A 575045 DL- S FB A S U'B S ALIME~NTARY C-'ANAL. -- - ---M -m - - - - I M123 Belmont Ave., Philadelphia, Pa, "I1 7* -~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~4 'A '4", 4 t~~~~~~~~~~~~~~~~~~~~~~~J Entered according to the Act of Congress, in the year 1841, by J. DOBSON, in the -Clerk's Office of the District Court 7or the Eastern District of Pennsylvania. E~. G. Dorsey, Printer, Library Street. ADVERTISEMENT. THERE is, perhaps, nothing in London life so remarkable as its combination of epicurean and sedentary habits. Its diseases, as remarkably, are precisely those which should arise from such causes; namely, affections of the abdominal viscera. These diseases, however, do not in general arise immediately from the habits now mentioned, but chiefly from such habits at once overloading and rendering torpid the intestinal canal, or producing constipation. Constipation may, accordingly, be reckoned the parent of metropolitan disease. It abounds in every district, in every age, and in every profession; and its consequences tend, perhaps, more than those of any other affection to embitter life and render it burdensome; for it is not only in PRE F A CE TO THE AMERICAN EDITION. AMONNG the numerous and valuable Homceopathic works which have been published on the various affections incident to the human system, there has not as yet been presented to the American public, one treating exclusively of diseases of the alimentary canal. The book, now offered to the public, has the advantage of being confined strictly to the disease called Constipation and its accompanying train of phenomena which present themselves in the various organs of the body. These are treated of in a plain and practical manner, and, without doubt, it will be found a valuable little work of reference to the practitioner. Knowing the distressing character of the x disease, to which our author's remarks are confined, and consequently the utility of a work specially treating of the subject, the Editor has no hesitation in offering this to the reader, hoping, at the same time, that the principles which it lays down, and the treatment it inculcates, may be found to answer every purpose for which it is intended. As regards the most advisable dilutions in which remedies may be exhibited, a great diversity of opinion is entertained. As it is altogether a matter of experience, the physician, almost universally, regulates his mode of prescription by the results which may have attended his observations in his own individual practice. Dr. Ruckert says on this point, "In respect to the doses, most generally, I make use of the first dilutions, and never exceed the twelfth, giving them in increased volume and repeating them frequently. I have been more successful in this course of treatment, than formerly in the use of the smaller doses." This plan has many adherents, whilst others, as Dr. Gross, &c. vary the dose from the highest down to the lowest preparation. xi If the remedy, properly indicated, be selected for administration, it is of little practical moment what dilution is used, and in a plurality of cases from the twelfth to the thirtieth potence will be found to produce the desired effect. As a general rule, in cases of patients whose constitutions are very susceptible of medical impressions, it is thought best to administer the higher dilutions, and vice versa. In some particular cases the first dilution may be given with advantage where symptoms appear to demand its exhibition. So varied are the constitutions of patients, that the repetition of doses must depend altogether on the nature of the impression which the remedy may have upon the disease; therefore, the practitioner must rely almost exclusively on his own observation in this instance. In reference to this subject, however, it may be said, that where the medicine acts in such a manner as to cause suffering to the patient, and it is evident that its operation is only to aggravate the disease in a too powerful manner, great care should be taken in repeating the dose; and where DISEASES OF THE DIGESTIVE ORGANS AND CONSTIPATION, TREATED HOMIEOPATHICALLY. rHE FIRST PASSAGES.-Few persons are ignorant that these, technically called the primam vim, consist of the oesophagus or gullet, the stomach, the small, and the great intestine; that the small intestine, which is of nearly similar diameter throughout, is considered as composed of three portions, the duodenum which commences at the smaller or right extremity of the stomach, the jejunum which is its continuation, and the ilium which, continuing the latter, terminates in the great intestine; and that the great intestine which, though of much greater diameter than the small one, is also nearly similar throughout, is considered as composed likewise of three portions, the ccecum which forms a bag with a vermiform appendix where the small A 14 intestine opens into it, the colon which is its continuation, forming by far the greater portion of the great intestine-in the arch which ascends on the right side, crosses under the stomach, and descends on the left side, and the rectum which, continuing the latter, terminates at the anus. It is also well known that there are innumerable apertures, more or less minute, on the whole inner surface of these passages, as well as the openings of ducts from the liver, gall bladder, pancreas, &c. which pour into them digestive and lubricating fluids which blend with the food, convert it into chyme, and facilitate its passage; and likewise that innumerable other apertures on the same surface, form the beginnings of the absorbent vessels, by which the nutritive matter is taken up from the chyme and poured into the great veins near the heart to increase the quantity of the circulating blood. Such is the general idea of the digestive apparatus, and though it is less complex than some other portions of the organization, it is evidently liable to many causes of derangement, in very different portions of its strueture. Their derangements.-The more obvious causes of intestinal derangement, are evidently errors in the quality and quantity of 15 the food we use, and neglect of regular evacuations. Exercise and mechanical means to remedy these.-To promote evacuation, no means are either so natural or so effective as regular and abundant bodily exercise. In the metropolis, and especially in the city of London, this is by some imagined to consist in a bustling and merely fatiguing walk through crowded streets; but no exercise is of much use that does not induce perspiration-the expulsion of the old and useless or noxious matters of the body, before it is gorged by new ones. In addition to exercise, it is always beneficial to attempt to obtain evacuations at a stated period of the day. Now, as persons when in good health, have usually an inclination to relieve the bowels soon after breakfast (because the pressure of the distended stomach upon the transverse arch of the colon causes it to contract and propel its contents towards the rectum, which, becoming distended, gives rise to the desire to relieve itself,) this opportunity should never be neglected, for the activity of the absorbents in the bowel soon removes the softer particles, and the bulk being thus reduced, the disposition subsides. When exercise and this precaution have 17 mouth, fatigue and somnolence in particular, deadening of the senses. Then appear little points or elevations of a pale or grey colour, which grow by degrees, and form superficial pustules, round, of the size of a millet seed, and filled with a sanious liquid. The viscous mucosities which escape from them soon form )ittle crusts which fall speedily, or at the end of a few hours, and are renewed more or less promptly. Aphthm are mild when they are white, pearl-grey, or yellow, transparent, humid, small, easily broken, isolated, when they fall easily and quickly, and affect only the mouth. But frequently they become malignant, and then they are larger, dull, blue, grey, brown, blackish, gangrenous, corroding, fcetid, numerous, close, confluent, covered with a thick and very adhesive substance, or quite dry and hard, re-appearing frequently, and easily invading the pharynx, the intestinal canal, and even the trachea. The aphthae which often attack children at the breast are almost always mild. It is these only that we have here to consider: the others are always a consequence of some serious malady. The most common cause of aphthas in little children, is food of bad quality, or which does not suit their age. A2 19 foetid mucus. The gums are spongy, extremely swollen or retracted, the teeth painful, dirty and often loose, mastication, deglutition, speech and respiration painful. There are formed, on the parts affected, small flat ulcerations, very sensible and obstinate. These ulcerations extend; their base is dirty or spongy; their edges are soft, little elevated, inflamed and unequal. In a great number of cases we observe spongy excrescences of different form, colour, consistence and size. Very frequently there flows from the ulcerated and tumefied parts, especially the gums, and particularly when we touch these parts, a putrid sanies, or liquid and deep red blood. At the same time, there is great weakness, and sometimes slight febrile movements. The best remedy against this disease is mercurius solubilis, 12th, which often completely cures it in a few days.