will easily
discover the symptoms indicating Staphysagria without our mentioning them. All that we intended to do
was to point to Staphysagria, and likewise to Senega,
which is indicated for many affections of the mucous
membranes, especially when the patients are of a
phlegmatic, passive disposition.  In cases where
Senega is indicated the fever is not very violent, there
are merely slight shiverings and heat, accompanied by
a beating pain in the head, laboured breathing with
anxiety, stitches in the chest, the whole body feels
bruised, the pulse is frequent, and the thirst increased;
the stools are rather less frequent, in a few cases more
frequent than usual; there is an accumulation of
viscid mucus in the throat, occasioning constant hawking.
The following remedies have likewise been found



WORM FEVER.


broken out, or should have receded, Arsenic may still
save the patient's life. The characteristic symptoms
in such a case are: sopor, cold sweats, blackish' lips
and teeth, dry, trembling tongue, unquenchable thirst,
meteorism, involuntary discharges of faeces and urine,
snoring, oppressed, and excessively hurried breathing,
small, trembling, very frequent pulse, automatic movements of the hands, nightly muttering delirium. (Acidum phosp., and Carbo veg. ought to be thought of
when those symptoms occur). Arsenic is likewise indicated when aphthae form in the mouth, no matter
whether it be a simple or putrid ulceration, and affect
the whole intestinal canal. For simple aphthous ulceration Mezereum may likewise be indicated, especially
when a violent burning in the fauces and stomach is
present, and the aphtha look flat and flaccid; Mercurius, Acid. nitr. and sulp. may also prove curative.
If gangrene threaten to set in, Arsenic is the first
remedy, China, Ac. mur., Carbo veg. and Baryta are
the principal remedies next to Arsenic.
The diet is of the utmost importance both in the precursory stage, in order to prevent the full development
of the fever, and in the stage of convalescence, in order
to prevent a relapse. The object of diet in the precursory stage is to arrest the excessive secretion of
mucus; in the stage of convalescence the object of
diet is to invigorate the patient by suitable nourishment without exposing him to the danger of having a
relapse for which there is a great disposition. The
patient ought to take small quantities of liquid food
with a good deal of drink, the convalescent patient
may add a few drops of wine to his drink.
~ 51. Worm fever; helminthiasis.
Worm affections, with or without fever, are evidently chronic diseases. Entozoa are no disease,
but the product of disease, which may however react
upon the organism as a morbific cause. We class
worm fever and even the chronic condition which is
termed helminthiasis, among the acute diseases for
this reason, that a worm fever is very similar to gas



WORM FEVER.


173


tric and pituitous fevers, and that it generally sets in
only while the organism is under the influence of some
other affection which makes the contents of the
bowels unpleasant to the worms; when this is the
case, the worms writhe and twist themselves about in
the intestines, irritating the mucous membrane of these
organs.
Physicians have mentioned so many symptoms as
indicating the presence of worms that it is difficult to
offer a well-marked image of a worm fever. Many of
those symptoms are eltremely changeable; they are
occasioned by the temperament, sex, individuality, or
mode of life of the patient, or may characterize the
gastric, pituitous, or other similar affections of the
patient. Nevertheless there is a sufficient number of
characteristic symptoms which leave no doubt about
the true nature of the affection; these are the phenomena which reveal the characteristic irritation of the
mucous membrane of the intestines. But even of these
symptoms, no single symptom has any decisive value
as a diagnostic symptom; it is the simultaneous occurrence of a number of such symptoms which decides
the character of the disease. The discharge of one or
more worms or pieces of worms is no certain proof
that the existing fever is occasioned by those animals,
since it is a well-known fact that worms may even
exist in the healthy body, and probably do exist more
or less in every child. The following are the more
permanent symptoms of a worm disease: pains in the
abdomen, almost always proceeding from the umbilical
region, and being frequently a mere sensation of pressure or constriction, which is sometimes very violent,
amounting to colic; if the affection arise from ascarides, the pain is generally local, accompanied with the
following symptoms: troublesome itching of the anus,
especially in the evening, dysuria, stranguria, tenesmus, apparent hemorrhoidal sufferings, discharge of
mucus by the rectum, bladder, vagina; uncommon
periodic sadness, gloominess, and irritability of temper;
when trenia is present, the patient frequently experiences a sensation as if something were crawling or



WORM FEVER.


twisting itself from the left side of the abdomen towards the stomach and even the oesophagus; or a
sensation as of the undulating movement of a cool
ball in one or the other side, sensation as if something
were sucking in the abdomen, vertigo, tingling and
numb sensation in the fingers and toes, they are disposed to go to sleep; the pain is always periodical, not
continuous, it occurs principally in the morning and
when fasting, and is generally relieved by eating; the
quality of the food influences the pain greatly: it is
increased by milk, sugar, and *other sweet things, by
acrid and salt food, ham, cheese, and by the so-called
anthelmintica.  The abdomen is not painful when
pressed upon, it is soft, sometimes distended, the taste
in the mouth is unpleasant, the smell from the mouth
is offensive, the appetite is irregular, now canine hunger, and then again aversion to food; the tongue is
frequently coated white, and the mouth is filled with
water. The bowels are at times confined, at times
there are loose and slimy stools. If the worms be
lodged in the duodenum and stomach, there is pressure
and a gnawing pain in the pit of the stomach, eructation, vomiting, sometimes even vomiting of worms.
Other symptoms are: itching, tingling, and bleeding of
the nose, frequent sneezing; pale countenance, sunken
eyes surrounded with blue margins, squinting, dilated
pupils; restless sleep, during which the patient starts
frequently; ruminating, grating of the teech, talking in
sleep; indolence; emaciation of the extremities;
bloatedness of the countenance. The febrile erethism
is characterized by a little chilliness, a small, irregular,
and even intermittent pulse, clammy sweat, turbid
urine, smelling like horse urine. The febrile phenomena, as a general rule, are vague and uncertain,
sometimes they are very violent, the heat being very
great and accompanied with sopor, shrieking and
trembling. Less permanent symptoms are: jactitation
of the muscles, spasms, vertigo, fainting turns, illusions
of sight and hearing, oppression of the chest, palpitation of the heart, hickup, paralysis, stupor, sopor,
cerebral diseases, hemorrhage, blennorrhcea, ischury,



WORM FEVERL                1
strangury. Worm affections almost always increase
and decrease with the moon; when the moon is on the
decline, a quantity of worms is frequently passed.
~ 52. The formation of worms occurs most frequently
in childhood. Sometimes the worms are hereditary
(they have even been found in the foetus); they occur
rarely in infants at the breast, most frequently in the
period of dentition, very rarely in the age of adolescence (except tenia, which is most frequent at that
age), and rather more frequently in the declining age;
they are more apt to be found in females, and in persons of a leuco-phlegmatic constitution, with disposition to excessive formation of mucus and blennorrhoea.
Exciting causes are: bad food, vegetable diet in preference to meat, uncleanliness, and a damp, tepid atmosphere, which may convert helminthiasis into an
endemic or epidemic disease.
Helminthiasis may easily be confounded with hydrocephalus, especially when the so-called nervous
symptoms, sopor, spasms, dilated pupils, vomiting, are
present; but in helminthiasis the abdomen is soft and
distended, whereas in hydrocephalus it is flat and
drawn in; in hydrocephalus the head feels hot to the
touch, and the symptoms occur in a certain succession, whereas in helminthiasis the symltoms are
changeable, and occur at uncertain periods.
Worm diseases have a slow run, and are very much
disposed to occur again, or the patient is apt to have
a relapse. Other diseases, such as chronic inflammation of the mucous membrane of the intestines, resulting in perforation, mucous fevers, epilepsy, hectic fever
(occasioned by the disordered process of nutrition),
may arise from worm affections.
The prognosis is favourable; it is most favourable
in diseases arising from ascarides, least favourable in
taenia on account of the symptoms being more obstinate and the cure more uncertain. If the worms be
lodged in the large intestine, the cure is always more
easily accomplished than when the worms are lodged
in the lesser intestines or the stomach.
~ 53. The surest way to cure worm diseases, is to



WORM FEVER


remove that morbid condition of the digestive organs
which always precedes and favours the formation of
worms. According to Hahnemann's view it is not required to remove the worms, inasmuch as they result
from a general constitutional illness, and an unwholesome mode of life; if the constitutional disturbance,
which has generally a psoric origin, be cured homoeopathically (which can be done easily in childhood),
few or none of the worms will remain, or, at any rate,
the children will not he troubled by them, whereas
the worms are reproduced in quantities after the
bowels have been purged with cathartic medicines,
even when mixed with Cina. However, not to mention the circumstance that the organism is in a more
or less anormal condition as long as worms are present, even if there should be an appearance of health,
it is certainly true that the entire removal of the
worms, either living or dead, is most desirable, and is,
in some respects, the chief object of the treatment, inasmuch as it is the most certain proof that the remedies have effected a cure. As long as no troublesome
or dangerous symptoms make their appearance medical aid is seldom resorted to against worms, nor is it
required. We know very well that lumbrici and ascarides may live on the contents of the bowels of
children without irritating these organs in the least.
Worms, taenia excepted, require medical treatment so
much less, as they exist only for a limited number of
years in the organism; after that period the worms
disappear of themselves, owing to the changes which
take place in those vital secretions upon which the
existence of the worms depended. At any rate a palliative treatment will be sufficient in such cases to effe ct a cure. We ought to observe, that notwithstanding the considerable number of remedies which we
possess in our practice for curing worm affections, in
which we succeed in most cases, there exist no specific
remedies, and, indeed, there cannot exist any for the
in mediate removal of the worms; if this be desired
v. e have to resort to large doses of the so-called anthelmintica. This, however, is entirely unnecessary;



WORM FEVER.


for we know for certain that the small homceopathic
doses of a properly-selected remedy are entirely sufficient to destroy the worms, which are afterwards carried off by the rectum.
The following are the general remedies against
worm diseases: Aconite, Bell., Cina, China, Dig., Ferrum, Asar., Calc. c., Graph., Ignat., Marum verum,
Merc., Nux v., Filix mas, Sabad., Spigel., Stram.,
Stann., Silic., Valer., Verat., Sulphur, and others.
If the symptoms arise from the presence of ascarides
in the colon 'and rectum (they are scarcely ever found
in any other part), Acon., Ferr., Ignat., Mere., Nux v.,
and Valeriana are the best remedies. Against the intolerable itching and the feeling of excoriation and
soreness, Ignatia, Tinct. sulph., and Marum verum are
especially useful; Mercurius is indicated for the violent
diarrhoea and tenesmus; Ferrum for.the vomiting
and the confluence of water in the mouth, Valeriana for the nightly itching and the muscular spasms
and sleeplessness arising from it.
The morbid phenomena denoting the presence of
lumbrici, generally correspond to Nux v.; China, Cina,
Bellad., Mere., Spigelia. Nux v. is especially useful
against great distention and sensitiveness of the abdomen and the region of the stomach, hea.t in that
region, hard stool, inclination to vomit, excessive
general irritability and sensibility, aggravation of the
symptoms early in the morning.
China is indicated when the symptoms are aggravated principally at night, when after every meal the
patient experiences a painful pressure below the umbilicus, fulness of the abdomen, heartburn with confluence of water in the mouth, cardialgia and retching;
when the nervous system is excessively sensitive, with
spasmodic jactitation of the muscles in various parts,
tremor and debility (Valer. may prove useful when
those symptoms occur).
Cina is a principal specific against worm affections
of children, when arising from the presence of oxyurides
vermiculares and ascarides lumbricoides, and when
the group of symptoms is constituted as follows:
8*



WORM FEVER.                179U
several times cured entirely by Silicea. That Silicea
is a useful remedy in those fevers, is evident from the
power which it possesses to occasion febrile and gastric conditions, and from the fact that the pathogenetic
symptoms of Silicea are more marked at the time
when the moon changes, which is likewise the case in
worm fevers.
The most powerful remedy in eradicating the disposition for worm diseases is Calcarea; it is entirely
adapted to children of a lymphatic, fleshy constitution,
with disposition to blennorrhcea and excessive secretion of mucus,* to feeble individuals whose assimilative functions are impaired, with pale, cachectic complexion, bloated countenance, weak feet, chronic dyspepsia, diarrhoea, and when scrophulosis and rickets
are present. Next to Calcarea ranks Sulphur, which
is especially adapted to lymphatic and leuco-phlegmatic constitutions, when a disposition to catarrh arid
blennorrhcea is present, and when the following symptoms occur: bitter, slimy taste in the mouth, aversion
to meat, irresistible desire for sugar, alternation of
canine hunger and loss of appetite, frequent regurgitation of food with heartburn and waterbrash, hickup,
gagging, vomiting, rumbling in the bowels, intolerable itching of the rectum, with raw and sore feeling
of that organ, etc. Puls., Ipec., Mere., Antim., and
other remedies, may likewise prove suitable for such
symptoms.
Worm affections cannot be cured unless the diet
and mode of life of the patient are strictly regulated;
the diet ought to be nourishing and substantial, the
principal food being meat; vegetable food, milk, flour,
and, above all, pastry, ought to be carefully avoided.
~ 54. This seems to be a proper place to add a few
words relative to the treatment of tmnia. Hahnemann
says, in his Organon, that the morbid phenomena denoting the presence of tenia can be speedily removed,
or rather quieted, by the smallest portion of the tincture
of Filix mas; the tania being calmed, it no longer ir.
* The German term is "Verschleimung," which conveys the idea as if
every thing were turned into phlegm.



