THE SPECIAL THERAPEUTICS OF THE NEW REMEDIES. MATERIA MEDICA AND SPECIAL THERAPEUTICS OF THE NEW REMEDIES. BY EDWIN M. HALE, M. D., PROFESSOR OF MATERIA MEDICA AND THERAPEUTICS OF THE NEW REMEDIES IN HAHNEMANN MEDICAL COLLEGE, CHICAGO: AUTHOR OF "LECTURES ON DISEASES OF THE HEART," "CHARACTERISTICS OF NEW REMEDIES," ETC. FOURTH EDITION- REVISED AND ENLARGED. IN TWO VOLUMES. VOL. II. SPECIAL THERAPEUTICS, WITH ILLUSTRATIVE CLINICAL CASES. BOERICKE AND TAFEL: NEW YORK AND PHILADELPHIA. ENGLAND: HENRY TURNER & COMPANY, OF LONDON. 187". Entered according to Act of Congress, in the year i875, by BOERICKE & TAFEL, In the Office of the Librarian of Congress, at Washington, D.C. TO w IMr. V'irbarb 3puaebo OF ENGLAND, AUTHOR OF THE MANUALS OF PHARMACODYNAMICS AND THERAPEUTICS, F0i0 Volume IS RESPECTFULLY DEDICATED BY THE AUTHOR. * * "Touching the open questions of medical opinion and practice — while each of us proclaims the opinions he has espoused, and zealously puts them in practice, let us cultivate the catholic and noble spirit of Chillingworth:'I will take no man's liberty of judgment from him, nor shall any man take mine from me, and what measure I mete out to others, I expect from them again."'"-CARROLL DUNHAM: Address before the American Institute of Homceopathy, I870. " Some people suppose that a physician, professing belief in the homceopathic law, is obliged to limit his practice strictly to the application of that law. He is not to administer a purgative, or to give an opiate, or to prescribe Quinine, or to recommend a mineral water, under any circumstances, without in some way incurring the suspicion of sailing under false colors, of having deserted his creed and betrayed his principles. To those who can not rise above the mere partisan spirit of cliques and schools, this may seem to be a righteous judgment. The man, however, who is loyal only to nature and to truth, regards such restrictions as sheer impertinence, and claims every thing which cures, be the process explainable or not, as inalienably his own. He is astonished at the blindness and bigotry of the old school, who permit the grandest treasures of the curative art to lie unrecognized before them. He sets them a nobler example. He cultivates assiduously his own special field of science, but if he finds any residuum of truth or usefulness in allopathy, or any other system, he asks no man's permission to use it; but acknowledging its source, appropriates it by divine right as the legitimate property of every healer of the sick."'-WM. H. HOLCOMBE: Address before the Hahnemann Medical Society of Cincinnati, I875. PR E F ACE. This volume contains my own personal experience in the therapeutical use of the New Remedies, together with the clinical experience of physicians belonging to the homceopathic and other schools of medicine. With some remedies this experience extends over a period of more than twenty years; with others a briefer time; a few of the medicines I have not used. In quoting the clinical experience of others I have tried to give all the authorities as far as attainable. I have not intended to show any preferences, for I believe in tolerating the largest liberty of opinion and practice. When the First Volume was in course of preparation, a few of my colleagues suggested that I should pursue the plan adopted'in the first two editions, namely: giving the day-books of the provers, and the authority for each symptom. After due consideration and consultation it was decided that such a plan was not necessary or desirable. The scope and purpose of the volume did not require it, for it was not intended as a general, but a special Symptomatology. In this volume, in my mention of each remedy, I have generally given its pathogenetic history, names of provers, etc. Moreover, Allen's Encyclopaedia of Materia Medica, now in course of publication, renders the citing of every authority altogether superfluous. Those who have any desire to ascertain the paternity, or investigate the original sources of my pathogeneticcharacteristic symptoms, are respectfully referred to the above mentioned work, wherein they are generally given with much accuracy. The few instances where I have appended the names of physicians to symptoms in Vol. I were inadvertencies; for it was not my intention to give any authority, except for some peculiar curative symptom, or indication, or for some very recent proving. I trust this explanation will serve as sufficient apology for any apparent omission or neglect in acknowledging my indebtedness to the many authorities from whom I have drawn. In this volume I have tried to explain the Law of Dose, based on the primary and secondary action of drugs, and have given some illustrations which appear to prove its truth. I expect it will meet with that persistent opposition and severe criticism, which greets every discovery or new principle; but my convictions are strong that when accepted and adopted it will prove of incalculable value in the advancement of our school of practice, and to the Art of Healing. EDWIN M. HALE. CHICAGO, July, I875. HOW TO USE THESE VOLUMES. It will be seen by the reader that these volumes complement each other. The student or practitioner should -have them both before him, and in the study of any particular medicine or disease, constant reference from the Symptomatology of a remedy, to its Special Therapeutics, will be necessary. The copious Therapeutical Index to this volume, it is to be hoped, will prove a valuable aid. THERAPEUTICS OF THE N EW REMEDIES. ABIES CANADENSIS. The use of the Hemlock Spruce for dyspepsia is empirical, and originated in domestic practice. A tincture of the buds made by maceration in whisky is said to have cured the following symptoms: A light-headed feeling, attended with a gnawing, hungry, faint feeling at the epigastrium, craving hunger, which if gratified was followed by distension of the stomach and hard beating of the heart. The condition represented by the above symptoms resembles that observed in catarrh of the stomach. Drs. Gatchell and Beckwith claim to have cured many cases having the above symptoms, with the tincture. A tincture of the gum of the Abies Nigra has caused and cured somewhat similar symptoms: (see Allen's "Encyclopedia of Mat. Med." Vol. I.) ACALYPHA INDICA. Ainslie in his Mat. Med. Indica says the Indian (Tamool) name for this plant is Koopamanie, and observes that the Hakeems (native physicians) prescribe it in consumption. 2 9 10 AESCULUS HIPPOCASTANUM. Dr. Tonnere, of Calcutta, claims to have cured some pulmonary symptoms, viz.: Dry cough, followed by spitting of blood. He, as well as Drs. Thomas and Holcombe, asserts that it will arrest hcemoptysis after all other remedies fail. It is indicated in expectoration of pure blood in the morning, and dark lumps of clotted blood in the evening. It cures this kind of haemorrhage, but not when caused by tuberculosis of the lungs. Z3SCULUS HIPPOCASTANUM. This is a veritable polycrest, having a wide range of action, but like some other polycrests,. it has a central point of action from which radiate a series of reflex symptoms. This central point of action is the liver and the portal system, and nine out of every ten of its symptoms are due to this action. I have found it analagous in its effects to Aloes, Collinsonia, Nux vomica, Sulphur and Podophyllum. It is not as poisonous as the Buckeye, its indigenous relative, for the nut is used in Europe to fatten animals, and they are often eaten with impunity by children; the meat of the seeds is sweet when boiled, but the rind is bitter. I think the tincture should be prepared from equal parts of the nut-meat, rind of the nut, and the bark of the tree or its root. In this way we shall be sure to get all its active medicinal principles. In my practice I have been most successful with it in the following disorders: Congestion of the liver, when accompanied by piles. It is indicated by the symptoms —aching, pinching pains in the right hypochondrium, aggravated by walking. The pain extends up between the shoulders. Constipation, when there is present a hard, knotty, dry condition of the stools, which are white. (If the stools are black or dark, or brown, knotty and hard, I prefer Nux vomica.) tHemorrhoids, if the following symptoms are present, are promptly removed by IEsculus. (It will not prove a suc LESCULUS HIPPOCASTANUM. 11 cessful routine remedy, but must be closely affiliated.) The tumors are protruding, or internal, are usually purple, hard, and very sore (not rawas in Aloes, but a bruised feeling), with aching, burning, rarely bleeding. The rectal symptoms are characteristic, and consist of very disagreeable sensations of dryness, soreness, constriction, fullness, and a feeling as if sticks, splinters, gravel or other foreign, irritating substances had become lodged in the rectum. We find also a feeling of fullness with protrusion, and a desire to strain (tenesmus). A zcharacteristic condition is usually present, which differentiates between this medicine and other pile remedies, namely: the absence of actual constipation. In nearly every case the stools are too frequent, and soft, sometimes quite loose, pale or dark, and rarely, if ever, large, dry, or scybalous. In this respect it resembles Aloes. I do not agree with Dr. Hughes, when he says, " when the only connected symptoms or appreciable cause is constipation, ALsculus is indicated; " for I believe its action on the portal system is the primary cause of its hmemorrhoidal symptoms, but I do agree with him in his belief that "when there is much pain, but little bleeding, AEsculus seems pretty likely to cure." My experience with AEsculus has been verified by the majority of physicians so that it may claim a high position as a remedy in diseases of the rectum. The pains in the back which attends its rectal symptoms are quite notable. They are sometimes shooting or cutting, but usually consist of a lameness as if strained, extending to the hips or legs, or an aching and weakness aggravated by walking, stooping, or any movement. Like Rhus, its pain and stiffness often goes off after continued motion. Dr. Guernsey advises it for a backache occurring during pregnancy when the pain is in the sacro-iliac symphysis, and prevents walking, because " that part of her back gives out, compelling her to sit down." I have prescribed it with'good results in slight cases of fissure of the anus, also in incipient stricture of the rectum. In prolapsus ani it compares favorably with Nitric acid, Podophyllum, and Mercury, which it 12 AESCULUS HIPPOCASTANUM. resembles in its pathological action. Nux and Ignatia cause prolapsus in a different way, namely: as a secondary paralysis of the circular fibers of the,intestinal and sphincter muscles. In some rare instances it will be found useful in headache when attended by constipation or piles. The pain is mostly confined to the occipital region, and is dull and pressing, or a bruised, stupefying aching with a sensation of heat. It has been recommended in influenza, and manlly of its symptoms bear a strong resemblance to those caused by a cold affecting the nose and throat. Dr. Buchmann says he cured, with Esculus, a chronic cough with emaciation. The symptoms point to a laryngeal origin of the cough, and it may be found' useful in catarrhal laryngitis, and possibly in some cases of cough of hepatic origin. Dr. Meyhoffer, in his "Chronic Diseases of the Organs of Respiration," says: "'2Esculus hippocastanum rendered us last winter great service in a case of pharyngo-laryngitis follicularis with considerable catarrhal inflammation of the lining of the throat and larynx, complicated with piles and the most obstinate costiveness of long standing; it not only restored the muscular contraction of the intestinal tube, but also greatly relieved the laryngeal irritation; cough and expectoration diminished speedily, and the signs of congestion in the affected parts diminished rapidly." In several cases of pain about the heart in heemorrhoidal subjects, it seemed to be of decided benefit. Dr. Neidhard says, " In a case of curvature of the spine the pains were entirely cured by tAsculus." Its action on the venous system, and mucous membranes, is undoubted. If it acts on the spinal cord, it is but sligllly, and not as intensely as the Buckeye. The lower attelluations have usually been prescribed. The triturations of the nut-meat (albumen) is generally used, but as before stated, I prefer a tincture of the various portions. Since writing the above, I observed a paper on this drug by Dr. Hart, of Wyoming, Ohio, who opposes Dr. Hughes' view of its action, and agrees with my opinion, namely: that the ~Esculus ii. is primarily homceopathic to portal and intra-abdominal conges AESCULUS HIPPOCASTANUM. 13 tions, and that the constipation is secondary.'Dr. Hart claims to have discovered a key-note to the employment of this remedy in a symptom not found in its pathogenesis: "Throbbing in the abdominal and pelvic cavities; especially the latter." Hence, he says, it is specially indicated in all active intraabdominal and pelvic congestions. I have prescribed it with invariable success in all cases of congestion and inflammation of the neck of the uterus, attended with the above mentioned symptoms. Nor is it necessary to use the remedy very low. One drop of iEsculus 6x, three or four times a day, has cured, in my hands, the most inveterate cases of inflamed cervix uteri, when not complicated with ulceration; and has greatly relieved, and sometimes cured similar cases attended with retroversion, prolapsus, ulceration, enlargement and induration, when characterized by great tenderness, heat and throbbing, as in the following cases: Mrs. C., aged 22, a small, delicate blonde, had suffered during the last five years with congestive dysmenorrhcea. Eight months ago she was thrown from a carriage, since which time she has been under both allopathic and homceopathic treatment for retroversion and prolapsus of the uterus. Growing worse under the treatment to which she was subjected at Denver City, she was brought to me for advice with the following result: Sept. 8. Semi-paralyzed, condition of the right lower extremity; muscles sore and contracted; has to be carried, being totally unable to walk; great weakness and emaciation; pulse 110, irregular and very weak; face flushed and eyes sparkling; bowels obstinately constipated; occasional nausea and vomiting; skin hot and dry; patient complains of great weakness and pain in the back, cephalalgia, and constant throbbing behind the pubes. A digital vaginal examination shows retroversion and enlargement. of the fundus, with great tenderness, heat and swelling of the cervix uteri, the vessels of which pulsate with great violence. Ordered the patient to lie constantly on the face and left 14 -ESCULUS GLABRA-AILANTUS GLANDULOSA. side; to use cold vaginal inject,ions three times a day, and to take lEsculus Cx, one globule every two hours, until the throbbing ceases, after which it is to be taken only twice a day. Sept. 12. Throbbing ceased. Continued treatment. Oct. 1. Patient greatly improved, and able to walk. Nov. 1. Patient dismissed cured. ZESCULUS GLABRA. This relative of the horse-chestnut has been neglected. It is doubtless a more powerful medicine than the latter, for the Buckeye cannot be eaten with safety by animals or men. From the meagre provings we have, it would seem to resemble Cocculus and Nux vomica. It has been found curative by Drs. Hill, P. H. Hale, Douglas and myself, in hcemorrhoids with the following symptoms: Very painful external tumors, dark purple, with constipation and vertigo; weakness of the sacrum and lower extremities. It is said that carrying the nut in the pocket, or wearing it on the body, will cure piles. Many physicians assert this to be a fact. Why not? May not the curative principle be absorbed in sufficient quantity? I would suggest its use in cerebro-spinal meningitis, when we have: Wry neck, vertigo, vomiting,- opisthotonus, tympanites, with stupor or coma. It has usually been prescribed in the first three triturations of the pulp of the ripe nut. AILANTUS GLANDULOSA. A careful study of the pathogenetic and toxical effects of this drug, cannot fail to convince one that it is a powerful blood-poison. When we compare drug-effects with diseases, AILANTUS GLANDULOSA. 15 we observe not only a similarity in symptoms, but a marked similarity in pathological effects. For example: the results of poisoning by Arsenic and Veratrum alb. compare closely with the toxic effects of cholera asiatica. The ultimate effects of Ailantus correspond to that condition and type of disease known as scarlatina maligna. Belladonna does not correspond to this form of the malady, but to the ordinary scarlatina of Sydenham. It is in the putrid, malignant and typhoid varieties of scarlet fever that Ailantus is indicated, not only by the symptoms, but the pathological state of the blood and secretions. Like the poison of the above disease, its morbific effects involve the brain and cerebro-spinal centers, and destroy life in the same manner. The eruption is peculiar; it is dark, almost livid, irregular, patchy, of a violet hue, even scaly, covering the whole body, or delayed and irregular in its appearance. In some cases there are large maculae or bullae filled with dark colored serum. It (the eruption) remains livid - it never takes on the genuine scarlet color. It sometimes takes the form of petechize. The fever is intense, with pungent heat, a rapid small pulse hardly to be counted, great thirst, delirium or coma, and heavy, hurried, irregular breathing. The head is burning hot, with great pain, eyes sparkling, with delirium, or inflamed (conjunctivitis.) The nose discharges a copious, thin sanious fluid, which irritates the skin, (Arum, Nit. ac., Ars.) or blood and pus; the tongue is of a livid hue, dry, parched and cracked; the throat livid and swollen; tonsils studded with numerous, deep, angry-looking ulcerations, exuding a scanty fcetid discharge; the pain when swallowing extends to the ears, and the teeth are covered with sordes. The urine is scanty, and voided unconsciously. This is certainly a vivid picture of disease, but the Ailantus has in many instances, in my own practice, appeared to dissipate this malignant condition. Drs. P. P. Wells, Small, Chambers, and others, have testified in its favor. Other physicians, however, have failed to get curative effects. Besides this disease the Ailantus has proved curative in 16 AILANTUS GLANDULOSA. congestion of the brain, purulent ophthalamia, conjunctivitis, ozoena, malignant ulcerated sore throat, tonsillitis with ulceration. and bronchitis, with asthmatic oppression, cough oppressed, deep and painful, with muco-purulent expectoration, free in the morning, sticky and scanty during the day, excessive tenderness all over-the lungs; feeling as if the air-cells were stuck together; inability to completely expand the lungs, crepitant rales; cough constant, dry, with oppressive, burning and stitching-aching pains in the chest. As these conditions often occur during the progress of measles and smallpox, as well as scarlatina, this remedy will meet all the indicatibns, not only in the latter disease, but all the eruptive fevers, when they are attended by the unfavorable symptoms above mentioned. In one case of cerebro-spinal meningitis I prescribed it with excellent results. The special symptom, in addition to the general condition, which led me to its selection, was " intolerable pain in the back of the neck, upper part of the back, and the right hip joint." Some of the symptoms indicate that we shall find it useful in malignant dysentery and some varieties of enteritis. Dr. Robert, a French surgeon, communicates a paper to the Archives of Naval Medicine, relating to the use, by the Chinese and Japanese physicians, of the bark of the root of Ailantus in dysentery. They use an infusion of the fresh bark, allowing the patient to drink it until it causes vomiting and ftecal stools. Dr. Robert tested its value; he used a tincture of the dried roots and bark in small doses, and found it superior to Mercury, Ipecac, or any other drug. He states that the blood began to decrease in a few days, and improvement set in soon, and continued steadily to convalescence. When we remember that this disease was tropical dysentery, and that dysentery in that hot climate is a far more serious one than in ours, the value of the Ailantus must have been very decidedly shown or Dr. Robert would not have considered it worthy of mention. ALETRIS FARINOSA. 17 ALETRIS FARINOSA. This is a remedy which has considerable reputation among western Homceopathists, but as yet no proving has been made of it. The clinical indications for its use were all obtained originally from eclectic practice. It has been a favorite remedy with me for many years for the peculiar anemtic debility of chlorotic girls and pregnant women. Given in the lower dilutions, alone or alternated with Ferrum, it will soon restore appetite, strength and the waning vitality. If such cases are attended by Dyspepsia, slow digestion and flatulence, the Aletris is very prominently indicated. I believe that certain remedies have such a special affinity for the reproductive organs of women, and that the term " uterine tonic " is not inaptly applied. Among the old remedies we have Calcarea and Sepia, which act in such a manner. Uterine atony, even to the extent of suspension of the menses or sterility, come under the curative sphere of this medicine. There are no characteristic symptoms yet known which specially indicate this remedy, but the general condition of the patient has been a sure guide to me in its selection. I have used it successfully for scanty, pale menses, where there was general debility, emaciation and impoverished blood. In the scanty menses of corpulent and plethoric women it is of no value. Prolaspus uteri, ante- or retroversion, where the dislocations depend on weakness in general, or of the uterine ligaments, can be cured by the lower dilutions of Aletris. Habitual abortion, or sterility, when caused by uterine irritability and weakness, is a condition for which the Aletris is almost a specific, if it is prescribed properly. It should be given during the few weeks before the expected miscarriage (three or four doses daily), and continued until the dreaded period has passed by several weeks, and its use 18 ALNUS RUBRA-AMPELOPSIS QUINQUEFOLIA. resorted to, afterwards, upon the slightest appearance o: threatening symptoms. It has been asserted on good author ity, that the fresh root has caused abortion; if so, like Sabina it is homceopathic to that accident. Several physician! have informed me that in cases even where pains and a shom of blood had appeared, it has succeeded, aided by quiet anc the recumbent posture, in warding off a miscarriage whici seemed imminent. Dr. Silas Jones, of New York, says it i, valuable during the first months of pregnancy, where ther( is excessive nausea, vomiting, faintness, giddiness, and pair in the hypogastrium. The tincture is intensely bitter and nauseous. In general, I prefer the 2x dil., although in some cases I like the action of the lx dil. best. ALNUS RUBRA.'Although a notice of this medicine appeared in all three editions of New Remedies, we know of no provings or clinical reports. I have had no experience with it, but have observed several cures in cases of obstinate chronic eruptions such as impetigo, prurigo, herpes, etc. It is said to be particularly useful in cases where eruptions on the skin alternate with diseased conditions of mucous membranes. Scrofulous enlargement of the glands, and even haematuria, have been, it is said, treated successfully with the Alnus. I am in doubt whether it is an "antipsoric" or not. The same may be said of the AMPELOPSIS QUINQUEFOLIA, which is said by Eclectics to affect the skin, mucous membranes and glandular system in nearly the same manner as the Alnus. Its continued use for a long time is said to cure obstinate cases of dropsy. Dr. Lee asserts that it is a stim ulant to the glands, and it is said to have cured enlarge AMYL NITRITE. 19 ments of the lymphatics. I have had no personal experience with it, but Dr. P. H. Hale believes that it restored the secretion of milk in a lying-in woman who was very weak, tearful and despondent. He gave it as a dernier ressort after Calcarea, Pulsatilla and other remedies had failed to affect the secretion. AMYL NITRITE. The Nitrite of Amyl is a singular and unique drug, having very little affinity for, and no close resemblance to, any other agent in our Materia Medica. Its only similarity to Glonoine is in the arterial relaxation it causes, which simulates congestion. But the arterial turgescence of Glonoine is active and forcible, and always accompanied by painful sensations. The congestion of Amyl is not due to any forcible rush of blood into the cerebral arteries, but a passive filling up, owing to relaxation of those vessels. Pain in the head is rarely present during the effects of Amyl, although it sometimes occurs at the height of its effect. It differs from Belladonna in the transient character of the cerebral fullness. Its action is of shorter duration than Glonoine, lasting but a minute or two in most cases. Its rapidity of action is another peculiarity of this drug. In thirty or forty seconds, whether inhaled, subcutaneously injected, or swallowed, its action begins, and shows itself by flushing the face, and starting the perspiration from the head, face and neck. This property makes it more valuable than Ether or Chloroform in cases of severe internal spasm with pain, such as angina pectoris, or in epilepsy and asthmatic sufferings. The most prominent symptoms induced when it is inhaled by man in moderate quantities (a few drops), are a sense of fullness and distension of the head, amounting at last to severe pain, and accompanied at last by intense flushing of the face, a deep, labored breathing, and an exceedingly rapid, violent action of the heart. The succession of these 20 AMYL NITRITE. phenomena is so rapid that often they seem to be simultaneous; but it is said that the cardiac disturbance is sometimes very distinctly manifest before the other symptoms. Dr. H. C. Wood, in his Materia Medica and Toxicology, says of its method of action: "I have found, as the results of numerous experiments made in the ordinary methods, that the diminution of reflex activity and of voluntary motion which undoubtedly occurs in toxoemia from this agent, is chiefly spinal in its origin: since, after death, the nerves and muscles preserve, though in an impaired condition, their functional power. In the motor centers of the cord, the Nitrite is a direct and powerful depressant, at the same time that it exerts a similar but much less pronounced action on the nerves and muscles, decreasing but not destroying their functional life. The diminution of reflex activity is never preceded by a stage of functional excitement. In some animals convulsions do occur, especially when the drug is administered by inhalation; but they are in all probability cerebral, not spinal, and due to the asphyxiating influence of the poison. Over the sensory nerves and centers, Nitrite of Amyl has but little power. They are among the last portions of the body to be affected, sensation being intact until near death, so that the drug is is in no sense an anaesthetic. The cause of death appears to be due to the failure of power in the cord, or respiratory centers higher up." The fact that it is not an anmesthetic does not militate against its power to relieve the pain of angina pectoris and similar painful affections. Angina is now supposed to be due to cramp, or a spasmodic contraction of the cardiac muscle. Cramp may cause the most agonizing pain known to man. A remedy that removes the cramp relieves the pain, not by any anesthetic power, but by relaxing the spasmodically-contracted muscle. Wood proves quite conclusively that its action on the arterial system is not that of a motor-stimulant. Its action is peripheric, not centric. In other words, its apparent stimulating action on the heart is reflex. It paralyzes the AMYL NITRITE. 21 arterioles, dilating them to such an extent that the heart gathers up and exerts its force violently for a short time; but if the inhalation be persisted in, its impulse constantly grows weaker, until its power is become extinguished. After this examination of its physiological and pathological action, the question arises, To what abnormal conditions and symptoms is the Amyl homoeopathic? It is primarily homoeopathic to those cases where there is dilatation of the arterioles, and a redness and flushing of the surface of the body, not due to any primary disturbance of cardiac power. The action of Amyl, according to eminent experimenters, is peripheric. It first exercises a paralyzing influence on the coats of the arterioles. This paralyzing influence spreads to the centers, and the heart itself is the last to feel its influence. This singular and unique quality of Amyl makes it one of the very few remedies which in their action correspond with the physical effects of the mental emotions. If you study the effects of. excessive joy, you will see a remarkable resemblance to the action of Amyl, namely: a sudden flushing of the face, a distension of the peripheral arteries, a quick, bounding pulse, and an increase in the number and frequency of the heart-beats. But during this period of increased action, there is really a diminution of arterial pressure at the surface of the body. Sometimes after this Amyl-flushing has lasted a few moments, the face changes to paleness and coldness, and a faintness supervenes, and the same occurs after the flushings of joy. Other mental emotions have a similar action. Joy is only one example. Amyl is homceopathic to all such symptoms. It is a singular and suggestive fact, and makes us very hopeful of the final acception of the law of Similia by the best men of all schools, that the foremost man in the Allopathic ranks in England, Dr. Sidney Ringer, recommends, from his own actual experience, the Nitrite of Amyl for the very symptoms and conditions which it primarily causes. I quote from his "Therapeutics," —a splendid work, which should be in the hands of every homceopathic physician. (The italics are my own.) He says: 22 AMYL NITRITE. Dr. Brunton shows that it relaxes the whole arterial system, probably by partially paralyzing the sympathetic ganglia, and motor nerves. This paralyzing effect of the arterial system is well shown by the sphygmographic tracings, the flushing of the face, and the increase in the size of visible arteries like the temporal, which oftten becomes notably large, sometimes, indeed, being doubled in size, and branches previously invisible become plainly apparent; and by the interesting fact observed by Talfourd Jones, who while cupping a patient over the loins and finding that the blood would not flow, administered Nitrite of Amyl by inhalation, when the cuts immediately began to bleed freely. After an inhalation, the larger arteries are slower in recovering their normal size than the capillaries, a phenomena well observed in the temporal artery, which remains enlarged half a minute or longer after the blush has quite left the face. Dr. Brunton first, employed Nitrite of Amyl in angina pectoris with signal success, and found it more effective than any other remedy in this painful and dangerous disease. During an attack, his patient suffered from throbbing of the heart and carotids as high as the ears, with severe proecordial pain extending to the right arm. The usual characteristic "sense of impending death" was absent. The pulse was slightly quickened and the sphygmographic tracing became modified, for as Dr. Brunton states, "as the pain increased the curve became lower, both the ascent and descent more gradual, and dichrotism disappeared. This form of curve clearly indicates that the arterial tension is much increased, and can, I think, be due only to contraction of the small systemic vessels." The increased tension first led Dr. Brunton to employ Nitrite of Amyl. In the case in question he considers that the attack consisted of spasmodic contraction of some, if not all, of the small systemic and pulmonary vessels, which state of arterial tension gave way on inhaling the Nitrite, and the pain then disappeared. On the recurrence of an attack, the patient inhaled the Nitrite of Amyl, and always obtained instantaneous relief. Dr. Anstie reports a well-marked case of angina greatly relieved by this treatment. He says, "the first sniff produced, after an interval of a few seconds, the characteristic flushing of the face, and sense of fullness of the head; the heart gave one strong beat, and then he passed from the state of agony to one of perfect repose and peace, and at his usual bed-time slept naturally. This experience has, I am happy to say, been repeated on several occasions, and with this fortunate result; that so confident now is the patient of being able to cut short the paroxysm that he has discarded all use of ether, and greatly reduced his allowance of stimulants." Dr. Talfourd Jones also finds it very useful in angina. Since the previous edition of this work, Nitrite of Amyl has been largely used in angina, and with considerable success. Indeed, in most cases no other remedy affords so much relief. As might be expected, it is not uniformly successful. Thus, in one case due, as we discovered after death, to aneurism of the heart immediately below the aortic valve, an inhalation always arrested the pain, but it returned after a few seconds or minutes, even if the administration were several times repeated, and was as severe and lasting as when no Amyl was used. In another case, whilst it gave great relief, always arresting the paroxysm, it took ten minutes to effect this, and was in no way superior to a full dose of Ether, which the patient preferred, as the Amyl produced so much giddiness and sensation of fullness in the head. In three other AMYL NITRITE. 23 cases, however, it proved strikingly successful. In one desperate case, the slightest exertion brought on intense pain; but by the aid of Amyl, the patient could always at once cut short the attack, so that now he can walk several miles, though he is obliged during his journey to employ the Amyl several times. It has appeared to me that by at once checking the paroxysm the attacks come on less frequently and less severely, and after a time a much smaller quantity suffices to control the pain; so that Aniyl really contributes to the prolonged relief of these unhappy patients. Dr. Talfourd Jones found it remarkably successful in very severe attacks of asthma, removing the dyspncea immediately and averting its return. Others have found it very useful in asthma. He found it useful also in a case of cardiac dyspncea, accompanied by extreme anasarca, due to a dilated and hypertrophied heart. Dr. Sanderson suggests that it may be a relaxer of spasm generally, and Dr. Anstie has used it with success in cases of spasm of the stomach. Dr. Talfourd Jones advises inhalation of the Nitrite in syncope, and thinks it should be of service in the paroxysm of whooping cough. It is useful in neuralgia, at least in neuralgia affecting the fifth nerve. It often eases the pain at once, ana in some cases a single administration has averted further attacks, but so signal a result as this is probably exceptional. Dr. Richardson finds that Nitrite of Amyl arrests in frogs the convulsions due to strychnia, and in this way he has saved their lives; and he advises a trial of the Nitrite, either by inhalation or subcutaneous injection, in strychnia poisoning and tetanus. In the foregoing diseases it is better to administer this remedy by inhalation, for, according to Brunton, it will not answer with anything like the same certainty when given by the stomach; for in the striking case of angina pectoris just cited, he gave ten minims in brandy by the stomach, with the effect of staying the pain for only a short time, but a single inhalation afforded perfect and permanent relief from the attack. It should be borne in mind that it affects some persons much more than others; one individual being able to inhale five or ten drops from a handkerchief, or to breathe the fumes from the bottle held close to the nose, while another on smelling a whiff from the bottle held at a distance, will become affected with great giddiness, much mental confusion, and general weakness. Jones directs five or ten drops poured on a handkerchief, or the fumes from the bottle held close to the nose, to be inhaled till the pulse quickens, when the inhalation should be discontinued; but this plan is far too potent for some persons, especially feeble and sensitive women, who in the first instance should inhale a much weaker dose. As Jones points out, patients become habituated to it so that after a while it must be inhaled several times before it affords relief. This habituation is well exemplified in the internal administration of the remedy. Jones also finds that by exposure it gets "flat " and loses its efficacy. Nitrite of Amyl is generally considered a powerful and even dangerous remedy, whose administration must be watched with great care, and only a measured quantity employed. I am sure it is not nearly so dangerous as is generally imagined, though it is true that nervous, sensitive women are far more powerfully affected by it than men. No doubt its administration at first should be conducted by a doctor, in order to ascertain how far the patient is 24 AMYL NITRITE. susceptible to its influence, and that the patient may learn when he ought to discontinue the inhalation. But after one or two inhalations, patients soon learn how to administer it to themselves. I have now five patients with angina pectoris, who always carry with them a small bottle of this medicine, and on the first warning of an attack they at once begin to sniff at the bottle, whether walking or standing. This they have done for months, and one patient for just a year, using the inhalation many times daily, so that he consumes about two drachms a fortnight with still unfailing relief. Except in relieving the angina, the Amyl seems to produce no other effect on the system. Dr. Jones recommends a trial of it in epilepsy. To an epileptic patient, who, in addition to severe and repeated attacks, suffered from much mental confusion, and was haunted many times a day with an indescribable dread and sensation as of an oncoming fit, although it came on only once or twice a week, the author gave it in three-drop doses thrice daily, and an additional dose on the earliest warnings of a fit. Amyl lessened considerably the frequency of the fits, and entirely removed the harassing sensations. Dr. Crichton Browne has lately published some valuable observations on the use of Nitrite of Amyl.in this disease. In two rabbits made artificially epileptic, he prevented the oncoming of the convulsions which otherwise follow the application of the electrodes to fhe brain, by making them inhale Nitrite of Amyl. By the same means he has likewise arrested epileptic attacks on the occurrence of the aura before the onset of the fit, and has even cut short the fit after its commencement. He has, too, obtained very satisfactory results in that form of epilepsy called status epilepticus, -a condition consisting essentially of a succession of fits, linked together by intervening unconsciousness, the fits recurring with greater frequency till at last no sooner is one fit ended, nay, before it has finished, another fit begins. Fits like these he has arrested, and has rescued several patients out of this desperate plight. Amongst other successful cases, Dr. Weir Mitchell reports one, where the remedy was used immediately the aura was perceived, and other cases where the spasms lasted for hours, one fit following another. These two gentlemen give it by inhalation. Since my last edition, I have given this remedy with considerable success to several epileptic out-patients, in whom the attacks have been very frequent. In some it has appeared to be more useful than full doses (20 to 30 gr.) of Bromide of Potassium thrice daily; in another case, whilst it decidedly lessened the frequency of the attacks, it was less serviceable than Bromide of Potassium. I have given it in two to five minim doses suspended in mucilage, every three hours or three times a day, and have not found these doses produce any unpleasant effects in these epileptics, nay, in some cases they have not even caused flushing, whilst in other cases patients have told me that they flush with each dose, but only whilst swallowing it. The patient should take the medicine whilst lying down; and as some patients, especially women, are very readily affected by the drug, it is well in the first instance to give it in smaller doses. But until the remedy is pushed to two and in some cases to five minims every three hours, I have failed to obtain conspicuous results. Dr. Crichton Browne maintains that epileptics are more sensitive than others to inhalation of Amyl administered in this way. I imagine that this medicine will be useful only where the attacks are frequent, and that it cannot be given thus, where they occur only at comparatively long intervals, as three weeks or a month. AMYL NITRITE. 25 Inhalation of Nitrite of Amyl has been recommended in sick headache, and one successful case is reported by 0. Berger. The author has used this remedy extensively with considerable success in cases of the following kind: A woman, perhaps from the siudden arrest of menstruation, depraved health, or nervous depression, or, more frequently, at the change of life, suffers from frequent attacks of flushings or "heats," starting from various parts, as the face, epigastrium, etc., thence spreading over the greater part of the body. The face, and even the backs of the hands, are often deeply reddened, the veins of the hands in some cases dilating to double the previous size. Sometimes, although the patient feels deeply flushed, the skin remains natural. The sensation of heat may be so urgent that the patient opens her clothes or removes the greater part of the bed-covering, and even throws open the window in the coldest weather. These heats may last a few minutes only, or an hour or more, and may be repeated may times a day. Sometimes they occur chiefly at night, greatly disturbing sleep. They are generally followed by perspiration, often very profuse, at other times the skin remains dry, the attacks are then commonly termed "dry heats," the "heats" are often accompanied by great throbbing throughout the whole body, and are followed by much prostration, the patient feeling scarcely able to rouse herself. After the heats pass away, the skin becomes cold and clammy, and may turn very pale. The least exertion or excitement may bring on these heats, and such a patient generally complains of cold feet. and sometimes of cold hands. The flushings are occasionally peculiarly and abruptly limited, reaching to the thighs, knees or elbows, and while all the parts above these feel burning hot, the parts below feel icy cold; sleep, too, is often much broken, the patient waking with frequent starts, and in the morning feeling unrefreshed. In many cases palpitation or "flutterings at the heart" occur on the slightest excitement, or even without apparent cause. Nitrite of Amy! prevents or greatly lessens these flushings or "heats," and averts the profuse perspiration, throbbing of vessels and great prostration. Sometimes it warms the feet and hands, and controls the fluttering of the heart, but in most cases it leaves these symptoms unaffected, and for their cure other remedies, as iron, are required. Amyl removes also giddiness, confusion of mind, heaviness in the head, and even headache; it generally produces calm, refreshing sleep. When the flushings and perspiration are slight, this remedy is scarcely needed; moreover, the perspirations are.generally considered vicarious and beneficial at the change of life. These symptoms, in many cases, form only a minor part of the troubles of the patient, who may complain of great sinking at the epigastrium, or severe pains in different parts of the body, and other sufferings incident to this period, over which Nitrite of Amyl has little if any influence. But when flushings, etc., constitute the chief part of the patients' troubles, this medicine is most serviceable. The Nitrite of Amyl in ten days completely cured the following singular case of a woman who had been horribly tormented, for three years, with attacks, repeated several times daily, of severe burning sensation over the loins, from whence a glow of heat spread over the whole body, followed by perspiration. The burning sensation was so unendurable that she was constrained to open the window at night even in Winter, and sometimes to rush out of doors. 3. 26 AMYL NITRITE. For the symptoms thus described, the author has generally administered this drug by the stomach, though inhalation answers as well. In respect of dose it must be borne in mind that, like Glonoine (Nitro-glycerine), its effects vary very greatly with different persons. One, two,,or even three minims produce in some only flushing of the face and slight giddiness, while with others even a drop will induce various disagreeable symptoms. Thus one woman immediately after a drop dose turned deadly pale, felt very giddy, and then became partially unconscious, remaining so for ten minutes. In another patient the same dose produced a sensation as if " a vapor spread from the throat through her head," and rendered her quite powerless for one or two seconds. A third of a minim dose sometimes excites great nausea or a tickling in the throat; and one delicate woman after one-thirtieth of a drop passed for a few minutes after each dose into a trance-like state, everything to her seeming unreal, and the breathing becoming rather panting. The author began with a minim dose, but was obliged to reduce this quantity, and he ultimately found that, for the most part, those patients can bear one-third of a minim without any disagreeable symptoms, but that a tenth, nay, even a thirtieth of a minim will in some patients produce the desired effect on flushing. It may be dissolved in rectified spirits: two minims to the drachm, and of this three to five drops should be taken on sugar every three hours, with an additional dose as soon as a flush begins. Relief generally ensues immediately, but sometimes not till the medicine has been taken for a week. As the patient grows accustomed to the remedy, the dose must be increased. Dr. H. L. Waldo, of Troy, N.Y., in a paper on the Nitrite of Amyl, takes a somewhat different view of its action than I have given. I quote his remarks, and also his clinical observations: Its power over all forms of spasmodic diseases is exerted by virtue of its direct action on the ganglionic centers of the sympathetic system, and not by any stimulating or paralyzing action on the capillaries, or any direct sedative action on muscular tissue, as certain allopathic physicians would have us believe. The vaso-motor nerves, which are a part of the great sympathetic system, supply the muscular coat of the arteries, and thereby regulate the expansion and contraction of these tubes, and so determine the amount of blood that shall pass through them. It is well known that all spasmodic diseases, as asthma, chorea, epilepsy, etc., are due to a deficient innervation, and in turn this deficient innervation is due to a deficient supply of blood to the nerve centers; and this deficient supply is due to an irritation of the cerebral ganglia, which is transmitted by the vaso-motor nerves to the coats of the arteries, causing them to contract. Now, Nitrite of Amyl acts directly on the cerebral ganglia of the sympathetic, and produces a commotion in the circulatory system, similar to that which occurs in an epileptic fit. "When it is given rapidly, the lungs and brain are found blanched, and the left side of the heart empty, though the right cavities are gorged with blood. If given slowly, it leaves a congested state of the brain and lungs, and blood is found in both sides of the heart." (U. S. Dispensatory.) We see that its action falls almost entirely on the nerves of the arteries, AMYL NITRITE. 27 scarcely any at all upon those of the veins; thereby greatly modifying the supply of blood to the brain, but not greatly influencing its return to the heart, and this again is just the state of things found in epilepsy. In chorea and spasmodic asthma, the spasm is due to the same cause, though it differs in extent. In syncope, too, we find the same condition of the cerebral circulation to which Nitrite of Amyl has just been proved to be so peculiarly homceopathic, and in this affection it has been found very useful by allopathic physicians. It is a powerful cardiac stimulant. The excitement which it produces is followed by diminished but not extinguished action of the heart. A reduction of the respiration and circulation so extreme as to resemble trance, may be induced and maintained for hours. Muscular action is at first " wildly excited" and then subdued by its use. I fully believe that if administered just before an epileptic fit is to occur, it will prevent the spasm of vessels, and hence prevent the fit every time; and in several cases that have come to my knowledge, it has thus far proved permanently curative, preventing any recurrence of the fits. In a case of seven years' standing, brought on by masturbation, now under treatment, the patient carries a vial of it in his pocket, and when the aura occurs, takes a few inspirations from it, and thus far has not failed to throw off the fits, a good many of which would certainly have occurred but for this treatment. Two fits have occurred while he was asleep and could not use the remedy. I have used it in several severe cases of eclampsia or fits in children, produced by various causes, and with the invariable result of at once breaking the fit. In a case of. meningitis caused by a fall, while the child was kept under its influence the fits were prevented or at once broken, but the child died in a few hours from the severity of the disease. It may be inhaled directly from a small vial, or five or ten drops may be put on a sponge or small cloth, from which it may be inhaled. For children I make the first decimal dilution with alcohol, and put ten or fifteen drops on a handkerchief and hold it near the nose.-Amer. Your. Materia Medica. Dr. H. C. Wood, in speaking of its use in Angina pectoris, says: "There is now abundant evidence of its value in relieving, almost instantly, agony which has resisted all other treatment, whether valvular disease or merely functional disorder exists." He adds, however, that " in cases of advanced fatty degeneration, or of very great dilatation of the heart, I think its use would be attended with danger, owing to its effect upon the heart's muscle." Here we have the opinion of one who only looks upon its apparent antipathic action, and the administration of large quantities by inhalation. But we can view it in another light. It is homceopathic to the very condition of debility alluded to by Wood, and in minute doses it may act promptly as a curative agent. 28 AMYL NITRITE. It will be remembered that we were warned against using Chloral in cases of weakened heart, because in large or toxic doses it paralyzed the heart. But it has been demonstrated many times, by myself and others of our school, that in small doses it actually strengthens failing cardaic power; as witness the remarkable case reported by Drs. Swan and Helmuth, and quoted under " Chloral." Pathogenesis. The characteristic symptoms of Amyl, so far as we have gained the knowledge of them, have appeared in Allen's Encyc. of Mat. Med., Vol. I, from which I quote them, adding a few which I have gleaned from other sources. Through an inadvertence they were omitted in Vol. I, "Special Symptomatology " —and are therefore appended hereunto. M[ind. Anxiety, as if something might happen, must have fresh air. Actual fright, at the throbbing in the head, and a bursting out feeling in the ears. Mental confusion and a dream-like state. She passed for a few minutes, after each dose of one-thirieth of a drop, into a trance-like state, every thing seeming to her unreal. Head. Great confusion of the head, with vertigo. Heat and throbbing in the head, with a feeling of intense fullness, with great heat and flushing of the face. * Beating, throbbing, bursting sensation in the- head and ears, with constriction of the throat and heart. Visible pulsating throbbing in the temples, with sense of tension in the temples. Sensation of something rushing upward; and throbbing in the vertex. Heavy, dull aching all through the head. It causes no severe pain in the head, until the acme of its effects is reached. Sensation as if a vapor spread from her, through her head, and rendered her powerless. AMYL NITRITE. 29 Face. Flushing of the face, a bright scarlet. It becomes intensely red and hot; on passing off the face became paler than usual. A sensation as if the blood would start through the skin of the face, with lachrymation. The flushing of the face is attended by heat and perspiration of the head, face and neck, while the hands and feet become very cold, and sometimes continue so for hours. 0 Flushing and perspirations of the face and neck of women at the change of life. 0 Neuralgia of fifth nerve. Eyes. Protruding, staring eyes, with bloodshot conjunctiva. Pupils dilated. Sight very hazy, the outline of objects indistinct. A spot on the wall appears of a yellowish hue, surrounded by a yellowish circle, and this again surrounded by a violetblue halo, with undulating edges. Under the ophthalmoscope, the veins of the disc were seen to become enlarged, varicose, and tortuous; the arteries small but not abnormally so. Urinary Organs. It causes a very profuse flow of urine, which contains an abundance of Sugar (in animals). Ears. Much throbbing in ears. Bursting sensation in ears, as if membrani tympani of each ear would be forced out with each beat of the heart. Nose. Pressure over the root of the nose. Throat. Choking feeling in the throat on each side of the trachea, along the carotids. 30 AMYL NITRITE. Feeling of constriction. The collar seemed too tight, with desire to loosen it. Tickling in the throat. Stomach. Slight nausea, with uncomfortable feeling of the stomach. Constriction, and pressure over the region of the preecordia, as though he wants to rub it. Spasm of the stomach (Dr. Anstie.) Chest and Respiration. The feeling of constriction in the throat extended to the chest, and produced dyspncea and asthmatic feeling in the larynx and trachea, with desire to eructate. An indescribable feeling of fullness about the chest, with involuntary coughing, but the normal respirations are not altered in frequency. It sometimes causes slight dyspncea, or breathlessness, with inclination to cough. A desire to sigh convulsively. ~ Asthma, it removes the dyspncea immediately, and prevents its return. Heart and Circulation. * Pracordial anxiety. * The beating of the heart and of the carotids is, in some persons, very marked. * Accelerated heart action, with increased frequency of cardiac pulsations. * Great cardiac oppression and tumultuous heart action. * An aching pain and constriction around the heart. (This sensation continued, more or less, for three weeks; was relieved by taking Cactus.) It invariably quickens the pulse, but in a very variable degree; sometimes doubling its pace. While the pulse is always increased in frequency, it is not in force. Pulse irregular and jerking. APOCYNUM ANDROSEMIFOLIUM. 31 It relaxes the whole arterial system, probably by partially paralyzing the sympathetic ganglia and motor nerves. ~ Angina pectoris, with throbbing of the heart and carotids, as high as the ears. Very severe prmecordial pain, extending to the right arm. (Dr. Sidney Ringer.) * Angina pectoris, with great agony. (Drs. Brunton, Anstie and Talfourd Jones.) Extremities. Tired feeling of the limbs. Tremulousness of the hand, and stiffness and slight numbness of the fingers. Generalities. General relaxed, weak feeling all over the whole body. General sudden pe'ispiration. She turned deadly pale, felt very giddy, then became partially unconscious, remaining so for ten minutes. A feeling of increased warmth and perspiration over the whole body, especially the head, face and neck, while the hands and feet may become very cold, and remain so for many hours. o A severe burning sensation over the loins, from whence a glow of heat spreads over the whole body, followed by perspiration. This sensation was so unendurable that she would rush to open a window at night, even in the winter, and sometimes rush out-doors. (This symptom had lasted three years, with several attacks daily, and was cured in ten days.) (Dr. Ringer.) APOCYNUM ANDROSEMIFOLIUM. Although belonging to the same genus as the A. cannabinum, it certainly differs very much from it in its specific action. The sphere of action of the Dog's-bane includes the muscular and fibrous tissues, especially those of the smaller extremities. 32 - APOCYIUM.CANNABINUM. My experience with this remedy has been quite limited. I have used it successfully in two cases of " rheumatic gout," so called by an English surgeon of eminence. The symptoms corresponded so nearly that it was given in preference to Bryonia or Benzoic acid. Dr. Williams, of St. Paul, Minn., writes that he considers it the chief remedy for acute rheumatic affections in that region. When the acute pains in the joints are attended by cramps, bilious stools, and flying pains in the teeth, it will be well indicated, according to Dr. Henry's heroic provings. Its curative power in dropsy is very much inferior to A. cannabinum, if it has any such power at all. The tincture in drop doses has been known to expel ascarides and other worms. Its analogues are probably Bryonia, Iris, Colchicum, and a few others, but the drug needs further development to determine its true place. APOCYNUM CANNABINUM. This should not be confounded with the India Hemp (Cannabis indica), a drug which has little or no analogy to this plant, and belongs to another family. This is one of those remedies whose sphere of action is very limited, but in that sphere it is of immense importance. Its pathogenetic and curative action appears to be confined almost wholly to the kidneys- all the other symptoms seem to be the result. This action on the kidneys does not seem to go beyond passive congestion, with some irritation of the urinary mucous membrane, for even in the most heroic provings no trace of blood, epithelium, or other abnormal sediment is observable in the urine. Primarily it causes profuse discharges, the secretion being very light colored. Secondarily it causes a peculiar torpid action of the kidneys, very scanty urine, but no pain, or renal tenderness. I do not doubt but it could cause vesical and urethral pain, for it has cured such conditions. This medicine had a reputation for the cure of dropsy, in APOCY~UM CANNABINUM. 33 the early history of this country, and has retained that reputation in all systems of practice. Homceopathists have made many brilliant cures where they have used it rationally. Dropsy, in its various forms, is the chief curative sphere of Apocynum c., but renal dropsy is strictly the proper sphere of its action, Other dropsies may be temporarily removed or palliated by its use, but not cured. It is this palliative power which gave it the name, among the early physicians, of the " vegetable trocar," meaning that its value was similar to that of tapping. Anasarca, ascites, oedema of the legs, and even hydrothorax, may all proceed from suspended action of the kidneys, as an idiopathic affection. When this is the case the Indian hemp properly administered will rarely fail to cure, if no structural disease of the kidneys exists. I will here repeat the two rules, given by me in New Remedies, as a guide to its administration: (1.) In cases of acute, idiopathic dropsies, use the dilutions, beginning with the high, and descending more or less rapidly, according to the progress of the disease. (2.) In chronic, atonic, or secondary dropsies, use the tincture, or the decoction in one or two-drachm doses. The most brilliant cures ever made with the Apoc. were made with the infusion or decoction (~j to one quart of hot water), in doses of half a drachm to four drachms. Even in acute dropsies the infusion acts more promptly than the tincture. This infusion can be "run up " to the third dilution, in water, if that strength is preferred. Like Digitalis, the Apoc. c. is often apparently inert if given in the alcoholic tincture. There is no variety of dropsy but may be amenable to its palliative, if not its curative, action. Even in dropsy from organic diseases of the heart, it will keep down the effusion and allow the heart a chance to regain much of its former strength. In post-searlatinal dropsy; or simple, uncomplicated albuminuria, it will often prove promptly curative. Bright's disease can not be cured by this medicine, and 34 APOCYNUM CANNABINUM. rarely by any other, but the dropsy may be kept in check sc long as any considerable portion of the kidney is free fron organic changes. Hydrocephalus has doubtless been cured by Apoc. c., if we are to accept the statement of two eminent physicians, one of each school of medicine (seesecond Ed. New Remedies), The symptoms were: "(1) Sutures of the head opened: forehead projecting, sight of one eye lost, the other almost; child lying in a stupor with constant involuntary motion of one arm and leg;" and, (2) "Paralysis of left side, one eye motionless, the other rolling, bowels disturbed, pulse slow." In the first case drachm doses of a weaker infusion cured. In the second, drop doses of the tincture. I think I have cured two cases with it, while it has failed in a great many, but in this respect it is no worse than the Hellebore, which has been so highly praised, and so unsuccessful. In addition to its value in dropsy, the Apoc. c. has been used successfully in other disorders. Nasal catarrh has been caused and cured by its use. The catarrhal symptoms are: " Peculiar dryness of the mucous membrane of the nose, with a sensation of stiffness, followed by secretion of thick, yellow mucus, preceded in some cases by a thin, irritating discharge. For this species of coryza the 2x trit. of the root is snuffed up the nose. The eyes, throat, and bronchia are affected with the same catarrh, which accounts for its popularity in bronchial and asthmatic coughs, for which it is certainly useful, as I have often proved. Diabetes insipidus is one of the primary conditions caused by this drug, and the characteristic concomitant symptom is: " A sense of sinking at the pit of the stomach, with great debility." Like all powerful diuretics, the Apoc. c. sometimes proves powerfully emetic and cathartic. In dropsy, when the stomach is very irritable, and vomiting of all drinks is a troublesome symptom, the Apoc. often corrects it immediately. Dr. Paine recommends it in diarrhoea, intestinal hcemorrhage and APOMORPHIN. 35 cholera infantum, but I have never had any experience with it in such cases. Uterine hemorrhage has been cured by Apoc. c., according to Dr. Marsden, who gives us the only clinical experience we have of its use in that affection. In one case (menorrhagia) the flow was profuse, clotted, and attended by "great irritability of the stomach," fainting, etc. In another case the hoemorrhage occurred at the change of life, but was checked in a week, after lasting six. Several other cases of long continued haemorrhage Dr. M. reports cured by the Apoc. in drop doses of the tincture. In my practice it has appeared to restore the menses when given for dropsical conditions, and Dr. Barnes, of California, reports that he often cures with it, amenorrhcea in young girls, when attended with bloating of the abdomen and extremities. Dr. Lindsay reports his own case of severe hremoptysis, which had resisted the use of Acon., Ham., China and Erig., but was promptly checked by Apoc. 1 x, repeated every few minutes. Another physician says he has checked pulmonary hemorrhage in consumptives with it. It would seem from the cures of hemorrhage reported that it acts very similarly to Ipecac in such cases, and is indicated by very nearly the same symptom, namely: the vomiting, or nausea. APOMORPHIN. This new alkaloid of Opium was discovered by Dr. Matthieson. It is a snow-white powder, which is permanent when dry, but when moist soon becomes green. A solution suffers this change in a few hours, and in.a few weeks the green color turns to black. For homceopathic use, triturations should be made with pure, dry sugar of milk, and kept closely corked. I ought to say that Dr. Dyche Brown says the 3d centesimal dilution does keep its virtues a long time. One of the most remarkable effects Qf this alkaloid is sudden vomiting. As small a quantity as one-twentieth or 36 APOMORPHIN. one-fifteenth of a grain injected under the skin of an adult man, will cause copious vomiting in five or ten minutes. Dr. Blackley (British Journal of Homceopathy, 1873), gives a graphic account of its action. He injected ten minims of a ten per cent. solution of Apomorphin under the skin of his left arm. During the first two minutes no effect was produced. After about ten minutes, the pulse began to rise slightly, and the respirations became slightly accelerated. At the end of four minutes he felt a sudden qualmishness, which was almost immediately followed by nausea and profuse vomiting. This continued for several minutes, and was followed, as soon as the contents of the stomach had been evacuated, by severe retching. On taking a draught of water with a little brandy in it, this was immediately rejected; the same occurred after drinking cold water. No bile, however, came up in the vomited matter. At the end of seven or eight minutes from the commencement of the experiment, he began to feel very faint, and was compelled to lie down, and almost immediately on doing so fainted entirely, and remained in a state of syncope for about five minutes. On awaking from this he felt giddy and chilly. He took a little brandy and water, which was retained. He then became drowsy, and slept an hour, during which he perspired profusely. On rising, he felt slight giddiness, but no desire to vomit; slept soundly all night; awoke pale and hungry. Dr. B. made several experiments on animals, in which it developed more grave symptoms, convulsive and cerebral; but I doubt if they are useful to us. The question arises, what use can we make of such a powerful drug? It will be noted that the vomiting is marked by suddenness, completeness, and the absence of pain, or continued nausea. It occurs to me that we shall find it the safest and quickest emetic in cases of poisoning, when the object is to evacuate the poison as soon as possible. In such cases inject hypodermically one-tenth or one-fifth of a grain in a few drops of a recent aqueous solution, or give internally, in solution, one-fifth to one-third grain of the APOMORPHIN. 37 pure drug. Next to the mustard-water emetic, it seems preferable to all others. Dr. Blackley says it does not interfere with digestion, as a man to whom he gave it, vomiting at 8 P.M., at 9 P.M. ate a hearty supper, and digested it. "This," says Dr. D. Brown, "coincides with what I find to be its sphere of action on the stomach. The cases where I have used it with success are, chiefly those where sickness or vomiting constitute the disease under which the patient is laboring. The tongue is clean, the bowels are regular, there are no headaches, the patient has a desire more or less for food, and has no pain after eating, but a feeling of nausea comes on at intervals, especially after taking food, which may or may not be omitted. In other cases, when there is marked dyspepsia, and when Nux or Pulsatilla is indicated, I find Apomorphin very valuable, given at the time of the onset of the sick feeling, and repeated every ten or fifteen minutes till it is relieved. In other cases still, when the vomiting is sympathetic, as in the case of neuralgic headache, gallstones, a cerebral affection, or uterine disease, Apomorphin is equally useful." Dr. Cooper states that he had seen it cause immediate cessation of vomiting in a distressing case where a tumor pressed on the brain. Dr. Brown thinks it resembles Ipecac. I do not agree with him; for Ipecac is useless in vomiting from cerebral, and nearly all other remote irritations. Apomorphin will not cause vomiting in animals if the vagus is cut, or if the subject is chloroformed. Some authorities assert that so small a quantity as one five-hundredth of a grain causes vomiting. This seems to prove, with Dr. Cooper's case, that the action of Apomorphin is central. If such be the case, it ought to cure or palliate all cases of vomiting from cerebral disease or irritation. I do not see how this can agree with the statement of Brown that it removes vomiting from uterine and hepatic disorder, but such seems to be the case. Dr. Brown reports thirteen cases of nausea or vomiting cured by Apomorphin (British Journal of Homceopathy, July, 1874), viz.: 38 APOMORPHIN. (1.) Case of nausea with disgust for food, white tongue. (2.) Case of a child vomiting for three days, bowels slightly loose, stools whitish, tongue white. (3.) A woman of sixty, vomits her food about an hour after taking it; nausea all the time. (4.) Frequent vomiting, and almost constant nausea, in a woman. (5.) A woman of fifty, constant nausea and vomiting, with pain and tenderness in the region of the liver, which was enlarged. He gave Bryonia and Apomorphin in alternation. He thinks the latter cured the sickness, as it was better after two doses. (6.) A young lady with displacement of the uterus had almost constant feeling of sickness, with frequent attacks of violent retching, followed by intense prostration. This medicine relieved the vomiting after all others failed. (7.) A lady of forty-two, with large ovarian tumor, had persistent vomiting; got immediate relief, after a fruitless trial of all other remedies. (8.) Sickness and incessant vomiting in a sailor, tenderness over the liver, but no enlargement. Three doses cured. (9, 10 & 12.) Vomiting of food in children. (11 & 13.) Morning sickness and vomiting (the patients did not report, but he thinks they were cured or they would have returned.) Dr. Brown further says: "I have found Apomorphin successful in removing nausea which frequently presented between attacks of gall-stones, and in a case of fong-standing supraorbital neuralgia." I have had no personal experience with this remedy, but would advise a trial of it in seasickness, and in the vomiting from riding in a carriage, or in railway cars. Some points of its action remind me of Cocculus. Dr. Brown used the 3d cent. dil. invariably. ARCTIUM LAPPA-ARALIA RACEMOSA. 