* * Nitric acid, given in water and frequently repeated, has been found beneficial in extensive ulceration of the gums, tongue, and cheeks, attended by a repulsive stench from the mouth. 20 BAD BREATH.* The cause of this is often uncleanliness of the teeth; and it consequently disappears if they are cleaned, and if the mouth is rinsed with warm water after eating. If the odour come from the stomach or lungs, it must be opposed by the following remedies: carbo animalis, 5th, agaricus, 12th, iodium, 30th, if it is observed immediately after washing the mouth with spring water; ammonium, 18th, if it is felt by the patient; baryta, 18th, if it is strong, but not felt by the patient; and sulphur, 6th, if it is augmented after eating.t FLATULENCE. I refer here only to such flatulence as depends upon errors of regimen and is of short * Vide ante. t If it be accompanied with acidity of the stomach, lycopodium and petroleum may be given. 21 duration. Flatulence occurs most commonly after eating certain vegetables, especially if these have been taken at the same time with fermented liquors. It does not cause pain, but it swells the abdomen, embarrasses respiration, and usually occasions general uneasiness. China, 12th, commonly produces good effects. However, we usually give nux vomica in preference to persons of vivid temperament, and pulsatilla, 12th, to women of a mild disposition. The latter is also indicated when flatulence follows the use of fat food. SPASMS OF THE STOMACH. In certain cases of spasm in the stomach, bryony deserves to be noticed as a proper remedy; and the necessity of using it is indicated by the following symptoms: the softest food or liquid occasions a constrictive pain in the stomach, frequently manifested whilst eating, or at all events immediately afterwards, accompanied by a sensation as if the epigastric region were swollen; and the ap 22 plication of the hand diminishes or at times removes the pain by producing eructation. CASE.-A man aged thirty-eight, of plethoric habit, suffered sudden and violent pressure at the stomach. He suffered most after eating, with constant numbness and pricking in the hands, and loss of feeling. The patient looked ill, perspired all day, and was very weak and peevish. Paralysis ot the upper extremities was dreaded; but two (loses of rhus, 4th, gutt. 1, at intervals of six days, put a stop to that condition. This was succeeded by a shooting pain across the sternum, which was increased by motion, not by respiration, and was most acute when the stomach was empty. The patient constantly suffered a trembling or sensation of leaping in the pit of the stomach. All the symptoms were removed by bryony, 6th, gl. 1, one dose. Very severe spasms in the stomach, griping and twisting pains in the epigastrium, accompanied by vomiting of a clear and acid liquid, towards evening or even night, and sour returns, were cured with phosp., 10th, gutt. 1, administered every third or fourth (lay. In one case, the spasm was so violent that several medical men believed it to be a schirrus commencing in the pylorus. 23 VOMITING. The treatment of this aftection is regulated principally by the causes which produce it, because they determine its nature. If the vomiting arise from an excess of nourishment, it would be wrong to prevent it by the employment of medicine; for it may be considered as an effort of nature to free the stomach from substances which overload it, and thus to prevent sometimes a serious disease. But it cannot always effect this evacuation, and art is often necessary to assist it. In vomiting, when it exists not as a symptom of other diseases, but as a dynamic affection arising from the nerves of the stomach, ipecacuanha is valuable. This is of frequent occurrence in children, in whom the slightest irritation of the stomach, caused either by food or liquid, suffices to produce immediate vomiting. In the sickness of pregnant women also, ipecacuanha is useful.* * Nux vomica has also been used in these cases where the vomiting is accompanied with aversions, extreme lowness of spirits, and involuntary fits of weeping. 24 DERANGEMENT OF THE STOMACH. This has for its cause excess of nourishment, food and drink which are heavy, indigestible, fat, sour, tainted, &c. Returns either acid or of the same taste with what has been eaten, disgust, heaviness, pressure and pain in the stomach, swelling and fulness of that region, trembling of the lower lip, vertigo, weight of the head, titillation or roughness of the throat, spitting, haemoptysis, disagreeable taste in the mouth, foul tongue, inclination to vomit, heat in the throat, weakness, anxiety, countenance puffed, pale and sometimes covered with spots of different colours, emission of feetid air, the urine sometimes mixed with mucus, &c.-such are the symptoms of derangement of the stomach, which usually show themselves some hours after a repast, and speedily terminate by acid vomiting of the nature of the aliments which have been taken, and sometimes of a green colour. However, there often remain for some days, anorexia, pain of the bowels, or diarrhoea. Nux vomica, 26th, remedies derangements of the stomach caused by nocturnal dissipation, by the abuse of wvine and of coffee, or 26 a year. She could not eat any thing without vomiting immediately, and if the vomitings did not occur naturally, it was necessary to stimulate them, from a feeling as if the stomach would burst. Sometimes vomiting took place immediately after eating, at others not for several hours. The matters discharged were sour and bitter: at times the patient vomited first water and a glairy matter, and afterwards the food she had taken. The motions were difficult and hard. The flatulence did not escape, but caused pricking pains on each side. The least pressure upon the region of the stomach was painful. The slightest motion appeared likely to produce sulfocation, because the cramp in the stomach rose to the neck, and caused contractions. There were frequent cramps in the calves of the legs, especially at night, loss of strength and substance, complexion disordered. Nux vomica was given in dilution, a dose every hour: four sufficed to cure her. Cramp of the stomach, connected with this derangement, is curable by the same means. This disease is very common, usually without fever, long and intermittent, attacking chiefly women, and appearing sometimes to be hereditary. In the beginning, it is merely a pressure, a very disagreeable constriction and pinching in the region affected, 27 especially at the pit of the stomach and the left side, and sometimes in the back. Afterwards, the. pains become very sensible, tearing, burning, insupportable, and are felt even in the gullet. In their highest degree of intensity, they are dreadful, accompanied by constriction, twisting, anxiety, oppression, dartings in the breast and back. The attack remains at first for some minutes, then for a quarter of an hour, an hour, and even for half a day, and it often ends by vomiting. The pain usually disappears when the stomach is empty or contains only light and mild food, and it returns after a repast. It is increased in an erect position: the leaning forward or being bent, and even pressure mitigates it. Sometimes the region of the stomach is rather hard and swollen, more commonly it is contracted, very seldom is it sensible or tense. A disposition to vomit is commonly observed, but it is not always followed by vomiting. The latter produces a brief alleviation. Cramps of the stomach are more or less obstinate according to their cause; and they sometimes resist for a long time the best directed treatment. They often disappear for several weeks, and return again at regular periods. The usual causes of this disease, are errors of regimen often and long reiterated, 29 second close must be given at the end of three or four days, and afterwards a third one. Sometimnes this state of the stomach is connected with hepatic affection and is similarly remedied. CASE.-Mr. B., aged twenty-eight, of good constitution and bilious-sanguine temperament, was seized suddenly on the 19th of July, 1836, with a violent constrictive pain in the epigastrium, and vomiting, consequent upon great mental affliction. His stomach rejected all food both solid and liquid almost immediately. The epigastric pain was incessant and not increased by pressure. The tongue was in its natural state, the patient having neither thirst nor appetite. The circulation was in no way disordered, but there was suborbital cephalalgia and general uneasiness. The skin had a very marked icteric complexion. On the morning of the 20th of July, all these symptoms had been in operation for twelve hours. Three globules of nux vomica of the twenty-fourth dilution, dissolved in two spoonfuls of water were then administered. The same evening the pain was greatly relieved, the vomitings had ceased, and the patient took some broth without experiencing any inconvenience. The following morning Bo 30 there was no symptom of gastralgia remaining, nor has it reappeared since. In this case, nux vomica effected a speedy and desirable cure, because it was exactly in accordance with the occasional cause, namely, with the mental distress and temperament of the patient, with his moral condition, and also with the cephalalgia, epigastric pain, vomitings, and even with the icteric complexion of the skin. Sometimes this state is connected with hemorrhoidal and menstrual affection, and may be similarly treated with advantage. Indeed, spasms in the stomach, resulting either from plethora and sanguine congestions in the abdomen, or simply from increased sensibility of the nerves of the stomach may be treated with nux vomica. The former case is met with more frequently than the latter, and then the spasm of the stomach is found to be connected either with hemorrhoids or irregular menstruation, in such a manner that the customary sanguine congestions towards the hemorrhoidal or uterine vessels are disordered. CASE.