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AMERICAN EDITOR'S PREFACE.


r~CrCM~CI~NV~Y~hM~~~)VYIF~MFICYW~CCMNCr


TuEE enterprise and liberality of my publisher has put it in my
power to furnish a more or less complete Monograph upon Apoplexy,
embracing nearly the same number of pages into which I once feared
I should be obliged to.compress all that I had to say, not only upon
this disease, but upon several others, equally, if not still more important.,
The literature'of Homoeopathy, thus far, has consisted mainly of
periodicals, synopses and repertories of the Materia Medica, of a few
more or less imperfect,systematic treatises, of more numerous theoretical and controversial tracts, but especially of very numerous volumes
on the Domestic Practice of Homceopathy. The dearth of elaborate
articles, or Monographs, upon  almost every disease, has long been
severely felt and deeply regretted by homoeopathic physicians, both
experienced and inexperienced. One of the editors of the British
Journal of Homoeopathy (see voll 8, p. 405) truly says: "What weshould much prefer to any system   of homoeopathic practice, would
be a series of papers-volumes, if you like-on diseases in which
Homoeopathy has been well tested at the sick-bed, and respecting
which, accordingly, we are able to lay down those special practical
rules, which are alone of value to the homoeopathist."
I have had some little experience in the publication of Monographsg
having already published articles upon Intermittent Fever, Dysentery,
Rheumatism, Diseases of the Heart, Diseases of the Chest, Bright's
Disease of the Kidneys, Ovarian Diseases, and Dropsy of the Brain;
and propose, if time be given and health spared to me, to furnish a



vi


PREFACI.


series of Monographs, more complete than any heretofore- published on
the homoeopathic treatment-first of the principal Diseases of the
Head, then of other organs. These Monographs or Treatises will of
course be similar in design and execution to the Treatise on Headaches,
already published, and to the present Treatise on Apoplexy. These,
when finished, will furnish a complete and practical General System of
Homceopathic Practice.
I have entered upon the consideration of the formidable diseases
treated of in this volume with a full sense of the responsibilities inseparable from the undertaking. In the presence of such terrible disorders,.
the true physician is necessarily elevated far'above all the trifling coiisiderations of prejudice, custom, partisan feeling, theory or system, and
has but a single eye to the recovery, or comfort, of his afflicted patient;
he should come fully prepared, by previous study and experience, to
use the gentlest means that will, suffice to accomplish these objects, or
to put in force the most heroic measures which may be necessary to
carry his patient through present emergency; while in all those, not
very rare cases, which are -necessarily and essentially fatal from  the
onset, he will quickly reject all Don Quixotic and eithusiastic attempts
at cure, and limit his endeavors to the palliation of present suffering.
In the construction of this Treatise,'I have followed the plan:adopted
by Riickert, less slavishly than I thought it indispensable to do in the
"Treatise on Headaches."   It was absolutely necessary for me to take
some liberties, as Riickert's contribution to the practical hpmceopathic
treatment of Apoplexy consists of but twenty-four cases, occupying
only eighteen pages, while the present Treatise contains at least one
hundred and seventy pages, illustrated by seventy-five dases. I do not,
however, claim  any particular credit for the additions which I have
furnished; in all that appertains to the Pathological Anat-my of the
diseases here treated of, I have largely quoted from   the celebrated
ROKITANSKY, of Vienna, and the almost equally celebrated HASSE, of
Leipzig, the friendship and instruction of both of whomi  I was once
fortunate enough to enjoy. The remarks on Pathological Chemistry
have mainly been borrowed from the labors 6f the celebrated SIMON,
of Berlin, and the still more distinguished LEHIMANN, Of Leipzig, whose
personal instructions I once endeavored to profit by.  In the general






INTRODUCITON.                   3
frequent occurrence in Apoplexy, is the rupture of a bloodvessel in, or about the brain; and the result in recovery or death
depends mainly upon the fact whether the artery which has
given way be large or small, the quantity of blood which is
poured in or upon the brain be great or trifling, and the
laceration, contusion or compression of the brain be extensive
or mpderate. I repeat that the result in recovery, partial
recovery, or death, does, or ought to depend, as.much upon
these circumstances, as upon the mode of treatment; although,
it seems unfortunately, but too probable, that some of the
milder cases are either allowed to progress into the severer
forms by inefficient treatment, or else are treated so savagely
and heroically as to be rendered fatal, when they would have
terminated favorably with very gentle management.
WATsoN candidly informs us: that " after a formal attack
of Apoplexy, the results of allopathic treatment will be very
uncertain; a large effusion of blood in, or upon the brain
will prove fatal; a smaller amount of extravasation cannot
be removed at all promptly by ordinary medical means; and
that the best which the unfortunate patient can expect in too
many cases, will be a long-continued or permanent palsy, a
weakening of the mental powers, and sometimes a state nearly
approaching to idiocy."
On the other hand, YELDHAM (see Homceopathy in Acute
Diseases, p. 173) says: "It must not be supposed that
Homoeopathy, any more than Allopathy, pretends to cure
every apoplectic patient; on the contrary, it is well known
that there are many cases (as, for example, where, from the
rupture of a vessel, a large quantity of blood is poured out,
and presses on the brain) in which all medical treatment
must, from a physical necessity, prove unavailing. In cases
of this kind, the two systems, as far as relates to a cure, are
on an equality." But while I admit this, I think it may be
asserted positively that in the majority of these cases, the
most prompt and heroic allopathic treatment does not, and
cannot save life; and that the gentle, or so-called inefficient
honmeopathic treatment is not the cause of death.



INTRODUCTION.


numbness, or a sense of creeping, crawling or formication,
loss or perversion of feeling, so that everything touched feels
like velvet, or felt, or itching in the limbs may arise from
fulness or sluggishness of the blood, from  a purely nervous
affection, or from. softening of the brain; slight paralytic
affections, such as drooping of an eyelid, or distortion of the
features, may arise from congestion of the brain, or slight
apoplectic effusion, or from debility of the nerves of the part;
double vision, difficulty of writing in a straight line, or of
reading, the presence of motes or corruscations before the
eyes, noises in the ears, or dulness of hearing, may be caused
by excess or deficiency of blood in the head, by great debility
of the nerves of the eyes or ears, or by indigestion; the substitution of one word for another, difficulty in pronouncing
certain words, a sudden loss of memory, may all arise from
weakness of the brain, a deficient flow of blood to it, or from
the pressure of an excessive quantity of blood.
If the physician can constantly keep these distinctions
and differences in his mind, he will rarely go wrong in his
treatment; unless he be so slavishly wedded to system, that
he will not follow the dictates of his own, and others' reason,
and experience. But it unfortunately happens that in very
many cases no premonitory symptoms precede an attack of.Apoplexy. RocHoux even goes so far as to declare that in 69
cases in which he collected the histories, only 11 presented
precursory symptoms; in such cases a fit of Apoplexy will, of
course, set in without any warning, and the physician must
treat the attack as best he may.
Prevention of Apo2pexy.
The principal point generally dwelt on, is: to prevent too
great fulness of blood in the head. This may arise either from
too great a quantity thrown to it, by excessive action of the
heart and arteries (Aconite); or, too great retention of blood
in the brain and head, from retarded circulation (Conium,
Carbo); or from diminished nervous energy (Nux, Plumbum).
HARTMA~NN says that in most cases we are undoubtedly



8


APOYLEXY.


called upon to treat, or prevent nervous Apoplexy, because
passive congestive-Apoplexy generally depends on nervous debility; and active congestive-Apoplexy upon nervous irritation
of the brain, exciting increased flow of blood to it; or upon
excitement of the sympathetic nerve, which presides over the
circulation (Veratrum, Nux, Coffea).  If there be a rupture
of a small blood-vessel, Arnica, Yeratrum, Millefolium, or
Ereosote deserve attention.
We can prevent too much blood being made, by great care
in diet and regimen. Watson gives the case of Dr. Adam
Ferguson, of Edinburgh, who was a man of full habit, at one
time corpulent and very ruddy, and, though by no means
intemperate, lived fully. He had premonitions of Apoplexy,
to which he paid no attention, and finally, in his 60th
year, had a decided attack of Apoplexy, with paralysis.
He recovered, and then became a strict Pythagorean in his
diet, eating nothing but vegetables, and drinking only water
and milk. lie got rid of every paralytic symptom, became
even robust and muscular, and died in full possession of his
faculties, at the advanced age of 93; full thirty years after his
first attack. Long after his 80th year his firm step, and ruddy
cheek, contrasted agreeably and unexpectedly with his silver
locks.
This course of diet is necessarily only suited against true
pletora, or that state of the system  in which an absolutely greater quantity of blood is made than the organism
requires for its sustenance.
On the other hand, those who are pale and delicate, have lost
much blood, or are reduced by chronic cough with profuse
expectoration, by severe dyspepsia, or long-continued diarrhcea, or diabetes, or profuse flow of menses, or piles, &e.,
may require tonic diet, meat, even wine, China, Ferrum, &c.
Still, if there be disease or brittleness of the blood-vesselswhich may often be detected by the presence of a peculiar
fulness or hardness of the pulse at the wrist-we should be
very careful of stimulants.
Anything which is calculated to hurry the circulation



PREVENTION OF APOPLEXY.


9


and increase the force of the heart's action, such as strong
bodily exercise, anger, violent passiop, loud and earnest talking, brisk or hurried walking, galloping on a hard horse,
should be avoided; holding the breath, especially when some
muscular effort is made, such as tugging at a tight boot, holding a high note in singing, in a violent paroxysm of coughing,
or in straining at stool, are particularly dangerous; in all
these acts blood is thrown violently to the head, the face may
turn purple, the patient become giddy, the eyes bloodshot, and
a fit of Apoplexy come on. Violent vomiting, sneezing, laughing, crying, singing, shouting, all have a somewhat similar
effect. In short, a person liable to Apoplexy is obliged to
exert such control over body and mind, that SOLLY categorically asserts, he must be content to live like a cabbage, to
vegetate, merely exist, and barely live. Far better would it
be for them to live like Dr. Adam Ferguson, already alluded
to, whose mixture of original thinking with high moral feeling and extensive learning, his love of country, contempt of
luxury, and especially the strong subjection of his passions
and feelings to the dominion of his reason, made him, perhaps,
the most striking example of the stoic philosopher which
could be seen in modern days.-(WATsON.)
Dr. Fothergill thought it very unsafe for short-necked
people to look backwards for any length of time, without
turning the rest of the body, thus twisting the neck. He
gives the case of a man seized with Apoplexy, while crossing a river in an open boat, keeping his eyes fixed upon a
particular ship, until long after he had rowed past her.
Tight cravats are also injurious. A  Swedish officer who
was desirous that his men should look well in the face, caused
them to wear tight stocks; in a short time quite a number of
his regiment died of Apoplexy. The case of a boy is also
given who had drawn his neckcloth remarkably tight, and
was seized with Apoplexy, while exerting himself whipping
a top.
Cold, is another frequent exciting cause of Apoplexy; it
drives the blood friom the surface, and accumulates it in the



10


APOPLEXY.


large vessels of the interior of the body. I have known several elderly persons, with a marked tendency to congestion of
the head, attacked while dressing or undressing in a cold
room, loitering about with their shoes and stockings off, and
remaining partially, or very nearly undressed for a long time.
On the other hand, expansion of the blood may be caused
by hot and stimulating food and drinks, large fires, crowded
rooms, excessive heat of the sun, hot baths, &c. The whole
mass of the blood becomes expanded, and cooling and refrigerating means are required.
This last state of the blood has been greatly overlooked by
almost all writers on affections of the brain, although it was
well known to the ancients. According to them, the so-called
Plethora ad volumen depends upon an apparent quantitative
increase of the blood from expansion, or increase of its volume, without actual increase of quantity. It was supposed to
arise from vital turgor, nervous orgasm, or simple expansion
of the blood from excessive heat. The best marked examples
occur in sun-struck persons.  SOLLY'S friend, Dr. SAMUEL
ROGERS, gives a most graphic description of this form of Apoplexy, as caused by great exposure to the heat of the sun.
He says: " About 8 o'clock, a most melancholy scene commenced among the troops; men were seen to drop down and
instantly expire; everyhour added to our melancholy situation, for notwithstanding the utmost exertions of the physi6ians, the day ended with no less a loss than 18, and left us
with 63 sick in the hospital. When warning of the attack
was given to the patients, they usually complained of difficult
breathing, with a sense of tightness and oppression about the
chest, followed by giddiness, burning heat of the eyes, and a
sense of great fulness about the head, in many amounting to
excruciating pain, succeeded by loss of sense and motion, faltering of the tongue on attempting to speak, fulness of the
eyes, dilated and fixed pupils, violent twitching of the muscles of the face, particularly those about the mouth, subsultus
tendinum, and involuntary stools. Along with these symptoms the patient also had a strong, full, and frequent pulse,
tremendous throbbing of the carotid and temporal arteries,



12


APOPLEXY.


of blood to the healthy standard. This may avert danger,
and certainly will not interfere with the action of the most
delicate homoeopathic remedies; but if the symptoms be not
urgent, the excess of blood may be more slowly reduced by
dietetic, and medical means. In deciding on the propriety of
blood-letting, it is very important to be certain whether true
plethora be present, or an absolutely greater quantity of blood
than the organism requires for its sustenance, or can readily
control the circulation of. If true plethora, or exceedingly
active and dangerous congestion be not present, the physician
should discard the lancet; but there can be no earthly
objection to bathing the feet in simple hot water, or in hot
pepper-, or mustard-water; the head and shoulders should be
raised, the clothes all loosened, and cold applications made to
the head. If the bowels be obstinately costive, or even
moderately sluggish, some mild but efficient purgative, such
as castor oil, may be given at once; or if the attack arise
from the suppression of piles, or menses, Aloes should be preferred as a purgative. Aloes may also be given when there
is bilious derangement, although as HARTMANN says, that
Mercurius solubilis corresponds to every variety of Apoplexy,
it may be allowable to give this in sufficient quantities to act
on the liver and bowels, in appropriate cases. I say appropriate cases, because there are others, which are characterised
by pallor of the patient, an inclination to dizziness with faintishness, palpitation, nervous tremors and timidity, in which
all the symptoms are increased when the stomach is empty,
or the bowels are freely moved, or from looking upwards, or
resuming the upright position after stooping, or rising from
bed, and in which all the above treatment would be injurious.
Aconite is regarded as the principal remedy when there
is great heat and feverishness of the head and body (see
article on Aconite); Bellad. or Stramonium, when there
is great and active congestion to the head, with excessive
restlessness, and more or less delirium; Opium, when there
is a more passive- and venous-congestion, with much drowsiness, great constipation and some stupor; Cocculus, when
nausea and giddiness constitute the prominent symptoms;



14


APOPLEXY.


TRUE, OR TYPICAL APOPLEXY,
With preceding plethorac and congestion, followed 6y Aemorrhage and paralysis.
The model type of Apoplexy occurs in persons with a robust
body, ruddy complexion, who are hearty and stout by nature
or good living, have too much blood in the whole system,
and proportionately still more in the brain, or head. This is
by far not the most frequent form of Apoplexy, although it
has fixed the ideas of world about the nature and treatment
of the disease.
Symrnptoms.-Such a plethoric, juicy and heavy man, apparently in good health, suddenly falls down deprived of all his
senses, wholly unconscious of surrounding objects, his countenance livid, the vessels of the face and head turgid with blood,
his breathing snoring or stertorous, his pulse full, slow, and
intermitting, his limbs powerless. In the most violent cases,
all the limbs are paralysed, but generally, the paralysis is
confined to one-half of the body, in the form of hemiplegia;
sometimes only a single limb is affcted, and in this case the
arm is much more frequently paralysed than the leg. The
paralysis may be confined to the face, tongue, eyes, their lids,
or other parts (see HIemorrhagic Apoplexy). From this state
the patient may never rally, even under the most active allopathic, anti-phlogistic, and revulsive treatment; he often sinks
without any change for the better in his symptoms, and dies
in the course of forty-eight hours. This, SOLLY truly says, is
an awful disease to suffer from, to witness, or to administer to;
but death soon closes the scene, and the brain when examined
after death, is found to have been more or less torn and
destroyed by large masses, and clots of blood extravasated into
and upon the brain. The case is typical because the extravasation of blood is so copious and severe that all the effects of
extravasation are produced; all the centres of nervous power
within the skull are either crushed, torn or compressed; or
ploughed up by, and intimately mixed and intermingled with
gore; while the neighborhood of large and. rather large.lota is



16


APOPLEXY.


precludes that freer circulation of the blood, and that more
liberal expenditure of it through the skin, and by means of
the other organs of secretion, which would occur under more
active habits. Such persons are apt to become fat, the adipose
tissue seeming to form a kind of safety-valve for the diversion
of the superfluous blood; the muscular and fibrous tissues,
however, suffer in their nutrition, because the imperfect respiration of heavy and sluggish persons does not form fibrin in
sufficient quantity for their full development. Such persons
naturally have turgid and florid cheeks, red lips, red mucous
membranes, and not uncommonly ferretty eyes; their entire
vascular system is preternaturally distended, and if you open
a vein, you find that they bear a large abstraction of blood
without fainting, and are even refreshed by it; while the blood
drawn separates into a large, but not very firm mass of
coa guhun, with but little seren (WATsoN).
The blood of the plethoric is also deficient in fibrin, and
hence, decidedly inclined to hemorrhage. According to
ANrDAL, in plethora and congestion of the brain, the fibrin
of the blood is apt to diminish from T-W to T-; the
quantity of blood globules to increase from  27 to 1.;
the solids of the serum  to increase from -,4~ to t   and
the quantity of water or serum to diminish from      to
7 4 0 Hence the blood will be thicker, more sluggish in its
action and less inclined to form a clot or coagulate, and even
is disposed to exude from its vessels in the form of hemorrhage. The effect of this kind of blood upon the brain and
other organs, is admirably described by BEcQUEREL and
RODEER; they say, that in true plethora or full-bloodedness,
not only is the whole mass of the blood increased, but sudden
accumulations of it in internal parts, frequently in the brain,
are apt to occur, disturbing its functions, causing fits of
insensibility, and sometimes even death itself. It is only too
true, when blood already exists in too great abundance through-:
out the body, that it is apt to fall in excess upon any debilitated, or irritated organ. Above, we have referred almost
exclusively to true,Petkora (PLETHORAM& EA), or that state in



TYPICAL APOPLEXY, PLETHORA.