180


WORM FEVER.


ritates the bowels of the patient. Hahnemann advises
a sort of palliative treatment, until the radical cure is
completed by means of the antipsorics. Several homoeopathic physicians agree with Hahnemann; among
"whom we may particularly mention the name of
Hering, who advises to keep the teenia, which he does
not consider as a very great plague, rather than to expel it by violent means, lest some other more dangerous affection should appear in the place of the tsenia.
However, not to mention the insufficiency of this palliative treatment, which every physician will be frequently obliged to resort to, it is absolutely necessary
that we should consider the express wish of the patient to have the monster expelled. If we do not
comply with his wishes, he will resort to nostra and
the pernicious expedients of old women and quacks.
We are so much more justified in attempting the expulsion of the taenia, as the antipsoric treatment is very
slow and very problematical. Several homceopathic
physicians have, therefore, been induced to attempt
that expulsion, and have indeed been successful.
Gross recommends particularly Graphites, Calcarea,
Sabadilla; also Fragaria vesca; Hering recommends
Sulp., Mere., and Calc.; besides these remedies, the
following deserve to be mentioned: Carbo anim. and
veg., Kali carb., Magn. mur., Natr., Phosp., Petrol.,
Plat., Stann., Tereb. Stannum is recommended by a
number of homceopathic physicians as a great remedy in worm affections; at any rate it is an excellent
palliative for the symptoms of tania and lumbrici.
Among the remedies which have effected the expulsion of tenia in a short period and directly, the first is
Filix mas. Bicking has been successful in almost
every case. He directed the patient to drink a quantity of cold water, to use cold water injections, and to
apply cold water douches to the abdomen. This being done, he gave the patient a saturated decoction of
Filix mas (half an ounce per diem); he admits, however, that the tmnia was frequently reproduced, but
speedily expelled again by similar means, without ever
reappearing. Lobethal affirms that the daily use of a



WORM FEVER.


few drops of the concentrated tincture of Filix mas
has been quite sufficient in his hands. In the Hom.
Gazette, vol. ii., p. 67, a case of a frightful worm colic
is reported, which was speedily cured by a single drop
of the tincture of Filix mas; eight days after the colic,
fifty yards of tania were discharged without the dose
having been repeated.
The same results have been obtained bymeans of Punica granatum. Lobethal recommends that remedy in
very obstinate cases. J. O. Miiller (Hygea, vol. x., pp.
137, 193,) mentions the following symptoms as having
been removed by Punica granatum: convulsive movements, catalepsy and epilepsy, fainting turns, emaciation, notwithstanding a constant appetite, sudden
waking, hallucinations, hypochondria, vertigo, stupor,
trembling before the eyes, dilatation of the pupils, yellow complexion, grating of the teeth, confluence of
water in the mouth, variable appetite, gulping up of
a watery fluid, vomiting, sensation in the stomach as
if a body were ascending in it, distended abdomen,
colic, chronic palpitation of the heart, etc.
The expulsion of the taenia frequently succeeds in a
very peculiar manner, and the cases of cure which
will be recorded in the following paragraphs confirm
Hahnemann's rule: "Remove the perceptible phenomena of disease, and health will be restored."
A lady suffered with irregularity of the menses;
they occurred either too early or too late, were either
too profuse or too feeble, the menstrual blood being
always thick, coagulated, black. Several times she
had been affected with the most violent symptoms of
inflammation of the liver, after which a jaundiced
complexion had remained. For some time past she
had been complaining about intense pain in the region
of the liver and umbilicus, recurring at intervals, accompanied with nausea, gagging, vomiting of tenacious
mucus, yellowish grey complexion. After having employed the remedies which we thought were indicated,
without any success, we exhibited the second trituration of Argentum nitricum crystallisatum, three times
a-day, each dose consisting of as much of the tritura



182


FEBRILE CONDITIONS


tion as would cover the point of a pen-knife. Eight
days after having taken the medicine, she passed a
quantity of fragments of taenia, all her troubles disappeared, and have not returned; it is now two years.
We were guided in the selection of the remedy by the
profuse menstruation, as Kopp advises.
Another lady had been affected with tenia for the
last seven years. The fragments which she had occasionally passed during that period were evidences of
the continual presence of the animal. The lady had
given birth to two children; one of whom was still
alive, but she had never been pregnant since, owing to
the presence of the tenia. She had gone through various
kinds of treatment for tmnia, including the cold-water
treatment, but without any success; she was now determined to try homceopathy.  The peculiar pain
which she experienced in the stomach, the constipation, the irregular menses, which were scanty, and at
times appeared too late and then again too early, the
jaundiced tinge around the mouth and nose, seemed to
require Nux, third attenuation; this was given, and the
condition of the patient soon improved to such an extent that the cure might be looked upon as terminated.
Some time after she had a violent chagrin, which
brought back all her former troubles, and required
Chamomilla, first attenuation, which effected an essential improvement, but left the constipation as it was.
This circumstance leading us to suppose that the
alternate use of those two remedies would remove the
trouble, we put the patient on Chamomilla and Nux,
giving her two doses of the former in the morning and
one dose of Nux in the evening. Four days after
taking the medicine, the entire tenia was expelled;
soon after she became pregnant, and expects soon to
be delivered.
We may here observe that the real tenia, bothriocephalus latus, occurs very seldom in Germany, the
taenia lata solium more frequently.
~ 55. Febrile conditions resembling Cholera.
Many will say that the various kinds of fever which



RESEMBLING CHOLERA.          183
we have treated in the preceding paragraphs are very
much like the febrile conditions which we shall speak
of in this chapter, and that the treatment, at any rate,
is very nearly the same. Although we are willing to
admit that the febrile conditions which we have
alluded to in the heading are not essentially different
from one or the other of those fevers, yet we think that
we ought to be as explicit as possible in this work,
were it only for the sake of beginners in homeopathy,
for whom this work is more particularly designed. It
is for this reason that we will make particular mention
of a kind of cholera fever which is very much related
to a gastric or bilious fever, and frequently occurs as a
sporadic disease in some parts of Germany. After
that we will likewise give a minute account of the
treatment of the Asiatic- cholera, which having appeared once, is likely to appear again amongst us some
time or other.
The sporadic cholera generally appears suddenly
and without any precursory symptoms. If there exist
precursory symptoms, they resemble those of a saburral, bilious, and pituitous gastroataxia, or the precursory symptoms of saburral, bilious, and pituitous
fevers, such as: general malaise, heaviness and indolence of the body, yellowish complexion, yellow slimy
coating of the tongue, the root of the tongue being
more thickly coated than the tip; these symptoms are
frequently accompanied with a slimy, bitter taste, and
beside this, nauseating bitter eructations are sometimes present; there is likewise a pressure, a crampy
drawing and fulness in the pit and region of the
stomach, with anxiety; flatulency, nausea, distention
of the abdomen, rumbling and colicky pains in the
bowels, the urine causes a burning in the urethra, has
a fetid smell, and deposits a reddish sediment.
If these symptoms be not speedily removed by suitable homoeopathic remedies, or if the disease have no
precursory symptoms, the symptoms of the disease
itself set in. In the commencement the patient vomits
suddenly and repeatedly, until the ingesta have been
removed from the stomach, after this a watery, slimy,



ASIATIC CHOLERA.


3. Heilung der Cholera, nebst einem Zusatze, das
dietetische Verhalten bei dem Gebrauche der Streukiigelchen betreffend.  Nuremberg, 1832.  (Treatment of cholera, with additions concerning the diet
which ought to be observed while using the pellets.)
4. Heilung und Ausrottung der Cholera, mit den
Regeln der homoeopathischen Diet. Leipsic, 1831.
(Treatment aid extirpation of the cholera, with the
rules of homoeopathic diet.)
5. Sendschreiben fiber die Heilung der Cholera und
Sicherung vor Ansteckung am Krankenbette, herausgegeben vom Medicinalrath Dr. Stieler. Berlin, 1831.
(Address relative to the treatment of cholera, and the
best means of guarding against the cholera-contagium
at the bedside of patients.)
6. Schubert, Dr. J. A., Heilung und Verhiitung der
Cholera. Leipsic, 1830. (Treatment of cholera, and
the means to prevent it.)
7. Ausziige brieflicher Mittheilungen aus Wien, die
asiatische Cholera, deren Eigenthumlichkeiten. und
ihre homceopathische Behandlung betreffend. Leipsic, 1832. (Extracts from letters from Vienna, concerning the character of the Asiatic cholera, and its
homceopathic treatment.)
8. Bakody, Dr. Joseph von, Homceopathische Heilung der Cholera zu Raab in Ungarn, im Jahre 1831.
(Hommeopathic treatment of the cholera at Raab, in
Hungary.)
9. Hommopathische Behandlung der asiatischen
Cholera, nach Dr. Hofrath S. Hahnemann. Von Dr.
Karl Kemmerer zu Schwabisch Gmfind. Stuttgard,
1832. (Homceopathic treatment of the Asiatic cholera.)
10. Was haben wir von der Cholera zu fiirchten?
Von Dr. K. Preu. Nuremberg, 1831. (What have
we to fear from the cholera?)
11. Du traitement homceopathique du cholera, avec
notes et appendice. Par F. F. Quin, M.D., Medecin
ordinaire de sa Majeste Leopold roi des Belges, etc.
Paris, chez B. Bailliere, libraire de l'academie royale
de medecine.   1832.  (Hommcopathic treatment of
cholera, with notes.)



ASIATIC CHOLERA.


189


12. Vier Vorlesungen fiber die Cholera in Europa,
von Dr. J. Reubel. Munich, 1831. (-Four lectures on
the cholera.)
13. Bestatigte Heilung der Cholera durch homoeopathische Arzneien, von Dr. Rohl. Eisleben, 1832.
(The cure of cholera achieved by homceopathic remedies.)
14. Die homceopathische Heilkunst in ihrer Anwendung gegen die asiatische Brechruhr, dargestellt von
Dr. J. J. Roth, practischem Arzte und Privatdocenten
an der Universitit zu Miinchen. Leipsic, 1833. (The
homceopathic treatment of cholera.)
15. Die Heilung und Prophilaxis der Cholera, v. J.
Eman. Veith. Hamm, 1832. (Curative and prophylactic treatment of cholera.)
Beside the above-mentioned publications, there are
several interesting articles on the subject of Cholera
in the Homeop. Gazette, Vol. I., Nos. 2, 4, 5, among
which Dr. Rummel's treatise, " On the second appearance of the Cholera in 1Verseburg," deserves particular
mention. Hartlaub and Trinks have collected, with
great care, the various letters which have been published on the subject of cholera, and have appended
them to the third volume of their Annals. The third
volume of Schweichert's Hom. Gazette likewise contains a number of interesting data relative to the
treatment of cholera.
~ 61. From the statements and observations relative
to the different degrees of cholera we infer, that every
age and sex is liable to the invasion of that epidemic;
little children and old people are least subject to its
attacks; individuals from the 25th to the 60th year of
age are most easily affected. The inferior degrees of
cholera seem to require a more or less marked predisposition to the disease, depending upon a torpid state
of the abdominal organs, upon the constitution of the
patient, upon temperament, mode of life, food, climate,
locality; this is the reason why the cholera is more
frequently met among the poorer classes. The higher
degrees of cholera and the malignant form of that
epidemic make their appearance among all classes,



ASIATIC CHOLERA.


external circumstances having no influence on the
character, course, and symptoms of the disease.
It is true there are extreme degrees of violence and
mildness in cholera, the former being malignant and
speedily fatal, the latter being controlled more easily;
but between those extreme degrees there are numerous shades and gradations in the first appearance, development, violence and concatenation of the symptoms,
most of which are founded in the individuality of the
patient, and have to be observed with great care, as
they determine the remedy which is to be used in the
case. Those degrees of violence occur much more
frequently in the inferior grades of the disease than in
the higher; these are more uniform in their principal
symptoms, and the most striking differences occur in
the nervous and muscular system. Either degree of
the disease, mild or intensely malignant, has no well
marked limits. The milder degree may easily pass
into the more malignant, but not the reverse.
From time immemorial we understand by cholera a
disease which is characterized by the following symptoms: the patient discharges by the mouth and rectum,
either continuously or at short intervals, with great
violence and in profuse quantities, a watery or else a
watery, slimy fluid, which is neither feculent nor, as a
general rule, bilious or sanguineous; accompanied with
cramp pains in the abdomen and pracordia, with or
without colic, properly so called, retention of urine,
sudden vanishing of strength, which increases to the
most excessive prostration, painful spasms in the limbs
and trunk if the disease continue for a certain length
of time, and rapid loss of animal heat. Cholera is
distinguished from other diseases by the fact that its
attacks come on suddenly, without any precursory
symptoms, and with great violence; that it is either
entirely without any fever, or that the fever is scarcely
perceptible, and out of all proportion to the intensity
of the symptoms.
Cholera has no well marked periods or stages; but
even if they could be defined, this would have no sort
of practical value in the more intense degrees of the



ASIATIO CHOLERA.


191


disease. Nevertheless, authors have thought proper
to lay down certain stages, and we will follow their
example.
First stage; stage of the invasion, precursory stage.
In the more violent degrees of cholera this stage is
scarcely, if ever, perceived; it sometimes lasts only a
few minutes. In the milder forms of cholera, the invasion is characterized more or less by the following
symptoms: About twenty minutes, and in very rare
cases some days, previous to the outbreak of the disease, the patient complains of a general malaise, without considering himself sick; he feels debilitated, and
exertions fatigue him extremely; there is an alteration
in the expression of countenance, the patient looks
anxious, sad, apprehensive, and a complete disfiguration of the countenance (the facies cholerica) soon
follows. The patient is out of humour, restless, he
moans, has an aversion to anything, especially to food
and drink, complains of a disagreeable sensation of
pressure, tension, creeping or rumbling in the stomach
and bowels, without experiencing any real pain, sometimes accompanied with frequent eructations and slight
nausea. The pulse is not much changed, but upon the
appearance of the second stage it becomes more rapid,
and withal smaller and weaker. The skin feels dry
and cool, portions of the skin being covered with a
slight, clammy sweat. The abdomen is generally
tense, bloated, as if too full, but scarcely ever painful
to pressure. In some cases the region of the stomach
is somewhat sensitive, and there is some disposition to
go to stool. Sometimes the patient complains of pressure in the chest, laboured breathing, a beating sensation in the chest, alternate chilliness and heat. The
urine is more scanty than usual, and is either pale and
clear as in spasms, or else turbid and cloudy. The head
is generally without pain, but somewhat dull, heavy, and
at times even giddy. Sleep is restless, frequently interrupted by starting and jactitation of the limbs.
Those symptoms have degrees of intensity. The first
stage may last from twenty minutes to twelve, fifteen,
or even eighteen hours.



ASIATIC CHOLERA.