-A lady, aged twenty-four, had been suffering for seven years from pains in the stomach; during the whole of which time she had taken nothing but cold milk, as other 32 eight or ten days, followed by hemorrhoidal tumours, weakness, perspiration and agitated sleep, was cured in eight days by two doses of coccul., 6th, gl. 1. Pulsatilla is particularly suitable when a repast is composed of aliments which are fat, and when it presents the following symptoms: taste bitter, salt or putrid mucus in the mouth, roughness in the throat, bilious returns, want of appetite, repugnance to warm food, fulness of the stomach, swelling of the abdomen, tension below the last ribs, borborygmi, constipation, or at least slow, difficult and scanty evacuation, shivering, depression, shooting in the limbs, and ill humour. CASE.-A patient experienced a sensation of tightness above the navel as if the intestines were inflated. At times, there was a round lump as large as a fist, hard and prominent, the bowels painful at the slightest touch, very painful pricking pains on each side of the abdomen, feet cold, head burning, febrile irritation, frequent tendency to sickness, followed at times by vomiting. This disease, which attacked the patient more especially in the evening, arose in the first instance from cold. In cases of this sort, pulsatilla is an actual 34 accompanied by great fear, aconite, 24th, is the specific. When the nervous system is very irritable, and the sensibility increased, good effects are obtained from chiamomilla, 12th, especially when the patient complains of pressure in the region of the stomach, of painful swelling at the pit of the stomach and of the left side, of asthma and of anxiety. It should also be observed, that a little coffee usually mitigates this kind of pain; while it is injurious in others which yield to the use of nux vomica. Chamomilla has no effect in persons who have used much camomile tea: it must then be replaced by ignatia, pulsatilla and coffee..rnica, 6th, is administered if the derangement of the stomach arise from a general and continued excitement of the nervous system caused by distress of mind, watching, excess in pleasure, fatigue of the body, and if it be accompanied by the following symptoms: vertigo, pain in the head, especially above the orbits, stupefaction, heat in the head, dryness of the tongue, sour or bitter taste in the mouth, desire for acids, tongue loaded with a yellowish matter, taste of what has been eaten, fulness at the pit of the stomach, nausea, flatulence, weight in all the members, disagreeable heat, agitated sleep, frequent awaking, starting during sleep, 35 anxious and distressing dreams. We may also give nux vomica, 30th, and chamomilla, 12th, if there be no circumstance which contra-indicates their use. We observe in the spring, particularly in persons who dwell in humid places, near stagnant waters, marshes, &c., a particular derangement of the stomach, of which the following are the characters: loss of appetite, continual satiety, a heaviness and fulness of the abdomen, eructations, depression, weakness, vertigo, dull head-ache, sometimes heats, alternating with shiverings, turbid and cloudy urine, sensibility to external impressions, agitated sleep, ill humour. This state is, in many cases, the forerunner of fever, which may be prevented by china, 24th. When in these affections there is some inflammatory tendency, belladonna is invaluable. CASE I.-In this case, the female was pregnant; and spasms occurred frequently, each time with increased intensity. There occurred violent spasmodic pain in the pit of the stomach, and left hypochondrium, with vomiting; general soreness of the abdomen, violent pressure downwards towards the pelvis, with frequent desire to micturate; face red, swollen and heated; eyes fixed, pupils 30 -dilated; partial loss of consciousness; occasional movements and moaning produced by the violence of the pain. A few doses of bellad. 5th, effectually removed the disease. CASE II.-A man had been suffering for forty-eight hours under hiccough and vomiting. The sensibility of the stomach was so great as to reject even a spoonful of water. Opium and lavements were inadequate to remove the symptoms or the constipation. The face was red and burning, and the body bathed in a cold perspiration. Belladonna, 10th, was immediately administered. At the end of three hours, the vomiting had ceased, but the hiccough still remained and continued even during sleep. In order to free himself from this distressing symptom, the patient had, during his attendant's absence, drank a few cups of strong camomile tea. But as the camomile counteracted the action of the belladonna, all these symptoms reappeared during the night, the hiccough in particular more violently than before. There was then administered a cup of coffee, as an antidote to the camomile; and a few hours after a homoeopathic d,-e. of belladonna. By the evening, all the symptoms had ceased, and they never recurred. 39 CASE II.-An aged female, who had often suffered from spasms in the stomach, had not for several months passed a single day free from pains in the epigastrium and back. These pains gradually increased, and were succeeded by vomitings occurring several times in the day, so that the sufferer could take nothing without vomiting immediately, or at the end of a few hours, with increase of pain. She sometimes even vomited when the stomach was empty. At the same time, she lost substance visibly; and finally weakness and incessant pain confined her to bed. The pain was constrictive and burning; the pit of the stomach distended and painful to the touch, with constipation; the tongue clean, throat dry, thirst, sleeplessness. A few doses of ars. 30th, administered at long intervals, obviated for a long time this chronic gastritis, which was doubtless accompanied by a tendency to the production of scirrhus. CASE III.-Inflammation of the stomach was cured by ars., 10th, gl. 1; twelve hours after which was administered coloc. 10th, gl. 1; and the same again sixteen hours afterwards. The patient, who was sixty years of age, complained of extreme burning pain in the pit of the stomach, so great that 40 he could not even endure the contact of the clothes, and his stomach rejected immediately every thing that he took; pulse small and quick; the patient extremely restless. The cure was rapid, without any other application. Chronic Indigestion.-In a case of continual swelling of the epigastrium arising from wind, difficulty of breathing in the morning, but more especially after meals, eructation, sensation of sickness, occasional vomiting, continual pressure, periodical heat in the stomach, and constriction of the abdomen, were almost instantly relieved by two or three doses of sulphur. Tinct. sulph. not diluted, gl. 1, repeated every eighth day has cured many severe cases of heart-burn in young persons. One case of this was so serious that the patient began to lose substance, as he could take nothing but a little broth. Two doses cured him: acids had been found useless. A female, between thirty and forty, had. for twelve years been suffering from nausea and vomiting, immediately after breakfasting, and very often after dinner. Besides this, she complained of shooting and tightness of the chest, with a dry cough, darting pain in the forehead, stupifying vertigo, coTd in the hands and feet, and pains in the abdomen. 41 Fifteen days use of the tincture of sulph. and ipecacuanha stopped the sickness: ars. and con. removed the cough and all other symptoms. Affections of the stomach arising from lead require the employment of its proper antidote. Mr. N., a house-painter, aged thirty, of sanguine temperament, after mixing colours for some (lays for a great number of workmen, was seized with colic, to which he paid little attention. At the end of three days, however, he fell into such a state of disease and suffering, that he exhibited the following symptoms:-dull, obtuse pain extending from the middle of the stomach to the epigastrium, not increased by pressure, dry tongue, vomiting of mucus and bile, obstinate constipation, pulse contracted and quick, respiration difficult, face pale, with convulsive movements of the extremities. Opium being an antidote to lead, and one of the best homceopathic remedies in cases of constipation, four globules, 12th, were dissolved in four spoonfuls of water, to be taken every hour, and the same at night. Next morning, the patient was generally more easy; but the pain and vomiting remained the same..Qlumine, 30th, 5, were administered in three spoonsful of water, to be taken c 43 CASE I.