39 ARCTIUM LAPPA. From time immemorial, this plant has been used as a "blood purifier" in domestic practice. It grows in nearly every country, and its popularity is almost universal. Dr. Burt observed that its continued use in the form of decoction or syrup was quite successful in curing obstinate cutaneous eruptions, and it occurred to him to use it in practice. He claims to have cured several cases of Tinea Capitis, "when the head was completely covered with a grayish-white crust, and most of the hair gone; the eruption extended to the face." These cases were cured by the Burdock after Sulphur, Iris, Merc., Graph. and Lyc. had been tried faithfully without benefit. Crusta lactea has also been cured by this remedy. Chronic erysipelas is said to be removed permanently by its persistent use. My observations have been mainly confined to its use in furunculi, when crops of boils persistently occur. In such instances I have known its use to be followed by an apparent removal of the furunculous tendency. Hordetldum and ulcerated eyelids are benefited by it, and Old Culpepper recommends it in fcatid sweat of the axillee. Abscesses of the axillary glands has been cured by it. It appears to me to be an analogue of Hepar Sulphur, Graphites, Phytolacca, and Sulphur. A proving may show this affinity; also its real value in dropsy, dysuria, and other disorders of the urinary organs, for which it has been recommended. ARALIA RACEMOSA. Although attention was called to this plant, so extensively used by the people in domestic practice, in the first and second editions of "New Remedies," it attracted but little attention, until Dr. Samuel A. Jones, of New York, made X40 ARALIA RACEMOSA. his graphic and unique proving, which was published in the appendix to my third edition. It always seemed to me that a remedy so popular with the masses as a curative agent in coughs of all kinds, ought to have some specific affinities for the respiratory organs. Dr. Jones has, I think, discovered its true sphere of action. Prescribing it for the symptoms which he elicited in his provings, I have succeeded in curing some very severe cases of " EHag-fever;" humid Asthma, and some cases of suffocating cough. As it may be interesting to the class, the most characteristic symptoms are here given: Dry, wheezing respiration, with sense of impending suffocation, and rapidly increasing dyspncea. Very loud musical whistlings, during both inspiration and expiration, but louder during inspiration. Could not possibly lie down; felt as if he would suffocate if he did not sit up. The oppression first appeared to be all in the right lung; it then attacked the left lung, and the right became entirely relieved. All the obstruction seemed to be in inspiration. When the attack reached its acme, expectoration set in; at first scanty, then increased in quantity, warm and salt. A constant desire to clear the chest of something, so that I could inspire better. On making a forcible expiration, in the attempt to clear the chest, had a raw, burning, sore feeling behind the whole length of the sternum, and in each lung. Although Dr. Jones was " inclined to asthma," as he says, this attack was very different from his usual attacks. The question arises — would the Aralia originate an attack in a person not inclined to asthma? When we consider that it is drank in large quantities. of the decoction, without causing any such effects — so far as we know —its power of causing such attacks sui generis, is more than doubtful. But this will not prevent its being useful and homceopathic ARANEA DIADEMA. 41 to asthma, especially in persons subject to attacks. Dr. Jones took ten drops of the mother tincture.' I have greatly relieved asthmatics with the same doses, repeated every hour. For children the 2x dilution acts well. The tincture, to be potent, must be made from the fresh root. Dr. Jones relates a case of hay-asthma, cured by Aralia, in which the characteristic symptoms were: Yearly attacks of suffocative catarrh, with "extreme sensitiveness to a draught, the least current of air causing sneezing, with copious watery, acrid discharge from nostrils and posterior nares, of a salty, acrid taste, excoriating all the passages." Waking at midnight, with suffocative breathing, inability to lie down, and the copious discharge above mentioned. Relief of the asthma by bending forward, elbows on knees. Inspiration more difficult than expiration. When the coryza ceased, the trouble went to the lungs, with dry, wheezing cough, ejecting yellow, thread-like pieces of tough mucus. Aralia, 10 drops, three times a day; cured in three days. It has been used with apparent benefit in dysmenorrhoea, leucorrhaea and suppressed lochia, but in these cases the home infusion was given. ARANEA DIADEMA. This remedy, heretofore rarely used except for hsemorrhages from punctured wounds, has lately been brought into notice by Grauvogl. The pathogenesis, as will be seen by reference to Vol. I, is very meagre, being made up of fragmentary provings. But Grauvogl, like many of his countrymen, has the power, apparently, of evolving unfailing indications for a remedy out of his "inner consciousness," rather. than from extended provings. Grauvogl (page 354) first mentions Aranea in the following way —after giving a clinical case illustrating the hydrogenoid constitution. He says: 4 42 ARANEA DIADEMA. " As I had found in my practice that Aranea diadema, still more than Nux and Ipecac, diminishes the influence of hydrogen on the system, and since it was also indicated, according to the laws of similarity, by the constant chilliness, I directed," etc. The case he narrates is of a woman subject to catalepsy, periodical headache, etc. Her sufferings were always aggravated by damp weather, the use of baths. She was constantly chilly, with cold hands and feet, even in a warm room. The Aranea cured this case in a short time. In another case of enlarged spleen, in a man subject to ague, who was constantly chilly, who lived in a damp location, and was worse when it rained, the 2x of Aranea cured. Grauvogl more than intimates that in certain cases this remedy would be specific for chlorosis. He narrates a case of protracted pneumonia — when the patient was " one day better-the next decidedly worse, and then at 8 P.M. he was worse than ever * * * he felt chilly, notwithstanding a constant sweat, and in spite of hot cloths to the abdomen." Nux and Ipecac ameliorated the symptoms, but "after eight days he still was chilly in the upper parts of the body." Aranea 3x was given alternately with Nux, under which he soon recovered. It does not matter, with Grauvogl, what the nature of the disease is, or where it is located, if the patient is constantly chilly, he cures him with Aranea or some hydrogenoid remedy. Thus, all old than had an abscess on his heel, due to " chronic inflammation of the periosteum of the os calcis." The ulcer was gangrenous, very painful. Aranea relieved the pains, but the ulcer deepened. Silica and Calc. carb. aggravated. Because the patient was constantly chilly, and the pains increased and decreased perodically, he gave Aranea, and says he effected a "rapid cure," although the time was five months before the " cure " was complete. On page 205, he gives a graphic description of a case of ague, in which the chill came on at 7 P.M., and lasted till 8 A.M. (no fever or sweat was present). He gave this ARANEA DIADEMA. 43 patient 80 grs. of Quinine, in three days, with no effect. Then he cured him with Aranea 2x, 5 drops every hour. An immediate improvement was observed. Additional cases as follows are reported in the Allg. Hom. Zeit., 55, 166. (1.) A case of chronic headache, preceded by flickering before the eyes and vertigo, which forces her to lie down. The headache is attended with dullness, great heat in the face, weariness, loss of strength, and lasts one day. Cured by Aranea 6th. (2.) Toothache; pinching, pressing pain in upper incisors, regularly from 9 A.M. to 7 P.M., leaving a sensitiveness and cold feeling on drawing in air. Nux was taken without result. The patient was bitten by a spider (Aranea), and "from that instant the pains gradually went off." This physician says he has often cured such toothaches, with sensation as if the gum or cheek was swollen, by means of Aranea. (3.) Pain in the temples, with vertigo on rising, and a disagreeable feeling, as if the hands and head were swollen. Cured by Aranea 6th. Dr. Chapman, in the Annals of the British Hom. Soc. Vol. II., cured a similar case, in a very nervous woman who, for several years, was nightly distressed with the sensation that her hands and arms were enormously swollen. She was speedily cured by this remedy. In Europe, ever since Dioscorides, the spider's web has been used for ague. In this country it is used in domestic practice for the same disease. Old physicians used it in epilepsy, palpitation from hypertrophy, spasms, neuralgia, sleeplessness, etc. It was given in pills about the size of a small pea. I have never given Aranea but once, viz.: when I thought it decidedly called for by Grauvogl's indication, but I saw no benefit from its use. 44 ARSENITE OF COPPER. ARSENITE OF COPPER. This heroic remedy has always been a favorite one with me. Many years before it was proven by Dr. Blakey, I had used it in many cases, and with uniformly good results. I selected it according to the indications afforded by the well known provings of both drugs, and from the recorded cases of poisoning found in the standard works on Toxicology. The reports of poisoning by sleeping in rooms which had paper colored with Scheele's green upon the walls, afforded me many excellent indications. I first used it in some severe cases of cholera which occurred in the years 1866 and'7. These cases were marked by the usual intestinal disorder, to which was added severe and painful cramps in the abdomen and extremities. The alternation of Arsenicum and Cuprum did not prove as satisfactory as I expected, but the use of Cupric Arsenite, in the 6x trituration, in water, for children, and dry on the tongue, in adults, generally acted promptly. I can recommend it in cholera infantum, spasmodic and neuralgic pains in the bowels, accompanied by screams, and cramps in the fingers and toes, attended with great debility and threatened collapse. I have also used it with good effect in chorea, dependent on a profound affection of the nervous centers, and presenting the well known characteristic symptoms of Cuprum, united to the dyscrasia which always indicates Arsenic. In the treatment of some anomalous disorders of the heart, which may be designated as cardiac chorea, it is eminently successful. These cardiac disorders have not until lately been sufficiently understood. They are marked by singular aberrations in the rhythm of the heart's action; at one time the beats are very irregular and feeble, at another violent and irregular. The attacks appear in paroxysms, with intermissions, during which neither auscultation or percussion reveals anything abnormal in the action of that organ. In some cases the irregular cardiac action is changed to choreic movements in other parts of the body. ARSENIATE OF IRON-ARSENIATE OF QUINIA. 45 In several cases of this character which have come under my care, the 3x trituration several times a day, for weeks, has succeeded in permanently curing a malady which is very distressing, if not serious. ARSENIATE OF IRON. I do not know if this remedy has been used in our school by any one but myself. I came to use it in this wise: I had a case of chorea in a pale, anaemic girl. She had been dosed on the Tinc. Ferr..Mur., Citrate of Iron and Quinine, Fowler's Solution, and other drugs; but I felt that Ferrum was indicated. Arsenic was also indicated, and as a matter of convenience I had prepared the 2x trituration of the Arseniate of Iron. This patient, who had been dosed with massive doses of both medicines, without good effect, recovered rapidly under the use of minute doses of this compound drug. We have no provings of this drug, nor do I know that any are necessary. If we take the well-known effects of both, as a basis, for our indications, we shall succeed very well, and avoid alternation. There are very few drugs, if we except the Bromide salts, which are changed by a true chemical union. I have used the Arseniate of Iron a good deal, and its effects have rarely disappointed me. My selection has been based on the Ferrum blood-impoverishment, and the well-known effects of Arsenicum on the nervous system. I have never used it in any gastric or intestinal disease, because I have an idea that the Arsenicum alone, or the Arsenite of Copper, is a better remedy for such cases. But if I had to treat cutaneous diseases in which Arsenic was indicated, and the patient was decidedly chlorotic or anaemic, I should prescribe the Arseniate of Iron with a great amount of confidence. ARSENIATE OF QUINIA. This is another unproven drug, which I think ought to be used more than it is by our school. My experience with 46 ARSENIATE OF QUINTA. it in a certain class of malarious diseases has been quite satisfactory. While engaged in practice in a miasmatic district, I frequently had to treat mismanaged intermittents of an obstinate character. They were generally of a mixed type; sometimes tertian, then quotidian, and often changing to a maskedform, such as periodical neuralgia and various obscure neuroses. To treat such cases was like chasing a " Will o' Wisp" through a dark swamp, especially if I tried to treat them symptomatically. In fact, I can assure you that it is useless to treat the symptomns of such cases, for you will have to change your remedy every day, and then fail to cure the disease, which will constantly elude you. You must strike at the root of the malady; you must select the remedy for the genius of the disease, FIRST; afterwards, characteristic symptoms may be taken into account. In the majority of these obstinate and masked intermittents, both Arsenicum and Cinchona are indicated, and instead of using them in alternation, I hit upon the plan of prescribing this compound, or chemical union of the two drugs. Some cases required the 1x trituration, but rarely did I have to use it below the 2x. It was usually ordered in doses of one or two grains every two or four hours, and the patient was urged to persist in its use for several weeks. This plan, aided sometimes by a temporary removal to a nonmalarious region, was generally very successful in eradicating the disorder. The Professor of Obstetrics and Diseases of Children in this Institution, Dr. Geo. A. Hall, is enthusiastic in his praises of this remedy. He values it very highly in all diseases where Arsenic and China are indicated. In diseases of children, characterized by chronic intestinal derangemelits, combined with debility from loss of fluids and poor nutrition, he prescribes the 3x trituration, with good results. I have never given it higher than the 6th dilution. Pellets saturated with this attenuation often act kindly in children of sensitive nervous systems. I believe it will prove a valuable addition to our Materia Medica. Dr. W. H. Holcombe, in a clinical lecture on "Primary ARUM TRIPHYLLUM. 47 Chronic Malarial Poisoning," says: " It is only by prolonged treatment that we can effectually cure these insidious and complicated chronic diseases. If the remedy now chosen fails to make an impression in a fortnight, I shall probably remind you of two others, which I have found exceedingly valuable in these cases of chronic malarial poisoning. These are the Arseniate of Quinine and Arseniate of Iron. I use them in the first centesimal trituration, not the decimal, for there is too much arsenic in them for that. I prefer the former when the nervous system is more deeply implicated than the organic; and the latter when the anaemia seems to be the preponderating element in the pathological state." ARUM TRIPHYLLUM. This northern representative of a family which, in the tropics, attain great size and intense virulence, has been used in the dried state, ever since the settlement of the United States, for coughs of various kinds. The dry bulb is almost tasteless, the acrid volatile principle having escaped. The Homceopathists were the first to use any preparation of the fresh bulb. It is very difficult to procure a permanent tincture of the fresh root. Alcohol does not preserve it. Glycerine is some better, but not adapted to our use. A distilled water, to which sufficient alcohol is added, may be a successful method of preparation. The virtues of the drug doubtless reside in the acrid, volatile principle, and it is probably the minute quantity retained in the dry bulb which gives it some of its curative power. Its sphere of action appears to include the mucous membrane of the mouth, fauces, larynx and bronchi, and it probably exerts some disorganizing effect on the blood. It has been used successfully in Malignant scarlatina, with " delirium; nose discharges much watery, thin, ichorous fluid, making the nose, lips and corners of the mouth cracked, sore, and bleeding; excoriation of the inside of the mouth; tongue red, papillae swollen 48 ASARUM CANADENSE. and prominent; sore, moist places in the bends of the thighs and knees; sub-maxillary glands swollen; voice hoarse; pulse 140, full; urine very abundant and pale; eruptions all over the body, with much itching and restlessness." Another symptom which is an important " key note " for this remedy, is " the children pick the nose and lips and chin persistently, until they are raw and bleeding." In a few cases where this symptom was very prominent the Arum has appeared to act promptly. In its relation to scarlet fever, it is analogous to Arsenic, Nitric acid, Ailantus and Phosphorus. It is used from the 6th to the 200th. Sudden hoarseness and loss of voice, in public speakers and others, is promptly cured by Arum. Tonsillitis, sudden and painful; oedema of the glottis; catarrhal angina; glossitis, and similar inflammatory affections of the mouth and throat, should be cured by this remedy. In all these diseases the symptoms indicating the Arum are the pricking, stinging pains, and the sudden swelling of the tissues, as well as the subsequent burning, excoriating discharge. The British species, Arum maculatum, is nearly identical and may be used for the same symptoms as the A. triphyllum. Its value in coughs and asthmatic affections has not been full tested; further experience and provings are needed. ASARUM CANADENSE. This plant only differs from the Asarum lEuropeum in degree. Its effects are similar to the foreign root, but less irritating and potent. The same qualities, however, have been ascribed to both. The indigenous species has the reputation of being an " emmenagogue and abortivant " in domestic practice. In Europe and England the foreign species has the same reputation, and is even credited with the power of. causing miscarriage. That the foreign plant possesses an irritant action on the uterus is proved by its pathogenesis and the testimony of the old physicians. Our species may have the same action, ASCLEPIAS INCARNATA-ASCLEPIAS SYRIACA. 49 but in a minor degree. I have never used it but once, and then in a case of pain in sacrum following miscarriage. It seemed to relieve. It was prescribed as a substitute for the A. Europeum. Theoretically I should place it as an analogue' of such new remedies as Senecio and Trillium. ASCLEPIAS INCARNATA. When this remedy was mentioned in the second edition of New Remedies, I supposed it would be used and proven, but no clinical experience has been reported. I have tried it several times in gonorrhoea, on the recommendation of Dr. Hauser, but without good results. Dr. Fowler recommended it in amenorrhea, but no verifications have been reported. Only a systematic proving will show its real value as a medicine. We have a very good fragmentary proving of the ASCLEPIAS SYRIACA (Cornuti). Which is really a potent plant, and one that ought to prove useful if prescribed with judgment. The proving by Dr. Clerborne was a singularly careful physiological experiment for a member of the allopathic school to make. The head-symptoms were quite notable, and the following symptoms are especially valuable: (1.) " When the drug did not cause sweating or profuse urination, it caused violent headache with vertigo, pulse quick, full, 92." (2.) "A feeling as if some sharp instrument was thrust through from one temple to the other, with feeble pulse and cold skin." (3). "Violent headache, between the eyes; a sense of constriction across the forehead." I would particularly recommend it in Congestive headaches from suppression of sweat or urine and fever. Also 50 ASCLEPIAS SYRIACA. Nervous headaches, which are attended by dry skin, and scanty urine, cool skin and feeble pulse, and followed by sweating or profuse urination. In the latter cases it may rival Ignatia, Pulsatilla or Gelseminum. Diarrhcea, brown or yellow, with nausea and vomiting, and the headache above described in the second symptom. Constipation has been cured by the administration of 10 to 30 drops of the tincture three times a day. I predict that its chief curative value will be confined to those cases in which the organic and inorganic solids which should be eliminated by the urine, are not excreted fully. Like Colchicum it causes the amount of solids excreted to greatly increase (from 565 grs. to 700 grs.), or an increase of 132 grs. in six days. This power would make it the best remedy in the urcemia of pregnant women, or from any cause; also in post-scarlatinal dropsy, when it would rapidly eliminate the poison of the disease, and prevent the unpleasant sequelae. Dropsy, especially when caused by renal diseases of an obstructive character, ought to be cured as readily by Asclepias s. as by Apocynum, and perhaps more promptly. In the provings it caused the urine to increase from the normal quantity of 35 ounces to 135 ounces in six days. This shows its immense power over the secretory power of the kidneys, and that it is secondarily homceopathic to dropsy, for the secondary effect of such hyper-stimulation must be an almost complete arrest of secretion and excretion. It has cured many cases of renal dropsy, when given in the tincture and infusion. I have palliated many cases of cardiac dropsy by its use, and with many of my colleagues it has a high reputation in acute cases of anasarca from sudden check of perspiration. Gonorrhoea and gleet have been cured by this drug, and even syphilis. It is homzeopathic to dysmenorrhoea and threatened abortion, when the pains are intermittent, and pressing from the sacrum to the hypogastrium, with scanty flow. Rheumatism has been successfully treated by many physicians by the use of this species. Dr. Lee says it rivals Cim ASCLEPIAS TUBEROSA. 51 icifuga. Dr. Pattee states that in six cases of acute rheumatism it caused the average duration to be confined to eight days. The inflammation was confined to the large joints, with considerable pain and swelling. It had a remarkable effect in relieving the pain. The lowest dilutions will probably be found most useful. ASCLEPIAS TUBEROSA. This plant, commonly called Pleurisy Root, is one of the oldest in use, and one of the most popular of all our indigenous remedies. The popular name given to the root indicates the estimation with which it is held. The early physicians incorporated it into the pharmacopoeia, and its use by eclectic practitioners is varied and extensive. Their principal use of this Asclepias is in disorders of the respiratory organs, and in nearly the same conditions as we use Bryonia. We have only two provings of this remedy: one by Dr. Savery, of France, the other by Dr. Nichol, of Montreal. The former I consider untrustworthy in the main, because only two drops of the tincture were taken, and all the symptoms for forty days recorded! Dr. Nichol took every day twenty to forty drops of the lx dil. and 0, and got symptoms which were characteristic. I believe this Asclepias acts chiefly on the mucous surfaces, especially those of the respiratory organs; and the serous tissues, especially the pleura and synovial membranes. It is common in the country for the people to treat pleurisy and pleurodynia with an infusion of the root. When sweating occurs, the pain subsides. Bronchitis is also treated successfully in the same manner. Our provings testify to the fact that it is homeopathic to these affections. The chest symptoms of Nichol's provings are: " Cough dry and spasmodic, with constriction of the throat; harsh, dry cough causing pain in the forehead and abdomen. "Dull pain at base of both lungs, with a feeling of tightness. 52 ASCLEPIAS TUBEROSA. "Sharp pains shooting from left nipple downward. "Sharp, cutting pain behind the sternum, aggravated by breathing, moving the arms, singing or loud talking. "Acute, darting pains in left side, shooting over to the right, and up to left shoulder, with tenderness of the spaces between the ribs. "The pains left the left side and attacked the right side, and extended to right shoulder. "The pains were relieved by bending forward." These symptoms give us a fair picture of a case of subacute pleuritis. The fever was slight (pulse 88). I have used it successfully in mild cases of pleurisy and intercostal rheumatism, giving the lx frequently repeated. Dr. Nichol had many rheumatic symptoms. The pains were stitching and aggravated by motion. The Asclepias is especially adapted to the diseases of children, not only the thoracic but the intestinal. It resembles Ipecac in this respect. It is also useful in asthmatic complaints and catarrhal affections of old people. It is useful in the coughs and colds of children, in "snuffles," in catarrhal croupy coughs, and suffocative catarrh. The fever attendant is not very severe; the skin is hot, but at the, same time moist. It is indicated in those cases of catarrhal fever in which the intestinal mucous membrane is affected simultaneously with the bronchial, and as having slimy, green alvine evacuations. I have prescribed it with benefit in sub-acute rheumatic pericarditis, when there was "pinching pain in the region of the heart, extending to left shoulder; palpitation; feeling of contraction in the cardiac region; tenderness over that region; fever, with hot, moist skin. Catarrhal dysentery, with rheumatic pains all over, yields readily to this medicine. I usually use the mother tincture or lx, 20 drops in half a glass of water, a spoonful as often as seems necessary. If oftener used instead of Bryonia, I think it would gain in favor with our school. ATROPINE. 53 ATROPINE. It may seem out of place to call this drug a new remedy, when Belladonna is so old; but Atropine was not used in homoeopathic practice until about the year 1860, or about the time the new remedies began to appear in our school. No complete provings of Atropine have been made; but the symptoms which have been obtained, both from provings and cases of poisoning, are identical with many of the symptoms of Belladonna. Atropine cannot cause all the symptoms of Belladonna, any more than Quinia can cause all the symptoms belonging to China, for the reason that it does not contain all the medicinal forces residing in the plant. To the mere chemist, or the crude experimenter, there seems nothing of value left in the plant after the extraction of its active principle. But they do not appreciate the fact that there are intangible or atomic forces in plants which do not reside in any alkaloid or resinoid, and will escape the subtlest analysis of the chemist. These medicinal forces can only be evolved by careful physiological provings on the healthy. Atropine, therefore, cannot represent the Belladonna in the treatment of disease, except in its own limited sphere. I cannot advise the use of Atropine in the febrile diseases, in acute or chronic exanthemata, inflammations of organs and tissues, or certain cerebral disorders, for which we have in Belladonna such an admirable remedy. Its sphere of action appears to me to include the nervous system, affecting alike the nerves of sensation, motion, and the sympathetic. In functional disorders of these nerves, especially when hypercesthesia and irritation obtains, Atropine will prove a valuable remedial agent. In neuralgia, certain acute congestions of a nervous origin, painful spasmodic affections, especially of the sphincters, and nervous jactitations, hyperaesthesia, spinal irritation, etc., Atropine will often do better service than Belladonna. 54 ATROPINE. Its action is analogous to Solanum, Strammonium, Agaricus, and many of the analogues of Belladonna. I cannot accept the assertion of allopathic experimenters that Atropine contracts the blood-vessels of the brain and spinal cord. We have abundant evidence that it causes death by acute congestion of the brain. As to its action on the blood-vessels of the spinal cord, I am not prepared to dispute the statement of Brown-S6quard, who says that "it is a powerful excitant of blood-vessels, and especially those of the spinal cord and its membranes. In consequence of this influence, it diminishes the amount of blood in the vertebral canal, and in so doing produces a relative diminution of the vital properties of the spinal cord and its nerves." But granted that this is its primary action in toxical doses, its secondary action is directly opposite. In death from poisonous doses, the surface of the body is pale and cold, and the internal organs all congested. But death must in such cases occur from its secondary action. Death rarely occurs from its primary action. In homceopathic practice, we usually prescribe Atropine for symptoms similar to its secondary effects, for all the morbid conditions which I mentioned as indicating Atropine are due to such secondary action, or for symptoms of irritation of the motor, sensitive, and vaso-motor or nutritive nerve fibers of the spinal cord, or of the roots of its nerves; or, in other words, in cases of congestion, meningitis, myelitis, and cerebro-spinal meningitis. Pain anywhere in the body is not properly a primary effect of Belladonna (Atropine), any more than of Opium (Morphine.) Contraction of the blood-vessels of the spinal cord and brain correspond to painlessness in the parts supplied by the nerves having their origin in such locations. Atropine causes primarily such conditions, but secondarily it causes congestion, and even inflammation, bringing with it pain, spasm, hyperaesthesia, etc.-all the consequences of irritation of nerve-tissue. ATROPINE. 55 In diseases of the brain I rarely find Atropine of service. If we use it at all, it must be used cautiously, and Belladonna is to be preferred in all but purely functional disturbances. Certain it is that in hemicrania, facial neuralgia, neuralgic cephalalgia, and other very painful affections of the nerves of the head, the 2d c. trit. of Atropine is one of our most successful remedies. In acute congestion, however, when the face is red, temples throbbing, eyes bloodshot, ears ringing, and wild delirium, who would dare to give any but the high attenuations of this drug or of Belladonna? In typhoid fever, particularly typhus-cerebralis, when nightly delirium, spectral illusions, wild, uncontrolable laughter, obstinate insomnia, and often furious delirium and redness of the face occurs, the 6th of Atropine will often dissipate the troublesome symptoms, due in this case to irritation of the brain from congestion. On the other hand, we meet with cases of advanced typhoid, where, with the general prostration, there is insomnia, with rambling, incoherent muttering, coma vigil, with picking at the clothes, very dry tongue, pale, cool face, etc., due to cerebral ancemia with irritation. Here we find Atropine 2d c. trit. an admirable remedy. I will briefly enumerate the disorders in which Atropine has been found efficacious in our practice, when used in the 2d or 3d centesimal triturations. Neuralgia, especially of the head, face and eyes. Gastralgia, purely neuralgic. IEnteralgia, a neuralgia of the abdominal nerves. Nephralgia, neuralgic, or owing to passage of calculi. Violent, irresistible and ineffectual urging to urinate, with agonizing tenesmus, both vesical and rectal. Nocturnal emissions, from paralysis of the sphincter. Ovarian neuralgia, and uterine colic. Vaginismus, when purely spasmodic and neuralgic (internally in the 6x trit, and apply a cerate of gr. 1 to f j of simple cerate.) 56 BADIAGA FLUVIATALIS. Whooping cough, with violent paroxysms very frequent, and expectoration of very tough mucus. Chorea, tetanus, and even convulsions. I would advise you to carefully study not only the symptoms I have collected in New Remedies, but the careful experiments recorded in the best allopathic works on toxicology. In Wood and Stille you will find most of value. BADIAGA FLUVIATALIS. The provipgs of this medicine appeared in the Hahnemannian Monthly, and also in Hering's Mat. Med., but no clinical use of it has since been reported. I am not able, therefore, to give any additional information relative to its curative value. I have never used it myself. Many of its symptoms closely resemble those of the marine sponge which we use in practice. The head symptoms would indicate its probable value in some cases of headache, and "tetter-like eruptions on the scalp." It causes painfulness of the left eye-ball, especially the posterior portion, and Dr. Bedford says he has had very good results from its use in " Scrofulous inflammation of the eyes, with hardening and induration of the meibomian glands." Hahnemann considered it an anti-psoric, but never published any account of it. It contains Carbonate of Lime, Silicea, Phosphate of Lime, and a trace of Alumina, which would make it an anti-psoric in the sense Hahnemann used the word. Hering says of it: " A comparison with Spongia, its nearest of kin in the animal kingdom, will show striking similarities and remarkable differences." He also compares it with Silicea and Clematis. Rosenstein considers it complementary to Sulph., Iodine and Mercurius. This last writer reported a complete cure of a chronic syphilitic bubo, with Badiaga, after Sulph., Carbo., Clemat. Sil., Iod. and Ars. had been given in vain. Among the new indigenous remedies, its analogues are Phytolacca, Corydalis and Stillingia. BALSAMUM PERUVIANUM. 57 Hering thinks the Badiaga will be useful for the complaints of adults who had scrofulous complaints in childhood, and which showed again in after life. He adds that it had a reputation in Russia for the cure of hcemorrhoids. He thinks it follows well after Lachesis. I doubt if it will be used much, for we have many similar and more active remedies. It may, however, meet special cases when its analogues fail. Its heart-symptoms are peculiar, and are worthy of attention. BALSAMUM PERUVIANUM. The scientific name of this tree is Myrospermum peruiferum; the substance used is the resinous juice which exudes from the tree when cut. It is strange that this agent should be now nearly obsolete with the allopathic school, for when it was first introduced into Europe by the Spanish Jesuits it was lauded as highly for the cure of consumption and kindred complaints as is now the cod-liver oil. It remains for homoeopathy to take up these neglected medicines and make of them valuable curative agents. Although no systematic provings have been made of it, we know enough of it to assert that it is an analogue'of Copaiva, Cubeba, Chimaphila, Stannum, Thuja and Uva ursi. Its sphere of action is upon the mucous membranes, especially those of the respiratory tract. Its special indication is for muco-purulent discharges-yellow, green and fietid. The pathological condition calling for its use is doubtless torpid, indolent ulceration, or purulent catarrh. For many years I have made extensive use of this balsam, and have seen most gratifying results in the following affections: Chronic, purulent, fcetid anterior or posterior nasal catarrh, with or without ulceration. Coughs, with copious expectoration of thick, yellow, green and foetid pus. This condition occurs commonly in old people, and scrofu5 58 BALSAMUM PERUVIANUM. lous subjects, and may arise from laryngitis or bronchitis, or neglected catarrh of those organs. It will not cure tubercular phthisis, but may act as a useful palliative. My usual dose is the 1st or 2x dilution, or trituration of the crude balsam. (It seems to act best in trituration.) But I do not confine myself to its internal administration. The most brilliant results are obtained from its inhalation by means of the steam-atomizer. By this means the finely divided atoms come in direct contact with the diseased surface. If triturated with equal parts of Carbonate of Magnesia and sugar, or pulverized Glycyrrhiza, it will mix with water, otherwise it clogs the instrument. Make of the lx trit., thus prepared, a solution representing in strength the 2x dil., and have its spray inhaled three times a day, each inhalation lasting for five minutes. Dr. Hoffman, in some French Hom. Journal, reports as to his use of the balsam. He praises it highly in cases of Cough after pneumonia, when it is loose, thick, yellow and fietid, (one-tenth dil.); also in Suppression of the accustomed expectoration in bronchial affections. (6th dil.) (In very large doses the Bal. Peru. has been known to check copious expectoration, but with resulting fever, dry cough and oppression, a primary effect of the drug.) Hoffman says: " I have seen persons laboring under perfectly formed phthisis, and seriously affected for several years, happily restored by the use of the balsam." I doubt if these persons had tuberculous phthisis. They may have had vomicce, for there are many authenticated cases of vomicce, with offensive expectoration, cured by this balsam. It formerly had a high reputation for Hectic fever, which it doubtless cured, by removing the suppuration upon which it depended. Not only in purulent discharges from the bronchia is it useful, but I have cured cases of gastric catarrh with obstinate vomiting of food mixed with mucus: chronic mucous catarrh of the bowels (sometimes called chronic dysentery); catarrh of the bladder and even obstinate leucorrhoea, uterine and vag BAPTISIA TINCTORIA. 59 inal, in which last disease I advise injections of the Aqua Bal. Peru, such as above recommended for inihalation. A cerate of the balsam is the best application, next to Glycerole de Aloes, for indolent ulcers, cracked nipples, cracks in the fingers and palmar surfaces of the hands, or fissured and chapped lips. It is said that the most inveterate case of Itch is cured promptly by one application of the pure balsam, warmed and rubbed all over the surface of the affected skin. BAPTISIA TINCTORIA. This indigenous plant has proved to be one of the most valuable additions to our Materia Medica. It has become an indispensable agent in the treatment of adynamic fevers and similar disorders. There are thirteen species in the United States, and all of them probably have similar medicinal action. I have used -besides the officinal species —the B. australis (blue-flowered), B. leucophoa (cream-colored flowers), and B. leucantha (white-flowered), and can see no difference in medicinal effects, and but little in smell or taste. All the above grow in the Northern States. In the Southern States some very large. species grow, which ought to be equally if not more potent. Although this remedy covers many grave and important morbid conditions, it has not a very wide range of action. It seems to affect. principally the blood, impairing its integrity: the nervous system, which it deprives of its normal tonicity: and the mucous surface, which under its influence ulcerates and takes on inflammatory action, with a decided tendency to unhealthy, fcetid discharge. It was first used empirically in typhoid and typhus fever, in which its popularity is still very wide and well deserved. It was for a time supposed that its use was called for in all stages of the malady; but more recent observations seem to prove that its period of greatest usefulness is during the premonitory and first stage of allfevers of an adynamic type. 60 BAPTISIA TINCTORIA. The testimony is too large and authoritative to be set aside, that it possesses a real abortive or preventive power over such fevers, if given at the proper time. Numerous observations and experiments, both in England and this country, have shown conclusively that if prescribed for the following characteristic conditions and symptoms it will arrest the disease which, but for its influence, would end in the typhoid state: - A condition of great prostration, when typhous epidemics abound, at any season of the year. - General malaise, with a feeling as if one had been bruised all over; cannot lie on either side long, because the part on which he is lying becomes sore; pressure on any part of the body soon causes soreness. - The extremities feel too large, tremulous, with " thrilling" sensations in them. - General foetid odor from the body, the breath, and all the excretions. - General heat, with very dry, red or brown, parched tongue; and dry throat. - Head heavy, confused, internally sore, with a feeling like that preceding delirium. "An illusion as if he was several persons, and he tries to get himself together." (Bell.) Stupor or incoherent raving. The Baptisia is infinitely superior to Aconite, Gelseminum or Verat. viride, in all fevers having a typhoid tendency, while it is nearly useless in the so-called "synochal" fever. The condition is one of. erethism, rather than inflammation, the pulse rarely goes above 100, and the skin is not as hot and dry as in true febrile conditions. The lowest dilutions, or mother tincture, have generally been most successful in the treatment of typhoids. I prefer the tincture made from the fresh root. One part to nine of alcohol, by weight. Ten or fifteen drops of this preparation in four ounces of water, a spoonful every one, two or three hours, until a decidedly favorable change occurs or the symptoms call for Bryonia, Rhus, Arsenicum, Phosphoric acid or Terebinth. BAPTISIA TINCTORIA. 61 Not only in the beginning of typhoid fever is the Baptisia indicated, but in all similar conditions, whether occurring idiopathically or during the progress of any other disease. For example: if during the progress of scarlatina, small pox, pneumonia, bilious fever, dysentery, or puerperal fever, the above symptoms characteristic of this remedy appear, a few doses will generally dissipate them, and either restore the patient to convalescence or allow the original disease to pursue its normal course. Its action on the cerebro-spinal nervous system is of such a depressing character that it led me to suggest it as a probable remedy for "spotted fever," as far back as 1864. Recent observations of its good effects in cerebro - spinal meningitis, by Dr. Searle and others, as well as myself, have proven that in the typhoid variety of the disease it is nearly a specific. It is useful when a condition of general paralysis threatens, the excretions all become offensive, and the blood rapidly tends to disorganization. It may have to be alternated with Gelseminum, Secale, or Calabar, as it rarely succeeds alone in averting that terrible malady. Taking the one symptom, " Putrid odor of the discharges, with dark red, or ulcerated. mucous membrane." I have used it extensively in chronic sore mouth, whether mercurial or cachectic; in malignant dysentery, or diarrhea; offensive leucorrhoea, or 7ochia; and even offensive ulcers on the skin. I prescribe it as a topical application as well as internally. It appears to resemble, in its topical effect, Chlorate of potassa and Carbolic acid. In putrid angina and diphtheria, it aids the action of Ars. iod., Phyto., and Merc. cyanate. One drachm of the tincture to four ounces of water makes an efficient gargle in such cases. One peculiar symptom indicates Baptisia in some sore throats. The throat may look dark purple, livid, and as if very painful, but it is not. Dr. Miner cured an inveterate sore throat, which was not painful (with the 30th.) There are two gastric symptoms of Baptisia which are worthy of notice, namely: (1.) " Gone —empty feeling at the stomach." 62 BAPTISIA TINCTORIA. This symptom is readily removed by Baptisia when it is the result of anxiety, grief, night-watching, or fasting, provided the breath is foetid and the tongue dry. If not, then Ignatia, or Caladium, is more appropriate. Dr. reports a case of " dyspepsia after typhus," presenting " sinking at the stomach, frequent fainting, brown, dry tongue," etc,, cured promptly by Baptisia. (2.) " Nausea, with want of appetite and constant desire for water." In the beginning of fever this is often a prominent symptom, and may be removed, with all of its concomitants, by this remedy. The abdominal symptoms are not peculiar, but Dr. Hart reports a case which he believes to be abdominal neuralgia, which he cured with Baptisia. The symptoms were "Extreme uneasiness rather than pain; a sensation as of something crawling about in the abdomen. The paroxysms occurred after midnight, with throbbing and congestion of the bowels, vomiting, purging and great prostration. The pulse, at first accelerated, became slow, weak and often imperceptible." My experience with Baptisia in bowel affections, leads me to esteem it highly in all cases of adynamic or typhoid diarrhoea and dysentery, when dependent on an epidemic typhoid miasm, or the result of local septic conditions. If the miasm be malarial (ague poison) it is of small value, as compared with Arsenicum, China, Eucalyptus, or Gelseminum. The evacuations indicating Baptisia are usually dark, black or brown, watery, murky, slimy, bloody, and always particularly offensive. If, with these appearances, you find a dry tongue, fcetid breath, sinking at the stomach, and other characteristic symptoms of this medicine, it will prove a prompt remedy. I prefer the lx or 2x dilution. It has rarely been recommended in diseases of the urinary and genital organs, but there is one condition in which it is specific, namely, in threatened miscarriage from mental depression, shock of bad news, watching and fasting, or from low fever. I have often prevented miscarriage by its timely BAPTISIA TINCTORIA. 63 use. In case of death of the foetus in utero, the mother often falls into a condition in which the " dreadful sinking at the stomach," fcetid breath, dry brown tongue, and great prostration, with or without feetid vaginal discharge, are the prominent symptoms. Here the Baptisia acts well, preventing blood - poisoning, and aiding Caulophyllum or Ergot in expelling the decaying substance. As an important addenda to my lecture on Baptisia I will give the following excellent comparisons of that drug with Rhus, Arnica, and Muriatic acid, by Dr. E. A. Farrington, of Philadelphia: BAPTISIA. RIUS TOX. Anxious, certain of death. Faint, timid, fear of death. Delirium constant, low; thinks her I)elirium mild, low; thinks that he is head is scattered over the bed, and roaming over fields, swimming or that she must toss about to get the engaged in some other physical pieces together. work. While answering a question, goes to Answers correctly, but in a hasty sleep. manner. Mentally restless, yet too lifeless to Mentally restless; slow flow of ideas; move; confused as if drunk. better moving. Feels as if the top of the head would Feels as if a board were bound across fly off. the forehead. Expression besotted: cheeks yellow, Expression listless; or anxious appearwith a deep central flush. ance; cheeks dark red. Teeth covered with sordes; mouth full Teeth and mouth covered with thick, of ulcers, fcetid breath, aphthae. hard, brown mucus; vesicles. Jaws rigid; pain. Jaws crack; feel stiff. Tongue white, dry, yellow center, Tongue white on one side, dry, (early (early stages typhus). stages typhus). Tongue dry, dark red, shining, cracked, Tongue dry, hard as a board, hardened, ulcerated; or, dry, with a brown dirty phlegm; or, red triangular streak down the center, edges clean, tip, cracked, shows imprints of red. teeth. Saliva viscid, thick. Saliva bloody, runs out in sleep. Dry mouth, great thirst; spits out the Dry mouth, unquenchable thirst; reliquid put into his mouth. pugnance to either food or drink. Uvula long; mucus in the throat, can- Throat sore as if strained; swallownot raise or swallow it; can only ing difficult from paralyzed epigswallow liquids. Putrid, painless, lottis oesophagitis, cannot swallow dark ulcers, (I). solid food. (I) The painlessness may decide for Baptisia not only in typhus, but in scarlatina, putrid sore throat, etc., when the suspicious odor and general weak 64 BAPTISIA TINCTORIA. BAPTISIA. RHUS TOX. Stool yellow, involuntary, horribly Stool yellow, slimy, involuntary at fetid; sourbelchings. night, almost no foetor; empty belchings. Dysentery, great tenesmus with dis- Dysentery, tenesmus, discharge of charge of pure blood, no mucus. transparent lumps of mucus. Urine alkaline, offensive, dark red. Urine albuminous; involuntary at night. Cannot draw a full breath, gasping; Difficult breathing referred to the tightness across the chest. lower chest and pit of stomach. Heart throbs audibly; seems to fill the Heart beats feebly; trembling about chest. the heart. Pulse full, whether hard, slow or Pulse small, weak and quick, weak quick; variable, thread-like. and small, thread-like. Cannot lie long anywhere; yet motion Cannot remain quiet; motion of the is painful. limbs improves. (2). Must chapge position, the bed feels so Must change to relieve thepains in the hard. limbs. Feels as if sinking away; lies with Feels as if paralysis were coming on; the head thrown back; jaw dropped; mouth open; lies as if intoxicated; sliding down in bed; putrid breath. involuntary stool and urine. (3). BAPTISIA. ARNICA.* Anxious, certain of death. Indifference. Falls asleep in the midst of his answer. Falls asleep, forgetting the words for his answer. Lies with head thrown back, lower Lies quiet, no complaints; says he is jaw dropped; slides down in bed. well; lower lip trembles. Vertigo, worse stooping. Vertigo raising the head. ness, offer a dangerous reason for the absence of pain. The ability to swallow only liquids, distinguishes it from Lach., Apis, Canth. Rhus tox has not so marked a tendency towards putrid ulcers. In cesophagal spasm, both can only swallow liquids; but with Baptisia solids simply cause gagging; with Rhus, vomiting. (2) Rhus, in the beginning of typhus during profound weakness, has an exceptional symptom; wants to lie still in one spot. (3) It would be premature to characterize Baptisia while so imperfectly proved. But in general, it shows a heavy, besotted face; foetid breath, stool, and urine; dyspncea from weakness; in the beginning, nervous restlessness. Rhus shows a bland expression, pale, waxy skin; hepatization of lower lobes (hence dyspnoea is referred to the stomach and hypochondria); in the beginning, erethism (hence the nose bleeds, which relieves). * Arnica has but little resemblance in the beginning of typhus; but when stupor and petechiae appear, we find in common, such symptoms as: must move, the bed feels so hard; brown tongue; putrid breath; goes to sleep, while answering; stupid, heavy look, etc. BAPTISIA TINCTORIA. 65 BAPTISIA. ARNICA. Gasping; breathing as if he could not Loud, blowing inspiration and expiradraw a long breath. tion in sleep. Can swallow only liquids; spits out the Pharynx seems "lame;" a gurgling water taken. noise when swallowing. Stool involuntary, fcetid. Stool and urine involuntary. Pulse full and slow; variable. Pulse frequent, sunken. Nervous symptoms predominant. Stupefaction from the very beginning. BAPTISIA. MURIATIC ACID. Goes to sleep while answering. Forgets what he has said. Delirium; cannot sleep, because she Delirium; would sleep but cannot; must toss about to get the pieces of her vivid hallucinations of changing head together. images from past to present. Soreness as if in the frontal brain; Brain feels sore, as if it was torn or wild feeling. had been beaten. Senses generally blunt; besotted, heavy Senses generally too acute; distant expression. talking gives headache. Dull hearing during and after typhus. Dull hearing, with dryness of ears, or dark wax. Cheeks, dark red, yellow ground. Circumscribed glowing red cheeks. Aphthaeputrid, dark, ulcerating; thick, Aphthceputrid, small, bluish, deep. viscid saliva. Tongue dry, brown down the center; Tongue small, bluish or rattling like feels numb or scalded. leather; heavy, as if paralyzed. Goneness; sinking at the stomach. Emptiness all over the abdomen. Stool involuntary, putrid; occasional Involuntary while urinating; pudiarrhcea or costive (beginning). trid; during crisis, papescent stool relieves. Urine offensive, alkaline. Urine acid; difficult to expel. Heart-beats seem to fill the chest. Heart-beats seem to be felt in the face. Pulse full and slow; variable; thread- Pulse irritated, but without energy; like. omits every third beat. Slides down in bed; lower jaw dropped: Slides down in bed; lower jaw hangputrid breath. ing; moaning. Scarlatina with dark, fetid ulcers in the Scarlatina with blue feet; dark bluish throat; great prostration; petechie; fauces; scanty eruption; sudden red stupor. face; petechia; stupor. Stupor resembling that of Arnica and Stupor and nervous weakness after Opium. Rhus and Bry., fail. 66 BAROSMA CRENATA. BAROSMA CRENATA. It often happens that a drug suffers in reputation from the company it keeps. So with the Buchu. It was taken up by an unprincipled adventurer, and its fair fame prostituted to the vilest purposes. Previously, it had been quite largely and successfully used by the allopathic school as a remedy in abnormal discharges from the urinary organs. Its sphere of action seenis to include the kidneys and mucous surfaces of the urinary organs principally. It has also a specific action on all mucous membranes, especially when brought in contact with them topically. We should not reject it because it lacks a proving, or because it has been improperly used. It is in chronic diseases of the urino-genital organs, when characterized by muco -purulent discharges, that the Buchu seems to act best. I have made some notable cures of such cases, when the urinary deposit showed an abundance of epithelium mixed with pus and mucous corpuscles. " Chronic inflammation of the pelvis of the kidneys, and mucous membrane of the bladder, with copious discharge of mucus," is mentioned by several authors as curative by this remedy. Irritable bladder, with vesical catarrh, or gravel (Lithic acid calculi), complicated with spasmodic stricture of the urethra or sphincter, has, in my practice, rapidly disappeared under the use of the Barosma. Prostatic disorders have been cured by this remedy when the general conditions coincided (compare Populus, Copaiva and Thuja.) Certain varieties of dropsy have been cured by Buchu, but the cases reported have not been characterized by any peculiar symptoms. I have cured several cases of vaginal leucorrhoea with this medicine, prescribing it by enema (fl. 3 j to'iv), as well as internally. Dr. Stille, in his Materia Medica, recommends it as a BELLIS PERENNIS-BENZOATE OF AMMONIA. 67 specific for "undue secretion from the mucous follicles of the urethra, the vesiculae seminales, or prostate, produced by excessive venery or self-pollution." It seems to act best in the lowest dilutions, and in some cases, a weak infusion cures with surprising promptness. BELLIS PERENNIS. In Dr. Thomas' additions to Hom. Mat. Med. (London, 1868), is a proving of this plant. He recommends it as a substitute for Arnica. He thinks it will prove a specific for boils, bruises, sprains, whitlows, etc., used topically and internally. We have a Daisy (B. integrifolia), indigenous to the United States. It probably has the same properties. I have had no personal experience with either. BENZOATE OF AMMONIA. This preparation was first recommended by Dr. Todd as the best remedy in dropsy after scarlet fever. The symptoms indicating its use do not differ from those laid down by Hering and Kitchen as calling for Benzoic acid, namely: " Very, scanty, dark red, bloody-looking urine, with strong, pungent odor, and red, thick sediment." It is indicated also by " scanty, dark, smoky-looking urine," such as we find in albuminuria-dropsy in children. If this kind of urine occurs in rheumatic or gouty affections, this drug is just as well indicated, and will promptly remove the disease. Dr. Seymour recommends it highly in gout, when tht small joints are red and swollen, or when fluid is deposited in the joints of the great toe; also in cases when the lithate of soda existed in the joints of the fingers (gouty concretions.) I have had excellent success with it in rheumatism. (The Benzoate of potassa will act more satisfactorily in some cases.) 68 BISMUTH. In that form of jaundice arising from arrest of secretion of bile, and not from obstruction, the Benzoate or Benzoic acid is often a specific, especially when the urine is similar to that above mentioned. I believe these preparations are preferable to the Benzoic acid, because of their ready solubility. The 1x triturations for adults, and 2x for children, have succeeded best in my practice. Dr. McAffee, of Mt. Carroll, Ill., writes me he has used this preparation successfully in many cases of dropsy from disease of the liver. BISMUTH. This is a very old remedy in one sense, but very new in another. Teste introduced it into his Materia Medica with the remark that it "is very little known to homceopathic physicians." The same remark applies almost equally well now, for the great majority of our school rarely use it; only those who have been allopaths, or have gained some knowledge of its value from allopathic text-books. Bismuth is a very important remedy in its sphere of action, but that sphere is narrow, and confined to the nerves of the stomach, and those organs in special sympathy with it. Hahnemann published a few symptoms of the Oxide of Bismuth in his Materia Medica Pura, but they have attracted little attention. Teste tried to call attention to it, but he absurdly linked it with a group of medicines to which it has but slight resemblance. His clinical observations were from allopathic experience, mainly, and his own personal experience with it was quite fanciful and unreliable. My experience with it has been large enough to warrant me in speaking decidedly as to its value. I have found it of the greatest use in painful digestion, or a kind of gastralgia which comes on soon after eating. The pain is peculiar; it is a remittent pressure, as from a stone or some heavy substance in the stomach. Some describe it as a crampy pain, others a griping. It differs from the gastralgia BISMUTH. 69 of Nux which comes on later after eating; from Carbo veg. which is later, as well as burning. The only medicines which closely resemble it, in the nature of the pain, are Dioscorea and Calabar. This gastralgia of Bismuth is often attended with eructations tasting of undigested roast meat, frontal headache, vomiting of undigested food, but these are not necessary concomitants. In vomitinq from gastric irritation, it is an excellent remedy. The vomiting is not attended by fever, is generally chronic; or has followed acute gastritis; or has been caused by irritating drugs. It is not useful in vomiting of sour, ropy fluids, or when inflammation is present. It will often palliate the vomiting from cancer, or ulcer of the stomach; also the vomiting of pregnancy, when the reflex has caused local irritation of the stomach. Of Teste's observations, the only trustworthy one, is, that Bismuth is indicated in " absence of fever, nidorous (roastedmeat-smelling) eructations, mucous or brownish, foul smelling vomiting; small, serous, intermittent diarrhoea, stools of a light color, and foul odor, preceded by crampy pains at the stomach, and pinching in the abdomen." In the diarrhcea of infants, when teething, if they have the above symptoms the Bismuth is a specific. If the diarrhea occurs in poorly nourished adults, or feeble persons with slow digestion, it will act admirably. In headache it is an excellent remedy when it alternates with, or is attended by, the gastralgia, or when it comes on immediately after eating, and is relieved by vomiting of the ingesta. The pain is generally frontal. In the treatment of dyspepsia or painful digestion, not complicated with any liver affection, it is almost indispensable. I have been very successful with it, aided by Pepsin, which is peculiarly adapted to assist Bismuth in its curative action. I do not approve of those quackish combinations of "Bismuth, Iron, Strychnine and Pepsin," with which the country is flooded. Pepsin will not combine properly, in solution, with any drug. It should be given uncombined. My 70 BI-SULPHIDE OF CARBON. plan is to give the Bismuth, if indicated, just before eating, and the Pepsin with the last portion of the food taken at meals; followed by the Bismuth again in half an hour, if the pain and distress comes on. I usually use in all cases the first decimal trituration of the sub-nitrate of bismuth, giving to adults ten to twenty grains, to children five or ten grains. I do not hesitate to give the same quantity of the crude medicine in obstinate cases. If the preparation is chemically pure no aggravation can possibly accrue from its use. When it is given for the vomiting and diarrhea of children, the same plan, namely: a dose just before nursing or taking the bottle, with or without the Pepsin after. You will find recorded in -Hempel's Materia Medica, also in Orfila on Poisons, some cases of alleged poisoning from Bismuth, but it is now ascertained beyond a doubt that it is only when Arsenic is combined with Bismuth that it has unpleasant effects. " Notwithstanding all the care of modern pharmacy," says Wood, " Bismuth even yet contains Arsenic, and I have seen it from this cause produce bloody purging." You should be careful then that you procure a pure article. I do not mean to infer that the chemically pure Bismuth will not cause diseased conditions similar to those it will cure, for such an assertion would contravene our law of cure. I do say, however, that only its long continued use, in large doses, could produce such effects, by slowly deranging the gastric nerves. Its primary effect is doubtless to benumb and abolish the normal sensitiveness of the nerves of the stomach and intestines, while its secondary effects would be to cure just that hyper-sensitiveness, which results in the gastralgia which it is so successful in curing. BI-SULPHIDE OF CARBON. This drug was once used to some extent by the allopathic school, and was found quite useful in many diseases, but it BI-SULPHIDE OF CARBON. 71 has gradually fallen into disuse, more on account of its intolerably foetid odor, probably, than from any deficiency of curative power. It was employed in obstinate rheumatic and arthritic affections, paralysis and cutaneous eruptions, and as a resolvent in indolent tumors. In the latter case, a few drops were applied to the tumor several times a day. A Dr. Otto claims to have reduced a strangulated hernia by applying a few drops. The vapor was said to cause the disappearance of indurated lymphatic glands, also in deafness from want of nervous energy. It was recommended to be rubbed on the face in neuralgia, toothache, etc. Workmen exposed to its fumes are affected with headache, vertigo and over excitement of the nervous system, as evinced by voluble talking, incoherent singing, immoderate laughter or weeping. A long continuance of exposure causes a kind of cachexia, characterized by general weakness, loss of sexual appetite, dullness of sight and hearing, and loss of memory. It does not seem to cause any lesion of the brain (in rabbits killed by its fumes), but only congestion of the lungs. From the symptoms caused by it in workmen, I would suggest its use, by inhalation, in some cases of hysteria. Its odor, if nothing else, would help to dissipate the peculiar abnormal condition of the nervous system, which occurs in some of the victims of hysteria. I have had no personal experience with this agent. It is recommended in Hering's pathogenesis, for several ailments, He mentions among the clinical cases: ~ Intoxication, to entire loss of consciousness, from drinking whisky. I cannot recommend this to you as a good report. People "dead drunk" generally recover after a time, and it is doubtful if the medicine had anything to do with the recovery. Hering recommends it in " asphyxia from alcohol or coal gas." It is evident he thinks the victim would recover sooner with than without this remedy. 72 THE BROMIDES. The head symptoms are quite prominent, and it is reported to have cured the following kinds of headache: o "Violent pain in the head, increasing until it causes confusion of mind, with feverish attacks, cold extremities and spasmodic (?) pulse." It is recommended for facial neuralgia, and "toothache brought on by warm food." It causes quite severe intestinal irritation, and among the curative symptoms you will find 0" chronic diarrheaa, every four or six weeks, lasting one or two days; stools yellowish, frothy, sour-smelling, fluid, with tenesmus and colic in umbilical region, at night. It is said to cure o constipation with sour-smelling flatus." Its administration to rabbits is said to cause " congestion of the upper lobes of the lungs; hepatization of the lower and posterior lobes; deposit of tubercles in the lungs, some ecchymosis, and infiltration." Hering therefore recommends it "in the first stages of tuberculosis of the lungs, before any or only slight fever has set in, flying, burning and stitches in the chest, flushing of the face, dry cough, and difficult breathing when moving." Also, for " constriction, stitching, pressing pains in the chest." By referring to the provings you will see that it is recommended for rheumatism of the upper and lower extremities; for sciatica, very severe, of both the left and right thigh. The rheumatism seems to be attended with much " cracking of the joints." It is further recommended for "itch, tetter, impetigo, herpes, and other cutaneous eruptions." The dilutions may be made by adding to 10 grs. of the drug 100 drops of alcohol. It should be kept in a glass or rubber-stopped bottle. Do not try to make triturations. THE BROMIDES. The introduction of the Bromine salts into allopathic practice marked an era of improvement in the therapeutics of that school. It occurred just about the time that the THE BROMIDES. 73 influence of homceopathy, acting through public opinion, obliged the relinquishment of blood-letting. The Bromides took the place of the lancet, and were an incalculable improvement upon that instrument of destruction; for, notwithstanding the very general abuse of these salts, they rarely caused notable injury to the patient, and never, I believe, caused death. On the contrary, they have been of vast benefit in the treatment of disorders of the brain and nerve-centers. The amelioration of one disease, epilepsy, by their use, is enough to give them claim to a high place in the Materia Medica of any school. Before taking up each salt, I propose to make some general remarks relative to their mode of action; and explain how such action may be made to agree with our law of cure, and how our school may use them as homoeopathic remedies. I. The primary effect of the usual medicinal doses of any of the Bromides, is to contract all the blood vessels, notably those of the brain and spinal cord. Under their primary influence all the organs sleep, or are placed in that condition of quietude which leads to sleep. They arrest reflex action, and diminish muscular irritability. II. The secondary effect of the Bromides, which may occur during their prolonged use, or after their suspension, is just the opposite, namely: the contracted arteries dilate, congestion occurs, either passive or active; sleeplessness, nervous erethism, hypermesthesia of the reflex nervous system, and abnormal muscular irritability, results. These pathogenetic effects are those which occur when the Bromides are administered to healthy animals or men. Now in choosing a homceopathic remedy we cannot ignore, but must take into account both actions of a drug. Herein we differ from the allopathic school, which, until very lately, made use of the primary effect of drugs only. The latter prescribes a drug to cause its primary action (the Bromides in fullness of the cerebral blood vessels), and usually give unnecessarily large doses, which are apt to lead to secondary symptoms. In homceopathy we can prescribe the Bromides for cerebral and spinal anamia, etc. (primary effects), using 6 74 BROMIDE OF AMMONIUM. very minute doses, and thus aid in restoring the normal equilibrium of the circulation. In congestion, spasm, erethism, etc., we can prescribe the Bromides, for the latter belong to their secondary effects. According to the only rational law of dose, we give appreciable doses, but not enough to lead to an aggravation of the malady. The homeopathic physician, using the Bromides, according to these rules, becomes possessed of a class of valuable remedies, without which his success in the treatment of many severe and dangerous disorders would be greatly diminished. BROMIDE OF AMMONIUM. This is the only one of the Bromides which has been subjected to a physiological proving by a member of our school. Dr. Cushing has published an excellent pathogenesis, made up chiefly from provings upon his own person. Its action appears to be principally upon the brain, the cervical and dorsal portion of the spinal cord, the eyes and nose. Its action upon the brain is similar to that of all the Bromides. According to Brown-S6quard it is preferable to Bromide of Potassa, "when there is a suspicion of the existence of congestion of the base of the brain, or of the spinal cord and its meninges." In accordance with this view of its special action I have usually selected this salt in the treatment of the first stages of cerebro-spinal meningitis, basilar meningitis, and certain severe occipital headaches. It is well known that certain cerebro-spinal congestions are attended by a peculiar spasmodic cough. In such cases I consider this salt specifically indicated. It has not been as much used in epilepsy as the potash-salt, but in those cases where the predominant symptom is basilar congestion, I give it the precedence. In the above affections the dose must be graduated to suit the age and idiosyncrasies of the patient. My experi-,ence leads me to the belief that the maximum d6se is one BROMIDE OF AMMONIUM. 75 grain for each year up to twenty years. For instance, a child of three years requires in severe cases three grains, repeated every two or three hours. A strong man of twenty or thirty requires twenty grains every three or six hours, until improvement sets in. In cases of less severity half or onefourth the quantity may cure. Cases may occur where we may select this remedy from the symptoms of its primary action, namely: in conditions of ancemia of the base of the brain and upper portion of the cord, when such anaemia is due to a diminished caliber of its blood vessels. It is evident that it would not be indicated in cerebral anaemia due to feebleness of the heart's action, or a deficiency in the amount of blood. Such cases must be met by other remedies, as China, Ferrum, etc., aided by Digitalis and a blood-making diet. Hammond (Dis. of Nervous System) says: " It cannot be doubted that spasm of the blood vessels produced through the sympathetic and vaso-motor nerves, explains the origin and continuance of many cases of cerebral anaemia. It is in this way that mental emotions act, and sometimes with such rapidity as to cause instant death. This spasm may be kept up for a considerable time, with the effect of developing the ordinary symptoms of cerebral anaemia even after the emotion which originated it has long disappeared." It is in just such cases that the Bromides are primarily homceopathic. If the reader will consult the symptoms of these salts, he will find a perfect picture of brain anaemia. Especially do the mental symptoms point to that condition. The dose in such cases must be very minute. I have seen prompt curative action from the 3x and 6x dilution, frequently repeated until improvement set in. The eyes are specially affected by the Bromide of Ammonium. Dr. Cushing experienced " redness and soreness of both eyes, with sticking together of the lids in the morning; the eyes were full of stringy mucus, the eye-balls felt unnaturally large, and pain around both eyes into the head; in the evening the eye-lids droop, and it is painful and difficult to raise them." 76 BROMIDE OF AMMONIUM. Dr. Gibbs, an English surgeon, recommends it very highly in "strumous ophthalmia, conjunctivitis, corneitis and leucoma." Dr. Woodyatt, of Chicago, an occulist (homceopathic), esteems it very highly in similar affections, and also in swelling of the edges of the lids and inflammation of the meibomian glands. I know of no more efficient remedy in that common affection, catarrh of the posterior nares and fauces, especially when the discharge is a thick, stringy mucus. A few grains of the lx trit. three times a day, used persistently for a few weeks, will effectually remove that condition. It was once lauded very highly by allopathic physicians in the treatment of whooping cough. It was used successfully in many cases, but did not cure all, and as a consequence of its failure it has fallen into disuse. Too much was expected of it, but to the homceopathist it will prove a valuable aid in the treatment of that malady, and many other coughs of a spasmodic character. The characteristic indications are: "Sudden, deep, spasmodic cough, causing a pain in the stomach. "' Cough, deep, spasmodic, severe, at intervals of a few moments, almost continuous for hours, especially when lying down at night, with sensations of tickling, irritation in the larynx, sometimes with a distinct whoop." The expectoration, if any, consists of a stringy, tough mucus. The provings of Cushing and Okie demonstrate that this Bromide is capable of causing a spasmodic cough resembling whooping cough. Another proof that all drugs capable of curing a disease are capable of causing a similar one. The curative dose I have found to lie between the lx and 3x dilutions. Dr. Griffiths considers that it acts upon the uterine bloodvessels, as does Ergot, namely: causing contraction. He claims to have used it successfully in uterine haemorrhage from any cause; also in amenorrhcea and dysmenorrhcea from congestion (?) I have had no experience with it in BROMIDE OF CALCIUM. 