17


which a greater quantity of blood is present than the
organism requires for its healthy nutrition and sustenance.
True plethora is necessarily universal, (plethora universalis)
as contradistinguished from local or partial plethoras, (plethora partialis); it may also be not only venous, but also
arterial in its character (plethora venosa et arteriosa); and
of course, is widely distinguished from dyscratic-plethora,
such as occurs in albuminuria, hydroemia, and other affections
(plethora cacochyrna). The principal causes of true plethora
are: 1st, excessive production of blood, especially when associated with diminished consumption of it; this is particularly
apt to be the case in true plethora, in which we have seen that
the blood is deficient in fibrin, hence is less plastic, less
inclined to assume a coagulable or solid form, consequently
more disposed to remain as blood, rather than to be converted
into any organized product. Arterial congestion and plethora
are closely allied to the above state of things; the conveyed
arterial blood is changed too slowly into venous, in conse"quence either of diminished nutrition of the tissues, or other
causes, and-consequently the arterial blood is only slowly and
imperfectly driven from such parts.
Another form of plethora is the so-called plethora ad vires,
in which the quantity of blood in the system, is relatively too
great for its powers; this is apt to occur from nervous or
mental exhaustion, long continued or extravagant grief, or
anxiety, sudden fright, depressing mental emotions, &c. Of
course the principal indication is not to remove blood, but to
arouse and invigorate the nervous system.
The so-called plethora ad volumen has already been alluded
to; but the fact that the blood in a dead body occupies only onetenth part of the space which it occupies in the living one, may
here be referred to in proof of the close connection which the
volume of blood has with its life, or with its amount of orgasm,
or vital turgor. The opposite of this state, or collapse of the
blood, may be produced by depressing agents such as Digitalis, Prussic acid, Tobacco, deficient nervous energy, &c.;
the pulse is then apt to be small, soft and frequent; the surface
B



18


APOPLEXY.


pale and cold, sensation and motion either deficient or extinct.
In plethora ad volumen the pulse is apt to be full, large, slow,
heavy and oppressed.
One other form may be mentioned, viz.: the plethora ad
spatium, such as is apt to occur from  diminution of the
calibre of the blood-vessels, or after the loss of large and
important limbs. (STanK.)
Although plethora is only one element of true or typical
Apoplexy, particular attention has been paid to it here because
the other elements, viz.: congestion, hoemorrhage, and paralysis will be treated of more fully under the heads of Congestive, Hcmorrhagic, and Paralytic Apoplexy.
Treatment of Typical Apoplexy.    Ferrum  is the most
important homceopathic remedy against true plethora and
Apoplexy. It is well known to increase the quantity of blood
globules; but it is not so well known to diminish the quantity
of fibrin in the blood. SmoN found the fibrin to diminish
from the normal standard of.o, as low as, l-,  after the
use of sixty-four grains of iron in the course of seven weeks;
ATDRAL and GAVARRET found it to lessen the quantity of fibrin
in one case from the normal standard, to.!2,, in the course of
four weeks; in another case from,05, or an excess above
the normal mean, to To,, or the natural standard. Ferrum
is also well known to diminish the quantity of water in the
blood. Hence as far as the pathology of the disease is a guide,
it is a, or even the, most homoeopathic remedy to true arterial
congestive plethora; while Opium is perhaps the most homceopathic remedy to true venous congestive plethora; in the
former disease, the face of the patient is red and flushed, in
the latter it is purplish, or livid.
Symptomatic indications for Ferrum. Active, sthenic
congestion and haemorrhage, with great vascular irritation.
Rush of blood to the head, puffiness around the eyes, swelling
of the veins and paralytic weakness. Headache from rush of
blood to the head. Vertigo with disposition to fall forwards;
staggering in walking; momentary shock in the brain, with
giddiness; dizziness, dulness and confusion of the head;



20


APOPLEXY.


thought to be very seldom absent when there is haemorrhage.
The patient falls down suddenly deprived of sense and motion,
and lies like a person in a deep sleep; his face is generally
flushed, or more frequently livid or purple, his breathing
stertorous, his pulse full and not frequent, generally slower
than the natural standard; sometimes slight convulsions of
the limbs, or contractions of the muscles of one side of the
body, and relaxation of those of the other are present. Of
course, if the congestion be sufficiently great to cause unconsciousness, or paralyze parts of the brain, it may also cause
greater paralysis of some parts or limbs, than of others;-still,
as has already been said, paralysis is not commonly present.
The patient may continue in a state of profound stupor for
several days, or he may recover after some hours, especially
if judiciously treated; a perfect recovery, however, rarely
takes place after the attack has lasted over one or two days,
although it does in some cases of several days duration.
In a larger proportion of this class of apoplectic cases,
excessive injection of the vessels of the pia mater, and engorgement of the whole vascular system of the brain are the chief
lesions. Under allopathic treatment the cases consisting of
congestion solely, almost always recover; the patient may,
indeed, survive numerous attacks of this form of Apoplexy,
but there is always danger that a congestive stroke may be
followed by one of a hoomorrhagic character; and even when
this danger is escaped, the disease is apt to leave traces behind
it, of an enfeebled condition of the memory and intellect; and
it sometimes happens that a patient has numerous attacks,
which reduce him at length to a state of mental imbecility,
little short of idiocy. (WooD.)
It is sometimes possible to make a distinction between
Apoplexy from active congestion of the brain, and that from
passive; in the former, there is often a full, strong, but sometimes slow pulse, with a red flushing of the face; in the latter
the pulse is apt to be comparatively weak, or else natural, and
the face has a livid hue. The symptoms of active congestion
have already been sufficiently detailed among the precursory



APOPLEXY.


the brain, are solely produced by this congestion, and are to
be regarded as cases of paralysis of the brain from pressure,
by the excess of blood?
(a.) He answers, that in a certain small number of cases,
this congestion of the brain is the only morbid appearance in
the body, and has reached a degree, which in the present
state of our knowledge justifies the conclusion that the brain
has been pressed upon, and paralyzed by it.
(b.) If, in a greater number of cases, moderate congestion of
the brain is found associated with congestion of the lungs, it
is scarcely possible to say which of these conditions was the
primary, and which the secondary, or whether they did not
arise simultaneously from the same source and cause, and
which of them actually produced death. But as it is quite as
common for congestion of the lungs to be the only morbid
appearances in cases of sudden death, and as it is decidedly
the more marked appearance in many cases in which congestion of the brain is also present, we may often conclude
that the congestion of the brain is of secondary importance.
(c.) Besides cases of these two kinds, there is still a number
of others, in which all that is discovered upon examining the
body of persons dead under allopathic treatment, is so slight
a congestion of the brain, that it would not be thought of, if
any other morbid appearance presented itself. Such cases
prove fatal only when there is a peculiar tendency of the
brain to exhaustion, or paralysis. (NERVOUS APOPLEXY.)
Dr. NEISSER, of Berlin, has lately described a severe form of
congestion of the brain, connected with dilatation of its arteries; he has termed it Ectasis vasorum cerebri; thinks it is
most common in young persons of a plethoric habit, short
neck, thick head, and stunted growth; that the disease most
frequently attacks the basilar artery and its branches, which
become simply and equally dilated along their whole length,
and not in aneurismal pouches; the blood consequently moves
more slowly along them.
Symptoms.-The patient is readily heated, complains of
overflow of blood, and these symptoms recur continually in



SIMPLE, OR CONGESTIVE APOPLEXY.


23


spite of the most energetic and methodical allopathic treatment. Finally the patient complains of vertigo, and a peculiar
heaviness and dulness of the feet; he has neither pa'n, nor
tingling, but walks with a tottering, uncertain step, staggering
first to one side, then to the other, as if intoxicated; he often
becomes so dizzy as to fall, especially towards evening, and in
the dark; all the symptoms are aggravated at night, and remit
in the morning; there are partial sweats on the head and face,
and in some cases partial blindness. Dr. NEISSER found the
most energetic antiphlogistic and revulsive treatment to be
entirely inefficacious.  Death, finally, generally  occurred
suddenly.
Treatment of Congestive Apoplexy. OPiuM is perhaps the
most important homceopathic remedy; at least WooD and
BACHE say, that it in full doses reduces the frequency though
not the force of the pulse, diminishes muscular power, and
brings on languor and drowsiness which soon eventuate in a
deep apoplectic sleep; the breathing is stertorous, there is a
dark suffusion of the countenance, a full, slow and laboring
pulse, an almost total insensibility to external impressions,
and when a moment of consciousness has been obtained, a
confused state of the intellect, and an irresistible disposition
to sink back into comatose sleep are present. The pulse,
though slow, is often full and powerful in its beat. But in the
space of a few, say six or eight hours, a condition of genuine
debility ensues; the patient will have a cool and clammy skin,
cool extremities, a pallid countenance, a feeble, thread-like,
scarcely perceptible pulse, a slow, interrupted, almost gasping
respiration, and a torpor little short of absolute death-like
insensibility.
It will be seen that Opium is homceopathic to some of the
most formidable apoplectic conditions; even allopathic physicians need not, and do not fear to use it in some of the nervous
and asthenic forms of the disorder, as it in moderate doses
increases the force, fulness and frequency of the pulse, augments
the temperature of the skin, invigorates the muscular system,
quickens the senses, animates the spirits and gives new energy



24


APOPLEXY.


to the intellectual faculties, all followed by calmness, delightful
placidity of mind, with quiet, but vague enjoyment.
It will be unnecessary to enter here into the minutiae of the,
indications for the use of Opium in Apoplexy; but it may be
well to notice some of the broader and more striking peculiarities. According to CHISTISON it is most homceopathic to
congestive Apoplexy, or rather to turgescence of the vessels
of the brain, and watery effusion into the ventricles, and on the
surface of the brain. It is very rarely homceopathic to hamorrhagic Apoplexy, at least CHRISTISON says that extravasation
of blood is a very rare effect of Opium; but he gives one case
in which several clots of blood were found in the substance of
the brain, one of which in the anterior lobe, was an inch long;
in a second case, the sinuses and veins of the brain were turgid,
and a moderately thick layer of blood was effused over the
arachnoid membrane; NOAcK and TRiNKS report RYL'S case in
which the veins of the neck were turgid with decomposed
black blood, the sinuses of the head and all the cerebral vessels
were distended with blood, while the ventricles of the brain
contained a teaspoonful of a bright-red fluid; also COLIN'S case
in which extravasated blood was found in the brain, and the
cerebral vessels were very much distended; LERoJux found in
one case, about a teaspoonful of bright-red blood at the base
of the brain, and the choroid vessels very much distended;
JOURD found several clots of coagulated blood in the substance
of the brain; in a child the sinuses of the dura mater were
filled with dark coagule, and there was slight extravasation
of blood on the surface of the posterior lobes, while all the
internal vessels of the brain were turgid with blood, and there
was effusion of serum at the base of the brain, and in the
ventricles. Still it must be remembered that these cases,
although they seem numerous, are in reality exceptional.
Opium is also homceopathic to the congestion of the lungs
which so frequently attends congestive Apoplexy according to
RoTrrANsKy. CHJISTIsON says that the lungs are sometimes
found gorged with blood, as in many cases of Apoplexy; four



26


APOPLEXY.


face becomes flushed and his features turgid; the oppression
then increases rapidly, he answers questions slowly and
heavily, and at last sinks into a profound stupor and coma.
(COPELAND and WATSON.)
This is the most fatal form of Apoplexy, and it is all-important to be fully aware of this, for, to an inexperienced eye
these cases, at first, do not seem so terrible as those in which
the patient falls down profoundly comatose from the commencement. The apparent amendment is fallacious, and apt to lead
physicians and friends to indulge in hopes of recovery, soon
to be dreadfully disappointed. A large quantity of blood is
usually found extravasated in, or upon the brain.
The primary management of these cases is very difficult to
the allopathic physician; the violent pain in the head, the
faintness, sickness, vomiting, the paleness and ghastliness of
the face, the weakness, frequency or irregularity of the pulse
cannot be treated with bloodletting, and dare not be met with
stimulants, although the preparations of Ammonia are generally relied upon. As by far the majority of patients soon
rally from the first shock, and coagulation of blood with the
formation of a clot is more apt to take place during the cold
and faint stage, while fresh bleeding almost always occurs as
soon as the circulation is restored, and reaction sets in, the
physician should be bold enough not to be in too great a hurry
to rally his patient. He should aid nature in forming a clot;
and should first use styptic and blood-coagulating remedies,
rather than stimulating ones. The principal astringents in
use in old-school practice are: Acetic acid, Tannic acid,
Elixir vitriol or Aromatic sulphuric acid, Alum, Catechu,
Creosote, Chalk, Sulphate of Copper, Per-nitrate, and Muriate
Tincture of Iron, Sulphate of Iron, Geranium maculatum,
Logwood, Kino, Rhatany, Matico, Monesia, Acetate of Lead,
Bistort, Oak bark, and Acetate of Zinc. Some of these, such
as Plumbum, Cuprum, Ferrum, Zincum, &c., are more or
less homceopathic to some of -the symptoms and forms of
Apoplexy. But Millefolium has the highest homceopathic
reputation in controlling bleedings from various parts. I



HLEMORRHAGIO APOPLEXY.


"believe that the use of styptics against haemorrhage of the
Sbrain has never before been so distinctly recommended as is
here done, or will again be urged.
A glance at the principal effects of a great outpouring of
blood in, or on the brain, will still more forcibly impress us
with the importance of checking the bleeding as rapidly as
possible.
ROKTANSKY says, that: IIemorrhagic Apoplexy consists in
the pouring out of blood into the substance, or upon the surface of the brain, and a proportionate laceration, breaking
down, contusion and compression of its substance. There are
various grades of this process:
(1.) A larger or smaller spot of white or grey cerebral
substance becomes speckled or striped with a small number
of dark red dots and streaks of extravasated blood (ecchymosis);
the fibres of the brain are then generally separated, not
entirely torn by the effusion of blood. The recovery of the
patient should be perfect, although the symptoms may be
severe, and some paralysis be present.
(2.) These minute extravasations may be more numerous,
lie closer to one another, and some of them may have run
together, so that some portions of the brain are uniformly
suffused with red blood, are of a soft and pulpy consistence,
and many of its fibres are broken into numerous shreds, and
softened,to a red pap. Recovery from this state of things is
apt to be slow and imperfect.
(3.) In consequence of the continuance or recurrence of the
bleeding, a single small extravasation may increase rapidly,
or by degrees, from the size of a poppy seed, tearing and
separating the surrounding brain, until a large clot and cavity
are formed. It is this process which old-school physicians
are so anxious to prevent by means of prompt and copious
bloodletting; but as it is very generally caused and aggravated by the existence of hypertrophy of the left ventricle of
the heart, it is also very important for them to use Aconite,
Digitalis or Veratrum viride, to lessen the impulse of the



30


APOPLEXY.


the utmost importance. These, especially when combined
with brittleness of the blood-vessels, are without doubt the
cause of the frequency of Apoplexy in advanced life, and
especially of its frequent recurrence in some cases.
lemorrhagic Apoplexy is generally supposed to depend
upon the relative, or proportionate thinness, fragility, or debility of the blood-vessels of the brain, as compared with the
amount of blood circulating through the whole system, and
especially of that which is thrown to the head by the action
of a strong and vigorous heart, or active circulation. But it
arises quite as frequently, from too great stress and pressure
upon these fragile, thin, or weakened blood-vessels by a
sluggish return of blood from the head into the general circulation; and also, from such an actual and absolute degree of
attenuation, brittleness, or weakness of the blood-vessels, that
they are not able to withstand the ordinary pressure of the
Circulation under the usual, and more especially from any
extraordinary exertion of body or mind.
Under all circumstances hoemorrhagic Apoplexy will be
most apt to occur in those localities where the blood-vessels
of the brain and its membranes most abound. In the brain
itself, the most vascular parts are: the Corpora striata, the
Optic thalami, and their immediate neighbourhood; hence it
is to be expected that hoemorrhagic Apoplexy will, and does
frequently happen in those parts. Of 386 cases of Cerebraland Spinal-hoemorrhage collected by ANDRAL, no less than
202 cases showed extravasation of blood in the hemispheres
of the brain, on a level with these bodies, and at the same
time in them; in sixty-one other instances the Corpora striata
alone were involved; and the Optic thalami only, in thirty-five
additional cases; amounting in all to 298 cases out of 386.
Of the remaining eighty-eight cases, out of the 386; the
Cerebellum was the seat of haemorrhage in twenty-two, the
Spinal marrow in eight, and all other parts of the brain in
fifty-eight.
It would be very natural to draw the inference, that the
most common and frequent symptoms and phenomena of



HIEMORRHAGIC APOPLEXY.


81


hemorrhagic Apoplexy arise from the mutilation of these
organs. Loss of motion and sensation are the most common
phenomena of hoemorrhagic Apoplexy, if we except more or
less loss of consciousness; paralysis of motion is far more
frequent than loss of sensation; paralysis of one side (Hemiplegia) is far more frequent than paralysis of both sides;
paralysis of the arm is far more frequent than the same affection of the leg; and supposing the patient to recover wholly,
or partially from hemiplegia, it is the leg, in nine cases out of
ten, which recovers first and fastest, i. e., sooner and faster
than the arm. In accordance with these pathological facts,.
we find: 1st, that haemorrhage into one side of the brain is
much more common, than into both sides; 2d, the Corpora
striata are implanted on the motor tracts of the Crura cerebri,,
which descend into the pyramidal columns, and we have seen
that extravasation of blood into the corpora striata is at least
twice as frequent as with the optic thalami; accounting perhaps for the greater frequency of loss of motion in Apoplexy,
than loss of ýensation; 3d, the sensory tract of nerves may be
traced upwards from the olivary columns until it spreads
itself almost entirely through the substance of the thalamus;,
moreover, the optic nerves and the peduncles of the olfactive
may be shewn to have a distinct connection with the thalami;
the former by a direct passage of a portion of their root into
these ganglia, and the latter through the medium of the
Fornix; hence we may regard the thalami opticii as the
chief focus of the sensory nerves, and more especially as the
-chief ganglionic centre of the nerves of common sensation,
which ascend to it from the medulla oblongata and spinal
cord; we have already seen that the optic thalami are the
seat of hsemorrhage only one half as frequently as the corpora
striata, and that loss of sensation occurs not nearly so frequently as loss of motion. Why paralysis of the arm is more
frequent and obstinate than that of the leg, is still an enigma.
Apoplexy of the Corpus striatum. SOLLY says, he believes
it to be invariable fact that extravasation of blood into
this body is followed by paralysis; and consequently that



HELMORRHAGIC APOPLEXY.


33


Extravasation into the Pons produces paralysis of one or both
limbs, according to its extent, but after the first effect of the
effusion is over, it does not affect the intellect, because the
brain proper is left intact; but as the blood advances towards
the medulla, the organs of respiration become affected; first
the muscles of respiration are unnaturally and irregularly
stimulated, and the sensibility of the respiratory passages
abnormally exalted, until the stage of excitement is succeeded
by one of paralysis of the organs of respiration, and the
patient dies suffocated. (SOLLY.)
Apoplexy of the Crus cerebri. Extravasation into, or upon
this organ, will produce paralysis of the limbs on the opposite
side of the body, and often of the opposite eye, from its also
affecting the optic eye. The intellect may remain clear as
long as the brain itself is not involved. (SOLLY.)
Apoplexy of the white, or tubular substance of the brain.
In these cases, after the first effect of the extravasation is
passed, the intellect remains intact, or only slightly disturbed,
while decided paralysis of the side opposite the clot is present.
Apoplexy of the Cerebellum. Disease of this part of the
brain has, perhaps, excited more attention than its importance
demands. GALL and SERRES have assumed that erections, or
seminal emissions in man, and discharges, sometimes of blood
from the female organs, are the distinguishing signs of Apoplexy of the cerebellum; but there is as much proof to the
contrary as in favor of this assumption, although CoPELAND
suggests that effusion into that part more immediately connected with the medulla oblongata, occasions a partial
asphyxia and stasis of blood in the lungs, and thus produces
a state favorable to erections, &c. The cases of Apoplexy
which take place during coitus, especially if there has been
a,severe pain in the back of the head, followed by great vital
depression, sickness or vomiting, convulsions, and general
paralysis of sensation and motion, may with some certainty
be predicted to depend upon disorder of the cerebellum.
Apoplexy of the cerebellum is said to cause a more serious
lesion of the functions of respiration and circulation, and to
C



34


APOPLEXY.


be more dangerous than the same amount of disease in the
brain itself. This seems quite probable, as it is in union with
each segment of the great nervous centres upon which all the
movements and sensations of the body depend, viz.: the
antero-lateral columns of the cord, and the anterior pyramids
and olivary bodies, supplying all the anatomical conditions
necessary for the development of acts of sensation and volition.
It has even been assumed that the cerebellum is the regulator
of all the voluntary movements, and the source of sensibility.
(COPELAND.)
Although Apoplexy of the cerebellum, like that of the brain
itself, generally produces. paralysis of the side of the body
opposite to the seat of the injury, yet ANDRAL asserts that
when hoemorrhage into the cerebellum occurs simultaneously
with that of the brain, or a little time after it, but so that the
blood is effused on the right into the cerebellum and on the
left into the brain, or vice versa, then there will be paralysis
only on the side of the body opposite to the hemisphere of the
brain where the bleeding has taken place; i. e., on the same
side as the extravasation of blood into the cerebellum. It is
most interesting and extraordinary that the movements of the
limbs of the right side should be abolished when there is an
effusion of blood into the left side of the brain, while the
effusion which takes place simultaneously into the right side
of the cerebellum should no longer possess the power of paralyzing the limbs of the left side.
Ventricular) Apoplexy. The symptoms of this form   are
not positively known, but the bleeding has been traced by
MORGAGNI, DE HAEN, and HUFELAND, to rupture of the vessels
of the choroid plexus, in many of those cases in which the
extravasation is confined to the ventricles of the brain, without
being preceded Vby laceration of the surrounding cerebral
substance.
Aneurismal Apoplexy. COPELAND says that small aneurisms
in various parts of the cerebral vessels may form, and by their
rupture occasion hoemorrhagic Apoplexy. SEZRES relates
cases in which rupture of an aneurism occurred in the basilar



HEMORRHAGIC APOPLEXY.