Second stage; stage of development. The symptoms
which characterize the second stage vary, like those of
the first, both as regards intensity and duration. In
some cases the principal symptoms set in at once, increasing steadily until death has taken place; the first
and third stage apparently do not set in. In other
cases the symptoms increase more progressively and
slowly, sometimes they seem even to remain stationary,
and the patient improves, or, at any rate, seems to improve. This improvement, whether real or apparent,
soon gives way to a new and so much more violently
increasing aggravation, which may be considered the
third stage. Some practitioners have observed, that
the degrees of violence occurring in the second stage
depend principally upon the nature of the locality
where the epidemic prevails. This observation may
be of importance in the treatment.
The second stage is generally characterized by the
following symptoms: sudden vomiting, sometimes preceded by short nausea, but very seldom by real vomiturition; the food, which happens to be in the stomach,
solid or liquid, is thrown up with a sudden jerk; after
the first vomiting the patient sometimes feels a certain
relief. Either simultaneously or a few minutes after
the vomiting, diarrhoea sets in; this is papescent and
partially liquid, the first three or four diarrhceic stools
being intermixed with faeces and half feculent, undigested food, slime and a watery fluid, accompanied
with rumbling in the bowels, sometimes with pinching
and real colic, which is very seldom violent, and sometimes entirely wanting. The vomiting very soon returns, the diarrhoea likewise, the substances which
are evacuated both by the mouth and rectum becoming
more and more fluid, and quite watery. In many
cases both kinds of evacuations are so frequent that
the patient is scarcely able to rise from the chair;
sometimes the debility is so excessive that the patient
is unable to leave his bed, and has to be assisted in
bed every fifteen minutes or more frequently, the average number of stools in twenty-four hours being from
thirty to forty, together with as many vomitings. It



ASIATIC CHOLERA.


is considered a symptom of the worst kind, and of approaching dissolution, if the diarrhceic stools diminish
in number while the strength of the patient and the
pulse decrease proportionately. Generally speaking
the number of the evacuations by the bowels or mouth
-varies; sometimes the evacuations are more numerous than in sporadic cholera, sometimes," and this is
the more frequent, they are less in number; there
have been cases of Asiatic cholera where only a few
extremely copious and watery evacuations took place
in the very commencement of the attack, occasioning
excessive prostration.
After the second, third or fourth evacuation all succeeding evacuations are watery, or of the consistence
and nature of an albuminous serum, or a serous mucus, or like rice-water; generally they are clear or
somewhat whitish, inodorous and tasteless, with albuminous, cheesy, blackish flocks, floating in the midst of
the liquid. As a general rule the abdomen caves in
after the first diarrhoea; the whole body, in fact, sinks
and becomes emaciated after the evacuations have
continued one or two hours. This alteration is especially visible in the countenance. It is remarkable
that there should not be any bile either in the evacuations upward or downward; even after death no
trace of bile can be discovered in the intestinal canal.
The want of bile is a characteristic phenomenon in the
Asiatic cholera; not till the disease is on the decrease
and an improvement sets in, do we perceive a tinge
of bile in the alvine evacuations. These evacuations,
which become painless as they continue, and finally
take place without anfy sensation, are accompanied
with a sense of exhaustion increasing to utter prostration. Restless and anxious, the patient is all the time
endeavouring to change his position, even if he should
faint in the effort. Shortly after, slight twitchings of
the muscles, or only a drawing and tension in the
muscles of the upper and lower limbs, sometimes make
their appearance; sometimes these twitchings amount
to violent and continuous spasms in the limbs, which
are extremely painful, and are characteristic phenome9



ASIATIC CHOLERA,


na in cholera. These spasms first commence in the
toes, fingers and hands; afterwards in the calves, etc.
Sometimes the spasms are tonic or tetanic, in which
case they are the most painful, and make the limbs
immoveable, and stiff and hard as wood; generally
the spasms assume the form of chronic convulsions.
The spasms affect most frequently the calves, forearms
and hands.
These spasms are accompanied by an increasing
but not suffocative oppression of the chest, and tightness of breathing, increasing anxiety, vertigo, and principally a sudden collapse and excessive smallness of
the pulse which frequently disappears entirely a long
time before death, or is, at any rate, scarcely perceptible. The same statement applies to the beating of
the heart. The sudden collapse of pulse is one of the
most remarkable, and, at the same time, one of the
most essential symptoms of this epidemic. This collapse of pulse appears to be dependent upon an arrest
of the circulation rather than upon spasm.
Simultaneously with these symptoms, or before, the
patient experiences a disagreeable, painful burning in
the epigastric region, or in the region of the stomach
down to the umbilicus. According to Annesley, this
burning, which is sometimes experienced behind the
sternum, and is one of the most constant, most distressing, and most alarming, symptoms, is so characteristic
of cholera-that, whenever it exists in connexion with
the anxious look, with sighing and anxious breathing,
one may safely infer from it the existence of cholera.
The burning remains frequently a long while after the
vomiting has ceased, accompanied with a burning and
tormenting thirst, the patient expressing a particular
desire for cold water, which he swallows with great
avidity, and throws up again immediately.
Simultaneously with the spasms, and sometimes a
little before, the whole surface of the body becomes
cold; first the lower limbs and then gradually the
whole body. This coldness increases to a coldness as
of a dead body (frigus marmoreum). It resists the
most persevering means of warming, and spreads



196


ASIATIC CHOLERA.


again, which may always be considered a favourable
symptom.
The secretion of mucus is not changed, only less
copious; the saliva is more viscid; the nasal mucus is
generally wanting.
This stage lasts from two to three, up to eight, twelve,
or twenty-four hours, sometimes two or three days.
The third stage cannot well be separated from the
former, for this stage either passes into the highest
degree of the disease, the stadium lethale, or into the
stage of convalescence. The fatal stage is simply an
aggravation of the symptoms which we have described
as belonging to the second stage; sometimes vomiting,
diarrhoea, spasms, abate shortly before death, the
patient falls into a kind of sopor, the heart ceases to
beat, the eyes become glassy, etc.
If an improvement set in, the pulse becomes fuller
and more equal, the animal heat returns, and the
spasms cease; the expression of countenance becomes
more natural, cheerful, anxiety is no longer depicted
in it; the look is firmer and more animated; there is a
warm exhalation from the skin; the watery diarrhoea
diminishes, the vomiting ceases, the alvine evacuations
again assume a bilious, sometimes greenish tinge; the
urine is secreted again.
~ 62. The prognosis is quite different from that of
sporadic cholera; the course of the Asiatic cholera
being extremely rapid. Generally the attack terminates in asphyxia after two or three hours; very seldom
the- disease lasts two or three days. If its course
should be slow, and if the disease should pass into a
typhoid fever, this may likewise be fatal. It is true
the homceopathic treatment of Asiatic cholera is much
more favourable than that of allopathic physicians;
nevertheless, the physician has to be constantly watchful lest he should overlook the dangerous moment. A
chronic weakness of the nerves, and particularly of the
digestive organs, frequently remains. According to
Hahnemann, and several other physicians, the best
remedy to prevent the complete development of the
disease is Camphor. For this purpose one part of



'200


ASIATIC CHOLERA.


when the cholera threatens to pass into secondary
typhoid affections.
Laurocerasus is given by some physicians when the
following symptoms are prevalent: small and slow
pulse, vertigo, stupefaction, convulsive spasms of the
muscles of the face, etc. According to our own judgment this is not a good remedy in cholera; it is our
opinion that a good deal of valuable time is lost by
resorting to that remedy in cholera. The symptoms
previously mentioned do not indicate Laurocerasus,
but rather Veratrum or Cuprum.
According to Rummel's experience, a distinguished
remedy in cholera is Secale cornutum, lower potencies,
from one to three doses, when the following group of
symptoms exists: the vomiting has either ceased entirely, or for the most part; the colour of the stools remains
unchanged, and there is every indication that no bile is
poured into the intestinal canal. Soon after the use of
Secale cornutum, yellow and green stools make their
appearance; as soon as this takes place, the patient
may be considered out of danger. The pains in the
extremities likewise abate during the exhibition of
Secale.
This remedy seems to be an excellent remedy in the
so-called cholerine, for which Camphor, Mere. sol.,
Phosphorus, and Acidum phosphor. are likewise recommended. The last of those remedies is said to be
indicated when the tongue is thickly covered with
mucus. The Russian physicians have made frequent
and successful use of Mere. sol. in the treatment of
cholera.
Every homceopathic physician will easily distinguish
the symptoms for which Aconite is indicated; they do
not require any further notice.
If cholera patients have been treated allopathically
"before the homceopathic treatment commences, it is indispensable to give them, in the first place, repeated
doses of Camphor, partly to excite the reactive power
of the organism, and partly to neutralize the large
doses of allopathic drugs.



204


DYSENTERIC FEVERS.


peculiar smell. The fever is proportionate to the degree and violence of the disease, and generally does
not make its appearance until the permanent symptoms of dysentery have all set in. That fever is a
continua remittens, having in most cases a rheumatic,
catarrhal, or bilious character; it commences with a
succession of moderate chills, followed by moderate
heat. The exacerbation generally takes place in the
evening, and is accompanied with a perceptible aggravation of the local symptoms.
~ 65. The disease is occasioned by various remote
causes, the principal being the suppression of some
kind of cutaneous action, with increase of acrid bile.
This is the reason why dysentery prevails almost exclusively towards the end of summer, in the months of
August and September, when the days are very hot
and the nights very cool. At that season of the year
dysentery is almost always epidemic. The disease is
endemic in low, damp, marshy regions, where intermittent fevers are likewise prevalent; in such districts
dysentery occurs almost every year. In epidemic
dysentery the putrid emanations from the stools frequently develope a contagium by means of which the
disease spreads rapidly and over a large extent of
country.
Other exciting causes are: unripe, acrid, watery
fruit; vegetables covered with mildew; corrosive
poisons, worms, haemorrhoidal congestions, metastasis,
difficult dentition. The prevailing type or character
of disease becomes easily ingrafted upon the dysentery, and may convert it into a catarrhal, rheumatic,
gastric, bilious, or typhoid dysentery, although every
one of those varieties may likewise be occasioned by
the individuality and constitution of the patient.
Children and females are principally affected by that
disease.
Chronic affections are sometimes roused by an attack of dysentery, and may in their turn complicate the
disease, and make the prognosis more or less doubtful;
although the termination of the disease does not depend exclusively upon the complication, but also upon



DYSENTERIC FEVERS.


205


the greater or lesser intensity of the dysentery itself.
As the disease increases, inflammation supervenes, an
excessive quantity of putrid bilious substances is expelled from the system, and the patient is extremely
debilitated. All these symptoms may occasion death
if the patient be not carefully treated, and the most
unfavourable prognosis has to be given if a sudden cessation of the intense pain, sunken countenance, coldness of the extremities, a small intermittent pulse, fetid
evacuations, which the patient passes without consciousness, indicate-the setting in of mortification.
The post-mortem examination shows that the disease
is seated in the mucous membrane of the large intestines. This membrane is swollen, red and injected,
softened (the softened parts being red and bleeding); a
serous exudation is perceived in the shape of a fine
miliary vesicular eruption, which results in the scaling
off of the epithelium of the inner walls of the large
intestine. These appearances characterize the lower
degrees of dysentery; in the higher degrees larger surfaces are affected, and the mucous membrane is covered
with a dingy grey, glutinous exudation, accompanied
with prominences which are formed by a copious
serous infiltration of the submucous cellular tissue.
This degenerative process increases until a dark red or
black brown sanguineous exudation has resulted from
it, which, in the highest form of the disease, becomes
a black, friable, tearable, and almost carbonized mass.
~ 66. We now pass to the treatment of dysentery,
commencing with naming the remedies which have
been used against the various kinds of the disease
generally. The principal remedy is Mercurius corrosivus, next to which we rank Mercurius solub. H., and
other mercurial preparations; Colchicum autumnale,
Capsicum, Carbo veg., Colocynth, Ipecac., Aloes, Cantharides, Acidum nitric., and Sulphur; Flores and
Hepar sulph., Rhus, Staphysag., Nux vom., Bellad.,
Pulsat., Chamom., Arsenic, China, Tart. emet., Sepia,
Plumbum, Veratrum.
Those kinds of dysentery which authors have denominated catarrhal rheumatic, and which do not occa



DYSENTERIC FEVERS.


207


is tormented with retching, vomiting of the ingesta,
and coldness of the extremities.
Inflammatory dysentery is very rare, sometimes
sporadic, but scarcely ever epidemic; it prevails mostly at the end of summer and the beginning of autumn,
when the days are hot and the nights cool.
The first thing we have to attend to in the treatment
of inflammatory dysentery, is to remove the synochal
fever, which we accomplish by means of a few doses
of Aconite. This remedy is frequently sufficient to
subdue the whole disease. If the disease should not
be subdued entirely, Belladonna has to be used.
To confirm our assertion we will mention the symptoms of the disease more in detail. Without dwelling
upon the febrile symptoms themselves, which have
been described with sufficient completeness, under the
head of synocha, we will at once proceed to treat of
the local affection, premising that Belladonna deserves
consideration if the dysenteric patient be of a plethoric constitution, and have a lively, ardent temperament. The exacerbation commences in the afternoon
and lasts until midnight, when the fever remits; nevertheless the patient is prevented from sleeping by a violent restlessness, and a great desire for cold drinks and
baths. There are moments when the patient is delirious, especially on waking from a light slumber;
his face is then red, and the head hot; gradually he
falls into a whining mood, which cannot be subdued
except by emphatic remonstrances, or which alternates with a firm resolution to jump out of the bed,
and to look for the chamber. The tongue is lined
with a whitish fur; the tip, which is not coated, inclines to be dry; the patient has lost all appetite, or
has a positive aversion to food; the pains in the bowels are either spasmodic and colicky, or else cuttingburning, the abdomen is somewhat distended in the
umbilical region, there is a constant urging for stool,
and small discharges of a bloody mucus.
In other cases Nux or Mercurius is indicated. Nux
is indicated by discharges of a sanguineous mucus,
mixed with single hard lumps of feculent matter, and



208


DYSENTERIC FEVERS.


accompanied with violent cutting in the umbilical region, and pressing in the rectum. Mere. is a principal remedy when, after the removal of the inflammatory syniptoms, frequent discharges of bloody mucus,
or liquid feculent matter, remain, accompanied with
cutting and tenesmus, which causes burning and soreness of the anus; every evacuation is preceded by a
cold sweat in the face, as from anguish and excessive
uneasiness.
~ 67. The gastric dysenteries, together with the catarrhal-rheumatic, are the most frequent, and are characterized by the fetid smell and putrid bilious nature
of the evacuations. According to authors there exists
in the first place a bilious dysentery, which is apt to
occur when the nights are cold and the days hot, and
which sets in with all the symptoms of a bilious fever;
the stools are frequent, consisting from the commencement of a fetid, green or brown bile; colic and tenesmus are very violent, accompanied with great restlessness and oppression of breathing. The bilious dysenteries resemble, to a certain extent, the inflammatory
variety; spontaneous vomiting affords relief. They
occur most generally as an epidemic disease, towards
the end of very hot summers, and at the commencement of the fall, after a continuous heat.
In this variety likewise, the treatment ought to commence with the removal of the inflammatory symptoms by means of Aconite, after which the specific
remedy in this variety, Mercurius corrosivus, may be
exhibited.
This remedy is indicated by a succession of small
muco-sanguinolent evacuations, continuing day and
night, with constant cutting pain in the bowels, and
an insupportably painful tenesmus in the rectum; or
when the stools are mixed with fetid green or brown
bile; the patient has lost all appetite, suffers with an
unquenchable thirst, his tongue, the edges of which
have a whitish coating, inclines to dryness, he feels
anxious, hot, and is deprived of sleep in consequence;
the pulse is small, feeble, frequent.
The Colocynthis dysentery has the following symp