77 this direction, except in dysmenorrhwea; in a few cases, obstinate and obscure, it seemed to alleviate the suffering. In the treatment of epilepsy, convulsions and sleeplessness, this salt is not as useful as some other bromide. But it may be substituted, if necessary. To ward off a threatened attack of epilepsy, or convulsions from congestion of the brain, twenty grains is as small a dose as will prove effectual in an adult. In children the dose has been stated. In the obstinate sleeplessness preceding an attack of cerebro-spinal meningitis, the dose (20 gr.) must be given at bed-time, and when the house and street are quiet. BROMIDE OF CALCIUM. "This salt is said by Dr. Hammond, to have effects which resemble both Bromide of potassium and Chloral hydrate. It is asserted to be preferable to either when there is congestion of the brain, with delirium and sleeplessness, or in sleeplessness alone with great nervous irritability." This paragraph was written nearly two years ago. Since that time I have had frequent opportunities of testing its value, and do not hesitate to assert that it is the most valuable of all the bromides in the treatment of diseases of children. Hahnemann rightly considered the preparations of Calcarea almost indispensable in the treatment of diseases of children, especially during the period of dentition. Calc. carb., Calc. phos., Calc. arseniosum and Calc. iod., are a most valuable group, and if we add the Cale. brom. we have five medicines, with which I am almost ready to assert we can treat successfully a large proportion of the ailments of children from birth to puberty. Given in the lower triturations, or even 1 to 10 grs. of the crude salt, we can control the cerebral congestions and irritations of children, whether direct or reflex. The children for whom Calc. brom. is most useful, are the lax-lymphatic, nervous and irritable. They grow fast, but 0'3 BROMIDE OF CALCIUM. the flesh is not solid; they lehrn to walk with difficulty, the teeth come tardily, and are attended with gastric, intestinal and cerebral irritation. It is useful in the vomiting and diarrheea as well as for the sleeplessness, fretfulness, and tendency to brain disease. My experience with this medicine has given me greater confidence in it, in the incipient and first stages of cerebral diseases, in such children as I have described, than in the much vaunted Belladonna, Hyoscyamus, Aconite and Bryonia. (Before I learned the value of Calc. brom. I had better success with Solanum and Aethusa than the remedies I have named.) But to be successful with Calc. brom. it must be used boldly. No danger need be feared from its use. It is not a narcotic like Opium and its preparations; It simply contracts the cerebral vessels, preventing congestion, and at the same time it diminishes or prevents the dangers of reflex irritation. One grain of the crude drug can be given for each year of the child's age, and this dose can be repeated every hour, in urgent cases, with perfect safety, until the dangerous symptoms subside. In milder cases of erethism or irritation, the lx to 3x trit. may be relied on. I have often prescribed it for children fed by the bottle or otherwise, by dissolving two or three grains in their regular allowance of food for the day. I never saw any bad effects from it, but, on the contrary, the happiest results in the general improvement of the physical and mental condition. I will here add that in thin, bilious, nervous children, with black hair and eyes, I have found the Bromides of soda or potassa to act the best. I hope this earnest recommendation will have the effect of inducing physicians to pay more attention to the value of this truly beneficent remedy. BROMIDE OF CAMPHOR. 79 BROMIDE OF CAMPHOR. This bromide would seem to be a combination of medicines possessing directly opposite effects. All the bromides, except the Bromide of Quinine, cause primarily cerebral anmmia. Camphor causes cerebral congestion, and may cause epileptiform convulsions, primarily. It would seem that a union of the two elements would counteract each other. My observations of the use of this drug in allopathic practice leads me to believe that the Camphor-effects predominate in most cases when it is given in large doses. I have known doses of from 6 to 10 grs. cause congestion of the brain, with delirium, and threatened convulsions. So commonly have these unpleasant effects resulted from such doses that allopathic physicians are shy of prescribing it much, of late. Dr. Hammond, however, is quite successful with the drug, but he gives it in moderate doses. Its sphere of action is doubtless nearly that of Camphor, modified somewhat by the Bromine. It is primarily homzeopathic to cerebral congestion, with great nervous erethism, especially when it assumes the form of hysteria. I should consider it secondarily indicated in cerebral anemmia, from previous over-stimulation, and attended by sleeplessness, cold extremities, feeble circulation, and nervous headache. Dr. Hammond published several cases in which he found it useful. I condense them as illustrative of its use in his hands: Infantile convulsions due to irritation of teething, with the effect in each instance (two) of preventing the further occurrence of the paroxysms which, previous to its adminministration, had been very frequent. Dose: in each case, one grain an hour, rubbed up in a little mucilage of Acacia. Three doses were sufficient in one, and two in the other case. The ages of the children were respectively 15 and 18 months. A very obstinate case of hysteria, occurring in a young married lady, in the form of paroxysms of weeping and 80 BROMIDE OF CAMPHOR. laughter alternately with epileptiform and choreiform convulsions. Dose: four grains every hour. Improvement commenced after two doses were taken, but ten were necessary to entirely break up the attack. All previous seizures had lasted from five to eleven days, uninfluenced by medication or moral suasion. Headache in women and young girls, due to mental excitement and excessive study. One dose of four grains was generally sufficient to cut short the attack. Delirium tremens, in a large man of plethoric habits. Symptoms: great cerebral congestion, tremulousness and great jactitation of the limbs; conversation muttering and incoherent; pulse full and soft; no sleep for several nights: 100 grs. Bromide of Sodium did not cause sleep; 5 grs. Monobromide camphor caused sleep within half an hour; he slept over 12 hours; afterwards the same dose at night caused good sleep, and relief of all the other symptoms. In this case there may have been congestion of the brain in the beginning, but it could not very well have been present after the patient had swallowed 100 grains of Bromide of soda. In fact, the symptoms which existed when the Camphor bromide was given were those of cerebral anaemia, a condition in which 5 grs. of the drug would be likely to have a good effect. The Belgian physicians who first used it recommended it for delirium tremens. I think it will prove useful in the delirium of low typhoids, when anaemia of the brain and erethism are both present. Owing to the powerful depressing influence which both constituents of this drug have over the generative organs of both sexes, I predict that it will form a useful remedy in the opposite conditions of excitement and debility. It must be primarily homceopathic to impotence, torpor and passive spermatorrhoea, and I should expect it would cure such conditions when prescribed in the 3x or 6x triturations. It is secondarily indicated in nymphomania, chordee, active spermatorrhaea, with nocturnal emissions, and amorous dreams. Dr. Hamilton says it is far superior to any remedy he has ever tried in chordee. I can testify to the same, and 1 have found that BROMIDE OF IRON-BROMIDE OF LITHIUM. 81 two or three grs. at bed time will effectually control nocturnal chordee, emissions, and erotic dreams. In a case of obstinate neuralgia of the testicles and prostate gland, which were both indurated and enlarged, the patient having lost his sleep for weeks; two grs., at night, not only caused sleep, but greatly relieved the other symptoms. In my third edition of New Remedies I predicted that it would prove useful in cholera infantum with impending or actual spasms. Its use in several cases since that time has justified that prediction. The 2x trituration, a grain or two every half hour, acts very favorably in the collapse with cerebral symptoms. It may prove as useful in cholera morbus and cholera asiatica. BROMIDE OF IRON. This medicine has been recommended very highly by several physicians for spermatorrhoea with anaemia, great debility, and great depression of spirits. It has been used in the 2x trit. My experience is limited, and not very satisfactory. BROMIDE OF LITHIUM. Dr. S. Wier Mitchell prefers this salt to the other Bromides, in that it does not cause eruptions, and that its action is far more speedy. He gives a case of a gentleman threatened with apoplexy, who had had one attack and was hemiplegic. He was taken with numbness, vertigo, headache and thickness of speech; one dose of 30 grs. removed the symptoms in less than half an hour. He also records a case of epilepsy, when a fit occurred every morning, on rising. Cured by 10 grs. twice a day. When the other Bromides lose their effect in epilepsy, this salt will arrest the fits. It relieved a case presenting the following symptoms: after any prolonged mental exertion, flushed face, insomnia and intense pain between the shoulders. If I was to prescribe any Bromide in rheumatism and 82 BROMIDE OF MERCURY-BROMIDE OF POTASSIUM. gout, I should prefer this, on account of the Lithia which it contains. BROMIDE OF MERCURY. I have used this preparation in a few cases of diphtheria, with great painfulness of the inner throat, white deposit, and a dusky redness of the fauces and tonsils. It acts very satisfactory in the 3x trit. Dr. Hildreth (an occulist) was enthusiastic in its praises, in iritis, and intense congestion of the tissues of the eye. BROMIDE OF POTASSIUM. This was the first preparation of the Bromides which was presented to the profession. It has been most extensively used, and its effects recorded with greater minuteness than any other. Of late, however, the Bromide of Sodium, owing to its less irritating effects on mucous surfaces, its pleasanter taste, and some other qualities, is considered preferable. In fact, I think for most purposes the sodium salt may be used as a substitute for the potassium. The pathogenetic and physiological action of the latter has been so well studied that we may safely allow it a place among our best proven medicines. Already it has been prescribed successfully for its direct primary effects by several physicians of our practice. No physician can read of its effects upon the mind without being convinced of its great power in causing abnormal conditions of the brain and mind. It is supposed that the uniform pathological condition caused by its direct effects in large doses is cerebral ancemia. If this condition is kept up, we have deficient nutrition. If the brain has been already diseased, structural or functional disease may become permanent —fixed by its primary or secondary action. The most prominent, unvarying symptoms of the brain and mind caused by this drug are: BROMIDE OF POTASSIUM. 83 (1.) Profound melancholic delusions, either a religious depression or a feeling of moral deficiency. (2.) Loss of memory, absent-mindedness, he forgets how to talk, slowness of ideas. (3.) Delusions of conspiracies against him. (4.) Illusions, as that of seeing her brother fall overboard. (5.) Amnesic aphasia, he could pronounce any word he was told to, but could not speak otherwise. It does not cause melancholy with belief in approaching poverty and want, but the contrary; a belief that " thousands of dollars are sewed up in his clothing," or that "gold was concealed in the lining of his coat." These profound melancholic and other illusions were all caused by massive doses. If, therefore, this medicine is prescribed for the symptoms enumerated as primarily pathogenetic-e. g., mental depression from cerebral anaemia or exhaustion-it must be given in minute doses, 3x to 6x. Dr. Waesselhceft, of Boston, and myself have prescribed it successfully in such cases, after Cimicifuga, Sulphur and Veratrum failed. The secondary pathogenetic effects of large doses are sometimes quite serious. It has been observed that when doses of 40 to 60 grs. several times a day have been suddenly suspended, one of two conditions sets in: (1) a condition of cerebral irritation, (2) cerebral congestion. In cases of post mortem, of animals to which the Bromide had been given in massive doses, intense congestion of the brain and its meninges were found. This proves that the secondary action of the bromides is to cause that condition for which it is given successfully. It is therefore homoeopathlc in rational doses, (1 to 20 gr.) in cases of cerebral irritation and congestion. I have collected numerous cures of such cases, and recorded them in New Remedies, 4th edition, but will here briefly enumerate them, and will add that I have verified nearly all of them in my own practice. The first or irritative stage of delirium tremens is ordinarily treated by 5 to 10 grs. of Bromide repeated every two or 84 BROMIDE OF POTASSIUM. three hours; but the face must be flushed, eyes red, pulse quick and hard, with delirium of active type and horrid illusions. If the face is cold and pale, pulse weak and thready, Digitalis is the proper remedy. I have found these two medicines, aided by Cimicifuga 3x or Hyoscyamus lx, to control all cases of that fearful malady. No remedy compares in efficacy with this in the treatment of night terrors of children, from any cause. A few grains, according to the age of the child, given at bedtime, banishes these attacks at once, and often for a long time. If worms are present, a few doses of Santonin lx, during the day, is a valuable adjunct. Frightful imaginings in pregnant women, usually caused by an engorged condition of the brain, are speedily dissipated by a few doses. Somnambulism has been cured by it. Puerperal mania, when attended by ferocious or erotic delirium, is always relieved and often cured by the free administration of this medicine. Spasms and convulsions from fright, anger, and other emotional causes, occurring in plethoric nervous people, or in women at the time of the menses. I prefer it to any other medicine. -Epilepsy, when the attacks are attended or caused by un mistakable congestion of the brain, are always alleviated. It has been asserted by our school that it never cures. I know that it has cured many cases of epilepsy of a recent character, and not dependent on constitutional causes. I admit that it will not cure congenital epilepsy, or the syphilitic, but it will modify such cases greatly; and it is only common humanity to give it for that purpose, even when a cure is not expected. I must mention one other condition of the brain and mind in which I have often found it useful, namely: in that condition of nervous irritability caused by the severe illness or death of some dear friend, or loss of property or reputation. the patient is constantly fretting, will not eat, can not sleep, is very irritable to all around; the pulse is quick, BROMIDE OF POTASSIUM. 85 tongue coated and breath fcetid. In these cases, give, every hour or two, a teaspoonful of a solution of 20 or 30 grs. in half a glass of water. You will be gratified with the result. In acute congestions or inflammatory diseases of the brain, I confess to a great liking for this medicine. It ranks with Aconite, Gelseminum, Veratrum viride, and Solanum. (I regret to say that I have nearly always been disappointed in Belladonna and Glonoine.) In active congestion, or the first stage of inflammation, before effusion has occurred, I verily believe the Bromides, if promptly and properly given, will arrest the disease. I did not at one time believe this, but repeated failures with our best remedies prompted me to give this a fair trial. I had, hundreds of times, been mortified and angry at the failure of Acon., Bell., Bry., Gels., Glonoine and Veratrum, aided by hot foot-baths, and cold water to the head. The patients would grow worse, and either run into fatal cerebral disease or into the hands of allopaths. I once resolved that the next case that occurred I would treat boldly with some Bromide. Two severe cases soon came under my care-a child, aged 3, and an adult woman of 30. To the former I gave 3 grains, and to the latter 15 grains, every hour for four hours, when I had the satisfaction of seeing a decided improvement, followed by a recovery under smaller doses and less often repeated. Since that time, unless I see very prominent characteristic indications for some other medicines, I give the Bromide (of Sodium generally), and have been perfectly satisfied with the results. In the reflex cerebral irritations and congestions of children during teething, cholera infantum, or in scarlet fever, it is almost specific. Also in incipient basilar meningitis, many cases of which I have arrested before serious disease fixed itself on the child. The Eye and Ear symptoms are unimportant as designating local disorder. The amaurosis, strabismus, squinting, photophobia, etc., the ringing in the ears, and sensitiveness to noise, all point to cerebral irritation. It causes, and will cure, a peculiar state of the throat, in 86 BROMIDE OF POTASSIUM. which the patient is choked every time he tries to drink fluids, although he can swallow solids with impunity. I have often verified Dr. Caro's recommendation and practice in treating difflcult and painful dentition of children by its local application. Dissolve a few grains in an ounce of milk or water, and bathe the gums. From being turgid, swollen and red, they assume their natural color. If the salivation is difficult, it restores it; and the sleeplessness, jactitation, vomiting and diarrhoea are all relieved. In the vomiting of drunkards, and of pregnant women, it often acts magically. It quiets that reflex action, whether arising from the brain or uterus. Give a dose, say 10 grs., at night, and the same amount in the morning before rising. A few days' trial will suffice to test its value. One of the worst cases I ever saw was cured by enemas of 20 grs., night and morning. Hysterical women often vomit their food after each meal, especially if they are subject to exciting emotions. A few grains given just before eating will often prevent the recurrence of the vomiting. Several years ago, one Dr. Caro, of New York, made a report on cholera infantum, in which he claimed to have cured one hundred and fifty-seven out of one hundred and sixty cases, by the administration of Bromide of Potassium, in doses varying from one-fiftieth to two grains every hour. This report created quite a sensation, and allopathic physicians all over the United States tested its value in that disease. Many homeoopaths, attracted by the "glittering generalities" of Caro, gave it a trial. But the results failed to verify Caro's experience, and the medicine fell into disuse. Such is too often the case with new remedies in allopathic hands. How shall we explain this discrepancy? Bromide of Potassium does not cause this disease, by its primary action —and its secondary action has not been sufficiently studied to show that cholera infantum belongs to the secondary effects. I believe, however, that it would appear if children were the subjects experimented upon. BROMIDE OF POTASSIUM. 87 What is cholera infantum? A disease of the bowels? I believe that true cholera infantum, that kind which comes on suddenly, attended by great prostration, cold hands and feet, hot head, dilated pupils, rolling of the eyes and head, starts, jactitation, spasms, watery, very offensive stools, vomiting of all drinks, and intense thirst, is nearly always a disease of cerebral origin, or an over-excitement of the nervous and vascular systems. Probably Caro's cases were all of that character, or nearly all. Certain it is, that when I meet with cases such as above described, I find one of the Bromides to be almost specific in removing those symptoms. I do not rely on it in all cases alone, but alternate Camphor, Veratrum alb., Carbolic acid, or Solanum, as the case seems to indicate. But in the majority of cases I rely on the Bromide alone. Asiatic cholera has been successfully treated by twentygrain doses of Bromide every hour. Dr. Begbie says: "In the first stage, it arrests the vomiting, the cramps, and the rice-water discharges, restores the secretion of urine; the warmth and color returns to the previously cold and livid skin." He suspends its use when reaction sets in. I have never had opportunity to treat cholera with this remedy, but from my happy experience in certain cases of cholera infantum I should prescribe it with every hope of success. Colic in young children, of a peculiar character, according to Sidney Ringer, is readily cured by it. I have often verified his recommendation. The special symptoms are: "the walls of the belly are retracted and hard, while the intestines can be seen at one spot contracted into a hard lump, of the size of a small orange, and the lump can be seen to travel from one part of the belly to the other. These attacks are frequent and excruciating, are unconnected with diarrhaea or constipation, but are often associated with an apthous condition of the mouth." I have often observed that the attacks were periodic, coming on in the evening at a regular hour. I give a grain or two of the lx trit. in water every two hours during the interval, and every fifteen minutes during the attack. 88 BROMIDE OF POTASSIUM. Constipation of years standing has often been cured unexpectedly while giving this remedy continuously for other disorders. I cannot pretend to give a rationale of its curative action in such cases; but the fact is worth noting. Some anomalous disorders of the rectum have been benefited by the Bromides. Dr. Helmuth cured "'polypoid tumors." I have relieved spasms of the sphincter ani. Dr. Caro records a cure of a child three days old who had retention of the meconium. The infant vomited all food, no action of the bowels. One half grain of the 1x trit. every hour rapidly removed these conditions. If this medicine was useful in no other sphere, its prompt and beneficent action in Miorbid affections of the organs of generation would give it a high rank as a curative agent. In massive doses, it causes a diminution, sometimes absolute, of all sexual desire and power. In this respect it resembles Gelseminum, Conium, Camphor, Baryta and Caladium; but, unlike these drugs, it does not cause this impotent condition in all cases, It does, however, often give rise to secondary effects just the opposite. Pelvet says it causes contraction of the minute afferent vessels of the corpus cavernosus (primarily). The reaction against this contraction is therefore congestion or fullness, thence erections, etc. It is (primarily) homceopathic to impotence, with loss of desire or power, or both, with or without atonic spermatorrhcea, and in such cases should be used in the 3d or 6th attenuation. It is (secondarily) indicated in satyriasis, nymphomania, erotomonia (hysterical, with spasms), sensual, amorous and disgustingly lascivious dreams, nocturnal emissions, with erections and dreams, chordee, etc. I have made frequent and very successful use of it in all these latter conditions, giving 5 to 20 grs. once, twice or thrice a-day, and have never seen other than good effects from its use. In some of the menstrual ailments it is specific,:namely: when they are preceded or attended by epileptic spasms, catalepsy, headache, and congestive heat, burning and irritation of the BROMIDE OF POTASSIUM. 89 genitals, nymphomania, erotic fancies, lascivious dreams, sleeplessness, spasms of the uterus, pains in the ovaries, menorrhagia, and many disagreeable reflex symptoms. I have records of many cases cured promptly, by giving a few grains daily through the month, and every hour or two during the menses. Ovarian disorders, such as irritation, neuralgia, swelling, and even tumors, have been cured by the Bromide. It has a specific influence on those glands, and ought to be used more in the reflex disorders caused by ovarian diseases. Enlargement of the uterus, especially that kind called by Simpson " sub-involution," or a failure to return to its normal size after labor or miscarriage, speedily resolves under the use of this medicine. It has even relieved the pain, and diminished the size of fibrous tumors of the uterus. This, with the Iodide of Baryta and Ergotin, will, I believe, prove to be the best treatment for all tumors. Among the few pathogenetic symptoms recorded by homceopathic provers, we find "profuse urination, with thirst, copious, yellowish-white, thin urine, having a peculiar fcetid smell; the urine sometimes contains albumen." These symptoms would appear to indicate it in diabetes, and Beybie reports two cases of diabetes mellitus, which he cured in six weeks, by giving 20 grs., three times a day. The symptoms were pronounced and unmistakable. The inquiry may arise, why did such large doses cure? When it is remembered that if a man with the ague takes 20 grs., daily, of Quinine, the urine will contain the 20 grs., yet the man is cured of his ague (see Grauvogl), we can say the same of the Bromides. It is all, apparently, eliminated by the urine, yet the patient is cured. Maybe one gr. or less would have cured the two cases, but if the 20 grs. cured without injury, where is the harm? Nocturnal enuresis has been cured by the Bromides. I cured several children of this troublesome disorder, when giving them this medicine for " night terrors," which sometimes has some connection with the bladder difficulty. In whooping cough it often acts as well as the Bromide of ammonium. 90 BROMIDE OF POTASSIUM. Spasmodic croup is often relieved promptly, especially when it occurs suddenly in the night, and is the result of reflex irritation from teething or worms, rather than a catarrhal irritation. Dr. Snelling once treated many cases of diphtheritic angina and membranous croup, successfully, with this Bromide; but for some reason his use of it was not adopted extensively. (The Bromide of Mercury will probably prove a better remedy.) Dr. Carson relates an obstinate case of nervous cough during pregnancy, threatening abortion. The cough was dry, hard and incessant. No disease of lungs or throat. Opium and Belladonna were tried for two months, uselessly. A few doses of the Bromide of Potassium cured. I have cured several similar cases, even when occurring in children; a peculiar barking, brassy, incessant cough, which Kali bich. ought to have cured, but did not. It ought to cure, in high potencies, loss of sensation in the glottis and larynx, but I have had no experience with it in such cases. Spasmodic asthma in children (asthma of Miller), according to Hebra and Londahl, has been cured promptly by this Bromide, even when suppression of urine, cedema, lividity of the body and great dyspncea had set in. Cardiac neuroses are often among the most obstinate and difficult of all the maladies the physician is called upon to treat. Medicines which have a special affinity for the heart, such as Digitalis and Cactus, exercise but little influence in these affections, unless the disorder has its origin in the ganglia of the heart itself. The majority of cardiac neuroses have their origin remote from that organ, namely: in some irritation or atony of the brain, spinal cord, liver, or reproductive organs. They are kept up by reflex irritation, or nerve-enervation. The Bromides, if judiciously prescribed, will act curatively in that class due to irritation of a reflex character, especially when that irritation is in the uterus, ovaries, brain BROMIDE OF POTASSIUM. 91 or spinal cord. If the disorder is due to nerve-enervation, the most useful remedies are Phosphorus, Zinc, Ferrum, Ignatia, Nux vomica, Lilium, etc. I can give no characteristic symptoms. The best guide for its use is in the general indications above given. All kinds of excited action, irregularity, palpitation, etc., when unattended by local lesion, come under the sphere of its usefulness. In sleeplessness, no medicine has been more abused. It is not useful in all cases. In fact there is but one pathological state in which it is useful, namely: an overfullness of the cerebral blood vessels. When we have this condition, the Bromide, in doses of 10 to 20 grs., restores the normal caliber of the blood vessels, and sleep comes of itself, i. e., it is not forced. The remedy acts in a physiological (homceopathic) manner. Sleeplessness from this cause may arise from various causes, namely: mental anxiety, excessive intellectual labor, hysteria, pregnancy, teething, the exanthemata, typhoid fever, erysipelas, and a general " nervous irritability; " also anger, and various exciting emotions. Sleeplessness may arise from an anemnic state of the brain, and then demands Opium, Hyoscyamus, Ignatia or Digitalis, aided by food, and a low position of the head. The action of Bromide of Potassa on the skin is quite decided and specific. It seems to cause, invariably, after it has been taken some time in large doses, (a) an eruption of small boils, in successive crops, chiefly over the face and trunk, with troublesome itching; (b) a papular rash on the face, with heat and itching; (c) acne, chiefly on face, scalp and shoulders, not very painful, varying in size from a millet seed to a large pea; (d) pustular eruptions of malignant aspect, much resembling varioloid; (e) corroding ulcers. Nursing children have had the characteristic acne, from the taking of a bromide by the mother, showing that it is taken up into the milk. It ought, therefore, to be homceopathic to these cutaneous affections. My clinical use of the Bromides, in skin diseases, 92 BROMIDE OF QUININE-BROMIDE OF SODIUM-BUFO. has been confined to the treatment of acne in young people of gross habits of eating, in which disorder it has seemed to act beneficially in the third trituration. I have used it successfully in the following general nervous affections: paralysis agitans, tetanus, chorea. In that condition known as hysterical spinal irritation, and in anomalous disorders of the vaso-motor nerves, it is worthy a thorough trial. BROMIDE OF QUININE. Dr. Richardson, of England, introduced this medicine, and used it with favorable results. I have had no experience with it, but should I have much ague to treat, I think I should give it a fair trial. It ought to prove very useful, and in some respects superior to the Sulphate. The unpleasant congestion of the head might be avoided, as the two constituents are antagonistic. BROMIDE OF SODIUM. I have already mentioned this salt. It is to be preferred in nearly all cases to the Bromide of potassium. It can be mixed with the food of patients, with the milk of children, as its taste is almost identical with common salt. BUFO. I have seen no reason to change the opinion I expressed in the third edition of New Remedies, relative to the trustworthiness of the provings of this and other medicines of which Houat has given pathogeneses. It would be better for our school had they never seen the light. I have tried the Bufo, in several cases of epilepsy, when it seemed indicated, but I never saw any such brilliant results as have been recorded by Dr. Holcombe and others. CACTUS GRANDIFLORUS. 93 CACTUS GRANDIFLORUS. I doubt if this medicine has come up to the expectations of some members of our school of practice. It was heralded by the most fullsome laudations of its great value, not only in diseases of the heart, but in all other acute inflammations. I do not remember, however, to have seen any record of cases other than disorders of the /tkart cured by the Cactus. It is my opinion, from careful observation and study of its action, that all the symptoms an.l Cnditions caused and cured by Cactus are due to its affinity for the heart, and its pathogenetic action thereon. It appears to me that its action on the heart is that of an intense irritant of the ganglia of that organ. It may thereby cause the several conditions of hypercesthesia, irritability, neuralgia, spasm, irregular action, and, finally, inflammation. It differs from Digitalis in this, that it seems to have an action on the circular fibers of the muscular tissue of the heart, while Digitalis acts on all the muscular fibers alike. Cactus is capable of causing carditis and pericarditis; Digitalis is not. Cactus resembles Bryonia, Aconite, and Spigelia more than it does Digitalis. In only one condition does it resemble Digitalis, namely, cardiac failure, and in both, the failure is a secondary effect. If you will carefully study the symptomatology of Cactus, you will see that the mental, cerebral, occular, aural, nasal, pharyngeal, gastric, hepatic, urinary, ovarian, uterine and thoracic symptoms, can all be traced back to a profound cardiac disturbance. It will be useless, therefore, for you to prescribe Cactus in disorders of the above mentioned organs, unless the great central organ of circulation is at fault. I wish to call your attention particularly to the hmemoptysis of Cactus. It is not indicated in spitting of blood, unless it is caused by an excited action of the heart, acting on pulmonary vessels weakened by disease of the lung tissue. 94 CACTUS GRANDIFLORUS. In hoemoptysis with weak, small pulse, it is not indicated; but if the heart's action is hard, tumultuous, and the pulse similar, then Cactus will arrest it. The blood must be bright and fluid (arterial). It is recommended in pneumonia and pleuritis, but has not attained any popularity in those diseases. In the few cases reported, the pulse was hard, vibrating, 120. I suspect, in all cases when it is useful, some cardiac inflammation or abnormal excitement must be present, as a complication, or as a cause. The bronchitis and asthma in which it is indicated is, without doubt, always a cardiac complication. The characteristic symptom of Cactus heart-trouble is " a sensation as if the heart was constricted as by an iron band." This sensation is very distressing, and, whenever felt, is a pretty sure indication for this remedy, or for Iberis, Arnica, and sometimes Digitalis, but in a less degree. TFalvular diseases of the heart may be palliated by Cactus in a large proportion of cases, unless the disorganization is too far advanced, when Digitalis will be of greater service. Hypertrophy with enlargement is more under the control of Cactus, than is hypertrophy with dilatation, which is just the reverse of Digitalis, Iberis, or Lycopus. For the numerous cases cured or relieved by Cactus, see the extended collection made in the fourth edition of Symptomatology of New Remedies which I copy: *Sensation of constriction in the heart, as if an iron band prevented its normal movement. *Palpitation of the heart, continues day and night, worse when walking, and at night when lying on left side.'Functional disorder of the heart from mental emotion, aggravated at the menstrual period. ~Angina pectoris. ~Palpitation, acute and chronic, even in organic diseases of the heart. oAcute inflammatory affections of the heart, idiopathic, and even from rheumatism. ~Acute carditis, with blueness of the face; oppression of CACTUS GRANDIFLORUS. 95 breathing; dry cough; pricking pain in the head; can not lie on the left side; pulse quick, throbbing, tense, and hard. ~Chronic carditis, with Eodematous and cyanotic face, suffocating respiration, continued dull pain in the heart, dropsical effusion throughout the body; can not drink or speak; hands and feet cold, pulse intermittent. ~Hypertrophy with dilatation; patient is pulseless, extremely exhausted, panting and sad; can not lie down or speak; has scarcely slept for fifteen days; forgetful; feet cedematous. (Is soon relieved, lies down, and sleeps twelve hours.) ~Organic diseases of the heart; valvular diseases (an invaluable palliative for many distressing symptoms.) ~Heart disease, with cedema of left hand only (no other remedy has this symptom). ~A constant fluttering sensation in the stomach over the location of the cceliac axis, in a spot about the size of a dollar; a burning line extends down from it to the lower ribs on either side; a hot flash shoots downwards frequently (cured by a few doses.) "Rheumatic inflammation of the heart with severe pain in the apex of the heart, and pain shooting down the left arm to the ends of the fingers; dyspncea, pulse feeble, 120, etc. ~Palpitation of the heart from any exertion, with excessive pain over the left side between the scapule and sacral region. "A whizzing to-and-fro sound, or bruit de soufflet. "Endocardial bruit, increased preecordial dullness, excessive impulse of the heart's action, and evident enlargement of the right ventricle. "Great irregularity of the heart's action-intermittent at times and of varying character-great frequency of action alternating with slowness. (Enlargement of left ventricle, with great irritation of the cardiac nerves.-SANFORD.) "Irregularity of the heart's action, from reflex irritation. "Palpitation with vertigo, dyspnoea, loss of consciousness. Indications for Cactus in cerebro-spinal meningitis: Melancholic and hypochondriac mood. 96 CACTUS GRANDIFLORUS. Vertigo from congestion to the head. Heavy pains, like a weight on the vertex, worse from sounds, even talking. Pulsative pains in the temples, intolerable at night. Dimness of sight, circles of red light before the eyes. Pulsations and buzzing in the ears. Contraction in the throat and cesophagus, preventing swallowing. Oppression on the chest, like a great weight, or as if the chest were compressed; with fainting, cold perspiration, and loss of pulse. Sensation of constriction around the heart, as if an iron band was around it. Very acute pain, and such fearful stitches in the heart as to cause him to cry aloud, with distressing palpitation, faintness, dyspnoea, etc. (Pains everywhere-head, arms, legs, back, chest, heart; darting, springing like chain-lightning, terminating with a sharp, vise-like grip, only to commence again a moment afterward, with restlessness and groaning.) This last symptom is a curative one, observed by Dr. Lilienthal, and doubtless would be found pathogenetic in a full proving. This sense of constriction seems to affect all portions of the body. Dr. Farrington writes me that "a very intelligent lady, who for years has used Homceopathy, took many doses of Cactus 30. She complained of irresistible inclinations to cry. She felt as if her whole body was in a wire cage, and that each several wire was being twisted tighter and tighter." Dr. F. also sends me a case of rheumatism of the diaphragm, cured by Cactus 30th and 200th. The symptoms were "constriction around the lower part of the chest as from a cord, the constriction marking the periphery of the diaphragm; jerking breathing; sharp pains shooting through the body, towards the back and upwards into the chest, with sensation of rush of blood to the chest." CALABAR BEAN. 97 CALABAR BEAN. This powerful and unique medicine has not been sufficiently proven by our school to enable us to arrive at any definite conclusion as to its special symptomatic indications. There are certain pathological conditions which it has been known to cause, and these afford us trustworthy data for its use in some peculiar cases. According to the best observers of its effects in large and poisonous doses, its operation is spinal, not cerebral; it acts on the anterior or motor column, so as to suspend or deaden its energy, or reduce the activity of its functions. The powerless parts are those which receive their nervous supply from the spinal cord and its nerves. The muscles of the extremities and of respiration are most enfeebled; the paralysis is primary and always seated in the striped muscles; there is no failure of volition; the will is strong, but a difficulty lies in the way of carrying out its purpose. The paralysis is commonly preceded by twitching or trembling of, the muscles (in animals, convulsions.) In rare cases the unstriped muscles and brain are involved (secondarily.) Death occurs from paralysis of the heart, or fatal syncope. (Digitalis from the opposite, or tetantic contraction.' To sum up its effects, as I conceive them: (1.) General paralysis of motor nerves, or voluntary muscles (primary); (2.)' paralysis of involuntary muscles (secondarily.) Viewing its action in this light, you will see that it is primarily homceopathic to such maladies as: Chorea, of which there are several cases reported as cured by ten to eighteen drops a day. (a) A boy of fourteen, the disease had lasted several months; had resisted Ferrum, Arsenicum and Zinc; cured in nine weeks. (b) A girl of twenty, cured rapidly. (c) Chorea of right side, the tongue seemed too large (paralyzed.) The symptoms were not fully recorded as they should have been. Paralysis agitans, if no structural lesion, as softening of 98 CALABAR BEAN. nervous tissue, exists. Several observers (allopathic) mention that it did no service in such cases. Hammond (Dis. of Nervous System) says: " Under the term paralysis agitans several affections have been included, which are very different in character." He classes them: (1) multiple cerebral sclerosis; (2) cerebro-spinal sclerosis. " These two are usually met with in old persons, and depend on organic wasting changes in the nervous centers, is incurable, and known as " shaking palsy." (3) A form of tremors occurring in younger persons, is more curable, and therefore is presumably not dependent on organic change. The causes of this variety are, emotional disturbance, continuous or severe muscular exertion, exhausting diseases, rheumatism, blows, falls, etc. The Calabar Bean in small doses (lower dilutions, possibly the high) will doubtless prove curative in this form of tremors. It may have to be preceded or followed by Arnica, Ignatia, Scutellaria, Cocculus and Phosphorus. The " constant primary electrical current," according to Hammond, is very useful in all cases. The heart may partake of this variety of tremors. I have met with several cases due to emotional disturbance. In one case I used Calabar 3x with good results. It is certainly homceopathic to cardiac debility, and ought to be useful in that peculiar condition I have named cardiac chorea. I recently cured with Calabar a casA of tetanic spasms, where the heart was affected by the disease. (See N. A. Jour. Hom., May, 1875.) Cerebro-spinal meningitis. It was first used in that terrible disease by some eminent allopathic physicians of Chicago. Their successful use of it coming to my knowledge, I ascertained that they used it, as they thought, antipathically, or for the tetanic contractions of the spinal, cervical, and other voluntary muscles, which commonly occur during the progress of that malady. This condition, however, is only apparently tetanic in many cases, it is really a paralysis of the opposing or antagonistic muscles. In such cases the Calabar is primarily homeopathic to the condition. If, however, CALABAR BEAN. 99 the condition is really tetanic, it is secondarily indicated, for I believe a primary paralysis is often followed by a secondary tetanus. In the former condition the attenuations (2x to 3x) would prove most useful; in the latter five to ten drops of the mother tincture every three or four hours, either in alternation with, or followed by Secale 0 in similar doses. I speak from my own experience, for I have the records of several cases, pronounced incurable, which recovered under the use of Calabar. A primary symptom indicating Calabar is contraction of the pupils; a secondary, dilated pupils. The heart's action is tumultuous, feeble and irregular. Idiopathic tetanus has been successfully treated with Calabar in large doses. Many severe cases have been reported. It has also been efficient in tetanic spasm from Strychniapoisoning. Certain epileptiform spasms have been cured by this medicine, but the details of the cases were given with that peculiar indefiniteness which belong to allopathic reports, I can not give you the specific indications. The action of Calabar on the eye is specific and unvarying. It is the opposite of Belladonna. It causes contraction of the pupils to the size of a pin's head, attended at first by a "twilight gloom " which wore off before the pupils dilate. It causes short-sightedness in healthy eyes, and restores, temporarily, normal vision in long-sighted persons. Astigmatism is a condition caused by Calabar. It has proved curative in several cases of paralysis of the circular fibers of the iris and ciliary muscles of one or both eyes. In prolapsus of the iris from injuries, its topical application caused the retraction of the prolapsed portion, and contraction of the pupil. Occulists make extensive use of it, locally, when it is desirable to cause contraction of the pupil. The provings of Beckwith, Chase and Wesselhceft give some peculiar symptoms, but they did not use sufficient quantities to cause those distinctive characteristic symptoms which we require. 100 CAFFEINE. Beckwith found it to cause and cure a form of dyspepsia, marked by great pain (pressure) immediately after eating. In this it is analogous to Dios., Arg. nit. and Bismuth. An allopathic observer claims to have cured an obstinate constipation with Calabar. It resembles somewhat, in its action, Agaricus, Gelseminum, Solanum, Conium and Arnica, but no remedy is very closely analagous to it. It is one of those medicines which you will find have a narrow but decided action, and when indicated will act promptly and profoundly. CAFFEINE. This substance is the alkaloid of the Coffee Bean. It is said that a cup of coffee, forming an infusion of 16.75 grs. of dry coffee, contains about 0.1 to 0.12 grs. of Caffeine; and an infusion of 5 grs. of very good tea contains the same quantity of Caffeine. The chemists have decreed that Caffeine and Theine are identical, but we can not always accept the dictum of the chemist, for two substances may appear chemically identical, yet may possess different physiological properties. It was once supposed that Caffeine represented the principal qualities of tea, coffee, guarana, and some other substances used as beverages by various nations. But it is doubtful if such is the fact, for they all differ in effect, while the action of the Caffeine is uniform. It is probable that coffee contains several other constituents in smaller quantities than Caffeine, so that Caffeine can not be made a complete substitute for the "Coffea " which we have used in practice. Dr. Aubert (Pfluger's Archiv.) who has studied the effects of this substance on the nerves, muscles, respiratory movements, heart and circulation, says it increases the reflex excitability and may produce tetanus. He considers this "a medullary tetanus, for it is produced in the frog if the ischiatic nerves are cut, and it takes place in a limb the circulation in which has been stopped by a ligature before the subcutaneous injection into the skin of the back." CAFFEINE. 101 Caffeine has been used in the practice of European and English physicians, and also in this country, much as the guarana (paulliana) is now used, namely: for nervous and sick headaches. Its pathogenetic power of causing excessive reflex excitability, accounts for the virtues of Coffea, even in high potencies, in the nervous erethism of children and women, and shows that it may homoeopathically prevent the accession of tetanoid spasms during intestinal irritation, or even the irritation of dentition. It is therefore an analogue of Nux and Ignatia, but antagonistic to Scutellaria, Cypripedium, Calabar and the Bromides (also Chloral.) But it has other curative powers which may be utilized. It has been found curative in cardialgia, spasmodic asthma, hemicrania and nervous palpitations. Coffee drinkers are notoriously subject to crampy pains in the stomach, palpitation of the heart, and severe headache. A proof that tea is not identical with coffee, is the fact that after the suspension of the use of coffee, and a resort to tea as a beverage, these symptoms disappear. Tea-symptoms subside after substituting coffee. I have used Caffeine a good deal during the last few years, especially in sleeplessness; nervous agitation after excessive pleasurable emotions; nervousness in teething children, and in women suffering from uterine diseases. I usually prescribe the 3x trituration, nor have I ever observed any aggravations from it. On the contrary, it generally relieves, when Scutellaria or Ignatia fails. Sometimes Coffea 200 will act better than Caffeine. This is probably due to some idiosyncrasy or extreme susceptibility. One of the pathogenetic symptoms of Caffeine is "flushing of the face." You will find it palliative of that symptom when occurring in women at the climacteric. 102 CANCHALAGUA-CANNABIS INDICA. CANCHALAGUA. This plant was introduced as a remedy for ague, but its use was never attended with such success as to warrant its continuance. While practicing in a malarious district many years ago, I tried it in many cases but it proved useless. I do not believe it is now used, as it is rarely, if ever, ordered from our pharmacies. Its botanical identity is in doubt. The name above given is the vulgar name given it in California. CANNABIS INDICA. The marked and peculiar influence of the Haschisch upon the brain and mind, has always given it a high rank as a supposed remedy in mania, insanity, and other disorders of the mind, but the experience of both schools has not realized the hopes of physicians. It stands almost alone as a medicine that seems to possess the power of acting on the soul. It seems to give us some idea of the vast capabilities of emotion, comprehension and capacity for happiness and sorrow which the soul of man possesses, but which lie latent while the body encloses it. As a homceopathic remedy, it is indicated in all degrees and varieties of insanity, from profound depression to the highest exhilaration. I can find recorded, however, but few cases of insanity where it has been of much service. Dr. Gray reports its successful use in " spectral illusions, not accompanied by terror, caused by nervous fevers, puerperal mania, or religious excesses." It ought to be useful in puerperal mania, with nymphomania (in a high dilution), but in two cases in which I used it, no curative results were obtained. It is my opinion, that in order that it shall prove curative in mental diseases, they must be purely psychical in their CANNABIS INDICA. 103 origin, and not depend on any bodily ailment. In this respect it differs from Belladonna and Strammonium. In some affections of the brain and nerves of the head, the Cannabis takes a high rank. It is one of my favorite remedies in nervous vertigo, so called, which comes on after mental excitement, or remains after acute congestion of the brain. (Dose, 2x to 6th.) Hemicrania, in its severest form, is often cured by the hemp, when all the usual medicines have been used in vain. The symptoms of the provings do not give us any characteristic indications, but the published experience shows that it is indicated when the attacks occur periodically, every week or two, and are very agonizing, rendering the patients delirious or unconscious, leaving them prostrated and nervous. The face is generally pale, the head cool, noise and light aggravates, but no vomiting occurs. In such cases it is analogous in some respects to Sepia, Spigelia, Arsenic and Zinc val. The dose most successful has been the mother tincture, 5 drops three times a day as a preventive, and every hour during the paroxysm. This variety of neuralgia generally occurs in thin, delicate women, and has lasted for years. I am cognizant of some cases permanently cured by this plan of treatment. Dr. Marcy claims for it great value in subacute inflammation of the brain, delirium tremens, and hypochondria in females advanced in life. A prominent symptom in its provings is "involuntary shaking of the head," such as we see in some cases of palsy. (See Calabar.) Since the third edition of New Remedies was published, the India hemp has been used successfully in many cases of cerebro-spinal meningitis. Both schools of medicine claim its use. It is undoubtedly homoeopathic to that disease, as the pathological effects of poisonous and fatal doses on the spinal cord and brain, as well as the recorded symptoms, are very similar to these observed in that disease. My observation and experience lead me to restrict its value to the first stages of the malady, or the stages of irritation and con 104 CANNABIS INDICA. gestion.'After effusion or structural lesion has taken place, its action is not strictly curative, although it may prove a valuable palliative, and thereby aid indirectly in bringing about recovery. The following indications were published in a paper on that disease contributed by me to the U. S. Medical and Surgical Journal, 1873: Delirium, generally gay; laughter, hallucinations, ecstasy, with or without loss of consciousness. On regaining consciousness, violent shocks are felt passing through the brain. Vertigo on rising, with stunning pain in the back part of the head, and he falls. Fullness, and throbbing in the forehead, as if it would burst, with sensation like a heavy blow on back part of head and neck. Involuntary shaking of the head. Fixed gaze; dilated pupils; redness of the eyes; throbbing, ringing and buzzing in the ears; sensitive to sounds. Cold face, with drowsy and stupid look. Stinging, burning and scalding before, during and after urination. Amorous paroxysms. Anguish in the chest, with great oppression. Pain across the shoulders and spine, forcing him to stoop, and preventing him from walking erect. Entire paralysis of both lower extremities and the right arm. Convulsions; emprosthotonus, with loss of consciousness; catalepsy. Collapse; stupor; insensible pupils; pale, clammy and insensible skin; extreme debility; feeble, irregular pulse. In that dreadful disease, hydrophobia, it is highly recommended as the surest palliative when death is imminent. The dose should be large and frequently repeated (gtts. xx to xl every hour, until quiet is obtained). In cases due to imagination, pseudo-hydrophobia, it will doubtless act as a curative agent, in smaller doses. CANNABIS INDICA. 105 lysterical spasms and a host of hysterical manifestations ought to be controlled by Cannabis, for its symptoms are more closely allied to the hysterical malady than any drug in our Materia Medica. A healthy lady once took 10 drops — probably more —to see if it would cure mental excitement. It caused decided hysterical paroxysms, although she had never before had anything of the kind. It causes hypercesthesia of the auditory nerves, also the optic. Hearing and vision are curiously perverted. I have cured several cases of tinnitus aurium with the 3x dil. It causes canine hunger, but differs from China and other medicines causing that condition in this: that digestion is equal to the emergency. One person records that "pastry and fat food, which previously he never ate without suffering from rancid risings and headache, are now digested regularly." The urinary symptoms are very similar to those of Cannabis sativa. It is well known to botanists that the two are merely varieties, the C. indica being the original and stronger species. If there is any difference in the symptoms, it is in the greater effect the C. indica has on the nerves of the urinary organs, as witness the symptoms of paralysis of the bladder and spasmodic action. On the other hand, the blenorrhagic symptoms are not as well marked, nor are the inflammatory. Its primary action on the organs of generation of both sexes is that of an aphrodisiac, for which purpose it is largely used in the East. It causes satyriasis, erotomania, nymphomania, priapism, chordee, involuntary erections and emissions,-always with amorous dreams. Its secondary effects are just the opposite, and the Haschish-eaters of the East all become prematurely impotent. The homceopathic indications are evident. I often substitute it with good effect for C. sativa. Dr. Hirschel recommends it very highly in profuse menstruation, menorrhagia, and hcemorrhage from the uterus of pregnant women. In the treatment of dysmenorrhcea it rivals Viburnum, 8 106 CANNABIS INDICA. Caulophyllum and Xanthoxyllum. It appears to control the neuralgic and spasmodic varieties, but is more particularly indicated when the patient is hysterical, emotional, and the menses are preceded, attended or followed, by unusual sexual desires. In allopathic practice it has effected some wonderful cures of dysmenorrhoea in women subject to neuralgia, and in my own practice it has relieved and cured patients who had been treated ineffectually, for years, by uterine specialists, and with electricity. I use the lx tincture-trituration, or the mother tincture, giving a few grains of the former, or a few drops of the latter, three times a day during the month, and every hour or oftener in severe cases, during the pain. My experience is, that it is useless to expect a radical cure by giving the remedy only during the paroxysms of pain. The system must be brought under the influence of the medicine, and kept under it, before the period of suffering arrives. It has been claimed that as a parturiant or uterine-motor remedy it is analogous to Secale and Caulophyllum. In a few cases where I have given it to accelerate lingering labor, it has seemed to have the desired effect. It is decidedly beneficial in the lx in after-pains. Spasmodic asthma has often been promptly relieved by India hemp. One of its most prominent symptoms, which I have often witnessed from one dose, is: "A feeling of suffocation, wants to be fanned; oppression of the chest, with deep, labored breathing; anguish, accompanied by great oppression, ameliorated in the open air." When these symptoms are present, a few drops of the lx, every half hour, will give prompt relief. Cardiac asthma will also be relieved by it, as the following symptoms show: " Pressing pain in the heart, with dyspncea the whole night; anguish at the heart; stitches in the heart, accompanied by great oppression, the latter relieved by deep breathings." It has two other prominent heart-symptoms which may be remembered with benefit: CARBOLIC ACID. 107 "Pain (stitches) in the heart, with palpitation, when lying on the left side." " Palpitation of the heart, awakening him from sleep." Dr. Gray reports as cured a case of "paralysis of the lower extremities," but he alternated it with Nux vom., which spoils the value of the report. Cannabis has, however, many symptoms of paraplegia and may prove curative in some cases, not caused by any grave lesion of the cord, but functional in its character. It ought to be an excellent remedy in sleeplessness from mental excitement, for nightmare and for the night-terrors of children; also for a sleep disturbed by vivid dreams, which weary the patient. I regret to say that you will find many " Haschisgh-eaters "in your practice. Its seductive influence is little less fascinating than Opium, and men and women are both driven by care and trouble to its use. CARBOLIC ACID. This powerful agent, introduced into medicine as a disinfectant, is worthy a righ rank as an internal remedy. The provings instituted by Drs. Hoyne and Mitchell, develop the fact that its true analogues are Arsenicum, Baptisia, the Bromides, Cimicifuga, Kreosote, Lachesis, Belladonna, Solanum, Sulphur, etc. Many of its symptoms remind us of the acro-narcotics; others of the corrosive poisons. It is feared that it will meet the fate that Arnica meets at the hands of the majority of our school. Hahnemann had a high opinion of Arnica as an internal remedy, and he gave us an excellent pathogenesis, but somehow the idea takes possession of the average homceopathist, that it is to be used solely as an external application, or if given internally at all, only in case of injuries. The fact is that Arnica is nearly as valuable as Bryonia or Nux vomica in a variety of internal diseases. So with Carbolic acid. It will prove far more useful as an internal remedy than it ever has as a topical application. 108 CARBOLIC ACID. As a disinfectant even, it has lately been deposed from the high rank once assigned to it. My present estimate of Carbolic acid is, that its sphere of action is the cerebro-spinal centers, and that the disorders of the mucous surfaces, of the blood and secretions, of digestion, etc., are but the consequences of this primary action on the central nervous system. Its pathological action, when applied locally to any tissue, is that of a caustic, disorganizing the surfaces when it is applied in a peculiar manner. It causes an ulceration and sloughing, with tendency to putrescence. It is in this class of local lesions that its use, in very dilute solutions, will cure by its homoeopathic relations. It has been supposed by some that this acid cures diseases, external and internal, by its power of destroying certain germs, which permeate the blood and secretions. It is true that this substance destroys the life of animal and vegetable growths, such as infusoria, bacteria, vibriones, microscopic fungi, etc., quicker than any known substance, unless it be the Sulphite of soda. But this does not prove that it cures, or can cure, all diseases where these organisms abound in the fluids and solids. In a majority of diseases these Qrganisms are a result and not a cause of disease. Just in proportion as the nervous life of the body becomes weakened, comes the tendency to deterioration of the solids and fluids, and finally the presence in them of animal and vegetable organisms. Now, it is my belief that Carbolic acid has the same effect on the human as on the lowest organisms, namely: the destruction of the vitality of the nerve-centers. We will now take up the most characteristic symptoms of the drug, and compare them with the cures made with it, and see if the above speculations are borne out. The head symptoms are quite prominent, thus: "Feels as if a band was around the forehead." (Bell.) "Dull pain, running from forehead to occiput." "Burning in top of the head." (Sulph.) "Constant dull pressure and pain in the occiput and mus CARBOLIC ACID. 109 cles of the back of the neck, especially just behind the ears. "A very great sense of weight on the neck, with a tenderness even to the touch, on the seventh cervical vertebrae. "Constant vertigo, not relieved by shutting the eyes; better when walking fast in the open air; much worse when sitting down." "Constant humming, buzzing noise in the ears, with the headache, but without dullness of hearing. " A full, dull, but constricted feeling in the head." All the symptoms closely resemblle the headache, and abnormal sensations from cerebro-spinal irritation, and resemble the symptoms of Silica, Gelseminum, Calabar, Cannabis indica, and other irritants of the cerebro-spinal centers. It has been used successfully, by myself and a few others, in the headaches following meningitis, and " spotted fever; " or the head-symptoms occurring after sunstroke; for sickheadache, periodical, generally just before or after the menses. The eye-symptoms are notable —they point to failing vitality of the optic nerve. I would call the attention of our oculists to these symptoms. In fetid, purulent discharges from the nose, from any cause, its topical application, not too strong, will be attended by the best results (10 grs. of the crystals to a pint of water.) It may be injected with a sponge, or thrown up by an atomizer, or simply snuffed up. If it is done thoroughly, two or three times a day, the unhealthy nature of the discharge will soon disappear. In cases of ulceration, it may have to be aided by Aurum, Silica or Mercurius. If the infusorial origin of hay fever, " catarrhal cestivus," is proven, or even if it is caused by the pollen of plants, the injection of a dilute solution ought to cure that disorder. Helmholtz says Quinine cures it, and Carbolic acid has the same action, only more rapid on such organisms. In apthous conditions of the mouth and fauces, if the odor is very offensive or cadaverous, Carbolic acid washes are useful; if not, the Sulphite of soda, or Borax, are better. 110 CARBOLIC ACID. Irn diphtheria, with foetor, the same observation will apply, but if fcetor is not decided, I prefer Phytolacca or Guiac. In ulceration of the throat, syphilitic or not, the Acid may be used as a gargle. It is said to have cured " spasmodic stricture of the oesophagus," but the authority is not known to me. In caries of the teeth, a plug of cotton, moistened with the officinal solution, and crowded into the cavity, destroys the sensitiveness of the dentine and abolishes the fretor. As might be expected it has cured vomiting of sarcince, but Sodme sulphite is just as effectual and much more safe; for, in order to be effectual, enough must be given to destroy the fungi, and prevent their propagation. One of the most persistent of the symptoms in all the provings, was morning nausea and vomiting, and it has been very successful in the practice of both schools, in the treatment of the morning nausea of pregnancy. It cures vomiting of ingesta during pregnancy, and in children. You may find it very useful in some of the many forms of dyspepsia, and flatulence. Dr. Hoyne considers it indicated in attacks of " diarrhoea from bad drainage." It may be useful in diarrhoea from drinking impure water. I have found it very efficacious in cholera infantum, attended with great prostration, hot head, ftetor of the breath and all the excretions; the discharges from the bowels were putrid and like rice-water, or like the odor of spoiled eggs. In true cholera infantum, when the head is implicated, and the disease runs a rapid, malignant course, I have had the best success with Camphor, Bromide of soda, and Carbolic acid. I now rarely use Arsenicum, Veratrum, or other of the routine remedies usually recommended. All the provers had increased urine. It is known to be diuretic, as is Creosote. I predict it will prove useful in some of the varieties of Bright's diseases, and possibly in diabetes. It is a favorite remedy in pruritus of the organs of generation, and of the perineum and anus. Pruritus is often CARBOLIC ACID. 111 caused by ulceration of the os uteri, chronic vaginitis, apthous conditions of the vagina and vulva. When these conditions are present, a weak solution should be used as an enema, and the same wash applied topically. One of its pathogenetic symptoms is, "itching of the scrotum and inside of the thighs-intense burning itching of the genitals." As an application in ulceration, or granulation, of the os uteri, it is equal to Chromic acid. Carbolic acid is, par excellence, the remedy for the unhealthy discharges from the uterus and vagina following miscarriage and natural labor. In the best managed cases some small portions of membrane or scraps of placenta will remain and give rise to foetid discharges. I am in the habit of ordering the nurse to use enemas of Carbolic acid, of the strength of ten grains to a quart of water, twice a day, so soon as fcetor shows itself. I believe by its use we may prevent the occurrence of pyaemic poisoning, or phlebitis, in the majority of cases. It may be alternated with Sulphite of soda. In uterine cancer, its use is indispensable, either alone or alternated with the Sulphite of soda, or Bromo-chloralum. I may as well state in this place, as in any other, that the pretentions claimed for Carbolic acid, as a curative agent (when internally administered, in the attenuations), in the treatment of cancer are without foundation. These claims were trumpeted forth by a once notorious surgeon belonging to our school of practice. The idea that infinitesimal quantities of this acid, will exert any destructive action on the cancer cells or germs in the blood or tissues of the body, is absurd in the extreme. I have carefully watched the progress and termination of the cases of alleged cures, and assert that in no single instance can I learn that the disease has been eradicated. The cough and laryngeal symptoms are important. It causes " short hacking cough, with tickling in the throat." The cough is constant, irritating, and generally dry, or may end in expectoration of thick white mucus." This resembles 112 CARBOLIC ACID. the cough. of Rumex, but without the excoriation in the chest. It is an excellent palliative in this kind of cough, when occurring in chronic laryngitis, bronchitis and consumption. It may also act as a curative agent in these diseases, in the early stages, if it is administered in a proper manner. It should be prescribed internally in the 3x or 6th, and used in a spray or steam atomizer, in about the same strength. It has one symptom similar to Lachesis, Hepar and Stillingia, namely: " Left side of larynx very sore when pressed upon -not the right side." It is a favorite remedy with many of our school in whooping cough. Some prefer it in the middle attenuations, others in the lowest, and a few claim brilliant results for its use when inhaled from an atomizer. If the infusorial cause of this disorder be true, it ought to be the specific. It is said to be of great value in malignant scarlatina, even when coma is present. Dr. Middleton* reports several cases of confluent variola treated with Carbolic acid. He says: " The pocks began to dry up on the eighth day, tongue cleaned off, no secondary fever; the pocks were dry all over the body on the twelfth day." Dose: a few drops of the 2x every two hours. It is an excellent plan to put a small quantity of the acid into the water with which patients sick with malignant fevers, etc., are bathed. It is enough if the water has a faint odor of the acid. In diseases of the skin, it has been found curative, when given internally, and applied externally in the form of a lotion or unguent. It caused in the provers, " itching of the skin all over the body; vescicular eruptions itching excessively, better after rubbing, but leaving a burning pain." It is said to have cured leprosy, prvrigo, pityriasis, lupus, carbuncles, indolent and irritable ulcers, acne, impetigo, scabies, and psoriasis. I have italicized those in which I have used it successfully. * Hahnemannian Monthly, April, I872. CARBOLIC ACID. 113 Since the pathogenesis in the first volume of this work was printed I have found the following case of poisoning by Carbolic acid. The symptoms of the heart are so important that I quote the case: " A man of thirty years, suffering from stricture of the urethra, took by mistake a teaspoonful of a solution of Carbolic acid " containing perhaps twenty-five to thirty ctgme. of the acid (two and one-half grains.) He felt a burning in the throat and esophagus, and took some milk and water and a dose of Castor oil. After ten or fifteen minutes a slight tremor set in over the — whole body, steadily increasing, followed by delirium, irritability and rage, with copious perspiration. His breath smelled slightly of the acid. At the attempt to examine his throat, he closed his teeth tightly. The beat of the heart as well as the pulse could not be felt. Pupils were normal and reacted to light. The abdomen was bloated, especially in the epigastric region, but neither hard, nor tense, nor sensitive to pressure. He could not take medicine. After about two hours he became more quiet, the sweating decreased, pulse and beat of the heart could not yet be counted. Instead of the tremors a somnolent state set in, the sweating ceased, the pupils dilated, but showed reaction to light. He swallowed now the most part of a tablespoonful of Magnesia. The pulse was irregular and intermitting, the veins appeared swollen and raised. Three hours after taking the poison the pulse became more regular and stronger but frequent (120 to the minute), the pupils began to contract, the patient more quiet, answered rationally, and only complained of feeling languid. The pupils were now normal, the pulse full and 100 to the minute. The oil showed now its action, but the faeces showed no smell of Carbolic acid. Later he vomited twice a watery thin fluid, not smelling of the acid. No pains in the stomach. He slept good, and when awakened complained only of some burning in the throat; fauces were slightly red, and showed some small grey spots which soon passed off. The urine showed at first large quantities of albumen, after a while it was clear, but 114 CARDUUS MARIE. of a dirty brown color; it never smelled of Carbolic acid. The dark color passed off gradually, but it remained albuminous for four days. Chemical analysis showed the acid in the dark colored urine. The most pregnant symptom in this case is the relaxation of the activity of the heart; if death had occurred at the beginning of the stage of the depression, following the primary stage of excitation, the paralysis of the heart would have to be considered as the causa morbis.