37


deviation of the mouth to one side, is also much less frequent;
while both forms of meningeal Apoplexy frequently assume
an intermittent character, which is very rare in ordinary
Apoplexy.
It isisometimes impossible to distinguish it from softening
of the brain. The duration of sub-arachnoid Apoplexy does
not often exceed eight days; while the intra-arachnoid variety
may last for a month or longer, and then occasionally terminate in recovery.
Treatment of Heemorrhagic Apoplexy.
(Atheroma.)
The preventive treatment of a very large number of cases
of hemorrhagic Apoplexy will consist in the prevention of
that disease of the arteries which leads to the formation and
deposition of atheroma, and to ossification of the arteries.
According to ROKITANSKY atheroma is formed, and poured
out from the walls of the internal coat of the arteries; at first
it resembles coagulated albumen; although it is generally
associated with an arterial crasis of the blood, still, it is not
the product of inflammation of the arteries; it is rarely associated with tubercular disease of other organs; but is frequently coexistent with an excessive formation of fat in the
whole body. Chemically, atheroma has been found to consist
of a great number of cholesterine crystals, some oil globules,
and of large, small, and very small molecules consisting of
albumen, and salts of lime; this atheromatous mass often
thickens and is transformed into a moist, soft, mortar-like
substance, and finally into a granular, rough, stalactite-like
lime concretion; another transformation of the deposit is
ossification of parts of the walls of the arteries, which is very
frequently preceded, and associated with fatty degeneration
of the fibrous coat of the arteries.
The homceopathic treatment of atheroma has not yet been
pointed out; if there be a preceding arterial crasis, Ferrum,
China, Natrum muriat., Manganese, &c., would be homceo



38


APOPLEXY.


pathic; if there be a strong tendency to the development of
adipose tissue, Calc. c., Antim. crud., Kali c., Kali hydriod.,
&c., will be most indicated, although CHAMBERS (see work on
Corpulence) gives most striking results from the free use of
Liquor potassoe in excessive corpulence. When atherodhatous
deposits are fairly formed upon the arteries, we must get rid
of them as best we may; we have already seen that they
consist mainly of cholesterine crystals; cholesterine is a white,
crystallizable, fatty substance, somewhat like spermaceti, free
from taste and odor, and composed almost entirely of carbon
and hydrogen; it may be obtained by a chemical process of
no great complexity from   the serum  of the blood, and is
conjectured by some physiologists to be altered Serolin, or
the natural non-saponifiable fat of the serum; one of its most
striking characteristics is, that it is not affected by a solution
of Caustic potash, and that concentrated Nitric, Muriatic, and
Arsenious acid exert no chemical effect upon it. On the
other hand, WAGNER found that four parts of soap solved in
water would dissolve one part of cholesterine; according to
SIoN it dissolves so freely in heated Holz-geist or Na2phtha,
that the solution appears crystalline when it cools; ether,
the fatty oils, and turpentine also dissolve it; but, the latter
only in a moderate degree; while it requires twelve parts of
cold ether, to solve one part of cholesterine. As cholesterine
exists in the normal brain and nerves in considerable quantities, and is a principal constituent of atheioma, we may
readily infer that the arteries of the brain would often be
found in an atheromatous condition. Again, CARPENTER has
suggested that one of the principal sources of bile is the continual waste of nervous matter, which in some respect so
nearly approximates to bile in its composition, that it is
asserted by FREMY, that the peculiar acids of the brain may
easily be detected in the liver; hence we may infer, the
frequent practical connection of bilious derangements, with
Apoplexy and atheroma. For want of better remedies
against atheroma, it may be justifiable to use the chemical
ones, above pointed out, viz.: Naphtha, Ether, Sapon. commun.,



40


APOPLEXY.


brain being already excited, resists the oppressive effect of the
effused fluid longer than it would in its natural condition; so
that at first the symptoms of compression are not in proportion
to the amount of the effusion.
In febrile and inflammatory Apoplexy we always have
increased heat of skin, and a febrile pulse; while Apoplexy
from haemorrhage is characterized by a slow pulse and
diminished temperature. One of the most common causes of
this form of Apoplexy, is extension of rheumatism of the
muscles of the nape to the membranes of the brain; the
muscles of the neck will then be found to be tense, swollen,
and so tender to the touch that if but slightly pressed the
patient's countenance expresses pain, he will often be roused
from his unconscious state, and mutter loudly some unintelligible words; he will hold his neck in a constrained position,
and if we attempt to move his head or neck there is an
expression of pain on the countenance, and the head returns
at once to its unnatural position. (NEISSER.)
The treatment of febrile and inflammatory Apoplexy is so
well known that it requires but few words to indicate it.
Aconite, Belladonna, Bryonia, and Tart. emetic, are the most
important remedies.
SEROUS APOPLEXY.
WATsoN says, that a moderate quantity of serous fluid
poured out rapidly during life will certainly occasion a degree
of pressure adequate to the production of fatal coma-but
how the serum comes to be so effused, it is not always so easy
to say-yet there is one condition of the blood-vessels of the
brain which, when it can be proved to exist in a given case,
is sufficient to account for the effusion. Any real or virtual
retardation of the blood in the cerebral veins would lead to
what is tatamount to dropsy, there, as well as in any other
part of the body.
SOLLY assumes that serous Apoplexy is always more or less
dependent on general debility, with local vascular excitement,
and congestion of an asthenic character-for instance, a man



42


APOPLEXY.


aged 30, but somewhat dropsical, and near the full period of
gestation, fell down suddenly; she instantly became insensible, with stertorous breathing, a hard vibrating pulse, and
violent convulsions, which recurred paroxysmally. Delivery
of the child occurred in a few hours, but the symptoms of
Apoplexy remained unabated, until thirty drops of laudanum
were given. The next morning the insensibility, stertorous
breathing and convulsions returned, and remained after an
injection, which had a proper effect, had been administered;
then twenty drops of laudanum were ordered every ten
hours, until the symptoms should abate. At the end of the
third day manifest advantage had been gained over the
disease; in four days recovery appeared certain, and it happened accordingly. (KIRKLAND.)
I claim the credit of being the first to point out a truly
homoeopathic, and specifically curative remedy, viz.: Mercurius corrosivus, against one variety of Bright's disease of the
kidneys (see Homceopathic Examiner, new series, vol. 1,
p. 285), as long ago as the year 1846. Besides the successful
cases there recorded, I have heard of numerous other fortunate recoveries, both in our public allopathic medical institutions, and in private practice. It is well to add that RoKITAN KY distinguishes no less than eight different varieties of
Bright's disease; hence we require at least eight different
remedies to cure all these varieties, and doubtless several
more will be necessary to meet all the peculiarities of some
cases. Of course Mercurius corrosivus will not cure all cases
of Bright's disease; some require Cantharides, others Nitric
acid, or Hydriodate of Potash, or Copaiba; while remedies
for the remaining varieties have yet to be discovered. Marsh
Marigold will probably cure some cases. (PETERS.)
NERVOUS APOPLEXY.
"WOOD says it is now generally admitted by old-school
authorities that death may occur, even after, and perhaps in
consequence of the most active treatment, with all the phenomena of Apoplexy, without leaving any observable lesion in



CARDIAC APOPLEXY.


45


CARDIAC APOPLEXY,
Or Apoplexy connected with, or arising from     preceding
Organic disease of the heart.
In every case of threatened or happened Apoplexy, it should
be regarded as imperatively necessary for the physician not
only to examine the pulse carefully, but also to investigate the
condition and action of the heart. According to BtRowES,
"simple hypertrophy of the left ventricle of the heart will
cause an increased activity in the general circulation; the
blood will be thrown to the head with more than usual force,
and there will be a more rapid transit of the blood through
the arteries of the brain. But, after a time, this constantly
increased force of the left ventricle will have the effect of
dilating the cerebral arteries, and thus of overcoming the
healthy elasticity of their tunics. Congestions of the brain
will now ensue, and the coats of the dilated vessels no longer
protect the surrounding substance of the brain from the inordinate momentum    of the blood propelled from  the heart.
Apoplectic coma is now very likely to occur from some
sudden accidental increase of pressure of blood on the brain,
or from rupture of an artery, and pouring out of blood into
the brain.
Hence, enlargement of the left ventricle of the heart must
be admitted as a powerful predisposing, or even exciting
cause of Apoplexy, and sudden paralysis. In 132 cases of
Apoplexy collected by various authors, the heart was found
diseased in no less than eighty-four instances, or sixty-three
per cent. Andral, in twenty-five cases, found the heart diseased
in fifteen; Clendinning, in fifteen cases, out of twenty-eight;
Hope, in twenty-seven cases, out of thirty-nine; Burrowes, in
twenty-three cases, out of thirty-four; Guillemin, in four cases
out of six; Rochoux, in four cases out of fourteen.
But, simple enlargement is not the only disease of the heart
apt to cause Apoplexy; in Andral's fifteen cases, there was



46


APOPLEXY.


valvular disease in eleven cases; in Burrow's twenty-three
cases, there was valvular disease in sixteen.
A careful examination of the state of the heart of an apoplectic patient is much more necessary for the safety of one
under allopathic treatment, than under the homoeopathic.
For if the Mitral valve be diseased, and allow    of regurgitation from the left ventricle, then the small and irregular
pulse so generally attending that state of the valves, will
probably dissuade the allopathist from that free abstraction
of blood, which the state of the brain seems to require, according to his mode of treatment. Again, if in another case of
Apoplexy or paralysis, the Aortic valves be found diseased to
the extent of not only obstructing the onward current of blood,
but also of allowing regurgitation into the ventricles, there
will probably be associated with this lesion, considerable
enlargement of the left ventricle. Then we will find a full
and vibrating, or thrilling pulse, but a pulse of increased
action without real power, and hence a deceptive pulse; and
one which, if it be regarded without reference to the disease
of the heart, would tempt the physician to a more copious
abstraction of blood than will be called for by the general
symptoms. (BURROWES.)
It will be unnecessary to enter here upon the treatment of
those affections of the heart which are attended with Apoplexy,
because the treatment of Organic affections of the heart has
been given minutely and completely by the translator in the
Homoeopathic Examiner, vol. 2, (new series, 1847), and
reprinted, both in Hull's Laurie's (Appendix), and in Hull's
Laurie (new edition, 1853,) all published by WM. RADDE.
BILIOUS APOPLEXY.
Buni (see Treatise on Diseases of the Liver,) has made quite
a large collection of fatal cases of jaundice; followed by delirium, coma, paralysis or convulsions. RoKITASKY, however,
was the first to call attention to this formidable disorder,
under the name of acute yellow softening of the liver; owing
to his researches, the disease can now be readily detected



48


APOPLEXY.


GASTRIC APOPLEXY.
A very large number of cases of Apoplexy occur after a
full meal; a person predisposed to Apoplexy, either from
plethora, or disease of the arteries of the brain, but especially
when both are present, is very apt to be attacked with Apoplexy, after a full meal. This is best illustrated by a case.
A colored woman, aged about 50, and somewhat corpulent,
after a hearty meal of meat, peas and rice, fell down in a
state of insensibility, and soon expired. As soon as the skull
was opened, a considerable collection of blood was found
about the base of the brain, and large clots were discovered
in its substance; the arteries of the brain were rigid, much
dilated, and studded over with numerous points of ossification; the bleeding had taken place in consequence of a
rupture of some of these arteries. On examining the stomach,
that organ was found impacted with peas, rice, hominy and
other articles of the individual's repast, to a degree to which
it would scarcely be possible to believe could be borne without extreme suffering, and an extensive embarrassment of the
functions of the whole of the associated organs. It was so
distended as to encroach upon the intestines, compress the
aorta, and the vessels given off by it in the epigastric region,
press upon the plexus of nerves behind the stomach, and
finally, force up the diaphragm upon the lungs so as to interrupt their play, and thus embarrass the function of respiration, thereby interrupting the passage of blood through
them, and consequently impeding its return from the head.
The blood being thus confined on the one hand to the vessels
of the brain, by these causes, and driven upon it, on the other
hand, by the pressure sustained by the aorta, which prevented
the distribution of the usual quantity of blood to the lower
part of the body, it is not to be wondered at, when the fragile
state of the coats of the arteries of the brain is considered, that
they should have been unable to sustain the pressure thus
suddenly thrown upon them, and that they gave way under
its influence. (CoPEmAN.)
The above is a fair exposition of one cause of a very large



50


APOPLEXY.


of signal service; they empty the intestines, which are sometimes loaded, and which by distending the abdomen have
perhaps occasioned undue pressure against the diaphragm,
embarrassed the breathing, and through it the circulation in
the brain; another very important purpose of hard purging,,
is the producing of copious watery discharges from the bowels,.
whereby the blood-vessels are drained, and the tendency of
blood to the head especially relieved."
I am sorry to say that in my experience, purging has had
no such good effects; in at least four cases of Apoplexy,
previously treated by allopathic physicians and in several by
myself, I have seen decided purging produce not only no
good effect upon the patient, but render his condition one of
great misery and filth to those around him, all the evacuations
being necessarily passed in the bed, while the necessary
attentions in cleansing and moving the patient have certainly
aggravated a state which requires the utmost repose and
quiet. COPEMAN even gives two cases, viz.: cases 193 and
194, in which hypercatharsis seemed to bring on Apoplexy.
"A foreman of a mill, strong and stout, was under the care
of a physician for disorder of the liver, which was treated by
mercury; this produced a hypercatharsis so prodigious that
he nearly became bereft of all power, and all pulse; he rallied
partially, but in twelve hours presented all the symptoms of
cerebral Apoplexy; he was lethargic and flushed; notwithstanding the usual treatment, he went on into all the degrees
of Apoplexy, and died in twelve hours more.
A stout, unwieldy lady, aged 70, in.her usual health in the
morning, had taken a purgative, which produced a hypercatharsis; after the evacuations she was struck with Apoplexy.
COPEMAN exclaims: Emptied vessels, with great debility, yet
the blood determined fatally to the head!"
WEST gives the case of a child attacked with diarrhoea, producing great exhaustion; and while suffering from this affection, he suddenly became comatose, cold and almost pulseless,
and his breathing became so slow that he inspired only four
or five times in a minute. In this state he lay for twenty



52


APOPLEXY.


place, if an infant when born, were to present great lividity
of the surface, and especially of the face; and if the heart
were to beat feebly, and at long intervals, although the pulsations of the cord were slow, or faint, or had altogether ceased.
Death may take place without any effprt at respiration being
made, the beatings of the heart growing feebler and fewer till
they entirely cease; but at other times the child breathes irregularly, imperfectly, and at long intervals. The hands are
generally clenched, and spasmodic twitchings are of frequent
occurrence about the face; or these twitchings may be more
general, and more severe, and may amount almost to an
attack of convulsions. (WEST.)
Bleeding within in the skull in the new born infant takes
place almost under the same circumstances that bleeding into
the tissue of the scalp, or extravasation of blood between the
bone and pericranium takes place (Cephalhcematoma).
Infantile Apoplexy, though at no time so frequent as immediately after birth, may occur at any subsequent period of
childhood, either under the influence of causes which favor
congestion of the brain, or even independently of any cause
that we can discover.
"WEST, LEGENDRE, EILLIET and BARTHEZ, all concur in representing its symptoms as exceedingly obscure; paralysis was
observed only twice in twenty-six cases of hemorrhage into
the cavity of the arachnoid, owing probably to the pressure
exerted on the brain being generally diffused over its surface,
and being nowhere very considerable; just enough, perhaps,
to cause general dulness and torpor. On the other hand, the
sudden ýoccurrence of violent convulsions, and their frequent
return, alternating with spasmodic contraction of the fingers
and toes in the intervals appear, to WEST, to be the most
frequent indications of effusion of blood upon the surface of
the brain.
Both BED1NAR and WEST lay some stress upon hemorrhage
into the brain, in children, being connected with an altered
state of the blood, and with disease or enlargement of the
liver; bilious symptoms are often present, the region of the



SECONDARY EFFECTS OF APOPLEXY.


liver is often tender to touch, and the liver itself is sometimes
found enlarged. WEST has met with only two instances of
distinct extravasation of blood into the substance of the brain
in older children; one was in a little girl, aged 11 months; the
other also in a girl, but aged 11 years.
SECONDARY EFFECTS OF APOPLEXY.
Having made some remarks, about the nature and treatment of the principal varieties of Apoplexy, it may not be,
out of place to refer to the precautions and remedies necessary
for the after-effects of the disorder.
A principal precaution is to prevent the patient from
making any exertion for some time after the first effects of the,
attack have passed off. A very large number of lives have
been lost from want of attention to this. In Copeman's 18th
case, the patient, after being successfully treated, so that he
became conscious, knew his friends and was able to walk with
assistance from one bed to another, soon relapsed after this
exertion, and finally died. In case 21, the patient had recovered sufficiently to walk across his room, when he cried out
suddenly with pain in the head, fell down insensible, and died
in thirty minutes. It will be useless to multiply cases to this
effect; BUE.owEs (see on Disorders of the Cerebral circulation,
p. 146) has an excellent chapter on, and very instructive cases
illustrative of the bad effects of premature exertions of body or
mind after Apoplexy.
In other cases, two or three days after the emergence
from coma, we often observe the patient's face to become
flushed, the scalp hot, a frowning or knitting of the brows,
slight squinting, and complaint of pain on one side of the
head. This pain is usually referred to the side opposite to
the palsied limbs; and if the patient be deprived of the power
of expressing his sensations, his uneasiness is often indicated
by the occasional movement of the sound hand to the forehead; at the same ~time the paralysed arm is perhaps observed
to be occasionally drawn up to the face, or across the chest.
This latter movement taking place after the fit, often gives



SECONDARY EFFECTS OF APOPLEXY.


times happen that the redness and heat will subside, but the
neuralgia remains. These cases are very distressing to witness,
on account of the constant suffering which we cannot remove
by allopathic treatment; nevertheless, after the lapse of some
time, weeks or months in different cases, the pains gradually
disappear (BURROWES). Aconite, Nux and Veratrum are important homceopathic remedies against the irritative, inflammatory, spasmodic and neuralgic affections, although Creosote,
Phosphorus, Colocynth, Spigelia, and Ranunculus bulbosus
may also be required.
Another most important point in the after-treatment of
hemorrhagic Apoplexy is to aid nature in the removal of
the clot; old-school physicians generally depend upon the use
of mercury, given so as to act as a purgative, and to slightly
affect the gums, but not allowing it to produce salivation,
which is always very distressing to the patient, whose powers
of mastication and swallowing are already impaired by his
disease. Kali hydriodicum would probably effect this object
more promptly than Mercury, and might at the same time
relieve the pains and swelling about the periosteum and
bones, and consequent neuralgic pains. Arnica and Baryta
also deserve attention. (J. 0. PETERS.)



ON THE


HOXI(EO]?ATHIC TREATMENT
OF
APOPLEXY.
RIiCKET has furnished twenty-four cases of Apoplexy, treated
and cured by means of homceopathic remedies. I have added
about thirty additional cases from BLACK, SIMPSON, DUNSFORD,
MALAISE, BEAuvAIS and others. I have also thought it advisable to include the cases of Congestive vertigo, collected by
IROOKERT, and those instances of "Affections of the Speech,"
which seem to depend upon some disorder in, or of the brain;
they are so closely allied to Apoplexy, or its premonitions,
that I trust no excuse will be necessary for this liberty.
R-CKERT truly says, that quite favorable results have been
obtained in these formidable disorders by homceopathic treatment. He also assumes, that these not very numerous cases
prove that, whenever life can be saved at all, it can be saved
without the aid of exhausting bloodletting, and quotes SHoBERT, who asserts that whenever he bled his apoplectic patients,
their disease and recovery progressed more slowly than when
he omitted it. SOHUBERT only found bloodletting useful when
decided plethora, or full-bloodedness was present; but always
found homceopathic remedies useful, and even indispensable.
Of ROcKEET'S cases he has assumed that fourteen cases were
instances of sanguineous Apoplexy, while nine cases are
assumed to be examples of nervous Apoplexy.



AcONITE.