-A lady in delicate health, who had suffered from dyspepsia for several years, and latterly from disease of the liver, was labouring under the following symptoms:-frequent giddiness, dull pain with pressure in the forehead, face flushed, sleepiness even after breakfast, tongue yellow, thirst, acid eructations, weight in the stomach much increased after eating, acute pain in the region of the liver augmented upon pressure, dull pain in the loins, bowels constipated, no relief without purgatives latterly of the most drastic kind, feet cold, pulse quick and hard, nervous system highly excitable. 'The acute pain in the liver with inflammation, and the condition of the pulse indicated the use of aconit. 30th, which was repeated three times a day for three or four days, when the pulse became subdued, and the liver much less painful. Bryon. 30th, was ordered every night for a week, and subsequently every alternate night for another fortnight. During the action of the bryony, the symptoms gradually diminished; the bowels became regular, and at the end of several months no medicine was required, and digestion had so much improved, that she recovered her strength and former healthy appearance. 45 CASE IV.-A lady had for many years suffered most severely from a stomach affection, which had latterly increased to such an extent that all food was immediately rejected, even fluids not being always retained; the pain in the stomach most distressing, much increased upon pressure, distention of the stomach and bowels, eructations, and severe dull pain between the shoulders and in right side, copious secretion of aqueous fluid from the mouth, violent fits of coughing both day and night, more particularly on lying down and alter taking nourishment. During one of these attacks, she ejected a large quantity of black blood, twelve or fourteen ounces at least; pulse quick, small, hard..aconite, 6th, dissolved in water, was given every ten or fifteen minutes, until the pulse became soft and less frequent, when bryony, 10th, followed by nux, 10th, daily, removed the pain and vomiting. This patient had long suffered from disease of the liver, and had consulted several of the most eminent men of the present day with no relief. 46 OBSTRUCTION IN THE INTESTINAL CANAL. This is a morbid state of which the principal symptom is a superabundant secretion of mucus, in consequence of weakness of the digestive organs. This affection, the result of a sedentary life, of a moist and unhealthy atmosphere, of painful emotions, or some other malady, attacks especially infants, women and old men, and occurs chiefly in autumn. The secretion may have its principal seat in the stomach, or in the intestinal canal; but this produces little difference in the symptoms, which are generally the following: -want of appetite, thirst, sweetish nauseous taste, abundant secretion of viscous saliva, a white, thick coating on the tongue, much mucus about the teeth, paleness of the face, depression, fulness at the pit of the stomach, swelling of the abdomen, sometimes vomiting of mucus; when the evil reaches a great degree of intensity, it is frequently accompanied by diarrhoea or colic..Nux vomica, 30th, is the most efficacious remedy against this affection, especially when it has for its predominant symptoms cramps in the stomach, much water of an 49 and twenty times in a minute, the face became red and the head confused, terminating in oppressive head-ache. This condition had existed for four years, without any remedy affording relief. dcon., nux, coloc., ars., carbo an. and veget., and phosph. performed a perfect cure in less than six weeks. CASE II.-A young man, who had been hypochondriacal for some years, and had become weak and emaciated, complained of hemorrhoidal affections, frequent colic, constipation, wind, spasms of the abdomen and chest, with loss of sleep. He had become restless, timid, morose and often very irritable. A few doses of nux, phosphorus and nux again, combined with anacardium, removed the principal symptoms; the evacuations became regular, the appetite and digestion improved, the spasms ceased, the system gained strength, physically as well as morally. CASE III.-A female had been suffering for five years under almost daily darting pains on the right lower region of the abdomen, which extended as far as the loins and back; there were hemorrhoids, frequent tenesmus, constipation, flatulence, swelling of the bowels, legs and feet, accompanied D CONSTIPATION. This is a very common disease. Its severity varies with the causes which produce it. Sometimes it is an accessory of other affections, or the consequence, as already observed, of some organic change in the intestines. The most common constipations, which continue during several days without being accompanied with any other accident, have generally for their cause the too scanty secretion of the liquids necessary in digestion, or a particular weakness of the intestines. They attack chiefly women and old men, and are occasioned by a sedentary life, a dry kind of nourishment, advanced pregnancy, the abuse of remedies, or a predisposition resulting from previous constipations. Constipation is always accompanied more or less with other affections of the abdomen; the difficulty, however, of discovering them renders it necessary for the practitioner to 52 undertake a careful examination of the patient. Frequently we find the patient suffiering also from a sensation of fulness or oppression at the stomach and epigastric region after eating, and that for several hours; frequently also there exists a ravenous appetite followed by nausea, temporary heat in the face and a pressive pain in the head. In these cases, high dilutions are preferable to low, because they speedily remove the disease without producing accessory symptoms. The treatment is regulated according to the causes of the affection. Opium, 6th, is very salutary in case of a simple constipation, which does not originate from an internal disposition or a malady of long duration, but from external circumstances, particularly from those which have a debilitating influence upon the nervous system, and when that constipation, without being truly painful, presents the following symptoms: desire to relieve the bowels, with sensation as if the intestines were obstructed, and there existed impossibility of evacuation, beating in the abdomen, pressure at the stomach, want of appetite, thirst, dryness of the mouth. CASE.-For a patient, having a sallow complexion, loss of appetite, tendency to vomit, 53 flatulence, pressure at the stomach, constipation, dry cough, was prescribed tincture of nux vonica, one drop night and morning, advising him to increase the dose one drop every day. An improvement was speedily manifest without any crisis. At the end of fifteen days, he had quite recovered; the cough left him in a short time. Constipation constitutes very frequently a separate disease, often produced by abuse of coffee. Out of many cases, one was very remarkable. During six days, no motion, giddiness, stupor, intoxicating heaviness in the head, especially in the morning, great heat and redness of the face, dryness of the mouth, acid and bitter taste, heart-burn, nausea, especially in the morning, loss of appetite, flatulence, pressure at the stomach, swelling of the stomach after eating, shooting pain in the abdomen, tenesmus, pain in the rectum and loins, oppressive constrictive pain in the chest, sleep disturbed at night, great lassitude and drowsiness in the morning, restlessness, great general depression. A few doses of pure tincture of nux vomica removed these symptoms entirely.* * A few drops of the tincture of lycopodium repeated twice a day, will relieve such cases when nux has been given in vain. D2 54 The following cases occurred lately in my own practice. CASE I.-An elderly man had, for upwar(ls of twenty years, suffered from constipation, accompanied by severe head-aches, to such an extent that he was compelled every few days to absent himself from business, having fulness in the stomach after eating, tongue dry and loaded, &c. He could exist only by taking, every second day, a dose of some aperient medicine, which relieved his head for the day only; the pain returning as regularly as possible the following day. The stomach had become so weakened by repeated purgatives, that it was unable to digest even the best food; and they had produced a distressing disease of the lower intestines. He complained likewise of dull pain in the region of the liver, which was much increased upon pressure. Sulphur, in five weeks, enabled the bowels to act daily, and the headache entirely subsided. CASE II.-An old naval officer, was placed in early life, on the West India stations, where he had yellow fever several times, and with difficulty escaped with life, leaving on one occasion only eight or ten on board his vessel. These attacks produced disease of 55 the liver, and consequently confirmed constipation, which had existed upwards of thirty years when I saw him. He informed me that, during that time, he had never obtained relief from the bowels without aperient medicines: taking them regularly every second day, they had become as necessary to his existence as food. Accompanying this state of stomach and bowels, were most distressing head-aches, and great depression of the nervous system. Though introduced to me, he did not expect anything like permanent relief. Nevertheless, after continuing for two months the medicines I prescribed, the bowels became regular and acted daily; and, upon seeing him many months afterwards, he told me that, during that time, he had not taken or required one dose of aperient medicine. The remedies were nux, 30th, bryon. 