- Schmidt's, Jahrb. 10, 1874. CARDUUS MARIEE. This medicine, with an odd contradiction of terms, I should call the oldest of the new remedies. I found a pathogenesis of it in one of the early numbers of the British Journal, and if one half its alleged powers are possessed by it, we should test its value thoroughly. Its sphere of action seems to begin and end in the liver and portal system, and, so far as we can judge, from our present knowledge of its effects, all symptoms are the result, direct or indirect, of such action. It is a close analogue of Bryonia, Chelidonium, Nux vomica, Podophyllum, Benzoic acid, Chionanthus, and Ammonium muriaticum. It causes hypochondriacal depression of mind, vertigo, dull heavy pain in the forehead, over the eyes and in the temples, confusion of thought, bitter taste, nausea, pyrosis, eructations, distension, retching, vomiting of sour, green fluid, and many other unmistakable "bilious" symptoms. Dr. Liedbeck asserts that no remedy more surely removes such symptoms. The same author has collected a number of clinical cases illustrating its powers, namely: Morning vomiting of pregnant women; the food remains undigested all day. Swelling and painfulness of the liver. Jaundice (many cases.) It is a very popular and successful remedy in domestic practice in Europe. CARDUUS MARILE. 115 "Tenderness and hardness of the right hypochondria, especially in the left hepatic lobe; pressure there caused oppressed breathing and cough; stools brown, urine yellow, respiration asthmatic, expectoration thick and tough, with violent cough." These symptoms indicate enlargement of the liver, with sympathetic bronchial irritation, a condition in'which Chelidonium and Muiiate of Ammonia are both now used very successfully. It is capable of curing a more serious condition of the liver, for a case is reported of "Pain in the liver with oedema of the feet; scanty, bright urine, and asthma." It may prove useful in dropsy from hepatic disease. Like Chelidonium, it has a great popularity in Europe, for the cure of "Gallstones, with jaundice, pain in the stomach, vomiting of bile, etc. Dr. L. cured two cases, with half an ounce of the tincture in a pint of water, a tablespoonful every two hours. He does not say whether the calculi were expelled or dissolved, but the patients got well, and that was quite as satisfactory." A case is also reported of "painful tenderness and swelling of the gall bladder," probably from obstruction of the ductus choledochus communis, and which was promptly removed by the Carduus. Among other clinical cases, he mentioned "Hepatic affections with haemoptysis and croup. "Portal congestion and obstruction, with its consequences. ~" Hypertrophy of the left hepatic lobe, with tenderness of the cervical and dorsal vertebra,. ~ " Pain in the whole abdomen, near the ceecum, cramps, urine normal, complexion smutty, yellowish; sleeplessness, great emaciation and hectic fever." An affection of the liver, primarily. It causes tardy, knotted, and hard brown stool, followed by "stool soft, yellowish, thin, loamy, chocolate colored, pappy, or without bilious tinge." 116 CARDUUS MARIE. The urine at first is normal, but as the bile disappears in the stools, it appears in the urine, which becomes scanty, yellow, and finally brown. This gives a complete picture of ordinary cases of jaundice. Dr. Reil recommends it highly for "affections of the climacteric period in women, viz.: megrim, metrorrhagia, ieucorrhcea, asthma, with consensual disorder of the liver." This is similar to the action of Aloes, which is so useful at the change of life, when the liver is the suffering organ. Dr. Reil narrates his experience with Carduus in an epidemic of influenza with hepatic symptoms, namely: a peculiar, brown, dirty-gray complexion of the patient, sometimes a real jaundiced tint; sensitiveness of the left hepatic lobes to pressure; bright, pale yellow, seldom dark green stools; dark brown urine, oppression of the chest, stitches in the side, debility, fever, frontal headache. Nux, Chelid., and Puls. did no good, only Carduus promptly cured. Here in Chicago, during the months of March and April, we'have similar epidemics. In several such epidemics I have found the Carduus indispensible for removing the hepatic difficulties. It is one of the few remedies which is capable of controlling serious pulmonary symptoms resulting from disordered liver. It has cured "painful cough at night, obliging him to sit up in bed;" "expectoration of pure blood, or blood and mucus, generally connected with liver troubles;" "is palliative in the cough of consumptives and asthmatics." It has an extensive popular reputation in Europe for "stitches in the side," generally the right, and nearly always connected with so-called bilious conditions. You will observe, in your practice, that severe stitches in the sides and chest often precede a " bilious attack." These " stitches" are said, by Dr. Inman, to be generally sympathetic, and are in the muscles oftener than in the liver. In pleurisy it has some reputation, but it is not probable that Carduus is indicated in idiopathic pleurisy, but rather in pleurodynia (thoracic myalgia.) CASTANA VESCA. 117 All the observers of the action of Carduus make this remark: "It relieves, but does not appear to remove, the fever and oppression (in pleurisy) as well as Aconite;" which confirms the opinion I have just expressed. CASTANA VESCA. It is a little singular that an infusion of the leaves of the common edible chestnut should prove a remedy for whooping cough; but a Dr. Unzicker seems to have been very successful with it, if we can believe his report. He says: " I have found in all cases that it would, in from four to ten days, relieve the spasms of pertussis, and in about two weeks cure it. The little sufferers would whoop no more, but go on to a speedy recovery, to the great delight of myself and their friends." He uses one-half an ounce of the leaves in a quart of water. This infusion was given in tablespoonful doses, every few hours. Later, he publishes further experience with the fluid extract in five to ten drop doses. No experience has been published in the literature of our school since my first mention of it, nor have I had any good opportunity to test it. I would suggest a trial of the tincture in some obstinate spasmodic coughs, for which it may prove useful. Since writing the above, I have seen a report of Dr. Davis, in the Philadelphia Medical Times, of a careful study of the effects of Castana in whooping cough, made in the Philadelphia Hospital. Fifteen children were selected, all with severe paroxysms and the characteristic whoop. They had been taking other drugs, but were left without medicines two days, during which time the paroxysms increased in frequency and severity. After being put on Fl. Ext. Castana in doses of thirty to sixty drops every three hours, the paroxysms decreased rapidly, so. that on the fifth day, none occurred 118 CAULOPHYLLUM. except in three cases! The nurse in charge, who had witnessed many epidemics of the disease, declared she had never seen a medicine act like it. CAULOPHYLLUM. This is one of a class of remedies whose virtues seem to have been well known to the aborigines of this country. They called.it " squaw-root," by which name it is known to the common people. Early pioneers, lay as well as professional, all bear witness to the high estimate placed on it by the Indians, for the relief of the sufferings and weaknesses of the women of that race. It has another name, "blue cohosh," the origin of which I have not been able to ascertain. Its sphere of action, as near as can at present be stated, is not extensive, but confined to the small muscles and joints; the muscular tissues of the generative organs, and possibly the motor nerves and mucous membranes. The provings made do not throw much light on its general powers. Its clinical uses afford us almost all the data upon which we base our knowledge. Its most prominent value seems to be its power of causing intermittent contractions of the gravid uterus, and possibly of the unimpregnated. In this it differs from Ergot, which causes, or tends to cause, persistent contractions. The remedies which most resemble it in this respect are Viburnum, Cannabis indica and Cimicifuga. It has become very popular with a portion of our school, for the following conditions: (1.) Deficient labor pains; (a) when they do not appear with sufficient vigor and regularity, at full term, and during labor. (b) When the pains have disappeared from exhaustion. (c) When they are too severe and too painful, or are spasmodic. In' the two first instances it should be given in doses varying from one-fourth grain of the Caulophyllin, crude, to a grain of the lx or 2x, frequently repeated, but, in the last instance, to which condition it is primarily homceopathic, the dose should be from the 3d to the 6th, or higher. CAULOPHYLLUM. 119 I mention the active principle, because it seems to possess the desired powers of the medicine in a pleasanter form than the tincture, which, in its crude state, is quite irritating to the fauces. But the tincture can be used in about the same proportions, if necessary, substituting ten drops for each grain of Caulophyllin. The same directions will answer for the dose in other conditions in which it is. specific, namely: (2.) Spasmodic dysmenorrhoea, when the flow is natural in quantity and quality. This distressing condition is often cured by Caulophyllin, but to be successful the medicine must be given several times daily during the week or two preceding the menses, as well as during the painful period. (3.) Spasmodic after-pains, in which it is indispensable. (4.) Spasmodic pains in the uterus, broad ligaments, etc., occurring at any time, from a cold, rheumatism, during pregnancy (false pains); also general as well as local spasms, from suppression of the menses or lochia. As might be expected from its powers which I have just enumerated, it is a powerful agent for the prevention of premature labor and of miscarriage, provided the premonitions are pains of a spasmodic character. The aborigines and early settlers claimed for it the power of preventing tedious and painful labors. This testimony has been substantiated by many prominent and trustworthy physicians of the eclectic school, as well as of the hommeopathic. A few of our school have denied it such power, but the weight of the evidence is against them. Dr. A. E. Small is sure, from the observation of many years, that it actually prevents the unusual sufferings which many women undergo. He also testifies to the singular fact that many women who have taken it for such purposes have overrun their time to the extent, in some cases, of ten or twelve days. The cases referred to, however, all had very easy labors, and a good recovery. My experience has been so uniform and conclusive on this point, that I do not hesitate to assert that it prevents not only a too painful labor, but it prevents those premature 120 CEANOTHUS VIRGINIANA. labors which are so common among the weakly women of this age. You must not expect it to prevent painful labors (dystocia) in women who become advanced in life before they bear children, or in whom there exists any deformity of the pelvic cavity. Such cases are mechanical obstacles to easy, natural labors. Caulophyllum removes only abnormal functional causes. The method of giving it in such cases, is to prescribe a few grains of the 2x or 3x trit., or a few drops of the 0 or lx dil., three times a day, for the last two weeks previous to the expiration of the term. If, however, a premature labor is feared at the seventh or eighth month, it should be taken during the two weeks preceding those periods. Caulophyllum has been recommended for rigid os uteri, but I believe the rigidity is overcome, not from any specific power on the circular muscles of the os, but from its general action on the uterus. Gelseminum and Belladonna are better for this condition. If uterine displacements are attended by periodic, spasmodic pains, Caulophyllum will form a valuable auxilliary to Sepia, Lilium, Nux, or Belladonna. In my' second edition of New Remedies was recorded a case of paraplegia from retroversion, which the Caulophyllum was supposed to have cured. We need further confirmation, however, before we accept it as a remedy for such condition. It seems to be homceopathic to rheumatism of the short muscles and small joints of the extremities, and a few cases of that character have been reported. It is said to be indicated when spasmodic pains occur in the stomach, intestines and other organs, in sympathy with the same kind of pains in the uterus. There is no particular reason why they should always be in sympathy with that organ, in order to render this remedy curative. CEANOTHUS VIRGINIANA. This shrub, called Jersey Tea, derives its common name from the fact that during the Revolution, when Chinese Tea CERASUS VIRGINIANA. 121 could not be procured, it was used as a substitute, as were many other plants. It is said that the infusion possesses slightly exhilarating effects. It would probably repay a good proving. I found in the Atlanta Medical and Surgical Journal a communication in which it was stated that the Ceanothus possessed the power of curing splenitis and enlargement of the spleen. Dr. - says: "During the late civil war I used this plant for splenitis, and so well satisfied have I been with the results that for six years I do not remember using any thing else for enlarged spleen. I have used it in the worst cases I ever saw, from infancy to old age. I have yet to see or hear of its failure in a single case, however inveterate." This is pretty strong and positive testimony, and the author fully confirms my idea that a remedy which cures is homceopathic, always, for he further says: " In chronic cases, when the organ is no longer tender; under the use of the tincture, even without friction, it soon becomes painful and tender, then sinks rapidly to its normal size, and so remains, the patient no longer being conscious of its presence." We see here a true homceopathic aggravation, showing that the drug has a specific affinity for that organ. I would advise you to make use of it when you meet with cases of " ague-cale " so common in malarious districts. The tincture is made from the leaves, and is given in drop doses of the 0 or 1x dil., and applied to the region of the spleen. Dr. Carroll Dunham informs me that a physician of his acquaintance cured an enormous enlargement of the spleen by the use of this remedy. CERASUS VIRGINIANA. This tree, the inner bark of which is officinal, is also known as Prunus virgqiniana. There is another species known to botanists as Cerasus serotina (Prunus serotina). 9 122 CERASUS VIRGINIANA. The latter is the common black wild cherry; the former a red wild cherry, known as " choke cherry." The plum and cherry family, as well as the peach and apricot, the bitter almond, and laurocerasus, all contain the elements from which hydrocyanic acid is evolved. When properly prepared, the.infusions or tinctures of these agents all contain that acid, upon the presence of which nearly all of their peculiar effects on the heart depend. But the cherry family also contains Tannin, and a peculiar bitter principle which resembles Cinchona somewhat. A cold infusion of the inner bark is the best preparation. If prepared by heat, the acid is not formed. A tincture may be made which contains all its active principles; but the fluid extracts and the so-called prunin and cerasin are frauds. They contain only the tannin and bitter principle. From time immemorial the cold infusion has been in use for irregular and intermittent action of the heart, with deficient impulse. For this condition Hydrocyanic acid, Laurocerasus, Iberis and Amygdala are primarily homeopathic; and Digitalis, Lycopus and Collinsonia are secondarily homoeopathic. With the cold infusion in tablespoonful doses I have frequently removed the above abnormal condition of the heart's action; also the cough sympathetic with functional or organic disease of the heart. It is a valuable palliative in quick, weak pulse, during convalescence from disease; during phthisis; and in hypertrophy of the heart with dilatation. The tincture made with dilute alcohol has been useful in my practice for dyspepsia with tendency to acidity of the stomach: in slow digestion with pyrosis; loss qf appetite, etc. It is all the more indicated in these affections if they are attended by weak, irritable heart. I have found it much more efficacious when Pepsin (the saccharated powder) is given before each meal, followed by the Cerasus after meals. I have known cases where excessive quantities of the infusion have caused a fullness, and a dull, heavy feeling in the head. This may have been due to the cardiac tonicity which it caused, and implies that we should not give the lower di CEDRON. 123 lutions in concentric hypertrophy of the heart, or when real fever is present. In the higher dilutions it might prove useful for the symptoms mentioned. CEDRON. Cedron is the seed of the fruit of the Simaruba Cedron,according to Hooker's London Journal of Botany. Teste's Materia Medica, p. 577. North American Journal of Homceopathy, vol. viii, p. 120. Monthly Homceopathic Review (London,) vol. v, pp. 164, 208, 251; vol. vi, pp. 71, 136, 203. New Remedies, Symptomatology of, 4th edition. According to Dr. S. A. Jones, in the latter work: The earliest mention of the Cedron is found in The History of the Buccaneers, Anno 1699. The native Indians first offered the seeds for sale in Carthagena in 1828. Analogues. Arnica, Cinchona, Cornus, Cimicifuga, Eucalyptus, Eupatorium perf., Gelseminum, Nux vom., Sepia, Sanguinaria. It has some analogous relations to Pulsatilla, Chelidonium, Lachesis, and other polychrests. The sphere of action of Cedron appears to include both the cerebro-spinal and sympathetic systems, and is a decided "anti-periodic " remedy. " Its chief characteristic is a periodicity which is often clock-like in its regularity." (Dr. S. A. Jones.) The clinical uses of Cedron have been mainly confined to obstinate intermittents which resist the usual ague remedies. After the appearance of Teste's Materia Medica, the demand for it was very large, especially from Western and Southern physicians. At that time a few clinical reports were published favorable to its efficacy in ague; but very many failures were also reported. It did not give general satisfaction. But now that we have a fuller pathogenesis, it will probably be selected with greater certainty. The general opinion, with which I coincide, is that cerebral congestion is one of the key-notes for its use in ague. To illustrate this, I copy 124 CEDRON. some of the head symptoms collected by Dr. Jones, and published in the 4th edition of New Remedies: " Head dull and heavy in the morning; distensive headache, increased during the night; temporal arteries enlarged; bending the head backward, with pressure on the occiput and parietal regions, as if these parts were going to burst; forehead cold, and as if it were empty, in the morning." All these symptoms were more marked in the women than in the men. " Pressure at the right temple, causing a dull pain in the whole right side of the head, disappears wholly toward noon; heaviness in the head; headache increases in the open air, (toward 9 A. M.); pressive pain over the eyes, as if a band were tied round the parts; pressure at the top of the head, slight in the day-time, somewhat violent just at the moment when the shivering begins, it never wholly ceased during the whole proving; towards 6 P.M. shuddering, soon followed by a dull and heavy frontal headache, spreading to both parietal regions; pulsating sensation in the temple, and a twisting pain behind the right ear, changing to a dull pain and extending to the temples; head felt as if swollen; —whole head feels swollen and heavy, most on the right side; pressure on the o3ciput in the morning; in the forenoon, occasional sharp, jerking pains in the occiput; successive sharp pains in the occiput, abdomen and lower limbs. These pains in the head are dull, except those in the occiput, which are acute. At 10 P. M. dull pain in the top of the head, with sharp flying pains in all the joints of the extremities, worse in the feet, particularly the first joint of the great toe; awoke late A. M., after a sound sleep, with dull pain in the vertex; awoke with dull pain in the whole upper head; throbbing in the temples; throbbing in the temples increasing to pain; pain across the forehead, over the eyes, from temple to temple; beating in the temples, increasing to pain and extending over the ears; throbbing in the temples, increasing to pain, and extending over the eyes; throbbing pain in the head, commencing in the temples and extending around the forehead; sharp pain in the occiput; dull pain CEDRON. 125 in the vertex; pain over the ears; headache, especially in the bottom of the orbits (compelling him to close the eyes) and extending to the occiput." The resemblance to the China-headaches is very marked. These headaches are decidedly periodic, and the following clinical cases illustrate its efficacy in this direction: 1. Tearing, shooting pain on the left orbit, extending to the inner canthi and to the superciliary ridge of the os frontis. This pain came only post coitu, and when the circumstance had occurred which gave rise to it, his sufferings were so intense on waking in the morning that he was compelled to keep his room for several days, and was unable to eat or drink during the greater part of that time. 2. A similar pain over the left eye followed involuntary nocturnal spermaperthy in the case of a woman-pain came on when waking in the morning, and was very severe until noon. 3. Chronic intermittent headaches, with shooting and pressing pains in different parts of the head, recurring at certain periods of the day or night. The eye-symptoms somewhat resemble those of Gelseminum; also Pulsatilla, and Cimicifuga. "Eyes protruding and red, with pressive pain extending to the forehead; pupils fixed and dilated; objects appear red at night and yellow in the day time; eyelids injected bright red, and painful when pressed; enlargement of the meibomian glands and conjunctiva; smarting in the eyes, especially when closing them; sensation in the eyes as if one had wept a good deal; itching of the eyes; dimness of the sight; the left eyelid seemed dried to the ball; conjunctiva inflamed and dry: when exposed to the air the eyes feel dry; eyes felt swollen; misty vision as from thick smoke; dizzy, could not see to light a candle, and could not tell when it was lighted. It has cured ~flashes of light before the eyes; ~dull appearance of the eyes; ~tumid face, with pupils much dilated; ~a peculiar, unsteady, glistening appearance of the eyes, and intolerance of light. It has many of the ear symptoms of China: 126 CEDRON. Singing in the ears as of crickets; buzzing of the ears toward noon; hardness of hearing at night; it antidotes the effects of Sulphate of Quinine on the auditory nerves. Its value in facial neuralgia is substantiated by the following clinical cases: ~Prosopalgia, more frequently in women than in men, generally on the right side, recurring in regular paroxysms of indefinite duration, with spasmodic distortion of the muscles corresponding to the affected region (the zygomatic process almost always.) ~Chronic intermittent prosopalgia always coming on at 7 or 8 P.M., and lasting from two to four hours. " In facial, especially supra-orbital neuralgia, in more than one instance a single dose was sufficient where the periodicity was well marked." (Dr. Liebold: New York Jour. of Eomceopathy, vol. i, p. 362.) Its action on the throat is quite specific. The following case contains its peculiar symptoms: ~Mouth and tongue very dry; difficulty of speech; great thirst all the time; painful pricking of the tongue, with a sensation of heat; she felt at times as if the tongue was paralyzed; face pale; deep-sunken eyes; odontalgia every night; fcetid breath; lips cold, bluish, dry; now and then slight bleeding of the gums. These symptoms appeared only wtith the catamenia, and lasted as long as that discharge, at the termination of which she had a profuse ptyalism and leucorrhceal flow. The gastric symptoms remind one of Arnica, especially in the amelioration by eating, thus: Eructations of bitter wind from the stomach before rising in A.M., with dull pain in the temples; sensation as of a stone on the stomach; rolling pain in the stomach; sensation of heat and fullness in the stomach; distension of the stomach and disposition to nausea, generally aggravated by rest, but relieved by walking, and by eating; 0uncomfortable feeling of the stomach which obliged him to lie down; great sensitiveness of the preecordial region; pulse small and hard; dryness of the mouth and fauces; depressed spirits and inquietude, relieved by food and drink. These symptoms CEDRON. 127 appeared every day from 10 to 11 A.M., lasted from one to two hours, after which there was prostration of body and mind for an hour or two. The following cases illustrate its curative power over abnormal stools and urine: oSemi-liquid, whitish freces, somewhat like starch: white, frothy, and papescent evacuations immediately after meals, accompanied with slight colic and discharge of inodorous wind; involuntary discharge of urine and fieces. ~Scanty urine; profuse emissions of watery urine; frequent emission of large quantities of pale urine; frequent ineffectual urging to urinate; dark urine with sediment; urine of a dark-red color; scanty urine and deep yellow color; ~frequent desire to urinate; Ourine very high- colored; ~urine precipitates a bran-like sediment; ~involuntary emission of urine; ~a great deal of pain in the kidney. The genital symptoms are not as prominent as the cures alleged to be made, namely: ~A tic-like pain over the left eye, for more than thirteen years, with the singular circumstance that such a pain never come on except post coitu (radically cured in 3 days;) ~involuntary nocturnal spermaperthy (in a woman.) ~Post coiturn, irregular and uncontrollable movements of the left upper and lower extremities, and of some portions of the face, manifested by grimaces and contortions of different kinds, these symptoms lasted from fifteen to twenty minutes. She could not speak without stammering, and her respiration was very much affected. She also had involuntary discharge of urine and freces at times during the attack-[ Choreic.] - ~Leucorrhoea regularly every month, five or six days previous to the appearance of the catamenia, with pain in the uterus and enlargement of the vulva; ~leucorrhceal discharge appearing in the place of the catamenia. Menstrual epilepsy (epileptoid convulsions,) precursory symptoms of which were manifested precisely the same day that the catamenia commenced; vertigo, tinnitus aurium, and irregularity in the action of the heart; then the aura epileptica, followed, with loss of consciousness and falling: a distressing cry, 128 CEDRON. now and then, alternated with risus sardonicus, and slight foaming at the mouth during the attack. ~Epileptiform eclampsia (hysteria); attacks came on regularly twice a day, morning and evening, at the same hours, with these symptoms; intense pain in the forehead; tumid face, with pupils much dilated; then a feeling of giddiness, resulting in her falling down in the most distressing convulsions; insensibility, closed teeth, and frothy secretions from the mouth; difficult respiration, irregular pulse, and palpitation of the heart-the whole lasting for six or eight minutes. On recovering consciousness she felt very weak, and discharged a large quantity of inodorous urine as clear as pure water(primipara, in seventh month of utero-gestation.) The nerves of the larynx are evidently irritated by the drug, reminding us of the action of Lachesis and other serpent poisons. (It is considered almost a panacea for the bites of serpents, in the countries where it grows.) o Larynx constricted and tender; difficulty of swallowing; difficult respiration with partial loss of voice recurring at intervals; ~ breath cold; ~ hurried respiration and feeling of suffocation in the throat; ~ chronic intermittent laryngitis, the attack comes on every evening, with shivering chills, lasts about two hours, terminates with a profuse perspiration; ~ suffocating fits regularly every day from 10 to 12 o'clock; there are sensations of choking or stifling; difficulty of breathing, obliging her to stand in an erect position; enlargement of the tonsils during the attack, with redness of the velum palati, and constant need of swallowing — all these symptoms were aggravated after sleeping, and mitigated by eating; ~ troublesome cough coming on regularly every morning at about six o'clock, and lasting from two to three hours - the patient was perfectly free from it during the rest of the day. We see the similarity to Lachesis again in its effects on the cardiac nerves, especially on the accellerators and regulating nerves. "Oppression of the chest and throbbing of the heart; oppressive pain in the chest every now and then, extending CEDRON. 129 to the back, with frequent desire to moan and take a long breath; palpitation of the heart and hurried breathing, with headache; pulse increased from 12 to 15 impulses per minute, in from 20 to 30 minutes after the dose. (This was a constant phenomenon in all the American provers —three women and two men. The doses were from one to three drops of the matrix.) It has cured irregularity in the action of the heart; ~irregular pulse and palpitation of the heart; ~ rapid intermittent pulse, impossible to reckon the strokes; also palpitation of the heart, rapid and intermittent. The oppression of the chest and throbbing of the heart occurred in nearly all the provers in whom febrile paroxysms were developed. Many of the symptoms of the spinal region, such as "stiff neck "-" pain all along the spine,"- verified by cures, point to its homceopathicity and possible usefulness in cerebrospinal meningitis, especially when the cerebral, laryngeal, febrile, and spasmodic symptoms correspond. I quote the fever symptbms in full, as a guide to its future administration in ague: 1. Feverish paroxysms every day in some provers, every other day in others, toward 8 P.M., preceded by depressed spirits, dullness of the senses and pressive headache at noon; cramps, then contracting and tearing pains in the upper and lower extremities, with a cold sensation in the hands and feet; mouth dry, great thirst and desire for cold water;chills and shivering; sometimes very strong shuddering of the whole body; palpitation of the heart and hurried respiration; pulse weak and oppressed. These symptoms lasted from one to two hours, varied much in intensity, and were followed by a sensation of dry heat, and then of profuse perspiration, full and quick pulse, with animated red face; cold and pale in the apyrexia; thirst and desire for warm drinks. 2. At 3 o'clock P.M., shuddering all over the body, with malaise and desire to lie down; the shuddering is renewed by motion; hands, feet, and nose are cold; flying heat in the face several times; lastly, toward 6 o'clock in the morn 130 CEDRON. ing, constant heat in the face, which looks animated, with smarting in the eyes, especially when closing them, lips dry, with desire to moisten them often; headache, especially in the bottom of the orbits, compelling him to close the eyes, and extending to the occiput. While this congestion of the head lasts, the shuddering continues all the time; the hands, feet and nose remain cold; urine of a dark red color. 3. Toward six o'clock in the evening (immediately after dinner) cold all over; shuddering in the back, icy coldness in the feet; the hands are burning; sensation in the eyes as if one had wept a good deal. In the evening toward half-past six, half an hour after dinner, shuddering in the back and legs; unusual paleness of the hands; red face; heaviness of the head; stretching toward seven in the evening; general coldness all evening; increase of the headache in the open air, (toward nine o'clock); pressive pain over the eyes as of a band of iron tied round the parts; no thirst during the shuddering; dry heat at night. At half-past six P.M., feverish paroxysms with itching in the eyes, which is only stopped for a moment by rubbing; laming and weary pains in the shoulders; profuse emission of watery urine. Toward half-past five P.M., prickings in the tongue; itching of the eyes; half-anhour later shiverings, with heat of the face, hands pale, feet and tip of the nose cold. Towards six P.M., shuddering, soon followed by a dull and heavy frontal headache, spreading to both parietal regions, with redness of the eyes, itching of the internal and external surfaces of the eyelids;icy coldness of the hands and tip of the nose, even in the midst of the febrile reaction (the pulse is 80) the rest of the face is red and burning; lastly, dimness of sight, dilatation of the pupils; objects look red; mouth dry, with thick, viscous saliva; constriction of the throat, which scarcely allows her to swallow the saliva; anxiety, restlessness, general malaise. The medicine being taken by healthy provers, was generally followed by - 1st. A certain state of mental excitement, and augmentation of vital energy; florid face, and a sensation of heat CEDRON. 131 throughout the body; full and strong pulse; more or less perspiration, and no thirst. This group lasted from twenty to forty minutes in some, and disappeared after that time to return no more, without any other abnormal manifestation in their health; whilst in others the symptoms were prolonged from one to two hours, and were followed by2d. Depressed spirits; dullness of the senses, and torpor of the mental faculties; general debility, languor, and faintings in some. When these symptoms are followed by those of the first group, the phenomena of both sets are often repeated, and at certain intervals of time; but neither of the two occur periodically, unless when they are together. Nor are they absolutely concomitant to pyrexia; for the paroxysms generally take place without them, as in the natural disease. It is for this reason that such phenomena were disconnected from the category of the physical group; but whenever pyrexia occurs, or follows that condition, the symptoms, after weakness of the body and mind, are as follows: 3d. Great thirst; yawning; cramps and painful feelings of contraction in the lower extremities; cold sensation in hands and feet; chills and shivering of the whole body; palpitation of the heart; pulse weak and oppressed; hurried respiration; chattering of the teeth and shaking of the whole body; scanty and highly-colored urine; slight nausea in some, with yellow color of the skin and face in others; great debility; dilated pupils and confused sight. These symptoms lasted from one to two hours, and varied much in their intensity; after which - 4th. Dry heat follows, with full and quick pulse; animated face; profuse perspiration; longing for cold in some, and for warm drinks in others; and discharge of pale urine in large quantities. These symptoms lasted from two to three hours, and were generally followed by a desire to sleep. The provers felt as if they were contused; sound sleep in some, and somewhat agitated in others during the night. The apyrexia generally lasted from fifteen to seventeen 132 CHELIDONIUM. hours, after which, and in about the same time as the previous day, the paroxysms were repeated as per group third, and continued almost quotidian. CHELIDONIUM. This plant-the Great Celandine-belongs to the family of Papaveracece, to which also belongs Papaver (Opium), Sanguinaria (Blood root), Argemone, Stytophorum and Glaucium-all members of the above family, and growing wild in the United States. When the critics reviewed the third edition of my New Remedies, they disputed my statement that no complete pathogenesis had ever before been published. But I was right. In the Symptomen Codex was a brief pathogenesis which had been partially copied by Lippe; while my pathogenesis was made up from Buchman's splendid provings, found in the twenty-third volume of the British Journal of Homceopathy, together with previous provings and clinical cases scattered through our Journals. Teste's provings and observations were referred to, although I consider them of but little value. The chemical analysiS of Chelidonium is of some interest. It contains Chelidonic acid, which, with Malic acid, is combined with the organic bases and lime in the plant itself. It contains a principle called Chelerythrin, which is also found in Saguinaria and Glaucium. I believe we can trace pathogenetic affinities between all the plants of this (Poppy) family, especially between the Chelidonium and Sanguinaria. The sphere of action of Chelidonium includes the liver, portal system, lungs and kidneys. Voight, in Lehrbuch der Pharmacodynamickl, 1838, gives, in the language of that day, a good idea of its action. "It causes an increased secretion from the outer skin and kidneys, especially a more active circulation of the fluids of the portal system and in the lymphatic vessels, and the abdomi CHELIDONIUM. 133 nal glands; and, in general, a more active metamorphosis of the vegetative organs of the abdomen." Rademacher, a close observer, says it acts on the internal structure of the liver, and he believes that all its general effects are due to this specific action. It was proven by Buchman and others, with the mother tincture in massive doses, and in the 6th dilution. In Buchman's summing up of its physiological effects, he says: "The power of exciting the whole arterial and capillary system is possessed by Chelid., in common with Aconite, as appears from the great similarity of the febrile symptoms, but it does not agree with the transient character of the action of Aconite on the vascular system. This is especially evident from its effects on the vena porta and its functions, inasmuch as it calls forth all the phenomena of fully developed abdominal plethora. This effect is always, for the most part, produced by defective circulation in the liver, and continual catarrhal excitement of the mucous membrane of the abdominal viscera. There is no room to doubt that the attacks of palpitation, slowness of the pulse (50,) the distension of the veins of the hands, the paralysis, weight and stiffness of the limbs, and the coldness of the extremities, the cedematous swelling of the legs, dull pains in the head, vertigo, pressure in the occiput, pains in the back and sacrum; weakness, indolence, irritability, ill-humor, alternation of diarrhcea with costiveness, fits of colic,, yellowgray color of the skin, renewal of the symptoms on change of weather, etc., are to be referred to a congestive retention of blood in the portal system, and the hyperaemia thereby determined in the abdominal organs. In the cutaneous system it is primarily the mucous membranes upon which this medicine acts, by exciting catarrhal inflammation. We have accordingly observed catarrhal inflammation of the eyes, nostrils, larynx and bronchial tubes. Even the stomach and alimentary canal, and mucous membranes of the female sexual organs, partakes of this catarrhal inflammation. It extends also to the mucous lining of the canals through which flow the gall and urine. 134 CHELIDONIUM. We find three different conditions of the secretion of bile caused by the Chelidonium. (1.) Diminished secretion. We find, e. g., light gray or yellowish-white stools, without deposit of biliary coloringmatter in the skin, and without separation by the urine. (2.) Suppressed secretion, with resorption into the blood. (3.) Absorption, without stopping its escape into the intestinal canal. The urine in most cases was sour to the smell, and reddened litmus paper like a powerful acid. In intimate connection with the increased acidity of the urine we find a diminution of the acid of the stomach. Analogues.-Buchman says: "Its symptoms combine a great part of those of Bryonia and Arsenic. It is allied to Arnica, Nux vomica, Ledum, Thuja, Nitric acid and Sulph. acid;" to which I shall add Agaricus, AEsculus, Benzoic acid, Carduus, Lycopodium, Leptandra, Mercurius, Podophyllum, Phosphorus and Sanguinaria (Chionanthus?) Clinical Observations.-Buchman gives a list of what might be termed pathological key-notes, for the use of Chelid., namely: Vertigo, stumbling, dizzy confusion of the head; trembling and twitching in the limbs; grayish-yellow (sallow) amber countenance; increased secretion of the meibomian glands; inflamed sebaceous glands; so-called worms in the face; heat in the face; fits of rigor in the evening; cold extremities; restless sleep before midnight; dreams about corpses and funerals; sweat in morning; being terrified out of sleep by the urinal sufferings; cessation of the sufferings after dinner; drowsiness during the day; shortness of breath; and anxiety relieved by eructation; a feeling of constriction, tension, and sensitiveness in the region of stomach and right hypochondria; dryness in the throat; nausea, and dislike for flesh-meat; bright-colored (yellow) slimy stools; sour-smelling, reddish and turbid urine. Buchman thinks it especially indicated in spare subjects, where there exists a disposition to abdominal plethora, cutaneous disease, catarrh and neuralgia. He agrees with Teste, that it acts with special effect upon persons of blonde ccrplexion. (Bry. for dark complexion.) CHELIDONIUM. 135 Chelidonium is certainly not used by Homceopathists, as much as its merits demand. Its pathogenesis, as recorded in the British Journal, vol. xxiv, 1866, contains many very important symptoms which point to very decided pathological conditions. It could be prescribed successfully (perhaps more successfully) in many cases where we think Nux vomica, Bryonia, Mercurius, and Iris are indicated. In certain forms of headache it is indispensable. It is indicated particularly in bilious headache, or those which arise from a deficiency of the eliminating function of the liver. The characteristic symptoms are: "Tension of the head as from a bandage close over the eyebrows, as if the head was compressed; or, " Weight on the head, as if bound or compressed in a vise. "Violent pulsating pains from the nape and occiput to temples and forehead (Sanguinaria also.) " Great pain in the head, pressing from within outwards, especially towards the forehead, as if everything was falling out (like Bryonia.) "Pressure and weight in the occiput, with painlful throbbing there; this weight is so great that the head can hardly be lifted from the pillow: (Silica, Eupat. perf., Bromides.)" The headaches are generally increased by fresh air (contra Puls.), by cough, blowing the nose, stooping (Bry., Ferr.), relieved by eating (contra Nux.) CONCOMITANTS.- Vertigo, feeling of congestion, flickering, and bright or dark spots before the eyes; white or gray coated tonghe; nausea, retching and vomiting of tough mucus. "In some sick headaches," or "neuralgic headaches," it is very useful. In periodic neuralgic headache located in the region of the eyebrow and temple, especially of the right side, it has effected some brilliant cures. In vol. xx, British Journal of Hom., page 47, Dr. Ferivat, of Madrid, reports five cases of neuralgia of the eyebrow and temple (four in the right, one in the left,) marked by the following symptoms: "Shivering, followed by pulsating pains in the eyebrow 136 CHELIDONIUM. and temple, occurring at the same hour every day (on getting out of bed, at 9 A. M., 11 A. M., 3 P. M.) " The pain, at first slight, increases gradually until it becomes almost insupportable, driving the patient to distraction. There is a bruised sensation in the eye from the front to the back. The eye becomes red and watery, and very sensitive to the light. Aggravated by fresh air, moving and holding down the head. Ameliorated a little by pressure. The attacks end with slight perspiration (often sour). Nux was used ineffectually, but Chelid., in the 2d and 3d dilution, every two hours, promptly arrested the paroxysms." I have cured several cases similar to the above, but only when the neuralgia was non-malarial. If it was a form of masked ague, Chelid. will rarely cure, but generally Gelseminum, Quinia, Cedron or Nux will have to be used. In diseases of the eye, Chelidonium always had a reputation, even in the time of Dioscorides and Aristotle. Dr.' Ferivat, above quoted, says: "I have often proved its efficacy in acute inflammations of the eyes, where they are swollen, injected, with a sensation of burning, as if from the presence of a foreign body. When there is excessive photophobia, lachrymation, abundant sebaceous secretion, agglutination of the eyelids in the morning; shiverings from time to time; pain which generally extends not onlv to the forehead, but sometimes all over the head; this pain, beginning to be felt towards 2 or 3 P. M., is at its height about 8 or 9, and prevents sleep, or even lying down, till nearly daybreak." Amaurosis in some of its varieties may come under the curative sphere of this medicine; also tinnitus aurium, and other nervous affections of the ear. It is the value of Chelidonium as a remedy for diseases of the liver to which I wish particularly to call your attention. Its action on the liver is strongly marked in all the provings. It causes pain, both acute and dull, and tenderness of that organ; pain in the right shoulder; (" under the right scapula" is a key symptom;) stools either soft or bright yellow, or whitish and costive; deeply tinged urine. In CHELIDONIM. 1387 three the skin became yellow or dark, and in one, regular jaundice was set up. Rademacher, who was a kind of embryo homceopathist, declares Chelid. to be a specific in " affections of the internal structure of the liver," the symptoms of which he enumerates as follows: " The perfect form of the internal hepatic disease is distinguished by white, quite colorless freces, as in jaundice, and by the complete absence of all the other symptoms of jaundice. The skin is, and continues white, and has not even a dirty appearance, and the urine is nearly strawcolored, as in healthy persons." (He admits that this disease is very rare. He only saw five cases in his practice.) " The unknown organ (in this disease) whereby the bile is formed from the blood is itself diseased: no bile is present, none is therefore absorbed, none therefore deposited in the skin, or urine, consequently no jaundice." I have never seen but one case of this peculiar disease. The patient died. Rademacher implies that he has cured cases of this nature with Chelid. But Chelid. certainly cures cases of acute and chronic hepatitis; jaundice from absorption of bile; jaundice caused by catarrh of the biliary ducts; jaundice from gallstones; jaundice complicated with pneumonia, and many other common and anomalous hepatic disorders. Rademacher, after using and observing the use of Chelid. in massive doses, became afraid of it in such quantities (as did Hahnemann of other medicines), and reduced his doses to a few drops or fractions of a drop. He mentions one case of a jaundiced patient who had previously taken a thimbleful of the juice four times a day, and the disease was thereby so much aggravated that the bright yellow of the skin had turned to dark yellow, and the tension of the upper abdominal region was greatly increased. Fifteen drops of the tincture, three times a day, restored him without further trouble. In the British Journal of Homoeopathy, 1867, are recorded several cases of biliary calculi cured by large doses of Chelid. 10 138 CHELIDONIUM. These cases were not ordinary ones, but obstinate, severe, and with dangerous symptoms. In every case, the prompt curative action of the medicine was unmistakable. In my own practice, in 1869, one of the most protracted cases of gallstones on record (so far as my reading extends) came under my care. The patient was a gentleman, an old resident of Chicago. He had been jaundiced nearly two years, and during that time had suffered intolerably with " congestive rchills," terrible cardialgia, periodic; intense hepatic pains, and his appearance when I first saw him was frightful. He was bronze-yellow; emaciated in the extreme; urine scanty and nearly black; stool hard and white; total inability to retain food; pulse intermittent and almost imperceptible. Like the case above alluded to, he had been drugged constantly for the two years, without the slightest benefit. I began with two drops Tinct. Chelid. every three hours, increasing it a drop each dose every day, until he took ten drops, when he was seized with intense pains in the gallbladder, followed by the expulsion from the bowels of a stone, dumb-bell shaped, nearly an inch long and half an inch in diameter. He rapidly recovered. Induration of the liver was cured by Dr. Benedix with the Extract of Chelid., after the disease had lasted a year and a half, and had been (mal) treated by a host of drugs. Dr. Niedhard considers it an excellent remedy in hepatic diseases, and has reported several cures. You will find no better remedy, and none oftener indicated in the disorders of the liver met with in general practice. Study your cases carefully, and select the medicine with equal care, and avoid the routine treatment, so common, of giving Podophyllum or Mercurius in every case. In my experience Chelid. is oftener indicated than either of them. A disorder of the secretory functions of the liver, described by Flint under the name of Cholesteromia, may be successfully treated with Chelid. One case came under my care which closely resembled that disorder. Chelid. lx removed the symptoms (like acute rheumatism) in a week. CHELIDONIUM. 139 Buchman says he " cured the fatty liver of a scrofulous girl, aged 4, the border of the organ extended as far as the navel, with a.ccompanying icterus, in six weeks, by three doses of the 6th of Chelid." (!) It is just possible the cure was one of nature's making. The gastro-intestinal disorders in which Chelid. may be used to advantage are comprised under two classes, namely: intestinal catarrh and bilious diarrhoea. Buchman gives several cases illustrative of its action in the former disorder. It was not usually attended by pains in the abdomen; it occurred at night; was yellow-slimy or whitish-yellow; the face was pale or sallow; and there was much debility. The bilious diarrhoea was attended with much debility, but not much pain.' My studies and experience with Chelid. convinces mne that the action of Chelid. on the liver and intestinal tract is as follows: Primary.-Irritation of the secretory function of the liver, with yellow foecal discharge, debility, etc., followed by yellow mucous diarrhoea, showing irritation of the intestinal mucous membrane. (6th.) Secondary.-Arrest of secretory function from over stimulation (reaction), or obstruction of hepatic ducts, with white stools, or brown, watery-with jaundice; urine brown or yellow, and sour (loaded with bile). (3d to 0.) It is important to understand this dual action, for thereupon hinges the selection of the proper dose, which I have designated above. Bell, in his admirable monograph on Diarrhoea, says the Chelid. diarrhoea is aggravated at night, ameliorated from (colic) wine, and attended by rumbling in the abdomen, both before, during, and after stool, with slimy, white-coated tongue, disgusting or bitter taste, desire for wine, milk which agrees; for hot drinks which agree: aversion to cheese and boiled meat." I am of the opinion that the pain is not sufficiently mentioned, for it is not possible for a bilious diar rhcea or intestinal catarrh to be attended with only rumbling, and no pain. 140 CHELIDONrUM. In the summer diarrhoea of children, I have found it at certain seasons one of the best of remedies. It is especially indicated in the diarrhcea which attends infantile pneumonia or capillary bronchitis. Sanguinaria is also indicated here, although it has been but little used. Buchman was quite enthusiastic that Chelid. would prove a valuable renal remedy. He based his hopes on one proving -his wife's. Her symptoms were "pressive pains in renal region-not confined to the kidneys, but extending to the ureters and bladder-accompanied by turbid urine. He says he discovered' renal cylinders' in the urine, from which he divines a condition of' croupose inflammation, and consequent degeneration of the glandular epithelium.'" " Just as in this proving, so in morbus Brightii, we found increased uric acid, diminished chloride of sodium, and dissolved hematine in pale yellow, slightly turbid urine, which, when albumen is abundant, is colored reddish." His wife had, also, other symptoms of Bright's disease: "o dematous swelling of the extremities, neuralgia in the region of the trigeminus and supra-orbitalis." No subsequent experience has been published in relation to Chelid. in diseases of the kidneys. Buchman, however, gives one case, with the following symptoms, which he removed with the 6th: " Pain in the region of the kidneys, and in the head, with sparks before the eyes; urine reddish, turbid, containing fibrine, flakes and sand." I doubt if Chelid. will prove a very valuable renal remedy. It certainly needs further proving in that direction. I am of the opinion that its renal symptoms mostly depend on the hepatic derangement it causes. Chelid. is recommended by both Buchman and Teste in laryngitis, bronchitis, pneumonia, influenza, whooping cough, asthma, spasm of the glottis, endocarditis, pericarditis, pleurisy, typhoid fever, hcemorrhoids, worms, chorea, acute rheumatism, measles, erysipelas of the face, acne, eczema rubra, ulcers, and, finally, injuries (instead of Arnica.) I do not propose to go into detail and examine the homeeopathicity of the drug in these diseases. If you would in CHELIDONIUM. 141 vestigate the extensive history of this medicine, I refer you to vols. xxiv and xxv of the British Journal. I will only say that the therapeutics of Chelid. has been almost too elaborately worked up. It has a pathological keynote, which should be the guide, next to the totality of the symptom, for its selection. That key-note I believe to be derangement of the hepatic system. I do not believe that Chelidonium is capable of causing idiopathically all of the diseases mentioned above; but they may appear in some form during the provings, if heroic enough, as concomitants of the central hepatic irritation. With this explanation, you will have no difficulty in adapting it to any of the diseases for which it is recommended. My experience with it in pneumonia is, that when the liver is implicated, and the right lung is affected, it will prove useful, if a yellow, slimy diarrhcea is found. In cardiac affections, consequent on hepatic derangements, it is a good remedy; (on the contrary, if the hepatic trouble is caused by cardiac disorder, Digitalis.) I have found it useful in haemorrhoids; in some phases of typhoid fever; and in influenza. I have not used it enough in whooping cough to give any favorable opinion of its virtues. It is highly praised by some. Dr. Clifton, of England, writing of his experience in dyspepsia, speaks highly of Chelidonium. He recommends it for the following conditions: 1. Tongue. Dry and white. 2. Appetite. (Desires and dislikes:) a. Desires for milk which produces comfort, though it formerly caused flatulence. b. Great longing for wine, which does not as before produce congestion and heat in the head. c. Prefers hot things, dislikes those which are cold. d. Dislikes boiled flesh. e. Must eat more breakfast than usual, in order not to get faint before dinner. f. Disgusting taste; food tastes naturally. 142 CHELIDONIUM. 3. Eructations relieve nausea. 4. Stomach, aching and gnawing pain in; constrictive feeling over, aggravated by pressure, but relieved by eating or during the early hours of digestion. 5. Sensation of constriction, and sensitiveness in the scrobiculus cordis and right hypochondrium. The first of these symptoms or "characteristics" relates to the tongue. All that is said of it is, that " it is dry and white." The description I would give of the Chelidonium tongue is, that it is moderately dry or moist, of a good natural color, but slightly coated white, and sometimes streaky, the shape of it being narrow and pointed. It has been, in cases of dyspepsia, where there are other symptoms indicating Chelidonium, that I have found the tongue to answer to this description. Where the liver is more affected, there is often a yellowish fur. 2. Appetite, desires, dislikes to food. (a.) "Desire for milk, which does not cause flatulence as it used to do, but produces comfort." In several cases of dyspepsia, where Chelidonium has been otherwise indicated, this symptom has been very marked. In all cases of dyspepsia, where the appearance of the tongue answers to that indicating Chelidonium, I generally find that when such persons are in health milk gives rise to flatulence. One such case was a man, 64 years of age, suffering from hypertrophy of the heart, with gastric dyspepsia, giving rise to loud, tasteless, or bitter eructations. He had suffered from gall stones, and I had successfully treated him with Berberis. To relieve his dyspepsia, I unavailingly gave him Carbo v., Argentum nit., and Bismuith, as well as other medicines; Chelidonium greatly relieved the dyspepsia, though it failed to check the eructations. I kept him on a milk diet (not skim milk) for a month with benefit. Previously he had had the desire for milk, but was unable to digest it. Another patient, who suffered frightfully from spasmodic pains in the stomach, followed by bitter and bilious vomitings, had noticed that when well she could not take milk, CHELIDONIUM. 143 but was able to do so when ill, provided it was warm. She obtained rapid relief from Chelidonium (1st dec.) in two attacks, and the dyspeptic symptoms which ordinarily preceded and followed an attack were quite cured by the same remedy. b. " Great longing for wine, which does not cause congestion or heat in the head as before." I have occasionally noticed these symptoms in cases of dyspepsia indicating Chelidonium, though not to so marked an extent as the incapacity to digest milk just referred to. In one case - to be noticed presently — there was a longing for beer which I did not gratify, as it manifestly disagreed with the patient, but I permitted him to take wine with advantage. c. "Prefers hot things." This I have often noticed in dyspeptics cured by Chelidonium. d. The dislike to boiled flesh, said to be a characteristic of the Chelidonium dyspepsia, I have not noticed. e. The feeling a necessity to eat a larger breakfast than usual in order to prevent faintness before the next meal, I have seen something like in the desire for food to prevent stomach pains. 3. Eructation relieving nausea I have occasionally observed to occur in dyspeptics relieved by Chelidonium. 4. Stomach. —" Aching, gnawing pain in the stomach, with a sense of constriction, aggravated by pressure, but relieved by eating, or during the early hours of digestion," is, I believe, a very marked characteristic of Chelidonium dyspepsia. 5. "Sensation of constriction and sensitiveness in the scrobiculis cordis and right hypochondrium," are often associated with the foregoing; or rather, whilst the former the aching gnawing is relieved, during the early hours of digestion this is often aggravated slightly, and in my experience is more frequently indicative of Nux vomica, if other symptoms correspond, than of Chelidonium. As an illustration of symptoms 4 and 5, I will adduce the following case: A gentleman, aged fifty-two, of spare habit, accustomed 144 CHELIDONIUM. to a moderate amount of exercise by day, but poring over his books and plans till one or two in the morning, had frequently suffered from indigestion. On one occasion he had jaundice, and once had had intermittent fever. When he consulted me he had been suffering for two months, and had taken from his own medicine case Bryonia, Nux, Chamomilla, Sulphur, etc., without benefit. He complained of giddiness in the morning, and of headache on waking. His sleep was unrefreshing from vivid dreams of business matters. He disliked his usual mental studies. The appetite was diminished, but when he had eaten a little he.could eat more, because he then felt better. An aching pain in the stomach was nearly constant, but was better after food. Constrictive feeling across the stomach from right to left hypochondrium, so much so as to oblige him to loosen his clothes two hours after a meal. Slight eructations; bad taste in mouth; desire for beer, which, though he relished it, caused heartburn and headache; his stools were pappy and light-colored; urine normal; his tongue was only slightly coated white, and rather moist, thin and narrow in shape, like that in persons of a nervous temperament, or where there is nervous irritability; his face was pale, and of a yellowish tint. For a month I gave him Nux, China and Ignatia of various dilutions, but without benefit. I therefore turned to a record I keep of characteristics, where, under "Stomach and Appetite," I found No. 4 characteristic of Chelidonium. I next consulted the Repertory of the Hahnemann Publishing Society (a work it is disgraceful to us as a body not to have completed long since.) In this I found that, under Petroleum and Nitric acid, there is " aching pain when fasting, relieved by food; " under Pulsatilla, " gnawing pain when fasting, relieved by food; " under Nux vomica, " contusive pain when fasting, relieved by food." None of these corresponded so, well, especially in the mental sphere, in the totality of their symptoms to the case under consideration, as did Chelidonium. One drop of Chelidonium, 3d dilution, taken four times a day, gave relief in three days, and in a fortnight my patient was well. He has CHELONE GLABRA. 145 had a similar attack since, when a few doses of the same medicine soon cured him. Such are the chief characteristics of the Chelidonium dyspepsia I have been able to verify clinically. I have in addition seen one case of mental distress cured by this medicine. Without much dyspepsia, there was a dry, white, narrow, and pointed tongu6; with a desire for wine and but little appetite. The mental symptoms were restlessness and uneasiness of conscience. She felt that she had committed the unpardonable sin, and that she would be eternally losta condition very similar to one described by Dr. Buchman in his proving of Chelidonium." (Hom. Review.) CHELONE GLABRA. The Chelone is one of those bitter indigenous plants which has always had a popular reputation as a tonic, or strengthrestorer. The same may be said of Gentian, Frazera, the foreign Columbo and others. But the Chelone seems to possess some specific powers aside from its general action. No provings have been made, but the clinical experience of a few homceopathists, and my own, show that it must affect the liver. It has been found very beneficial in weak digestion, especially when due to want of tone in the stomach. Jaundice, with loss of appetite, disgust for food, constipation and debility, has been removed promptly by drop doses of the tincture. Dr. Ball, of Marshall, Mich., has had much experience with Chelone in intermittent fever after abuse of Quinine. In such cases, the Chelone cures, not by possessing any antimalarial virtue like Quinine, but by its power of removing the Quinine-cachexia. That troublesome condition, which follows severe attacks of malarial fever, known as "dumb ague," consisting of ill-defined paroxysms of aching, with fever and distress, may be removed by this medicine if its use is patiently continued a few weeks. 146 CHLORAL. Dr. E. C. Price, of Baltimore, verifies Dr. Ball's experience. He gave it to a man broken down with ague, and who, notwithstanding the use of Quinine, Iron and Strychnine, became so weak as to be unable to sit up. " The tincture of Chelone, five drops three times a day, brought him right up, and he has remained well ever since." CHLORAL. The Hydrate of Chloral was discovered by M. Liebreich, and introduced by him as a therapeutic agent, before the Medical Society of Berlin, in June, 1869. It is a white solid, made up of needle-form crystals having the appearance of snow. It has an odor similar to ripe muskmelons. On exposure to the air it rapidly deliquesces, and after a time wholly disappears. It is soluble in water, alcohol and ether. The lower animals are readily affected by very small doses, two to five grains causing profound sleep. It is certain and rapid in its action. For an adult man twenty grains is the average dose. This generally causes the semblance of a normal, profound slumber, commencing in fifteen to twenty minutes after the drug is taken into the stomach, and lasting from six to ten hours. Certain persons, however, are so constituted that they require double this quantity to produce the same degree of somnolence. As a rule, the quantity may be safely graduated for a single soporific (sleep-causing) dose. One grain can be given for each year of age until the patient is twenty. This dose may be repeated in an hour (or even thirty minutes if intense pain is present.) If you give the Chloral hydrate to cause sleep and alleviate pain, you must administer the definite quantity known to cause the desired result. You can no more produce anaesthesia with the attenuations than you can with the attenuations of Chloroform or Ether. It is only for symptoms and conditions simulating its primary effects, that you can give attenuated doses; nor will it bear much attenuation, all theorists to the contrary notwithstanding. CHLORAL. 147 Under a heavy dose the breathing is imperceptible; after a moderate one the breathing is soft and gentle. There is no sensibility during this sleep, not even upon the external applications of stimulants. They sleep on, while all the functions of life are apparently at rest, except one, the circulation. On a microscopic examination of the web of a frog's foot, while under Chloral, the circulation is found most perfect, confirming the theory of Liebreich, that the heart is the last to die. One prominent and persistent effect is the decrease of animal temperature, with contracted pupils. No excitement precedes the sleep. Patients can be aroused at any time to full consciousness, the natural functions are performed, there is no disturbance of the secretions, and waking is not attended by disagreeable symptoms. In fatal cases the following symptoms occur: Stertorous respiration; eyes set and glassy, pupils contracted and insensible to light; conjunctiva congested; motion of the heart quite rapid and so feeble as to be scarcely felt; blood settles under the finger nails; purple spots are on the side on which they lie; extremities cold, and frothy mucus flows from the mouth; insensibility of the skin, with occasional moments of hyperaesthesia. The functions are destroyed in the following order: (1) The cerebral; (2) the involuntary muscles; (3) the respiratory; lastly, the heart. It paralyzes the ganglionic cells of (1) the brain, (2) the spinal cord, (3) and last, the heart. Its mode of action is quite analogous to Chloroform, but large doses should be avoided when the heart is weakened. Its therapeutical uses in homceopathic practice are similar, in one respect, to its use by the opposite school, viz.: for the necessary alleviation of pain, and the production of sleep. I do not hesitate to resort to it, after a fair trial of our most approved homeopathic remedies; nor should any of you, after you have decided in your best judgment that your patient will be in better condition from its use than without it. It is, to the public, one of the most fascinating of nar 148 CHLORAL. cotics, if its taste is tolerated; but its habitual use is attended by all the evils which follow the abuse of such agents. Attempts to break off the habit have resulted in a condition similar to delirium tremens, and other depressed and irritable mental states. Its immediate effects on the mental sphere are always calming, soothing and quieting. Its remote (secondary) effects, depressing and irritating. It is, therefore, secondarily homoeopathic to many forms of insanity, idiocy and dementia. The records of insane asylums give the following pretty uniform results, the average dose being from 20 to 30 grs.: "When patients are destructive and violent, it acts as an excellent hypnotic by night, and a soothing agent by day; they become free from destructive habits, and gain in weight and strength; the action of the bowels and bladder improves; the appetite is increased; it relieves abnormal sensations and hallucinations; it checks the desire for self-injury; and melancholic patients become more cheerful." It has been observed that " the greater the disorganization of the brain and cord, the sooner does the system come under its action." I have used it successfully in many cases of delirium tremens and puerperal mania, when the symptoms were like those I have just described. The pathological condition which it induces in the brain, in fatal cases, is said to be ancemia. This I suppose to be the primary, direct result of a single fatal dose. But cases are on record which go to show that an opposite condition results from longer use -of massive doses ending in death. In other words, secondary effects supervene. Thus, Hammond relates a fatal case, where he gave it for a disease of the brain - and found *congestion of the brain - postmortem. In other cases, the brain, cerebellum and their membranes, showed an increased vascularity; but these I believe were secondary effects. Its purely homoeopathic applications in brain disorders are as follows: CHLORAL. 149 In cerebral ancemia, suddenly appearing, with the usual effects of a dangerous single dose, you may prescribe it in the 3x or 6x dilution. In such cases it is analogous to the Bromides and Conium. In cerebral congestion, occurring as a reaction from previous anaemia, the Chloral is one of the best remedies you can use, if you select it judiciously. It here rivals the Bromides. This condition of the brain is that which is found in patients whose insanity takes the form I mentioned at the beginning of this lecture. There is sometimes excruciating pain in the occiput and temples; great heaviness of the head, and a feeling of compression of the head, as if in a vice; also aching and redness of the eyes, illusions of vision, and photophobia. I have cured congestion of the brain in children after cholera infantum, with the lx dilution. It is useful for the night terrors of children, when arising from worms, teething, and the result of cerebral irritation after colliquative discharges. Here it rivals Cuprum aceticum and the Bromides, either of which are superior to Belladonna which is so absurdly used in a routine way. I can hardly give you the differential diagnosis between the Chloral and the Bromides in such cases; the line of distinction is very intangible. You will have to learn it by experience, or rely upon your intuitions, or wait until we have complete provings of these important drugs. I believe it will prove useful in some cases of cerebro-s pinal congestion, but doubt its usefulness after inflammation has taken place. The pains in the occiput and head seem to indicate its relation to this disease. When inhaled it causes intense irritation of the nasal and other surfaces of the respiratory mucous membrane. You may find it useful in cases of hay fever (catarrhus aestivus) if inhaled at the very outset of the malady, in a very dilute form. In my own case, 10 grs. taken at the onset of an influenza always arrests it. Its effects on the eye and sense of vision are unique and 150 CHLORAL. peculiar. (You will find many hay-fever symptoms among its eye symptoms.) It causes aching in the eye-balls, which feel too large. (Spig.) The lids feel so heavy he can hardly lift them. (Gels.) Intense itching of the inner canthi and edges of the lids; the lids are puffy and swollen; red, injected and blood-shot eyes; burning in the eye and eyelids; profuse irritating lachrymation. You will find some interesting contributions to the therapeutics of Chloral in the British Journal, for July, 1874, by Dr. D. Dyce Brown. Taking the above symptoms of the eye as the indications, he treated twelve cases of conjunctivitis with Chloral, and with uniform success. His doses were"one grain of the pure salt, in water, three times a day, for adults, and fractional doses for children." In two cases in my own practice, its curative effects were simply magical. In additipn to the symptoms already given, his cases presented others, namely: small ulcers on the cornea; phygctencen; severe circumorbital pain; chemosis; loss of appetite, and sleeplessness. It ought to be useful in abnormal conditions of the sense of vision, such as asthenopia, color-blindness, ocular hypercesthesia, photophobia, and perhaps threatened paralysis of the optic nerve. Many of its eye-symptoms resemble those of Gelseminum, Coca, Calabar and Cannabis indica. Spasm of the glottis is imitated by the symptoms of the tongue and throat (primary.) I have made some very gratifying cures of traumatic odontalgia by means of Chloral, several of which have been reported in our journals. If the toothache is from the pressure of a filling, give the usual anodyne dose internally; if from substances which have gotten into a cavity, clean it out, and fill it with the crude salt, or cotton saturated with the mother tincture (one grain to each drop of water or alcohol.) It may be useful, in the attenuations, in the severe flushings which occur at the critical age, for it has caused a " dark scarlet flushing and heat of the head and face, from roots of CHLORAL. 