DYSENTERIC FEVERS.


great debility, profuse, colliquative, and excessively
fetid stools; dry, brown, cracked tongue, extremely
rapid and scarcely perceptible pulse.
A secondary putrid dysentery cannot possibly occur
under hommeopathic treatment, unless the physician
be utterly incompetent. If a pituitous dysentery be
properly treated, it ought to improve four or five. days
after the treatment has commenced, it ought never to
last three weeks, or even a fortnight, as is stated in
pathological books.
A primary putrid dysentery has all the symptoms of
an epidemic and contagious malady.    Beside the
pathognomonic symptoms of dysentery, there is this
peculiarity, that its phenomena set in with the utmost
rapidity and violence, and with a considerable sinking
of strength. At first a putrid dysentery has an inflammatory character; the stools are not so frequent
as afterwards, but are so much more painful, and are
accompanied with violent colic. At this stage of the
disease it ought to be treated like an inflammatory
dysentery. If the symptoms of a local affection of the
intestines should become more prominent; if decayed,
fetid masses should. be discharged from the bowels
without any very great pain, and sometimes involuntarily; if the patient should frequently vomit bile or
mucus, and should complain of great loathing, and a
putrid taste and smell; if the symptoms of a general
status putridus should develope themselves, such as:
hemorrhages, aphthae, petechiae, blue spots and serous
vesicles on the skin, a burning hot skin; turbid, flocculent urine, having a cadaverous smell; sunken, stupid
expression of countenance, indifference to surrounding
things, soporous condition, etc., Nux, Arsenic, Petroleum, Carbo veg., Acid sulp. and nitr., Kreosot, China,
are the best remedies to be used; these remedies,
especially Sulphur, Nitric Acid, and Petroleum, ought
likewise to be employed when the disease improves
but slowly in spite of the best selected remedies, or
when it threatens to get worse again after an improvement of some days; in one word, when the disease is protracted, which is usually the case in persons



214


DIARRIHEA.


with a depressed vitality, debilitated, nervous, sensitive, scrofulous, and disposed to chronic maladies.
In this disease the diet is of the utmost importance.
Errors in diet may be extremely detrimental to the
patient. The patient ought to abstain from fruit and
green vegetables, both during and for some time after
the malady. Slimy soups and beverages are the most
suitable nourishment, especially salep, oatmeal-gruel,
and the white of an egg with sugar and water; and
lastly, boiled water, which agrees with the patient
better than anything else, and aids in restoring the
process of sanguification to its normal standard. We
know from pathological anatomy that the blood undergoes a morbid change in dysentery, which, in its turn,
favours the development of the disease.
~ 68. If typhoid symptoms should be developed in
the course of a pituitous or putrid dysentery, which
happens in the colliquative stage, the same rules apply
which have been laid down for the treatment of a
secondary putrid dysentery.  A typhoid dysentery
never exists as a primary disease, and has to be treated
with remedies which correspond both to the typhoid
and dysenteric symptoms.    (See the chapters on
typhoid fevers.)
~ 69. Diarrhea.
Diarrhea is generally a symptom of some more
general disease, or a salutary crisis.  However,
diarrhea may likewise occur as a primary disease of
the reproductive system, accompanied with fever.
The essential character of diarrhoea is an increased
and looser discharge from the bowels, the colour being
more or less different from the natural. It is frequently
preceded by the precursory symptoms of a gastric
affection. Colic is not always present; sometimes,
however, it is very violent (diarrhcea torminosa);
tenesmus is scarcely ever present.
The disease lasts from a few days to several months,
and even years. The discharges vary likewise, feculent, fluid, mucous, bilious, purulent, bloody. Diarrhcea
may be without any danger, getting well of itself, or



DIARRHEA.


215


it may become dangerous by its continuance, or danger
may actually be present when diarrhoea sets in.
A diarrhoea which is not manifestly dangerous
ought not to be arrested suddenly; danger may be
supposed to exist when the discharges are quite
watery (although this is not always a symptom of
danger),* and great debility after every evacuation,
sometimes amounting to syncope.
The selection of the remedy depends upon the form
and nature of the discharges. We distinguish the following kinds of diarrhcea:Diarrhcea stercoralis, being generally a consequence
of overloading the stomach with heavy, undigestible
fat, rancid, sour food and drink. It is preceded by
offensive eructations, aversion to food, colic, distention
and tightness of the stomach and abdomen, nausea,
and sometimes vomiting; after these symptoms have
set in, a quantity of flatulence is generally emitted,
accompanied with loose, fetid, papescent stools, sometimes corroding the anus and causing a burning and
pain in that part.
As regards the treatment, the same rules apply
which have been laid down for the treatment of the
precursory symptoms of gastric and bilious fevers.
This kind of diarrhea gets well of itself, as nature is
competent to remove the noxious substances. In some
cases a cup of black coffee will have to be used for
that purpose, or, if this should not be sufficient, one of
the above-mentioned remedies may be employed.
Diarrhoea aquosa serosa is a second form of diarrhoea.
This diarrhoea is occasioned by a cold either of the feet
or abdomen, and is sometimes a prevailing or even
epidemic disease in the latter part of summer, or in
the fall season. It is sometimes accompanied with a
lancinating pain in the bowels and spasms in the abdomen, retching, and nausea. The discharges take
place in rapid succession, they are watery, serous,
have very little smell, sometimes, however, they are
* I am now treating a gentleman who has been suffering with watery
diarrhcea for the last six years, from three to eight discharges a-day. He is
as strong and healthy as any man.-HaPiaL..



216


DIARRHiCA.


bilious; every discharge is accompanied with a new
and violent attack of colic. The diarrhoea of children,
occasioned by dentition, is of a similar kind, it is sometimes accompanied with heat, fever, and loss of appetite. If such diarrhoeas should be violent, and last a
long while, serum and even fibrin are passed, occasioning sudden prostration.
Dulcamara, frequently repeated, is the best remedy
for most cases of this form of diarrhoea, when it takes
place in the summer season, consists of green or yellow mucus, has a sour smell, the evacuations being
preceded by colic, followed by debility and remission
of the pain, and generally taking place in the evening.
If the diarrhoea be not so much accompanied with
pain in the bowels, but debilitating; if it be a kind of
lienteria, where the evacuations take place shortly
after a meal, and especially at night, with or without
cutting in the bowels; if they contain undigested food,
China will prove serviceable; in many cases Bryonia
will have to be given, especially if the diarrhoea have
been occasioned by a cold, if the evacuations occur
almost involuntarily, have a fetid smell and brown
colour, if they be liquid as in infants, accompanied
with flatulence or fermentation in the bowels. This
kind of diarrhea is sometimes controlled by Rheum,
especially when it affects children of any size, during
dentition or afterwards, they look pale, grumble and
quarrel a good deal, with heat all over; the evacuations are feculent, papescent, smell sour, and are accompanied with a constrictive pain in the bowels.
Mercurius solubilis will afford help if the discharges
of green mucus should be accompanied with a pinching and cutting pain, and should be so acrid that they
cause a burning and itching of the anus; the rectum
sometimes protrudes, and the stools are streaked with
blood.
Chamomilla is the surest remedy against diarrhoea
which occurs during dentition and is occasioned by a
cold; it is generally watery, green or like chopped
eggs, smells, like putrid eggs and is accompanied with
pinching colic. If the. diarrhoea should, set in.with



DIARRHOEA.


greenish stools do not always depend upon an effusion
of bile, but upon acidity in the primse vie; they frequently have a chopped appearance or look like
stirred eggs; in some cases the anus is corroded by
the stools.
The remedies for bilious diarrhea are the same
which have been indicated ~ 40, and the following.
The diarrhoea which is occasioned by acidity in the
primae vim, and is most frequently met with in children,
is cured by Chamomile or Rheum. Sometimes such a
sour-smelling diarrhoea becomes chronic; in such a
case Magnes. carb. will remove the trouble in a very
short while. If the anus, genital organs, and inner
surface of the thigh should be very sore, and if the
whole body, but especially the thighs, should be covered with a miliary eruption, Sulphur is the best
remedy.   If the children should be still at the
breast, the dose had better be given to the mother or
nurse, recommending a strict homeopathic diet. This
diet is likewise necessary, when the child is brought
up without the breast or is already weaned. In very
many cases the little being is stuffed with pernicious
things or an excessive quantity of food, pap, etc., to
keep it quiet. In cases where Chamomilla is indicated,
the physician ought to inquire very carefully whether
Chamomile-tea had been given; for the diarrhcea frequently arises from an abuse of that drug. In that
case the symptoms ought to be antidoted by Coffea or
Pulsatilla before another remedy is given.
Besides the remedies already mentioned we refer to
Mercurius, Hepar sulp., Sepia, Calcarea, and Graphites. We have seen this diarrhea in children several
times, who looked like a piece of raw flesh all over
the body, lamented a good deal at night, and were
prevented from sleeping by the pain. This condition
depends generally, but not exclusively, upon syphilis in
the parents. There is no better remedy for that group of
symptoms than Mercurius; this either effects a cure or
modifies the symptoms so that they will yield to Hepar
s., Sulp., or Graphites.
The remedies which we have indicated in the pre



DIARRHCEA.


219


ceding paragraphs, but especially Calcarea, are especially adapted to such diarrhoeas when occurring in
scrofulous patients; the secondary symptoms, which,
however, are not always very prominent, will point
more distinctly to one or the other of those remedies.
A fourth class of diarrhcea is the diarrhcea mucosa,
pituitosa. This diarrhoea sometimes arises from a mismanaged watery or feculent diarrhoea. Or it may be
occasioned by a cold in damp, wet and cold fall-weather, and in low and marshy regions; when such
causes- prevail, the diarrhoea may become epidemic or
endemic. Weakly, nervous, dyspectic persons are
most easily affected. The disease is ushered in by distention and hardness of the abdomen, pressure and
feeling of repletion in the abdomen, flatulence, loss of
appetite, slimy coating of the tongue, etc. The discharges have various colours, generally they are slimy,
and sometimes streaked with blood. They are debilitating, and induce emaciation unless soon arrested.
This kind of diarrhoea is, in most instances, a consequence of existing affections, especially of mucous
fevers.
As a general rule, mucous diarrhoeas are treated
like mucous fevers. It is a remarkable fact that such
diarrhoeas, together with their accompanying symptoms, generally correspond to Pulsatilla, especially if
the colour of the stools vary. If the diarrhoea should
be greatly debilitating, Colocynthis may be given. If
the evacuations should be slimy, green, sanguineous,
accompanied bytenesmus, Mere. sol. is the remedy. If
the disease should be one of long standing, Petroleum
will sometimes cure it, provided it corresponds to the
secondary symptoms; Acidum phosp. or Phosporous
are sometimes the best remedies. According to Dr.
Gross, the best remedy in painless diarrhea is Ferrum
metallicum. Lately Secale cornutum has been frequently given for mucous diarrhoea, especially when
the tongue was coated with mucus, and the patient
complained of papescent taste and rumbling in the
abdomen. It may be remarked that all those remedies have to be given repeatedly.



2< a


TYPHUS.


We do not speak of diarrhcea verminosa, diarrhoea
sanguinea, diarrhoea urinalis, and diarrhoea purulenta;
these are secondary affections which have to be treated in company with the primary disease.
Slimy kinds of food and drink, such as sago, salep,
rice, vermicelli, gruel, barley, oatmeal, etc., are to be
recommended in this kind of diarrhoea; if the diarrhcea
be chronic and yield only for a few days to the remedies which are given for it, the patient may eat
whortleberries, either raw, dried, or stewed. Freshdrawn milk, not boiled, is an invaluable remedy for
diarrhoea of children which does not yield to medicine.
FIFTH CLASS.
FEVERS AFFECTING PRINCIPALLY THE NERVOUS SYSTEM.
*~ '70. Typhus.
As in synochal and erethic fevers the vascular system is principally excited, so is typhus characterized
by great erethism of the nervous system, especially the
ganglia and brain. Typhus is characterized by great
variability of all the symptoms, an apparent contradiction between" the symptoms themselves, and between the symptoms and the disease, for instance:
dryness in the mouth and no thirst; no pain even when
causes, are at work which tend to produce pain;
violent illness and no great feeling of illness, the
patient asserting on the contrary that he feels well.
The moral symptoms are of the utmost importance
in typhus, as the selection of a remedy frequently depends upon them exclusively. It would be a fruitless
attempt to give an accurate and never-changing
description of typhus, which is an assemblage of the
most varied phenomena. In the following chapter we
give a general description of the characteristic symptoms of typhus, and shall furnish the particular indications for the remedies which are used in typhus, when
we come to speak of the varieties of that disease.
Recently it has been ascertained that the mucous
membranes and the lymphatic glands, especially those
of the ileum, are the principal seat of the disease,
whence it has been termed typhus abdominalis; for



TYPHUS.