30th, and verat. 12th, every second or third day in succession. CASE III.-A gentleman had long suffered from an eruptive disease covering great part of the body. At the same time, he complained of dyspeptic symptoms, such as acid and bitter eructations, fulness of the stomach and bowels after eating, with pain in the region of the liver and consequent constipation. I prescribed verat. for the skin dis 56 ease, to which it yielded. At the same time, the stomachic symptoms subsided, and the constipation gave way; so that, at the end of two months, although he had not taken purgative medicines of any kind, as previously in the habit of doing, at least weekly, he assured me his health was in a much better state than for many years before. CASE IV.-A medical man. who had lived in the country where he was accustomed to horse exercise and active life, upon his settling in town, where he had now resided nearly twenty years, soon became affected with derangement of the digestive organssuch as nausea, giddiness, weight and pain in the head, loss of appetite, distension of the stomach after eating, with acid flatulence, loaded tongue, pain in the liver, general falling away, and palpitation of the heart, to such an extent that in bed the clothes were often lifted up. This continued for several years, when the bowels became obstinately constipated, requiring purgatives, tonics, alkalines and alteratives continually. He informed me that a week never passed without medicine-seldom a day without either soda or a purgative. All these means were discontinued; and, by the use of calcarea carbonica, and subsequently carbo vegetabilis, 58 the condition without curing it entirely, we may administer ignat. 6th, gl. 2, after which nux, 10th, again. In some cases, bryony, 6th, gl. 2, opium, 2nd, gl. 2, and veratrum will answer. When the constipation is obstinate, it will be advisable to assist these remedies with lavements. If all these fail, we must then have recourse to plumb., alum., platin., sepia, and especially the two last. Bryony is still more important in cases of lying-in women, when constipation arises very frequently from inflammatory irritation of the abdominal organs, to which this remedy is strikingly adapted. We may in the same manner treat the constipation which usually occurs in the first days after delivery, if it do not speedily disappear of itself. CASE.-A lady, the wife of a professional man, had suffered from constipation for upwards of twenty years, and during the last four or five years, had been obliged to take aperient medicine daily. In such a way, indeed, had purgatives been administered, both as to quantity and quality, that they had produced ulceration of the lower intestines, discharging blood, pus and mucus, in quantities that became alarming. She had long suffered from torpid, if not diseased, state of 60 ment of warm milk, water gruel, with or without castor oil, is frequently sufficient: should it fail, another lavement of honey water will be certain to produce the effect. If the mother is not accustomed to coffee, two or three spoonsful may be administered to the child. When these dietetic precautions are not sufficient, we must have recourse to internal remedies. For this purpose, nux, 10th, is appropriate, especially when the mother has been accustomed to coffee, in which case it is a specific. But it is also efficacious in other cases, for instance, when constipation is produced by undigested food, or when the alvine excretions are so hard that the child cannot void them without great straining, pain and blood. Next to this stands opium, 2nd, which is indicated when the peristaltic movement of the intestinal canal is, so to speak, destroyed, when there exists no inclination to obtain relief, and the abdomen gradually swells. Advantage has sometimes been derived from a higher dilution than that just mentioned. Next to these two remedies, bryon. 10th, 1 and 2, veratr. 10th, 1, are most effective. The first operates in a manner very similar to nux vomica, and frequently succeeds when 62 is sometimes accidental constipation, more frequently a little diarrhoea, rarely any fever. In children, after evacuation of urine, more considerable than ordinary, we often remark much agitation and impatience, continual crying, sudden screams, contortions which disfigure the countenance during sleep, sleeplessness and cramps. They draw up the limbs, bend them, and are incapable of lactation. The treatment of colic is regulated principally by the causes which have produced it. n children, it is usually caused by cold, or "by worms: in adults by severe cold, by excess in eating and drinking, but often also by a particular disposition to flatulence and to hemorrhoids. Chamomilla, 12th, or pulsatilla, 15th, cures colic produced by a cold, when it presents the following symptoms: violent, cutting, tearing pains in the bowels, causing agitation which allows the patient no rest, a sensation as if the abdomen were entirely empty, with continual commotion in the intestines, dark circles around the eyes, frequent collection of saliva in the mouth, violent and tearing pain below the navel, pains in the loins, nausea, inclination to vomit, diarrhoea, evacuations green, watery and mixed with mucus. 64 disgust for food, continual desire to relieve the bowels, the abdomen hard and swollen, tensive and burning pain, eructations, general weakness, diarrhcea, evacuation of mucus, with pains in the bowels, especially towards midnight. The symptoms of colic produced by excess of nourishment or by unhealthy food are: nausea, weight, with a feeling of extension and of painful tension in the abdomen, tearing, pinching, and cutting pain, increased by touch, white saliva foaming from the mouth, pains above the navel, diarrhoea, evacuations green, or of a citron colour, with violent pain in the stomach, countenance pale, dark circles round the eyes, slight convulsions of the limbs, bending of the body, pressive and tensive head-ache. Half a cup of strong coffee would have the effect, in persons who do not make habitual use of that beverage, of evacuating the superabundant or unhealthy aliments contained in the stomach and intestines. When this means has produced the desired result, it should, after some hours, be followed by pulsatilla, 18th. Pulsatilla, 12th, is the best remedy against hemorrhoidal colics, of which the usual symptoms are the following:-beating at the pit of the stomach, a painful feeling of constriction as if it were too full, borborygmi in the abdo 66 ing him no rest, and compelling him to writhe with the agony. Colics with which some women are attacked at the commencement of the catamenia, usually disappear when it has occurred; but the affection may, in certain circumstances, continue and become very distressing. Nux vomica, 30th, is then often employed with success, especially when the disease is characterized by a twisting in the abdomen, with some nausea, a poignant spasmodic pain in the pelvis chiefly about the ischium, which becomes remittent, pressive, or shooting, with constriction in the region of the bladder. Coffee, 3d, causes the disappearance of the following symptoms: pains in the abdomen, violent and spasmodic, which affect even the chest, bending of the body with convulsions of the limbs, grinding of the teeth, general cold, crampoid stiffening, loss of respiration, sighing, fulness of the abdomen, with pressure. Pulsatilla, 18th, may be employed in the same circumstances when they are accompanied by violent and pressive pain of the abdomen and loins, and by an evident shooting from the trunk to the thighs, which ceases when seated, and to which are joined a pain 68 riods, and has commonly for its result a more or less considerable excretion of mucus or blood. During pregnancy, we generally find some disorder in the alvine secretions and hemorrhoidal eflusions. Two or three weeks after delivery, every motion is accompanied by lancinating pain in the rectum. In a short time, the evacuations occur every three or five (lays, the excretions being dry and hard. After long and inefficient efforts, no relief is obtained, or at most but of a small quantity of matter; the pain in the rectum reaches the greatest degree of suffering, with anxious perspiration of the face, and tendency to syncope; with the evacuation a discharge either of pure blood, or sanguinolent mucus; after which the heat and shooting pains in the recturn, remain for some time. The anus itself forms a round, hard, livid tumour. There are continual pains in the loins, extending towards the back, especially during movement. Hemorrhoids may be divided into two large classes, internal and external, and each of these classes may be subdivided into fluent and dry. The patient ought above all things to observe a severe regimen, to take much exercise in the open air, to keep the feet warm, 71 rhoeal evacuations, we employ with success capsicum annuum, 15th: arsenicum album, 30th, possesses the property of dispelling this burning in the rectum and the neighbouring parts.