151 the hair to ramus of the lower jaw, including the eyes; it was persistent under pressure; was blotchy in places, and extended to the neck and chest. There was excited circulation, and slight contraction of the pupils. Similar paroxysms occur premonitory to, and during tubercular meningitis, and I observed them, last Summer, after attacks of cholera infantum. In the latter it came on in the evening and prevented sleep from the heat and itching. I have used it in a few instances in the severe pains, vomiting and retching from passage of biliary or renal calculi; but you must avoid its use in large doses in jaundice from arrest of secretion, for it has caused "jaundice, with coma and stupefaction," and aggravated many cases. It has also caused atrophy of the liver, but these facts need not deter you from trying it in just such cases, if you prescribe the attenuations (1x to 3x.) The law of Similia ought to hold good in relation to Chloral as well as to Mercury. Chloral does not cause diarrhoea, nor do the Bromides, yet in those cases where the diarrhcea is the result of morbid nervous depression with irritation, it will remove the cause, thus indirectly curing that symptom. For example, in cases of cholera infantum, where there is intense nervous erethism, severe pain, and threatening spasms., I have not hesitated to give Chloral in doses of 1 to 5 grains. The Bromides and some other remedies may be equally well indicated by the symptoms; but no other drug acts as quickly, and in some cases a few minutes lost is fatal to the patient. It has been suggested in cholera. It causes all the symptoms of cholera, except the purging and vomiting. But in some cases of cholera (cholera sicca) no discharges occur. The patient is stricken down suddenly, and dies from syncope induced by cerebral and cardiac paralysis. Chloral is homceopathic to such cases. No special observations have been made as to its pathogenetic action on the kidneys and bladder. It has been used with good results in incontinence of urine. 152 CHLORAL. Dr. Leonards considers it the only reliable remedy to remove the spasmodic action of the detrusor vesicae, which overbalances the contraction of the sphincter. He gives children from 6 to 10 grains, dissolved in water, just before going to bed; allows only small quantities of fluids at supper, which should be taken several hours before going to bed. He adds: " We must, in enuresis nocturna, strictly differentiate between spasm and atony of the vesical muscles, as in the latter case Iron and Quinine are indicated." (Ferr. mur., Nux.) It appears to have some diuretic action, either direct or indirect. In the case of anasarca where it was given by Dr. Swan, in 5, 10, and finally in 15 grains, every 2 or 3 hours, it alleviated the terrible sufferings; and the action of the kidneys, which had been almost suspended for days, became active again under its use. Chloral eaters are said to lose their sexual desires and become impotent. I have not observed any such phenomena. I have used it in many cases of painful and persistent chordee during gonorrhoea. Ten or fifteen grains taken at bed-time, not only causes sleep, but actually prevents the painful erections. In the diseases peculiar to women, the Chloral is a useful palliative. In dysmenorrhoea of unusual severity, it will give relief when specific remedies fail. It may require 5, 10 or 15 grains every hour, according to the intensity of the symptoms and the idiosyncrasy of the patient. In a paper read before the Edinburgh Obstetrical Society, E. Lambert claimed that while Chloral could not supplant Chloroform, it can be used to advantage in the first stage of labor. He also claimed that it could be given " under favorable circumstances" all through labor, and that the woman could go through from commencement to termination without consciousness. I suppose he means by " favorable circumstances," that the patient had no tendency to hcemorrhage, for if any such exists, Chloral is not considered a safe remedy. CELORAL. 153 American accoucheurs rarely give Chloroform during labor, and then for a few moments only at the very termination. If the patient requires it for an hour, or for hours, Ether is the best and safest anaesthetic. I should hesitate to administer Chloral in large doses to a person with weak heart, or in whom I suspected a tendency to hemorrhage. I have, however, used Chloral in several cases of labor, when the intense nervous irritability led me to fear convulsions, and when Veratrum viride was not admissible. In all these cases it had the happiest effects. I agree with Dr. Lambert, that "it does not suspend, but rather promotes uterine contraction, by suspending all reflex actions which tend to counteract the excitability of the centers of organic motion." The dose of Chloral required will depend on many circumstances. I have given 10 to 15 grains every hour. Lambert advises gr. xv. every quarter of an hour until the desired results are produced. I have alluded to its power of preventing puerperal convulsions. I believe it has such power, The late Dr. F. A. Lord reported two cases where 20 grains arrested such convulsions promptly. It causes pulmonary cedema, yet it has been found a valuable palliative in that condition, as well as in emphysema. In very small doses it ought to cure the former, if the general state of the patient is not too much depressed. It weakens the heart; it paralyzes the ganglionic life of that organ, yet, true to the law of Similia, it has been found to restore force and motion to the heart when life was rapidly ebbing away. In Drs. Swan and Helmuth's case, there was organic disease of the heart. The Chloral almost restored normal action to the seriously disorganized organ. The symptoms it causes are: "Great dyspncea, a sense of suffocation, oppression at the base of the chest, in front; tendency to fainting, intolerable sinking at the stomach, livid lips, cold extremities, respirations as low as four per minute, pulse. imperceptible. I have given it in the threatened paralysis of the heart, 11 154 CHLORAL. during pericarditis. The dyspncea and distress was fearful, yet 5 grains every 15 minutes restored the action of the heart, and the patient made a good recovery. The pulse of Chloral is frequent, weak, irregular, in both force and rhythm, frequently intermittent; but the heart at the same time acts regularly, but with increased frequency and diminished force. I predict that in cardiac neuroses, the Chloral in properly graduated doses will prove one of our best remedies, not only palliative, but curative. I am not as sanguine as Dr. Swan, who claims to have got heart-symptoms by taking the 200th dil., and that the 40th will cure cardiac neuroses. Such assumptions need be put to the test of positive experience before we accept them. When brought in contact with blood, it stops the process of coagulation. It destroys the blood corpuscles, and produces a general destruction of that fluid. Its continued use, internally, has caused purpura hcemorrhagica, preceded by a "bright, red blush, erythematous in aspect, but permanent under pressure," followed in two days by "deep, red spots, mixed with mottled, livid patches. The buccal mucous membrane becomes red, raw, ulcerated and blistered, breath fcetid, pulse 120 and feeble. A desquamation ensued, but with bed-sores in some places. In other cases in caused petechie, vibices and echymoses. If this action of Chloral is dynamic, it may prove a homceopathic remedy in purpura and scurvy. If chemical, we need not expect curative effects from it. Reference has been made to the peculiar flushings of the face and neck caused by Chloral. It causes another species of eruption, namely: of blotches of different shapes, raised above the surface, and of a deep red color. These blotches nearly coalesced; nearly resembling measles. This was attended with high fever, thirst, coated tongue, loss of appetite and intense irritation of the skin, preventing sleep at night. It has caused an eruption on the arms and legs exactly like nettle-rash, in large raised wheals, with intense irritative itching." Another case so imitated scarlet fever that the CHLORAL. 155 person was supposed to be laboring under that disease. In this same case-" A number of large, pale elevations, or wheals, showed themselves on the legs, shoulders and waist, while similar ones could be produced on other parts by scratching. At the same time, burning and stinging sensations, and a feeling of tightness and hardness over the whole surface, with lassitude, headache, sharp pain in the eyeballs, wheezing respiration, etc." It is not improbable to suppose that it affects the mucous membrane in a similar manner. These symptoms make Chloral an analogue of Apis, and this analogy may be closer than we now imagine; it is also a congener of Urtica urens, Copaiva, and Arsenic. Dr. Dyce Brown, believing that Chloral might be used with advantage, tried it in nine cases of urticaria, and with complete success. He gave from one to one quarter gr. every three hours. In another six cases the patients did not return and report; and he thinks they too were cured. In one case of pruritus vulva it relieved, after Collinsonia failed. It will be a lucky thing for us if we have found a specific for nettle-rash, for it has been a difficult matter to affiliate a remedy. Some of the freaks of nettle-rash resemble Chloral effects, namely: the sudden stupefaction, asthma and cramp of internal organs, not to mention vomiting and purging, which latter is supposed to be due to its retrocession upon mucous surfaces. I have only had the opportunity to try it in a few cases, one of which was quite satisfactory. A child, a year old, had suffered from severe summer complaint for several weeks, had become pale and weak, when a new symptom set in which deprived it of all rest and sleep,-an urticarious eruption, red, blotchy and itching, on the face, neck and shoulders, worse in the evening. Apis, Arsenicum and Croton were tried unsuccessfully. Chloral, 5 grs. in half a glass of water, a spoonful every hour, removed the trouble in two days. There is a kind of nervous itching, a species of pruritus, affecting the whole body, coming on after undressing, especially at night: there is no visible eruption until the skin is 156 (HLORAL. scratched, and sometimes not then. Ignatia is recommended, and will sometimes relieve, but Chloral may prove a better remedy. In certain spasmodic diseases the Chloral has been of infinite service to the physicians and surgeons of all schools. I have already alluded to its use in puerperal convulsions. In tetanus it has made some very brilliant cures. It is indicated for tetanic spasms from strychnine poisoning; trismus from traumatic causes; from cerebro-spinal meningitis; and also in infantile tetanus. You must not expect to cure such a terrible disease as tetanus with any but massive doses. You might as well attempt to propel a 5-lb. shot with 10 grains of gunpowder. The dose in cases of tetanus in strong adults ranges from 10 grs. to 3 drachms, repeated every one, two or three hours, as the case demands. One patient, with traumatic tetanus, reported by Dr. Vernuil, took the enormous quantity of 200 grammes (3000 grains) in 28 days, and made a good recovery. Dr. 2Eschenthal cured a case of trismus in a child seven days old. It had twenty-seven spasms, and took in all 25 grains. In trismus and tetanic convulsions of very young infants, or in teething children, I have given it in many cases. I prefer it to any other remedy because it acts so quickly (in 10 to 15 minutes), as in some cases a few moments lost is a life lost. In tetanus it rivals Calabar, Atropine, Gelseminum, Bromide of Potassa and Curare, all of which cure by virtue of their secondary action. I do not assert that remedies primarily indicated in tetanus, like Nux vomica, Strychnia and Ignatia, will not cure, for I know that cases have been cured by the latter class. I would advise you to use the latter in cases of less intensity, or when you think you have time to test their power. I need not inform you that primarily indicated remedies must be used in minute doses (from the 6th to the 30th attenuations.) Chorea in its severest forms has been treated by Choral with success. CHLORAL. 157 A severe case, in which the little child could neither lie nor stand, the head, limbs and body being in constant motion and each muscle apparently partaking of irregular action. She could not utter a syllable, and swallowed with difficulty. She would wake from disturbed rest, cry out, and scream until perfectly exhausted and in danger of general convulsions. She became anaemic and emaciated. Two grains of.chloral put her to sleep. Its use was continued every night for a week. After that time, improvement was so rapid that it was abandoned. M. Bouchet says: " Chloral is a most prompt and efficacious remedy in those cases of intense chorea where the constancy and severity of the spasmodic movements threaten the life of the patient." Dr. Russel relates a case of severe chorea during the fifth month of pregnancy cured by Chloral. Dr. Strange cured an obstinate and long-continued case of chorea in nine days, with eight grains repeated every three hours. No remedy, in my experience, will so quickly and permanently remove the uncontrolable nervous agitation of hysteria. A dose of 15 or 20 grains will quiet a fit of hysterics so suddenly as to astonish the patient and her friends. It is quite homeopathic to a hysterico-cataleptic state, when the patient is conscious of all that transpires but can not rouse herself. A word as to the proper treatment of a case of Chloral poisoning. Nux vomica lx, Strychnia 3x, and Atropine 2x, are the best antidotes, aided by Digitalis when the heart is failing; electricity applied to the spinal cord; and Ammonia by inhalation and internally. The sleep caused by Chloral is not always calm. Some patients seem to suffer from and complain of horrible dreams, frightful visions; they scream and cry out, sit up in bed and can not be quieted. An adult who was taking it for rheumatism, after sleeping a few hours, would jump out of bed trembling with fear, bathed in a cold, clammy sweat, and scream frightfully as if in mortal terror. Here we have a 158 CROTON CHLORAL. good picture of those conditions known as nightmare, nightterrors, and similar morbid conditions occurring premonitory of, or during meningitis. I usually give in such cases very small doses, -t to 1 or 2 grains, according to age, and have been very successful in removing these abnormal symptoms. In the 6th or 30th it may prove curative in "comatose conditions lasting for days, ending in cerebral congestion." The pleasantest vehicle in which to administer this drug, when given in appreciable doses, is the Syrup of Tolu, to which you can add from 1 to 20 grains to each teaspoonful. The dilutions from the mother tincture (1 gr. to 1 drop) are made with water, alcohol, or syrup. CROTON CHLORAL. This drug is said to possess the singular property of producing anesthesia of the brain and nerves of the head, leaving all the body below in a natural condition. It is highly recommended for neuralgia of the head and face, and other very painful affections of the head. In the British Journal of Homceopathy for 1873, page 188, Dr. J. W. Legg is quoted as reporting this medicine as useful in the principal affections of the fifth nerve. The drug was given to about twenty persons, all suffering pains in the regions supplied by the fifth nerve, i. e., the upper and lower jaw, the face and supraorbital -region of the forehead; pains paroxysmal, increased at night mostly. In nearly all the patients there was caries of the teeth, and in about onehalf, signs of anaemia. Five, ten, and twenty grains were given at a dose, dissolved in water. In all the patients except two, great relief from pain followed the dose. In the two cases, the pains were aggravated.. Some slept, others were eased but did not sleep. I have never used it, and it does not seem to have become popular with physicians. You will do well to watch its history and use, for it may CHIMAPHILA. 159 prove homceopathic to some serious conditions - paralysis of the brain, for instance. Dr. Otto Leibreich, the famous German physician, who lately applied a-priori principles to medicine, was rewarded with a discovery, which, though not yet pursued to its ultimate consequences, has already been shown to possess great value. The application of his investigation was, in the first instance, to chloral hydrate. He has more lately, through a series of experiments, brought to light some four or five new anesthetics. A correspondent of the New York Graphic, who subjected himself to the influence of these drugs, under the supervision of the discoverer, describes his sensations in a late number of that journal. A mixture of Beurine and Babeine seems to have produced results in some respects like those of haschish-dreamers, great exhilaration, blissful feelings, and bodily insensibility. Denomine, on the other hand puts the patient into a deep and healthy sleep. "It has, moreover," writes the correspondent, "this remarkable property, which will render its general use certain, if it shall be found in all cases to be perfectly harmless: one hour of the sleep produced by it is equivalent in reparative power to eight hours of ordinary sleep. The slumber is profound, and the medulla oblongata, whence are spread the nerves which govern the lungs, must be powerfully affected, for the breathing is deep and rapid, whereby enormous quantities of oxygen are taken into the system and a proportionate amount of carbon eliminated." CHIMAPHILA. This pretty little plant, a native of the Northern and Middle States, belongs to the class of popular renal remedies. That it possesses undoubted affinity for the genitourinary mucous membrane is now admitted. It is called by allopathic authorities an "astringent diuretic "- curious and apparently incongruous name, which is doubtless meant to imply that, while it increases the watery portions of the urine, it decreases its solid constitutents. This it does do, 160 CHIONANTHUS VIRGINICA. especially when such constituents are abnormal. It is probable that massive doses, long continued, would provoke inflammatory action, but such effects have not come under my observation. Its principal curative indications are: Scanty urine, containing a larqe quantity of muco-purulent sediment. Excessive itching and painful irritation of the urethra from the end of the penis to the neck of the bladder. Sensation of swelling in the perineum, as if, in sitting down, a ball was pressing up against it. It has proved curative in the following: Dropsy after scarlatina, or during Bright's disease. Chronic catarrh of the bladder, with hectic fever. Chronic disease of the prostate gland. Hcematuria, passive, symptomatic, in local disease. _Dysuria, in plethoric, hysterical women; scanty, frequent urination, with pressing, scalding and smarting pain; also tenesmus of the bladder; urine filled with mucus. Urine thick, ropy, brick-colored, with bloody sediment. It has some reputation in scrofula with glandular enlargements, and is said to have cured, in the practice of various physicians, tumors of the mammace, enlargements of lymphatic glands, scrofulous eruptions, and even scirrhus and cancer. Success is claimed by use of the 30th, as well as the tincture and infusion. I prefer the infusion in diseases of the bladder. CHIONANTHUS VIRGINICA. This is a singular looking shrub, growing from Pennsylvania to Georgia, on river banks and sandy plains. It presents clusters of snow-white flowers in May and June. The common names are "old man's beard" and "fringe tree." I call your attention to this medicine, which may fill a place in your armamentorium which no other can fill. It seems to be very similar, in its action on the liver, to the Chelidonium upon which I lately lectured. I get my knowledge of it from Dr. Goss, a well-known physician. He CIMICIFUGA RACEMOSA. 161 says: "The most important therapeutic property that it possesses is its specific power over morbid conditions of the liver. " I have tried it in hypertrophy of that organ, and with uniform success; and also in obstruction of the liver, in malarious districts, with like success. "Some years ago I called the attention of the profession to its specific effects in jaundice, and gave several cases in proof of the fact. "Since then I have used the Chionanthus in a great many cases of jaundice, and have never failed to remove it in but a single instance, and that one I think was a case of obstruction of the gall-ducts by calculi; in that case I trieda 11 the reputed chologogues without success. It removes jaundice of years standing in from eight to ten days. I have treated several persons who had been subject to jaundice annually, in summer, for several years, and had been dosed with blue pill, calomel and other articles without any benefit, and I have not failed in a single instance to remove the disease entirely. And when it is removed by the Chionanthus, it does not return - at least it has not, in any instance, to my knowledge." This is very positive testimony. He adds that it is not a purgative —which would go to prove that it was a true hepatic remedy. The tincture of the bark should be made with strong alcohol, and given in ten or fifteen drops every three hours. CIMICIFUGA RACEMOSA. We now come to speak of one of the most important of all the new remedies. It is to the new, what Ignatia was, and is, to the Materia Medica of Hahnemann. Its range of action is quite extensive; it has been quite thoroughly proven; the clinical experience with it is already large; and it has large possibilities for future development. It is known under the common names of black snake-root, black cohosh, and rattleweed. Its former botanical names 162 CIMICIFUGA RACEMOSA. were Actaea and Macrotys, from wrlich latter came the name of its active principle Macrotin. (Now Cimicifugin.) Sphere of action. It is essentially a cerebro-spinal remedy. The brain and spinal cord are directly under its influence, and upon which it acts primarily as a depressing irritant. Its action on the muscular system is probably not direct, but a result of its effect upon the spinal cord. Its differs from Nux and Ignatia, in that they are exciting irritants of the spinal cord. Cimicifuga indirectly affects the vegetative system-the functions of digestion and assimilation. It has but few symptoms of gastric or intestinal derangement not due to reflex irritation. It has become one of our most potent remedies in disorders of the mental sphere, namely: in melancholy and aberration of mind. The characteristic symptoms indicating its use are: " Great melancholy; she feels grieved; troubled with sighing; sensation as if a heavy black cloud had settled all over her, and enveloped her head, so that all was darkness and confusion, while at the same time it weighed like lead upon her heart." (Cured by Dunham with the 200th, and by myself with the 3x dil.) " She was suspicious of everything and everybody; would not take medicine if she knew it; indifferent, taciturn; takes no interest in household matters; frequently sighs and ejaculates; great apprehensiveness and sleeplessness." These symptoms are always promptly removed by Cimicifuga. The size of the dose, if it is above the Xx, does not seem to be important. I have treated very many cases of profound melancholy, even from disordered liver, by this medicine, and can assure you that it has cured the majority, and even when the disorder of the mind depended on incurable physical disease its palliative effect was remarkable. One key note to be remembered, is sleeplessness. Many physicians have informed me that if, in cases of melancholy, sleeplessness was present, Cimicifuga nearly always cured. Delirium tremens. In this terrible disorder the Cimi;cifuga CIMICIFUGA RACEMOSA. 163 is indispensable. When there is nausea, retching, dilated pupils, heavy pressing-out headache, trembling of the limbs, incessant talking, changing from one subject to another, obstinate sleeplessness, imagines strange objects on the bed, rats, sheep, etc., with quick, hard pulse, and a peculiar wild look in the eyes, the 3x dil. frequently repeated, aided by a good diet of milk, wine, whey, mutton broth, etc., will soon restore the patient. A lady patient of mine who was taking five drops of the Ix for rheumatism, was annoyed by an illusion of a mouse running from under her chair. This illusion disappeared upon suspending the medicine, and recurred when taking it in the same doses. I have found it useful in puerperal mania, and in those depressed states of mind and body following the excessive use of tea, valerian and morphia. The nerves of sensation are very unfavorably affected by massive doses. It causes a pure neuralgia, and what the older authors called neuralgic rheumatism. The neuralgia is not confined to any particular set of nerves, as is the case with some remedies. Its depressing irritant action seems to be universal. The pains are aching, pressing, remitting, and are attended with great restlessness and a weak, exhausted feeling. It seems to affect the sensory nerves of the leyt side most. The nerves of motion are profoundly irritated. In the words of Dr. T. C. Miller, whose experience with it for fifteen years enabled him to judge of its powers: " It is one of the most remarkable remedies in all diseases of the gangliospinal system, particularly when the motor side is excited, and yet, in the whole, prevails an atony in the muscular and nervous system." This statement of its pathological action gives us the clue to its wonderful efficacy in chorea. It is indicated in many kinds of chorea, whether arising from rheumatic irritation of the cord, from uterine disease, or from purely psychical causes. The symptomatic indications are chiefly: abnormal movements, uncontrolled by the will, in all those parts of the body supplied by motor nerves; it affects both voluntary 164 CIMICIFUGA RACEMOSA. and involuntary muscles. The motions consist of twitching, jerking, twisting actions; they are sometimes attended by pains like neuralgia or rheumatism. The movements abate or are absent during sleep. They are aggravated by emotions; at the menstrual periods; or are caused by suppressed menses. They are attended by depression of spirits, and sleeplessness, and often by mental derangement. The Ciniicifuga is useful in many kinds of tremors, which resemble St. Vitus Dance, but due to functional derangement of the nerve centers. If they are caused by structural changes this remedy is useless, or if they are caused by mercurial or other mineral poisoning. I do not think the Cimicifuga will be found very useful in convulsions of any kind, unless they resemble chorea; consequently it will not be available in ordinary puerperal convulsions or epilepsy. It bids fair to become a prominent remedy in cerebro-spinal meningitis, and possibly myelitis. Dr. W. S. Searle, of New York City, first called attention to it in the Transactions of the New York Homoeopathic Society, and gave his experience of its use in a case of the former disease, when after the inflammatory period had passed, the patient was tormented day and night by alternate clonic and tonic spasms, and obstinate vomiting. Since Dr. Searle's observations were published I have used it in many cases of cerebro-spinal trouble, and with unvarying success. Those of you who have been in practice, or have observed the practice of your preceptors, must have noted the prevalence of more or less cerebro-spinal irritation, in nearly all fevers, and some other diseases, and occurring in the winter and spring months. It is only within a few years that these phenomena were of such frequent occurrence. As the late Dr. Williamson used to say: " It has become the genius of the prevailing maladies." Cimicifuga, in the lower dilutions, is indicated in the three grades of this disorder, namely: Cerebro-spinal meningitis, in the 6x dil. Cerebro-spinal congestion, in the 2x dil. Cerebro-spinal irritation, in the lx dil. CIMICIFUGA RACEMOSA. 165 I will give you the indications for its selection: Delirium like mania-a-potu, with nausea, retching, dilated pupils, tremor of the limbs; quick, full pulse, and wild look out of the eyes. Headache; pain over the eyes, extending along the base of the brain, into the occiput. Brain feels too large for the cranium —a pressing from within outwards; or a sense of compression in the temples. Excruciating pain in the forehead and in the eyeballs, vertex, nape of the neck and occiput, with fullness and throbbing, as if the top of the head would fly off. Dull pains in the occiput, with shooting pains down the back; the head is jerked backward. Intense pain in the eyeballs; with black specks before the eyes; dilated pupils; double vision; congested conjunctiva, and lachrymation. Intense throbbing pain, as if a ball were driven from the neck to the vertex, with every throb of the heart. Tongue swollen; breath offensive; pharynx dry; dysphagia; roughness and hoarseness of the voice. Nausea and vomiting attend the pain in the head. Pains in the back, of a drawing, tensive character, or dull and heavy, with tenderness on pressure. Alternate tonic and clonic spasms, night and day. Spasmodic jerkings, like chorea. Rigidity of the muscles of the neck and back. Intense aching pains in the neck, head, and all the joints of the extremities, like'the pains which accompany the fever of variola. Eruption of white pustules on the face and neck; sometimes large, red and papular. There is a disorder known at one time as " spinal irritation." It is now known that in the great majority of cases, it is not a spinal, but a muscular affection, and its proper name is myalgia. In this disease Cimicifuga is one of our best remedies, rivaling Arnica, Hydrastin or Nux. This leads us to consider its.action on the muscular system. It is curative in two kinds of muscle-disease: 166 CIMICIFUGA RACEMOSA. (1.) Myalgia, or a loss of tonicity in the muscular fiber, probably from atony with irritation of the nerves which supply them. Myalgia in its various forms includes, certain headaches from an affection of the muscles of the head and nape, pleurodynia, myalgic colic, stiff neck, "crick in the back," and burning, cramping, stitching, aching pains all over the body, and even in hollow internal organs. (2.) MAyositis, or inflammation of muscular structures, either idiopathic or rheumatic. It seems to affect by preference the belly of the muscle. Arnica acts in a similar manner, but is better for traumatic myalgia and myositis; Bryonia resembles Cimicifuga, but the cause of the Bryonia-muscular disease lies more in the state of the blood and secretions than in the state of the nervous centers. Bryonia does not cause reflex muscle disorder. Cimicifuga does (so does Caulophyllum.) Hydrastis differs from both, and resembles China and Ferrum more nearly. In inflammatory muscular rheumatism, Cimicifuga has always had a deserved high popularity, both with physicians and laymen. The rheumatic fever for which it is specific is marked by several very characteristic symptoms, namely: the suddenness of its onset, the severity of its manifestation, and its location in large muscles. In such cases it often acts with surprising rapidity, relieving the fever, pain, soreness and restlessness in a few days. It differs from Rhus in not acting on the tendons, or terminal attachments of muscles, and from Colchicum, Bryonia, and Asclepias, in not acting on serous tissues; at least I do not think it has that affinity for serous tissues which is possessed by other well-known medicines. I would not give you the impression that Cimicifuga is not useful in chronic rheumatism, for some of its most brilliant achievements have been in that direction. But in such cases the location of the disease has been in the belly of the muscle, i. e., its longest or middle portion, and its inception was originally sudden and severe. In my practice, and those of my colleagues, also in the practice of the eclectic and allopatliic schools, it has made CIMICIFUGA RACEMOSA. 167 some surprising cures of chronic inflammation of the cervical and lumbar muscles (" stiff neck" and lumbago); in chronic inflammation of the muscles of the upper and lower extremities, and intercostal rheumatism. I remember one case, the mother of Clara Louise Kellogg the prima donna, who had for many years such stiffness, pain, and lameness of the muscles of the thighs that her sufferings were at times intolerable. After trying faithfully Rhus, NuN vom., Bryonia, Turpentine, Sulphur, etc., she took ten drops of Tinc. Cimicifuga three times a day, which accomplished the removal of the disease in a few weeks. The febrile symptoms of Cimicifuga are irm6re erethestic or irritative (reflex or sympathetic) than inflammatory or synochal. It will rarely be useful in the fevers, except as an intercurrent remedy. In the exanthematous fevers, it has not been specially recommended, except by Drs. B. L. Hill and D. S. Smith, who used it in.variola and varoloid. It certainly does seem indicated in the first stage of small-pox, for the intense aching in the extremities, head, and back resemble the symptoms of that disease. It even causes "white pustules on the face and neck." I would advise you to keep this remedy in mind, in the treatment of variola. I have found it useful in the myalgic troubles which often follow scarlet fever. It relieves those intolerable pains in the back and limbs, the stiff neck, and muscular cramps, which are such painful sequelae of that malady. Night sweats, when not due to suppuration or anaemia, but to some fault in the proper supply of nervous energy to the skin, are readily arrested by Cimicifuga. In the provings, you will observe that cold sweat was quite a common symptom, especially after three A.M., sometimes lasting all day, with weak, irregular pulse, and pain under left breast. You will find these symptoms very common in women, and sometimes men, whose nervous system has been weakened by long illness, trouble or care; and you will find in all such cases that the Cimicifuga, in the 3x to 6th dilution, will prove an admirable restorative. 168 CIMICIFUGA RACEMOSA. No drug in our Materia Medica uniformly causes such severe pain in the head, both internal and external. Internally it causes passive congestion or anaemia, according to the constitution of the prover. Externally it causes pains in the muscles, and the nerves supplying them. The character of the pains and distress are, internally: "a sensation as if the temples were compressed," - dullness and heaviness in the head, as if he had been on a " spree " —head felt as if it had been pounded full of something heavy-moving the head or turning the eyes causing a sensation as if the cranium was opening and shutting - head feels as if he had been without sleep a long time - brain feels too large for the cranium, pressing from within outward- severe pain in the forehead, extending to the temples and vertex, with fullness, heat, and throbbing; when going up stairs, a sensation as if the top of the head would fly off; excruciating pain in the forehead, with coldness of the forehead, and severe pain in the eye-balls. Nearly all the pains in the head extend to the eye-balls; they are aggravated by movement —relieved by the open air; attended by faintness and "sinking," at the pit of the stomach. Externally it has: severe pain over the right or left eye, extending into the eye, and back into the base of the brain pain over the eyes, extending along (around) to the base of the brain and occiput, and nape of the neck - pain in the occipital region, with shooting pains down the back of neck — dull, boring pain over the left superciliary ridge, at 10 A.M., pains in the occiput, extending to the vertex. All these symptoms are trustworthy, and have been verified by clinical experience. Cimicifuga is indicated in Headache, resulting from loss of sleep, night-watching, and abuse of alcoholic drinks; from mental strain and worry of mind; and from exposure of the head to draughts of cold, damp air. It is useful in the following kinds of cephalalgia: Congestive headache (passive, perhaps active.) Nervous headache (periodical or remittent.) CIMICIFUGA RACEMOSA. 169 Bheumatic headache (in the muscles - catarrhal.) Hysterical and menstrual headaches (at change of life.) Cerebro-spinal headaches: In the cerebral irritation of children during teething, when they are fretful, feverish, sleepless, the 6th or 30th has a soothing effect. I do not think you will find it useful in acute cerebritis or meningitis, but it may be in the chronic. Its analogues in head affections are Bryonia, Spigelia, Glonoine, Nux vomica and Ignatia. The eyes are severely acted upon by Cimicifuga. Few drugs cause such intense and persistent pain in the eye-balls. The pains are chiefly aching, extending to different portions of the head. Many of the pains, however, seem fixed in the center of the eye-ball, and simulate rheumatic and neuralgic affections of the eyes. In some cases the eyelids become inflamed. One characteristic of the eye affection is that in the majority of cases no redness of the eye-balls exist; in other cases, as in Dr. Hill's proving, the " eyes were congested so as to attract the attention of every one, although there was no disagreeable feeling in them." This discrepancy is probably owing to some difference in the constitution or idiosyncrasy of the prover. It will probably be found useful in that painful sensitiveness of the eyes known as " ocular hypercesthesia," for which Spigelia is such an excellent remedy. Both should be used in the high potencies for this affection. It is reported to have cured catarrhal conjunctivitis; and should be tried in sclerotitis rheumatica. It causes amaurotic symptoms, "black specks," and " double vision," both of which it has cured. The catarrhal symptoms, especially of the nasal mucous membrane, are very decidedly shown in all the provings. But it has no special reputation in ordinary catarrh and influenza. It affects the laryngeal and bronchial mucous membranes in a similar manner. A study of the provings will show, however, that the catarrhal irritation rarely goes beyond the serous stage. 12 170 CIMICIFUGA RACEMOSA. I think the Cimicifuga catarrh is in keeping with its rheumatic symptoms. In other words, it causes a catarrh which precedes a rheumatic attack. Dr. Hill suggests that it causes catarrhal conditions similar to those produced by a sudden change in winter from a cold day, to damp thawing, by a south wind that melts the snow. Now this is the very atmospheric condition that causes the severest kind of rheumatism. In rheumatic sore throat, rheumatic prosopalgia and toothache, when preceded by the above catarrhal conditions, it is clearly indicated. The older authors recognized a rheumatic bronchitis and pneumonia. Given the other symptoms of Cimicifuga, I should not hesitate to advise it in acute bronchitis and pneumonia preceded by the characteristic catarrh. It is indicated for the premonitory symptoms of diphtheria, but does no good afterward. The action of Cimicifuga on the stomach seems to arise from its depressing effect on the solar plexus and its sympathetic nerve connections. It resembles the action of Sepia, Digitalis, Murex and Ignatia, all of which produce, like Cimicifuga, that peculiar sensation of faintness, sinking and emptiness which attended all the provings. This sensation was sometimes attended with nausea and vomiting. This faint sensation alternated, during the same day, with a sensation of fullness or repletion. Both sensations resulting from a depression of the same nerve. In the nausea and vomiting of drunkards, tea-drinkers, and pregnant women, when attended by the above morbid sensations, it will act curatively. It is well indicated in the vomiting which precedes cerebral and spinal irritations, and the vomiting which is sympathetic with, and resulting from, nervous headache. There are three diseases of the abdominal structures in which you will find Cimicifuga useful: (1) Rheumatism of the muscular tissues. (2) Neeuralgia, often mistaken for peritonitis, especially if it occurs after miscarriage and confinement. (3) Rheumatic neuralgia. It does not seem CIMICIFUGA RACEMOSA. 171 to be homoeopathic to, or useful in, any abnormal discharge fronp the bowels. It increases the quantity of urine, which is pale and limpid. Take the symptoms in connection with the general nervous depression, sinking at the stomach, etc., and we have good data for prescribing it in nervous diabetes, or that condition which frequently precedes or follows nervous attacks of various kinds, hysteria, and the like. The symptoms of the male genital organs are those which might attend general rheumatic irritation, affecting the spermatic cord and testicles. Its curative action in some cases of spermatorrhcea and its consequences, is undoubted. Cimicifuga is one of our most important remedies in many of the diseases of women. In amenorrhcea or delayed appearance of the menses in young girls, from deficient nervous energy in the ovaries, and when the abnormal nervous influence is directed to other organs, giving rise to chorea, hysteria, nervous headaches, etc., the Cimicifuga will restore the functions of the reproductive organs to a normal state. Should there be, at the same time, witl the above conditions, a chlorotic state, Helonias or Ferrum should be alternated with this remedy. In retarded menstruation, when Pulsatilla or Senecio are not indicated, and when at the usual menstrual period the discharge does not appear, but in its place comes a pressive, heavy headache, melancholy, palpitation of the heart, and other reflex symptoms —in these cases the Cimicifuga will restore the normal condition of the system and cause a regular return of the menses. In suppression of the menses from a cold, mental emotions, or febrile conditions, when rheumatic pains in the limbs, or intense headache, or uterine cramps, are present, this remedy will be found very useful. In dysmenorrhoea, the Black Snake-root has been used successfully by all schools. The eclectics consider it a sort of panacea. Many of our own school speak highly of its value. Dr. Hill, in his " Epitome," advises it in all cases, in alternation with Caulophyll-un. It is not a general specific, yet it will benefit a majority of 172 CIMICIFUGA RACEMOSA. cases. It is most useful in rheumatic and neuralgic cases, but is often of benefit in congestive dysmenorrhcea, when alternated with Veratrum viride, or Belladonna. The best method of administration in these diseases is to give Cimicifugin, first decimal, or one-hundredth, three or four times a day during the inter-menstrual period, and every hour or thirty minutes during the severity of the pain. The Cimicifugin, second or third decimal trituration, will in some cases act more satisfactorily than the tincture. Several of my colleagues have reported cases of dysmenorrhcea cured or very much relieved by it. They think more highly of the Cimicifugin in the neuralgic type, than of Caulophyllin. The latter is more indicated in cases complicated with uterine spasms or general hysterical convulsions. Dr. Williams sends me the record of two severe cases of dysmenorrhcea, probably of a rheumatic origin, which were apparently cured under the action of Cimicifugin 1st. I have treated many cases of difficult and painful menstruation, arising from various causes, and while in all there was improvement, in many the morbid condition seemed to be permanently removed. I consider the following symptoms as indicating its use: Before the menses the peculiar headache, similar to that caused by this medicine; during the menses, aching in the limbs, severe pain in the back, down the thighs and through the hips, with heavy, pressing-down, labor-like pains, weeping mood, nervousness, hysteric spasms, cramps, tenderness of the hypogastric region, scanty flow of coagulated blood, or profuse flow of the same character; between the menses, debility, nervous erethism, neuralgic pains, tendency to prolapsus, etc. It is useful in menorrhagia, when the flow is profuse, but of a passive character, dark coagulated, and accompanied by the above mentioned pains. The Cimicifuga does not primarily cause haemorrhage, like Sabina, Erigeron, or Crocus, but secondarily, by impairing the tonicity and normal vitality of the uterus. In leucorrhoea, the eclectics speak highly of its efficacy. Tshe late Dr. Morrow, to whom is mainly due the introduction of the remedy into that practice, gained much celebrity CIMICIFUGA RACEMOSA. 173 by his treatment of leucorrhcea, with the internal and local application of the Black Cohosh. He gave it until it produced and kept up its peculiar action on the brain in a slight degree; a decoction of the root as an enema was used every day. Leucorrhcea may be vaginal, cervical, or uterine. In the present state of our knowledge of the action of the drug, we can not point out accurately the particular form of leucorrhcea for which it is indicated. It may be beneficial in all varieties; the general symptoms must, to a great extent, be our guide. Dr. Hill mentions a "leucorrhcea of long standing cured during a week's proving," and another case of "leu — corrhcea, and chronic inflammation and congestion of the uterus, cured during the proving, while no other symptoms were observed on the provers until the disappearance qf the uterine disease." Believing in the local as well as general action of a drug, I would advise it to be used both topically and internally. The lower dilutions seem to act most beneficially. It is now more than sixty years since it was claimed by Stearns, in the American Herbal, to have an especial affinity for the uterus, particularly over the menstrual function, and Dr. Tully regards this claim as well established by the experience of New England practitioners. As a parturifacient it was in general use among the Indians in the early settlement of this country. Bigelow speaks of it as an active agent in facilitating parturition; and Tully says he has known many cases where it has produced abortion in pregnant women, when prescribed for a cough. The evidence on this head is far more full and satisfactory than in regard to its emmenagogue properties. Prof. Lee says: "'It is believed to exert a specific influence on the uterine contractions, lasting longer than that of Ergot, and followed by less torpor and greater susceptibility and capacity for action in the uterus than before its employment. Its operation, also, is not attended by that deleterious and stupefying influence on the fcetus which often follows the administration of Spurred Rye." It is doubtful if the Ergot acts medicinally on the feetus at all. It is the continued, unintermitting pressure of the 174 cIMICIFUGA RACEMOSA. uterus upon the child, or the cord, which causes the coma or asphyxia in the infant before birth. "After delivery, adds Prof. Lee, it has also been extensively and successfully used for the purpose of inducing firm uterine contractions, expelling the placenta, and checking post-partum haemorrhages. For this purpose a drachm of the saturated alcoholic tincture should be given every half hour, or oftener, until the desired effect is produced." (This dose is enormously large and unnecessary. Ten drops is sufficient.) A knowledge of the uterine-motor action of Cimicifuga should be appropriated by homceopathists. They are capable of making much more valuable use of such knowledge than the adherents of other schools of medicine. The homceopathic school gladly avail themselves of the use of Ergot in slow and difficult labors arising from an atonic condition of the uterus, or perverted function. I can not give my assent to those mythical relations of the effects of Secale third or thirtieth, in causing uterine contractions when deficient during labor; the proof is not sufficient. I consider the Cimicifuga, as well as Secaje, Caulophyllum and other drugs, possessing similar powers, as being secondarily homceopathic to conditions of uterine inertia. To explain: The primary action of Ergot in moderate medicinal doses is to cause contractions, more or less persistent, of the muscular tissues of the uterus. Under the continued action of the drug these contractions will become more intense and firm, until, from over-stimulation, an opposite condition or muscular atony obtains. Now, this latter condition, with its accompanying symptoms, is a secondary effect of the drug, as mudh due to pathogenetic action as was the primary. When, in practice, we meet with similar conditions, i.e., when the uterus, after vain and powerful efforts, becomes exhausted, Ergot is the proper remedy if the primary symptoms correspond with those of the drug, viz., persistent and violent contractions. But if the uterine atony be caused by Ergot, then that medicine will not answer our purpose, and we must resort to Cimicifuga, Caulophyllum, Cannabis, or galvanism. Secondary states of uterine CIMICIFUGA RACEMOSA 17T5 muscular atony may be brought on by all the last named agents, and for this reason they will all be found useful in similar morbid conditions. The dose which should be used in such cases should be as large as can be given with safety to the patient, and just large enough to arouse the torpid muscular tissue. My theory of dose, which experience strongly substantiates, is, that for symptoms which simulate the primary effects of the medicine selected as the remedy, minute doses should be administered; but larger doses for symptoms simulating its secondary effects. In resorting to the Cimicifuga in atonic labors, we need not give the massive doses of the eclectic school -doses which tend to bring on secondary exhaustion. I have found five to ten drops of the mother tincture, every fifteen or twenty minutes, to be amply sufficient to bring back or arouse the deficient vitality of the uterus. But there is an opposite condition of the uterus which sometimes obtains during labor, a state of hyper-excitation, in which the normal uterine contractions are spasmodic, painful, and intensely powerful, but intermittinag; sometimes with cramps in the extremities, and a tendency to general convulsions. Here the Cimicifuga is primarily homaeopathic, and a small quantity of the third or sixth attenuation will suffice to restore the normal parturient action. This medicine will be found useful after labor, in producing firm contraction of the uterus, expelling the placenta, or checking post-partum hemorrhage. But I think for this purpose the Secale is to be preferred, because of its power to cause firmer and more persistent contraction. After-pains ar'e often readily relieved by small doses of Cimicifuga, second or third, or Cimicifugin third. I have used it with signal benefit in those cases which seemed to be kept up by a neuralgic disposition, or mental and nervous irritability, and the patient was sleepless, restless, sensitive and low spirited. Suppression of the Lochia is treated successfully with this remedy. When from a cold or mental emotion the discharge is arrested, uterine spasms and cramps in the limbs sometimes occur, accompanied with headache and even delirium. 17 6 CIMICIFUGA RACEMOSA. A case of this character which came under my treatment, was relieved in a few hours by Cimicifugin, second trit., two grains every half-hour. Warm fomentations were applied to the abdomen and vulva, as should always be the practice in such instances. It is also useful for the relief of those bearing-down pains, indications of prolapsus, which women frequently suffer from after severe confinement. It is eminently homcopathic to a tendency to abortion. It has caused abortion in many instances, and is commonly resorted to for that purpose by reckless women, and advised by still more reckless physicians. It has been successfully used in instances of "habitual abortion," with the result of preventing the usual miscarriage in the second and third months. But unless the general symptoms correspond, Caulophyllum, Sabina, Tanacetum or Helonias will have to be selected. When the chill, uterine pain, tenderness of the hypogastric region, and flooding, have'already set in, and the loss of the foetus becomes imminent, the Cimicifuga in small doses may arrest the progress of the morbid process, provided the membranes have not become extensively detached. If the separated portion be slight, and the patient be kept quiet, and the proper remedies given (Aletris Viburnum), I believe it possible to prevent a further separation. If all hope of saving the fcetus b.e abandoned, and the uterus is deficient in expulsive power, then this medicine may be given, as recommended for uterine atony in labors. But no physician should rely alone upon medicinal action in such cases. The sponge or sea-tangle tent, placental forceps and blunt hook, should be used early and efficiently, to effect the entire removal of the contents of the uterus. Sterility, when not due to extensive ulceration, or other structural changes in the uterus, may be cured by Cimicifuga. Among the causes of sterility, by which I mean, inability to conceive, which are removed by this remedy, are, congestion of the cervix, thereby closing the cervical canal; deficiency of nervous energy, accompanied with melancholy; feeble circulation, scanty menstruation, lack of sexual deire, etc. CIMICIFUGA RACEMOSA. 177 Prolapsus uteri is often removed by this remedy, especially when occurring in nervous, melancholy subjects, and is the result of abortions, cervical congestion, or deficient nerve-innervation. Two key-symptoms indicate it in prolapsus, namely: melancholy, and " sinking" at the pit of the stomach. Helonias also has the former, and Sepia the latter, but in both I think the pathological conditions are different from those cured by Cimicifuga. Ovarian disorders, of a nervous rather than inflammatory or structural character, will often find a specific in Cimicifuga. Ovarian neuralgia is perhaps as often cured by it as by any other remedy. In this affection it is specially indicated when the ovarian pains are reflected, or change their location to other portions of the body, as the leg of the same side, the region under the left breast, or extend up the whole side to the shoulder. It causes congestion of the head, the uterus and other organs, and, very likely, the ovaries. As ovarian disorder is usually attended with abnormally depressed states of mind, the Cimicifuga is as often indicated as Platinum, with which it closely affiliates in many respects. In puerperal mania, it has been found curative by all schools. Many cases successfully treated by it have been published in our literature, some in the eclectic, and a few in the allopathic. The late Prof. Simpson reports a case called by him " puerperal hypochondriasis," in which he had tried all the usual remedies. He gave the enormous dose of fifty drops of the tincture thrice a day. He says: "In eight or ten days she was altered and changed in a marvelous degree, but all for the better. On the third or fourth day, she informed me that the cloud of misery which had been darkening her existence suddenly began to dissolve and dispel, and in a day or two more she felt perfectly well again, in gaiety, spirits and energy." He adds that nothing would induce her to give it up, but took it for six weeks longer! And no pathogenetic symptoms! What will the ultra high dilutionists say to this? Does it not prove that the danger of medicinal aggravations from appreciable doses is very much 178 CIMICIFUGA RACEMOSA. exaggerated? The fact is, that if a medicine is homeoopathic to a case, it will cure in any dose, in a high or low attenuation. (See Dr. Dunham's cure of just such a case as the above, with the 200th.) Dystocia is one of those abnormal conditions which come clearly under the domain of homoeopathic medication. It is useless to cling to the antiquated superstition that a woman must suffer "pangs of childbirth." Dystocia is always the result of an abnormal condition of the tissues concerned in the functions of childbearing. I do not wish to have you understand that a majority of cases of painful labor can be remedied by medicines. I have attended very many women who did not suffer to any degree; they expressed themselves as caring very little for the pains. Nor were these women all healthy. But this abnormal phase was somehow absent, or nearly so. I have also attended many women whose previous labors had been exceedingly painful, almost unendurable without Ether, but, owing to the administration of Cimicifuga during the last weeks of pregnancy, they suffered very little. So many of these cases have occurred in my practice, and in that of my colleagues, that it is not proper to affect skepticism or unbelief. As a rule, first labors are painful and protracted, while subsequent ones are less so; but if five or six are very painful, and each one seems to be more painful than the last, we can not expect the seventh to be painless, except from some remedial interference. Now, if in such cases Cimicifuga, Caulophyllum, or Viburnum is given, and the woman's next labor is easy, what are we to think? Evidently, that the medicine effected a change of condition, from abnormal to normal. In such cases give the Cimicifuga at least two weeks previous to the expected date of labor, in doses of one to ten drops, two or three times a day; the doses repeated oftener as the date approaches. In irritable uterus, that condition once described by Gooch, and lately declared by Hewitt to be a condition of flexion, the Cimicifuga is an admirable remedy, when the pains seem like those of rheumatism or neuralgia. If they are decidedly CLMIICIFUGA RACEMOSA. 179 spasmodic - crampy - Viburnum is the specific. In irritability of the uterus, such as occurs at the change of life, when the menses are irregular, and the pains are more or less periodical, in the lumbar regions, or in the side, or in the top of the head - at night - this remedy rarely fails to relieve. Mammary pains of a reflex character, occuring during pregnancy, with dysmenorrlhea, or at the climacteric, and even after confinement, are also included in the curative sphere of this medicine. Phlegmosia alba dolens, is not always alba. The swelling is sometimes very red, and assumes all the character of acute rheumatism. In such cases Cimicifuga is the remedy. It is not the remedy alone, when it is due to septicoemia or absorption of morbid secretions, in which case Baptisia, Arsenicum and Carbolic acid should be used. But this disease is sometimes the result of exposure, added to the contusion of the veins and nerves, and calls for Cimicifuga, Aconite, Arnica Apis, and Hamamelis. (I do not advise " Macrotin," in all cases, because I do not believe it contains all the medicinal properties of the drug, any more than Leibig's Extract of Beef contains all the nutritious qualities of beefsteak. It may prove useful in a large proportion of cases -but when it fails, you will often find that the tincture of Cimicifuga will cure. I adhere to the name Cimicifugin because both "- Actea " and "Macrotys " are obsolete, according to recent botanists. The active principle, moreover, should be called " Cimicifugin." Remember, too, that you should not order the " tincture of Macrotin," as has been done.) The laryngeal and bronchial irritations of Cimicifuga are either reflex or rheumatic. It has cured the reflex cough of pregnancy and uterine irritation. I can hardly understand the high estimate by which it was held by Drs. Tully, Hildreth and Lee (allopaths) in pulmonary affections. Here is what they say of it: Dr. Gardner used it in his own case for the following symptoms —pulse 100 to 120, harrassing cough, purulent expectoration, pains in the right breast and side, hectic par 180 CIMICIFUGA RACEMOSA. oxysms, loss of flesh and strength, frequent hmemoptysis, and deranged stomach and liver-cured in a few months. Dr. Hildreth says -" In phthisis, in nearly every instance the pulse was reduced to near the natural standard, the hectic symptoms disappeared, and with it the cough and other symptoms." He also removed "those intermittent congestions and inflammations so frequent in the second and third stages of phthisis, when they arose from atmospheric exposure." Drs. Lee, Wood and Chapman give similar testimony. In homoeopathic practice it has not succeeded in getting a reputation in pulmonary troubles, although it has an excellent one in pleurodynia and intercostal rheumatism, both of which conditions are found to be present in nearly all cases of pulmonary phthisis. I would suggest its more extensive use in chronic diseases of the lungs, not alone -for I doubt if it affects the parenchyma of the lungs — but in alternation witn Sanguinaria, Phosphorus, Kali carb, Stannum and others. In pleurisy it may be useful, but I prefer Bryonia. They act very well in alternation, in both pleurisy and pleurodynia. For those obstinate reflex pains in the left side, occurring in women-generally the unmarried, this remedy is as nearly a specific as can be. These pains are said to arise from uterine or ovarian irritation. They occur " under the left mamma, or under both; they often extend up to the left shoulder and down the arm; they frequently change to other localities, as the back, neck, and head. Under the use of Cimicifuga, lx, they are nearly always palliated, and cured if no structural lesion exists in the uterus or ovaries. Diseases of the heart are cured or greatly palliated by Cimicifuga. It is useful in Endocarditis, especially idiopathic or rheumatic. Pericarditis, in alternation with Aconite, Spigelia or Bryonia. Cardiac myalgia, which is often mistaken for true angina pectoris. CISTUS CANADENSIS. 181 Cardiac debility, characterized by irregular palpitation, with intermitting and weak pulse. Its symptoms are so similar to Digitalis, that it is often impossible to select between them. The history of the case will decide. If the symptoms of cardiac debility are primary, i. e., arising from nervous atony, the Cimicifuga is primarily indicated. If the condition is a secondary one-arising from previous excitement-Digitalis is better indicated. Chorea of the heart- a disorder now admitted to exist, even when no other choreic symptoms appear. It is characterized by tumultuous, irregular, unexpected and strange motions of the heart, aggravated by emotions, and subsiding during sleep. I have cured with it many cases of cardiac disorders, such as I have just mentioned, Eid consider that in its sphere Cimicifuga is one of our most potent cardiac remedies. It is a veritable polychrest, with a marked individuality, and will do you good service in practice. CISTUS CANADENSIS. The Rock-rose, or Ice-plant, has long been esteemed as a popular remedy in scrofula. It was partially proven and incorporated into our Materia Medica by Dr. Hering, who had a high estimate of its properties. He suggests that as it grows by preference in a soil abounding in Magnesia (talc.), it ought to follow Magnesia. Is Magnesia one of its inorganic constituents? If so, some Magnesia symptoms might be cured by it. A study of the pathogenesis can not fail to impress you with its similarity to some of the anti-psorics, namely: Calcarea, Corydalis, Graphites, Hepar sulphur, Phytolacca, and Stillingia. It has some resemblance to Belladonna, Paris quad, Kali bich. and Lachesis, especially its throat symptoms. Like the above anti-psorics it has made some brilliant cures of swelling and suppuration of the cervical and lymphatic glands. It has cured scrofulous abscesses located on the neck, 182 CISTUS CANADENSIS. shoulders, hips, and other portions of the body. Scrofulous hip disease (called " white swelling of the hip"), with fistulous openings leading to the bone, and ulcers on the surface, with night sweats. This case was cured in 39 days by a decoction of the plant. ~Eruptions; scrofulous; tetter; chronic erysipelas, boils beginning with a blister; and lupus of the face, all come under its curative power. It has a decided affinity for mucous membranes, or rather for the glandular structures imbedded in them. Beginning with the eyes, you will find it has cured scrofulous ophthalmia; in the mouth, scorbutic gums, swollen, separating from the teeth, bleeding easily, putrid. In the throat and air passages it gives us a vivid picture of chronic catarrh with strumous disease of the glands of those passages. I am surprised that with the following striking symptoms, it has not been used to a greater extent by all physicians. It causes dryness of the tongue and roof of the mouth. Inhaling cold air caused soreness and pain in throat, feeling of dryness, heat, and as if sand was in throat. Rawness extending from the chest into the throat. He is constantly obliged to swallow saliva to relieve an unbearable dryness, especially at night, or from 1 P.M. to 1 A.M. A small dry spot in the gullet (?) for a year, then general dryness of throat, better after eating, worse after sleepingas if tearing asunder, he must get up and drink water; the inside of the throat looks glassy, on the back of the throat are strips of tough mucus (Lachesis, Kali bich.) Periodical itching of the throat; tickling and soreness of the throat; in morning sore pain and dryness of throat, (Hep.) Tearing pain in the throat when coughing; stitching in the throat causing cough; cough aggravated by every mental excitement (Phos.), expectoration of bitter mucus. Fauces inflamed and dry, without feeling dry; tough, gumlike, thick, tasteless phlegm, brought up by hawking. I would advise you to use it in the catarrhal throat and bronchial affections so prevalent now-a-days. In domestic practice, I frequently hear it highly lauded for chronic diarrhoea and dysentery. Dr. Cqmstock, of St. COCA. 183 Louis, reported several cures from the use of the infusion. In Hering's provings the following symptoms appear: All night, till daybreak, thin stool, squirting out; grayishyellow in color, thin and hot. The chronic dysentery which it cures is probably of the same nature as the chronic laryngitis and bronchitis. COCA. The leaves of the plant Erythoxylon Coca, have, from the earliest authentic accounts, been used by the natives of Peru, for the purpose of stimulating the nervous energies, much as the Chinese use tea, the Arabians, coffee, the Asiatics, Cannabis indica, and the American aborigines, tobacco. Every nation has its peculiar nervous stimulant, which is at the same time, in different quantities, a calmative or nervine. Coca is an analogue of Paullinia, Scutellaria, Cypripedium, and Valeria, as well as the other nerve-stimulants above named. The primary action of this whole class is to excite the energies of the nerve centers. While the system is under their primary effects, the person is enabled to perform more arduous labors, severer exercise, and stronger mental exertions. The thoughts flow with unwonted freedom, and the scope of imagination and fancy is enlarged. Sleep is not as necessary to the organism; in other words the system can go longer without the repose of sleep. Unfortunately the secondary effects of all this class - if the drug or beverage is taken to excess-is a corresponding depression of the nervous energies, with a loss of the normal capacity for mental and physical labor. During the primary effects the senses are all more alert, the perceptions keener, and they are not morbidly irritable; while a sufferer from the secondary effects finds that he is irritable in body and mind, his nerves have lost their tone, and are shattered in proportion as he has abused the stimulant. The first use of Coca in the United States was as a tobacco-antidote. I do not know the originator, but suspect it was the 184 cocA. erratic Dio Lewis, M.D. In the many cases in which I saw it tried, no permanent good resulted from its use. If you will refer to the symptoms of the Mental Sphere, in New Remedies, fourth edition, you can readily separate the primary from the secondary. I doubt if the drug will ever come into extensive use in our school in the treatment of diseases, unless they are complicated with, or are caused by abuse of other nerve-stimulants. It may be a good antidote to the secondary effects of Tea, Coffee, and perhaps Opium. You. may find it useful in some nervous affections of the eyes. It causes white spots dark spots, and fiery spots before the eyes, (Chloral has"everything looks white.") It has symptoms closely resembling the dyspepsia and cardialgia caused by abuse of tea and coffee; it may be worth a trial in such cases. The symptoms of the respiratory organs are very striking. The natives of Peru, after chewing the leaves or drinking the tea, are enabled to climb with ease the highest mountains, and carry heavy loads where the air is so rare that the traveler (unless he takes the Coca) can breathe only with the utmost difficulty. It is said to prevent the hoemorrhages caused by high altitudes and rare air. In partial paralysis of the nerves of respiration, it may be very useful in removing or palliating the distressing dyspnoea, or, it may be very useful in the dyspnoea of weak persons who easily get " out of breath " during the slightest physical exertion. You may find it a valuable palliative in emphysema, and pulmonary 3edema. It may even assist in the cure of these distressing conditions. I have used it with apparent good results in some cases of.functional heart disorder, and in one of organic disease, to relieve the excessive dyspnoea. It palliated some, and seemed to be the chief means of cure in others. It is indicated in that condition which we so often find in women and children, which is best described by the word "fidgetyness," or nervous erethism. The patient can find CODEINE-COLLINSONIA. 