57


The remedies treated of by RtCKERT, are: Aconite, Arnica,
Baryta, Belladonna, Cocculus, Crotalus, Ipecac., Hyosciamus,
Iaurocerasus, Nux vomica, Opium and Phosphorus.
Numerous notes and several additional articles have been
added. (PETERs.)
1. ACoNITE.
GENERAL REMARxs.-(a). [Fortunately, both old and new
school physicians agree about the utility of Aconite, in the
treatment of congestive and inflammatory affections of the
brain, although they entertain almost diametrically opposite
views about the general action of this remedy. Dr. FLEMIG,
President of the Royal.Medical Society of Edinburgh, thinks
that it exerts a purely sedative action upon, and diminishes
the flow of arterial blood to the brain, acting in the same way
as excessive loss of blood, between which and the action of
Aconite, he says there exists a very strong analogy. On page
30, he draws the inference that it is an advisable antiphlogistic
in Apoplexy, inflammation of the brain, or in any disease in
which the circulation of the brain is excited, because it exerts
a direct, sedative influence upon the vascular system, reducing
more or less, according to the dose administered, the strength,
volume and frequency of the pulse. He asserts that the pulse
often falls to 60 per minute, and in some cases sinks to 48, 40
and even 36. On page 36 he draws the inference that Aconite
is a powerful antiphlogistic, and that it is calculated to be of
great value in all cases where there is an inordinate activity
of the circulation. (See Inquiry into the Physiological and
fedicinal Properties of Aconitum napellus. London, 1845.)
A majority of the most able old-school writers on the
Materia Medica, viz.: PEREIRA, WOOD and BACHE, TAYLOR,
CHRISTISON, NELIGAN and others, now agree with these views
of FLEMiNG; but it should not be forgotten that HAINEMANN
pointed out the use of Aconite in congestive and inflammatory
affections full fifty years ago.
Many old-school writers now compare the action of Aconite
on the circulation to that of Digitalis, Tobacco, Colchicum,



58


58  rEATMlS'T OF APOPLEXY.


and Veratrum viride, excepting that Aconite has also been
found to act specifically on the skin, causing ready and profuse perspiration, while Digitalis acts more decidedly on the
kidneys, causing a free flow of limpid urine; Tobacco acts
more decidedly on the stomach and muscular system, causing
great nausea and muscular debility, while Colchicum not only
diminishes the action of the heart, but causes profuse flow of
bile from the liver, and an increased excretion of urea from
the blood and kidneys. Hence of late, various uses and
combinations of these remedies have been proposed, in the
dominant school, in congestive, comatose, febrile and inflammatory affections. Colchicum has been more particularly
recommended in cases of Apoplexy arising from-'or connected
with bilious derangements, jaundice, or deficient secretion of
bile; but still more, especially by Dr. IMCLAGA, of Edinburgh,
in all cases of coma and Apoplexy connected with suppression
of urine, presence of albumen and deficiency of urea in the
urinary secretion; in all cases in which albumen and urea
appear to be vicarious, and where coma supervenes evidently
from the accumulation of urea in the blood, viz.: in all cases
of Bright's disease of the kidneys, and dropsy dependent
thereon. The use of small or moderate doses of Aconite,
Digitalis and Colchicum, promises ere long to usurp the place
of profuse bloodletting, active purging, and other savage treatment in the dominant school.] (PETERS.)
(b). According to iKREUSSLER, Aconite is decidedly indicated
against sanguineous Apoplexy, and almost every other remedy
must yield the priority to this, which generally affords the
most speedy relief. Hence, he always gives it, even in cases
in which he is somewhat undecided about the proper treatment, without being fearful if it does not afford relief, of not
being able to make up the lost time by some other remedy;
still, he only waits a quarter of an hour for signs of improvement,
which in the majority of cases become evident in the com'so
of a few minutes.
It is most indicated in the Apoplexies of persons who present the appearance of the apoplectic habit, or constitution;



ACONITE.


59


who have previously suffered with disease which can be traced
to some affection of the vascular system; or who have been
attacked with Apoplexy in consequence of the suppression of
accustomed hbaemorrhages. In these cases the head is apt to
be hot, the carotids to beat violently, the skin to be warm, the
pulse full, strong, hard, or labored, but not intermitting.
(c). [Of all the narcotic remedies, Aconite is most homoeopathic to Apoplexy, as proven by the case of a young man
who had incautiously chewed some seeds of this plant; he was
shortly afterwards seized with a sense of numbness of the face,
soon followed by complete Apoplexy, complicated with paralysis, from which he recovered with great difficulty, and with
palsy of one side, with which he is still affected, now upwards
of twelve months from the time of the attack.]  Diet. Prat..Med., p. 92. (PETERS.)
(d). Aconite is most homceopathic, when Apoplexy is
attended with paralysis of sensation, rather than of motion;
according to TAYLOR, (see Medical Jurisprudence, p. 225,)
it proved homceopathic in one case to tremors of the muscles,
a pricking sensation over the whole body, unconsciousness,
followed by confusion of sight and intense headache, the skin
being cold and clammy, the pulse slow and irregular, the
breathing short and hurried. Also in another case, with:
a sensation of swelling of the face, a general feeling of numbneess and creeping of the skin, restlessness, dimness of sight
and stupor, almost amounting to insensibility, arising from
exhaustion, however, rather than from congestion; followed
by speechlessness, -frothing at the nose and mouth, clenching
of the hands'and jaws; the patient appearing occasionally as
if dead, and then again reviving; cramps and tingling in
the flesh succeeded, and he did not entirely recover for five
weeks. Sir BENJAMIN BRODIE found Aconite homceopathic to
staggering, excessive weakness, slow and laborious respiration,
with slight convulsive twitches. CHRISTISON found it homceopathic to a gradually-increasing paralysis of the muscles,
which terminates in immobility of the chest and diaphragm,
and consequent asphyxia. PImRRA thought it most homceo



60


TREATMENT OF APOPLEXY.


pathic to an extraordinary diminution of common sensation,
evidenced by insensibility to pinching and pricking, there
being a total absence of stupor. Dr. FLEMING found it most
homceopathic to weakness and staggering, gradually increasing paralysis of the voluntary muscles, slowly increasing
insensibility of the surface of the body, more or less blindness
from excessive weakness of the eyes, with great contraction
of the pupils, excessive languor of the pulse, and convulsive
twitches. FLEMING also infers decidedly, that Aconite is more
homceopathic to nervous paralysis and Apoplexy, than to
sanguineous Apoplexy, as it does not occasion vascularity of
any membrane to which it is applied; even the lips and
tongue while burning and tingling from its topical action, do
not show the least sign of redness or inflammation, and hence
this peculiar effect is decidedly a nervous phenomenon. FLEMING
also found it homceopathic to warmth in the stomach, nausea,
numbness and tingling in the lips and cheeks, extending more
or less over the rest of the body, diminution of the force and
frequency of the pulse, which sometimes sinks to 40 in the
minute, great muscular weakness, confusion of sight or absolute blindness. In very severe cases, there may be a sense of
impending death, sometimes a slight delirium, and a want of
power to execute what the will directs, but without any loss
of consciousness. The warmth of the skin to which Aconite
is homoeopathic, is a purely nervous warmth, being unattended with any elevation of temperature, vascularity of the
skin, or acceleration of the pulse. It does not cause any true
hypnotic effect, but merely drowsiness from excessive exhaustion, debility, or languor; but by inducing serenity or deadening pain it may also predispose to sleep.
According to FLEMING, it is homceopathic to extreme
depression of the circulation; also to an overwhelming
depression of the nervous system, so severe that it may prove
fatal in a few seconds, without arresting the action of the
heart; and finally to asphyxia, or arrestment of respiration,
the result of a paralysis gradually pervading the whole muscular system, respiratory as well as voluntary.



ACONITE.


63


when the patient could lift the right arm, he could not move
the left, and vice versa, but finally he recovered the control
of both arms. BAcoN noticed such exhaustion of the strength
that the patient was obliged to lie down; weakness and unsteadiness of the joints, especially of the knees; BAIDRIANI:
rapid prostration of strength in ten cases, with an unusual
degree of exhaustion. SHERVIN: failure of the legs to such an
extent that the patient fell down and had to be carried to bed.
PEREIRA: trembling of the limbs, swooning. DEVAY: trembling of the legs so as to produce a peculiar, staggering gait.ý
PEREIRA: excessive trembling, great weakness, yet with ability
to walk until a few minutes before death, in one patient;
while in another, the muscular debility was so great, that
standing was impracticable; in animals it weakens the muscular system so much as to cause staggering in wallkng.
HAHNEMANN: weakness and instability of the ligaments of all
the joints, unsteadiness of the knees, paralysis of the rectum
and bladder, transient paralysis of the tongue, loss of power
in the thighs, which prevents walking, paralytic weakness of
the thighs and legs, with staggering and, fear of falling; in
fact, many signs of paralysis of the lower portion of the spinal
marrow, and of the pelvic nerves. ATNEiR: feeling of paralysis
in the right forearm and hand while writing, disappearing
after more active exercise of the limb, to. return again when.at rest. HORNBURG: immediate tremblingr of the arms and
hands. IRUCOKERT: trembling of the hands, great lassitude of
the limbs, while walking; forty drops of the tincture produced
such heaviness and weakness of the limbs, in a stout peasant
girl that she. was forced to lie down. ARNETHI: lameness and
weakness of the left shoulder-joint, weakness of the knees, so
that he could not stand straight, nor walk without his knees
giving way (from forty drops of the tincture). Borm: (from
twenty drops), walking and talking tired him quickly; he felt
lassitude and feebleness. GErSTEL: (from ten drops), unusual
but transient weakness of the legs; (from forty drops) persistent weakness of the feet, when going up stairs; (from ififty
drops) lassitude of the feet. MAscrAumz: (from fifteen drops)



64:


TREATMENT OF APOPLEXY.


great lassitude; (from twenty drops) great general lassitude;
(from ten drops night and morning) feverish lassitude; (from
twenty drops) lassitude with chilliness; (from fifty drops)
palpitation, with slow pulse, and such sudden loss of strength
that he was unable to stand up; (from sixty drops) excessive
relaxation. REISINGER: (from one hundred and twenty drops)
leaden heaviness of the feet, while sitting or standing; (from
one hundred and forty drops) tottering of the legs and leaden
heaviness of thefeet, so that he can scarcely move; (from two
hundred drops) leaden heaviness and relaxation of the limbs;
(from one hundred and sixty drops) extreme relaxation of the
limbs, tottering of the knees, general debility, so that he was
unfit to attend to his business; anxious trembling. Trembling
of the limbs. General relaxation. Relaxation of the arms and
thighs. Relaxation and lassitude of all the limbs. Sudden
prostration of strength. Paralytic stiffness of the outside of
the right arm. Lassitude of thefeet, especially while at rest.
The feet refuse their office. Trembling of the legs. Sensation
as if the ligaments of the joints had given away. DIEMBAOH:
extraordinary sensation of weakness and lassitude.
Aconite-failure of the circulation, has already been sufficiently alluded to. (See page 57.)
Aconite-numbness and tingling.
BRODIE: singular numbness of the lips. CmRISTIsoN: numbness and prickling from chewing a single seed; tingling in the
jaws, extending subsequently over the whole body. DUNGLISON: one or two grains of Aconitine to a drachm of alcohol
or lard, if rubbed for a minute or two on the skin, causes heat
and prickling, followed by a sense of numbness and constriction, as if a heavy weight were laid upon it, or as if the skin
were drawn together by the powerful and involuntary contraction of the muscles beneath; this lasts from two to twelve
hours or more. DIERBACH: the leaves, roots and seeds if
chewed, occasion a violent burning in the tongue and lips
which lasts for many hours, and is attended with a peculiar
feeling of numbness. VOGT: large doses excite a peculiar



66


TREATMENT OF APOPLEXY.


drops) numbness from the sacrum down to the legs, while sitting or standing; it seemed as if his feet fell asleep, or as if an
attractive power held them fast to the earth; this feeling disappeared instantaneously while walking, but returned again
as soon as he stood still, or sat down; falling asleep of the right,
foot, While walking; a sense of boiling and simmering through
the body, as if the hands and feet would fall asleep; (160 drops)
a kind of numbness spread itself from the teeth, over the jawbones to the external angle of the eye, and then almost over
the whole body; (from 108 drops) numbness of the lower
limbs, especially of the feet, even while walking, so that he
was often obliged to stand still, in order to get rid of this unpleasant sensation by moving his feet to-and-fro. WATZKE:
sensations not unlike those produced by a pretty large electromagnetic apparatus; prickling in the forehead, back, sides of
the chest, fingers, backs of the hands, and other parts of the
body, as if he stood upon the isolating stool of an electrical
machine, and sparks were drawn from him. Tickling in various parts of the muscles, especially of the forearms, as if
one held the conductors of an electrical apparatus in the
hands. ZLATAROVITCO: Over the whole body a peculiar sensation, comparable with that felt when steam falls rapidly upon
one in a steam-bath, and one feels the drops upon the skin;
crawling over the scalp; falling asleep of the feet; crawling
and creeping (from 150 drops) over the whole body, attended
with a troublesome rather than a violent chilly sensation, first
in one place, then in another, but most marked in the arms
and legs; formication in the scalp, down the back, and over
the arms and thighs; qvumbnes8 of e fnAgers and toes; (from
170 drops) creeping and crawling in the skin, over the whole
body, and at the roots of the hair; a constant crawling and
creeping, especially in the right leg, with the sensation at
times, as if the cuticle were separated fr-om the true skin by
a thin layer; (from 200 drops) chilliness and formication, especially between the shoulders and down the back, increased
by motion; numbness and coldness of the fingers and toes.;
the scaljpfeels as if swollen and numb; creeping and crawling



ACONITE.


67


again over the whole skin; creeping and biting over the whole
skin, first here then there, as if from fleas.
Aconite-nervous, and -rheumatic pains.
VOGT (see Materia Medica) says: After great restlessness
comes relaxation, diminution of pulse and heart-beats, the head
becomes confused, and often very painful, the face puffed up
and livid, while pains set in, in the limbs, especially pains in
the bones and joints. SOBERNHEIM (see Materia Medica) says:
It causes painful sensations in the bones and joints, which
disappear after the breaking out of a profuse sweat and abundant flow of urine, and adds that it differs from Conium by its
more prominent action on the fibrous system, as is evident
from the bone- and joint-pains which it causes. HAxNIscH:
It causes painfulness and trembling of the limbs, especially of
the legs, and the patient suffers from the most violent pains
in the bones and joints. KiiTTNER: General'painfulness of all
the joints not unfrequently arises, after the use of large doses
of Aconite. CLAUDIUS EICHARD'S case of poisoning, is probably the source of the above old-school writer's information, he
says when the delirium passed away, the patient complained
of pain in the stomach and head, in the jaws, chest, and here
and there in the joints; after the lapse of seven hours, all his
joints were painful. MATTHIOLUS, noticed such violent pains
in the jaws, that the patient held fast to them in the fear that
they would drop off. PEREIRA: trembling and formication in
the limbs, attended with piercing pains. HAHNEMANN: aching
compressing pain in the sides of the chest; pain as if bruised
in the sacro-lumbar joint; rheumatic pain in the nape, only
felt when moving the head; drawing piercing pain in the bones
of the forearm, piercing pain in the right side. AHNER:
violent piercing, boring pain for two hours along the whole
left side of the spine down to the sacrum, so much increased
by inspiration, that it repeatedly forced tears from him (rheumatism of the spinal muscles or ligaments). DE. GERSTEL says
that the.most of the pains experienced by AHNET, were of a
piercing-boring character, which points to an affection of the



68


TREATMENT OF APOPLEXY.


periosteum, or of the fibrous aponeuroses of the muscles; the
rending and drawing pains are probably seated in the muscles
themselves. WAHLE: burning, biting pain in the right side
of the spine; aching pains to the left of the cervical vertebrae.
ARNETH: (from   40 drops of tincture); pain and sense of
shortening in both tendo-achilles lasting for twenty days, preventing the free use of the feet, and depending according to
Dr. Gerstel, upon a slight inflammation of the tendons.
GEESTEL: (from eight drops,) Bruised feeling in the nape,
when moved, especially in the evening and at night; (from
10 drops) pain in the nape again; (from 16 drops) same pain
in the nape again); (from 40 drops) pain in the nape during
the whole day; sensation of swelling of the whole body, especially of the left side, attended with various pains, such as
bruised feeling in the muscles, bruised or aching sensation in
the bones, first in one, then in another rib, then in the left
arm; pain in the bones around the ear; constant penetrating
piercing about the left wrist; constant pressing pain, in the
left shoulder, in connection with a drawing, and numb feeling
in the left -side of the occput, and in the posterior surface of
the left arm, followed at a later period by a bruised feeling in
these parts, especially in the arm (from 40 drops); drawing
pain in the right side of the nape. WACHTE:r (from 20 drops)
bruised pain in the sacrum; stiffness, with bruised pain in the
left side of the neck, extending beyond the left shoulder-joint
to a portion of the back, aggravated when in bed, and lying
down, relieved in the free air, and by motion, lasting three
days, alternating at times with similar feelings in the arms
and legs, then suddenly returning to its original seat in the
back, (this reminds one of wandering rheumatism, or spinal
irritation). WURSTL, it is a little remarkable, although pre-,disposed to rheumatic affections, experienced none while using
Aconite, though he took it in divided doses, for six months.
The homceopathicity of Aconite to numbness, paralysis, and
the severe pains which often attend apoplexy has been made
abundantly evident. PETES.



70


TREATMENT OF APOPLEXY.


CASE 2.-A robust man, aged 64, with short neck and
broad shoulders, much given to excesses with wine and
women, was attacked with sanguineous Apoplexy, with all
the signs of departing life.
After the use of Aconite, 1st dilut., one drop every hour,
signs of returning animation ensued; then Aconite 3, every
three hours, and cold applications to the head were used with
such good effect, that in twelve hours consciousness was
entirely restored, with warmth of the body, mobility of the
"upper limbs, but paralysis of the lower, and also of the bladder
and rectum. He complained of great pain in the loins and
back. Nux vom., 6th dilut., followed by the 15th dilut.,
repeated every twelve or twenty-four hours, restored him
perfectly in ten days.-Ibid., p. 67. (STURM.)
CASE 3.*-A lady of full habit of body, laboring under
well-marked enlargement of the heart, was very subject to
congestion of the head; for this she had always been cupped
and purged, and such attacks were apt to occur three or four
times a year. She derived some benefit from my prescriptions,
as regarded the heart; but when one of these attacks threatened her, her confidence was much shaken, and with difficulty
her scruples in favor of cupping were overcome. The attacks
came on with sensation of great fulness and heat in the back
of the head, giddiness, stiffness of the nape of the neck, roaring
noises in the ears, flushing of the face, and full, bounding pulse.
Treatment.-Aconite, 3d dilut., for a few hours, followed
by Belladonna, speedily gave relief; in some attacks Lachesis
was more useful than Bellad.-Brit. Jour. Hom., vol. 5, p. 49.
Dr. BLACK.
CASE 4.*-A commercial traveller, aged 35, with short
neck and stout body, had returned the night before from one
of his circuits, and had for some days previously indulged in
eating and drinking too much, although not habitually intemperate. His breathing was so stertorous through the night as
to alarm his wife; he was unable to stand or sit up, his eyes
were prominent, his face turgid, and of a sub-purple color;



ACONITE.


73


hours at a time. Latterly, he has had two such attacks,
attended with vomiting, and great weakness; his walk was
unsteady and slow.
Treatment.-After taking six doses of Aconite, 3d dilut.,
one drop night and morning, he was entirely restored.Gen. Horm. Jour., vol. 32, p. 228. Dr. LEMKE.
CASE 8.-A young man of apoplectic habit, suffered from
frequently-returning attacks of dizziness, with roaring in the
head; he was often affected with transient loss of consciousness, and was obliged to hold on to something to prevent his
falling.
Aconite, 3d dilut., one drop per dose, daily, cured him
entirely.-Hygea, vol. 5, p. 102. Dr. SOEROEN.
CASE    9.-A   lady, aged 43, was attacked with vertigo,
after a fright, recurring whenever she attempted to rise, with
great anxiety, and feeling as if she would die, so that she was
obliged to lie down again. After the fright she had a feeling
of turning in the stomach, ascending up into the head, and
attended with trembling, faintness, and dizziness.
Treatment.-Aconite, 15th dilut., followed by two doses of
Opium, 9th dilut., relieved her entirely.-Annals, vol. 1, p. 72.
BETHMANN.
Dose, The 1st dilution was used successfully in two instances; the
2d dilution in one case; the 3d dilution, in six instances; the 15th
in one case, while Dr. Kreussler prefers the 15th or 18th. The very
high dilutions do not seem to have been trusted to in any case, of so
severe a disease as Apoplexy. NOACK prefers 1 or 2 drop doses'of the
2d dilution every half, one, two, or four hours. In very acute and severe
cases, 3 or 5 drops of the tincture, or of any of the above dilutions
which may be preferred, may be put in a tumbler half full of water, and
a dessert- or tablespoonful given every five, ten, or fifteen minutes in
very urgent cases, or every half, one, or two hours, in less dangerous
attacks. Or, six globules may be dissolved in a wine-glassful of water,
and one teaspoonful given as often as above recommended; or two or
three globules may be given dry upon the tongue, at the same intervals
of time. It is rarely used in chronic cases. PETERS.