* CASE I.-A female, aged twenty-two, mother of six children, of a venous-arterial constitution,,had been for two years suffering from blind hemorrhoids, arising principally from a sedentary life, and the habitual use of very strong coffee. She one day found three tumours at the anus, as large as nuts, which produced great throbbing and burning pain, and prevented her sitting down. The pain extended half way up the rectum, accompanied with febrile symptoms, heaviness of the head, vertigo, loss of appetite and constipation. An allopathist prescribed twenty leeches, hip baths and emollient lavements. This treatment was continued for eighteen days, during which the patient had ninety leeches and thirty-six hip baths. Instead of the disease, however, being in any way alleviated, the symptoms increased to an extraordinary degree, the patient suffering excessive pain, which no narcotic could relieve. The * The best remedies in herpetic hemorrhoids are calc. kali. and lycop. little effect, for the symptoms remained equally severe during two days. On the third day, however, there was an improvement; the tensive pressure of the hypochondria, and especially the moral condition were sensibly ameliorated. It became clear that the moral affection was closely connected in this patient with that of the abdomen; for, in proportion as the pains in the hypochondria reappeared, the disposition of the mind changed also. He was left for eight dlays under the operation of conium, administering only a little milk and water each day, in order to satisfy his desire of taking something. The conclusion of this period was followed by constipation and loss of appetite, which led to the prescription of nux, 10th, 3; but the nux vomica had no effect, although it was the first dilution. Recourse was then had to lachesis, 10th, 2, which was more successful; although it did not agree perfectly with the moral state, it accorded well with the primitive affection, its action being remarkably powerful upon the function of the venous system, or rather of the nervous system that influences it. Three doses were then administered, one every third day; an exhibition peculiar to lachesis, which requires to be repeated till the development of a manifest action, which we must be especially careful F2 78 not to disturb, even when it appears after the first dose. There is not in fact any medicine likely to do so much mischief as lachesis: it is one of the best polychrests we possess, but at the same time, one of the most dangerous when improperly applied, or repeated too frequently. In repeating a dose of lachesis, great attention must be paid to the moral condition, the sleep and the appetite: if all be right in this respect, we may repeat the dose with confidence, although fresh symptoms have been exhibited. After these three doses of lachesis, nothing was administered for fifteen days, in order to leave sufficient time for their action to exhaust itself. It was then found that the symptoms for staph ys. and natr. carb. were indicated, which was prescribed in dose 10th, 3. These remedies concluded the treatment, and the patient was perfectly cured after two months application of the homoeopathic system, without recurring to a course of mineral water which his medical attendant had advised. Experience has proved that nux vomnica, 24th, is peculiarly efficacious against this disease, especially when it is caused by the use of heating drinks, such as wine, spirits, strong beer and coffee, by the influence of sedentary habits and of prolonged study, by the hardness of the fcecal matter, worms, 79 pregnancy, swelling of the abdominal viscera, organic injuries of the rectum and neighbouring parts. When it has for symptoms considerable excrescences which are the seat of burning and shooting pains, a sense of strangling in the rectum, narrowness of that viscus, joined to dull and darting pains felt by shocks in the loins and hip-bones; a pain as of cracking in the loins on the slightest movement, which causes the patient to cry out, and does not permit him to remain erect or to walk except in a bent position, a flow of pure and clear blood after alvine evacuations, or accompanied by desire of evacuation. CASE.-Mr. S., aged thirty, of strong constitution and very corpulent, had for some years been afflicted with a hemorrhoidal affection, characterized by swelling and thickening of the hemorrhoidal veins accompanied with constipation and strangury. The use of leeches applied to the part almost every month afforded the patient a temporary relief, but the disease grew worse and each time it became necessary to apply the leeches at shorter intervals. He exhibited the following symptoms: vertigo, confusion of ideas, throbbing pains in the temples as if nails were being driven in, face pale and puffed, 80 contraction and slight convulsive movement of the eye-lids, singing in the ears, tongue whitish, the patient having a sensation as if it were contracted, thirst and desire for cooling drinks. In the morning, vomiting of slimy acid matter, mucus in the mouth. Six hours after dinner, rejection of food taken, either wholly or partially, with sensation of weight in the occiput, numbness of the right arm, especially of the third and fourth fingers, (these symptoms disappeared when every thing was thrown off the stomach,) indigestion, acid eructations, flatulence, constipation, continual desire to micturate, urine voided by drops with sensation of heat at the prostate gland, occasionally bloody, palpitations of the heart or caliac arteries after repose; sensation of oppression at the chest, compelling the patient to take long inspirations, numbness in the shoulders, arms and legs, starting and nightmare at the commencement of sleep; lassitude, weakness, feeling of languor in the stomach, constant drowsiness, great want of prolonged sleep, yawning, sensation of cold, restlessness, nervous depression. Nux vomica, 30th, was prescribed, and a second dose three days afterwards, from which he received great benefit; afterwards sulphur, graphites, silicea, 30th, re-established 83 should administer sulphur and belladonna, alternately at suitable intervals until the sufferings are relieved or the symptoms appear more marked, guided by which we can easily discover the proper remedy. Salphur may also be administered at intervals of two, four, six, or eight days, according to the susceptibility of the patient. The selection of dilutions may be regulated in the same way. A susceptible patient is often acted upon as strongly by a very small dose as another not easily affected will be by the strongest. Peculiarity of constitution can alone decide the point, and hence so many opinions upon this important subject. In this matter all depends upon the extent of the patient's susceptibility, and this is the reason why hypochondriacs are frequently so long before they experience any effect. CASE.-In the case of a young female, at the end of her sixth accouchement, after two attacks of intermittent fever, the inflammation of the hemorrhoidal tumours extended between the ninth and the thirteenth day, gradually to the following extent: the orifice of the anus swollen in a round and thick bunch, divided by furrows into three unequal parts, one being the size of a small egg, the others of a nutmeg. The tumours were of a lient and slightly laxative lavements, bathing of the lower extremities, emulsions and calomel, finally joined with opium, the disease instead of decreasing, increased daily up to the seventh, at which time the patient was all but dead. sJconite, 8th, 3, was prescribed to be repeated every three hours during the night. The next morning, the eighth of the disease, the young patient was much better. For the first time since the commencement of the disease, she had slept for quarters and half hours at a time during the night; the constant vomiting accompanying the taking of food, had ceased; the pains in the lower part of the abdomen, which had been previously incessant, had almost entirely departed; the abdomen was but little sensitive to the touch, less swollen, and distended; the fever, previously incessant, was fast subsiding, and this complete change occurred without any crisis by perspiration. The patient again took a few doses of aconite during the day. The following morning she was perfectly free from danger. This homoeopathic case astonished her friends not a little. Still I could not persuade myself that it was attributable to the administering of aconite in such small doses. I rather thought it ought to be considered as a consequent effect of the antiphlogistic 91 cretion of saliva, loss of appetite, sensation of fulness, without any desire to vomit, pressure at the stomach with tensive pain, palpitation in the region of the stomach, contraction of the abdomen, pressure at the anus, respiration slow, deep and noisy, gaping, moaning, dleep and pressive pain in the chest, occasional cough, palpitations of the heart, swelling of the abdomen, tension and extreme sensibility of the part when touched, and violent darting pains when leant upon, swelling in a direction toward the inguinal region, shooting with pricking pains, on the slightest touch, decrease of