185 no rest any where, wants to sleep but can not, finally becomes hysterical, feels like fainting; wants to be alone in the dark. (The Strammonium patient likes company and light.) In the cases just mentioned, the 6th or 30th attenuations appear to be best indicated; while for dyspncea, the matrixtincture must be used. CODEINE. This name is given to one of the alkaloids of Opium. It has been very little used by the allopaths, probably on account of its enormous price - about six dollars per drachm. The provings do not evolve many symptoms other than we can find in provings of Morphia. A few homceopathic physicians use it as an anodyne instead of Morphia, but it -has no special recommendation superior to the Morph. acet. Dr. Marcy used it in the 5th dilution in a case of twitching of both eyelids after reading, a symptom I have often cured with Hyoscyamus. He also gave it in troublesome night cough, of consumptives. It is said to cure severe neuralgia of the stomach and solar plexus; but we get this from allopathic authority. COLLINSONIA. This indigenous plant has a root so very hard, knotty, and tough that the name of stone-root has been given it by the country people. A thorough knowledge of the qualities of this medicine has not yet been attained. There are many doubtful points about its action which need elucidating. I propose to give a study of its action, based on the facts relating to its use. By this method we shall avoid bending the facts to suit a preconceived theory. From all available sources, we learn that it has been successful in the treatment of: 13 186 COLLINSONIA. (1.) Bruises, sores, wounds, sprains, and contusions. (2.) Constipation and hemorrhoids. (3.) Flatulent colic, indigestion, diarrhoea, and dysentery. (4.) Dysmenorrhcea, urinary difficulties, and varicocele. (5.) Hmemorrhage from the lungs. (6.) Irritable heart. Now what shall be said of the sphere of action of a medicine useful in those conditions? Is it analogous in its action to AEsculus, Arnica, Aloes, Dioscorea, Hamamelis, Hydrastis, Ignatia and Sulphur? I feel inclined to say that its special action is on the portal system, and its connections. How else are we to account for its varied action. The question then arises, how does it act on this system of blood vessels? With much hesitancy I will state that I believe its primary action is to contract the caliber of the portal veins. I am not sure but it has a similar action on all the blood vessels, and even the heart. Its common use by the country people, who use it as we use Arnica, and assert that it causes the rapid disappearance of extravasations, local congestions from injuries, etc., goes to show that it has a decided action on the capillary vessels. Again, its popularity in flatulent colic, indigestion, and diarrhcea, would go to show that it has a specific curative action in such cases. In Dr. Burt's provings it caused severe griping in the hypogastrium with flatulence and diarrhoea, bloody stools, also nausea and faint feelings. Decided bilious symptoms were evolved in his provings, and such irritation of the lower bowels, as would lead to hemorrhoids and congestion of the pelvic viscera in general. We see by this that it is capable of originating irritations which would lead to all the conditions of the bowels and pelvic viscera which it is said to have cured. There is no doubt of its action on the urinary organs. It has cured disorders supposed to be due to gravel; catarrh of the bladder; and dropsy from deficient action of the kidneys. It certainly acts on the organs of generation. Reports show its curative powers in prolapsus uteri; in dysmenor COLLINSONIA. 187 rhea; in varicocele; pruritus; amenorrhca; mnenorrhagia; vicarious menstruation, and threatened abortion. But what is the key-note for its use in all these affections? The pathological condition present I believe is passive congestion, and the key-note, is the presence of hcemorrhoids. In other words, nearly all the troubles cured by Collinsonia, having their location below the diaphragm, are either dependent on the same conditions that caused the presence of hsemorrhoids, or were due to the irritating effect of the piles on contiguous organs. I also believe that these conditions are due to the secondary effects of the drug; and that the colic, diarrhoea, bilious symptoms, nausea, etc., noted by Burt, are primary symptoms. For the former, appreciable doses have been found most efficacious, for the latter, higher attenuations have been most effectual. Let it be noted, that a study of the testimony relative to its cures in various disorders, goes to show that all the cases were associated with hcemorrhoids. This is especially true of the constipation, uterine disorders, urinary difficulties, and even affections of the male genital organs. The Collinsonia removes the congested state of the haemorrhoidal vessels, and the disorders of contiguous organs and tissues disappear. But how are we to account for its cures of affections of the body above the diaphragm? It has cured headache, hcemoptysis, and irritable heart. The headache we might safely assert was due to biliousness, or was that variety which precedes piles, or attends the suppression of their bleeding. We might suppose its specific power over the blood vessels of the lungs, and on the heart, was due to its power of contracting them, or giving tone to their muscular fiber. But there is one fact recorded by observers which may throw some light on the subject, namely: The haemoptysis supervened upon suppression of a hetmorrhoidal flux; and the piles returned after the haemoptysis ceased! In Dr. Liebold's case, however, the patient supposed he 188 COLLINSONIA. never had piles, but he was very constipated, and a bleeding from the rectum preceded the haemoptysis. The sputa was "very tough, dark coagulke of blood, as large as a bean, enveloped in a viscid phlegm. Some cases of cardiac irritability are distinctly traceable to suppressed hremorrhoidal bleeding, or the non-appearance of habitual piles. This the Collinsonia has cured, but it also has cured irritable heart, when the general health of the patient appeared good. It is somewhat singular that Burt experienced no heartsymptoms. Perhaps their absence was because he was not expecting them. I suspect that many of the symptoms of our Materia Medica have their origin in the power of expectation. It may have been because the heart-symptoms are always sequential,-i. e., must be preceded for some time by irritation or congestion of other organs. I believe it acts on the heart in two ways-(1) by removing obstructions or irritations in the liver, portal system, or kidneys; (2) by increasing its muscular tonicity, in the same manner that it increases the tone of the muscular fibers of the stomach, intestines and blood-vessels. Varicosis, as a general disorder, may come under the curative sphere of Collinsonia. I would advise its use in such condition, when Hamamelis, Pulsatilla and Sulphur fail. Its curative effects would seem to prove its affinity for variGose conditions. Piles are a kind of varicosis; so is varicocele. Pruritus of the vulva in pregnant women has been cured by it. Now pruritus is often due to a varicose condition. Dr. Cushing's case was one of varicosis evidently, for he makes no mention of aphthae, and he says the parts (vulva, etc.) were " dark red (purple?) and protruding." Pruritus often precedes varicose veins of the leg, and the varicose ulcer. I suspect it affects the venous side of the heart, in preference. But I do not think its exact field in cardiac disease is yet definable. Dr. Fenner cures with Collinsonia cases which he calls "irritation of the cardiac nerves. A functional disorder of the CUCURBITA PEPO SEMEN. 189 heart, with rapid, regular or irregular beating; pulse 130 to 140 per minute; the slightest motion or excitement aggravates the symptoms; periodical spells of faintness and oppression; attacks of syncope, with fullness of the chest, dyspnoea, and great prostration." It is said to be useful in valvular diseases, and some cases illustrating its value in disease of the mitral valve have been published. It allays the distressing cough attending some heart difficulties. And with some physicians it is esteemed very highly for all hard, shaking coughs, with or without expectoration. It is in hernmorrhoids, and their consequences or complications, however, that this drug has achieved its greatest triumphs. Drs. Carroll, Fowler, Holcombe, Lord, Barnes, Franklin and Hughes all agree upon its great value in obstinate and chronic piles, bleeding or not, but always attended by constipation. I am inclined to believe that its curative powers in disorders of the organs of generation of women (and men) depend almost wholly on the disorders of the rectum which it causes. Dr. Storer, of Boston, believes that a large proportion of uterine diseases depend on rectal disorders. Dr. Storer is doubtless correct in his estimate. In every case of uterine disorder, you should carefully inquire into the condition of the intestines, the bowels, and rectum. You will often find the cause therein, and you will very often find Collinsonia a remedy which will prove far more useful than the ordinary medicines prescribed in such cases. What Sepia is to chronic diseases, Collinsonia is to the acute. CUCURBITA PEPO SEMEN. The seeds of the ordinary pumpkin have long had a reputation as a demulcent diuretic, for the relief of strangury and other urinary difficulties. The same may be said of the seeds of the water-melon, musk-melon, cucumber and all that family. But the pumpkin seed has a value which you would hardly 190 CUCURBITA PEPO SEMEN. expect from a seed so mild and edible. In fact, it is doubtful if they possess any actual medicinal properties as we understand it; for the seeds may be eaten in any quantity sufficient to satisfy hunger, with no other result than profuse urination. The property I refer to is the power of the pumpkin seed to aid in the expulsion of tape worms; (tmeniae.) I use the word to aid, for the reason that we are not certain that the effects of the seed alone' would expel the worms, or even poison them. It may do nothing more than gorge them to such repletion that they lose their power of adhesion to the intestine. In apparent contradiction to this supposition is the recorded assertion that the oil expressed from the seeds, as well as an infusion of the seeds, has destroyed taenike. Various methods of administration have been advised. One authority advises one ounce of the peeled seeds to be taken on an empty stomach, followed in six hours by a dose of Castor oil. Another directs two ounces to. be beaten up with sugar into an electuary, or with water into an emulsion, and taken fasting in the morning, the patient having dieted the previous day, and a brisk purge taken some hours after. My method, and I have expelled a great many with it, is to direct the patient to eat but little of the lightest food all day, take no supper, and on going to bed eat one ounce of the Ieeled seeds bruised, with milk or cream. In the morning, on waking, take a tablespoonful of Castor oil mixed with half a teaspoonful of pure Sulphuric Ether. No breakfast is to be eaten, only a cup of tea or coffee. In two or three hours the oil will operate, expelling the worm. I have seen them expelled without the use of the oil and Ether, especially in children; but in adults I think they had better be taken. The Ether undoubtedly plays an important part in the expulsion of the parasite, for it has lately been advised alone, and is said to succeed in expelling tape worm, in doses of 30 to 60 drops, taken fasting. It is supposed to stupefy the worm, during which condition it drops from its attachment, and is carried along the intestines until it is expelled. CUCURBITA PEPO SEMEN. 191 The oil of pumpkin seed is recommended to be taken in doses of half an ounce, fasting, followed in six hours by another half ounce, mixed with an ounce of Castor oil. Half the above quantity will be a sufficient dose in the case of children under twelve years. In this connection I will mention some other remedies for tape worm which you may be obliged to resort to, for, although the pumpkin seed is the safest, and is generally efficient, there are cases where, owing to some idiosyncrasy in the worm (not the patient), the seeds fail to destroy it. The next best agent is undoubtedly the Oleo-resin of the male fern (Felix mas.) The patient should live upon bread and a little milk for one day, and the following morning take a full dose of 30 to 60 drops, fasting, repeating it in three hours. At noon the patient may eat food, and in the evening a cathartic is to be taken. I would advise the Castor oil and Ether as above. I have somewhere seen, in homocopathic works on practice, a recommendation to give the attenuations of Felix mas. Such a practice is simply absurd. Kousso (Brayera) has a high reputation as being the most efficient remedy against tape-worm. Baehr advises it in preference to any remedy. It causes less pain and inconvenience than any other agent except the pumpkin seed. The powdered flowers in doses of half an ounce, or twenty to forty grains of the resin Koussin, is prescribed to be taken suspended in water, in the morning. No purgative is necessary as it causes loose watery passages with but little pain and nausea. The worm is usually expelled dead, in the last passages. Granatum (the bark of the pomegranate), has been used, but it is harsh and unpleasant. Turpentine is unsafe and even dangerous. Kameela is sometimes efficient, but inferior in efficacy to the first named. The rules laid down by Hahnemann, Hartman, Hering and others appear to me, as they do to Baehr, to be superfluous. The tape-worm does not depend for its existence on any dyscrasia of the system, but it is introduced from without 192 CYANURET OF MERCURY. with the food, and. must be expelled or destroyed, just as we should destroy a snake or any other reptile living in the stomach or intestines. CYANURET OF MERCURY. This drug is almost as poisonous as the Cyanide of Potassium. It may not kiilras suddenly, but the sufferings of the victim are a hundred times more intense. In cases of poisoning by this agent we have all the symptoms of Hydrocyanic Acid, to which are added the terrible effects of Corrosive Mercury. Worse than this, even, we have a picture of the most malignant forms of diphtheria. The following are its characteristic symptoms: " The tongue is pale, with a yellowish streak on the base; swollen, with red edges. "The throat looks rough; pharynx red and injected. "Gums swollen, and covered with a white adherent layer, under which is found a violet border. "A white opaline layer forms on the columns of the velum palati and tonsils; on the inside of the right cheek was a round ulcer with a grayish base, the borders as if cut out and surrounded with great redness. "The lips, tongue and inside of the cheeks dotted by ulcerations, and covered by a grayish-white coating. "A pseudo-membranous formation extends all over the fauces and down the throat. "Inflammation of the whole buccal cavity, with salivation, fcetid breath, and great pain on swallowing." We have here a picture of malignant diphtheria accompanied by ulceration. This pathological condition, coupled with the suddenness and severity of the attack, fully indicate this drug above all others. The concomitant symptoms are equally important as an indication, namely: epistaxis, cerebral congestion, pupils contracted, syncope, loss of consciousness, vomiting, diarrhcea, diphtheritic formations on other portions of the mucous membrane and even the skin. CYANIDE OF POTASSIUM. 193 The diphtheritic process attacks the kidneys, causing one of the worst valeties of Bright's disease, and it may prove to be one of our best remedies in the croupous form of nephritis, and in albuminuria following diphtheria and scarlatina. I once saw an epidemic of malignant scarlatina, which presented nearly all the symptoms and conditions caused by this drug. It had not been introduced into our Materia Medica at that time, or I might have saved some cases. Malignant dysentery is closely imitated by the symptoms of the Cyanuret of Mercury. It is attended by great prostration, putrid bloody stools, diphtheritic patches at the anus, ulceration, gangrene, and finally collapse and death. It causes phlebitis and varicosis, and ought to be specific in the worst cases, as well as varicose ulcers. Physicians have reported cases cured by Merc. cyan. of what they termed malignant membranous croup, but it is evident that the croupous symptoms were due to an extension of the deposit or exudation to the air passages. I would suggest its possible usefulness in those cases of sudden paralysis, or sudden heart-failure, which occurs after attacks of diphtheria, even when it has been supposed to be non-malignant in its character. Among other remedies for diphtheria, none resemble it in intensity of action; but those which approach it nearest are, Kali caust., Kali bich., and Lachesis. The 6th dilution or trituration is as low as it can be safely used for children; the 3d cent. in adults. The use of this medicine alone, or in connection with a gargle, or spray of Chloride of Lime (Liq. Calcis. Chlor. 3 j. Aqua E iv.) is the best treatment now known for this terrible disease. CYANIDE OF POTASSIUM. This drug, sometimes called the Cyanuret of Potassium, is one of the most violent poisons known. Its action is very similar to Hydrocyanic Acid. Its analogues are, Prunus, Lycopus, Laurocerasus, Digitalis and Amygdala; three grains are sufficient to destroy life in a human adult. 194 CYANIDE OF POTASSIUM. Allopathic physicians are very cautious how they use this medicine. Their utter disbelief in the value of inappreciable doses unfits them for the selection and administration of such agents. The poisonous effects of this salt do not differ essentially from the Acid. It has been proved by numerous experiments that the latter "acts through the blood, directly upon the cerebral and spinal centers, and indirectly upon the lungs and heart, probably first suspending respiration through the want of the proper nervous influence to the pulmonary function; and secondly, arresting the heart's action through the want of blood from the lungs. Death, therefore, takes place through asphyxia. Hence the general venous congestion observed after death, affecting the brain, lungs, etc. The insensibility, however, is the antbecedent of the asphyxia, and depends not upon the want of blood in the brain, but upon the immediate paralyzing influence of the poison." I do not see why it may not paralyze the heart, directly, as well as the brain; but some facts seem to point to the contrary, for it is asserted that "the heart continues to beat after respiration has ceased." Prescribed according to the law of similia, it can be used in all cases where the provings of the Acid show that it is indicated, for its union with Potassium does not effect any change in that respect, although we may get additional symptoms belonging to the alkali. The key-note, or characteristic primary condition or symptom indicating the Cyanide is the suddenness and severity of the attacks. A woman who took 12 grains fell as if struck by lightning, and died in forty minutes. In fatal poisoning by the hydrocyanic acid, death has occurred in less than a minute. I believe you will find it useful in those rare cases of cerebro-spinal congestion which have been known to throw the victim into fatal or dangerous coma in less than half an hour; or in cases of apoplexy from venous congestion, striking the patient down with equal suddenness. CYANIDE OF POTASSIUM. 195 We find recorded among its symptoms " severe sudden pain in the head, vertigo, and sensation of weiqht and great. pain in the back of the head." It has cured some very intense periodic neuralgias, viz.: (1.) Torturing neuralgic headache, in orbital Ond supramaxillary region; the pains recurring daily at the same hour, with much flushing of that side of the face. (2.5 Agonizing attacks of neuralgic pains between the temporal region, ciliary arch, and maxillary, with screams and apparent loss of sensibility, as if struck with apoplexy; pulse 84, face flushed. (3.) Severe neuralgic pains in temporal region and left upper jaw daily, at 4 P.M., increasing till 10 A.M., and ceasing at 4 P.M.; in the interval, anorexia, fever, headache, etc. Similar cases have been cured by Arsenic, Quinine, Atropine, Chelidonium and Nux vomica, but the diagnostic difference in favor of the Cyanide is the suddenness and severity of the paroxysm. The dose in such cases (or in any case) should not exceed the 1st centesimal trituration, in a one-grain dose, repeated every hour or two in the apyrexia, and every fifteen minutes during the paroxysm. Allopathists direct the maximum dose to be one-eighth of a grain. The I or I would be safe for an adult. A dilution containing 16 grain to a drop makes an eligible preparation, as the 2c or 3c could be used for children. It has been used externally for the relief of headaches. Trosseau directs a solution not stronger than two to four grains to an ounce of water, but I can not recommend it, except as a last resort in the most severe cases. It seems indicated in spasmodic affections of the oesophagus, followed by vomiting from paralysis of that tube, as witness the symptom: "Nausea, with sense of choking when trying to swallow fluids, followed by copious vomiting." I think it will prove valuable in gastritis of very sudden onset and severe character. It corresponds to threatened asphyxia from venous conges 196 CYPRIPEDIUM. tion of the lungs; also to whooping cough when asphyxia occurs during the severe paroxysms. You may find it useful in some cases of nightly cough of a paroxysmal character, even when caused by cardiac disease. I have prescribed it a few times in functional disorder of the heart, with slow, feeble, irregular pulse, alternating with palpitations. Even if the cardiac disease is organic, and the nervous element largely predominates, it will be found useful. A tendency to venous congestions, and a bluish color of the lips and skin, are specific indications. CYPRIPEDIUM. There are eight species of Lady's Slipper indigenous to this country. It has an singular looking flower, resembling an Indian moccasin or a Chinese shoe, whence its name. It is also commonly called " Valerian " and "nerve root," both of which names are given to the Scutellaria. The C. pupescens (large yellow) has been selected as the officinal species, but as the roots of all are collected and used, I do not see how we can discriminate. They all contain in common a peculiar "nervine" property. Rafinesque considered this species to be the strongest, next te C. acaule, and last, the C. spectable and candidumrn. King says the two latter possess more narcotic power than the others, especially when found in dark swamps. The medicinal action of the various species differs in quantity, rather than quality. In domestic and- eclectic practice this root is held in the highest esteem. I have been surprised, however, to find that our school have almost altogether neglected it in favor of Scutellaria, although the testimony is about equal relating to their power over the nervous system. When an infusion in large quantities, or a strong extract, is taken by a healthy person, it causes at first a feeling of exhilaration of the mental and nervous system. Afterwards comes a sense of calmness and quiet, followed, if larger CYPRIPEDIUM. 197 doses are taken, by a sense of mental fatigue, an oppression and heaviness of mind, and a disposition to drowsiness. It is resorted to by women whose nervous systems have been shattered by long and wearing illnesses and excessive green-tea and coffee drinking. It removes abnormal irritability, but if it is used to excess, the secondary effect is to increase the very irritability and weakness which it palliated. This is the case, however, with all its analogues, namely: Teas, Coffees, Valerian, Scullcap, Paullinia, Coca, Chloral, and the Bromides. It is for conditions similar to their secondary effects that these medicines are usually prescribed. The sphere of remedial action possessed by the Cypripedium is not wide. It acts upon the cerebro-spinal systemupon the gray nerve-tissue, and is useful for the effects of over mental exertion, or reflex nervous excitement. You will probably find it useful in hysteria, chorea, nervous headache, delirium tremens, hypochondriasis, neuralgia, and that peculiar condition for which there is no better name than "fidgetyness." For all these conditions, however, it never can rise above that of a palliative, unless the case be very recent. For serious cases, some remedy whose action is deeper, is usually required. There are some affections, however, in which it appears to act more permanently. It is invaluable in that well-known condition to which children are subject, when from some gastric or intestinal irritation the reflex excitability of the cerebro-spinal centers is aroused, the brain becomes irritated, and convulsions impend. Here it rivals the Bromides, Chloral, Scutellaria and Cuprum acet., and is superior to the routine Belladonna, Hyoscyamus and Chamomilla. In such cases a few drops of the mother tincture or lx, frequently repeated, is attended by the best results. Sleeplessness, when depending.on functional disorder of the brain and nervous system, or mental excitement, is often promptly removed by similar doses. This sleeplessness of Cypripedium is not an unpleasant condition; there is a desire to talk, a crowding of pleasant ideas, with a restlessness of 19[8 CYPRIPEDIUM. body; a twitching of the limbs, etc. It is more adapted to the delicate organizations of children and feeble women, than to men. I have found it useful in the mental depression and irritability consequent on venereal excesses or spermatorrhcea. It is equally useful when the mental despondency is the result of brooding over an imaginary spermatorrheea, or the imagined ill effects of nocturnal emissions, a very common condition caused by the reading of those foolish books published by quacks and charlatans. In typhomania, and the jactitations, tremors, restlessness, etc., of patients with low fever, its effects are very pleasant, and renders such patients quiet and comfortable, without interfering with the action of the proper specifics. There is a condition of cerebral hypercesthesia, occurring in young children, which is often dangerous in its consequences. It results from teething, or mental stimulation. It is too much the habit of doting parents to over-stimulate the tender brains of infants, by attempts at teaching them beyond their normal capacities. The children become miorbidly excitable. They become precociously bright, sleep but little, are inclined to laugh and play at night, crave light and noise; and parents, not knowing the danger impending, favor instead of suppressing this dangerous condition. I have often seen this functional irritability end in convulsions. It often leads to congestion, and fatal meningitis then closes the scene. Now, Cypripedium will aid you in removing these premonitory brain symptoms, if you can oblige the attendants to place the child where it can have quiet, sleep and a dim light; but this remedy is of no value after the irritation has become fixed, for it is not homeeopathic to congestion or inflammatidn of the brain or spinal cord. In relation to the dose and best preparation, my advice is to use, for very young children, the lx or 2x aqueous dilutions, to avoid the alcoholic stimulation, or dried pellets of the alcoholic dilutions, or an infusion of ten grs. of the root to four ounces of hot water. This preparation may COTYLEDON-CUNDURANGU. 199 be given in teaspoonful doses. For adults, tablespoonful doses of an infusion of one drachm of the root to E iv. of hot water, or ten drops of the mother tincture. It is said to have caused symptoms of the skin similar to Rhus-poisoning. (See Vol. I.) COTYLEDON. I found the provings of this common English plant (Navelwort), in the British Journal of Homceopathy. It seems to affect the mental sphere like Ignatia, causing alternate states of exhilaration and depression. It also resembles Asafoetida. I am surprised that so many important symptoms were caused by such an insignificant plant. I more than suspect the imagination of the provers called them up, like the phantasmagoria which float through Houatt's notorious pathogeneses. The only clinical observation I have been able to find relating to Cotyledon is one, quoted by Lilienthal, from C. Muller, to the effect that he had found it useful in eczema capitis (tinea), but in what doses he does not say. CUNDURANGU. This medicine is prepared from the bark of a climbing plant found in Ecuador, South America. It is called the Condor-plant by the natives, and it is from them that the knowledge of its supposed virtues were first obtained. It was introduced into practice and notoriety by a Dr. Bliss, of Washington City, but the manner of its introduction was so suspiciously unprofessional, and smacked so much of quackery, that Dr. Bliss was expelled from the allopathic society to which he belonged. The testimony relative to its value is singularly at variance. Dr. Bliss, and a few others, claim to have cured many cancers by its use. Other physicians claim to have tested it in private and hospital practice, and found it worthless. The British Hospital physicians report against it value. 200 CUNDURANGU. Dr. Andrews, of Chicago, in a communication to the Academy of Science, stated that he had corresponded with many of the most eminent physicians of South America, relative to Cundurangu, and while they denied its curative powers over cancer and syphilis, they asserted its usefulness in "old, obstinate, foul ulcers." Several homceopathic physicians in this country have reported favorably of its value in "foul and obstinate ulcers." Dr. Clotor Muller, of Germany, reports that he has used it in over twenty cases, " some were'real carcinoma, others benign (purely scrofulous) glandular swellings and ulcerations. In the latter it showed no action whatever. It also failed to act in scirrhous indurations. The size, hardness, and lancinating pains, remained unaltered." He decrees that "favorable action may be expected in open cancer," but the cases he cites do not prove its value in cancer, for he fails to show that his cases were cancerous. I give his cases, as he reports them. (1.) Carcinoma of the lip, an unclean and sinuous ulcer about the size of a dime, with surrounding hardness and swelling, burning pains, lip everted outward, emaciation. Five drops of 1st dil., morning and evening. In ten days the ulcer looked better and the surrounding hardness was reduced to a minimum. (2.) On the right of thorax and around the nipple several tumors, of which two suppurated and formed sinuous, ugly-looking, foul-smelling ulcers, with raised edges. Cured in two months. (3.) An ulcer seated on false ribs, of the size of the hand, beginning years ago. It looked carcinomatous with its high uneven edges, its deep, small islets of half-destroyed cellular tissue and muscular fibers at the base, and with its ichorous, acrid secretion; the pains were severe. After taking Cundurangu the ulcer had decreased to half its size. I do not consider these cases as brilliant illustrations of cures, by any means, nor do I believe the ulcers were cancerous. They were simply old, foul smelling, ichorous ulcers, just such ulcers as South American physicians found it useful CUNDURANGU. 201 in, and the sphere of Cundurangu evidently includes just such ulcers appearing any where on or in the body. In the North American Journal of Homceopathy, May, 1874, is reported a case, by Prof. N. Friedreich,' as " carcinoma ventriculi, with co-affections of the epigastric and supra-clavicular lymphatic glands. This case was so nearly cured by Cundurangu, in three months, that the patient was discharged. The dose: was 3iv of the bark to half a pint of water; a tablespoonful twice a day. I have given it in several cases of uterine cancer, but without any good results. From the British Journal of Homceopathy, January, 1875, I quote the following -translated from a paper by H. Goullon, Jr., in Hirschell's Zeitschrift, No. I6: " Dr. Obolinski, surgeon to the St. Lazarus Hospital, Cracow —experimented with the Cundurango, in several cases, with the following result: CASE I.-Patient is suffering from an epithelial cancroid of the right foot. He gets fifteen grs. pro die, in the form of docoction, for three weeks. The remedy was likewise applied locally. Result.- No amelioration; the pains are getting intolerable. Dr. Obolinski performs amputatio cruris. CASE II.- Patient is suffering from an epithelial cancer of the left temporal region, of the size of the palm of the hand. Medication as in case one, but during six weeks. Result. - The whole ulcerative surface covers itself, in the fourth week, with healthy granulations, and this led Dr. Obolinski to perform a heteroplastic operation, after the manner of Reverdin, and that, too, with success. However, no sooner had the transplanted bits begun to show signs of activity, than the cancer began afresh and destroyed both granulations and the transplanted portions of skin. Here the whole of the epithelioma was extirpated right down to the bone, and the place was brought to heal (for good - Goullon, Jr.) But when, not long ago, Professor Freidreich published a case of cancer of the stomach cured by the bark of Cundurango, and thereby called attention to the fact that many of the experimenters had got negative results, because they had had spurious or bad preparations, Obolinski began to experiment again, and this time made use of true American Cundurango bark, prepared from the sources named by Professor Freidreich. He had two cases in his private practice-an octogenarian woman, with a flat epithelial cancer (ulcus rodens), of about the size of a farthing, on her lower eyelid; and a woman, set. fifty, with a flat epithelial cancer, about the size of a bean, on the left side of the nose, and which had been repeatedly cauterized with Kali causticumn, but kept on coming again. To these two he exhibited the remedy. He gave to both patients, daily, two, and later on, three tablespoonsfuls of medicine, and charpie impregnated therewith was laid on the sores. Both went their way to their 14 202 COSMOLINE. homes, with the onder to persevere in this manner for a couple of weeks, or even months, and when Dr. Obolinski saw them again, six weeks thereafter, he was very greatly astonished to find both sores perfectly healed. These cures have no small clinical interest for us homceopaths. First of all, they seem to confirm the opinion expressed already, in 1872, by Cl. Mueller, in his clever essay on this subject, viz.: that the newly imported drug is no infallible remedy against all sorts ot growths called cancer, but rather curative of a definite form of such growths. " It will be seen," said he, " Cunduranago does not act curatively in cases of tumors and scirrhous indurations, but rather in cases of open caricinomata and cancerous sores; in other words, it happens as with other discoveries, that the discoverer himself thinks his little babe a kind of Messiah, who shall work such wonders and signs as neither Creator or creation intended. Then, when the public finds itself disappointed by the numerous failings, there follows such an odious and blind reaction, that the really good part of the discovery is no longer seen, and all who desire to get better acquainted with the thing are repelled by the giant, Prejudice. Is not homoeopathy itself a sad example of all of this? Of further interest in these cases of Obolinski is the question of the dose. Cl. Mueller himself soon perceived that but little was to be expected here from light, infinitesimal doses. He gave, night and morning, five drops of the first dilution. The external treatment of the sores, carried out at the same time with the same remedy, is probably of very decided advantage. Mueller's case was cured with Cundur. I, internally alone. We think that we are also justified in concluding, from the observations of the Cracovian surgeon, that where Cundurango should prove of no avail, a stronger and not a weaker dose would be called for. It is not with Cundurango as with Silicea and Lycopodium." COSMOLINE. This remedy is used quite extensively by the homceopathic school, as an external application. It is a purified, concentrated petroleutn, or the substance which remains after all the ether, coloring matter, impurities, etc., have been removed. It is a white, oleaginous and odorless substance, having an absolute non-affinity for oxygen, and evaporating only above 400~ Fahr. Dr. McFarlan, of Philadelphia, asserts that the provings of the lower triturations develop symptoms which have some similarity to those of Pulsatilla, Urtica urens, Petroleum, Carbolic acid and Rhus. The workmen engaged in its manufacture suffer from the same pathogenetic symptoms. They have also the following skin symptoms: COSMOLINE. 203 "Great apparent dryness of the skin and itchiness everywhere, with a constant disposition to scratch. The skin is often dry and scurfy, in irregular patches or blotches, which itch a good deal. On scratching, the skin raises in welts or blotches." I am not aware that it has been used much as an internal remedy, but it has become quite a favorite external applicacation, not only in our own but all schools, and extends largely into domestic practice. It is manufactured on a large scale, and is sold by all druggists in the United States. Its effects, when applied to the skin in cases of urticaria, eczema, psoriasis, herpes, and in nearly all cutaneous diseases in which the skin is dry and irritable, is certainly very soothing, and often curative. It has been combined with various substances, forming compound Cerates. In fact it is largely used as a base for making Cerates with Arnica, Calendula, Carbolic acid, Hamamelis, Hydrastis, etc. I find, however, that while these Cerates are sufficiently stable in cool weather, they soften and assume an oily consistence when the mercury goes above 70~ Fahr. In order to make the Cosmoline cerates sufficiently stiff to be used in summer, it is necessary to combine with it Cocoa butter, Mutton tallow, or Spermaceti. My usual formulTe for these Cerates are on the decimal scale, namely: One drachm of the tincture selected, to one ounce of Cosmoline. Or, gr. 60 of crystals of Carbolic acid to one oz. of Cosmoline (lx.) This is too strong for all except old, torpid skin diseases. For a sensitive skin, one dr. of this Ix to Sj of Cosmoline. This is called Carbolated cosmoline. The names Arnicated cosmoline, Hydrastis cosmoline, Calendula cosmoline, may be used to designate these preparations. Many physicians use the pure Cosmoline for burns, scalds, blisters, cuts, bruises, sprains, and even acute and chronic rheumatic affections, with alleged benefit. There can be no objection to its use in our practice. On the contrary, a positive benefit may ensue, by preventing the use of those noxious, disagreeable, and often injurious 204 CLEMATIS VIRGINICA —COMOCLADIA. ointments which are sold every where. Patients will use something, and if the physician does not recommend anything, they will resort to the nostrum most convenient, or one that is most largely advertised. CLEMATIS VI1RGINICA. This is an indigenous species, not differing essentially from the European, C. erecta. The latter is a very valuable remedy, and not sufficiently appreciated by our school. Belonging to the same family as the Pulsatilla, it resembles it very closely in many respects. It has the same, if not a greater action on the organs of generation —uterus and ovaries, testicles and spermatic cords-and upon the skin and glandular system. Its action on the nervous system has been overlooked. In this respect it somewhat resembles its relative, Cimicifuga. Dr. Scudder (eclectic) first called attention to the indigenous Clematis. He says it is a "powerful nervine," useful in controlling erethism of the nervous system in women. Several years ago I procured the leaves and made a tincture which I have prescribed on many occasions in that kind of nervousness, half physical, half psychical, which affects some women who have been worried by care and illness combined. In doses of a few drops several times a day it acts admirably. I have cured with it several cases of acute pustular skin diseases, and a few cases of orchitis and ovaritis. No indigenous remedy is more deserving a thorough proving. The time will come when our own (indigenous) plants will supersede the foreign, for they possess analogous if not identical virtues. COMOCLADIA. This poisonous shrub, known to the natives of the West Indies as Guao, is very similar in effects to the Anacardium of the East Indies, and the Rhus of the United States. So virulent is its poison that sleeping beneath its shade COMOCLADIA. 205 often causes fatal illness, especially if the sun is shining. It has been observed that the poisonous influence of the Rhus is felt more intensely in hot, sunny weather. Like the Anacardium, the Guao causes not only vesicular eruptions, but malignant pustules and ulcers. The ulcers are deep, with hard edges; they discharge a thick, purulent, yellowish-green matter, having a very peculiar fcetid smell, the parts becoming in appearance like a piece of raw, decayed meat, while the surrounding skin is covered with small shining scales. This gives a very good picture of the worst forms of malignant erysipelas, of a greater severity than that for which Rhus is indicated, and for which we have usually used Lachesis and Arsenicum. It has been used in leprosy by the Spanish homceopathic physicians, and with considerable success. In erysipelatous inflammation of the tissues in and around the eye, it will be found superior to the ordinary remedies. Dr. Navarro cured a sloughing ulcer of the right breast; also an " indolent ulcer" on the lower third of the right leg near the external malleolus, of irregular shape and hard edges;'the ulcer was deep and discharged a sanious and fcetid pus; it had lasted six years. (Cured in four weeks by the 6th dil.) The same physician reports a case of inflammation of the left leg and foot with violent fever; the swelling increased enormously, when the pain subsided the skin became white and covered with shining scales; cracked and discharged a sanious fluid. This case was cured with the 6th. It causes the same rheumatic pains and swellings, aggravated by rest, relieved by continued movement, as does Rhus. I have rarely been able to procure the drug, and while we have the Rhus and Anacardium we hardly need it. It corresponds more closely to the diseases of the tropics than those of the temperate zone. 206 CORNUS FLORIDA-CORNUS CIRCINATA. CORNUS FLORIDA. This shrub or small tree is the true dogwood, although where it got this name I never knew. It presents a very beautiful appearance in the early Spring, when, before the leaves appear, the tree is white with its snowy and showy blossoms. The sepals, however, and not the petals, are the most showy portion of the flower. The bark is intensely bitter, and among the common people is used largely as a tonic, and as a substitute for Quinine, in ague. An active principle called Cornine was at one time sold, but it is unreliable. In large doses, Cornus causes a fullness in the head, with some pain, quick pulse, and gastric irritation. I have used the tincture in obstinate intermittents, where Quinine had been abused, and found that when the following group of symptoms was present, it usually cured: The ague-paroxysm is preceded for days by sleepiness, sluggish flow of ideas, headache of a dull heavy character. The paroxysms are attended by nausea, vomiting, and sometimes watery or bilious diarrhcea. In the chill there is cold, clammy skin; in the fever v~olent headache with thrbbbing, stupor, confusion of intellect, and vomiting. The tincture should be given in doses of five or ten drops, every two hours, in the apyrexia. The 2d or 3d dil. every hour during the paroxysm. In some old cases of dyspepsia, when the chief symptom is acid pyrosis, this remedy, like Columbo, Chelone, China and Nux, will often effect very satisfactory cures. CORNUS CIRCINATA. This species of Cornus is a smaller shrub than the flowering dogwood. It has a small but pretty blossom, in large flat or depressed cymes; a small, light blue fruit, nearly the size of a currant. The bark on the young branches is a bright green, giving the name Green osier to this species. It" is very popular in the country as a remedy for aphthous CORYDALIS. 207 and ulcerated conditions of mucous membranes. It certainly has some marked specific virtues in such conditions even when chronic, for I have known it to cure chronic ulcerations of the mouth and throat, recurring occasionally for many years. It acts best when used as a lotion; and also internally in appreciable doses of the tincture or infusion of the recent bark. It has also been used in agues of nearly the same character as described for Cornus florida. The provings made and published by Dr. Marcy give us similar symptoms. It is evidently an analogue of China, Hydrastis, Eupat. perf., Chelone, etc. The principal disorders in which it has been successfully used are bilious headaches, jaundice, aphthous stomatitis and hepatic derangements. Dr. Marcy and several others value it very highly in bilious diarrhoea and dysentery. The symptoms are similar to those of Merc. cor., Aloes, and Nux, for which it may be judiciously substituted in some cases occurring in connection with malarial conditions, and in hot weather. CORYDALIS. There are some medicines in the vegetable kingdom which closely resemble in remedial action those from the mineral. No chemist can explain this resemblance by any chemical analysis, for the analogy lies deeper than any manipulation in the laboratory can discover. It may be that the ultimate atoms of Phytolacca and Mercurius, Iodide of Potassa and Stillingia, Aurum and Corydalis, are similar, and that this ultimate similarity gives similarity of action and curative potentiality. A glance at the clinical history of Corydalis will show some striking resemblances in the results obtained from its use, and the known curative action of those medicines so renowned as specifics against the syphilitic dyscrasia. No provings of this agent have been made, and we have to rely mainly on reports of cures in eclectic literature. My 208 DIGITALINE. experience, although limited, because I treat hut few cases of syphilis, has been favorable. I remember two cases of syphilitic nodes on the tibia with nocturnal pains, which had been treated for nearly a year with massive doses of Iodide of Potassa, without benefit. Under the use of the Tincture of Corydalis, in 10-drop doses, four times a day, the swellings slowly but permanently disappeared. We have trustworthy testimony that it has cured syphilitic nodes of the skull, with falling off of the hair; also syphilitic and scrofulous eruptions on the scalp. It has also cured syphilitic and non-syphilitic ulcerations of the mouth and fauces. I think it will be found to be better adapted to secondary syphilis than primary. Whether it is useful in the so-called tertiary forms, or the mercurial cachexia, which some believe to be identical with the latter, future observation must determine. I would not have you think I confine its use to syphilitic diseases alone. It may prove just as useful in the scrofulous (strumous) dyscrasia and in obstinate cutaneous diseases. It would be worth while to try it in congenital syphilis. You may find it useful in the cachexia caused by intermittents, when you find enlargement of the spleen and liver. Its use in massive doses has caused, according to eclectic physicians, the following conditions: —" A derangement of the stomach, attended with profuse morbid secretion of mucus, there being always a coated tongue, with foetor of the breath and loss of appetite and digestion." It is therefore indicated in gastric catarrh, and is, in this respect, an analogue of Hydrastis. DIGITALINE. I introduce this drug among the new remedies for the same reason that I introduce Atropine and Ergotine, namely: that it is not mentioned in our text books on Materia Medica, and that there are instances where the active principles of plants are substituted for the original drug, with great benefit. DIGITALINE. 209 Digitaline is the active principle, or alkaloid of the plant Digitalis, and possesses a large proportion of its pathogenetic effects. I assume the same ground in treating of this substance, that I did in treating of Atropine - that while an alkaloid may represent the principal effects of the plant, it can not represent all the symptomatic effects, and nicer shades of action. Digitaline, from the very numerous experiments recorded, made by the most eminent physiologists, seems to affect the heart in a manner nearly if not altogether identical with Digitalis. I have written a good deal concerning the action of Digitalis, and my papers have been severely criticised by physicians so bigoted that they would not see the logical deductions which must arise in consequence of new discoveries in the action of medicines. But time has confirmed my views and silenced my critics, and I am content. I will state, in as brief terms as possible, the known and undisputed action of Digitaline on the heart: (1.) Digitaline produces a condition of excitement in the controlling centers in the heart, and hence the slowing of the pulse with increased power of the heart's impulse. (2.) It has a peculiar specific influence on the heart's muscle, whose contractions are strengthened in the first stage, becoming irregular in the second, and in the third a peculiar rigidity is induced. The primary action of Digitaline and Digitalis, is to cause increased power of the heart's contractions, the pulse being first regular and slightly accelerated; next irregular and intermitting; and finally very slow, until the heart ceases to beat and stops in systole, i.e., in rigid, tetanic, permanent contraction, which ends in death, or recovery with secondary effects. These secondary effects are the reverse of the primary, i.e., the pulse is very slow and soft, then irregular, intermittent and weak, and finally quick and weak; the heart rarely completing its normal contractions, because of the feeble condition of its muscular fibers. 210 DIGITALINE. Now it is evident to me, as the result of twenty-five years of close observation, that Digitalis is homceopathic to both its primary and secpndary effects; but that it has rarely been used except for the latter. Hahnemann evidently did not understand the action of Digitalis; he as much as confesses it in several instances, as when he states that its action in certain dropsies is " curative but nevertheless antipathic." Now it is a fact, that unless we understand and appreciate the secondary effects of drugs, a large proportion of our cures made with appreciable doses, appear to be antipathic. This is especially the case with Digitaline, and this is the reason our school are continually losing the advantage they might gain by the rational use of Digitalis in many diseases. Now, according to my law of dose, if we prescribe Digitaline for symptoms similar to its primary effects, we must prescribe the attenuations as high as the 6th, or we shall get unpleasant aggravations. But if we are treating conditions similar to its secondary effects, we must use the low attenuations. The question is, How low can we go with safety? Digitaline (and I must here warn you not to use the spurious substances called by this name, manufactured by various firms in this country, for they are generally inert, or no more powerful than the dried leaves), the crystallizable active principle (alkaloid) occurs in short and delicate needle-shaped crystals, and possesses an intense and persistent bitter taste; slightly soluble in water; soluble in twelve parts of cold and six of boiling Alcohol, of 90~; less soluble in absolute Alcohol; nearly insoluble in Ether; and very soluble in Chloroform. Amorphous Digitaline in a whitish or yellowish powder, odorless, but of a very bitter taste, nearly insoluble in Ether and water, readily soluble in Alcohol. Crude Digitalis is said to contain ten or twelve per cent. of crystallizable Digitaline, which is said to be somewhat more powerful than the amorphous Digitaline. Either preparation is a very powerful poison. It is said that "one-ninth of a grain has been taken without toxic effect," DIGITALINE. 211 but I advise you not to try such a dos6. One-fiftieth of a grain has caused very unpleasant if not dangerous symptoms. I should not like to give one one-hundredth of a grain frequently in repeated doses. When we wish to get prompt, decisive action, as in a case of cardiac failure, syncope, or threatened paralysis, a few doses of the one-hundredth might be given, but for general use in cardiac diseases, the one-thousandth (or 2c) is as low as I advise you to use it for adults. The action of toxic doses of Aconite, Veratrum viride, Veratrum album, and Gelseminum, is just the opposite of Digitalis; for in a case of poisoning by the latter, or serious aggravation from an overdose, Aconite, or Verat vir., is the best antidote (in doses of one to three drops of -the tincture, repeated frequently until the symptoms are better.) In my " Lectures on Diseases of the Heart" I have carefully pointed out the characteristic symptoms and conditions for which Digitalis is indicated. I will therefore only briefly enumerate them. In cardiac diseases it is primarily indicated (in high attenuations), when the heart is excited and beats with increased force and power, causing congestion of the head, ringing in the ears, flushed face, etc. Such conditions are usually caused by over exertion, over excitement from the stimulating emotions; certain cerebral irritations, etc. In pure hypertrophy, i.e., with enlargement of the heartmuscle, where allopaths now pronounce Digitalis unsuitable it may be used with advantage in the 6th dilution. But its chief value is in those conditions which simulate its secondary toxic effects, namely: "When the muscle of the heart is for any reason unequal to the task set it, the systoles become rapid and imperfect, and by this irregular action the ventricles neither completely filling nor emptying themselves, increase, the embarrassment. Under these circumstances, Digitalis, by lengthening the diastolic pauses and increasing the force of the systolic contractions, causes the ventricles to fill themselves in the one, and to completely empty themselves in the other act. By 212 DIGITALINE. subduing irregular action through the inhibitory nerves, by energizing the muscular.power of the heart vessels, the remedy is of incalculable value, and, increasing arterial tension all over the body causes the disappearance or lessening of symptoms due to a low pressure in the arteries." The Digitaline would therefore be indicated in hypertrophy with dilatation; mitral insufficiency; aortic constriction; irritable heart without enlargement; and many valvular diseases with cardiac debility. There are many cases, and you will meet with them in practice if you watch for them, where the patient seems suffering from a condition known by the vague term "general debility." There is an atony of all the tissues, and a poverty of all the secretions, due to lack of assimilation of the nutritive elements of food. You will observe in all these cases that the heart appears to be the weakest organ, probably because it is constantly laboring. Now, while you are building up the system with good food, fresh air, gentle stimulation, and such medicines as Nux, Phosphates, Ferrum, and the like; do not forget to give a special tonic for the heart. It will aid in a wonderful manner other remedies. Thus, if you alternate Digitaline 3x, with Ferrum lx, you will succeed in curing anaemia and chlorosis in half the time you can with Ferrum alone. Digitaline 3x, and Phosphate of Strychnia, 3x, act beautifully in alternation in feeble, broken down constitutions. You can alternate Digitaline with many other specific restorative medicines, now that you understand the principle involved. In cardiac dropsy we know that Digitalis is the chief of all remedies. When the heart has become so weakened that effusion takes place in all the cavities, and the general cellular tissues (anasarca), we know of no medicine which will bear any relation to Digitalis in curative power. It has been suggested that Digitaline might act as well as the infusion of the leaves, or the tincture, both liable to deterioration, and at times uncertain in their action. Christison's experiments prompted him to assert that "Digitaline was the most powerful and certain diuretic DIOSCOREA. 213 known," and that " its action on the heart, and its diuretic effect, were never coincident." All the old authors remark that Digitalis is not diuretic until after it affects the heart and pulse. I think there are many cases where you can substitute the alkaloid for the herb and its other preparations. It will sometimes act promptly, when the tincture, or trituration of the leaves will not, or have lost their virtue. In cases of dropsy from heart disease, begin with 3x trit., in grain doses, every two hours. If no action on the kidneys takes place in a few days, give the 2x in the same. In spermatorrhcea, and nocturnal emissions from erethism of the sexual organs, it often acts with surprising efficacy. But do not give it as Baehr and Burt recommend, " in grain doses," unless you use the 3x trit. Digitaline acts on the sexual organs of men very much as the Bromide of Potassa, namely: it abolishes power and desire. It is therefore primarily homoeopathic to impotency with spermatorrhcea, and secondarily, to emissions with over-excitement. I would recommend, from my own experience, its use in delirium tremens; fainting attacks from sudden heart failure; nervous vertigo; collapse from uterine hwmorrhage; poisoning from tobacco, Aconite, Veratrum, Mushrooms, Calabar, and other poisons which weaken and paralyze the heart. In fact, you can use Digitaline for nearly all the conditions for which Digitalis is indicated, and it will often act quicker, and as safely, in the proper doses. DIOSCOREA. This plant, which is found in the Middle, Western and Southern States, climbing over fences and shrubs, is known by the common names of Wild-Yam and Colic Root. The former name is given to it from its apparent resemblance to the edible Yam of the West Indies; the latter on account of its virtues in abdominal pain. I have often speculated on the manner in which the curative power of the root was discovered. It is easy enough to imagine why it 214 DIOSCOREA. should have been dug up under the idea that it might be used as an article of food, for its leaves and manner of growth closely resemble the Yam used as a substitute for the potato. The root, however, is woody, and very tough and hard, so much so that when dried it is very difficult to pulverize it. How did the first colic-patient ascertain its power in that disorder? It must have been by some accident, for it has no aromatic taste like ginger or calamus, but is intensely bitter, with an acridity like that of Iris versicolor. But however discovered, it had a reputation among the aborigines for curing pains in the abdomen. You will hear the most enthusiastic praises of its power, and country nurses will narrate almost miraculous cures from its use in bilious colic, after the patient was given up to die by the attending physician. It is generally given in domestic practice in hot infusion, and in quantities only limited by the patient's ability to swallow. The allopathic school have always ignored it. The eclectics have valued it highly, and homceopathic physicians who have used it speak well of it in severe and peculiar cases. It has been proved by Burt, Nichol and Cushing. The provings by Burt were somewhat surprising. It seemed to affect the whole system in a manner reminding one of rheumatism, but a close study of its action will show that although the pains resembled rheumatism, they were really nerve-pains, and generally of a reflex character. It also caused cutting pains in the umbilical region. Dr. Nichol's proving developed the sanre abdominal pains, with a good many head and mental symptoms. Dr. Cushing's provings were heroic, and evolved very many peculiar symptoms. Some eclectic students also proved it, and got severe colic. I am inclined to the belief that its sphere of action embraces the spinal cord, and the reflex nervous system (generally); the umbilical plexus of nerves (specially); and by exalting the reflex excitability of the spinal cord, it causes pains in portions of the body remote from the seat of the primary irritation. An eclectic writer says it causes hypermesthesia of the spine, brain, uterus, and abdominal nerves. DIOSCOREA. 215 Its chief clinical use in all schools is for that condition commonly known as bilious colic. This name, however, is not the correct one for all the cases designated bilious colic, for many careful observers assert that the liver is not at fault in the majority of cases, the vomiting of bile being only a symptom resulting from the spasmodic retching. It is only in cases where the pain is caused by the passage of biliary calculi, or other obstruction, in the gall duct, that the name is at all appropriate. It is only another illustration of the law of similars, that the abdominal symptoms caused by Dioscorea, resemble the colics cured by it. Both start in the umbilical region, and radiate all over the abdomen. All who have written of the value of Dioscorea, outside of our school, coincide in their description of the colic cured by it. They say it is a " constant pain, aggravated at regular intervals by paroxysms of intense suffering;" the pain is located at first in the center of, but is gradually diffused all over the abdomen, attended by vomiting, retching, furred tongue, distended and sensitive bowels, etc. Now it is evident that no one distinct disease is here represented, but a definite disturbance of the abdominal nervous system, commencing at a given point (the umbilicus), and radiating all over the abdomen, extending to the stomach, uterus, bladder, and even to the extremities, and affecting both the nerves of sensation and motion, causing pain and spasm. The fact is that any kind of colic may be cured by Dioscorea, provided the symptoms have any similarity to its pathogenetic symptoms. More than this, it has cured, and will continue to cure, many abdominal and gastric pains not found in the provings. But if you find in any painful a;ffection of the abdomen, stomach, uterus, or even the heart or head, that the pain, though constant, is aggravated in paroxysms; is attended by spasmodic symptoms (vomiting, cramps), or sympathetic pains in distant parts of the body, you can prescribe the Dioscorea with advantage. For instance, it has cured headache, remittent, paroxysmal, attend 216 DIOSCOREA. ed by spasmodic pain in abdomen; facial neuralgia; cordialgia, spasmodic and flatulent colic; painful tenesmus; spasm of the bladder and uterus; spasm of the gall-ducts.; sciatic neuralgia-the pain running from the hip to the ankles. In addition to these purely neuralgic affections, it has been used successfully in many other disorders, among which are various kinds of headache. (For the indications refer to symptoms in Volume I.) The headaches of Dioscorea resemble those caused by -Esculus, Bryonia, Nux vomica aud Cimicifuga. The eye symptoms are quite notable, and Dr. Woodyatt predicts it will prove valuable in some affections of the eye and its appendages. Acne punctata (comedones), according to Cushing, disappeared during the provings. I have used it very extensively in many disorders of the stomach such as accompany dyspepsia, namely: a dull, wearing pain in the cardiac region of the stomach; inordinate belching of gases; cramps of the stomach, and acute lancinations in the stomach. It seems to resemble in its action on the stomach, Bismuth, Bryonia and Nux. It is of value in the vomiting pyrosis and gastralgia of pregnant women, or when occurring during the menses. My experience accords with that of Dr. Helmuth, who says it is most successful in enteralgia when the pains are twisting, aggravated by lying down, relieved by pressure, unless the abdomen is tender. The abdominal pains have a remarkable resemblance to those of Colocynth, and you will often find it impossible to decide which is the remedy. You can only try the one which seems the best indicated, for a reasonable time, and then use the other, but never alternate them. It is just as useful in renal colic from passage of calculi, as in hepatic colic. In fact, renal colic is often mistaken for bilious colic by superficial observers. You will find it an excellent remedy in diarrhcea, which, like the sulphur-diarrhcea, occurs in the early morning, driving the patient out of bed. The stools are slimy, jelly-like, DIOSCOREA. 217 like white-of-egg, attended by straining, burning in the rectum, and generally, not always, by the peculiar twisting lancinating colic in the umbilical region, offensive fiatus, and often nausea and vomiting. This kind of diarrhcea often runs into dysentery, or may be called the first stage of dysentery, especially when the disease is a catarrhal mucous enteritis. In the Dioscoreadysentery the stools are not bloody, i. e., the symptoms do not indicate it for bloody stools, but it will remove its characteristic colics, pains and tenesmus, without arresting the sanguineous discharge, which may call for 2pecac or some remedy more homceopathic to that condition. Cholera morbus, when attended by excruciating abdominal pains, has been greatly palliated by Dioscorea; but as it is not indicated for the watery evacuations, it should be alternated with Camphor or Veratrum. Even in cases of cholera infantumrn I have often given it for the excessive pain in the bowels which causes the children to scream in agony. In this respect it resembles Cuprum, in all but the cold extremities caused by that medicine. Dr. Burt had hemorrhoids, and yellow, thin, bilious stools with prolapse of the rectum when proving Dioscorea, but no other prover had piles. No clinical experience proving its value in this affection has been recorded, except one observation, by the same prover, that "a heemorrhoidal tumor of nearly four years' standing disappeared during the proving." A medicine that can cause tenesmus can cause heemorhoids, and you may possibly find it a good remedy in the latter disease. In Cushing's provings it delevoped a decided action on the male organs of generation, and fortunately for practitioners, its primary and secondary action was noted. It first caused strong-smelling perspiration of the genitals; constant excitement, with strong and frequent erections day and night, and amorous dreams with emissions. Afterwards came the reaction-the genitals became cold and relaxed; no erections; desire absent, and emissions in sleep without erections. Now to prove that my law of dose is trustworthy, I cite 15 218 DIOSCOREA. Dr. Cushing's several cures of nocturnal emissions, having the primary symptoms of Dioscorea, which he cured with the dilutions above the 15th; also Dr. Pease's case of spermatorrhoea, having its secondary symptoms, which he cured with. the 2x trit. of Dioscorea. In respect to its action on these organs, Dioscorea resembles Phosphorus, Cannabis indica and Nux vom.; and is the opposite of Caladium, Camphor, Agnus castus, and Nuphar, which cause depression of the genital functions, primarily. Dioscorea will be found valuable in pain and spasm of the spermatic cord when the pains commence in the inguinal region, and extend to the testicles and penis. No provings have been made on women, but it has been found useful in dysmenorrhoea, uterine colic, after-pains, and some of the false pains of pregnancy. The symptoms indicate that it may be a good remedy in intercostal neuralgia, and one physician claims to have cured with it a case of angina pectoris, with "sharp, cutting pain in the region of the heart arresting breathing and motion." Dr. Cushing has cured "CUough, with pain in the epigastrium and temples, brownish-yellow tongue and weak knees." You may find it of value in some of the protean forms of spinal irritation. It has been recommended in felons, and neuralgic rheumatism of the extremities. It is a remedy which ought to be still further studied, proven, and used in practice. Much depends on the preparation which is prescribed. I rarely got good effects from the tincture, probably because it was made from the dried root. Others have failed to get the desired results from the tincture. The triturations of the dried root, or of Dioscorein, have acted satisfactorily. In the colic for which it is so useful, you may fail with the ordinary preparations, while the infusion of the root, made with hot water, will act magically. (One drachin of the pulv. root to 5 iv. of boiling water. A teaspoonful or two every 15 or 20 minutes, in the worst cases.) Dr. Scudder (Specific Medicine, p. 128) says the article sold for Dioscorea by most of our druggists, for the past ten DORYPHORA-EPIGEA REPENS. 219 years, and from which Dioscorein has been prepared, is the root of a species of Smilax. This will probably account for the unreliable quality of some of the homceopathic preparations. DORYPHORA. The poison of the Colorado potato-bug appears to resemble Cantharides, with which it is closely allied. I collected many cases of poisoning, some fatal, together with a partial proving by Dr. Ruden, and published the symptoms in the 3d edition. Its analogues are the narcotic poisons,-Belladonna, Strammonium, Agaricus; and the animal poisons, Apis, Lachesis and Crotalus. I have never used it. The only clinical experience yet reported is the cure of a few cases of dysuria, gonorrhoea and dysentery. Its pathological effects are more malignant than those of Cantharis, and less so than Lachesis. You may find it specific in some cases of meningitis, cere bral congestion, ophthalmia, enteritis, malignant erysipelas, anasarca, and inflammation of the urinary organs. The key-note for the selection of this medicine will be the presence of its peculiar urinary symptoms, when occurring in the conditions above named. EPIGEA REPENS. This beautiful plant-the trailing Arbutus-around which clusters so much poetry and sentiment, has been used for very non-poetic purposes. Medicinally, it is an analogue of Uva ursi, Mitchella, Chimaphila, Cannabis, and others of that class. No provings have been made of it, but it has been used ever since the settlement of this country, as a popular remedy in renal calculi, or those conditions supposed to arise from the presence of "gravel." It has been successful in the removal of dysuria and strcangury, as well as urinary tenesmus. It seems best adapted to the uric acid calculi. I once used it in a case of that nature; the urine had a bloody, 220 ERECTIITES. muco-purulent sediment, and there was intense dysuria. After taking the tincture in 10-drop doses, six times a day, a copious deposit of fine brown sand (uric acid crystals) was observed, followed by amelioration of all the urinary troubles. ERECTHITES. This plant contains an oil, which goes under the name of Oil of Fireweed. But an " Oil of Fireweed " is also extracted from the Erigeron. The true fireweed is, however, the Erecthites, while the Erigerons are " Fleabanes." Chemists tell us that the oils from these two plants, as well as turpentine, are chemically identical. This may be true, but it does not follow that their physiological or pathogenetic effects are identical. They are very closely allied, however, in their effects on the human system. All three are homoeopathic to both active and passive arterial hcemorrhage; the former is their primary, the latter their secondary effect. The Fireweed has been proven, but not very thoroughly. Sufficient symptoms have been obtained to give us a clue to its method of action. It seems to cause primarily an acute congestion of the principal organs of the body. The headache is similar to that caused by Belladonna and China, or that headache which often precedes epistaxis in plethoric subjects. Had the provings been carried far enough, nose-bleed would doubtless have resulted. It is a specific for epistaxis of bright red blood, as well as hcemorrhages of similar character from the mouth, lungs, bowels, uterus and kidneys. The primary hemorrhages of Erecthites, Erigeron and Turpentine are always attended by excitement of the circulation. Iin such conditions you must be cautious and not prescribe too large doses, certainly not below the 3x. The passive haemorrhage of these medicines is very different in character, it is attended by a torpor and laxity of the blood-vessels, and the blood is darker, lacks fibrine, and deposits a blackish sediment, showing disorganization of the blood-globules. We find this latter form in typhoid fever, ERIGERON. 