221


merly the dynamic character of the disease, the depression of the nervous system was principally considered and, in accordance with that character, the
disease was named febris nervosa which could now be
properly applied only to typhus cerebralis. The more
precise appellation of this fever has led homceopathic
physicians to the discovery of many valuable remedies
for typhus, which it might have been difficult to discover without the pathological seat of the disease
having been first ascertained by post-mortem examination.
~ 71. General symptoms of typhus; diagnosis.
There is no violent chill in the commencement, but
slow chills alternating with heat. The brain and
nervous system are principally affected from the commencement, as may be inferred from the following
symptoms: dulness and tightness of the head, gloomy
mood, headache, vertigo, sometimes syncope, trembling, subsequent delirium, sopor, spasms of every kind,
both external and internal; convulsions, great debility
and prostration; small, feeble, soft, easily compressible, moderately frequent, sometimes slow, very variable pulse, which does not harmonize with the respiration; for instance, is rapid when the breathing is calm
(Hufeland).
There are three kinds of more or less distinct forms
of typhus:
1. Typhus cerebralis, affecting principally the brain,
spinal marrow, or the nervous system   generally.
This variety of typhus is principally characterized by
symptoms which denote a deep alteration of the
functions of those organs without any inflammation
being present; there will always be delirium, sopor,
or paralysis of the organs of sense, when the irritative
stage-great hurriedness in all the movements and
manifestations of the senses-has passed over. At
this stage of the disease there is the most remarkable
difference in the quantity of blood contained in the
brain and spinal marrow and their membranes, from
extreme congestion to anemia; sometimes those organs



222


TYPHUS.


are compact and tenacious, sometimes they are interstitially distended.
2. Typhus abdominalis, where a portion of the abdominal organs is the principal seat of the disease.
This variety contains a great number of shades and
has a slow course. The brain is only gradually invaded; the cerebral disturbance manifesting itself with
a certain rapidity in full-grown persons only, where
the organs, which are the principal seat of the typhus,
have attained a normal size without showing any
striking changes in the reproductive functions. We
now know from post-mortem examinations that the
principal seat of the typhus abdominalis is the mucous
membrane of the ileum which exhibits various forms
of degeneration, congestion, infiltration, ulceration, induration, interstitial distention, softening, exanthematic spots, gastro-enteritis, open or cicatrized ulcers.
Little by little the mesenteric glands and the spleen
are likewise affected, becoming considerably enlarged,
and from the spleen the affection frequently extends
to the mucous membrane of the cul-de-sac of the
stomach.
3. Pneumo-typhus, the organs of the thoracic cavity,
especially the lungs, being principally affected. This
variety of typhus frequently sets in in the shape of a
catarrh, or of an imperfectly-developed and therefore
not distinctly marked pneumonia; the heart and the
larger vessels are sometimes affected. The patient
complains of great anxiety, hurried, incomplete, labored breathing, with short, croaking, exhausting cough;
the expectoration has a bad colour, is purulent and
blood streaked; -certain regions in the chest are more
or less painful. A post-mortem examination reveals
the following appearances: degeneration of the lungs
by inflammation and gangrene, hepatization, adhesions,
effusions in the mucous membrane of the bronchia and
the parenchyma of the lungs; the heart is flaccid, pale
or of a dingy-red. The diagnosis is not very difficult.
The excessive prostration, the violent and universal irritation of the sensus communis, the appearances about



224


TYPHUS.


to the vital forces and favours the development of an
epidemic typhus; such an atmosphere arises from a
continuance of wet weather and easterly winds.
~ 73. The prognosis depends upon the form of typhus, the typhus in our climate is less dangerous than
the pest or yellow fever; also upon the stage in which
we find the fever, a typhus which has been continuing
for a time, is more uncertain than an incipient one;
upon the course, the more regular the course, the
more favourable the prognosis; upon the violence of
the symptoms, constant delirium, floccilegium, subsultus tendinum, constant sleeplessness, colliquative secretions, sopor, difficult swallowing, are very unfavourable.
Typhus generally terminates by some imperfect
crisis, metastasis, metaschematismus, miliary eruption
(which may also be one of the symptoms), furuncles,
abscesses, deafness, blindness, etc.
Death takes place by paralysis of the nerves, or by
some local affection, inflammation of the bowels, or
by colliquation, putrid decomposition.
It is very difficult to measure the exact extent of
the danger, owing to the deceptive feelings of the patient, the uncertainty, and the variability of the symptoms, and the opposition which seems to exist between
the apparent symptoms and the internal condition.
The pulse likewise cannot always be relied upon, inasmuch as a rapid pulse is not always proportionate
to the intensity, nor a calm and regular pulse to the
unimportance of the disease. The urine indicates an
improvement, if the turbid urine become clear, or the
clear urine moderately turbid; if a sediment should
form at the bottom of a lemon or straw-coloured urine,
this is a sign of recovery. The danger increases in proportion as the head is more stupified, insensible, soporous, the patient feels well, the local paralysis spreads
over an increasing number of parts; the tongue, for
instance, feels paralyzed when talking, or when protruding it from the mouth; there is difficult deglutition,
incontinence of urine, involuntary stool, violent convulsions. The greatest danger occurs when the skin



228.


TYPHUS.


there is vertigo, increase of headache, and excessive
erethism of the nervous system. Gastric symptoms
are manifestly present; the patient complains of bitterness in the mouth, dryness and yellow coating of
the tongue, aversion to food, nausea, with inclination
to vomit, pressure and stinging in the pit of the
stomach, sensation in the hypochondria as if they were
distended, difficult stool.
As the disease progresses the violent heat becomes
permanent, and is accompanied with violent delirium,
without the patient complaining much of his illness;
the distortion of the features, and the grasping at the
head, are the only signs of the continuance of the vio'ent headache; the continued moaning, even when
the patient is awake, points to an approaching rash,
which frequently breaks out in the shape of a white
miliary eruption, and sometimes in the shape of petechim. The delirious talk of the patient in most cases
turns about the patient's business, which gives him so
much anxiety that he endeavours to escape. The
thirst becomes more intense, the tongue drier and
parched; the face is red, bloated, the dry lips are
cracked; the alvine evacuations cease entirely, and
the urine looks brown-red. Bryonia ought to be repeated every two or three hours.
Mercurius is an important remedy when the fever
has the character of erethism from the commencement. Mercurius is best adapted, especially in the
commencement of the disease, to puffed leuco-phlegmatic individuals with soft and spongy flesh and predominant inclination to catarrh and profuse sweats,
and affected with bodily and mental weakness. It is
certain, that Mercury deserves a preference over
many other remedies when catarrhal and rheumatic
fevers turn into typhoid. Mercurius is indicated by
the following symptoms: a long while before the
typhoid symptoms set in, the limbs go to sleep when
the patient sits or lies down, with numbness, insensibility, and tingling in the same; the patient finds it
hard to drag his limbs along, sweats or is affected
with palpitation of the heart upon the least move



TYPHUS.


229


ment; nevertheless the uneasiness which he experiences in his limbs, compels him to move his limbs
constantly. Although the patient does not yet complain of any thing in particular, yet he is so debilitated and feels so ill all over that he.is obliged to lie
down; he is scarcely inconvenienced by any thing,
except slight heat, erethism of the blood and trembling, which occasions a constant starting and jactitation of the limbs during sleep; frequent watery stools,,
with moist and coated tongue, bitter, putrid, pappy
taste, slight thirst, sensitiveness to pressure in the pitof the stomach, in the umbilical and hepatic region,
distention of the abdomen. The mental and physical
debility gradually increases, fainting turns supervene,
and the patient is attacked with paroxysms of spasmodic contraction of the limbs occasioned by the sudden paroxysms of vascular erethism; henceforth he
finds it impossible to leave his bed.
If, in the progress of the disease, the following
symptoms should occur, Mercurius is still indicated:
general erethism of the nervous system; the delirium
is not altogether inconsiderable; the chills which, in
the commencement of the fever, were interrupted by
flushes of heat, have yielded to a constant burning
heat with excessive desire for iced water. The patient complains of fulness, painfulness in the epigastrium; symptoms of a general plethora, especially in
the portal system, make their appearance; frequent
bleeding from the nose, from which we may infer,
that the blood begins to be decomposed; excessive
restlessness, anxiety, vascular erethism, pulsations,
violent headache, as if the head would burst, preventing sleep and frequently interrupting it by causing the
patient to start. Little by little the patient becomes
more indifferent, he is desponding, does not care about
life; he is frequently unable to collect his senses, he
loses his memory, which loss is probably a continu,
ance of the previous dizziness and dulness of the
head. His face becomes livid, the eyes grow pale,
the nose blackish, the gums swell and bleed readily;
a putrid smell from the mouth makes its appearance,



S101


I"" ""~


S' TYPrHUS. U31
As the fever progresses, a typhus abdominalis becomes more and more marked; the evening chilliness, which is followed in bed by several hours' dry
heat and thirst, cutting as with knives in the abdomen, and diarrhoea, disappears entirely and is changed
to a continuous heat with violent delirium, pains in
the limbs, excessive weakness, dry, blackish tongue
and lips, burning-red cheeks, subsultus tendinum,
floccilegium, sopor with muttering and snoring, small
accelerated pulse. When the delirium abates, the
greatest anguish is depicted in the features, which
takes place more frequently before than after midnight, and is accompanied with prostration of strength.
If the patient should be on the point of falling asleep
again, he is constantly prevented from so doing by
starting as in affright. The following are some of
the accompanying symptoms: Redness and lachrymation of the eyes, which are no longer susceptible of
any impression from without, dryness of the nose,
collapse of countenance, fetid odour from the mouth,
involuntary discharge of stool and urine; the urine
is whitish and turbid during emission, before any colliquative symptoms had set in, and becomes much
more so by standing; oppression of the chest is a
characteristic symptom for Rhus; this oppression
continues from the commencement to the end of the
disease, whether terminating in death or recovery.
Rhus is one of the most distinguished remedies
both in the commencement and the progress of the
disease, in typhus versatilis as well as in stupidus
(especially in the latter); it is likewise of great value
during the stage of convalescence, when the improvement is very slow, the pulse continues feverish, there
is an appetite, but more for particular things, than for
natural simple food; there is yet some inclination to
diarrhea, and the oppression of the chest is not entirely removed.
Next to Rhus is Phosphorus, which is principally
indicated, when typhus arises from onanism or from a
slight cold. This kind of typhus has a long precurso



234


TYPHUS.


quiet recumbent posture, the patient giving a proper
answer for a few moments, but shortly afterwards relapsing again into his former condition.
Having spoken of a typhus stupidus, we ought to
allude to a remedy which is closely allied to Phosphoric
acid, and is yet too much neglected in typhus, we mean
Acidum muriaticum. There are two symptoms which
indicate this remedy exclusively, they are the following: the patient constantly settles down in the bed
with moaning and groaning during sleep, and this
settling down takes place again even after the patient
has been raised, with constant muttering in the waking
state, and inability to collect his senses; the second
characteristic symptom is: the paralytic condition of
the tongue, with great dryness in the mouth and fauces;
even when fully conscious, the patient is not able to
move his tongue as he would like; the tongue feels
heavy and too long, so that he is unable to raise it.
The accompanying symptoms, such as burning heat,
obliging the patient to uncover himself, accompanied
with anxious uneasiness in the body, the tossing about,
and the frequent waking from sleep; the loss of appetite, aversion to nourishment, etc., are not sufficiently
definite to indicate any one remedy in particular.
The intermission of the pulse every third beat, and the
profuse quantity of watery urine, might perhaps be
considered as characteristic indications for Muriatic
acid. As a general rule, Acidum muriaticum is a great
remedy in typhus stupidus.
The principal specific in typhus, especially in a well
marked typhus abdominalis and putridus, is Arsenic.
Diseases of the mucous membranes, which have developed themselves out of gastric, bilious, and mucous
fevers, constitute the greater part of the curative
sphere of Arsenic; diseases with intermittent type
likewise correspond to Arsenic; this is another reason
why Arsenic is a great remedy in typhus, with wellmarked exacerbations. The homceopathic physician
will think of Arsenic even in the commencement of
typhus, if unimportant symptoms, such as a single
vomiting, a diarrhaeic stool, a little pain, etc., should



TYPHUS.


235


be accompanied with great debility, obliging the
patient to lie down, and with drowsiness, the sleep
being nevertheless disturbed by restlessness and anxiety,
with burning heat. Soon after the seated, characteristic,
burning pains in one side of the abdomen make their
appearance, with sensation as if a heap of incandescent
coal were deposited in that region, with coldness of
the limbs, and parchment-like, dry, hot skin, panting
for drink, petechie, and white miliaria. The patient
complains of giddiness, with buzzing in the ears, and
hardness of hearing; the countenance is pale, livid,
and distorted in a. peculiar manner; aphtha form in
the mouth, with frequent inclination to vomit, occasioning a faint feeling every time the inclination
occurs; meteorism, with burning and excoriating
alvine evacuations, consisting of a yellow water, with
cadaverous smell, and passing off without the patient
being conscious of it.
Further observations will have to show whether
small doses of Arsenic are as efficient in typhus as
larger (the second, third, sixth attenuation). As for
ourselves, we have cured our patients with the lower
attenuations, repeating the dose less frequently as the
improvement progressed more rapidly. It ought to be
noticed that many typhus patients do not complain of
pain in the bowels until pressure is made upon the
part; in this case the pain is very rarely burning, but
on the other hand so much more characteristic as a
therapeutic indication.
Carbo vegetabilis holds almost the same rank with
Arsenic in those forms of typhus for which Arsenic is
such an admirable specific. We have found Carbo
not only indicated in the last stage, characterized by
decomposition of the fluids, ulceration of the intestinal
canal, decubitus gangrmnosus, stupor, with rattling,
cold sweat over the whole body, hippocratic countenance, small, weak pulse; but also in the second stage,
which is, in fact, its principal sphere of activity. In
the third stage it has been used with great success by
many practitioners. The principal indications for its
use are the following: burning stinging in the inmost



236


TYPHUS.


parts of the abdomen, with great anguish and troublesome flatulence coming on after every meal, and accompanied by loose stools, with tenesmus, burning,
light-coloured, bloody, and having a putrid smell.
The appetite is not entirely extinct, the patient has a
great desire for salt food and coffee, complete aversion
to meat; the patient is afraid of taking any nourish"ment, on account of the above-named symptoms, together with burning in the stomach, arising from it.
There is nightly agglutination of the eyelids; the
patient suffers with hardness of hearing, tingling in
the ears; (Carbo is a very important remedy for the
anguish which is occasioned by violent congestions of
the chest and head, and accompanied by burning skin;)
bleeding of the nose, with stoppage of that organ,
which is maintained by a constant formation of scurfs;
eruption around the nose, and the blackish-looking
chapped lips; the patient sleeps with his limbs drawn
up; it is a restless sleep and frequently interrupted
by waking. On raising the head the patient feels
giddy, and is extremely unhappy and oppressed.
Carbo is a most important remedy in typhus abdominalis during the ulcerative stage.
When the above-mentioned symptoms occur, Rhus,
Acidum nitr., Phosphorus, and Lycopodium ought
likewise to be considered. Rhus and Nitric acid when
the pains are not very burning; Acidum nitricum is
indicated when certain parts of the abdomen are very
sensitive to pressure, with dragging, stinging pain in
the rectum, evacuations of green mucus, difficult urination, tendency to collapse; Lycopodium  deserves
consideration when the urine is burning.
An incomparable remedy in the first stage of the
disease is Staphysagria, when the following symptoms
occur: sordes on the teeth, pale and bleeding gums,
with painful swelling of the gums, and rapid decay of
the teeth; vanishing of thoughts and ideas, weakness
of memory, dulness of mind, great indifference and ill
humour; vertigo, with stupifying headache; dimness
of the eyes, itching, stinging, and heat in the canthi;
fulness in the pit of the stomach, with frequent hickup



"* TYPHUS.