urinary secretion, occasionally accompanied with heat, borborygmi in the hypogastrium, ulcerative pains, imnmobility ot the legs, sensation of curvature in the loins, occasionally violent burning heat followved by cold, great agitation, loss of sleep, frequent sighing, mnoaning, indolence, with great irritability of the nervous system. The symptoms of enteritis were clearly developedand the disease was so advanced that slight hopes remained of cure. Less reliance was to be placed on aconite, than upon those remedies adopted to oppose nervous symptoms. Neither nux vornzca nor bryony appearing suitable, nigella, 6th, gl. 1, was administered. At first, it did not appear to produce any favourable effect; at the end of 92 one hour, all the symptoms were increased: delirium, with extreme heat at the back part of the head, continual jactitation, cries, respiration short and quick, unquenchable thirst with burning heat, violent pains in the abdomen towards the loins, sharp cutting gnawing pains in the intestines, involuntary movements in bed, requiring the patient to be held down. At the end of two hours, these affections diminished, the head was relieved, accompanied by repose, tranquillity and general improvement. Towards evening, increase of symptoms, but in a slight degree and for a shorter period, soon succeeded by drowsiness and tolerably quiet sleep, disturbed only by agitating dreams, involuntary startings and inarticulate words. The patient passed a quiet night. The following morning, with the exception of shooting and tensive pains in the abdomen, and excessive weakness, the patient was tolerably well, and complained only of dull pressive head-ache in the forehead, with rather sharp pains in the occiput, thirst, and dislike to food. A second globule was administered, which produced a very short aggravation of the symptoms, especially of the head-ache, whilst the tensive and darting pain in.the abdomen was succeeded by shooting pains. The febrile exacerbation of the evening was also less violent; nux, 10th, 95 turn, tenesmus, great weaknes, alterations inll the features and even faintings. Dulcamara, 24th, is an infallible remedy against aqueous diarrhceas which arise from cold, and are not accompanied either with pains in the abdomen or any other accessory indisposition. To diarrhoea arising from cold must be opposed china, 12th, when the evacuations are of an acrid and clear liquid, without mixture of foecal matter, are preceded by violent colics, by spasmodic and pressive pains in the intestines, eructations, borborygmi, and by a sensation of weakness in the abdomen. CASE.-A man aged eighty one, in full possession of his intellectual faculties, though of a delicate constitution, generally healthy an(l of regular habits, was seized in the autumn of 1836, without any perceptible cause, with a serious disease; after a few days, during which the disease had continued to increase, I was called in to prescribe. For the last two days, and especially at night, a very copious diarrhoea, watery and mucous; the patient voided what little food he took undigested; he had frequent vomitings of mucus, water and aliments, with sour and bitter taste; however small the quantity of liquids or solids, he instantly 97 undigested; thirst extreme. Six doses of china, 11th, one every three hours, having produced no effect, one drop of tinct. ratanhire, was administered night and morning. At the end of four days, the complaint had subsided; but the remedy was continued, since which time she has had no relapse. If the cold is caused by night air, and produces a pinching at the pit of the stomach, borborygmi, a feeling of relaxation as if evacuation were about to take place, a cutting and tearing pain with pressure in the abdomen, which is cold, nausea, shivering, sudden and frequent desire to evacuate, at first without result, and afterwards with excretions, frequent, aqueous and green, with disposition to fainting, it is desirable to administer mercury, 12th. If diarrhoea arises from errors of regimen, and manifests itself by loss of appetite, with sensation of dryness, &c., of slight burning of the tongue without thirst, a bitter and saltish taste in the mouth, eructations fortid, hiccough, nausea, and vomiting, fulness of the abdomen, colic, much flatulence, commotion of the intestines, urgent desire to relieve the bowels, inquietude, with frequent evacuations, pulsatilla, 12th, is the best remedy. Chamomilla, 12th, is employed successfully against diarrhoeas which arise from anger, H 102 Diarrhcea in Children.-An infant, thirteen weeks old, had been crying incessantly for days, suffering from green diarrhcea, sometimes mucous, and at others watery. The family attendant administered an infusion of camomile and opium in fennel water from time to time, because the child refused all food and even fluids. For the last two or three days, he dosed with the eyes half open; the veins of the head were full of blood; at times he awoke starting from his sleep, cried violently and exhibited extreme restlessness. The medical attendant finding him very weak, began to doubt if he would live through the night. After a few doses of coff. Sd, 1, belladonna, 10th, 2, and one of nux vomica, 10th, 1, employed as an antidote to the opium, matters returned in three days to their primitive state. The diarrhoea, restlessness, and griping were speedily removed by a single dose of senna, 2nd, 3. The child recovered its health ten days afterwards. Ipecacuanha is useful in serous diarrhoea in children, accompanied by vomiting of a green or white mucus, with griping pains in the abdomen. In those acute diarrhceas in children described as relaxation of the stomach and the intestinal canal, the diarrhoea is established 103 without any perceptible cause. Evacuations copious and more or less frequent, according to the intensity of the disease, consisting of aqueous mucous matter, sometimes greenish, and at others greyish, of fcetid smell. At the same time, slight fever, heat in the palms of the hands and soles of the feet, incessant thirst, loss of appetite, rapid wasting of the body, constant agitation, moaning and weeping, paleness and dryness of the skin without turgescence, abdomen very sensitive, puffed, elastic, occasional vomiting, urine small in quantity and colourless, sleep comatose or light, eyes half closed. The patient remains in this state from three to five days. A few doses of calc. acet. gl. 1, suppressed the incessant and copious evacuations, and the child, which was previously almost a skeleton, soon became florid and ruddy. In another case, in addition to chalk, mere. sol. was administered with good effect. In the most acute form of this disease, especially when attended by violent pains in the abdomen, colocynthis is undoubtedly the first and best remedy. In children towards the fourth month, those green diarrhoeas, attributed to acidity in the primwe via, or to dentition, are often observed. The disease appears to depend upon some particular anomaly of the biliary 107 anxiety, diarrhoea, spasms in the abdomen, violent pain in the loins, tenesmus, and voiding of a small quantity of blood. The remedies applied, antiphlogistics, did not diminish the disease; on the contrary, the anxiety, tenesmus and thirst increased; every ten minutes the patient vomited sanguineous mucus mixed with blood. On the third day, he took sublimate, 16th, which in a few days entirely removed the symptoms. In dysentery in a child eighteen months old, who had previously suffered from humid tetter, the dysentery had baffled allopathic treatment. The child, which was previously strong and healthy, grew pale and thin at the end of three weeks, and ejected sanguineous mucus without particular suffering several times a day. A few doses of baryta effected its speedy removal. A female, aged twenty-three, of phlegmatic temperament, was seized, in consequence of eating unripe fruit and other errors in regimen, with discharge of blood, to which she at first paid no attention. The skin was dry; there were sharp, shooting pains in the abdomen; thirst, bitter taste in the mouth, tenesmus, bilious evacuations streaked with blood. A very small dose of tartar, emetic, removed it in three or four days. In the beginning of July, an epidemic 113 and sulphuric acid: the case, however, of the elder brother exhibited an instance of the danger of bleeding and leeches in this epidemic. CASE III.