221 Bright's disease, and other diseases of low vitality. In passive haemorrhages you will get the best results from the lx or even drop doses of the oil or mother tincture. The action of Erecthites on the mucous membranes is that of an irritant. It causes burning in the stomach with cramps, nausea and vomiting; cramps in the abdomen, with copious yellow diarrhcea, worse in the morning (Copaiva, Sulph., Dios.) One person was cured of a dyspeptic condition from which he had suffered for some time, namely: " Eructations and heartburn after eating warm bread and coffee." In dysentery, when the discharges are pure blood, with fever, colic, etc., alternate the Erecthites with Aconite or Ipecac, and you will soon arrest the disease. In premature and profuse menses it rivals Calc. and Senecio. My favorite method of treating this aberration is to give Caic. or Senecio during the latter part of the month, and when the menses appear give Erecthites or Erigeron until the flow ceases to be abnormal in quantity. Gonotrhiea and gleet have both been treated successfully by this remedy. It differs from Copaiva and Cubebs in the character of the discharge, which is always scanty. The inflammation is more like that of Cantharis and Turpentine, with scanty, bloody discharges, and great pain. When orchitis occurs during gonorrhwa, or from suppressed discharges, it is equal to Pulsatilla or Clematis. ERIGERON. Many of the recommendations for the use of Erecthites will apply equally well to Erigeron. For some reason, the latter appears to be more popular with the profession. If both were thoroughly proven we should doubtless get characteristic symptoms; but at present we can substitute the one for the other, especially in hcemorrhages, without much fear of failure. We have more decided renal symptoms from Erigeron, and 222 ERIGERON. in some cases of nephritis, and in some phases of Bright's disease, I have used it with decided advantage. Dr. Ring once published his successful use of it in dysuria in children. "They have frequent desire, and cry when urinating; the urine is profuse, and of a very strong odor; the external parts are inflamed and swollen." He used a low attenuation. I have found it excellent in vesical catarrh, with unusual pain and irritation. In uterine hcemorrhage it is inferior to no remedy. Eclectic physicians consider it the specific in the worst cases, in doses of ten drops of the oil, repeated every twenty or thirty minutes. It is not necessary to use such large doses; 10 drops of the lx is quite sufficient. I prefer the lx trituration of the oil, or even the 3x, if there is much arterial excitement. It resembles Ferrum, in its applicability to active hemorrhage. Of course, you will not expect to avert permanently any hemorrhage from the uterus, with this or any remedy, if any foreign substance, like a retained placenta, a polypus, or other matters remain. It may check the bleeding for the time, but the substance must be removed before the patient is safe. We find some rheumatic symptoms in the provings, but if it is homceopathic to any kind of rheumatism, it is that which arises from some affection of the urinary organs, or gonorrhaea. It has been very highly praised in gonorrhcea and gleet, very many prefer it to any other remedy in that affection.' It is said to cure cases which have resisted Cubebs, Copaiva, and other routine medicines. In tympanites, occurring during typhoid fever, enteritis or peritonitis, I consider the Erigeron, next to Turpentine, the most reliable remedy we possess. I do not know which to give the preference. I can not imagine why both are ignored in our works on practice. They recommend China, Phosphorus, Rhus, and other drugs, which may answer in mild cases, but are useless when the'intestines become paralyzed by distension. Nor do I EQUISETUM HYEMALE. 223 depend upon the internal administration alone, but habitually use them in enema, throwing up half a drachm or a drachm, beaten up with yolk of egg, and mixed with a pint or more of milk. The most enormous and dangerous tympanites will disappear after a few such enemas. Both Erecthites and Erigeron are analogous to Arnica and Sulphuric Acikd in the treatment of contusions and sugillations. Country people use the bruised plant as we use Arnica. A dilute tincture, used in the same proportions as we prescribe Arnica, is an excellent topical application in bruises. EQUISETUM HYEMALE. The scouring-bush has been used from time immemorial as a domestic remedy for dropsy, suppression of urine, gravel, hcematuria, gonorrhoea and gleet. An infusion of the stalk is made with hot water, and drank ad libitum. It contains a large amount of mucilaginous fluid, and perhaps soluble Silica, both of which may aid in its diuretic effects. Dr. J. S. Marsden, one of our best homoeopathic physicians, writes me that he has used an infusion of the stalks very successfully in the dysuria of women, with " extreme and frequent urging to urinate, with severe pain, especially immediately after the urine is voided. He has also used it in painful urination with albuminous urine. It must possess some specific influence over the mucous membrane of the bladder. Dr. M. gives his infusion in tablespoonful doses. I would suggest that you try it in the troublesome dysuria of children. I do not know if the dried stalks are efficient, and I would suggest that if you wanted to keep the remedy ohn hand, you should make a strong decoction, and add onetenth its bulk of good alcohol. This will make a permanent preparation which will doubtless be efficacious in drop doses of the crude, or first dilution. 224 ERGOTINT. ERGOTIN..Ergotin was discovered by the chemist Wiggers, and was believed by Prof. Schroff to contain all the medicinal properties of Secale. It has not been used to any considerable extent in this country, and very rarely by our school. In its crude form it looks like an oleo-resin, a thick, syrupy, brown substance, with the peculiar smell and taste of good powderel Ergot. The triturations are best made with granulated sugar of milk. In the North American Journal for 1859, is to be found a translation by Hoffendahl of a paper on Ergotin by Dr. Kafka, of Prague, who uses the following language: " Just as Atropine is applicable when Belladonna is indicated, but appears insufficient, in the same manner Ergotin is to be used when Secale does not answer our expectations, perhaps because the preparation is not reliable, or the remedy is not sufficiently powerfuli" To which I will add that the preparations of Ergot are notoriously unreliable, especially when kept for a long time. The trituration of Ergotin (of Wiggers on Bonjeau) is a very convenient preparation, and will keep for any length of time, in any climate. Kafka's clinical experience with Ergotine was altogether in uterine hcemorrhage. He gives the well known indications of Secale, namely: Excessive and protracted menstruation; menorrhagia; venous congestion of the womb; haemorrhage from the womb, passive and paralytic, of dark fluid blood, pouring out at every motion or elevation of the body; haemorrhage during and after delivery; hemorrhage from cancer of the wotnb; insufficient contraction of the womb, after abortion; irregular, feeble, deferred, or spasmodic labor pains." You will observe that all these symptoms, except the last one, are secondary symptoms of Eigot. Kafka gave for these conditions grain doses of the first decimal trituration, tRGOTIN. 225 which is in accordance with the requirements of my law of dose. The primary uterine symptoms of Ergot are: very severe, spasmodic, very painful contractions of the uterus, almost continuous; if occurring during menstruation, the flow scanty, only a few drops; if during labor, the pains seem to do no good, for the very severity and continuousness of the contractions wear out the mother, and may injure the child; if they occur at other times, they are due to some spinal irritation, and are called " uterine cramps;" also uterine congestion, of an active, arterial character, such as occurs before inflammation sets in. When these symptoms occur, you will do injury if you prescribe the first decimal trituration. Keep above the third, not too frequently repeated. Kafka gives one case of protracted menstruation; one of hoemorrhage after delivery; one of climnccteric menorrhagia, and one of profuse menstruation. In all these cases this characteristic symptom was present: " little or no pain, the blood in dark clots, or dark fluid, aggravated by any motion or mental excitement." In all, Secale 1st was tried, ineffectually, while Ergotin 1st acted promptly. I have used Ergotin occasionally, ever since I read that article, and its administration has generally resulted satisfactorily. But I use it in other conditions besides uterine troubles. The recent researches of Brown-S4quard and other eminetit experimenters, show that Ergot has, uniformly this primary effect, namely: a eontraction of the blood vessels in every portion of the body. In organs like the brain and lungs, the effect is bloodlessness or anaemia. In the uterus and other hollow organs it contracts all their tissues as well as their blood vessels. The secondary effect or reaction, is a relaxation, ot even paresis of the coats of the blood vessels; thence passive congestion, haemorrhages, relaxaton of muscular tissues and finally their complete paralysis. Brown-S4quard, Hawley and others, claim that Atropine 226 ERGOTIN. has this same effect upon the blood vessels of the spinal cord, but I have my doubts. The proofs are not sufficient to satisfy me. Nor is the Atropine useful in any case of haemorrhage, as it would be if its action was similar to Ergot. I know of no drug that acts exactly like Ergot, unless it is the Ustilago, a similar fungi. Caulophyllum somewhat resembles it, but how close we can not now determine. In accordance with its pathological effects, and selecting it by its secondary symptoms, I have used Ergotin very successfully in very severe congestive headaches, when they occur in persons of lax fiber, large, phlegmatic, lymphatic individuals, whose blood vessels are doubtless relaxed and easily distended, almost to bursting, whenever the circulation is abnormally directed. Such headaches usually occur at the climacteric period in women, and in old drunkards of both sexes. The pain seems to rise up into the head from the back of the neck, the occiput first suffers, then it extends all over the head, and the agony and distress more than the acute pain, becomes almost unbearable. The face is rather pale and cool, than suffused, the extremities cold and livid. (This is not the case when Belladonna or the Bromides are indicated, for the face is hot and red, with throbbing temples.) The congestion is more internal - central - than general or peripheral. Sometimes the head is drawn backwards by almost continuous contractions. In this condition, Ergotin, in doses of one-tenth or onetwentieth grain (using the lx trit.) given every half hour, soon removes the sometimes dangerous condition. In cerebro-spinal meningitis, when the above symptoms occur, the Ergotin acts very satisfactorily. In passive pulmonary hemorrhage, it acts as well as in uterine, in which my experience accords with Kafka's. There is another very valuable use of Ergotin which should not be lost sight of by our school, namely: its value in paralysis. In all the cases of severe poisoning on record, and in all the experiments on animals, paralysis is generally a prominent effect of the drug. Yet the old school are ERGOTIN. 227 now using it extensively in paralysis, and with good results. Brown-S6quard was the first to recommend it in a distinct form of paralysis, and to point out the pathological condition upon which the paraplegia depends, and which large doses of Ergot cures. In his admirable brochure (Paralysis of the Lower Extremities), he says: "This powerful remedy has been employed quite blindly, although its mode of action being better known than Belladonna, it would have been easier to discern in what cases of paraplegia it is able to be of benefit. Ergot, like Belladonna, produces a contraction in the blood vessels of the spinal cord and its membranes, and therefore diminishes the amount of blood circulating in these-organs. The following is a summary of the indications and contra-indications for its use: " st. Ergot must be employed in cases of paraplegia with irritation of motor, sensitive, or vaso-motor nerves; i. e., in conges.tion or inflammation of the spinal cord and its meninges. " 2d. Ergot must be avoided as an agent only able to increase the paralysis in cases of paraplegia without symptoms of irritation, such as cases of reflex paraplegia, or of non-inflammatory softening of the spinal cord." These directions for the use of Ergot may do very well for the allopath, but our therapeutics need a broader scope. Let us inquire-how does Ergot cause paralysis? Evidently by causing such an anmemia of the spinal cord as to diminish or abolish its nutrition, and thereby its vitality. This is the condition which Brown-S4quard describes as being present in reflex paraplegia, and in which he declares Ergot to be injurious. And so it would be in massive doses, but we, who believe in the efficacy of attenuated medicines when indicated, are not confined to the use of Ergot in material doses. I believe, and have substantiated it in practice, that Ergot is useful in paraplegia from reflex irritation; i. e., when anaemia of the cord is present, and non-inflammatory softening is imminent. But in such cases the dose must be in the attenuations above the 3x trituration of Ergotin, or above the 1x of a good tincture. 228 ERYNGIUM AQtUATICUM. Althou'gh it has been decreed that it may be used, and has been used with apparent success in congestion and inflammation of the spinal cord, I do not think it is safe in large doses, if the disease is acute and intense. The secondary action of Ergot is passive congestion (engorgement is a better word) of the cord and its meninges. In active inflammation I prefer Veratrum viride, but in passive congestion or Aehrotic iftamnmation, or even the second stage of spinal meningitis (when of a low type), I am willing to accord a curatiVe value to Ergot, and admit that it must be prescribed in material doses, e. g., the 1x of Ergotin, or pulv. Ergot, or drop doses of a good etherial tincture or a fluid extract, repeated every two or three hours until improvement sets in. In old cases, a dose three or four times a day will suffice. Finally, you will find Ergotin a valuable remedy in some obstinate feutialgias (sciatica and odontalgia.) In night aseats, in chronic diarrheat and chronic dysentery, in certain cases of the hctmorthagic diathesis, in hypertrophy of the uterus, in uterine tumors, aneurismns, and probably varicose ulcers and senile gangrene. ERYNGI2IM AQUATICUM. This endogenous-looking plant, resembling in its leaves the Yucca of our gardens, grows all over the West on the low prairies. It does not grow in swamps, in water, and therefore is not quite correctly named. It has a peculiar taste (the root) somewhat like Senega, but more like Aralia racemosa. In its action it resembles several medicines, more particularly Cubebs, Copaiva, Hepar sulph., Senega and Spongia. It appears to have an affinity for the mucous membrane of the tarynx, bronchia, bladder, and urethra. The provings show that it is homoeopathic to catarrhal inftammataon of the fauces, throat, larynx, and urinary organs. It has cured catarrhal ophthalmia (conjunctivitis) in a scrofulous subject. The head-symptoms are very similar to those cases of ERYNGIU1W AQUATICUI. 229 rheumatic-catarrhal headache, which occur before a coryza breaks out, or when a catarrhal discharge from the head is suppressed. I have found it a valuable remedy in some cases of epidemic influenza which were not readily controlled by Gelseminum and Sticta, when there were raw, smarting, burning sensations in the throat and larynx, with constant irritating cough, and expectoration of tenacious, yellow mucus. This confirms Dr. Morgan's experience reported in my previous volumes. It ought to prove curative in catarrh of the stomach, a disorder with which its symptoms and genius correspond. Dr. Cushing reported a case of hcematemeis - following a blow on the epigastiium - which he thinks he cured with Eryngium, but I can see no special indications for its use in such cases, and would prefer to rely on Arnica or Sulphuric acid which experience has found so useful. Dr. Morgan says he has used it with success in the muncous diarrhaeas of children, which I do not doubt. He also says: " In leucorrhcea and gonorrhcea it has a specific influence. It certainly does act on the virile force, suppressing it, as several instances have proved to my satisfaction." This allusion leads me to refer to a proving of Eryngium maritimum, by J. B. Ivatts, of Dublin, Ireland, found in the American Observer, vol. x, p. 164, in which he refers to the medical history and popular beliefs concerning that species. The general reputation of the Sea-holly is that of an aphrodisiac, or an excitant of venereal desires. It is singular that opposite properties are alleged of two species of the same genus! But this is not so strange as giving opposite qualities to the same plant; which, however, can be explained by the doctrine of primary and secondary effects, and in no other way. Mr. Ivatts' proving shows a decided similarity in the two species of Eryngium. He got similar laryngeal symptoms and urinary aberrations. To his surprise-knowing the popular reputation of the plant - he got " great insensibility of the glans corona, with absence of all desire for coition for 230 EUONYMUS ATROPURPUREUS. several days — the power of erection seemed gone." This shows the double action of the drug. He thinks it the secondary action, which is quite probable. The alleged curative powers, as recorded by old English herbalists, accord with the reputation of our indigenous species among the common people. King, in his Eclectic Dispensatory, says, a few grains of the root taken several times a day, will cure hcemorrhoids and prolapsus ani, but we have no clinical confirmation of it. The two cases of spermatorrhcaa recorded in Hill and Hunt's Surgery, cured by Eryngium, influenced many to use it in that complaint, but the success attending it use was meager. It may be applicable to some cases, but we have not yet'ny definite characteristic indications. I would recommend a trial of it in those cases of gleet which recur after every exposure to cold, and as a result of catarrhal affections. EUONYMUS ATROPURPUREUS. This indigenous remedy - commonly known by the Indian name of Wahoo, and by the common name of Burning bush -has not been sufficiently studied. It has been exceedingly popular as a domestic remedy, and a nostrum called " Wahoo Bitters" once had a high reputation for the cure of ague. Whether it possesses any anti-periodic power has never been accurately determined. I am inclined to class it with Chelone, Eupatorium perf., and others of a similar nature, whose specific virtues can only be known through careful provings. From the few pathogenetic symptoms which have come under my observation, I will predict its value in intermittent fever, attended, as is common in certain seasons, by exhausting diarrhcea. It is certainly homceopathic to attacks of diarrhoea similar in character to cholera morbus, for it causes violent, profuse evacuations, with excessive tormina, much fiatus, cold sweats, prostration, death-like nausea, and vomiting, with chills. (See Symptomatology.) EUPATORIUM PERFOTIATUM. 231 EUPATORIUM AROMATICUM. The late Dr. B. L. Hill once recommended this plant as a specific in aphthous stomatitis in women and children; also for the burning in the stomach with " nursing sore mouth,'" before and after confinement. A few physicians, acting on his recommendation, claim to have used it successfully. The eclectics speak highly of it as a nervine, classing it with Scutellaria and Cypripedium, alleging that it removes restlessness and morbid watchfulness, morbid irritability of the nervous system, tremors, jactitations, chorea and hysteria. No provings have been made. When you meet with cases of aphthous disease, concomitant with nervous erethism, it will afford you good opportunity to test its value. It is used as a wash, as well as internally. EUPATORIUM PERFOLIATUM. This plant, common to all parts of this country, grows in wet, marshy places, and seems to bear out the supposition of some medical writers, that certain plants are specially adapted to the treatment of the maladies which are prevalent in the localities inhabited by them. The Boneset -so called by the common people on account of its virtues in fevers characterized by severe aching pains, apparently in the bones -has been extensively used in this country, from its earliest settlement. Its sphere of action appears to include the gastro-hepatic system, the muscular or Jibrous tissues, and the bronchial mucous membranes. Its congeners are Arnica, Baptisia, Bryonia, Ipecac, Mercurius, Podophyllum, Phytolacca, and perhaps Chelidonium and Cimicifuga. Introduced into homeopathy by such veterans as Jeanes, Neidhard and Williamson, it has been used for nearly the same diseases for which it was recommended by Rafinesque fifty years ago, namely: intermittent and remittent fevers, petechial or spotted fevers, rheumatism, influenza, and diseases of the liver. 232 ]UPATORIUM PERFOLIATUM. In intermittent and remittent fevers it has always been a favorite remedy, and its characteristic indications are well marked, and may be briefly stateL as follows: (1.) The chill is nearly always in the morning, and is preceded for several hours by thirst, soreness, and aching in the bones (apparently.) The thirst continues during the chill and heat. The chill is attended by nausea, vomiting of bile, intense aching and soreness in the flesh of the extremities, and often all over the body. These symptoms continue during the heat, especially the vomiting, which is often painful and incessant, so that nothing can be retained in the stomach. The heat is apt to be prolonged until evening or into the night, and may be followed or not by sweat (with chilliness.) If no sweating occurs, the apyrexia is short, and attended by chilliness, nausea, thirst and debility, showing that the febrile action never altogether subsides, giving us a true type of Remittent fever -a fever in which the Boneset is often our best remedy, especially if occurring in the Summer and Autumn, and is attended by very severe bilious symptoms. This fever goes by the various names of "biliousremittent," "gastric remittent," and even. "bilious-rheumatic" fever. It matters not much what the epidemic is called, if you find the characteristic symptoms of this remedy —the "aching in the bones," the soreness of the muscles, the bilious vomiting, etc.-you will be successful in its use if you prescribe the lowest dilutions, or even the infusion of the plant, to be taken through the apyrexia and paroxsym. Cerebro-spinal fever is said to have been cured by this remedy, but I doubt its value in cases when the cord or meninges are the seat of inflammation. You will meet with many cases of malarial fever, sometimes occurring epidemically, where the symptoms closely resemble true cerebrospinal meningitis; but a close study of such cases will convince you that the similarity is only apparent. The vomiting instead of being due to cerebral irritation, is of hepatic EUPATORIUM PERM)LIATUM. 233 origin; the intense pain and soreness in the head, back, and all over the body, is due to the action of malarial poison, and not to spinal congestion. I do not deny, however, that the poison of marsh-malaria may not cause actual cerebrospinal irritation and congestion, but what I want to impress upon your memory is this, that the cause of such symptoms must he taken into account. Although Eupatorium perf. causes symptoms very similar to cerebro-spinal fever, it will not cure them unless caused by marsh-miasma. True epidemic " spotted fever " is a disease rarely sporadic, generally epidemic, and occurs usually in the Winter or early Spring, and requires such remedies as Secale, Cannabis indica, Calabar, Solanum, and Veratrum viride. Cerebro-spinal symptoms due to malaria occur at a time when agues abound — in the Summer and Autumn — and are best treated by!0upatorium perf., Eucalyptus, China, (Quinia), and a few other medicines. A severe form of fever, generally epidemic, has been known on several occasions in our Western States, characterized by profuse perspiration, without mitigation of the heat, pain, the bones, and other sufferings. This "sweating fever has been cured by appreciable doses of the tincture or infusion of this plant. Catarrhal fever, or epidemic influenza, when attended by the peculiar pains and other symptoms of Boneset, but having in addition intense bronchial irritation with severe cough, has been treated successfully with it. In all these fevers, and even in the beginnings of typhoids, the Eupatorium is looked upon as a specific by the country people. They always give it in infusion, a small quantity of the leaves (3 ij. or iv.) in a quart of water. If there is no vomiting it is given in a warm infusion which causes vomiting, which is not considered a bad symptom when caused by the remedy. If much vomiting and gastric irritation is present it is given cold, when it allays and arrests it. When practicing in malarious districts, you will observe, as I often have, that the Boneset macerated in whisky, is generally recommended and used as a preventive of " fever 16 234 EUPATORIUM PERFOLIATUM. and ague." I can testify from my own personal experience, that a few drops of the tincture, taken several times daily, is an excellent prophylactic to prevent the return of intermittents and bilious remittents. The headaches of Eupatorium are in keeping with the general character of the medicine. They are such headaches as are caused by hepatic derangement. Some persons are subject to attacks which they call biljous sick-headaches, in which vomiting of bile constitutes the principal symptom. The headaches usually come on in the morning, preceded by thirst and chilliness; the pain is in the top and back part of the head. We usually give Nux, and Bryonia in such cases, but you will often find this remedy curative when the former fail. It has one kind of headache which is identical with that of Chelidonium-namely: "Pain in the occiput after lying, with sensation of great weight in that part, requiring the hands to lift it." Bilious subjects often wake with this sensation, and it is apt to be followed by a distressing headache all day. Either remedy will cure such headaches, but the Chelid. has more marked symptoms of jaundice than Eupatorium. Headache with pain and soreness in the eye-balls indicates this remedy. Congestion of the liver, with an oppressive feeling of soreness, fullness, and tightness in the hepatic region, yellow tongue, cough, vomiting and purging of bile, indicates this remedy. Small doses will cure, because the above are primary symptoms of the drug. You may occasionally find it useful in ordinary bilious vomiting and diarrhoea of adults and children. In such cases, when closely indicated, the higher dilutions may act favorably. The catarrhal symptoms of Eupat. are quite notable. It has cured " nocturnal loose cough," " hoarse, -rough cough with scraping in the bronchia," "violent cough with soreness in the chest," "cough with flushed face and tearful eyes-the patient supports the chest with his hands," " coughs with soreness and heat in the bronchia," etc. The cough EUPATORIUM PURPUREUM. 235 resembles those of Phosphorus, Bryonia and Sticta. I would suggest its usefulness in those coughs called " liver-coughs," which undoubtedly owe their origin to derangement of that organ. Generally, however, the coughs of Eupat. are connected with other symptoms indicating that remedy. It is said to have cured asthma and bronchitis with great dyspnoea, but I have never used it in such cases. Although Dr. Williamson recommends it in rheumatic, gouty, and even dropsical affections, I doubt its adaptability to such conditions. Be careful to distinguish this medicine from another belonging to the same genus of plants-the Eupat. purpureum, for the two are quite different in their action. EUPATORIUM PURPUREUM. This species, commonly known under the name of " Queen of the Meadow," does not resemble the E. perfoliatum, except in its curative properties in intermittent fever. The symptoms indicating it in ague are: "Paroxysms at various times of the day; chills beginning in the small of the back, spreading up and down the trunk and extremities; lips and nails blue, violent shaking with conmparatively little coldness; fever with nausea and vomiting followed by moisture not amounting to sweat, principally about the head and forehead; any attempt to change position ever so little, during the sweat, a chilliness would pass through the body." Many of these symptoms, you will observe, are similar to the Boneset. How the medicine happened to be used in ague I do not know. * The symptoms are not found in the provings. It may have been by accident that its curative powers in ague were discovered. Its proper analogues are Apocynum cannabinum, Asclepias syriaca, Cannabis, Senecio, etc. Its sphere of action appears to include the urinary and genital organs, the muscular system, and the mind. The symptoms of the urinary organs are very important. 236 EUPATORIUM PURPUREUM. It causes primarily very profuse urination, very frequent, with deep, dull pain in the kidneys; cutting pains in the kidneys; constant urging to urinate all day, with cutting, aching pain in the bladder. The urine was clear, limpid and of low specific gravity. The secondary symptoms were scanty but very frequent urination, with very intense smarting and burning in the bladder and urethra. The urine was higher colored and of greater specific gravity. It has always had a great reputation among the people (who call it Gravel-root) as a remedy for painful affections of the urinary organs, and dropsy. Eclectic physicians use it in irritable bladder; diabetes insipidus; incontinence of urine and in calculous affections. The provings verify the trustworthiness of its reputation and add another proof of the truth of the law of Similia. I have used it successfully in calcareous concretions in the bladder and kidneys; in diabetes insipidus (it may prove useful in glycosuria); in dysuria, enuresis nocturna, and other conditions of irritation of the bladder from direct or reflex causes. In dropsy it has been used quite successfully by many homceopathic physicians. The dropsy in which it will prove curative will be found, generally, to be a secondary condition, preceded by undue excitation of the kidneys, which after a time gives way to the opposite condition of torpor, or passive congestion. In this respect it closely resembles Apoc. cann. It appears to have some specific action on the generative organs, but the precise nature of such action is not yet determined. It is claimed that it has cured impotency. Impotency is a frequent concomitant of diabetes, and the two conditions may jointly indicate this remedy. It is also claimed that Eupatorium purpureum is indicated in sterility; threatened miscarriage; habitual abortion; ovarian and uterine atony; inefficient labor-pains; amenorrh1ea and dysmenorrhoea, and as a general "uterine tonic." I have not used it very extensively in uterine affections, but its similar EUPHORBIA COROLLATA. 237 ity in effect to Cimicifuga, Helonias, Caulophyllun, and especially to Helonias, would make it advisable for you to try it when those remedies fail. Among its symptoms of the sensorium is a persistent sensation, " as if falling to the left," with a " dizzy feeling all over." It causes also a feeling of " homesickness," although the prover was in her own house. A general hysterical, low-spirited state was also present. The dose in diabetic affections or the nervous disorders, should be in the third attenuation; while in dropsy, gravel, inflamnmations and congestions of the urinary organs, and atonic conditions of the organs of generation, lower dilutions may be used, and in some cases the infusion. EUPHORBIA COROLLATA. This is an indigenous species of Spurge, possessing properties similar to those of the E. officinalis of Europe. In our older Materia Medica you I will find a very good pathogenesis of the latter, which will give you a good idea of the character of both. This indigenous specific is, however, much milder than the foreign. The juice of the latter will produce painful vesications on the skin and mucous membrane, while the former rarely if ever affects the skin as severely, even when the juice is applied topically. The sphere of action of Euphorbia is on the mucous membrane of the intestinal canal, which it affects in a manner similar to Croton tiglium, Elaterium, Jalapa, Helleborus niger, and Veratrum album. Large doses of the root or its tincture produce great nausea, profuse vomiting, followed by diarrhcea of serous, watery fluid, with painful colic, great prostration, cold sweat, fainting, cramps, etc., affording us a good picture of such diseases as cholera, cholera morbus, cholera infanturnm, etc., in which diseases I have used it as successfully in many cases, as I have its analogues. It acts well in such colliquative discharges when given in the 3x to 6x dilutions. 238 EUPHORBIA COROLLATA. So profuse are the watery evacuations caused by this drug that the eclectics call it a "hydrogogue cathartic," and use it in dropsy to run off the serum through the bowels, just as Elaterium is used by the allopathic school, and in rare cases by our own school. I would recommend you to give it a trial in irritable stomach, profuse watery vomiting, colliquative diarrhoea in typhoids, and of consumptives. The ultimate primary effects of Euphorbia, after the watery diarthoea has ended, is to cause mucous enteritis with tormina, mucous and bloody stools with tenesmus. In my second edition of New Remedies, I suggested its use in dysentery when the symptoms corresponded, namely, when the dysenteric evacuations had been preceded by vomiting and diarrhoea similar to that caused by the drug. Since then, several physicians have used it with good results in that variety of dysentery. Some epidemics of dysentery, both in adults and children, commence with attacks of cholera morbus or cholera infantum, and "run into " dysentery. Naturally enough, as it shows the inevitable influence of a natural law, we find that the eclectic physicians recommend it in "cholera infantum, diarrhcea and dysentery." They try to avoid the truth by asserting that it cures "by giving tone to the action of the secretory vessels." How contemptible are such subterfuges! How much nobler would it be to admit the truth of the law of Similia! I wish to call your attention to the similarity of the action of Spurge to some epidemics of summer diarrhoea, when previous to the attack the child or adult have an eruption of small watery vesicles with redness of the skin. It has been observed that if the eruption suddenly recedes, choleraic evacuations occur. Now this remedy may be quite homceopathic to such cases, as is Croton tiglium. If the eruption has been like urticaria, Apis or Arsenicum are indicated; if papular, Pulsatilla or Dulcamara. I have found it beneficial in a few cases of gastritis, with burning in the throat and stomach. FAGOPYRUM ESCULENTUM. 239 It is also indicated in that peculiar form of gastro-enteric irritation, when the slightest cold or indiscretion in diet results in vomiting of water or food, diarrhoea of undigested matters and water, followed by bloating of the abdomen and constipation. In the latter disorder the remedy should be given persistently for several weeks, in order to effect a radical cure. Another species, the Euphorbium hypericifolia has been used very successfully in epidemic dysentery when the discharges were very bloody. It has generally been given in weak infusions. I suggest that you give it a trial in the lower dilutions. FAGOPYRUM ESCULENTUM. This medicine is prepared from the stems and seed-shells of the common Buck-wheat. It has long been a popular belief that the eating of buckwheat cakes was a prolific cause of a definite eruption on the skin. It is supposed that in some way it sets up an irritation in the skin by changing the character of the blood. Many physicians coincide in this opinion, and it has been suggested by some practitioners of our school that the medicinal principle in this plant acted in the same manner as do the anti-psorics, and that it would prove to be a remedy of that class. Provings have been recently made of the tincture in various potencies. They were first published in the Transactions of the American Institute. From these I have had compiled a resum6, which you will find in the first volume. Many of the symptoms are certainly suggestive of some specific action not only on the skin, but on the mucous surfaces. I have not used it much in practice; but it is certainly indicated in intertrigo, erythema, and some forms of eczema, in which you may find it curative. 240 FERRO-CYANURET OF POTASSIUM. FERRO-CYANURET OF PYTASSIUM. This compound salt is quite innocuous in comparison with the Cyanide of potash with which you must be careful not to confound it. Its action has been but little studied in our school, while the eclectics have been using it largely for many years. It is a little sii- ular that it can be given in doses of ten or fifteen';ains several times a day without causing any poisonous effects, while the C.yanuret in doses of one-sixtieth of a grain will cause very unpleasant effects. It is said that the Perro-cyanuret is carried off so rapidly by the urine that the system does not absorb sufficient to cause deleterious effects. But this is not a good reason. We must look ti some other direction for an explanation of this seeming anomaly. I think the Hydrocyanic acid forms, with the iron, a compound which resists disintegration to such an extent that only an infinitesimal quantity of the acid is liberated. The pathogenetic effects of large doses of the Ferro-cyanuret, so far as observed, are " giddiness, debility, non-fcetid salivation, with ulceration of the mouth. It lessens the force and rapidity of the heart's action, and decreases the heat of the body. It is said to temporarily destroy all sexual desire and power. From these symptoms, and its effects in disease, we should place it as an analogue of the Bromides, Prunus, Laurocerasus, Lycopus, Digitalis, etc. It bids fair to become an important remedy especial in diseases of the nervous system, and the heart. Dr. Towne, in giving his experience with this remedy, says that he has used it with the greatest benefit in females especially, of enfeebled constitution, relaxed fiber, feeble digestion, sour stomach with flatulence, sleeplessness, and other symptoms attending such states of the system such as pains in the head, stomach, bowels, head, back, etc. The pulse is feeble, irritable, easily excited and seldom regular for any length of time; the hands and feet more or less inclined to be cold. FERRO-CYANURET OF POTASSIUM. 241 This is just the class of cases in which we would naturally suppose it to be homeopathic, as it doubtless is. It is said tQ be very useful for the sufferings due to excessive lactation. Such cases present symptoms much like those mentioned above. Headaches of a purely nervous character, depending on an impoverished state of the blood, are greatly benefited by this medicine. " Cases of- pure neuralgia," says Dr. Towne, "not depending on decayed teeth or organic lesions, are usually promptly relieved by its use. That variety called sun-pain has been immediately cured in every case. I have had no cases of neuralgia which have given me any real trouble since I have used this preparation." The same writer claims that it is almost specific in asthma. But all the Potash salts have some reputation in that disease. It has been praised in whooping cough, epilepsy, chronic bronchitis, night-sweats, and hypertrophy of the heart. Dr. Ray speaks highly of its virtues in hypertrophy, also in functional disorders of the heart. From among the many cases which he reports, I select the following characteristic symptoms which he removed by its use: palpitation, ringing in the ears, vertigo, intermittent pulse, waking with a sense of suffocation, and disturbed sleep at night. (All were improved in the open air.) Some of his cardiac cases were organic, others purely functional in their nature. I will try and give you an idea of the symptoms and general pathological state for which this medicine is suitable. Taking into consideration the constituents of the drug, it is evident that the first general indication for its use is a depraved and impoverished condition of the blood. Ndxt in importance we must have a debilitated and irritable state of the nervous system, and finally, as a result of these two conditions, we shall find a weak and irritable heart. If you will remember the symptoms first mentioned, for which the eclectics have used it so successfully, you will 242 FERRO-CYANURET OF POTASSIUM. recognize the fact that they all depend upon one or more, or all, of the above three general morbid states. My own experience with the remedy has been almost altogether in the direction of diseases of the heart. I have found it particularly useful in that condition known as chlorosis, where the heart is particularly enfeebled, the blood in a watery condition, with an excess of white corpuscles, and a dropsical tendency impending. Such patients may be quite obese-looking, but it is obesity without plethora, -a contrary condition. I imagine the apparent obesity is not from fat alone, but a condition of the cellular tissue simulating it. In these cases the heart beats very feebly and irregularly, fainting spells are frequent and distressing, dyspncea is excited by the slightest exercise, and the kidneys are very torpid. In these conditions give the remedy in doses of five to ten grains of the lx every four hours, until improvement sets in. Larger doses can be used with benefit and safety, namely: as much as from two to five grains three times a day. In irritable heart it is fully equal to Lycopus or Collinsonia. it is especially indicated when the extremities are cold, and the patient is sensitive to cold air. All the functions of nervous life are enfeebled, and the symptoms are similar to those quoted from Dr. Towne. Fatty degeneration of the heart ought to be favorably affected by this medicine, but I would advise it to be given as high as the 3x trituration. I would not prescribe it in hypertrophy of the heart with enlargement, for I do not consider it homeopathic to that condition. If, however, with such hypertrophy you find great poverty of the blood and an exceedingly irritable state of the cardiac nerves, it might be used with advantage as a palliative. In hypertrophy with dilatation, it ought to prove al excellent remedy, for it possesses the power of imparting tone to the attenuated and feeble muscular structure and quieting the irritable cardiac ganglia, and the accelerator nerves of the heart. In these cases you can use it in appreciable doses (two to four grains every six hours.) FORMICA-GALLIC ACID. 243 It is readily soluble in water, and a drachm can be dissolved in four ounces of aqua gaultheria, and a teaspoonful or two prescribed as often as required by the exigencies of the case. FORMICA. This remedy, which should be called Formic acid, is a secretion of several species of ants - particularly the Formica rufa. It is an acrid, irritating fluid exuding from these insects when they are irritated or angry. It was introduced into practice by Dr. Hering, who has a penchant for unique and out-of-the-way remedies. He recommends it for the following affections: Affections of the spinal cord, spastrs. Rheumatism appearing suddenly, mostly in the joints, with restlessness; the patients desire motion, although it makes the pains more acute; pressure relieves the pain; there is sweat without amelioration. Ophthalmia, rheumatic, and its sequelae. Deafness, and other diseases of the ear. Lack of milk in nursing women. Seminal emissions. The predominant time of day is from 2 to 4 P.M. Consequences of cold and wet, cold baths, or damp weather. It often helped when Chamomilla only ameliorates, and when Belladonna did not agree. The analogues of Formica are Apis, Rhus, Urtica, Dulcamara and Croton. I have never used it, and think you will find other remedies more useful. It ought to be useful in nettle-rash, -or Chloral Hydrate, which contains Formic acid, causes and cures urticaria. GALLIC ACID. This substance forms six per cent. of the astringent principle of Nut galls. 244 GALLIC ACID. The first notice of the remedy appeared in the New Materia Medica, published as an appendix to the North American Journal, by Drs. Marcy and Peters. No proving appeared until 1872, when a brief one was published in the American Observer, communicated by Dr. Kimball, and it will be found in Vol. I. of this work (Symptomatology.) By referring to my lecture on Geranium, you will find my explanation of the homceopathic action of "astringents.' In common with all that class, its primary action is to cause contraction of all the tissues with which it comes in contact. As it is absorbed into the blood, it may reach any tissue of the body if it is taken in large quantities for a sufficient length of time. It is said to be much less powerful than Tannic acid, but we are informed that Tannic is almost wholly changed to Grallic acid in the body; it follows that as a remedial agent the Gallic acid answers for both. Gallic acid is eliminated from the body by the kidneys. We should naturally expect, then, that in diseases of the urinary organs this medicine would prove curative, if anywhere. The clinical experience which I have been able to collect from both schools, together with my own use of it, confirms this idea. In hematuria, especially of the non-inflammatory variety, it has been highly praised by Dr. Garrod, an eminent allopathist, author of a work on Diseases of the Kidneys; and by our Dx. Marcy. The haemorrhages of the kidneys in which it is most useful are those which occur after scarlatina, in Bright's disease, and after injuries to those organs. I have used it myself with decided advantage in many cases in which Millefoil, Turpentine, Hamamelis and similar remedies failed. Dr. Garrod gave three grains three or four times a day; but I have had good effects from grain doses of the first decimal trituration. In albuminuria, after the inflammatory stage has passed, it has been known to change the urine to a healthy standard. You must bear in mind that it is secondarily homceopathic GALLIC MCID. 249 to these affections. If I should prescribe it in active haemorrhage from active congestion, or albuminuria from the same cause, I would prescribe it in the 6th or 12th, and probably in alternation with Cantharis 6th or 12th. A number of excellent cures of nephritic maladies are reported by the late Dr. Redmund Coxe, of Philadelphia. He employed it in the lx trit, Dr. Marcy says: " In many cases of chronic nephritis, onegrain doses of the first trituration repeated every three or four hours, has effected prompt cures. It removes pain from subacute nephritis more speedily than any remedy we have ever employed." In certain cases of pyrosis, when every other remedy has been tried ineffectually, it has been known to cure. " It not only checks the secretion with certainty and rapidity, but it gives general tone to the stomach, increases the appetite, and even removes constipation in many cases." Its power to cure constipation is due to its primary action. The small quantity not eliminated by the kidneys acts dynamically upon the intestines, and performs a veritable primary homceopathic cure. Even Tannic acid will cure constipation, according to Dr. J. G. Wilkinson, of London. Gallic acid has been recommended for hemorrhages of other organs, but I doubt its efficacy. We have so many specific-haemorrhagic remedies that we need not resort to this. Dr. Marcy quotes many authorities in favor of its power in checking colliquative perspirations. He gives his own experience with it in cases of advanced phthisis with copious expectoration of purulent matter, profuse night-sweats, diarrhcea, and other hectic symptoms; and alleges that in some cases remarkable palliative effects resulted from its use in the first trituration. It seems to check the disease for a time, and even prolong life and give comfort, when there is no hope of a cure. - I once had a case of disease of the prostate, probably ulceration, in which profuse haemorrhages appeared very often. The only remedy which appeared to have the power of checking it was Gallic acid in the lx trituration. 246 GALIUM APARINE. GALIUM APARINE. The members of the genus Galium are all called " clivers" in this country, and " goose-grass" in Europe. This species is found in the woods-a trailing, rough plant, with white lateral flowers, rough seeds, leaves eight in a whorl. There are a dozen or more species in the genus, some with leaves six in a whorl, others have only four. Some have flowers yellow, others a dull purple. Not all have identical medicinal properties, for some contain glycyrrhiza-sugar, and others a coloring agent like madder. They belong to the Madder family. Clivers has been very extensively used in domestic and "botanic" practice, and it appears to possess some remedial virtues which render it worthy a place in our Materia Medica. We have no provings of it, but the clinical experience obtained is worth something. The eclectics have a good deal of confidence in Galium in calculi of the bladder or kidneys. They allege that it possesses " a solvent power over the stone, causing it to crumble into a sandy mass, so that it can be discharged." They assert that if used in large quantities it causes constant chilliness —" owing to its cooling properties," and that it is therefore " contra-indicated in passive and atonic states of the bladder and kidneys." It is said that an analysis of the plant shows it to contain. Citric and Tannic acids. In the second edition of my New Remedies, I made the following observations on the use of Galium. They are so appropriate that I quote them now, instead of attempting to offer any new remarks: While engaged in an extensive country practice, I often observed that the cold infusion was drank freely by fever patients, especially if scalding or burning during micturitien was complained of. At first, I disliked to have them use it in connection with homveopathic remedies, but I found its use so general, and the idea of its mild curative powers so GALIUM APARINE. 247 engrafted into the minds of the people, that it was a difficult matter to proscribe it. I have never noticed that its use interfered in any way with the action of homceopathic medicines. In order to test in a practical manner its alleged usefulness in urinary affections, I have often selected cases of simple dysuria, strangury, suppression, etc., depending on uterine irritation, or a cold, and prescribed the cold infusion in alternation with blank powders or pellets. In this way I have gained some correct ideas of its sphere of action. It seemed to me particularly useful in the dysuria and suppression of urine in young children from colds, or when attended with aphthae, or what might be called a scorbutic state of the system; also in the strangury of women from uterine diseases, haemorrhoids, or irritable bladder. It seemed to be useful in the strangury and scanty urine in rheumatic fever, and in the irritable bladder (from prostratic disease) of old men. Dr. Kendal, a homceopathic physician, reports to me two cases which show clearly its curative action: (1.) A young child had been troubled with painful dysuria for several days. Every attempt at urination was accompanied with cries and screams. A weak infusion of Galium 3rd was given, and in less than one hour the child urinated profusely, without pain. (2.) An old man had been troubled for months with intensely painful dysuria, frequent ineffectual urging, scanty discharge, etc. He was directed to drink a pint a day of a cold infusion. In a few days he reported himself cured..Several similar cases have been reported to me by physicians and lay members of the school. I think the G. asprellum is the tincture generally used, as the G. aparine does not grow so abundantly in the West. Officinal Preparation. —In general practice the cold or warm infusion is usually used. All writers agree that this is the most eligible method, because heat destroys or dissipates the medicinal virtues of the plant. The herb (the root is not used), should be placed in cold or tepid water and allowed to stand for two hours. Three or four ounces 248 GALIUM APARINE. to one quart of water is the usual proportions. It is sometimes sweetened. The expressed juice has been used, according to Wood, three ounces twice a day. King advises the inspissated juice, one or two drachms three times a day. I do not know if alcohol injures its medicinal qualities, but it is probable, as alcohol acts on some vegetable juices much in the same manner as heat; if not, an equal or one-fourth part of alcohol might be added to the expressed juice, to form a mother tincture. I would, how-ever, advise the following method of preparing this remedy for homoeopathic use, in cases where the infusion was not acceptable, or when the physician could not rid himself of antiquated prejudices suffi4ently to use it. Mix together equal quantities, by weight, of the cold expressed juice and sugar of milk; triturate until the mass is perfectly dry. It may then be put up in close bottles. DosE. —I am aware that I am treading upon disputed ground when I advise the use of infusions of vegetable remedies. But if it is better for our patients to use such a preparation, we should not hesitate. Moreover, do we not advise cold infusions of Ulmus fulva, Flax-seed, Althaea, all of which are mild, medicinal substances. Hahnemann, in the early part of his homceopathic practice, used infusions, and he distinctly advises the use of infusions of plants of small medicinal power, when we desire to prove such plants. (See " Lesser Writings.") I am aware that some physicians would prefer to prove even this medicine in the attenuations. In this way, "itching of the elbows and nose "-" drawing in the fingers," —" slight vertigo after smoking the sixth pipe;" or even " unpleasant dreams while lying on the back," might be noticed, but nothing which could show us the real sphere of action of the remedy. I do not deny that certain potent or inert drugs may be proven in attenuated quantities, but remedies similar to the Galium can not. He who would prove this plant, should, without altering his mode of life, drink a wine glass of the ordinary infusion, four or six times daily, for a week or more. In disease, I would advise the cold infusion in the com GALLIUM APARINE. 249 plaints enumerated above, in which it has been found useful. It may be taken in tablespoonful doses, every one, two, or three hours; or the powders prepared as above, may be prescribed in doses of five or ten grains at short intervals. It seems to be primarily homoeopathic to passive, torpid conditions of the urinary apparatus. In such cases the 3d trituration may be found curative. The infusion should be made from the fresh plant, when obtainable, as the dried possesses less power. Children may be made to take it readily by adding sugar and cream, or milk, to the infusion. The following clinical record of the use of Galium in cancer, etc., is taken from the British Journal of Homceopathy, Vol. xxiii, page 189 (1865.) Hard Nodulated Tumor of the Tongue, apparently of a cancerous nature, which disappeared under the use of Galium aparinum, by F. A. Bailey, F. R.C.S. Jane C-, a married woman, met. 60, residing at Ramsbury, in Wiltshire, was admitted into the hospital, April 5, I864, on account of a hard, firm, somewhat circumscribed tumor of about the size of a boy's marble flattened, imbedded in the substance of the tongue, on the right side, about an inch from its apex, which had been gradually increasing in size since she first observed it, five weeks before, when it was about as large as a hemp seed. The upper surface was nodulated and uneven, and the swelling generally had the appearance and feel of a scirrhous. formation of the organ. It had all along been extremely painful, so much so as entirely to prevent her sleeping at night; it was exquisitely tender to the touch when handled, and latterly she had experienced a throbbing, beating pain in it, which had induced her to think it was about to burst. There was no appearance of its having been caused by injury to the tongue through a decayed tooth. She had always been in the habit of living tolerably well, but had been suffering a good deal from general debility and languor for some time before the commencement of the swelling. Her countenanee did not indicate any peculiar cachectic condition of the system, and there was no history of any hereditary cancerous taint in her family. The tumor had increased rather rapidly lately, and she was quite unable to masticate solid food, on account of the pain it induced, which had added much to her original weakness. She was ordered to have strong cold beef-tea frequently during the day for diet, with a pint of porter daily, and to take the following medicine: R. Extract Galii aparini solidi, two ounces; Aquae ad. half pound. M. ft. extract fluid. Of this extract a drachm and a half was given twice a day, in a wineglassful of water. She was also ordered to use the above mixture as a warm lotion to the mouth, several times during the day, keeping it in the mouth for some time during each application. 17 250 GELSEMINUM. A month after her admission she had completely recovered from the languor and debility under which she had previously been suffering; her face, instead of being pallid and sallow, had recovered a healthy and somewhat florid appearance, which was natural to her; the pain in the tumor had been gradually diminishing, and the tumor itself had become so much reduced in size as to be scarcely discernible to the touch, and as she was now able to take solid food without discomfort and with an appetite, she was at the end of five weeks, discharged from the hospital. A fortnight afterwards, having continued the remedies prescribed, she presented herself as an out patient, when it was found that the tumor had entirely disappeared, and the tongue had recovered its natural structure and appearance. GELSEMINUM. The Yellow Jessamine is one of the most important and interesting of all the new remedies. Although it has been studied with much interest by investigators of all schools, much remains to be discovered concerning its pathological and pathogenetic effects. It possesses a peculiar interest to me, and I hope the class will be kind enough to listen to its medical history in the homceopathic school. After the appearance of the provings of Podophyllum, Sanguinaria and Phytolacca nearly twenty years ago, no new investigations of any importance appeared relating to our indigenous remedies. In 1860, I became interested in the brief notices of Gelseminum which I found in eclectic medical journals, especially the cases of poisoning which were of unusual and unique character. I therefore began, with Dr. J. S. Douglas, of Milwaukee, a series of experiments, physiological, pathogenetic and clinical. The more I investigated its properties, the more I became convinced that it would prove a valuable addition to our Materia Medica. In 1862, I had collected enough data to enable me to write a monograph of fifty-six pages, octavo, which Dr. Lodge, of Detroit, was kind enough to publish. Such was the interest excited by this brochure that the whole edition was disposed of in a very short time, and the remedy rapidly rose in the estimation of physicians, till it GELSEMINUM. 251 took a front rank along with Aconite and Belladonna in the armamentorium of homceopathic practitioners. The reception of Gelseminum was so favorable that it emboldened me to study and investigate other indigenous plants, and embody the results of such studies in a volume entitled " New Remedies," published by Dr. Lodge. While I am proud of the title, which some of my colleagues have given me, of "Father of the New Remedies," I must accord to Dr. Lodge the title of "God-father," for he it was who took the risk of publishing the work, and placing it in the hands of our school. Ten years have now elapsed since the publication of the original monograph, and the literature of Gelseminum, and of nearly all the New Remedies has grown largely, and will still grow, I hope, during the next and succeeding decades. The cases of poisoning on record, and those which I have observed in men and animals, show the following effects: (1.) General prostration and paralysis of all the voluntary muscles, while the mind is clear and the involuntary motions are intact. In this stage, dimness of sight, slight or complete, is nearly always present, together with dropping of the eyelids, with much difficulty of opening them. A slight degree of stupor or sleepiness is usually present, or a sluggish condition of the mental faculties, which are, however, easily aroused. (2.) Partial paralysis (complete if death occurred) of all the involuntary muscles. First the sphincter muscles, then the respiratory, and finally the heart. In this stage, the functions of the brain are not always abolished, but can be aroused by electricity and physical agitation of the body. In other cases a profound stupor occurs, which lasts until death or convalescence. (3.) In some exceptional cases, when a very large dose is taken, the brain seems suddenly congested, and a kind of apoplexy occurs. In cases where death seemed imminent, or was to all appearances present, recovery has been brought about by the free use of stimulants and galvanism. 252 GELSEMINUM. The nearest analogues of Gelseminum are Calabar Bean and Conium; next in order come Aconite and Veratrum viride; and finally, Chloral hydrate may have a close resemblance. It has been thought by some to stand midway between Aconite, and Belladonna and the other narcotics; but the fact is that its primary action and secondary effects follow each other in the same order as those first named; while they appear in reverse order when compared with those of Belladonna and its congeners. In other words, the primary effects of Gelseminum are similar to the secondary effects of Belladonna. The sphere of action of Gelseminum is doubtless principally confined to the motor side of the spinal cord, the brain, and the mucous membranes. The sensory nerves are certainly not as profoundly affected by Gelseminum as by Aconite, for I have never seen from it the benumbing sensations or the aniesthesia of the latter; nor, does it cause primarily the hyperaesthesia of Nux, although it may secondarily. I am of the opinion that it primarily causes passive congestion of the brain and spinal cord, just as Nux causes active congestion of those organs. Gelseminum, like Calabar and Conium, benumbs and paralyzes the nerves of motion, both voluntary and involuntary (primary), while Nux and Belladonna irritate and excite both sets of nerves. While Gelseminum produces death by a condition of general paralysis, or passive apoplexy (primary), Nux causes death by inducing just the opposite, namely, a tetanic state, or active congestion of the cerebrospinal centers (primary.) Nux and Belladonna cause, by their secondary action, a kind of secondary general paralysis similar to the primary effects of Gelseminum and Calabar. I make these comparisons in order that you may study the symptoms of both understandingly. It is almost impossible to separate the primary from the secondary symptoms, as the provings stand; but it will greatly aid you to do so, if you understand the nature of the primary and secondary states caused by this drug. GELSEMINUM. 253 I can not undertake to give you information as to all the morbid conditions to which Gelseminum is homceopathic, nor can I give you the symptomatic indications for the remedy in all cases. You must, by careful study and comparison, become familiar with its provings and pathogenesis, which you will find in my special Symptomatology of New Remedies, and in all your text-books on Materia Medica. Bearing in mind my doctrine of Dose, as relating to the primary and secondary action of drugs, you will readily understand that in diseased conditions which resemble the primary effects of Gelseminum, you should prescribe only the middle and high attenuations. Among the disorders in which this medicine is primarily indicated, are: (1.) Paralysis, general and special, of the voluntary and involuntary nerves (of the striped and unstriped muscles.) (2.) Passive congestions of the brain, spinal cord, lungs, liver and other organs. It is secondarily indicated in (1.) Convulsions, first of the voluntary, then of the involuntary muscles, namely: Hysteria, chorea, tetanus, puerperal spasms; spasms of hollow organs-of sphincter muscles. (2.) Active congestions of the brain and spinal cord and other organs. (3.) Fevers and local inflammations, hypermsthesiae, neuralgiae, etc. The Gelseminum is an important fever remedy, forming one of the group-Aconite, Baptisia, Veratrum viride and Gelseminum. It is useful in all fevers, where the symptoms indicating the drug are present, but it will be found most useful in the following orders: (1.) Catarrhal fevers, from the influence of a cold, damp atmosphere, or a sudden change from hot and'dry to damp air. When influenza is epidemic, at any season of the year, you will always find cases where this remedy is called for by the following symptoms: Chilliness up the back, can not move away from the fire without chilliness; the head is hot before the fever sets in, which is not attended by thirst, restlessness and anxiety, as with Aconite, but a torpid, heavy condition. The head feels heavy and big, the face scarlet, 254 GELSEMINUM. the eyes suffused, the nose runs a watery mucus, but little sore throat, the pulse large, full and quick, but not very hard, and the febrile motions are remittent, aggravated about the same hour every day. [Right here I will give you the characteristic pulse of each fever remedy: Aconite-Pulse small, hard, wiry, quick: Veratrum viride-Pulse hard, full, bounding, incompressible: Baptisia-Pulse quick, full, irregular, compressible. Gelseminum-As above given.] (2.) Bilious remittent fevers, when caused by atmospheric changes in the Spring, or due to miasmatic influences in the Autumn. The febrile symptoms are as I have given them above, and, in addition, such symptoms as intense frontal or occipital headache, puffed face, slimy and bitter taste in the mouth; the tongue may be coated white or yellow, and the breath is foul. In the Fall these fevers often take the place of agues, and may change into that form; but the Gelseminum is equally useful in (3.) Intermittent fevers, miasmatic or not. It is best indicated in the quotidian type. I do not deny its power of curing tertians or quartans, as it seems to have done, judging from the reports of various physicians; but in an extensive practice of many years I have rarely found it useful in any but quotidians. It possesses the curious power of changing a quotidian, or bilious remittent, into a tertian fever. The special indications are chills along the back; fever with hot head; flushed face, cold feet, sleepiness, followed by hot perspiration, rarely thirst and vomiting. In most cases it should be given low, even a few drops of the tincture every two hours in bad cases, continued through the apyrexia and paroxysm. It prevents the convulsions in children with agues better than any other ague remedy. It is useful in socalled " dumb ague," made so by Quinine. In such cases it follows Ipecac with excellent effect. It is also indispensable in "masked ague," assuming strange forms, such as chorea, neuralgia, etc. (4.) Infantile remittents, when due to irritation of teething, or intestinal troubles, or worms, or when caused by malarial GELSEMINUM. 255 influences. In such cases it acts better than any other fever remedy, but should be alternated with some remedy more homceopathic to the special irritation. (5.) Irritative fevers, or that type which is caused by some local irritation, such as ulceration, suppuration, the presence of a foreign body, etc. i know of no remedy which so readily controls this fever, while some specific remedy, or surgical treatment, removes the cause. In hectic fever, which is a variety of the above, even when shaking chills, followed by great heat, and drenching sweats, occur, as in phthisis, or pyaemia, the Gelseminum will arrest the paroxysms for a long time. It may be useful in some cases of enteric or typhoid fever, but unless such fever commenced as a catarrhal, I should not rely upon it. Even then it would be useful only in the first stage. In cerebro-spinal fevers it is especially useful, and ought never to be forgotten. If you refer to the head-symptoms and the cerebral conditions you will see the reason why. It causes both passive and active congestion, and inflammation of the meninges of the brain and cord, but of a less intense degree of severity than Veratrum viride or Belladonna. It occupies a position between the two. If any of the above fevers are attended by cerebro-spinal irritation, it renders Gelseminum all the better indicated. In all the eruptive fevers (the acute febrile exanthemata), it may be indicated, but especially in measles, as it causes both the catarrhal symptoms and the papulous eruption. In all, it assists in determining the eruption to the surface, and wards off the convulsions which tend to appear with the eruption. The mental indications are different from those of Aconite or Verat. vir.; it has no anxiety with fear of death, but a torpor, a sleepiness, and dread of movement, which is an unfailing indication. In the South it has been found valuable in yellow fever, but I have had no experience with it in that terrible malady. From the records of the symptoms of that fever, I judge that it may be indicated in some cases. 256 GELSEMINUM. You will find the Gelseminum an indispensable remedy in many diseases of the brain and head, which I will briefly enumerate: In active congestion of the brain, when occuring during fevers, from unusual exertion, or from exposure to the sun. (use the lowest dilutions.) In meningitis, especially in children; in passive congestions; (use here the middle dilutions.) In threatened or actual apoplexy, with stupor, coma, and nearly general paralysis. (It is rarely useful in hemiplegia or paraplegia.) In all these cerebral affections, stupor, torpor of the mental faculties, and wild incoherent delirium is the rule; while active excitement and violent delirium is the exception. The headaches of Gelseminum are both inter- and extracranial. It corresponds to the congestive variety, the cerebrospinal and the febrile. It is also curative in the neuralgic, especially when due to malarial or catarrhal influences. The typical Gelseminum-headache may come on suddenly, with dimness of sight or double vision; with vertigo, great heaviness of the head, it feels too big, and often too " light;" with a semi-stupor, bright red face; dull, heavy expression of countenance; full pulse, and general malaise; or, The headache may be of a settled, dull, heavy character, mainly in the occiput, mastoid or upper cervical region, extending to the shoulders; relieved when sitting by reclining the head high on a pillow. In neuralgic headaches the pain is either in the upper cervical and occipital region, extending upward and forward; or it occupies the forehead, over one or both eyes. The pains are cramp-like, drawing, tearing; aggravated by any exertion, or study. Gelseminum is best indicated in these headaches when they are remittent or intermittent. A characteristic symptom is "Sensation as if a band was drawn tightly around the head above the ears; with soreness in the scalp and brain." The head may even be retracted backwards, and is relieved by bending the head forward. (Contra in Calabar.) Headaches of this character.have been cured promptly, in GELSEMINUM. 