AGARICUS.


75


Bologna. In the course of two hours he was seized with delirium, a maniacal disposition to rove, and some convulsive
movements; ere long these symptoms were succeeded by a
state resembling coma in every way, except that he looked as
if he understood what was going on, and in point of fact, he
really did so.
The Ananita citrinc caused vomiting, followed by deep
sopor, in a lady, servant, and one child; her other children
became profoundly lethargic, and comatose.
The effects of the small mouse-colored, conical fungus,
called yaddock stool, or Hyv/pophyliun sanguineum, are still
more peculiar; it is homceopathic to convulsions, as well as
sopor; in a family of six persons, four of whom were children, it caused pain in the pit of the stomach, a sense of impending suffocation, and violent efforts to vomit; which symptoms did not commence, in any case, under twelve hours after
partaking of it, in one not till twenty hours, and in another,
not till thirty hours. One child had acute pain in the belly,
which soon 6swelled enormously; afterwards he fell into a
lethargic sleep, but continned to cry; in twenty-four hours the
limb became affected with permanent spasms, and convulsive
fits, followed by a tetanic state. Another child, aged 10 years,
had convulsions of still greater violence. The mother had
frequent bloody stools, and vomiting, her skin became yellow,
the muscles of the abdomen were contracted so spasmodically,
that the navel was drawn towards the spine; profound lethargy,
and general coldness supervened. A third child had trembling, delirium, and convulsions. The father had a severe attack of dysentery for three days, and remained speechless for
five days.
A striking circumstance, in relation to the effects of these
fungi, is the great durability of the symptoms; even the
purely narcotic effects have been known to last over two days;
a deep lethargy may prevail for fifty-two hours.
In five cases, mushrooms produced a kind of tertian fever
and the formation of abcesses, which discharged a thin, ill
conditioned pus, and passed rapidly into spreading gangrene.



76


TREATMENT OF APOPLEXY.


Pathological appearances: Lividity of the body, very great
fluidity of the blood, abdomen distended with fetid air, excessive enlargement of the liver, congestion of the lungs, vessels
of the brain very turgid.
The Agaricus muscarius is homceopathic to enormous distension of the sinuses of the dura mater, as well as the arteries
with blood; scarlet color of the arachnoid and pia mater;
excessive engorgement of the vessels of the membrame between the convolutions of the brain, together with the Plexus
choroides; redness of the substance of the brain; clot of
blood as big as a bean in the cerebellum. CHRisTIsoN. P.
Dose. No cases of Apoplexy treated with Agaricus have yet been
reported. Noack prefers 1 or 2 drop doses of the 2d or 3d dilution,
repeated as often as occasion requires. The same doses as those directed
for Aconite, may be used. It is most serviceable in acute cases, or in
acute aggravations of chronic attacks. PETERS.
3. ARNICA MONTANA.
GENERAL REMARKS.-[This remedy, too, is beginning to find
some favor in the dominant school, in the treatment of apoplexy, or its consequences. It has long been supposed to
possess the power of promoting absorption of extravasated
blood-SOBERNHEIM asserts that it facilitates the circulation of
the lymph, increases the absorbent powers of the whole lymphatic and venous systems-hence its well-known efficacy in
extravasations of blood from mechanical injuries, viz.: from
falls, blows, concussions, and rupture of blood-vessels; for
these reasons it has also received the name of Fall-Eraut,
and was admitted as an ingredient of the Thea Helvetica, or
The Suisse of the French Codex, for wounds, bruises, &c.
TABERN.MONTANUS, once physician to the Churfurst Von Plalz,
says that in olden times it was customary, in Saxony, for persons who had fallen, or injured themselves, to use this remedy;
it also came into use in the town of Danzig, but as it did not
grow in that neighborhood, it was imported in casks from
Lower Saxony.
Besides its absorbing powers, the root of Arnica, from its



ARNICA MONTANA.


77


Tannin-like properties, is supposed to exert an astringent action
upon asthenic and profusely-secreting mucous membranes, and
to check passive, huemorrhages, such as asthenic dysenteries,
scorbutic, septic, and petechial fluxes.
As an absorbent remedy, it was used, and highly recommended in Arachnoiditis infantum, by the celebrated GOLIS,
of Vienna--he had the head of the child bathed with Arnica,
when signs of effusion, or of a sub-paralytic state of the
brain came on-and regarded it as a main remedy in concussions of the brain or spinal marrow, in sanguineous, or serolymphatic exhudations from contusions, falls, blows, concussions, &c.
It must prove as useful in the apoplexies of debilitated persons, as it has often done in the stupor and coma of typhus and
typhoid fevers. VOGT recommends itin asthenic fevers, attended with indifference to everything, dejection of spirit, sleepiness, dull unconcerned look, or when there is sopor, or even
stupor and other signs of a suppressed, sunken, torpid, or
paralytic state of the nervous system. Also in typhus fever,
when blue or brownish petechioe are present, oppression and
sluggishness of the vascular system, torpid state of the nerves,
and when the skin is cool, thick and flabby. SOBERNHEIM also
recommends it strongly in typhus fever, when there is great
prostration, dulness of the senses, typhous hebetude of the
brain, with muttering delirium and sopor; tongue trembling,
cracked and black, the look inexpressive, and the eyes staring
-in typho-septic affections, when attended with colliquative
haemorrhages, passive sweats, decubitus and septic meteorism.
The following are the celebrated STOLL'S indications for the use
of Arnica in fevers-great weakness, slow pulse, dry tongue,
or coated with much sordes, especially if the patient be dull
and sleepy, hears badly, has a slight delirium, and a miliary
eruption, or petechie show themselves.
In addition to all this, the careful use of Nux-vomica has
been found useful in both schools, in some of the torpid and
paralytic states which follow apoplexy-too frequently the
incautious use of Nux and Strychnine in the hands of old



'AR&A.-BARYTA.,                                      81
Dose, In Riickert's cases, the 3d and 30th dilutions were used., -  ack prefers 1 or 2 drop doses of the pure tincture, or of the 1st or*" " 2d dilution, repeated every one, two; four, six, or eight hours, according
' to othe urgency of the case. If preferred, globules may be dissolved.:.         dand given as directed for Aconite; or given dry upon the tongue, in the
W   - ^ "same quantities, and at the same intervals of time, as there recommended.
4:. z:nica is useful against the first shock of apoplexy, before reaction has: taken place; also after the first force of the disease has been moderated:,::  by Aconite and other remedies; and finally in the latter stages of the
disease, to promote absorption of the clot, and to remove paralysis.
PETERS.
"4. BARYTA.
GENERAL REMARKS: [Baryta has been supposed to possess
a peculiar curative relation to dulness of intellect, softening
and other morbid states of the brain, either when preceding,
or following an attack of Apoplexy. Also against the almost
"idiotic condition which follows Apoplexy.      According to
NEUMANN, the Muriate of Baryta is an admirable curative
remedy against many affections of the brain, and irritations
of the cerebellum, or Apoplexy of this latter organ, when the
sexual inclination is very much increased., Many old-school
writers assume that it is a liquefacient or absorbent remedy;
assert that it improves the appetite, increases the flow of
urine and perspiration, and causes looseness of the bowels;
that with no other more obvious symptoms than these, glandular swellings, enlargements, indurations, thickenings, &c.,
will become softer and smaller, and finally disappear; and
hence the inference has been drawn, that it might also liquefy
and dissolve apoplectic clots, and finally absorb or remove the
softened mass.
It is very easy to prove, from the same authorities, that it is
more or less homceopathic to some of the varieties, or at least
symptoms of Apoplexy. PEREIRA found the Carbonate of
Baryta homceopathip to dimness of sight, double vision, ringing in the ears, pain in the head with throbbing, and palpitation of the heart. He also says that it is homceopathic to
decided staggering, great muscular weakness, almost amounting to paralysis, with trembling; also to pain in the head



,BARYTA.                     83
scription of the despondency, pusillanimity, weakness of mind
"and irresoluteness to which Baryta carb., is so homceopathie.
It.hould not be forgotten when the patient is troubled with
forgetfulness, dulness, gloominess and heaviness of the head,
S-'with drowsiness; and with vertigo, headache and nausea.
The specific action of Baryta upon the cerebellum, as conjectured by NEUMANN, is fully borne out by a reference to the
~ Materia Medica Pura. It is homceopathic to pressure in the
brain below the vertex, extending towards the back of the
head, most severe on waking from sleep, and attended with. stiffness of the nape of the neck, probably from pressure on
the twelfth pair of nerves; also to dull aching pain in the right
side of the back of the head, extending from the bones of the
"neck obliquely to the side of the head, and recurring regularly
at 4 o'clock, P.M., for several days in succession; sense of weight
i n the whole back of the head, close to the nape of the neck,
with-,tepsion; sudden and intensely-painful drawing pain,
S exten dgfrom the back of 'the head across the right ear,,as far
as4the lower jaw; tearing pain in the left side of the occiput;
rheumatic pains in the back bone of the head, with swelling
of the glands of the nape, so as to compress the blood-vessels;
tearing pains, shooting deep into the brain behind the right
ea^  Dull stitches in the left side of the head from the occiput to the forehead. Pain with feeling of fulness and distension, commencing in the left side of the head, traversing
the whole left side of the occiput, and terminating in the
bones of the neck. Throbbing in the occiput, the impulse
of which is felt as far as the forehead. Considerable rush
of blood to the head, so that the blood seems to stagnate in
it, and circulate slowly; whizzing in the head as if from
boiling water; heaviness and heat in the head.
Slowness of the pulse is very common in Apoplexy, and
BLAKE found Baryta homceopathic to depressed arterial
action; two grains, injected into the veins, completely arrested the heart's contractions in twelve seconds.
In one case it was found homceopathic to dimness of vision,
followed by double vision, ringing in the ears, pain in the



84


TREATMENT OF APOPLEXY.


head, throbbing in the temples, ard violent palpitations; the
skin was hot and dry, the face flushed, pulse 80, full and
hard; sleeplessness from pain in the head and ringing in the
ears, followed by profuse perspiration; then cramps in all the
limbs, with a sense of weight in them, and soreness to the
touch; severe pain in the head, with great and long-continued
palpitations.
"WILsoN also found it homceopathic to severe headache,
throbbing in the temples, frequent and long-continued palpitations, abnormal vision, ringing in the ears, cramps, pain,
sense of weight, and numbness in the limbs.
In another case it proved homoeopathic to twitching of the
muscles of the face, and convulsive jerking of the hands and
feet. It is also decidedly homceopathic to Apoplexy, arising
from, or attended with great disturbance, or inflammation of
the stomach and bowels; to brain affections from inflammation of the peritoneal coat of the stomach; from ulceration of
the stomach, especially when the ulcer assumes the perforating form; and when the colon is contracted throughout its
whole extent, so that its calibre is more than one-third less
than that of the small intestines in their natural state.PETEmS.]
(b.) According to KEEUSSLER, Baryta carb. 30, is indispensa"ble in the apoplectic affections of old, cachectic persons, of
scrofulous constitution, especially when gouty derangements
are also present.-Kreussler's Therapeutics, p. 129.
CASE 14.-An old man, aged 84, remained in the following state, on the third day after an attack of Apoplexy.
Synptoms--Hle sat crooked and helpless, unable to speak
an intelligible word, or to put out his tongue.; he was unable
to think clearly; his manners were childish and thoughtless;
he was drowsy, but his sleep was disturbed, and attended with
groaning and muttering; his pupils were sluggish, his eyes
dull and somewhat reddened; there was a circumscribed, dark
redness upon his cheeks, his hands were cold and mottled with
blue spots; his pulse was weak, and rather quick; he was
troubled with frequent urination, and constipation.



BARYTA.-BELLADONNA..85


Treatment.-Baryta acet., 1st and 2d dilut., restored him
after 3 doses had been taken.-Hufeland's Journal. Dr. MEsSEESOHMID.
CASE 15.-An aged drunkard was attacked with Apoplexy,
after taking cold.
Symptoms.--Speechlessness, with paralysis of the tongue;
the mouth was drawn to one side; the right arm could not be
moved by any exertion of the will, although he seemed conscious.
Treatznent.-Baryta, 30, effected a cure in the course of
forty-eight hours.-Archiv, vol. 15, part 1, p. 103. Dr. GRoss.
CASE 16.-HARTMANN thinks that Baryta is the principal
remedy in paralysis of old people, especially when it remains
after an apoplectic fit, and refers to a case in which it did
more good than Causticum    or Stannum. (See Hartmann's
Acute and Chronic Diseases, translated by Dr. C. J. Hempel,
vol. 4, p. 7.)
Dose, Messerschmid preferred the 1st and 2d dilut.; Gross and
Hartmann, the 30th. Noack advises grain-doses of the 1st, 2d, or 3d
trituration to. be, giv9n dry upon the tongue, once or twice a day in
chronic cases; or 1 or 2 drop doses of the 1st, 2d, or 3d dilutions. If
*preferred, 2 or 3 globules may be given, per dose, dry upon the tongue;
or 5 globules may be dissolved in a wineglassful of water, and 1 or 2
teaspoonfuls given at a time. Baryta carbonica is only suitable in
chronic, or sub-acute, or slow cases; while Baryta acetica and muriatica
may be used in acute cases, and given in doses as large, and as frequently
repeated as those recommended for Aconite. PETERS.
5. BELLADONNA.
GENERAL REMARKS.-[It proved homceopathic in a case
with vertigo, faintness, andc dinonessiof s l4u  lady, so that
she had to keep her bed all the n.xt d1~ rhirt or forty
hours, she could not lift her head from h:e'  jlo  without ex
periencing a strange and disagreeable sensation. In another
case, with slight delirium and great vertigo.
JOMHsoN says it is one of the most effectual remediegsIlreducing morbid sensibility of parts, and mobid contrctility
of the muscular fibres, and may be usediwh f tiere is irritation,
4, *,          M  T)  _4.  k.,.  *  '   ^^  ^. "  4.  ''";;~~~-:l^- -* ^.^,  *.'  -^. "
d'..  ^     ' ^ ^  '     - '".  -.^  ^i: ''-;.'1.:..-:^:~*
^   * *  ''^     c    "-*1^^  ^:c ^ '.-.^.  - *:^:'  '  ~.,
ww^   ~*  '  *   '"   ~~ ~ ~~~~.:r-.*x^^ '-  '  *' '^ ^.: f;~*  '   "^..'.;".'



BELLADONNA.


87


obscurity of vision, absolute blindness, amaurosis, visual illusions, suffused eyes, singing in the ears, numbness of the face,
confusion of the head, giddiness and delirium; all of which
symptoms may be combined with, or followed by stupor.
These symptoms are usually preceded by a febrile condition,
with redness and swelling of the face, hurried and small pulse.
DIERBAcH says it is peculiarly homoeopathic to violent congestions to the head, redness and swelling of the face, and
inclination to sleep, which may pass over into deep sopor and
coma,, but be interrupted by delirium.
It is indicated in paralysis of the sphincters, when the faeces
and urine pass off involuntarily.
YOGT says RoGNETTA exercised considerable ingenuity
when he indulged in the opinion that Bell. was an antiphlogistic remedy, and placed it in the same category with bloodletting.
YOGT also asserts that in the first degree of Belladonnaaction we observe a more active motion of the blood, quicker,
fuller, and harder pulse, greater flow of blood to the skin and
head, whence the face seems more reddened, and the skin,
especially that of the head, hotter. After a while the increased arterial action ceases, and greater venosity supplies its
place, soon followed by increased secretion from skin and
kidneys; the throat also becomes moist, and mucus is ejected
from the bronchise, and genitalie.
Bellad. is homoeopathic when there is a violent and convulsive change of arterial into venous blood, while Aconite,
Digitalis, Hyosciamus, Prussic acid, &c., do this without previous orgasm and excitement of the vascular system.
It is homoeopathic when there is fever, dryness of the throat,
glimmering before the eyes, with flocculi and sparks, even actual
blindness, with dilated pupils, dulness of feeling, and roaring
in the ears; when the eyelids droop and sink with heaviness,.   are half closed, and the patient is sleepy; or when the eyes
are widely open, and the look is fixed and fiery; when there
i's a feeling of heaviness in the head, staggering, confusion, and
/ ,drunkenness, which may gradually pass over into a perfect
iEr...^ s



88


TREATMENT OF APOPLEXY.


loss of consciousness. The pulse from the first is more frequent, fuller, and harder; the skin becomes hot, red and
itching; the face swollen and very red; the lips dark, blood
red; the eyes red and protruding. Everywhere there is greater
vital turgor, and excited arterial action; breathing is quicker
and shorter; the limbs rather stiff, and tongue rigid.
After the lapse of twelve hours the arterial storm ceases,
and great venosity becomes evident; the redness of the face
becomes livid, the veins everywhere seem to be filled, the
muscles are more relaxed, confusion and stupefaction of brain
ensue.   Finally profuse sweat and urination restore the
balance of the system. But headache, vertigo, imperfect vision,
general lassitude, continued inclination to sweat, burning and
itching of the skin remain.
The third degree of action of Belladonna-action is marked
by paralysis of the nerves and decomposition of the blood,
the patient becomes soporose and paralytic; blue spots and
petechiae form on the skin; and decomposed, dissolved, brown
and stinking blood exudes from the various openings of the body.
With the exception of Stramonium, it causes a more constant
and far more violent action on the circulation than the other
narcotics; the brain is at first not only quickened and excited,
but forcibly excited, and rendered delirious; still the collective
action of Bellad. does not represent a pure inflammatory fever,
but a Febris inflammnatoria nervosa. VOGT.
SCHmUCKER, SELLE, and EVENs, have cured paralysis after
Apoplexy with it. PETERS.]
(c.) Dr. BLACK advises Belladonna in Apoplexy, in the stage
of excitement, when the face is flushed, head hot, eyes suffused and glistening, with hallucinations of sight, dilated pupils,
throbbing of the carotids, incoherence, tremors, and convulsions, followed by coma; especially when the disease has not
progressed beyond general congestion of the brain and its
membranes.-Brit. Journ. Horn., vol. 5, p. 53.
(d.) [According to CHRISTISON, Bellad. is homoeopathic to
apoplectic symptoms, with dilatation of the pupil, also to blindness, even when this is a very obstinate symptom, sometimes



BELLADONNA.


89


remaining after the affection of the brain has disappeared;
it was homceopathic in two cases in which the eyes were insensible to the brightest light for three days; and in general,
when the dilated state of the pupils continues long after the
other symptoms have departed; the pupil is not only dilated
in all cases, but likewise for the most part insensible, and the
eyeballs are often red, and prominent.
It is generally supposed that delirium with dilated pupils,
generally precedes Belladonna-coma, but sometimes the relatioi of the delirium to the coma is reversed, as in a case related
by Mr. CLAYTON, where sopor came on first, and delirium
ensued in six hours; but sometimes delirium again returns
when the stupor goes off; still the most frequent order of the
symptoms is dryness of the throat and delirium, soon followed
by drowsiness and stupor; this succeeding, stupor may remain
for nearly two days, and the departure of the stupor be attended with a retu'rn of delirium for some hours longer; SAGE
has related a case in which the patient was comatose for thirty
hours.
In Belladonna-apoplexy convulsions are rare, and when
present, slight; in one case there were convulsive twitches of
the face and extremities; in another case the muscles of the
face were somewhat convulsed; there is also, at times, more
or less locked-jaw, or subsiultus tendinum, and occasionally
much abrupt agitation of the extremities, but well-marked
convulsions, or paralysis do not appear to be ever present.
From OCHRISTIsON's remarks we may also infer that Belladonna will prove homceopathic to some of the severest, and
most hopeless stages of Apoplexy, viz.: when there is aphthous
inflammation of the throat and mouth, great swelling of the
belly, when the body is almost putrid, even before the patient
is fairly dead, when the skin is covered with dark vesicles, the
brain soft, the blood-vessels of the head gorged, and the blood
everywhere fluid, flowing profusely from the mouth, nose and
eyes. PETERS.]