237


and vomiting; tension across the hypochondria, oppressing the breathing; pressure, weight, and tension
in the abdomen; cutting pain in the bowels, with
nausea; copious diarrhceic stools. As a general rule,
Staphysagria is the best remedy, if the sexual organs
are involved, and if the characteristic pains in the
chest, heart, and spinal marrow, the various gastric
troubles, the fetid-smelling sweats, the weariness and
bruised feeling in the limbs, the morning and evening
febrile erethism occur; all those symptoms point to a
deep-seated affection of the nervous system, the complete development of which is frequently prevented by
Staphysagria.
In the second stage of the disease Valeriana is
frequently an efficient remedy, when white miliaria
and bland delirium have made their appearance.
The miliaria occurs most frequently on the chest and
inthe nape of the neck, it causes a burning and stinging
sensation and announces itself a few days previous to
its breaking out by stinging pains in the pit of the
stomach and a continuous oppression of the chest;
this latter symptom is greatly relieved by dry cupping at the pit of the stomach. The delirium is accompanied with great nervous erethism and tremor,
and consists of illusory notions, such as: the patient is
not herself, but some one else, to whom she has to
give way, on which account she keeps constantly
pushing towards the edge of the bed; or she is in a
carriage and has to make room for some other person
to come in; or some animals are lying by her side
"which she fears she will crush by the weight of her
body, and the like.* The patient complains, moreover of great pains in the limbs, especially in the feet,
which are spasmodically stretched, are extremely sensitive to contact, and resume their natural position
only gradually as the patient improves. The pains
which the patient experiences in the limbs, likewise
"* The reader will perceive that these symptoms are spoken of as belonging to a female patient; we may infer from this that Hartmann has met
such a group of symptoms in his practice in a female patient, and, having
cured it with Valeriana, has inserted it here as a group of general occurrence.-HEM.PEL.



238


TYPHUS. *


involve the spinal column, decubitus supervenes very
speedily. As a general rule Valeriana may be employed in typhoid fevers which commence with an
irritation of the spine, as manifested by violent
spasms, asthma, distortions of the countenance, &c.
The appetite never disappears entirely, but the thirst
is much greater; the febrile heat is continuous, the
pulse being accelerated and weak, 100 beats a
minute; the sleep is restless, disturbed with anxious
dreams, during which the patient constantly endeavours to uncover himself. The abdomen is sensitive
to the touch in the ileo-coecal region, it is generally
distended; costiveness, scanty, turbid urine.
~ 75. In typhus gastricus the following remedies
are the most efficient: Ipec., Cham., Puls., Ignat.,
Nux, Cocculus, Arnica, China, Digitalis. Ipec. is indicated when the gastric symptoms prevail; by slimy,
bilious diarrhoeic stools, occasioned by the abuse of
pork and pastry (see also Pulsatilla) and appear in
company with spasmodic pains. Children and females being particularly predisposed for such affections, Ipec. is especially useful to those classes of
persons, and the more so when the following symptoms occur: the spasms consist in tossing the head
to and fro, distorting the features, jactitating the
limbs, stretching the body as if in a state of rigor
(spinal irritation); starting from sleep as in affright,
violent, general heat, especially in the evening hours,
accompanied with great nervousness and irritable
mood; yellow coating of the tongue with constant
inclination to vomit, and vomiting of bilious substances, &c. (see gastric and bilious fevers).
On a par with Ipec. ranks Chamomilla, when convulsions and spasmodic symptoms occur, with brightred, dry, cracked tongue, lined with a yellowish-white
coating, slimy, putrid, and bitter taste, putrid smell
from  the mouth; inclination to vomit, and bitter
vomiting of food; pressure at the stomach and distention of the abdomen with great sensitiveness to pressure, with cutting, burning, and pinching pains; diarrhceic stools of white or yellowish-green mucus; urine



240


TYPHUS.


mingled with flushes; hard, full and frequent pulse;
pains and debility in the limbs, tightness and dulness
of the head, vertigo, aching pain in the forehead
(relieved by laying the head upon the table); oppressive crampy pains in the stomach and a tensive pressure in the pit of the stomach with nausea, bitter
taste and eructations, with yellowish coating of the
tongue, complete loss of appetite and vomiting of the
ingesta, cutting spasms in the abdomen, constipation,
painful emission of urine, which looks reddish and
frequently bloody; all impressions from without are
intolerable to the patient, he is deeply affected by
them, he moans, groans, he becomes vehement, even
unto rage.
Cocculus ranks on a par with Nux, when the gastric symptoms, such as: loss of appetite, aversion to
any kind of food or drink, inclination to vomit and
nausea unto fainting, bitter tructations, painful oppression in the pit of the stomach, and constrictive
spasms in the abdomen in the direction of the inguinal ring, frequent, small, diarrhceic feculent evacuations, are accompanied by heat of the upper part
of the body, chills of the lower limbs, cold feet,
burning heat in the whole countenance, burning
thirst, sudden attacks of violent anguish, &c. This
remedy deserves consideration whenever typhus developes itself out of a severe illness, or is brought on
by frequent chagrin. In this case it is indicated by
frequent attacks of a disagreeable burning heat and
redness of the cheeks, by evening exacerbations characterized by hot hands and a sensation of dry heat
over the whole body, with nightly sleeplessness and
delirium; by frequent shiverings in the day-time,
with great debility, obliging one to lie down; great
sensitiveness of feeling, extreme ill humour, depression of the vital energy, tremor of the limbs, paralytic immobility of the limbs, hemiplegia, sudden attack
of anguish with shortness of breath and palpitation
of the heart.
Arnica is a valuable remedy not only in typhus
gastricus, but also in genuine typhus, if stinging pains



242


TYPHUS.


back and limbs which is most intense after dinner.
Weight and indolence in the limbs easily supervene,
requiring the patient to lie down. The first symptoms
generally denote a depression of the vital energies,
with slow, sluggish pulse. Characteristic and infallible indications for Digitalis, are: a yellowish complexion, constant desire to urinate, disturbing sleep, alternate chills and heat, burning of the head, face and
ears, redness of the cheeks, anguish, excessive dread of
the future; optical illusions; violent vomiting of bile,
with crampy pains in the stomach sometimes relieved
by eructations; painful pressure in the region of the
liver, etc.
~ 78. The remedies which we shall mention in the following paragraphs, are no less efficient in the treatment
of typhus than any of the preceding, and may have to
be used in any variety and stage of typhus as the
symptoms may require. In order to avoid the necessity
of constantly recurring to the same remedy in describing the various groups of symptoms for which it
may be required in the various stages and forms of
typhus, we will mention at once the whole series of
the symptoms to which the remedy corresponds in
typhus generally.. Stramonium is particularly indicated by muscular
spasms, spasms of the facial muscles, pharynx, especially when drinking or generally when swallowing, distortion of the eyes, tremor of the limbs, even of the
tongue when protruding it. It will be found efficient
in that form of typhus which is occasioned by spinal
irritation; the fever increases to a great degree of
violence with exacerbations at different periods of the
day, especially in the afternoon and at midnight, accompanied with loss of consciousness, trembling, small,
rapid, and frequently intermitting pulse. The delirium,
if present, is generally of a bland character, a sort of
unintelligible muttering; the patient is either in a
state of sopor or sleeplessness; stool and urine are
frequently retained. These symptoms denote evidently
a typhus stupidus for which Stramonium has been



TYPHUS.


243


employed, with success. It may likewise prove useful in typhus erethicus. Closely related to Stramonium and useful in typhus stupidus, is
Hyosciamus. This remedy deserves attention when
the fever has set in suddenly without any precursory
symptoms, or perhaps with a sudden swoon (see
Veratrum). In spite of the burning febrile heat of the
whole body with evening exacerbations, without
thirst, putrid taste in the mouth, red, dry tongue: the
pulse is small, slow and weak. The patient tosses
from side to side owing to the violent erethism of the
nervous system, he has no sleep; if any sleep should
take place, it is frequently disturbed with startings as
if by fright, grinding of the teeth, profuse sweats,
which disappear again as soon as the patient wakes
and cannot, therefore, be considered critical; the skin
is dry, parchment-like, the extremities are cold, the
whole body feels weak and exhausted, there is great
anguish as precedes the eruption of miliaria; the
patient is entirely stupid and unconscious, or else
there is muttering delirium, absurd talk and floccilegium. Hyosciamus is likewise suitable for the following symptoms: excessive wakefulness, subsultus
tendinum, slight convulsive movements of the limbs;
quick, full, and hard pulse, with distention of the veins
all over the body, and burning heat; constant delirium
with open eyes; desire to escape, without knowing
why; rattling breathing, distortion of the features and
eyes; demeanour as of a maniac; scanty emission of
urine, which needs not to depend upon a spasm of the
bladder, but may be occasioned by a diminished secretion; the involuntary emission of stools and urine
during an absence of consciousness is no counter-indication of Hyosciamus, inasmuch as that phenomenon
may occur in consequence of a paralytic weakness of
the sphincter muscles, and of an entire absence of
mind in the patient with consequent absence of all
volition. These two symptoms.hold a prominent rank
among the physiological effects of Hyosciamus upon the
healthy organism.
Opium is another valuable remedy in typhus. It is



244


TYPHUS.


particularly indicated by the following symptoms: loss
of consciousness and sopor; the. patient lies with open
eyes, and is speechless; the limbs are rigid; the pulse
is quick, full, and hard; the face is dark red, and
puffed; the respiration laboured, shoring and rattling;
all these symptoms afford an image of a true typhus
stupidus (apoplecticus), Opium will be found efficient
in that condition of the patient. If this condition have
lasted too long, and a slow, feeble, intermittent pulse
set in, and those parts which were bloated collapse,
Opium will not do any good. Nor will any other
remedy. Death will soon take place. If the patient
should be lying with his eyes closed, without sleeping;
if the hearing and taste of the patient should not have
entirely disappeared; if the patient should still give a
sign of life when spoken to; if there should only be
the highest degree of sopor, without a complete paralysis of all the functions and organs: in such a case
it might perhaps be possible to reanimate the vital
energies and the mental powers. This result could
only be accomplished by one remedy, which acts by
exciting the olfactory nerves, it is Spiritus nitri dulcis,
which should be applied to the patient's nose every
minute at first, and afterwards less frequently, as the
signs of a restored vitality increase. As soon as the
patient's consciousness has returned, the Spiritus nitri.
dulcis ceases to do good, and Rhus, Nux, Belladonna,
Pulsat., Acid. phosphoricum, or some other remedy will
have to be employed.
Camphor has been employed with great success in
typhus by many homeopathic physicians. By some
Camphor has been found useful after Rhus, especially
when the following symptoms occurred: violent delirium, hot and tight and dull head; cold, clammy
skin, with colliquative sweats; great debility, inclination to diarrhoea. More particular indications for
Camphor are the following: the febrile paroxysm sets
in with a sudden loss of sense, falling down without
consciousness, spasmodic stretching of the body,
twitchings of the facial muscles, and shortness of
breath. After these symptoms have disappeared, the



TYPHUS.


245


patient complains of a constrictive, beating headache,
with burning hot forehead, cold hands and feet; the
headache increases by every change of position; vertigo sets in, as if the patient would fall over, with loss of
consciousness, weak and scarcely perceptible pulse;
these symptoms are gradually followed by heat, which
is first felt in the face, and then over the whole body,
hands and feet remaining cold; loss of thirst; scanty
and rare emission of turbid urine, depositing a thick
sediment.
Cina is said to be very useful in typhus, since it has
a powerful stimulating action upon the nerves of the
abdomen. Cina corresponds most     curately to a
worm fever, with typhoid symptoms; Xen such symptoms occur, Cina is probably of importance only in the
commencement, when burning heat of the face, redness of the cheeks, increased desire for cold drinks,
slight delirium, restlessness, tossing about, prevail,
especially in the evening and at night; between the
exacerbations the patient shows a sort of indifference
to either agreeable or disagreeable things, although he
calls for a good deal; he complains of a numb and
stupifying pain in the head, with sensation as if the
head were screwed in; this pain increases to such a
degree that it causes convulsions and contortion of the
limbs.
Hellebore has been recommended in typhus, which
has developed itself out of some other disease; for
instance-: out of scarlatina, measles, cholera, gastric
and worm fever, etc. Hellebore corresponds more or
less to the following symptoms: internal chills in the
evening, in bed, with burning heat over the whole
body, especially the head, with glowing cheeks, absence of thirst, sometimes even aversion to drink.
Particular indications for Hellebore are: the febrile
symptoms which have been mentioned in the preceding
paragraph, and which are accompanied by the following symptoms: bloatedness of different parts of the
body, with heaviness in the same; sopor, with numerous fancies, and tossing to and fro; hypochondriac
mood, and dulness of sense; the scalp feels bruised,
with cedema of the whole body; dark, turbid urine.



246


TYPHUS.


Among the symptoms of Lachesis we distinguish the
following typhoid condition: chilliness every evening,
with drawing in the back, and in the lower limbs from
below upwards; dry heat at night; loss of appetite
and exhaustion. In a few days the following symptoms supervene: vertigo when sitting up in the bed;
the eyelids feel paralyzed, and it is difficult to open
them; bitterness in the mouth; simple pain in the
chest and dry cough, tearing in the left thigh and back.
After these symptoms have lasted some time, a soporous condition sets in after the patient has passed a very
restless night, characterized by a sort of stupified lying
on the back, 4om which the patient only wakes by
shaking him violently, and talking to him with a loud
voice; his tongue is very heavy when talking; sunken
countenance, the lower jaw is hanging down; the
pulse is seventy, soft, unequal; some sweat, with coolness of the legs and feet; the tongue is red, smooth,
dry, and he protrudes it with great difficulty. He emits
a copious quantity of brown-red urine.
Secale has been found efficient by several homoeopaths in typhus arising from other diseases, as well as
in that arising from an irritation of the spinal marrow. The patients gradually lose their appetite, desire to drink continually, especially cold water, are in
a cofistant state of fever, which consists principally of
dry heat, with hurried pulse; they are very restless,
sleepless, debilitated; they complain of wandering
pains in the back and small of the back, gradually
assuming a spasmodic character, and flying from one
part to another; those spasms are of a tonic character
in the feet and hands, clonic in the facial muscles,
with subsultus, tremulousness, jerks; the spasms in the
muscles of the chest occasion asthma. Secale is a
distinguished remedy in that stage of the fever; if repeated every two or three hours the spasmodic pains
soon disappear, after which another remedy may be
exhibited, unless the delirium and the fever should
have subsided under the influence of Secale.
Lycopodium, of which mention has been made
above, is not only applicable to a few single symptoms
in typhus, but to typhus generally. It has been sue.