-A little girl aced eight years, of weak constitution, was seized with dysentery and exhibited the following symptoms. Pain over the right eye-lid, violent colic in the epigastrium, evacuations with pain in the abdomen, sometimes of mucous blood-stained matter with ascarides, at others of bright clear blood These evacuations were attended with intolerable pain, thirst, general coldness, paleness, loss of substance, fever in the afternoon, ceasing towards evening. Sublimate was administered, and two Says after, colocynth: no improvement; on the contrary, the patient was worse. Rhus was prescribed, and a cure was eflected in the fourth day of the treatment, after three doses, being the fifteenth from the commencement of the attack. CASE IV. --A young girl, aged sixteen, of rather strong constitution, was first seized with dysentery. On the fourteenth day of the disease, after she had gone through all the stages, it appeared to have degenerated into hectic fever. The following were the 115 strength. Colocynth, 6th, gt. 1, repeated every two or three hours, effected its speedy removal. Veratrum also is successful in sporadic cholera. A child six months old, of weak constitution, had been for three days suffering from vomiting and diarrhcea, and was extremely weakened. Six doses of veratrum album, 12th, were administered, one every two or three hours. Still no improvement in his condition. His body was cold as ice, and thirst insatiable. The case was critical. Cupr. metallic, 30th, was prescribed, and a tea-spoonful was administered every ten or fifteen minutes, till these symptoms disappeared. The child was saved, and in a few days completely recovered. ASIATIC CHOLERA. It will not be amiss, if I put before the eyes of my readers, the advice given by Hahnemann, for the treatment of cholera. It is sufficiently simple, concise and easy of application, to be readily understood by every 117 of wine, tea, coffee, or any other heating article which he had been daily in the habit of using. It may be as well to add that the medical man should be fully imbued with the importance of his functions at these difficult times, banish all fear from his mind, be prepared by reflection for all occurrences, and possess great presence of mind. Directly a patient is seized with cholera, administer one or two drops of the solution of camphor before mentioned, on sugar or in pure water. Repeat the dose every five minutes, whatever the intensity of the disease, the camphor should in all cases be administered during the first hour after the commencement of the attack. As long as the patient feels any benefit from the use of the camphor it should be continued, and if the disease yields to this application no other will be necessary. When this, however, is not the case, we must be guided in our treatment by what the symptoms require. If there is vomiting, or only tendency that way, or if the vomitings are accompanied by excruciating pain, agitation and icy coldness, the patient should take one or two globules of arsenic. If this produces a good effect without complete cure, the dose should be renewed every two or three hours, according to the strength of the patient. 121 very abundant, at times mixed with blood, extreme sleeplessness, face pale, eyes sunk, tongue dry and furred, sores on the sides of the nose, with obstruction of the nostrils, extreme thirst, loss of appetite, violent colic, with tenesmus causing the child to cry incessantly. The patient free from fever, the skin cold, extreme weakness and loss of substance, dispirited and exhausted. On the 28th of August, nux vomica, tenth dilution, was prescribed in four ounces of distilled water, three spoonsful every day. The next mnorning, 29th, the patient had only three evacuations, more cohesive and free from blood. Again was administered a teaslpoonful of the mixture; and, on the following day, the child was able to sleep, and had recovered his playfulness and appetite. On the 1st of September, the patient was a second time seized wvith frequent bloodstained evacuations, accompanied with convulsions of the limbs and very violent tenesmus, each evacuation preceded by cries and griping pains in the abdomen. On the second of September, prescribed veratrum, third dilution, in four ounces of distilled water, two spoonsful to be taken during the day. On the third, the (liarrhlea and colic K 122 were sensibly diminished, and on the fifth the patient was perfectly recovered. CASE II.-A child, aged five months, in the enjoyment of general good health, and strong for her age, was seized with very copious diarrhoea towards the end of the month of August. For nine days, she had been treated in the usual way; opiates and gums were administered both by the mouth and in lavements. On the first of September, she was as follows:Face very pale, eyes sunk and wandering, pupils dilated, features distorted, tongue dry and white, thirst, loss of appetite, frequent vomitings, violent colic and copious evacuations, discharge of fcecal matter almost every minute, loss of substance, skin dry and hot. No sleep for several nights, difficulty of breathing. As an internal remedy, nux vomica was prescribed, tenth dilution, in four ounces of distilled water, a spoonful every hour. At the same time, were applied to the stomach flannels soaked in warm water. On the following day the child was much better, and on the third of September entirely cured. 124 presence are the following: nausea, much aqueous saliva or other liquid in the mouth, foetid breath, countenance puffed and pale, bluish or brownish arches below the eyes, dilatation of the pupils, sleep disturbed, abdomen distended and tense. The tape-worm is flat, whitish, often very long, and composed of a great number of articulations. It is somewhat difficult to discover its existence. It sometimes occasions extraordinary sensations of pressure, of cold and of undulatory movement in the abdomen, acute pain, cramp, epileptic and convulsive movements; often none of these symptoms are observable. The only certain sign of its presence is the appearance of some portions which are naturally detached from its body, and are replaced by a new growth. The greater part of the means employed against these three kinds of worms have at most, for their result, the separation of a portion of them, without destroying the morbid principle which produces them. When the lumbrici or the ascarides live in the intestines in children without producing any serious effects, they do not require interference of art. But if we observe signs or a real alteration in health, it becomes necessary to oppose to each particular case the means wvhich it requires. We can most frequently employ 128 The examination of the doctrines and rules of each school, will demonstrate the existence of these contradictions and uncertainties; and I do not hesitate to affirm, that this will continue until the homoeopathic law is adopted, which, by giving a fixed and sure basis to therapeutics, will, at the same time, destroy all uncertainty regarding regimen. Homneopathic Rules of Diet and Regimen. The object to be attained by attention to regimen in the treatment of disease, is to place the patient in a condition the most favourable for the action of the remedy; and, to accomplish this, the two following rules are considered essential. 1st. To prohibit the use of every description of aliment which possesses medicinal properties, or which might destroy or modify the action of the medicines administered. 2d. To regulate the quantity of such aliments as are allowed to the patient, in order that the daily waste of the constitution may be supplied, without overcharging the digestive powers. The homceopathic physician prohibits his patients from using spirituous liquors, spices, acids, strong tea and coffee, and aromatic 131 complaints; although, in the latter, it is tsubject to many particular modifications which cannot be detailed in a work like the present. I will only observe here, that rigorous attention to diet in acute disorders, is rarely of long duration in homceopathic practice. In no case is the patient restricted from taking food, except in cases where he has a positive disinclination to it; and whenever the desire for food returns, he is allowed by degrees to indulge it. Besides, the duration of acute diseases being infinitely shorter by the homoeopathic mode of treatment than by that of the old school, the duration of dietetic restrictions is also shorter, and consequently the inconveniences arising from long abstinence from food are avoided. Such Rules a.ccessory, not Curative. From the preceding observations, an opinion may be formed of the rationale of the homoeopathic regimen. It will be remarked, that we consider it only as accessory, and not curative; and that, consequently, there is a wide difference betwixt the homccopathic school and that which has been called the expectant-that which looks to the efforts of nature for every thing, and proclaims diet, 132 water, and exercise, to be sovereign remedies. No doubt, diet, water, and exercise, are excellent things. Unquestionably, for him who has too constantly remained within doors, it may be well to prescribe exercise. To another, who has gorged himself with the delicacies of the table, it may be proper to recommend moderation in eating, and to dictate such a diet as will give the alimentary system time to recover from the effects of repletion. And, to him, who has indulged in an excess of wine, it may be wise to prescribe water: to deprive him for a time of that in which he has indulged to excess, is easily understood, and it may alone be sufficient to re-establish the health, which the abuse of it had deranged. We should not have mentioned the expectant school at all,-as it enjoys credit only with those who are absurdly credulous,-had it not been that we have always been represented as ranging ourselves under its banner. Those who have seen the success of the homceopathic treatment could not well deny it; but they have preferred attributing this success to the regimen, and not to the principle, and to that curative virtue of homoeopathic doses which we proclaim. Their arguments appear to us to be quite unfounded. It is I I I I I 4 I I' ~~~~I I I hif