BELLADONNA-APOPLEXY.


91


Loss of memory. Great weakness of memory, he forgets
immediately what he intended to do, and cannot remember
anrything.
SThe blood rushes to the head, when one stoops, and one
becomes heavy and dizzy. Congestion of blood to the head,
without internal heat in the brain. When one bends his head
backwards, it seems as if the blood rushed into it. Swelling
of the external veins of the head. The veins of the limbs are
distended, and the arteries of the neck beat so violently, that
when he opens his mouth the lower jaw is constantly forced
against the upper, so that a slight chattering of the teeth ensues; attended with a warmth, and a sensation of warmth in
the whole body, especially in the head. Beating of the arteries of the head, and of the whole body, early in the morning,
on awaking. Excessive heat of the whole body, with especially frequent and more violent beatings of the temporal
artery, with dulness of the head, all followed by profuse perspiration. Great heat of the body, especially of the head, so
that the face becomes very red, from time to time, occurring
daily after dinner. Frequently, excessive paleness of the face
is converted immediately into redness, with coldness of the
cheeks, and hotness of the forehead. Unusual redness of the
face. Great heat and redness of the face, not followed by
perspiration. Great heat and redness of the face, with icycoldness of the limbs. Glowing-redness of the face, with
violent, and inexpressible pains in the head. Heat and redness
of the head only. Congestion of blood to the head, with redness of the cheeks. Heat and redness of the whole face, as
if he had been drinking. Dark redness of the face.
The whites of the eyes are streaked with red, early in the
morning, with aching pains in them. Dimness, darkness and
blackness before the eyes. Dulness of sight, with trembling
in all the limbs. Darkness before the eyes, as if from a mist.
Roaring in the ears. Noises in the ears, and dizziness, with
dull pain in the aboien.     Deafness, as if a skin were
stretched before the ear iTificulty of hearing.
A tr,



92


TEEATMENT OF APOPLEXY.


Immediate bleeding of the nose. Epistaxis early in the
morning, and at night.
Violent gritting of the teeth. Gritting of the teeth, with
frequent flow of spittle from the mouth.
Sensation in the morning, as if the tongue were asleep,
numb, dead, and covered with fur. Trembling of the tongue.
Stammering weakness of the organs of speech, with clearness
of the intellect, and dilatation of the pupils.
Attacks of nausea in the forenoon. Frequent nausea and
retching. Vomiting, dizziness and flushes of heat. Excessive
vomiting, [from pressure on the brain].
Trembling in all the limbs, inability to walk, swelling of
the veins of the whole body, and unpleasant irritation in the
throat, all lasting for several days. Trembling and tired
feeling of the limbs. Lassitude of the limbs. In the evening he is so tired he can scarcely walk. Sluggishness of
all the limbs, and disinclination to work. Disinclination,
and disgust for all labor and motion. Weakness of the
body. Loss of strength. General debility. Frequently recurring, transient paroxysms of great weakness, in which
everything seems so heavy, and presses downwards as if he
must sink together. Fainting fits.
Sleepiness. Persistent dulness and drowsiness. Frightful,
and vividly-remembered dreams.
Attack of Belladonna-Apoplexy.
He lay without sense or consciousness. Extreme stupefaction of all the senses. Unconsciousness. Perfect unconsciousness, so that he does not recognize anything. Loss of sensation. Apoplectic condition. He lay motionless for four days,
without taking any nourishment. Lethargic, apoplectic state;
he lay night and.day without moving a limb; when griping
pains set in, he opened his eyes, but did not utter a sound.
Noise and rattling in the air-tubes. Difficult respiration.
Violent, short, frequent and anxiousdrawing in of the breath.
At times he breathed, at others the last gasp seemed to have



RBELL ADONNA-AP OPLEXY.


escaped him; recurringin paroxysms, four times in the course
of fifteen minutes.
During his drowsy stupefaction he opened his eyes, looked
wildly about' him, and then relapsed into a heavy sluber,
with rattling in the throat. Choking attacks of snoring, during inspiration, while asleep.
Largeness, fulness and slowness of the pulse. Yery small,
quick pulse. Largeness:of the'pulse,"which is ten beats too
frequent. Stiong and     ilse.
Widely-opene-leýyeos. Contracted puls. Dilated pup8ils.
Dilated and imnmovable pils.   Exeessivealy-dilated pupils.
Protrusion of-the eyhesand enlargement df the pupils.;  ixedness oft. eyes..Staring  look. The eyes are staring
and spark,zg-Glisteningawt.glassy appearance of the eyes,
with wideljdiaieapupils.
Spas.ifod ic o  i   the lips. The right angle of the
"   wards.Distoreion of the mo    from
m~iouth      ý,;ý_ ý twals
psasm  (Risu" Sarddnus).
Bloody foam befoe ",the muth.
Stuttering spehe    stutters as if intoxicated.
Difficulty of swallowing; painless "inability toswallow.
Involuntary discharge of freces; paralysis of the sphincter
ani. Small, sudden      volunt          Suppression of
stools and urine, with profuse perspi-raion.
Difficulty-in' urinating. Suppression of urine. Retention
of urine, which only passes off in drops. Involuntary discharge of nrin9   aralysis of the neck, of the bladder. He
cannot retain his~~iie.
Paralysis "oF-threright arm. Heaviness and paralysis of the
upperirb biiit      decided in the left arm. Paralysis of
the feet.- i  YP~ralsis of the right arm, and right leg. The left
sideespebily-'- the left arm and thigh, are quite paralyzed.
Cold sweat on the forehead.
CASE 17.-A plthoric man, aged 60, of short stature, was
found early-in te mor.ning, lying by the side of his bed, in a
fit of Apoplexy.
Symptoms.-lHe lay immovable, stretched out as if dead,
7e



BELLA.DOONNA.


97


limbso;f digot, ide butcquld not close, or grasp with his
le:h:  gi      next day he slept much, and spoke
" nt o nall fo  ihe received Opiumn 10, 1 drop every
S   e;'i os;ite evening he was able to walk about the
room  H:(e then took one dose of Bellad. every second day, until
iourteenth dy.. Despondency, loss of memory, and difficulty in speaking, were entirely removed by Anacardium,
Baryta, and Rhus.-Gen. Hom. Jour., vol. 8, p. 68. Dr.
ELWERT.
CASE 23.-A lady, aged 61, was attacked with vertigo and
confusion of the head. In the course of a few hours she had
"an unusual snoring and blowing out air through the lips; her
face was red and bloated; her mouth somewhat drawn to the
right; lips and left side in alternate convulsive motion; she
had fits of yawning, entire unconsciousness, paralysis of the
left half the body, and violent throbbing of the carotids; her
pulse was full and slow; urine was passed involuntarily; her
pupils did not contract when exposed to light; she made no
sound, except a kind of groaning noise; her hands were cold.
Treatment aid result.-Several drops of Bellad. 2, were
mixed in water, and a teaspoonful given every half hour, at
first; aftewards, a drop of the pure Tincture was occasionally
put between the lips. The above condition of things persisted
for two days, and the -ame treatment was continued; then
she groaned more frequently, seemed to hear when she was
loudly spoken to, and could swallow some food; she lay on
her back, unable to,alter her position, but could move the
limbs of the right side. On the fourth day, her consciousness
returned; her stuttering speech could be comprehended; she
knew not what had happened to her; complained of weakness, especially of the leftside, which she could move, however;
and could take nourishment, although swallowing was difficult.
The remainder of the disease was removed by Bellad. 3,
Nux-vom. 3, and Rhus 2. Dr. ELWERT, p. 40.
CASE 24.*-HARTMANN (see Acute and Chronic Diseases,
translated by Chas. J. Hempel, M. D., vol 4, p. 6,) reports a case
G



100


TREATMENT OF APOPLEXY.


and put out her tongue; that evening and the next morning
she got another spoonful of the medicine, and the improvement went on, so that on the 17th day she could move her
arms and legs; on the 18th, she ate with appetite, and soon
recoveredly completely.-Brit. Jour. Hom., vol. 8, p. 281. Dr.
RAMPAL.
CASE 27.*-A man, aged 42, of sanguine-choleric temperament, who had suffered for a long time with his head, and
with pains in his limbs, was seized with an attack of apoplexy one afternoon, in the midst of most violent pains in
his head; he was left paralyzed on the whole of the right
"side.
Symptoms. He was unable to speak; his mouth was drawn
to one side; at times the sound left side was agitated with
convulsive movements; the saliva flowed constantly from his
mouth; he had some hiccough; his pulse was full and hard;
eyes red and prominent; his face flushed; thirst excessive;
he had been constipated for four days; but he retained his
consciousness, understood his situation, and felt that his great
misfortune had reduced his beloved family to a very distressing situation.
Treatment and result.-He took two pellets of Bellad. 30,
and a quarter of an hour had scarcely elapsed before a change
was observed in his state; the pain in his head became less
violent; the redness of his face less decided; the convulsive
movements less severe, and in half an hour after, he fell into
a pleasant sleep, which lasted two hours, and from which -he
awokein a slight perspiration; he was able to speak in a brief,
comprehensible manner; sensation and motion had returned
in a slight degree to the paralyzed parts, and in twenty-four
hours more the paralysis had entirely disappeared; some pain
and heaviness in the head persisted for a few days after.
Beauvais' Clinique Homceopathique, vol. 1, p. 276. Dr.
BETHMANN.
CASE 28.*-A printer, aged 36, fell while at dinner, with
an attack of apoplexy, followed by paralysis of the whole left
side; when his arms or legs were raised, they fell heavily like



BELLADONNA.


101


inert masses; his face was red, his eyes brilliant, and full of
tears; he had not entirely lost consciousness, but was unable to speak a word; his tongue was drawn to one side; and
his pulse was full and strong.
Treatment and result.-Bellad. 30,1 drop. In the evening
the.paralysis had entirely disappeared; his speech had returned, but his voice was stammering; his pulse was frequent,
but soft. The same prescription was repeated, and by the,next day he was out of danger.-Malaise' Clinique Homceopathique, p. 1.
CASE 29.--A woman, aged 38, of violent temper, but pale
and delicate, had suffered for several years with Congestive
vertigo.
Symptoms.-The attacks occurred several times a day, generally in the morning, after stooping; were attended with flimmering before the eyes, and dimness of vision; she was obliged to
lay hpld of something to prevent her falling, on account of
staggering and pitching about; afterwards she felt exhausted in body, and mind.
She also was: annoyed with aching pain in the foreheal
over the eyes, increased by bodily exercise, and attended
with throbbing in the head, and heat in the face. She had
but little appetite, an aversion for meat-diet, with nausea and
inclination to vomit. In the forenoon she had flushes of heat,
alta:  of unconsciousness, and aching, and pulsation in the
epigastrium after eating, and while walking. She was costive, with bearing down upon the uterus; also had a chronic
cough, and shortness of breath.,   eatinment.-After nine doses of Bellad. 15, one drop per
"dGlse- the vertigo and headache had entirely disappeared.
-ux., Sulph., and Stramon., removed the remaining symp"^toms. Genl. Horn. Jour., vol. 19, p. 313. Dr. ELWERT.
%   I CASE 30.*--A boy, aged 15, who had suffered for a year
S ith attacks of vertigo and transient fits of unconsciousness,
was cured by Bellad. 4, one dose every day, for four weeks.
Genl. Homrn. Jour., vol, 19, p. 314. Dr. ELWEET.



102


TREATMENT' OF APOPLEXY.


CASE 31.*-A girl, aged 13, had suffered for several years,
with attacks of turning-dizziness attended with anxiety,
pressing headache, and staggering about, occurring several
times every week. She was entirely cured by Bellad. 5,
30 drops in 2 drachms of Alcohol, 10 drops to be taken
every other day.-Gen. Hom. Jour., vol. 19, p. 313. Dr. ELWERT.
CASE 32.*-A lady, aged 48, was subject to vertigo on rising from her seat, so that all objects seemed to stagger to and
fro; she was also apt to fall down, and to vomit mucus.
Bymptoms.-The attacks of vertigo were preceded by a
putrid taste in the mouth, nausea, and at times by bilious
and mucous vomits; occasionally, she was dizzy at night; the
vertigo was increased whenever she lessened the quantity of
meat she ate; she had a disgust for milk; and was every now
and then troubled with diarrhoea, or acrid leucorrhcea. She
often awoke at night in alarm; her sleep was disturbed before
midnight, and during the day she was anxious, unhappy,
and irritable.
Treatment and result.-She was somewhat relieved by
Bellad. 10, but still the dizziness and loss of memory remained; whenever she sat bent forwards heaviness in the back of
the head came on; near objects were seen indistinctly: she
had pain in the urethra while urinating; her urine was turbid
with mucus, and an acrid leucorrhaea was increased; her
stools were still loose; andshe had a frequent inclination to
doze. Conium 10, then cured her almost entirely, although
Lycopod. was required for the vertigo when stooping, the
flatulent distension, and the stools which had now become
too hard.-Annals, vol. 1, p. 231. Dr. SHREETEER.
CASE 33.*-A man, aged 26, of large and robust constitution, had suffered for three days with turning vertigo, and
dimness of sight after rising up from sitting or lying, from
moving the head or eyes, and from rising up from stooping.
He also complained of lassitude in his limbs, with trembling



S  BELLADONNA.                      103
of them while walking, of fulness in the head and pain in the
chest.
Treatment.-Four doses of Bellad. 9, were given, one drop
per dose, every six hours, with decided improvement: then
four doses of Bellad. 12,. 1 drop per dose, every six hours,
cured him   enitirely.-Gen. Hom. Jour., vol. 44, p. 47. Dr.
HALUSTEIN.
CASE 34.*^-The patient, aged 34, suffered with numbness
and weakness of the left side; paralytic drooping of the eyelids: lachrymation and squinting of the left eye: double
vision; distortion of the mouth. The head was dull and
confused; the tongue coated; appetite poor; pulse rather
tense; sleep restless.
Treatment.-Bellad. was administered in repeated doses of
the pure Tincture, for four weeks. For the obstinate remains
of the Paralysis, Rhus 1st dilut., was given every forty-eight
hours, for four weeks more, when the patient was entirely restored.-Dr. ELWEiRT, (Homceopathy and Allopathy in the
Balance, p. 42).
Dose. Of the eighteen cases treated by Bellad., three were treated with.the pure Tincture, which effected a cure in one case where the 18th
dilution had failed; the 1st, 2d, 3d, 4th, 5th, 9th, 20th, 24th, and 2000th
dilution, were each successful in one case; the 15th in two cases, and the
30th dilution in six cases. In four cases, single doses of the 15th, 24th,
and 30th dilution, sufficed to effect a cure; in other cases the doses were
repeated as frequently as every half hour, and from four to five, or even
nine or ten doses were required. In six cases, favorable results ensued
in the course of two hours; in three cases, after the lapse of ten or
Stwelve hours; in others, in the course of a few days. NOACK prefers
one or two drop doses of the 1st, 2d, 3d, 6th, or 12th dilution, repeated
every two, three, four, six, eight, or twelve hours, in acute and severe
attacks. In very severe cases, they may be given every five, ten, or fifteen minutes, or every half, or one hour. If preferred, from 3 to 6
pellets may be dissolved in a wineglassful of water, and a teaspoonful
given as often as above directed. PETERS.
6. BLOOD-LETTIrG.
Even if it be admitted that allopathic physicians bleed too
much in apoplectic attacks, it is generally supposed that ho



104


TREATMENT OF APOPLEXY.


mceopathic physicians bleed too little-if the strength and
vascular condition of the patient permit of it, or seem to require it, it seems very certain that bleeding will not interfere
with the action of homoeopathic remedies-and it is even supposed that in some apoplectic and congestive affections of the
brain, the pressure upon it and the nervous system may be
so great, that they are as it were benumbed, and unable to respond to the action of any remedy until the pressure be relieved by blood-letting-hence I will endeavor to state as
fairly as possible the advantages and disadvantages of bloodletting in apoplexy.
"Woon, the latest American writer on the theory and practice of medicine, says: " If the strength of the pulse admit,
blood should be drawn from the arm-but bleeding is not to be
indiscriminately resorted to, or pushed to an unlimited extent;
much injury has probably been done in this disease by excessive bleeding; if nature have already accomplished a great
reduction of the heart's impulse, if the pulse at the wrist be
small and feeble, no advantage is to be derived from the further loss of blood. It should be remembered that in the
hsemorrhagic and serous cases of Apoplexy, the disease is
not over when the effusion is suppressed; the brain has sustained a great shock, and a long series of actions will be necessary to repair the mischief done; it is bad practice to'destroy
all the resources of the system which may be necessary to
sustain this course of action, by an inconsiderate and exclusive obedience to the first indication, viz., that of arresting
effusion, or correcting congestion. The practitioner should
be guided by the strength of the pulse whether he shall bleed
or not."-Vol. 2, p. 628.
SOLLY says, " blood-letting is the most dangerous remedial
agent in some cases of Apoplexy. Many a valuable life has
been saved by the prompt and free use of the lancet; but more
have been hastened into eternity by its indiscriminate employment. At one time this opinion of the imperative necessity of
blood-letting in Apoplexy was almost universal, but it has lately been much modified; the deservedly-high reputation of



BLOOD-LETTING.                  105
ABERCROMBIE gave too much value to the use of the lancet in
Apoplexy. WATSON, he says, advises after one full, and sufficient bleeding from the arm, to abstain from farther use of
',the lancet; the disease itself is most depressing, and in its
treatment we must not consider the present moment simply,
but we must also look to the future. SOLLY is convinced that
large abstraction of blood gives rise to serous effusion, or
dropsy of the brain. He also quotes Dr. HOLLAND, who asks,
"1 Is not depletion by bleeding, a practice still too general and
indiscriminate in affections of the brain"-he believes that the
soundest medical experience will warrant this opinion. WATSON says, that he does not mean altogether to praise the modern (allopathic) practice in apoplexy; for it is often one of
mere routine-this routine may be most proper in many
cases; unnecessary in others, and pernicious in some, but
there are persons who seem to think that they have not done
their patient justice if any part of the usual active intermeddling has been omitted-they think that the patient must be
copiously bled, cupped or leeched, blistered, and thoroughly
dosed with calomel, senna and croton oil, and mustard poultices must be applied to the legs, &c.
BumRows says: until a very recent period, repeated and copious blood-lettings and active purgatives were the principal, if
not the only remedies recommended to be employed in all
Apoplexies by authors held in the highest esteem. Several,
however, of the present day have pointed out many circumstances which would cause such profuse expenditure of the
vital fluid in the treatment of apoplexy to be highly prejudicial-BuRRows says that his experience leads him fully to concur in reprobating the indiscriminate use of the lancet in
these cerebral affections. He also adds that: the principles
of treatment of apoplexy recommended by so eminent and
experienced a physician as Dr. ABERCROMBIE, have, he doubts
not, misled many into the abuse of the lancet. They have
been afraid to abstain from blood-letting, since that remedy
has been declared" to be almost a panacea by this writer.
Several modern writers have alluded to states of the brain



106


TEEATMENT OF APOPLEXY.


simulating congestions of its vessels, and where depletion
would only aggravate the symptoms.
But the most formidable antagonist in the old school
against blood-letting is CoPEMAN. He asks, "Could things be
worse under any plan of treatment, or would the mortality be
greater without any treatment at all. Surely there is a complete justification for leaving the well-beaten allopathic track
that has hitherto been trodden with so little satisfaction, and
endeavoring to find out a path that might lead us to more encouraging prospect. Of 155 cases, 129 were bled and only
26 were not; of the 129 who where bled only 51 recovered
and 78 died; of the 26 who were not bled, 18 were cured and
8 died.-See p. 6.
" From these facts," COPEMAN infers, that "bleeding generally speaking, is so ineffectual a means of preventing the fatal
termination of Apoplexy, that it scarcely deserves the name of
a remedy for this disease. That bleeding in the foot was the
most successful mode of abstracting blood, but that the treatment without loss of blood was attended with most success;
and that the mortality of the disease increased in proportion
to the extent to which bleeding was carried; the more copious
the loss of blood, the more fatal the disease." (See Collection
of fases ofApoplexy, by Edward Copeman, p. 7.)
COPLAND says, that during his own experience he has often
had cause to regret that apoplectic and other sudden seizures
had been treated by blood-letting by the first medical man
who had seen the patient. For many hundred years an idea
has been entertained by medical practitioners that active practice was good practice: that blood-letting was the best part of
active practice; and that this constituted the chief and greatest part of a medical reputation. They could not perceive
the fact that blood-letting could be injurious in any of these
cases; and they fully believed that patients died notwithstanding the bleeding, and not in consequence of it. Now matters have somewhat amended with the progress and diffusion
of medical knowledge; but there still renlains much to reform
even in this, and other practical measures. The number of



OOCOcULus,


109


headache with nausea and vomiting; headache with feeling
of emptiness and hollowness of the head, increased by eating
and drinking; when there is vertigo, with nausea and falling
down without consciousness; vertigo, as from intoxication, and
stupid feeling,in the head, as if he had a plank before it;
vertigo, when raising himself in bed, as if everything turned
around, with inclination to vomit, obliging him to lie down
"again; headache with inclination to vomit, as if he had been
taking an emetic; stupid feeling in the head, with cold sweat
on the forehead and hands. Attacks of paralytic weakness.
Apoplexy of the left side; epileptic- or convulsive-Apoplexy,
in which the patient first feels as if intoxicated, then becomes
quite still, and stares for a long time at one spot, without hearing or answering any questions, then falls down unconscious,
writhing and muttering unintelligible words, with involuntary
emission of urine, spasms of the limbs, convulsive clenching
of the fingers, paroxysmal choking in the throat, the mouth
being open as if he would vomit, the hands being cold, the
face covered with cold sweat, the eyes glassy and protruded;
after the attack he is partly unconscious and bewildered.
PIEREIRA says it is homceopathic to nausea, vomiting, staggering, trembling and convulsions; 3 or 4 grains of it have proved
homceopathic to nausea and fainting, although it is frequently
added to malt liquors for the purpose of increasing their intoxicating powyers. TAYLOR says it is homceopathic to vomiting and
intoxication. ATroMB regards Cocculus as indispensable in
some of the consecutive affections of Apoplexy, especially
against the weakness and irritability of the stomach, weakness
and dizziness of the head, and the paralysis. He regards it,
however, as more homceopathic to epilepsy than to Apoplexy.
Others regard it as most homceopathic to asthenic Apoplexy,
when the face is pale and sallow, but puffy and bloated, the
pulse feeble and easily compressed, the respiration heavy and
laborious; especially when these symptoms have been ushered
in by headache, giddiness, loss of memory, illusions of hearing, inarticulate speech, and inclination to somnolency.PETEES.]