248


TYPHUS.


for Natrum mur. are: typhus following upon exhausting diseases; typhoid symptoms may be prognosticated
when the patient is unable to recover his strength,
complains of bruised feelings in the limbs, depriving
him of his night's rest by arresting as it were the
breathing; extreme mental and physical debility, continuous febrile heat, with evening exacerbation; quick,
full pulse; hurried, oppressed breathing; constant
palpitation of the heart, with anguish, headache, as if
the head would burst, especially in the forehead, with
such a violent throbbing in the forehead that the
patient sometimes loses his senses and becomes delirious; the complexion is livid, the tongue dry and
heavy, so that he is scarcely able to talk; aversion to
food; a good deal of thirst-which, when quenched,
occasions a distention of the abdomen, and a good deal
of rumbling and cutting in the bowels, sometimes even
an inclination to vomit, and small watery stools; there
is a copious secretion of urine, which deposits a brickdust sediment.
~ 77. Some physicians have recommended Sulphur
in the treatment of typhus. In our opinion Sulphur
ought only to be given for the purpose of restoring the
susceptibility of the organism to the action of one or
the other of the remedies which we have indicated for
typhus. In this respect Sulphur acts like Opium and
Mercury, and should be employed when the following
indications for its use are present: the typhus is a
consequence of some acute cutaneous disease; or the
patient has been affected in former times with some
chronic cutaneous affection; it is likewise useful
when Pulsat., Mere., and Nux, although they seemed
to correspond to the symptoms, had no effect, or when
the action of the specific remedies is prevented by the
abuse of spirits to which the patient was addicted previous to his illness. Sulphur is likewise indicated
when the patient is of a scrofulous habit and had been
complaining of pains in the limbs previous to the invasion of typhus; it may also be usefully employed
when a violently burning miliary eruption frequently
makes its appearance in one or the other part of the



TYPHUS.


249


body during the course of the disease; or, finally, in
gastric fevers with typhoid symptoms. More particular indications are the following: continuous profuse
sweats which afford no relief; the sleep at night is
disturbed with fanciful ravings; even when the patient
wakes the fancies continue to crowd upon the patient,
the head feels dizzy and benumbed, which the patient
is unable to account for; he is extremely timid, inclines
to start, is out of humour, and easily vexed; hardness
of hearing; sunken eyes surrounded with blue margins; pale and wretched complexion; dry and chapped lips; dry, parched, bright-red tongue; and taste
as of blood in the mouth; Sulphur is, moreover,
characteristically indicated by the painfulness of the
abdomen to the touch, with sensation as if it were
sore and raw inside; there is no diarrhoea, but sometimes such a violent urging that the stools frequently
pass off involuntarily; this same statement applies to
the urine which is very rarely of the same colour, and
generally changes in colour frohn time to time.
Spigelia, Digitalis, and the Muriate of magnesia,
afford in many cases essential benefit in treating the
ailments which often remain after typhus. We have
already spoken of Digitalis. Magnesia muriatica
removes the pains as if bruised all over, the great
debility and weight of the limbs, the ill humour consequent upon that condition of the limbs, especially when
occurring in individuals whose nerves are weak even
in a state of health; the restless sleep at night which
is frequently disturbed by anxious dreams, nightmare;
the sensation of oppressive weight in the head, which
frequently lasts a long while, and is accompanied with
vertigo and a dull and dreary feeling.
Spigelia corresponds more particularly to the feeling
of weakness in the reproductive organs, without, however, being-an exclusive remedy for that condition.
Characteristic indications for Spigelia are: great debility after the slightest exercise; sad and desponding
mood, accompanied with a pressing pain in the forehead from within outwards, which extends deep into
orbits especially when stooping forwards, and appears
11*



250


TYPHUS.


with increased violence every other day; the acid taste
in the mouth with painful fissures in the tongue; the
complete aversion to smoking; excessive appetite and
great thirst; the painful pressure in the pit of the stomach, which makes every least pressure from without
unpleasant, and is accompanied with palpitation of the
heart and anxious oppression of the chest; the feeling
of fulness in the abdomen even after a moderate meal,
with rumbling in the bowels and papescent stools.
S~ 78. We shall conclude the chapter on typhus and
typhoid diseases by a few cursory remarks on certain
forms of typhus, which we have not yet had an opportunity to treat in our country (Germany), and the
probable remedies of which we will point out with a
few broad indications.
Before proceeding we will state, that it is exceedingly bad practice to change the remedies every six
or twelve hours, as some physicians do, who get
frightened, if they do not see an improvement in that
time. Typhus, if it sltould have fully set in, cannot
be cut short by a remedy, and all that the physician
can do, is, to cure the patient. It is therefore advisable to repeat the remedy, provided it has been chosen
with all possible care, until an improvement takes
place in the symptoms; if the patient should get worse,
this would be positive evidence that the remedy was
not homoeopathic to the disease. If the symptoms do
not get worse, this may be considered an improvement in typhus; it would be indiscreet to give another
remedy under such circumstances with a view of hastening the cure; we might perhaps destroy the good
effects which we had so far obtained by our treatment.
A frequent change of remedies is only justifiable in
case the symptoms should vary frequently, provided
always that the changes in the symptoms are no medicinal aggravation. The physician who conducts the
treatment has to decide about that. If he should not
clearly recollect the physiological effects of the remedy,
let him either refresh his memory, or else wait three or
four hours before prescribing a new remedy. At the
end of that period the disease will have taken such a



TYPHUS.


251


turn as will either justify or condemn the selection of
the last remedy. Should the frequent changes in the
symptoms constitute regular paroxysms, the physician
would then have to select among the following remedies, the principal of which we shall name first: Ars.,
Carbo veg., Veratrum, China, Nux, Cocculus.
A good deal is said about pneumo-typhus as a particular disease, without considering that the inflammatory process in the lungs frequently takes place in
company with the typhoid, and that the known hypostasis, which is going on in the lower lobes of the
lungs in every typhoid disease, sometimes increases
to a real pneumonia, in which case the inflammatory
symptoms are more marked than those which properly belong to the typhoid process. The treatment is
the same as that of pneumonia typhosa, of which we
shall treat hereafter. *
As regards diet, the patient ought to live on thin
gruel, soups made of salep, sago, oat-meal, &c., light
and easily digested meat, such as pigeons, capons,
chicken, &c., light vegetables, and even bread and a
little butter, if the patient should have any desire for
it. The patient may eat fruit, raw and boiled; his
drink should be boiled milk, toast-water with a little
mulberry, raspberry, althea or cherry-juice. The
patient may likewise drink buttermilk, which will not
injure him in the least. There is scarcely a disease,
where the desire of the patient for one or the other
kind of food ought to be regarded with more care,
than in typhus, especially if the patient desire acid
things, The temperature of the room should be the
same at all times, rather cool, and the patient should
not have too much covering. The room should be
kept perfectly quiet, as every impression, which the
patient receives from without, tends to irritate his
brain and furnish new food to his ravings. It is of
the utmost importance, that the patient should be kept
clean, and the room should be aired from time to time,
without, however, exposing the patient.*
* We recommend our readers never to allow recovering typhus patients
any raw fruit; for a fortnight after the cessation of the fever, the diet should



252


PUTRID FEVER.


~ 79. Typhus putridus, febris putrida. Fever with decomposition of the animal matter.
Typhus putridus sometimes sets in as an epidemic
fever; in which case it becomes a primary disease
which is engendered by a putrid contagium; most
frequently, however, typhus putridus developes itself
out of an acute fever, and more particularly out of
typhus; it may likewise arise from every other kind
of fever, even from an inflammatory, by the patient
being kept too hot, or in uncleanliness, vitiated air,
etc. In men who are affected with some morbid
dyscrasia, the scorbutic diathesis, or who have been
poisoned with Mercury.
The fundamental character of typhus putridus is an
excessive depression of the vital forces with disposition to putrid decomposition. Without mentioning
again the general characteristic' symptoms of typhus,
which are the same in all the varieties of that disease,
we will content ourselves with simply mentioning
those which belong to typhus putridus exclusively;
they are: quick, small, soft, easily compressible pulse;
calor mordax, the hand, when touching the patient,
experiences a disagreeable, pungent, burning, prickling and stinging sensation, which increases as the
contact is prolonged and leaves a similar sensation
behind for some time; internal chilliness occasionally,
or shiverings creeping over the skin; the breathing is
generally calm, no thirst; great anguish, despondency,
indifference, insensibility. Characteristic indications
are, likewise: putrid, cadaverous smell of the breath,
of the exhalations from the skin, and of other secretions; petechie; profuse, oily, clammy sweats; turbid,
dark urine, colliquative diarrhoea, hemorrhages from
every orifice of the body, decubitus, tendency to gangrene; the blood which is evacuated does not decompose itself into cruor and serum like healthy blood,
but forms a pappy mixture.
be extremely simple, although the patient need not starve; butchers' meat,
stimulating drinks, potatoes, celery, radishes, and the like, should not be
used. Some physicians, who are even very clever in other respects, are not
sufficiently careful in regulating the diet of their patients.-HEIPErL.



PUTRID FEVER.


253


~ 80. The treatment of these fevers, whether primary or consecutive diseases, is very seldom successful.
The existing symptoms do not so much point to
certain remedies as to a decomposition of the fluids
and more particularly the blood.
The fever is not a putrid typhus, as long as symptoms
of decomposition have not made their appearance.
Even if the putrid state should set in as a primary disease, there are precursory symptoms denoting a gastric,
bilious, pituitous, or typhoid state, and requiring a
treatment such as has been indicated for those conditions.
The following remedies are principally indicated
for that variety of typhus: Arsenicum, Arnica, Carbo
veg. and anim.; Kreosot, Acidum phosp. and muriat.;
China, Ipec., Mercur., Mercur. dulcis, Rhus, Bellad.,
Nux vom. and moschata, Hyosc., Opium, and sometimes perhaps Camphor and Cuprum.
Arsenic is probably preferable to every other remedy
when the disease has reached its worst stage, when
the patient complains of burning heat, great anguish
and restlessness, when petechie, aphthe and profuse
colliquative secretions are present. Arnica may be of
use when profuse and frequent hemorrhages take
place, and great thirst, headache, yellow countenance
and loss of appetite are present. The two varieties
of Carbo ought to be tried when the blood is entirely
decomposed, when stupor and raling are present, with
cold sweat of the face and limbs, hippocratic countenance, small, scarcely perceptible pulse, great distention of the veins, and especially, if such a fever occur
after the. excessive use of China. Kreosot may be of
service when the patient complains of an excessive
debility in the limbs, and when a racking, painful cough
from the inmost parts of the chest is present, accompanied with a sensation of warmth which rises into the throat; and lastlty hen the patient complains
of a painful pressure on the top of the head which is
aggravated by contact. The two acids correspond
particularly to the colliquative stage.  China is
indicated at the commencement of the disease by
hemorrhages, yellow skin and countenance, excessive,



254


HOSPITAL FEVER.


debility and pain in the limbs. Ipec. and Hyosc., may
likewise be indicated at the commencement of the
disease when the symptoms which have been describedlast, are accompanied byspasms. Rhus and Belladonna are preferable to all other remedies when
the nervous system is principally involved in typhus
putridus. Opium should be employed when the irritability of the organs is entirely gone, provided the
other symptoms correspond. Nux is the remedy when
the disease sets in with excessive debility and the
gastric and bilious symptoms such as: livid complexion, bitter and putrid eructations and taste, yellow
coating of the tongue, constipation, are predominant.
Nux moschata is more particularly indicated when
putrid debilitating diarrhoea and bloody expectoration
are present. Mercurius is to be administered when
the nervous system is very much excited, when there
is a tendency to profuse sweats and putrid decomposition, accompanied with great painfulness of the region
of the liver, the epigastrium, and pit of the stomach.
Mercurius dulcis is indicated by similar symptoms,
when the process of decomposition has reached its
acme. We have no other reason for recommending
Camphor and Cuprum except that these two remedies
have been employed with success in Cholera, from
which we have, perhaps wrongly, inferred that they
might likewise prove iseful in typhus putridus.
~ 81. Typhus contagiosus, bellicus. Hospital or jail
fever.
This typhus is characterized by the symptoms of the
ordinary typhus or the typhus putridus, and is propagated by a contagium. At first it is of an inflammatory
character, the typhoid symptoms only setting in afterwards with tendency to exanthema, whence the fever
is also termed petechial fever.
The treatment is pretty much the same as that of
typhus and typhus putridus. The principal remedies
in typhus petechialis are probably Bryonia, Rhus, Arsenicum.
Dietetic rules.-Every contagium being increased by



YELLOW FEVER.


255


excessive warmth and becoming so much more poisonous as the temperature of the sick room is kept above
the proper standard-the thermometer in a sick room
should never be above 670 Fahrenheit. To have this
temperature in the summer season, vessels with cold
water should be constantly kept in the room and the
room should be frequently sprinkled. The patient
should rest upon a mattress, and should be but lightly
covered.
The patient must be kept clean; the room is to be
frequently aired and only one patient should be in a room
at a time. The contagium is increased by several patients
being confined in the same room. Among the means
which have been recommended for the destruction of.
the contagium, the best is undoubtedly a frequent renewal of air by means of a current passing through it;
the patient has to be guarded against that current, of
course.
~ 82. Typhus pestilentialis.
We know nothing of the treatment of this disease,
and shall, therefore, content ourselves with stating the
characteristic symptoms.
The pest is propagated by contact, never by the air.
Its principal phenomena are: buboes and anthrax,
that is, inflammatory swellings of glands, with tendency to gangrene which sets in with great rapidity,
especially in the axilla and the inguinal region; petechiae, ecchymosis, violent fever, anguish, excessive
vomiting, the brain is greatly involved; all the secretions have a putrid smell and the prostration of the
patient is excessive.
The following remedies might perhaps be proposed
as corresponding more or less to the symptoms: Veratrum, Arsenic, Acidum hydrocyan., Lauroc., Kreosot,
Quinine, Lachesis, etc.
~ 83. Typhus icterodes. Yellow fever.
This disease arises from some endemic miasm. Its
symptoms are: yellow colour of the skin, violent vomiting of black substances, black stools, great anguish,



256


LENTESCENT TYPHUS.


debility, violent fever. The course of this fever is very
rapid.
The following remedies may perhaps be of use;
Arsenic, Digitalis, China, Nux, Crotalus, Bryonia, Sulphur, etc.
~ 84. Typhus lentus. Lentescent typhus.
This kind of typhus is a primary, idiopathic disease,
"which does not depend upon any local affection, and
may be occasioned by various causes.
The essential character of the disease is great nervous debility and prostration of all the functions. It
developes itself slowly, sometimes for months, without.any inflammatory symptoms. Sometimes it sets in as
a sequel of an acute fever, inflammatory typhus; or it
may arise from excessive physical and mental exertions, venereal excesses, onanism, great loss of blood,
chronic hemorrhages, and blenorrhcea. The symptoms
of such a fever are: small, quick, variable pulse;
changeable urine; chilliness and coldness more frequent than heat; no sweat, or only evanescent sweat;
cerebral symptoms; spasms; hypochondriac mood,
which is greatest in the morning and before breakfast,
when the patient feels worst; the fever is less after
dinner, and then the patient feels better; these last
symptoms distinguish the lentescent typhus from a
hectic fever which depends on local causes.
~ 85. The treatment of slow typhus does not essentially differ from that of ordinary typhus. The following medicines will be found the most efficient: Cocc.,
Camph., Acid. phosp., Phosphorus, Lycop., Ignat.,
China, Ipec., Arsenic., Verat. alb., Plumb., Mercur.,
Helleb. niger, Digitalis, Conium, Cuprum, Stannum.
If the disease arise from care and chagrin, a small
dose of Acidum phosph. is the most certain remedy
(according to Rummel it may, in that case, be given
alternately with Arsenic); if it arise from grief, one
or two doses of Ignat. 18 will cure it.
Cocculus is an excellent remedy, if the disease be
occasioned by frequent vexation and irritation of tenmper; the symptoms being as follows: frequent evan



LENTESCENT TYPHUS.


257


escent attacks of a disagreeable, burning heat, and
redness of the cheeks; evening exacerbations characterized by hot hands, sensation of dry heat all over the
body, sleeplessness at nights; or frequent shiverings in
the day-time accompanied with great debility, so that
the patient is obliged to lie down; the patient is very
sensitive and irritable.
Repeated doses of Camphor may be administered
when the temperature of the skin is very low, and the
patient is very weak and not very sensible.
Ipecacuanha is undoubtedly one of the most distinguished remedies in this disease; it ought to be repeated frequently.
Veratrum, not too high, is an excellent remedy when
the febrile paroxysm sets in at times in the evening,
at times in the morning, with redness and heat of the
face, heat of the hands, intermingled with febrile
shiverings and accompanied with great despondency;
between the paroxysms the body feels cold, and a cold
sweat makes its appearance, at least upon the forehead, the patient being, moreover, very weak and
listless.
Helleborus niger is indicated by the following
symptoms: constant chilliness of the whole body with
cold hands, burning heat internally, the head feels
dull and stupid; the patient complains of drowsiness,
heavinesss and debility of the feet, stiffness of the kneejoints. These symptoms occur when out of bed; as
soon as the patient lies down he feels hot and sweats,
without thirst.
China, Arsenic, and bigitalis, have been mentioned
in detail in the chapters on typhus.



260


INTERMITTENT FEVER.


liness, heat, and sweat, recurring at regular or irregular periods, followed by the appearance of a red,
brick-dust sediment in the urine; during the apyrexia
"the patient feels more or less comfortable and the
pulse is normal. Most frequently the paroxysms recur
at regular periods, every, twenty-four hours (quotidianse), forty-eight (tertianae), seventy-two (quartanae), etc.
We know very well that modern pathologists do not
number intermittent fevers among the febrile diseases.
Various affections may be distinguished by a regular
intermittent type without having a febrile character.
Such intermittent diseases originate in the peripheral
nerves, not the vascular system, which is affected
secondarily on account of the intimate relation existing
between those nerves and the blood-vessels; hence it
is ihat intermittent diseases are now termed ganglionic, cerebral or spinal intermittent. Nevertheless
we have preferred treating this class of diseases as
usual, pointing out their characteristic peculiarities as
much as was necessary and occupying ourselves
principally with their homoeopathic treatment.
The duration of an intermittent fever is very uncertain, from one week, to several weeks or even
months. In no disease there is a greater disposition
to relapses than in intermittent fevers; in a quotidian
a relapse takes place on the seventh day, in a tertian
on the fourteenth, in a quartan on the twenty-eighth
after the cessation of the last paroxysm. A relapse
may be anticipated if a feverish feeling should remain
in the system; if the feverish colour should remain on
the cheeks; if the strength of the patient should not
increase with his appetite; if the last paroxysm should
be like the first; if at the time when the paroxysms used
to occur, slight chills, a drawing and stretching of the
limbs, continual yawning, irritated pulse, changeable
urine, should make their appearance. Relapses are
frequently brought on by moral causes, slight errors
in diet, by eating milk, eggs, fish, etc.; by changes of
temperature, walking along the water, continual use
of cold drinks, etc.
An intermittent fever is not of itself a dangerous



262


INTERMITTENT FEVER.


higher potencies. If this kind of fever should not
yield to China in persons who have sufficient exercise
and otherwise live carefully, the cause is to be found
in the psora having become roused from its latent
state; all such cases require an antipsoric treatment.
Some very experienced homoeopathic physicians
administer a few doses of Aconite, higher potencies, a
few hours previous to the paroxysm if it be violent.
This proceeding is not irrational, as every paroxysm
partakes more or less of the character of a synochal or
erethic fever and is most readily controlled by Aconite.
The principal remedies against intermittent fever
are: China, Quinine, Ars., Verat., Arnica, Ant. cr.,
Nux, Bell., Cocc., Caps., Carbo veg. and anim., Canthar., Ignat., Lach., Puls., Sabad., Sepia, Dig., Bryo.,
Dros., Dulc., Natr. mur., Lye., Staphys., Sulph., etc.
China corresponds more or less to the following
symptoms; no thirst during the chilly stage, thirst between the chilly and hot stage; China is not suitable
when thirst is present in the hot stage; if thirst be
present during the hot stage of a China-intermittent,
the heat ought simply to be a burning or dryness of
the lips which require moistening, but no real thirst is
experienced by the patient. If the thirst set in after
the heat, or during the sweaty stage, China is the
remedy. China corresponds, if the fever should commence with a secondary symptom, such as: palpitation
of the heart, anxiety, frequent sneezing, nausea, great
thirst, canine hunger, oppressive pain in the abdomen
or head; or if the veins should become distended when
the head feels hot, or when the temperature of the
body is slightly raised, or when the patient merely
feels hot to himself and not to others, or when the skin
feels hot to others. China is moreover indicated by
congestion of blood to the head, redness and heat of
the face, generally accompanied with chilliness and
coldness to the touch of the extremities, or by heat of
the face which is perceptible only to the patient, the
face feeling cold to the hand, with cold sweat on the
forehead.
Nux, together with Verat., Bryo., Bellad., Coc.,
*



INTERMITTENT FEVER,


265


sion to food, vomiting, coated tongue, bitter taste, tight--
ness and pressure in the stomach, pain in the chest.
Cocculus removes fevers with the following symptoms in the apyrexia: obstinate constipation, spasms
of various kinds, especially of the stomach, paralytic
weakness of the small of the back.
Arsenic is a great remedy in intermittent fevers,
when neither the chilliness nor the heat are well
marked, or they appear alternately or simultaneously;
or when the heat is burning and unpleasant even to
the hand, accompanied with anguish, great restlessness,
and an unquenchable thirst; or when the chilliness sets
in principally in the afternoon or evening, fo4owed by
dry heat at night or towards morning, then sweat.
Arsenic is the best remedy when at the time of the
paroxysms unimportant existing symptoms become
much more violent, or when those symptoms set in
previous to the paroxysm, or when symptoms appear
during the paroxysm which do not seem to belong to it,
such as: violent anguish, buzzing in the ears, tearing in
the bones and limbs, tremor in the limbs, paralysis, syncope, etc. The chilly stage is preceded by ill feeling
through the whole body, with stretching of the limbs and
drawing in the same; yawning, debility, inclination to
lie down, headache, vertigo with stupefaction, confused
feelings in the head, with inability to collect one's
senses. Between the chilly and the hot stage; the following symptoms make their appearance: debility and
sleep; vertigo, thirst, hickup, anxiety, nausea, vomiting
of bile, diminution of the pains. During the apyrexia:
hickup, pressure in the forehead and temples, with
frightful dreams; bruised feeling in the limbs.
Arsenic is moreover suitable in fevers with the following symptoms: inclination to vomit, or bitter taste
during the chills; no taste, or the taste is not constantly bitter and spurious, the bitterness existing only
for a short while during or immediately after a meal;
excessive vertigo, nausea, tremor, sudden prostration
of strength; frequent drinking, but little at a time; the
sweat sets in a little while after the heat, or not at all;
intolerable pains and anguish about the heart.
12



268


INTERMITTENT FEVER.


ness of hearing, dry coryza, sleeplessness with restlessness and tossing about, thirst at night, nettle-rash,
gastric symptoms. The chilliness is sometimes characterized by pains in the limbs, headache, vertigo, inclination to vomit.
Chamomilla, Mezereum, Sulphur, Sepia, Tartar
emet., etc., are likewise suitable to the cure of intermittent fevers, the latter remedy particularly when
sopor is present during the paroxysm.
We will conclude this chapter with the description
of a few cerebral symptoms, recurring at regular intervals. There is a peculiar kind of headache which
is felt in the morning after waking; upon rising it becomes centred in the right frontal protuberance, increases to a pressing burning, as of an incandescent
coal; it extends down to the eye, and about noon it
has become so violent that the patient has to lie down.
The pain diminishes after 11 o'clock, and the patient
feels entirely well again at 1. This headache yields
to one or two doses of Carbo veg.
A headache on one side of the head, which recurs
every three days, with excessive sensitiveness of the
scalp in the morning, commencing with a feeling of
coldness in the limbs, and preceded by sleeplessness
and general sweat, yields to pretty large doses of
Quinine, one every three or four hours.
Repeated doses of Bellad. 2, 3, will remove a headache which seems to be seated in the glabella, and
feels like on oppressive weight; it is aggravated by
meditating and fixing one's attention, the vessels in
that region become distended, the place itself becomes
red, an inability to collect one's senses, languor of the
mind, and complete aversion to life supervene.; these
symptoms disappear by keeping perfectly quiet, and in
the afternoon the patient feels well, and the mind is
easy.*
Tartaricum emet. is a good remedy in intermittent
fevers when the paroxysm is accompanied with sopor;
* Spigelia is a specific for an aching over the eye, with soreness of the
eyeball. I have cured such headaches, even when of years' standing, with
"a few doses of the first attenuation.-HEMPEL.



INTERMITTENT FEVER.


269


also Chamomilla, Spongia, and Plumbum. If a psoric
miasm should have been roused by the fever, complicating the fever, and rendering it very obstinate, the
antipsorics have to be employed against it: Tinct.
sulp., Lycop., Amm. mur., Calc. carb., Sepia, Calc.
sulph. (Hep. sulph.), and others.
~ 89. China cachexia.
A China cachexia is an intermittent fever which
has been treated with large doses of Quinine, without
getting well, and has become complicated with the
symptoms of a China poisoning.
A China cachexia requires the greatest discretion
and circumspection on the part of the physician. It is
a threefold complication of disease: the original fever
which is scarcely yet recognizable, the morbid disposition originally existing in the organism, and having
become roused by the fever, and the poisoning by the
drug. The first thing to be done is to remove as much
as possible the effects of the China, in order to obtain
a distinct image of the original disease. ' Those effects
cannot be expected to disappear entirely, because they
are too intimately interwoven with the symptoms of the
roused psora. Nevertheless, the remedies have to be
chosen with a direct view of eradicating the effects of
the China from the system. Among those remedies
the true antidotes to China are the first to be used.
One of the first remedies against a China cachexia
is Belladonna, especially when the following symptoms prevail: extreme sensitiveness and irritability of
the nerves, langour of body and soul, excessive sensitiveness to the least noise, and to impressions of any
kind received through the senses; tremulous weakness
in all the limbs, dilatation of the pupils, dim eyes,
which are surrounded with blue margins; bloated,
livid countenance, yellow tinge of the whites of the
eyes; tearing headache, which returns at regular
periods, and affects the nerves very deeply; it is especially felt in the temples, and is reproduced or aggravated by the least noise; great debility and drowsiness,
without being able to sleep; or, if sleep should set in,



INTERMITTENT FEVER.


271


burning and of long duration, without much sweat,
and when other painful symptoms were either present
before the paroxysm and are aggravated by it, or
supervene during the paroxysm. Scarcely any remedy
is more efficient in removing secondary paroxysms of
fever than Arsenic, although other medicines may seem
to be indicated by the symptoms. The higher potencies of Arsenic are not as efficient as the lower for
such purposes; we have found the tincture of Arsenic
the most adapted to our use.*
Staphysagria cures fevers which reappear after
having been suppressed by Quinine, when the following symptoms occur: the cold stage comes on in the
evening, without any subsequent heat, and accompanied with scorbutic symptoms.
Sulphur is indicated when the well-selected remedies
do not act, and this want of action manifestly depends
upon an excited psora. These fevers generally have
an irregular type, are accompanied with great erethism of the circulation, distention of the veins of the
hand, slight convulsive jerks in the liabs, all these
symptoms appearing mostly at night.
Lachesis has been recommended in China fevers
with any type, especially, however, quartan, setting
in with twitchings during the chilly stage, and thirst
during the heat. Secondary symptoms are: drawing
in the back and extremities, loss of appetite, vomiting,.hickup, anxiety and uneasiness, as from apprehension
of some accident, violent headache, deep breathing,
moaning, etc.
Calcarea may be given for the same symptoms as
Sulphur, especially when occurring in young, plethoric
subjects, children and delicate women.
~ 90. There are other drug-diseases besides those of
* This may be true, and yet I recollect a case of fever which had been
treated for four months in succession, in the New-York Hospital, with large
doses of Calomel, Quinine, blisters, emetics, and the whole host of allopathic
deviltry, without the least benefit to the patient, and which I cured with two
doses of Arsenic, 18. The symptoms were: violent chills, with bilious vomiting and tearing in the limbs; burning heat of the skin, burning tongue and
mouth, unquenchable thirst, sensation as if fire were coursing through the
veins and epigastrium, anguish, horrid hammering in the temples, profuse
sweats, debility, etc.-IIEMPEl.