41ý4


SCOCCUXiS.-COON  MAOULATNM.            111.During the attacks he could scarcely speak; afterwards he had
difficulty in reading `7hd thinking.
Treament.-ihe doses of Cocculus 15, one dose every six
days, cured hinentirely.-Gen. Hom. Jour., vol. 8, p. 70.
Dr. ELWEET.i
Dose. The1th and 15th dilutions have been used successfully. In
other cases the same doses as recommended for Nux may be given.PETERS.
8. CONIUM-MACULATUM.*
GENERAL REMARK.-According to ATTOMYR, the principal
homoeopathic remedies against Apoplexy are: Belladonna,
CoNIUM, Hydrocyanic acid, Hyosciamus, Opium, and Plumbum.
According to CHRISTISON, Conium  acts as specifically in
causing paralysis of motion, as Aconite does in producing
paralysis of sensation. It is h-omceopathic to palsy, first of
the voluntary muscles, next of the chest, finally of the diaphragm, causing asphyxia from paralysis, without insensibility, and with slight occasional twitches only of the limbs.
In several soldiers, it proved hom'eopathic to such drowsiness that they seemed to drop asleep while conversing; but
they soon became giddy with headache; in one case there
was such a state of insensibility, that the patient could only
be roused for a few moments, his face was bloated, pulse only
30, and extremities cold.
It is also homceopathic to great congestion of the head, with
an unusually fluid state of the blood.
Conium also differs very widely from Bellad., Stramon., and
other narcotic remedies, in not producing violent orgasm,
commotion, and active congestion of the blood; POHLMANN
found after taking one-third of a grain of Conium, that his
pulse fell from 70 to 59, with slight dizziness, and a remarkable sensation of heaviness in the arms and legs, but especially
in the left arm. VOGT thinks that it checks the arterialization
S  of the blood, and renders it much more venous. ABLES also
thinks that it acts sedatively on the arteril system. SOBERN



114:


114         TREAThIENT, OF APOPLEXY.


ings and exudations, it is very probab~le~ that it will also, aid
powerfully in the absorptioit of apoplectic clots and frorr
its depressant a-ctioiI on the 1výascuiar S'ystemi, it may, jpto'Teý
antipathic to the infammafiory irrit'atioii which is'sso apt, to seth
in around the clot. PETERs.
Dose. NO' cases of, Apoplexy have as yet been reported, as culreclbyConium. NOACE adv~sesr 1 or 2 drops of 'the pure tincture per dose, ori
of the 1st or 2d. diluti~n.  Those wvho' prefer them,'may' u~se the' globules, eithet' dry upon the tongue, or~in so'lition' PrTERs,.,
9. CPOTALTIPS
CASE 38.- A man was, suddfenly attacked withý Apoplexy.
Sytoms.-lleadache,'6pprssion of( the,.chest, alitd- urn-'
ing fever with quick~ pulse;- inability to Sp'sak- deep slumber",
from -which he could -not be rouased; inutterbig to')himseslf.,',
Treatment.-Crotalus' ý3O effioteda a4seedy' cure,.   GeuL.
llom, Jour., viol. 39, p. ý8O. 1~r. WEBEE. 01
10., OUPE1Th- ANt), _PLUMMVBM-AOETIC'UM.
GrmNTRAL IREMrA~RK.-BEEr, of Vienna, in     css    ond'
Qopper to be homccopathic to5 very severe headachep, slight deliriUMconvulsive, moveme'uts,of ih6 leg_ý, great76xhaA'stion,' and'
somnolellce, which in,3 cas~es, amounted to 'IIcorma.-, From
CNiSTsmow's remarks 'e~ alsb learn that itip, often' homceopathic,
to violent headache and other affectiong of the, brasin, hin'wbch
symptoms' of,narcptism appear first, and ar& follh "ed by, ir'ri-'
tatioti.
It i's also Peculiarly ho 'Ce'opathicto A' ' leiy whichrisee
from  disorder or: digease of~theji've:r; to th~e' brai   asetip,
which are so cormonibili s" Personsand" in those wbný
have accute or chronic ja'un'dice;' 'lthoug~h we Will's oon'see that,
Phosphor:., also deserves attention.,
From' DANA's' American edition' 'of TAwQuEEERL'5 work on
Lead Disectse&, we learn ihatLead i's d~ddedly hornceopathic t&
s6rne varieties of,comca and j~artial A'p6ýilxy.'It ks so whehn
the  atint ~d'dnlyfall'sintd'-,comatose state in,'h: i~s
of an 'appearanice of good health, -,or'during the" piilrse of se'yore (ao1lic. In the hi ghest,'deg, ee' of, this variety of -di'seas'e,



OUPRUMI- ANP PLUMBTUM-ACETICUM.
i


115


the.patient is immovable, the limbs gathered upon the body,
the eyes closed or half closed, and snoring may be heard like
that from one in a sound sleep; from time, to time the patient; utters heavy groans, but if spoken to he cannot b6 roused from
the comatose state in which he is plunged; still at times, if
he be pinched sharply, he may open his eyes, look around, and
then fall again-into his lethargic sleep without replying to any
questioh. Involuntary automatic movements of the head,
trunk, and limbs take place from time to time; the pupils may
be dilated 'r contracted; and light either has no effect upon them
dr else causes them to slowly contract; sensibility and motion
are,lessened, but not abolished; the jaws aie firmly clenched;
and from time to time there may be an abrupt motion of the
lips accompaniied with a strong expiration, a movement comimon in Apoplexy, and.often calledL" smoking the pipe."
Lead is also hpmeopathic to a sub-delirious form of coma;
the'patieritafter having beenpluinged into a sleep, more or less
profound, seems to awake suddenly, opens his eyes, nearly always -mIutrs the same unintelligible words, or distinctly pronounces -thnem without any meaning; he may turn, and turn
again in his bed, rise'and take the most fanciful postures, and
S ten finally fall back into his first sleep. If he be briskly
a roused from, his lethargic state, he at first opens his eyes a
little then closes them immediately, or if he opens them completely they look fixed and haggard, aid if he then be questioned with mniuc earnestn'esshe will sometimes look fixedly
at the person'without pealding, or else he replies ii a stammering, very, laughable ahd sing-song manner; there is a
'cohstaLnt tendency to repeat the same, or similar sounding
words.
" Sometimes when'the patients are awakened from their stupor, their harsh jargon often 'expresses discoptent, and they
turn with ill humor away from their interlocutor; sometimes
when they are awakened, they articulate the first words of a
reply, abnd mutter tlhe rest as they fall again into their stupor.
Ih sbme cases-they can give a rational reply if it does not reS quire morethan one word,such as yes'or no. All the organs
of the, senses are blunted.



116


TREATMENT OF APOPLEXY.


Lead is also homceopathic when these two varieties of simple coma and sub-delirious coma occur in alternation, or appear,
and disappear without any particular order of occurrence.
Lead is 1peculiarly indicated when the above states set in without premonitory symptoms, and almost instantaneously; but it
is very rare that the comatose variety occurs alone, without
being preceded or followed by delirium or convulsions.
Lead-Atrophy of the Brain.
In 21 cases Lead proved homceopathic to a flattening and
shrinking of the convolutions of the brain, with increase or
diminution of the firmness or cohesion ofthe medullary substance,'and of the size of the brain. In 19 cases, to yellowness of the substance of the brain; in 32 other cases there
was serous infiltration, more or less slight; congestion of the
membranes of the brain, more or less great; and diminution of
the consistence (softening) of the white cerebral substance,
without any change of color.-TANQUERL says, that the shrinking and flattening of the cerebral convolutions deserve serious examination, because they have been noticed by
numerous and skilful observers, and consequently are Worthy
of the highest credence-in somhe of these cases there was also
an increase of the volume and consistency of the, brain, in
fact, an hypertrophy; but in other cases there was also a flattening of the cerebral convolutions, with diminution of the
size of the brain, in short there was either an atrophy, or at
least a shrinking, or condensation of the cerebral mass. In
other cases there is only a turgescence of the cerebral tissue.
It wilLbe seen that if homceopathy be true, Lead must prove
a most important remedy in some of the most serious chronic
affections of the brain; in acute swelling of the brain, in
hypertrophy, in white or yellow softening, in atrophy and
induration of the brain.
ROKITANSKY in particular has laid great stress upon the
more or less frequent occurrence of premature atrophy of the
brain in Apoplexy, associated or not with manifest premature
senility of the whole organism--he thinks it a very important
condition in itself, but it also becomes still more so from its



TREATMENT OF APOPLEXY.


attacks. It is particularly indicated, according to HERING,
against throbbing headache, aggravated by shaking the head,
and attended with great quickness of the pulse, which may
range as high as 120 per minute, and even more; it is more
homceopathic to these symptoms than any known remedy.
It is also indicated against:  sensations of swelling about
the face and neck; uncertainty of step; dizziness from moving
the head; heaviness of the head, especially over the eyes, and
extending to the ears; dull headache, with warm sweat on the
forehead. Headache ascending from below upwards, especially on the top of the head; from within outwards, especially
in the temples, with feeling as if 'the brain were swelling, or
getting too large; fulness in the head, especially on the top,
with throbbing and heat. Congestion to, and heat of the head.
Throbbing in the forehead, temples and vertex, extending back
into the nape, increased by every step, and by every motion
of the head. A bruised and sore feeling in the head. The
pain, heat and fulness of the head are peculiarly apt to ascend
from below upwards, i.e., to commence, in the chest, nape of
the neck, or occiput, and then pass up into the upper part of
the head. Shaking Of the head aggravates the pain very
much. The headache is attended with quick pulse, redness
of the face, and perspiration of the'forehead, with redness of
the eyes, heat in the eyeballs and lids, soreness and aching of
the globe. HEIRING.
There may be sparks, spots, and dimness before the eyes;
fulness and noises, with sense of stoppage of the ears; pain
and stiffness of the jaws; nausea and vomiting; increased
flow of clear, spastic urine; (an unfavorable sign in Apoplexy,
according to SOHCNLEIN); suppression of menses, with congestion to the head and chest, or with headache and fainting fits.
Also oppression of the chest, sobbing, violentpalpitatidn 6f
the heart, pain and stiffness of the nape of the neck (from
congestion of the brain5; pain, throbbing and fulness in the
nape; pain, heat and shivering down the whole0of the back;
heaviness, weakness, and numbness of the, arms, with pain
and trembling; fainting fits; throbbing, crawling, thrilling,



120             TREATMENT OF APOPLEXY.
pupils contracted, pulse quick and small, he could scarcely
speak, and had frequent retching to vomit.
Treatmnent.--This case, and several similar ones,'were quickly cured by Glonoine. Dr. CAMPOs, of Norfolk.
CASE 45.*--A delicate woman had headache upon..the
vertex and in the temples, which, without being throbbing,
increased and diminished in intensity, and some of the exacerbations were so severe that she almost wished to die; her
pulse was small, weak, and not quick.
Treatment.-Relieved quickly by Glonoine 12. Dr. HERING.
CASE 46.*-Rev. WAAGE had severe symptoms from an
over-dose of several hundred globules, but remained free fromn
an accustomed sick-headache from Nov. to May, i.e., for six
months.
Symptorms.-The attacks occurred at every opportunity;
commenced suddenly with the illusion, as if the focus of the
left eye were changed; he then saw eveyvthing half-light,
half-dark, and felt as if he must die; in half an hour inclination
to vomit set in, he was -obliged t6 sit down, and then it seemed
as if a cloud rose up, and melted away, when his sight would
"be restored, but the most violent headache would arise and
persist until he vomited. This headache was always on the
left side. Dr. ERING thought the attacks would ultimately
lead to Apoplexy, if not cured.
"Treatment.-Every variety of homoeopathic treatment
had been tried withput benefit until Glonoine was given.
Dr. HEmNG.
CASE 47.2*-An aged nurse, suffering with.chronic disease
of the heart, was frequently attacked with violent headaches,
lasting all day, especially in damp, foggy weather., The pain
was teariig, ascended from the occiput up to the vertex, where
it became throbbing; motion and stooping increased it; lying
down relieved it; she also had a sense of fulness, as if from
rush of blood to the nape of the neck and head.
lTreatment.-Relieved in one hour by Glonoine 12; this



HYOSOIAKUS.


123


ness of the face and dilated pupils; when the nose is apt to
bleed, the speech difficult and inarticulate, with sense of crawling and falling asleep in the hands and limbs; great debility,
disinclination to move or work, inclination to faint; great
drowsiness, with gritting of the teeth.
It is homceopathic in attacks of Apoplexy with snoring
respiration; against those profound and long-continued slumbers which are apt to end in Apoplexy; when epileptic attacks
occur in alternation with apoplectic conditions. When the patient falls suddenly to the ground with entire loss of consciousness,; when the breathing is quick and rattling, interrupted by
snoring and choking.
When the eyes are fixed and inclined to squint; or are
open,and roll from side to side; or are protruded forwards,
and move convulsively; the pupils being widely dilated;
When the patient's face looks as if he were drunk, or is distorted, bluish, or earth-colored, and the. jaw  is dropped.  Or
when the color of the face varies from being pale and cold,
to a bluish, or red and swollen state, or to a brownish red
color.
When there is inability to speak or swallow, the throat
being contracted or paralyzed, sb that the patient is obliged
to spit out the things which he has taken into his mouth.
Also when there is'looseness of the bowels, with urging to
urinate, retention of urine,.or paralysis of the bladder.
Hyosciamus acts more like Opium than any other remedy,
except that it is more apt to cause nervous irritations of various muscles, marked by twitching of the eyes and face, and
jerkings of the limbs. It is homoeopathic in those cases in which
Opium seemsindicated,, yet the pupils are much dilated. It
acts more powerfully on the vascular system than Conium,
yet not so' much as Bellad. and Stramon. PErTEs.
-CASE 51.--An unmarried lady, aged 59, fell into a comatose state; with frequent snoring, from which she could only
be roused imperfectly for a few moments by hard shaking, and
loud speaking; still she could answer no questions, neither



EYPr"'VDROOYANXC-AOID.----GNATIA.1


125


DOSe, NoAtý advises 1 or 2 drop doses of the 1st, 2d, or 3d dilutioi, repeated every half, ofie, two, or four hours, in acute and severe
ases. PETERS.
-15. IGarATA.*
GENERAL REMARKS.--The action,of this remedy is very
similar to that of Nux, and like it, it is best suited to Apoplexy when attended with convulsions.
CASE 52.*--A man, aged 38, had had an attack of Apoplexy, which weakened his memory of names, but left him
tolerably able to attend to - his business. But he was again
seized with a violent attack; he was copiously bled, but his
face and lips still continued livid and swollen; his teeth were
clenched; frothy and bloody saliva exuded from his mouth;
his breathing was stertorous, and he had general convulsions.
He was bled -again without relief, and matters seemed growing worse and worse, the patient remaining quite insensible.
Dr. GACHHAPI  then, in despair, -proposed to his colleague the
tiial of a homceopathic remedy, the indication for which
seemed precise, but as this was his first trial of homceopathy,
he admitted that he- could not predict the result. His colleague consented, and 1 -drop tinct. Ignatia, was given in a
spoonful of water; this dose was soon repeated, as the
patient could not swallow all of the first. In five minutes,
the convulsions were violently increased, but they soon began
to abate, and gradually ceased. In half an hour consciouness
began to be restored, and he soon recovered.-Brit. Jour.
Homn., vol. 5, p. 51.
S16. NX-voMIOA.
GENERAL REMARKS.- [Dr. BLACK suggests that Iux may
prove homoeopathic to the paralytic cases of Apoplexy, in which
there is often but little loss of consciousness; it is, however, far
morehomceopathic to Apoplexy which follows epileptic or other
convulsive attacks.. According to WooD and BAcHE it acts
specifically and principally upon the nerves of motion; its operation is evinced at first by a feeling of weight and weakness,
wittl tremblings in the limbs, and some rigidity on attempting



NTX-VOMIOA.


127


ture, with depression of spirits and anxiety. Also when the
limbs tremble and a slight rigidity or stiffness is felt; finally,
when the. patient experiences some difficulty in keeping the
erect posture, and frequently staggers in walking.
1It may also prove homoeopathic to Apoplexy of the cerebellum (see page 33), as TROUSSEAU and Pmoux say it is apt
to affect the muscles of the penis, rendering the frequent
diurnal and nocturnali erections quite inconvenient, even in
those who, for some time before, had lost somewhat of their
virility. PErEIRA alludes to two cases of paralysis in which
Nuix caused almost constant nocturnal erection, while females
experience more energetic venereal desires, as proved by confidential communications on this point, which cannot be
doubted.
Ayuxs-oftening of the Brain.
According to CnkiISTISON both it and Strychnine are homcnopathie to softening of the brain and spinal cord, congestion
of the'brain and its membranes, and effusions of serum and
blood. In one case the vessels of the brain were gorged, the
membranes of the spinal cord highly injected, and four
patches, of extravasated blood were found between the spinal
arachnoid and the external membrane; fluid blood flowed in
abundancefi'om the spinal cavity, where the veins were gorged;
the pia mater was injected,,and the spinal column softened at
its upper part, and here and there almost pulpy. There was
also congestion and softening of the brain. In another 'case
OirFIA and OLLIVIER found it homaBOpathic to much serous
"effusion on the surface of the cerebellum, and softening of the
whole c6rtical substance of the brain, but especially of the
cerebellum. BLUMHAEDT, too, found it homceopathic to soften"ing of the cerebellum and congestion of the cerebral vessels,
together with softening of the spinal cord, and general gorging of the spinal veins. CimIsTIsow says, this is some, confirmation of an opinion advanced not long ago by FLOupENS
that 'ux acts particularly on the cerebellum. TaoisoN found
it homoeopathic to much congestion of the whole membranes



128


TREAiTMENT OF APOPLEXY.


and substance of the brain and cerebellum, and even some
extravasation of blood within the cavity of the arachnoid,
over the upper surface of the brain (See Meningeal Apoplexy,
page 35). WTTr found it homceopathic to softening of the
substance of the brain, and lumbar part of the spinal cord.
CASE 53.-A man, aged 63, much addicted to the use of
coffee, fell suddenly to the ground.
Symptoms.-He lay snoring, in an unconscious condition;
the spittle ran out of his mouth; when loudly spoken to, he
opened his eyes, muttered to himself, and then fell again into
slumber; his eyes were dim, and the corners filled with purulent matter; the organs of deglutition, and his legs, were
entirely paralyzed; his jaw hung down on the right side; he
had no fever, but his pulse was full and slow; he grasped towards his head, with his right hand; he had a large, protruding inguinal hernia.
Treatment add result.-Nux-vom. 30 was given him to
smell, and five drops were added to an injection; in the
course of four hours his consciousness commenced to return,
and he attempted to speak. Nux 30 was given internally,
and in the course of the following night his rupture was, reduced spontaneously; the next morning his speech coild be
understood, and he could swallow without difficulty, but complained of heaviness of his head, and dizziness. After taking
several doses of Arnica 9, he was entirely restored in eight
days.-Archiv, vol. 8, part 2, p. 81. Dr. ScHiiLER.
CASE 54.-Lady S., aged 55 years, was attacked with
Apoplexy.
Symptoms.-She lay on her back, with rattling respiration;
her eyes were fixed, dim, and did not move even when the
cornea was touched; the pupils were dilated; thick white
mucus collected in the mouth, and her whole body was, cold,
and without feeling.
Treatment and result.-One drop of Nux 1 was given in
water, and repeated in a quarter of an-hour; in ten minutes



NUX-VOMIOA.


131


'Opium, Bellad., Puls., and tinct. Sulph., with benefit, when
"the sudden death of a friend excited her greatly, and brought
back most of the above symptoms, in addition to violent palpitation of the heart and intense headache, and finally, after
making some exertion in a stooping posture, she fell down
heavily in a comatose state.
Symptoms.-Her face was swollen, eyes turned up, and
breathing stertorous; she remained half an hour in a state of
insensibility, and then began to recover consciousness, but
there was icy coldness of the extremities, and of the whole
surface of the body; her pulse was scarcely perceptible; she
had much headache, with sensation of pricking on the top of
the head; she could not swallow, spoke with great difficulty
and very indistinctly; her eyes were shut, and could not be
-opened; the stertorous 'breathing changed to slow, full respiration.
Treaqnent.-Hot bottles were applied to the abdomen and
to the limbs. One drop of tinct. Nux-vom. was mixed in a
tumbler half full of water, and one teaspoonful given every
half hour. The next day, the skin iwas warm, pulse stronger,
and headache slight, but she had acute pain in the pit of the
stomach occasionally; she could open and shut her eyes, and
had somewhat recovered the use of her faculties, although there
was still a great tendency to mistake objects, and call things
by wrong names., Nux was given every four hours. On the
following day she was very much better, with the exception of
her headache; the pain was acute, and darted from one temple to another, and there was a tendency to faintness. Bellad.
3 was given, without much relief for a day or two; but it was
continued, and,.in eight days more, she was well enough to go
to church.-Brit. Jour. Hom., vol. 7, p. 169. Dr. KEn.
CASE 59.*-A carman, aged 50, very steady and temperate
in his habits, was seized, whilst loading his cart, with dizziness
and staggering, which caused him to hold by a post to prevent
falling. He recovered himself a little, and attempted to drive,
but had not proceeded many steps before he fell two or three



NUX-VOMIOA.


133


returned to a great extent. She continued Nux, and on the
following day there was still further improvement; she had
almost recovered the entire use of her limbs, but had had a
slight threatening of a relapse, in a feeling of faintness, and
numbness in.the tongue, and deep-seated pain in the head.
Lachesis 12, three times a day, perfected the cure.-Hom. in
Acute Diseases, p. 178. Dr. YELDHAM.
CASE 61.*-A man, aged 10, of herculean stature, robust
of his age, stout, plethoric, and accustomed to stimulants, was
seized with severe pain in the head, followed in a short time
by paralysis of the right side of the face, numbness and
partial loss of power of the right arm.: His head was heavy
and confused, but he was able to sit up, and speak rationally
and collectedly, but his articulation was considerably impaired; his mouth was completely drawn to one side, but the
paralysis did not extend to the tongue; he complained of a
sense of fulness and thickness about the throat; his head was
hot, his pulse firm and regular, and a little quick.
Treatment.-Nux-vomica 6, every four, hours; on the next
day his head was much relieved; it was not so heavy and
confused, and also cooler to the touch. - He repeated the Nux
every six hours, and then only once a day for eight or ten
days; the muscles of the face, arm, and hand gradually recovered their tone, and at the end of fourteen days there was
scarcely any trace of the attack remaining.-Hom. in Acute
Diseases, p. 179. Dr. YELDHAM.
CASE 62.-A lady, aged 27, eight months pregnant, and
of a phlegmatic temperament, had suffered for several weeks
with dizziness, both while at rest and when moving about;
she was often in danger of falling, especially after dinner;
she had aching pains in the forehead, intermingled with
sharp stitches, especially early in the morning, while in bed;
burning in the stomach after every meal, and frequently recurring flashes of heat.
Treatment.-She was entirely cured by 4 doses of iux
18, six globules each. In her next nregnancy, a similar



136


TREATMENT OF APOPLEXY.


dwell long upon them; still, as SCHMID truly says, it deserves
the first place in the attention of the physician who treats
disease according to the law " similia similibus curantr."
It]is most indicated when the face is of a mahogany red
color,.the pupils very much contracted, the sleep profound,
the limbs motionless, but not absolutely paralyzed, the pulse
full and slow, skin hot and perspiring,-the urine retained
or suppressed, and the bowels obstinately costive (see pages 23
and 24). Nux-vomica is most homoeopathic, when the face
is pale or livid, the pupils much contracted, and the limbs
powerfully convulsed, or rigidly contracted. Belladonna,
when the face is much flushed and bloated, the pupils excessively dilated, the limbs either motionless, or but slightly convulsed. Hyosciamus, when the face is pale or flushed, pupils
dilated, and twitchings of the eyeballs, muscles of the face, and
risus sardonicus, are present. Aconite, when the face is pale
or livid, the pupils much contracted, pulse very feeble, and
much numbness and tingling are present.-PETERS.
(b.) ATTOMYR'S indications for the use of Opium are the
presence of dull stupefaction, with dimness of the eyes, and
extreme weakness; or great activity of mind, and inclination for earnest and important labors.
Unusual redness of the face, with swelling of the lips;
very red face, with wild, protruding and very red eyes;
open and turned-up eyes; paralysis of the eyelids. Spasms
of the facial muscles, convulsive trembling of the face, lips,
and tongue. Distortion of the mouth.
Oppressed, difficult, and irregular breathing. Respiration
at times loud and snoring, then heavy, and then again very
weak. Panting, loud and difficult breathing; single, slow
respirations, followed by absence of breathing for several
moments; long and sobbing respiration; short and snoring
respiration, with absence of breathing for half a minute; loud,
difficult and rattling respiration. Snoring in sleep.
Pulse weak, suppressed, small and slow; pulse at first full
and slow, then weak; slow pulse and breathing; pulse large
and slow, with slow, heavy, and deep breathing.



PHOSPHOR.


139


Treatment.-She received Phosphor 1st dilution, 3 drops
per dose; signs of life returned in a quarter of an hour, and
then she took onily 1 drop per dose, every hour. At a later
period, she took 1 drop of the 6th and 12th dilution,,every
night and'morning. In 10 days she was able to leave her
bed.-Gen. Horn. Jour., vol. 1, p. 67. Dr. STURM.
CASE 71.ý--A man, aged 35, of full habit, healthy, but
anxious about business, arose in the morning not quite well;
he was dizzy and staggered, but went down town, where he
became stupid and heavy, lost his way, and wandered about;
a friend brought him home; he was cold, and when put to
bed soon became stupid and unconscious; his face was flushed.
Treatminet.-He took Bellad. 3; reaction with fever soon
set in, and Aconite was given; but he remained unconscious,
his breathing became stertorous and snoring, and he could not
be roused. Then Opium, 2 drops of the tincture, was put in a
tumbler half full of water, and a teaspoonful given per dose;
improvement soon commenced; he could be roused, and was
able to put out his tongue. The next day he was comparatively well. -Minutes of Pathologico-Therapeutic Society.
Drs. BALL and KINSLEY.
CASE 72.*-A lady in the habit of taking heavy suppers,
with wine, went to bed not very unwell, but her husband was
awaked at night by her noisy breathing and snoring; her face
was flushed, and she could not be roused.
Treatment.-Tinct. Opium, 1 drop per dose, every half
hour; she could be roused at the end of six or eight hours, and
recovered with paralysis of one eyelid and arm, which lasted
for two or three months. Is now well.-Ibid. Dr. BALL.
CASE 73.*-A child who had been sick for three or four
days, finally became stupid, and could not be roused. It recovered entirely under the use of Opium.-Ibid. Dr. BALL.
CASE 74.*-A man, subject to attacks of dizziness, fell
down insensible, and remained unconscious for twenty hours;



APPENDIX.
ON THE NATURE AND TREATMENT
OF.SOFTENING OF THE BRAIN AND PALSY."
SOFTENING- of the Brain is so closely related to, and so frequently connected with Apoplexy, that it would be almost
inexcusable to pass it over entirely here.  RocHoux, and
others, even maintain that the texture of the brain is almost
invariably softened prior to the occurrence of apoplectic effusions, which they suppose are occasioned by'the imperfect
support afforded under these circumstances to the blood-vessels
of the brain. Although exceptions to this rule are by no
means few, ROWLAND admits that, in many cases of Apoplexy
suddenly fatal, the brain is not only found softened, but also
bearing the marks of previous disease.
Again, one of the most remarkable varieties of the disease
is the Apoplectic Softening, so called from the suddenness and
peverity of the attack; comatose seizures are common to all
its forms, but sometimes the case assumes all the peculiarities of Sanguineous Apoplexy; although precursory symptoms of some kind generally precede these attacks, such as
headache, failure of intelligence, inaptitude of expression, pains
and weakness of the limbs, or other marks of disturbance of
the brain; but these warnings are generally extremely indistinct, when the comatose attack occurs.-ROWLAND.
The relation of this disease to Apoplexy is also manifested
in the manner of death; in seventy fatal cases, the death was
comatose in as many as forty, either from a sudden apoplectic



144


SOFTENING OF THE BRAIN.


disease is usually confined to a small portion of the brain.
The attack does not often commence with a distinct chill, or
the other phenomena that mark the onset of inflammation in
-viLal organs; in some cases, however, there are acceleration
of the pulse, heat of skin and scalp, and other signs of fever,
especially when the disease occupies the surface of the brain.
The first circumstance to excite attention is usually headache,
which is not always severe, but it is excessively harassing;
the pain seems to dart through the brain, and to proceed
from the centre of the organ, occupying now one spot, now
another, but having no fixed seat; it is always paroxysmal,
and sometimes intermittent. Accompanying the headache
there may be confusion of thought, and a settled apprehension
that the mind will be destroyed; at night, restlessness, excitement, and delirium come on, and sometimes a convulsive
paroxysm. These cases are apt to be attended with nausea
and vomiting.
Shortly afterwards, signs present themselves that foreshadow the coming danger; unusual sensations are felt in one
or both limbs of the same side; tinglings, prickings (pins
and needles), or numbness, with some degree of weakness,
alarm the patient with threatenings of palsy. At this period
the headache has probably fixed itself in one region, which
in many cases is on the side opposite to that of the limbs
whose functions are impaired.
The second stage of the disorder now begins;, the delirium
and restless excitement, the feeling of apprehension or terror,
give way to stupor, or indifference; the headache and vomiting cease, and the patient lies in a state of mental and bodily
torpor; the memory fails, there is great difficulty in comprehending questions, and in recollecting words suitable for a
reply; the face is dull and heavy, the pupils contracted, or
sometimes dilated, and insensible to light; the paralysis of
one side becomes more confirmed; the pulse is slow; the
skin at on' time flushed, at another covered with a clammy
sweat; the tongue is reddish and inclined to dryness; the
appetite bad, and bowels constipated.



CHRONIO, AND YELLOW SOFTENING, ETC.


147


" Such are the ordinary symptoms of cJhronic Softening.; it,may go on for years; while 11 cases of acute Softening termi'nated fatally in two-days, 26 other cases before the fifth day,
43 cases before the ninth day, 7 cases between the ninth and
twentieth days, and 9-more cases between the twentieth and
thirtieth days.-DAY.
"-In these cases, the pathological appearances may be either
Red-softening, from, chronic venous congestion and capillary
haenorrhage; or White-softening;' yellow patches on the con"volutions; or Yellowv-softening, with more or less fatty degeneration: These different varieties of 'course call for quite different treatment.
Accordiing to ROKITANSKY, Yellow-softening is founded upon
a chemico-pathological process. The yellow color is owing
to the presence of a thin, yellow, acid fluid, containing a number-of broken, extremely varicose, primary tubes, with their
contents of swollern blood globiles, very transparent fat globules of various sizes, and some yellow amocrphous pigment.
FREMY counsiders the brain to consist of Cerebric acid, either
free, or combined with Soda and Phosphate of lime; of Olophosphoric acid, both free and in combination with Soda; of
SOlein and Margarin;. of small quantities of Oleic and Margaric acids; of Cholesterine, water, and of a substance resembling white of an egg, but composed of 7 parts of albumen,
"5 parts of fatty matter, and 80 parts of water. The Oleo.
phosphoric acid, which is,usually yellow, is very variable in
its composition 'and cormbination, and readily separates into
Phosphoric acid and Olein from very slight causes. ROKITANSrY thinks that obstruction of the blood-vessels near the
softened part, from deposit of atheroma, or impermeability
of them  from pressure, and the consequent impeding and
interruption of the circulation in one portion of the brain, may
cause a lower state of vitality there, somewhat similar to that
which occurs in senile gangrene, and thus allow of the liberation of an acid or acids, viz., the phosphoric, and one or more
of the fatty acids, which then play a more important part in
-the farther process of Yellow-softening. This conjectureis



148


SOFIrENING OF THE BRAIN.


somewhat supported by the very decided acid reaction of the
fluid contained in the softened spot.
Another important.phenomenon in Yellow-softening is the
remarkable degree of swelling of the brain which Yellow-softening produces; softened spots, of the size of half a cubic
inch, or of a nut, give rise to quite a disproportionate turgescence. From these facts it may readily be conjectured
that the symptoms of Yellow-softening are severe and acute.
ROKITAWNSKY says, that it appears to be always, and often rapidly
fatal, still idiopathic Yellow-softening may last a longer time;
but the secondary variety, that which forms around apoplectic
clots or inflamed patches of the brain, often runs a rapid course.
It corresponds more nearly to the so-called acute ataxic variety than any other.
Treatment.-Arsenicum, Secale, and Phosphor-are homceopathic to that stage which resembles senile gangrene. If the
presence of atheroma can be conjectured by the presence of
peculiar hardness and inelasticity of the superficial arteries,
then the remedies pointed out for Atheroma (see page 38,)
will be brought in play. If the Softening be brought about
by a violent tonic, tetanic spasm, or constriction of the bloodvessels, similar to the violent contraction of the muscles which
is so characteristic a sign of Softening of the brain, then
Nux, Ignatia, Angustura, or Conium, and Opium, may be useful. The excessive swelling of the softened part, and consequent pressure upon the healthy part of the brain, together
with presence of an intensely acid fluid in the diseased part,
may call for Kali-hydroidicum, Baryta, Kali-carb., or Phosphor.
White-softening of the brain.-According to RoxITArsxr,
this consists in a loosening and subsequent maceration of the
substance of the brain by an interstitial effusion of serum.
Like cedema in general, it sometimes takes place without any
inflammation; at other times it is unquestionably so far inflammatory, that a certain quantity of coagulable lymph, capable
of assuming an elementary organization, is poured out with



TREATMENT OF APOPLEXY, ETC.


159


it is homoeopathic to Apoplexy when preceded by, or attended
with convulsionis, viz., in spasmodic and nervous Apoplexy;
alsoin bilious Apoplexy..It may prove antipathic when the
complexion bfthe patient is inusually white aid clear; when
there is a deficiency of bile, not only in the liver and bowels,
but'also in the whole system; and when paralysis is a predominant symptom.
FERRUM
Is apparently, although not absolutely allied in some of its
actions, to Bellad., Glonoine, Opium and Phosphor; but it is
more homoeopathic to truea arterial plethora and Apoplexy,
than any of these -remedies, except Glonoine and Phosphor.
It is somewhat antagonistic in its action to that of Conium,
Hydrocyanic Acid, and Plumbum. It is homeopathic to violent arterial congestion to the head, with powerful beating of
the.heart and arteries,, great redness and heat of the face,
heat of'skin, severe head-ache, heat and fulness of the head,
and dizziness, fiom rush of blood to the head. It is also homoeopathic, both symptpmatologically and pathologically,to h'emorrhagic Apoplexy, especially when there has been a
feeling as:if the brain' had received a sudden shock, or had
been rent asunder, soon followed by faintness and sense of
sinking, owing to rupture of a blood-vessel and pouring out of
Sblood in, or upon the brain.
-It is a4tipathic to the Apoplexies of anaemic and debilitated,persons; when the skin and lips are bloodless, the body
thin and feeble, the extremities cold, the mind weak and the
pulse feeble.
IPECAC
I's most suitable in gastric and nervous Apoplexy, especially
wfien there is'much nausea, and great asthmatic difficulty of
breathing.   '
GLONOINE
Ist most homceopathic to sudden and viblent congestive Apoplexies, It may prove the most antipathic remedy to anemia



\


IND DEX.


A.
PAGE
Apoplexy, Introduction to,.   to 4
"     Premonitions of,.  5 to 7
""    Preyention of,..  to 13
"  True or typical,. 14 to 19'
"     Simple or congestiv6,... 19 to 25
"     " Heemorrhagic,. 25 to 39
"     of Optic Thalami,     32
"  of Medulla Oblongata, 32
"  of Pons Variola,      33
"     of Crus Cerebri,      33
"     of White Substance of
Brain,,....    33
"     of Cerebellum,..    33
"     of Ventricles of Brain, 34
"     from Aneurism,..    34
"     from disease of the
Arteries,...    35
"     of the Meninges,      35
"     Sub-arachnoid,..    36
"     Intra-arachnoid,.    36
"     Febrile and Inflammatory,.. 39 to 40
"     Serous,.... 40 to 42
"     Nervous,... 42 to 44
"     from Disease of the
Heart,...       45
"     Bilious,...        4
"     from Derangement of
Stomach,..      48
"     Infantile,...      51,
"     Result of Old School
treatment,.. 4& 107
"C    Result of Homoeopathic treatment,      4
"     Secondary effects of,  53
Atheroma, nature of,...       37


"PAGE
"     Treatment of.       39
Aconite,.......    57 to 73
"   Cases treated with,
Nos. 1 to 9,... 69 to 73
Doses of,....           3
Agaricus,........74 to 76
" "    Doses of,...       76
Arnica,......... 76 to 81
"     Cases treated with,
INos. 10 to 13,. 79 to 80
"     Doses of,...       81
Atrophy of the Brain,...     29
"       ".  from lead, 116
B.
Baryta,.......   81 to 85
"   Cases treated with,
Nos. 14 to 16,..     84
"   Doses,......       85
Belladonna,......85 to 103
"     Cases treated with,
Nos. 18 to 34, 94 to 103
"     Doses of,...      103
Bloodletting,...       103 to 108
"       Results of,. 106 to 107
0.
Cocclus,.....       108 to 111
"   Cases treated with,
Nos. 35 to 37,       110
"c  Doses of,...        111
Conium nMaculatum,... 111 to 114
"      "     Doses of,     114
Crotalus,.......      114
"   Case treated with,     114
Cuprum and Plumbum,. 114 to 117
"         "      Doses of; 11