257 the practice of many physicians, by the tincture and low dilutions. A few cases have been as promptly cured by the 200th potency. In diseases of the eyes, Gelseminum ought to prove curative in many cases. I have myself used it with benefit in amaurosis, and it has cured many cases in the hands of other physicians. The disorder was generally attended by dilated pupils, a disturbance of the power of accommodation, a misty appearance before the eyes, and heaviness of the lids. This last symptom is a peculiar characteristic of the drug. A person under its pathogenetic influence finds the eyelids so heavy he can scarcely lift them. It may even cause complete paralysis of the lids — an indication of grave cerebral disease. It causes dimness of sight invariably, and if enough is taken complete blindness results. The exact pathological condition upon which this blindness depends has not been fully determined. When proving Gelseminum fifteen years ago, it caused an asthenopia, from which I have never fully recovered. It ought to be homceopathic to that disorder, and ought to cure it in the very highest potencies. It has caused hemiopia and diplopia. One of the most recent provings has this symptom: "Everything seems like rolling water before the eyes." Dr. Woodyatt, of Chicago, and many oculists of our school in other cities, value it highly in some nervous and paralytic effections of the eyes. In acute ophthalmia it does not appear to be generally useful, but in that curious form which occurs periodically, namely: an intense periodical congestion, from suppressed or masked ague, it cures promptly. The ear-symptoms are not notable. It causes rushing and roaring, and sudden deafness, which may be due to catarrhal trouble, or paralysis of the auditory nerves, both of which it will cure. It is an excellent remedy for otalgia, when applied topically, a few drops on cotton introduced into the ear. The catarrhal condition to which Gelseminum is homceo 258 GELS1EMINUM. pathic affects all the mucous surfaces, especially those of the eyes, nose and ears, and in the severest colds, when they affect all those organs, and the whole head suffers, there is no better remedy. It is rarely useful in chronic catarrh, while it is our best remedy for the effects of suppressed or undeveloped catarrh. In affections of the mouth, tongue and throat it presents a marked contrast to Aconite. The Gelseminum affects the nerves of motion more than the nerves of sensation, while Aconite acts in the opposite manner. The primary effect of Gelseminum is to paralyze the muscles of the tongue, glottis and the whole apparatus concerned in deglutition and vocal efforts, but this paralysis is not attended by the numbness and tingling caused by Aconite; the secondary effects of the drug result in spasmodic and tetanic conditions of the same muscular structures. You will be able to cure, as I have cured, some sudden and alarming paralytic affections of the throat with the high dilutions; while in spasm of the glottis, spasmodic croup and laryngismus stridulus you will be successful with more material doses. We can trace this same paralytic and spasmodic influence of the Gelseminum all through the body. In the stomach it causes a peculiar feeling of weakness and emptiness, which may be attended by that peculiar vomiting which is due to paralysis of the oesophagus. The sense of weight in the stomach, with dull pain, is indicative of the cramp which will result from its secondary action. The abdominal symptoms of Gelseminum are due to two conditions, (a) a primary paralysis, and secondary spasm of the motor nerves; and (b) a catarrhal affection of the intestinal mucous membranes with sympathetic muscular irritation. You will find it useful, then, in some singular paralytic conditions, especially of the sphincter. Many provers observed that it caused an involuntary diarrhoea, or rather, a tendency to involuntary evacuations from the bowels, excited by emotions of a depressing character,-as bad news of bat GELSEMIN1UM. 259 ties, disappointment, etc. Many cases are recorded where it cured similar conditions. During the war it was very effectual in the diarrhcea of soldiers, especially when aggravated by the excitements of the struggle. In these cases, probably the catarrhal and nervous elements of the disorder were both present. A case has recently been reported of a "chronic diarrhcea, aggravated by exciting emotions," cured by one dose of Gelseminum 2000th! It is indicated in acute catarrhal enteritis which may take the form of mucous diarrhoea or mucous dysentery, according to the grade of the inflammation. In the first stage of this affection the discharges may be almost involuntary; in the advanced stage they may be attended by intense spasmodic colic and tenesmus, both of which conditions equally indicate Gelseminum. The evacuations may be bilious as well as mucous. This is due to a catarrhal irritation of the liver, but niot to any specific influende exerted by Gelseminum on that gland. It has been suggested by some as a possible palliative in intense pain caused by spasm of the gall-duct during passage of biliary calculi. It is worth a trial, if Chloral is not at hand. The same paralytic and spasmodic conditions we have mentioned are found in its action on the genito-urinary apparatus. It has cured enuresis from paralysis of the sphincter; " wetting the bed " in children; paralysis of the bladder in old people; and involuntary micturition from exciting emotions. It has also cured opposite conditions, namely:- dysuria, with frequent urging, scanty urine, and vesical tenesmus; spasmodic retention of urine. It has no specific influence on the kidneys, but its primary effect is to cause the so-called "nervous-urine," a profuse limpid flow from nervous excitement. The primary effect of large doses of Gelseminum on the uterus, is to cause a paralysis of its motor power. This condition leads to those morbid states for which the remedy has been used so successfully in the high potencies, namely: Atony, resulting in want of contractility, false labor pains, 260 GELSEMINUM. passive hoemorrhage from loss of contractility. Secondarily: it causes congestion of the uterus; spasmodic pains; neuralgic pains associated with cramps in the uterus and legs. It will therefore cure those conditions when given in the lowest dilutions. I know of no remedy more efficient in most cases of dysmenorrhoea of the above character, violent after-pains, cramps in the uterine ligaments. (The pains of Gelseminum commence in front and extend upward and backward to the sides and back, or down the limbs.) It has been used successfully by obstetricians in deficient labor-pains, or when the pains are severe but make no progress owing to a rigid os uteri. In the former case the medium attenuations are useful, but in the latter quite large doses are often required (ten drops every half hour till relaxation.) When your patient is threatened with convulsions during confinement, and the pulse is large and soft, the face puffed and the expression heavy, do not hesitate to give ten or fifteen drops every fifteen minutes' while you are hastening the labor by the forceps or other means. Its action on the male genital organs is analogous. It causes primarily impotence from lack of muscular power in the penis, while it does not abolish sexual desire. It is thus homeopathic to that form of emissions which occur at night from dreams, or by day from sexual excitement, without erections. In such cases it will cure in the 30th and upward. I do not think it will be found as useful in active nocturnal emissions, unless they occur from local irritation of the seminal vesicles, or during gonorrhcea with chordee. If useful here, the tincture is required. I know of no remedy so generally useful in acute gonorrhaea, with great inflammation, scanty discharge, fever, etc. It controls the active symptoms, and often no other remedy has to be used - it seemingly cuts short the disease. My usual, efficient dose is two to four drops every two hours. When the discharge becomes thick, yellow or creamy, Cannabis, Copaiva, Cubebs, or oil of Sandalwood are needed. I should expect good effects from Gelseminum in spasmodic stricture of the urethra, for I have used it with benefit in GELSEMINUM. 261 an analogous affection-vaginismus of a purely nervous character with uterine irritation. In these cases its internal use may be aided by an injection of the same. I do not think Gelseminum is adapted to acute inflammations of the parenchyma of any of the organs of the body. Clinical experience has not found it of any value in pneumonia, pleuritis, carditis or pericarditis, during the inflammatory stage. If useful at all, it is in the congestive stage. Its homceopathicity to acute catarrhal affections, makes it an excellent remedy in some disorders of the mucous membrane of the respiratory organs, when caused by cold and dampness. It is all the better indicated in these catarrhal difficulties if motor disturbances occur, such as spasm of the larynx, pharynx and glottis, or so-called spasmodic asthma. The heart-symptoms of Gelseminum all point unmistakably toward cardiac paresis. The primary pulse of Gelseminum is soft, weak or imperceptible, except during motion. The heart's action becomes slow and very feeble, and the extremities become cold (but it does not cause the collapse of Aconite and Veratrum.) One peculiar symptom of the heart is, " a feeling as if the heart would stop beating if she did not move about." This was observed in a case of dangerous poisoning. It reminds one of the poisonous effects of Conium, where life is prolonged by movement; the symptom is just the opposite of Digitalis and China. I think it paralyzes the cardiac ganglia. In such cases movement of the body keeps the heart going by stimulating those motor nerves which are supplied to the heart from the spinal cord. Dr. P. P. Wells, when proving Gelseminum, experienced a symptom which goes to prove this theory- " A sensible motion of the heart as though it had attempted to beat, which it failed fully to accomplish, and the pulse then each time intermitted, worse when lying down in bed, especially when lying on left side." It is in cardiac neuroses that this remedy is best indicated. They may be primary, with deficient power and action, or 262 GERANIUM MACULATUM. secondary with excessive action. In hysterical palpitation I have found it quite efficient. Gelseminum is not useful in inflammatory rheumatism, only in that condition of catarrhal-rheumatic pains before the catarrhal discharge appears, or when rheumatic pains appear after suppression of catarrh. In this respect it resembles Pulsatilla, Clematis, and Ranunculus, and should be studied and compared with them. Future provings and experiments will doubtless increase the scope of the action of this drug, and give us new symptoms and special indications. I predict that it may be found useful in some affections of the brain and spinal cord, in which it has not yet been used. It may be curative in locomotor ataxia, softening, and other serious lesions. GERANIUM MACULATUM. This indigenous species, known under the common name of " Crane's-bill," from the peculiar shape of the seed-vessel, is used by the country people as an almost universal remedy for diarrhcea and other fluxes. The root contains nearly thirty per cent. of Tannin, and its curative action is doubtless due to the presence of that agent. Homceopathists have rejected- rightly or not —all the so-called astringent medicines for the cure of abnormal discharges. It is a question whether it is right for us to throw onut such medicines. Eclectic physicians claim that it not only cures diarrhea, but that it "leaves the mucous membrane in a moist, healthy condition," i.e., normal. As I shall speak of several similar medicines during my lectures, permit me to quote from the second edition of my New Remedies: My attention was first called to the remedy by observing the promptitude of its action in certain cases of diarrhcea, from loss of tone in the mucous membrane of the bowels, or in the discharges which continue after the inflammatory GERANIUM MACULATUM. 263 stage of a dysentery. In such instances I have known discharges to cease under the action of Geranium, when they had resisted the careful and persevering use of the ordinary homoeopathic remedies. One fact arrested my attention, namely: that it was rarely used by intelligent laymen or physicians (eclectic) until the inflammatory conditions had passed away; and that if used too soon, it was very sure to aggravate the conditions. In this respect it acted very much as does Rheum in the hands of allopathic physicians. These observations led me to inquire whether there was not something in the medicinal action of astringents, that would account for this favorable action under certain circumstances. In other words, could not their curative action be made to accord with the law of Similia, and with the law of dose, which is the necessary result of that law. To illustrate the curative action of Geranium, I here present several cases, which were treated by me or came under my observation: Case I.- A gentleman had been troubled for a long time with a copious secretion of mucus about the fauces, obliging him to constantly " hawk " and clear the throat, much to his annoyance. The condition originated in an acute catarrhal attack, which occurred several months before. An examination showed no traces of present inflammatory action; the mucous membrane looked pale and relaxed, and large drops and clots of mucus adhered to the fauces. I used for a reasonable time Mercurius iod., Hepar sulphur, Hydrastis, and several medicines which seemed indicated, but no curative effect was observed. I then prescribed Geranin in the first decimal trituration, two grains to be taken three times a day, and a weak lotion of the same remedy, and as a gargle. In a week the patient reported himself cured. Case II.-A lady aged 45 had been ill with chronic diarrhoea for nearly a year. The evacuations were usually watery, with but little pain, contained undigested food, and occasionally traces of mucus. The number of evacuations, daily, varied from four to fourteen. A good many medicines -were used, in high and low potencies, but with no perma 264 GERANIUM MACULATUM. nent curative results. Arsenicum and Sulphuric acid were, the most useful. Finally, she became very anoemic, debilitated, and so dispirited that her condition became critical. On the suggestion of a friend who had been cured with the Cranesbill, and with my permission, she commenced the use of the root, in infusion. It was prepared by pouring upon one teaspoonful of the powdered root, a teacupful of hot water. This, after standing a few hours, was taken as follows: one-third of the quantity every six hours. I carefully watched the case, allowing no other remedy to be taken, and permitting no change in her usual diet. After the third day, the evacuations became less frequent and profuse, until at the end of a week or ten days they had become normal. At this time, I suggested that the medicine be discontinued, which was done, but resumed again in two days, as relaxation of the bowels recurred. The remedy was continued in gradually decreasing doses, for a month, when it was discontinued, and she has since had no return -now two months. Case III. —was one of chronic, exhausting leucorrhcea, of a vaginal origin, and attended by no ulceration or abrasion; a mere passive discharge from a relaxed mucous surface. Geranium, ten drops, four times a day, was prescribed — with injections of the same medicine, prepared by pouring one pint of water upon two drachms of the powdered root; the whole to be used during the day-half in the morning, and half in the evening. In two weeks she reported herself as cured. These cases, together with my observations of its successful use in many other cases, has prompted me to offer the following suggestions in lieu of a thorough proving, which I have not been able to obtain. It must be remarked by every observing homeopathic physician, that while the opposite school estimate very highly the " astringent" medicines, they are but seldom used in our own school. Let us now proceed to examine into the nature of the action of the so-called "Astringents," in order to ascertain PERANIUM MACULATUM. 265 if they can be used in a practical manner in accordance with the law of "Similia." "Astringent" agents are taken from the vegetable and mineral kingdoms. The vegetable astringents comprise Tannic acid, Gallic acid, Kino, Quercus alba et rubra, Rhatany, Statice, Geranium maculatum, Haematoxylon, Epi-phegus virginiana, Trillium, Rhus glabrum, Ribus, Potentilla, Myrica cerifera, Matico, Uva ursi, Chimaphila, Erigeron, Erechthites, Hamamelis, etc. Among the mineral astringents are Sulphuric acid, Plumbum aceticum, Ferrum sulphuricum, Alum, Zincum sulphuricum, Cuprum sulphuricum, etc. In the Materia Medica of the opposite school, many medicines are mentioned as astringents which do not belong to that class, but are more properly "escharotics," namely: Argentum nitricum, Kreosotum, and Mercurius corrosivus. We will first examine the action of astringent medicines as explained by allopathic authors. It would occupy too much space to give the opinion and explanation of every writer on Materia Medica. We will therefore quote from Dr. Headland, who seems to embody in his chapter on "Astringents" all the most important speculations in vogue in his school, as to their physiological and curative action. He defines astringents in a "General Proposition," as medicines which " act by passing from the blood to the muscular fiber, which they excite to contraction." He remarks that:" they do not necessarily act in the blood, although many hmmatics are also astringents. They do not pass from the blood to the nerves. They do not always act by passing out of the body through the glands. As neurotics act directly on nerves, so these act directly and especially on muscular fiber. They cause this to contract, whether it be striped or voluntary, or of the involuntary or unstriped kind. Their action is more readily understood, because it can actually be seen. It takes place out of -the body, or in the body-externally or internally. Nearly all astringents have the power of coagulating or precipitating albumen. 18 266 GERANIUM MACULATUM. By virtue of this power they are enabled to constrict many dead animal matters. They effect fibrinous tissues in a similar chemical way. But they seem to effect a further dynamical influence over living tissues, which possibly depends in some way on this chemical property. This dynamical influence is, as I have said, to cause the contraction of muscular fiber. By this, all their operations can be explained. Taken into the blood in a state of solution, they pass through the walls of the capillaries to the muscular tissue, by inducing the fiber of the involuntary muscle to contract. Astringents may brace the system and simulate the action of tonics, but as the action of voluntary muscle is short and brief, it requires for its maintainance continual excitation; and unless the medicine is thus continually repeated, the tonic effect subsides. But astringents further contract involuntary muscles, this contraction is slower, but more durable and important in its results. Unstriped muscular fiber exists in the middle coats of arteries, in the walls of capillary vessels, in the lining of the ducts of glands generally, in the substance of the heart, and in the stomach and intestines. Astringents are irritants and poisonous in large doses. But in small doses, they constrict and stimulate to a healthy condition these tubes that contain in their coats the unstriped fiber. By diminishing the caliber of the capillary vessels generally, they promote health and counteract a lax state of the system. By the same action on the extreme vessels they prevent haemorrhages. By constricting the -ducts of the glands they diminish the secretion of those glands, because denying it an exit. By acting on the stomach and intestines they are able to give them tone, to diminish their secretions when excessive, and thus to promote digestion." The above may be said to embody " all the accumulated wisdom " of the old school in relation to the action of astringents. To the homceopathist it is vague and unsatisfactory. Let us see if we can get any light from further investigations. We will not stop to consider the chemical action of astringents, either on dead tissues, or on albuminous substances. GERANIUM MACULATUM. 267 Such action may be termed chemico-mechanical, and does not come within the scope of this paper. Dr. Headland seems to think that aside from the above mentioned, astringents have another method of action, which he would imply was the chemico-dynamic force. With a strong leaning to a belief in the presence of a dynamic power in drugs, not recognized by his own school, Dr. Headland can not get rid of a certain materialism which prevents him from accepting the great truth that all medicines act in a dynamic manner, when once taken into the circulation or even when brought in contact with nerve-matter. I agree with Dr. Headland, however, in his " General Propositions," that astringents do act by passing from the blood to the muscular fiber, which they cause to contract. But is this the only way in which astringents act? Must they pass into the blood —be carried through the round of the vascular system, before they are brought in contact with the muscular fiber of the coats of the stomach or intestines? When applied to the lax and debilitated mucous surfaces discharging an unhealthy secretion, is it necessary that the medicine must pass into the blood, and through the circulation, before it acts upon the mucous and muscular tissues of the organ or surface to which it is applied? Such a roundabout way is not necessary. The mere contact of a medicinal substance with the diseased tissue, for the morbid condition of which it is the remedy, suffices to effect the cure of that condition. It may be taken up by the absorbents, or enter the capillary system (if applied to the skin) or affect, by its dynamic force, the terminal nerve filaments. When brought in contact with such tissues or fibers, the astringent principle or dynamic force residing in such principles causes them to contract. This contraction of muscular tissue implies more than at first thought appears. Not only does muscular fiber exist in the walls of all hollow organs the blood vessels, etc., of the body, but the microscope has demonstrated that it exists in the fungiform papillae of the tongue; in the excretory ducts of the perspiratory and other minute glands. It has even been maintained by some 268 GERANIUM MACULATUM. that the cilia of the epithelium was due to the presence of muscular fibrillke. The astringent-dynamic force may therefore modify the physiological action of the minutest as well as the largest structures of the body, and morbid action wherever muscular fiber exists. In this way it may unnaturally contract the muscular coat of stomach and intestines, the blood vessels, etc., causing perturbed action of the organs of digestion and circulation. By acting on the excretory ducts of glands it will seriously modify the secretion from such glands, render membranes dependent on such glands harsh and dry, and check the secretion of urine and perspiration. When the medicine is applied locally, either in fluid or solid form, it dries up the natural secretions of the surface, and deprives it of some of its nervous sensibility. PATHOGENETIC ACTION OF ASTRINGENTS. 1. Primary Action.- Astringent medicines act on the muscular fiber of the Intestinal tract, Blood vessels, Excretory ducts of glands, Skin, Mucous membrane, in all of which they cause contraction with a diminution of secretion. 2. Secondary Action.-The loss of tone, the laxity and undue secretion, which follow the primary effects of astringent medicines, is as much the specific effect of these drugs as the latter. Says Dr. Headland: " But as the contraction of voluntary muscle is short and brief, it requires for its maintenance a continual excitation, and unless the medicine is thus continually repeated, the tonic effect subsides." This is the case also with involuntary muscle. The contractile effect of the medicine ceases, because the irritability of the muscular fiber is destroyed by the large quantity of the drug, or its frequent repetition, The secondary effect, then, of an astringent is to cause a loss of tone, and a deficiency of normal irritability in the muscular fiber which it affects. The loss of tone extends also to the particular mucous surface or surfaces, for which the drug had a special affinity. GERANIUM MACULATUM. 269 Hence, as a result of the above named conditions, there will exist distension or laxity of muscular organs; colliquative sweats; morbid discharge from glands; hemorrhages (passive), abnormal and profuse secretion from mucous surfaces (blennorrhceas.) The secondary action of astringents is often observed in the persons of patients under allopathic treatment for diarrhbea and other abnormal discharges from mucous surfaces. While under the first influence of the astringent medicine the discharge is checked, the mucous membrane becomes dry, and its substance more firm. But the reaction is sure to occur, unless the vital force maintains the equilibrium, and the discharge reappears in a more aggravated form, with a corresponding laxity of the mucous tissue. Alum is much used for relaxed uvula, and by singers to "strengthen the relaxed tissues of the throat." But Mialhe observes that the Alum used so largely by public singers maintains the vocal parts in a state of "flaccidity," instead of constringing them. The allopaths are well aware of this secondary action of astringents; for they caution the practitioner against using these medicines in too large doses, or a too long-continued use of small doses. The reason of this secondary relaxation is evidently found in the fact that the dynamic action of astringents upon muscular fiber is not by means of transmitted nerve force, or by an increase of vital force, but is more akin to mechanical irritation, an irritation which wears out the irritability of muscular fiber sooner than any other. CURATIVE ACTION OF ASTRINGENTS. The question, How does an astringent medicine cure a diseased condition? can evidently only be answered in one way. Astringents, like all other medicines, cure diseases and morbid conditions and symptoms, which are similar to those caused by this class of remedies. All medicines cure by virtue of the law of Similia, and astringents are no exception. But it must be born in mind that we can not assert, as do the authorities in old school therapeutics, that one astringent may generally be substituted for another. In fact, 270 GERANIUM MACULATUM. their recommendations belie the general rule, which they try to establish. By referring to any work on practice, it will be noticed that a certain astringent is recommended for night-sweats, one for diarrhcea, another for profuse mucous discharges from the vagina or urethra; and still another for haemorrhages. The truth is, that each medicine belonging to the class "Astringentia" is a distinct entity, having, perhaps, some properties in common with the rest; but at the same time possessing some qualities which cause it to differ essentially from all the rest of its congeners. To meet the demands of a scientific Materia Medica, each individual of the class should be separately proven, in order that we may see at a glance in what respect it differs from its analogues. In the homceopathic Materia Medica, we have the pathogenesis of very few astringent medicines. They are: Alum, Tannic acid, Ferrum sulphuricum, Sulphuric acid, Plumbum aceticum, Uva ursi, Gallic acid, Rhatany, Zincum sulphuricum. By referring to provings of these medicines, it will be seen that the primary and secondary symptoms of each are mixed together without any attempt at arrangement. If the physician did not possess some knowledge of the physiological effects of the drugs, our provings would give him no correct idea of the manner and order in which such symptoms were evolved. So too in the "clinical indications" prefixed to each remedy, the same want of order is manifest. They are recommended for diarrhoea and constipation, for spasms and paralysis, and so on, leaving the student in a maze of uncertainty, wondering how a medicine can be used for conditions directly the opposite. Unless we take cognizance of the primary and secondary actions of medicines, we can not reconcile those apparent discrepancies. Those who are familiar with my teachings in relation to law of dose, as based on the dual action of GNAPHALIUM POLYCEPHALUM. 271 medicinal agents, will readily understand the following propositions, as explanatory of the curative action of the class of medicines under consideration: PROPOSITION I. All astringents primarily cause contraction of muscular fiber in some portion of the body, together with a diminution of secretion from the glandular and mucous tissues. Therefore, astringents are primarily homeopathic to similar conditions, occurring as the results of disease. PROPOSITION II. All astringents cause secondarily a diminution of tone and laxity of muscular fiber, with a similar condition in, glandular and mucous tissues, and consequent increase of secretion even to colliquative discharges. Therefore, astringents are secondarily homceopathic where such conditions occur in the organism, and have been produced by the primary conditions before mentioned. GNAPHALIUM POLYCEPHALUM. This many-headed Everlasting was first introduced into our practice by Dr. Woodbury and others of Boston. Its sphere of action appears to include certain nerves of theface and lower extremities, and the mucous membrane of the bowels. The provings show it to cause an intermittent neuralgia of the superior maxillary nerve of both sides, and an occipital headache, with shooting pains in the eye-balls. Dr. Banks, selecting the remedy from its symptom, " intense pain along the sciatic nerve, following the larger ramifications," cured several cases of sciatica; and Dr. Woodbury has lately reported a case cured. By reference to the provings, you will see that the pain is attended by cramps of the calves and feet, and a numbness which takes the place of the pain, at times. It has been used successfully in colic, evidently flatulent; in morning diarrhcea of dark-colored, liquid, offensive stool in children; also in cholera morbus and cholera infantum, with the symptoms recording in the pathogenesis. It seems ta faintly resemble Colocynth and Veratrum album. 272, GOSSIPIUM. GOSSIPIUM. This medicine is prepared from the root of the Cottonplant. The first mention of it was in allopathic journals, where the statement was made that an infusion was commonly resorted to by the blacks of the South, then slaves, for the purpose of causing abortion. It was asserted that its use was generally attended by the. desired result. Soon after, the country was flooded with preparations of the drug —fluid extracts, solid extracts, gossipin, etc., all recommended in cunning words for the criminal purpose above named. Thereupon, every unscrupulous woman used, and unprincipled physician prescribed the drug, until an enormous quantity was sold yearly. Although no authenticated cases of miscarriage' from its use ever came to my knowledge, and although reputable physicians of both schools in the South denied that they ever observed any such effects, I have no doubt hundreds of barrels of the fluid extract were sold yearly. It was the fashion and the rage of the hour, and the money spent for the drug would have endowed a Foundling Asylum in every state of the Union. It still retains its reputation, although in a less degree, That it does cause miscarriage in weakly women xmay be true, but that it uniformly does I can not believe. In the hands of the homceopathic school, it has proven a beneficent remedy, and is capable of further development. The late Dr. Williamson, whose zeal fox the improvement o.f our Materia Medica was never exceeded, made several provings, and used it in many diseases. He considered it analogous in action to Apis, Bryonia, Sepia, Secale and Sabina. It also resembles Cimicifuga, Ustilago and Pulsatilla. Its pathogenesis proves that its sphere of action includes the internal and external genitals, and the reflex nerves connected therewith. It causes, and has also cured, anorexia and nausea at'the time of the menses; morning vomiting in the early months of GYMNOCLADUS. 273 pregnancy, with violent retching, tendency to fainting, soreness on the uterine region; the nausea appears on waking, and the vomiting on first raising the head; only a thick fluid and a little bilious matter is ejected, with passage of wind both ways. Dr. Williamson reports cases of amenorrhoea, dysmenorrhoea and menorrhagia cured by Gossipium. I have prescribed it successfully in scanty menses, painful or painless. In amenorrhoea, with anwemia, gastric derangements and debility, it has seemed to act well. It has been recommended for sterility from uterine torpor; for lingering labor from the same cause, where it is said to cause painless expulsive efforts (?). Many of its symptoms remind me of Ustilago, especially the skin-symptoms. It has some relations with Secale. It causes itching, with small tubercles of the labia and contiguous tissues. It may be that you will find it useful in many other uterine disorders, but it needs further provings and clinical experience to confirm its value. The tincture and lowest dilutions have been found most useful. GYMNOCLADUS. This is a tree, the fruit of which gives it its name of Coffee tree, from its resemblance to the Coffee bean, for which it has been used as a substitute. Belonging to the leguminoseae, it is botanically a relative of Baptisia and Robinia. It has not been much used in practice. It seems to affect the head similarly to Cimicifuga. It has caused erysipelas of the face. An old physician, I think the one who assisted in proving it (Dr. Sellers), informed me that he always found it curative in a sore throat, in which a dark livid redness was characteristic. I quote a portion of Dr. Seller's original letter to Dr. Hering: CINCINNATI, Dec. 9, I844. DEAR SIR: — I herewith send you a couple of pods of the Gymnocladus, commonly called the Kentucky coffee-tree, or fly-poison, the beans of which are 274 GYMNOCLADUS. roasted and used for coffee in some parts of Kentucky, while the pulp that surrounds the bean in the pods is used for poisoning flies. I was induced to suppose it might be a valuable addition to our medicines, from tasting the pulpy substance in the pods. About two weeks ago, while eating a small portion of it, I perceived a burning, drawing sensation in the roof of my mouth, extending to the uvula, which, however, soon passed away. I immediately commenced preparing a saturated tincture. On Sunday, December I, about 8 o'clock P.M., I moistened some sugar of milk with one drop of the tincture, and took about one-sixth of it. In half an hour, perceiving no effect, I took another dose of equal quantity; in less than half an hour I began to feel the same sensation that I had experienced when eating the pulp. By about 8 o'clock in the evening the symptoms were as follows: Headache, fullness and pressure in and over the eyes, in the forehead, and extending to the top of the head, with occasional shooting pains; scraping-burning in the roof of the mouth, extending to the uvula, drawing pain in the ulvula and tonsils, particularly the right side; right tonsil very much inflamed, and of a purple color; sensation of fullness in the stomach, with slight nausea; pain in the lower parts of the abdomen; pain in the small of the back. By Monday morning, December 2, these symptoms had all disappeared, leaving a tickling in the throat, producing a cough which continued to increase all day, and in the evening was one of the worst hard, dry coughs I ever had. By Tuesday morning, December 3, the cough had almost entirely left me (without having taken anything to arrest it), and by evening I was entirely well. I intended prosecuting my experiment, and should have commenced again taking it yesterday, but for sickness in my family. I do not know of this tree ever having been used medicinally in any practice; if you know anything about its properties I shall be pleased if you will inform me, or if you can give me any information as to the best mode of preparing or testing it, you will confer a favor on Yours most respectfully, CHAS. SELLERS. Dr. P. H. Hale and Dr. Delamater have used it in several cases of sore throat similar to the above-described, with excellent results. Dr. Delamater says he considers a blueish appearance of the throat characteristic. The following remarks of Dr. Hering are here presented as the best indications which I can obtain: "We may give the Gymnocladus in cases of cough accompanied or followed by tonsillitis; in erysipelas of the face where the malady is not reached by the better known drugs, even in scarlet fever, in so-called hives, and (where I expect the greatest utility from it) in typhoid fevers, remittent or intermittent epidemic fevers with a typhoid character, or, as I would prefer calling it, with the erysipelatous character. We have had such epidemics in America, and had great difficulty in finding the GUACO. 275 true specific for the whole epidemic, and have been obliged to tumble about between the narcotic Solanae, the Rhus and mineral acids, and the patients have lingered, notwithstanding the greatest care, for weeks; this ought not to be so, and I hope if such epidemics ever appear again, the Gymnocladus will be found highly useful. If this should prove to be the case, all the labor and suffering of the provers will be insignificant in comparison with the relief of a single patient. If this happens next year, in ten or a hundred years, what is time?" The curious are referred to Dr. Hering's elaborate analysis of these provings, in the first volume of the N. A. Journal of Homceopathy, 1851. GUACO. This is one of those South American plants which possess curative virtues, doubtless of a specific character, worthy of our close study. The plants of the tropics are supposed to be far more virulent than their relatives of the temperate regions belonging to the same botanical family. This climbing plant, "liane," is known to botanists by the name of Mikania guaco. It has been asserted by some writers that there is a probability that the notorious " Cundurangu" is the same as the Guaco. The similarity in the alleged curative action of the two plants, and their similar appearance, doubtless gave rise to this supposition. The Guaco has been but little used in this country. I have never used it in my practice, nor do I know of any clinical experience with it in the hands of my colleagues. Dr. Elb, of Dresden, Germany, published provings and a pathogenesis of the medicine, but a translation has not been made. Dr. Elb recommends it very highly in spinal diseases, and gives us full indications for its use in those affections. These indications you will find in my symptomatology of New Remedies. Its action seems to be analogous to Lachesis, Naja, and Crotalus; it has a great reputation in South 276 GUARAEA —-HAMAMELIS VIRGINICA. America as an antidote to bites of venomous serpents. It has been used successfully in the treatment of cholera, syphilis, old ulcers, apoplexy, paralysis, etc. GUARAEA. This medicine is prepared from the bark of a tree growing in the Antilles, and called by the natives " Ball-wood." The pathogenesis published in the Symptomatology of New Remedies is made up from provings by Dr. Petroz, of Madrid. Its sphere of action, as deduced from the symptoms, would appear to include the brain and spinal cord, upon which it acts as an irritant. It also acts upon the bones, and the mucous surfaces of the respiratory organs. It has a direct affinity for the nerves of the larynx, and in this respect resembles Lachesis, Drosera, Corrallium, Ipecac and Belladonna. It somewhat resembles the remedy last named, the Guaco, in its similarity to the symptoms of serpent-poisoning. Among the diseases which it' is said to cure are: spasmodic cough, asthma of Millar,.conjunctivitis, lupus, dysentery, foetid lochia, inefficient labor pains, menorrhagia, chronic constipation, intermittent fever, dry eruptions, hysterical tetanus, convulsions of children, paralysis, and caries of the bones. I am not aware that American physicians have used the Guaraea, to any extent, and I have had no personal experience with it. HAMAMELIS VIRGINICA. This is an indigenous shrub, sometimes called Winterbloom, Snapping-hazelnut, Spotted Alder, etc. It consists of several crooked, branching trunks from the same root, from one to two inches in diameter, ten or twelve feet in height, and covered with a smooth, gray and spotted bark. It is a much larger shrub than the edible hazel-nut, which has a straight trunk, not spotted, but brownish. The Hamamelis virginica grows in almost all sections of the United EHAMAMELIS VIRGINICA. 277 States, especially in damp woods, flowering from September to November, when the leaves are falling, and maturing the seeds the next Summer. The bark and leaves are the parts used in medicine; they have a pleasant, aromatic odor, and a bitter, astringent taste, leaving a sense of pungency and sweetness in the mouth. Water extracts their virtues. The shoots are used as "divining rods" to discover water and metals under ground, by certain adepts in the occult arts. They have been used, also, by certain superstitious quacks, for the cure of old ulcers, etc., by rubbing them on the diseased surface. Strange as it may seem, cures are alleged to have been made in this manner. There has always been a large amount of superstition connected with this shrub. The popular preparation known as " Pond's Extract of Hamamelis," is made from the leaves and twigs, by a process of distillation. It is now used by all schools of medicine as an anodyne application. It can not be expected, however, that it will relieve or benefit all the diseases mentioned on the extensive labels of the manufacturer, and the physician who pins his faith thereupon will be disappointed. The portion used in medicine is the bark of the branches and roots. The leaves and small twigs contain a proportion of the qualities of the shrub. A concentrated principle is obtained from the bark, and known as Hamamelin. It does not contain all the properties of the tincture. The article known as "Pond's Extract," also the "Distilled Extract," prepared by some pharmaceutists, is largely used in our school, administered internally as. well as by external application. For internal use, however, we should use the tincture of the fresh bark. The Hamamelis has been used in Homceopathic practice for about twenty years. Several physicians claim the honor of introducing it into our practice, among whom are Hering, Okie and Preston. I believe Dr. Okie was the first to write concerning the medicine, but he says Dr. Hering first called his attention to the remedy. Dr. Hering, it seems, became acquainted with its alleged virtues while attending Mr. Pond, the manufacturer of the 278 HAMAMELIS VIRGINICA. " Extract " which bears his name. Dr. Okie says —" Hering proceeded at once, by scientific trials, to discern for himself whether the remedy did or did not possess any or all of the virtues attributed to it by the proprietor." Dr. Hering recommended it for "chronic effects from mechanical injuries,"-" painful and bleeding haemorrhoids," —" severe pleuritic stitches supervening on tubercular phthisis." He thinks it is like a " union of Aconite and Arnica." The various provings of Hamamelis —although none of them are as full and thorough as they ought to be —together with the extensive clinical experience with the medicine in all its preparations, has greatly enlarged our knowledge of its sphere of action since its first introduction. That sphere of action is, however, very limited. Its action seems to be confined almost altogether to the venous system of blood vessels. It may be called the Aconite of the veins — acting upon those vessels as Aconite acts on the arteries. Its primary action appears to cause a spasm of the vaso-motor nerves which supply the veins (if a drug is capable of causing spasm of those nerves, and not, at the same time, those of the arteries.) It also acts as an irritant to those vessels to such an extent as to cause a condition favorable to, if not actually ending in inflammation of their coats. The secondary action leads to the other extreme, and we have paresis of those nerves, and thence paralysis of the coats of the veins, leading to varicosis, venous congestion, heemorrhages, and even structural lesions. It is primarily homceopathic, then, to phlebitis, not only of the venous system generally, but of the venous system of the lungs, and the venous side of the heart. It is also indicated for certain anomalous pains (supposed to be neuralgic) which arise from diseases of the veins. In these diseases it should be used internally in the medium dilutions, and not very strong, externally. It is homceopathic, secondarily, to venous congestion or stagnation; to dilatation, paralysis, and rupture of the coats of the veins; to varicose ulcers; and many diseases depending on venous obstruction. HAMAMELIS VIRGINICA. 279 When I enumerate the various disorders for which the Hamamelis is recommended, you will see that they call nearly all be included under the above category. Dr. Hughes, one of England's most acute medical observers, gives in the following quotation, some symptoms brought on by its use. They seem to show that in causing contraction of the veins of the head, it indirectly caused some arterial engorgement, a condition not unlikely to follow arrest of venous haemorrhage. Dr. R. Hughes, in giving his experience with this remedy, says: " I have the greatest confidence in Hamamelis in phlebitis, in the various forms of varicosus, and in venous haemorrhage. It is not always successful in phlegmasia alba dolens, but there is good reason to believe that in this disorder the mischief is as often in the,lymphatics as in the veins. In varicose veins of the leg, I conjoin its external with its internal use, laying strips of calico soaked in a weak lotion of one part to twenty, along the enlarged vessels, and supporting all with a bandage. The pain is relieved and the veins much reduced in size. In' bleeding piles' the first or second dilution of Hamamelis is a most valuable remedy. In passive haemorrhage from all parts, whether nose, lungs, stomach or bowels, I have the utmost confidence in its use. I think that the hsemorrhages it cures depend rather upon the state of the blood vessels, than on that of the blood. Its value in varicosus, and the absence of any report of its curative action in purpura, point in this direction. The following, moreover, is a case in point: I was treating a young lady suffering from a complication of disorders, amongst which were almost daily epistaxis and throbbing headache. To check the epistaxis, I put a few drops of the mother tincture of Hamamelis in a tumblerful of water, and ordered a desertspoonful to be administered alternately with the China, which was being administered for the headache. The first dose of Hamamelis was followed by a flushing of the face, the most distressing throbbing, aching, and sense of fullness in the head. These symptoms gradually subsided, and the 280 HAMAMELIS VIRGINICA. intermediate dose of China was taken without any appreciable result. The second dose of Hamamelis, however, was immediately followed by the same symptoms as at first, the head feeling as if it would burst. I stopped the remedy, and the epistaxis recurred next morning as usual. In a day or two I resumed it, giving it in the third decimal dilution. Again the dilatation of the cerebral vessels took place, though the symptoms were not as severe as on the first occasion. This patient has been very sensitive to all medicines, but I see no reason to suppose the effect of Hamamelis upon her to be exceptional otherwise than regards quantity. " In menorrhagia, I think Hamamelis less often useful than Ipecacuanha, Sabina and Secale. In haematuria, also, it yields to Terebinthina and Ferrum muriaticum; probably because this haemorrhage is dependent more frequently upon the state of the renal or vesical tissue, than upon that of their blood vessels." Of the remedies mentioned by Hughes as controlling haemorrhages, none effect directly the veins as does Hamamelis. Of its real action on the brain we know but little. It may be supposed, from analogy, to cause the same conditions there, as elsewhere. Dr. Hughes's experiment seems to prove that some arterial congestion may be temporarily caused by it. The symptoms would seem to indicate a condition of passive congestion, or venous stagnation. In headache, preceding epistaxis, this may prove an excellent remedy. Many cases are only relieved by bleeding from the nose. The Hamamelis acts by removing the cause, and in this manner arrests the bleeding, if present, and removes the condition upon which it depends. We have but little clinical testimony as to its value in cephalalgia. It will probably never be found as useful as Belladonna, Aconite, or Gelseminum. We have found in the various journals, nearly a hundred cases of epistaxis, some of them of an alarming character, which were promptly arrested by the use of Hamamelis in some form. Dr. Belcher cured a severe case in a boy aged fourteen, with Hamamelis 3d, one-eighth of a drop. The bleeding had not returned several months after. HAMAMELIS VIRGINICA. 281 Dr. Preston, in an article on venous hemorrhages, writes: "Epistaxis, or bleeding from the nose, forms the most common htemorrhage of childhood, and in a great proportion of cases is simple and perfectly harmless. When it is dependent upon active congestion it is usually arterial, and proves its own remedy; when it is the result of mechanical congestion, or forms one of the developments of the haemorrhagic diathesis, it is passive and probably venous." Dr. P. gives an interesting case, illustrating its treatment with Hamamelis. " An old gentleman, hemiplegic, who had been subject to occasional attacks of haemorrhage from the nose, often profuse and very debilitating, and on several occasions requiring Mr. Abernethy's operation of plugging the nostrils, before it could be stopped. He had now been afflicted at intervals of several days with slight oozing of very dark blood from the Schneiderian membrane, particularly three times a day shortly after meals, corresponding to the rythmical exac erbation of the pulse; after the afternoon meal the bleeding was very profuse. He was able to walk about, but complained of feeling very weak and faint, with occasional vertigo or confusion of ideas; his countenance was pale, and his pulse decidedly haemorrhagic. I ordered him home, and to keep perfectly quiet; to use a strong nourishing diet, with wine at each meal, and gave him China and Hamamelis 3d, in alternation every two hours. I was sent for to his house in the afternoon and evening, and the bleeding had been almost constant, but slowly oozing from his nose since he got home; by evening he was too weak and faint to sit up, but lay in bed with his head raised; gave China and Hamamelis 1st. The haemorrhage increased, however, all the next day, when small pieces of linen were wet with Hamamelis, and rolled funnel-shaped and pushed up the nostrils. No more haemorrhage, and in three days he was able to go about his business." It has been used with benefit in hcemorrhage from the buccal cavity, and that form which occurs after extraction of the teeth. Also for scalding of the tongue and mucous membrane of the mouth and fauces. 19 282 HIAMAMELIS VIRGINICA. Dr. Holcombe once reported two cases of conjunctivitis, treated successfully by Hamamelis internally, and as a collyrium. In one case it was caused by the contact of a "puff of flame," in the other by a " splinter in the upper palpebral conjunctiva." It would seem to be indicated for the effects of injuries to the eye. In whooping cough, the eye-ball becomes congested from the violence of the concussion, and small vessels are ruptured, Hamamelis soon dissipates these extravasations. Pond's extract has quite a reputation for black-eye from a bruise. There is a condition of the fauces and throat, which might not inaptly be designated a varicose angina, the posterior fauces, uvula, and pharynx are of a bluish hue, caused by distended veins which ramify on the surface; this causes a fullness, with cough, and pain on swallowing, and sometimes hawking of dark colored blood, mixed with mucus. In cases of this character the internal and topical use of Hamamelis proves curative. In hoematemesis, when the blood is dark and grumous, and arises from derangement of the liver or spleen, this remedy, in appreciable doses, will promptly arrest it. In haemorrhage from the stomach, from ulceration or other causes having a local origin, I prefer Sulphuric acid. In melcena, or haemorrhage from the bowels, it is not useful unless caused by a congestion of the portal system, either direct or indirect. Such hemorrhages often occur during the progress of hepatic derangements, and arise from ruptured portal veins. The haemorrhage may come from high up in the intestines, or what is more commonly the case, from the haemorrhoidal veins. In fact, it is in congestion, inflammation and bleeding of haemorrhoidal vessels that the Hamamelis has gained its greatest popularity. It is prescribed internally in doses suited to the severity of the case (a less quantity in inflammation and congestion than in actual hemorrhage), and a lotion of Pond's extract, or dilute tincture applied ex IIAMAMELIS VIRGINICA. 288 ternally, or injected into the rectum. It is claimed by electics that this anti-hmmorrhagic power is due to the large percentage of Tannin it contains. In 7,000 grains organic and inorganic matter found in the bark, 400 grains is Tannin, 1,038 is a "particular bitter principle," and the balance consists of the ordinary solids found in all vegetable substances. The chief medicinal power doubtless lies in the bitter principle. The Tannin plays but an unimportant part in the curative action, for Tannin alone, nor Gallic acid have any such specific action on the system. Dr. Preston asserts that he succeeded in checking hoemorrhage front ulcerating carcinoma of the bowels, by means of this remedy. In certain kinds of dysentery, many physicians use it with good results. The testimony is, however, that the blood is usually dark, in clots or patches, scattered through the mucus. (On the contrary, in the dysentery of Ipecac, Aconite and Erigeron, the blood is bright red and often fluid.) In kcemorrhoidal dysentery, which is really a phlebitis of the haemorrhoidal vessels; the Hamamelis is truly specific. In this disease it rivals Aloes, with which it possesses many qualities in common. In diarrheca, the Hamamelis is said to have been found useful, but the indications for its use are not ascertained. It will require more extended provings and clinical experiments, to establish its applicability to diarrhcea. I would suggest that it might be useful in mucous and serous discharges, arising from derangement of the portal system. It is in hcemorrhoids that the Hamamelis has achieved some of its greatest victories. It seems to have extraordinary powers over this disease, not only as externally manifested in the form of hmmorrhoidal tumors, but against the primary cause, which is often located in the portal system. It has been used in this affection from the earliest history of our country. The aborigines first imparted a knowledge of its curative virtues to the first settlers. It is mentioned as a remedy for piles, used externally, in the works of the early 284 HAMAMELIS VIRGINICA. " Botanic" physicians. When Pond first sold his extract, it was recommended particularly for this complaint. Dr. Hering was Pond's family physician, and was induced by him to try its efficacy in some diseases. In 1850, Dr. Hering informed Dr. Bushman, a pupil of Dr. Okie, that he had used it successfully in "painful and bleeding hemorrhoids." Dr. Okie was then induced to try its virtues, and in a letter to Hering, published in 1853, he says: "I next made use of the Hamamelis in a number of cases of painful and bleeding piles. Those cases in which it has proved most beneficial in my hands, are characterized by burning soreness, fullness, and at times, rawness of the anus; in the back a weakness or weariness, or as the patients graphically express it,'Doctor, my back feels as if it would break off.' The haemorrhage is generally profuse, and I have in several instances seen this latter symptom cured completely, with shrinking of the overloaded haemorrhoidal vessels so that the full, pouting look of the anus was changed to its own more natural, demure pucker, while the burning and itching, depending more upon cutaneous irritability, or some herpetic taint, still remained. I have here, likewise, made a wash of the remedy, applying it externally, while giving it internally in the more dilute form. Mr. T., a highly respected agriculturist, somewhere in the fifties, had been troubled with painful and bleeding piles for a number of years. On examination, I found the anus surrounded with a crop of tumid hemorrhoidal veins, bluish in color, and the whole anus encircled with a red, erythemic halo. I found that he suffered with'backache,' has a'pasty' mouth, digestion tolerable, was not much constipated. I gave Hamamelis, first dilution, six drops night and morning, and applied a lotion of one-third of the remedy and two-thirds distilled water. In a fortnight he called again, and I found him much relieved. I repeated the prescription, to be taken once a day, since which time he has remained well." In haemorrhoidal troubles, the true analogues of Hamamelis are Aloes, iEsculus, Collinsonia, Nux vomica, Sepia, and Sulphur. It is used externally as a cerate, ointment, and lotion, and at the same time prescribed internally. HAMAMELIS VIRGINICA. 285 I do not believe it capable of curing long-standing cases of. hemorrhoids, even when they are not of a character requiring surgical treatment, and for the reason that Hamamelis is not a medicine that affects the system deeply or profoundly; its effects do not tend to assume a chronic character. In the treatment of chronic cases, its proper sphere is that of an aid to the profounder curative action of Nux, Sulphur, Nitric acid, and Podophyllum. In this respect it resembles 2Esculus, Aloes, and Collinsonia. Its action on the urinary organs has not been sufficiently studied. Does it cause and cure the same conditions in the kidneys, that it does elsewhere? Is there a venous engorgement of the kidneys calling for its use? Can we diagnose a venous hbematuria from one of arterial origin? Is there a phlebitis of the kidneys? Is Hamamelis indicated in any stage of Bright's disease? I confess I am unable to answer these questions. Nor can they be answered till we shall poison animals with Hamamelis and then make minute dissections and microscopical examinations of those organs, as Dr. Jacobi, of New York, did in his experiments with Turpentine. Many cases of hcematuria and " bloody urine" have been reported cured by Hamamelis, but of their exact nature we are ignorant. I prefer Millefoil, Turpentine or Gallic acid. I doubt its value in any inflammation of the bladder or urethra, although it is recommended in strangury and irritable urethra. In some of the disorders of the organs of generation of women, it has been found curative, namely: in some cases of metrorrhagia, and vicarious menstruation. When the metrorrhagia occurs midway between the menstrual periods, and the blood has all the appearance of venous blood, or h as been preceded by venous plethora, it is specific. It may be useful in menorrhagia when the same abnormal condition precedes the flow, but in simple excess of the menses it is not indicated. When the vicarious discharge is from the lungs, bowels, or hemorrhoidal vessels, here too is the Hamamelis indicated. 286 HAMAMELIS VIRGINICA. In leucorrhcea it is a domestic remedy which has always been popular. It is generally used in the form of a decoction of the bark and leaves, or as Pond's extract. Many of my patients habitually resort to one of the distilled extracts now in use, as an injection in leucorrhcea. Dr. Paine (eclectic) says he has known Hamamelis to cause "violent contractions of the vagina and a smarting, burning sensation followed by prurigo." He asserts that it will cure "irritations of the vagina." Taking this as an indication, I have tried this remedy in vaginismus. It did not cure my cases, although the patients thought it gave some relief from the abnormal sensitiveness when used as an injection or in the form of a cerate. In pruritus, Pond's extract will often give relief when used as a wash, but it is not as effectual as a lotion of Borax or Carbolic acid. Dr. Okie first used it in ovarian diseases. He reported a cure of ovaritis from a blow on the abdomen. There were violent pains, at times, in the swollen and tender ovary, at other times radiating all over the abdomen, producing an agonizing soreness; menses irregular, with aggravation of the ovarian pains at the period. There was also exquisite tenderness of the vagina and os uteri, the latter very sensitive and swollen, as was the ovary when touched per vaginum. It has become a very popular remedy, both internally and as a lotion, in all kinds of ovarian disorders with tenderness, pain and swelling. You will not find it a specific in all cases, or any large proportion of them. The special pathological condition of the ovary calling for Hamamelis, can not at present be definitely stated, but it occurs to me that it may be some trouble with the veins which return the blood from those organs. Dysmenorrhcea has been treated successfully with Hamamelis, according to Burnett, Pattison, and some others, but I have not heard of its use of late in that disorder. Caulophyllum, Xanthoxyllum, and Viburnum are so. superior to it that it has probably fallen into disuse. Dr. Pattison, of England, makes a curious assertion that HAMAMELIS vrIGINICA. 287 Hamamelin possesses a peculiar power almost sui generis, in assuaging the pain, and preventing the periodical sufferings, while the tincture possesses none of this power. It is not easy to understand why an " active principle" of a plant can possess power differing from the tincture. You will find one of the extracts very useful in allaying the pain and tenderness of varicose veins in the limbs of pregnant women. I have seen equally good effects from its use, internally and topically, in phlegmasia alba dolens, when the pathological condition is a phlebitis, and not a lymphangeitis. The two conditions are often confounded, for, as Dr. Preston says, milk-leg is as often an affection of the lymphatics as the veins. As might be expected, the Hamamelis affects the organs of generation of men. The testicles are homologous to the ovaries, and it has a deservedly high reputation in orchitis when arising from injuries (where it rivals Arnica), or from idiopathic inflammation. It is not as useful in orchitis from metastasis of gonorrhoea, in which case Pulsatilla and Clematis are more appropriate. The symptoms in Burts' proving indicating its use in spermatorrhoea have not been verified, and unless turgescence or inflammation of the spermatic veins is at the bottom of the disorder, I do not imagine it will prove useful. In neuralgia of the testicles, as well as ovarian neuralgia, it may prove palliative, but I have not known any cures performed by Hamamelis. Cirsocele, or varicosis of the spermatic veins, has been treated successfully by lotions of Pond's Extract, or dilute tincture, the same being given internally. If there is such a disease as pulmonary phlebitis, as suggested by Preston, who surmises that many cases of " quick consumption" are of that character, the Hamamelis ought to prove curative for it. He supposes it to arise from local injuries to veins in distant portions of the body, or to the absorption of pus into the veins. In the former case I would advise it to be alternated with Arnica; in the latter with Carbolic acid. 288 HAMAMELIS VIRGINICA. Hamamelis has cured cough and hammoptysis, with a taste of Sulphur in the mouth, and dull, frontal headache. Also, "tickling cough, with a taste of blood on waking." In hcemoptysis it is considered by some to be a remedy par excellence, applicable to nearly all cases; but this is going too far. It can never take the place of Aconite, Collinsonia, Cactus or Lycopus. Dr. Preston (Diseases of Veins) says: "In general, we look upon Hamamelis as a specific for passive venous hemorrhages, and we have seen it successful in arresting this particular form of bleeding from the pulmonary mucous membrane; but we speak from only a few years' experience, and that of a few observers, and therefore we must be impartial enough to mention a few of those remedies which other practitioners have recommended as useful in the cure of some forms of hlemoptysis: Aconite, Ipecac, Ferrum aceticum, Arnica, Millefoil, etc. Dr. E. M. Payne reports the following case: A young lady, aged sixteen, was seized while at school, and without any premonitory symptoms, with blood-spitting. The patient was of slender build, light hair, blue eyes, fair complexion, lax fiber and phthisical diathesis; menses regular and normal. The blood-spitting commenced with a slight hack, and continued with scarcely a moment's intermission, up to the time of my visit, a period of nearly an hour. I found her lying upon a sofa, calm, with a napkin in hand nearly saturated with apparently pure venous blood, and spitting about the amount of a teaspoonful at intervals of one or two minutes. The blood came into the mouth without any effort. She described it as issuing about ten inches below the right clavicle, in a warm current, making apparently a tortuous course, and at the same time there was a sensation in that region, as from the pressure of a hard body. Pulse somewhat acceleratedeighty-five. Ferrum aceticum was given, but caused no improvement in three hours; Millefolium, Aconite, Ipecac and Belladonna caused no amelioration. Hamamelis, four drops of the tincture to half a tumbler of water. A spoonful was given. The bleeding immediately ceased, and did not afterwards return. I have never used the Hamamelis success HAMAMELIS VIRGINICA. 289 fully, in cases of blood-spitting when the blood was of light red fluid, frothy in appearance, or raised by much cough." Do not forget the value of Hamamelis in hamoptysis, when it is vicarious, from non-appearance of the menses, alone or in alternation with Senecio. The greatest triumph of Hamamelis has been in the treatment of varicosus of the limbs. Dr. Preston, writing on varicosus, remarks: " Homoeopathy has, as in many other cases, directed us to a specific remedy, which in my practice, as well as in that of a number of my colleagues in this section of the country, has been attended with uniform success in the treatment of this annoying disease. Since 1851 (six years), I have prescribed Hamamelis in upwards of fifty cases of varicose veins of the lower limbs, and in no single case has it failed to make a decided curative impression; but in the great majority of cases, it has thus far, at least, proved a radical cure. My plan is: First, to bandage the limb tightly, from the arch of the foot to a little above the knee, or to the hips, if the varices are above the knee, and the best bandage, in my opinion, is an elastic silk stocking, manufactured for the purpose. Under this, compresses of linen are laid over the dilated veins, and kept wet with Hamamelis tincture, or Pond's extract. I give the 3d dilution internally, two or three times a day. Some few cases, with large, indolent ulcers on the tibia or malleolus, have been under treatment a year, but most of them have been cured, or at least have disappeared, in less than half that time. The crowning point of its virtues (Hamamelis) rests in its peculiarly prompt action in, cases of phlegmasia alba dolens, and in varicose veins. In old cases of varicosus, I have never seen its equal, and have cured many cases of varicose veins of the leg and foot, which had resisted all other treatment for years." Dr. Belcher reports several cases of varices, in pregnant women, cured by Hamamelis. (See cases under "Organs of Generation of Women.") Dr. Barrows found this remedy a valuable auxiliary in the treatment of a child with the following symptoms: "Inflammation of the femoral vein, with 290 HECLA LAVA. the erysipelatous spot near the groin, and over the vein, spreading over nearly one-half the thigh, with flexion of the leg; swelling of the entire leg and foot, with tension; heat and pale appearance of the limbs; scanty urine, stiffening the linen (albuminous); tympanites; ocdema of the whole body, limbs and face. Calcarea, Hepar sulphur, and other remedies were used. (See case in full, in the North American Journal, vol. vi, page 317.) The Homoeopathic Review for April, 1864, contains a case of phlebitis, reported by Dr. H. Robinson, Jr., cured by Hamamelis. The symptoms were: "Great pain in the right leg, from the knee to the hip; leg much swollen, and quite sensitive to the touch. The cutaneous veins were hard, knotty, swollen and painful. The skin erysipelatous; pulse small and wiry; much thirst and no appetite; bowels costive; urine red and scanty; veins of the abdomen hard; like cords, red and painful. Gave Hamamelis 1st, five drops in half a goblet of water." Cured in ten days. Some physicians consider the Hamamelis of the greatest advantage in all cases of articular rheumatism with swollen and painful joints; as a local application, it seems to possess decided anodyne properties. They advise that cloths or cotton wool, wet in the dilute tincture, be applied constantly to the affected parts. I do not believe it has any curative power over rheumatic affections. The remedies most closely allied to Hamamelis in haemorrhages, are Lycopus, Collinsonia, Trillium and Pulsatilla. HECLA LAVA. This medicine, made by triturating the lava thrown up from Mount Hecla, was first introduced into practice by Dr. Wilkinson, of London. He narrated his experience in a letter to Dr. Holcombe, who read the letter before the American Institute in 1870. It appears, according to local observers, that the horses, sheep, cows, etc., in the vicinity of the mountain, became HEDEOMA. 291 diseased from eating the herbage upon which the scoriae had fallen. It affects the bones principally, causing immense exostoses, caries, etc., particularly of the bones of the head, jaws, teeth and legs. It has been used successfully in both high and low potencies in similar diseases, by Drs. Holcombe, Helmuth, Cate and Thompson. I have had no experience with the remedy. HEDEOMA. The plant which I allude to under this name and its common name Pennyroyal, is not the Mentha pulegium of Europe, also called Pennyroyal, but the Hedeoma pulegioides, or American Pennyroyal. It is a little singular that since the publication by Dr. Toothacher of the interesting and serious case of poisoning by the oil (see Philadelphia Journal of Homoeopathy, vol. ii., p. 18), and since my mention of it in New Remedies ten years ago, no clinical experience with it has been published in this country. I believe it has been used by some English homceopathists. I have used it in some disorders of women, in which I believe it rivals Sabina. If you will study the pathogenesis or characteristic symptoms, in Vol. 1., you will see that it corresponds to many symptoms of uterine disorders. The most popular uses of the Oil of Pennyroyal are for suppression of the menses, flatulent colic, and effects of a cold. It has been resorted to for the criminal'purpose of causing miscarriage, as in Dr. Toothacher's case of poisoning. The symptoms evolved by the case referred to indicate that it is primarily homceopathic to dysmenorrhoea, threatened abortion, uterine spasms, uterine hcemorrhage, and acrid leucorrhoea. I make no doubt it is secondarily homceopathic to those conditions in which it is so much used as a domestic remedy, namely: suppressed menses from a cold, suppressed lochia, and passive congestion of the uterus and ovaries. I am inclined to believe that it affects the spinal cord, as an 292 HEDEOMA. irritant in a manner similar to Turpentine and Tanacetum, and that it affects the uterus through the spinal nerves. The uterine symptoms are quite notable; e.g., "excessive bearing down pains with pressure outward from the whole lower abdomen to the utero-vaginal region; drawing down from the upper sacral spine to the uterus, also from the epigastrium; these pains periodical, like true labor pains, and almost unendurable, greatly aggravated by movement, and attended by a sense of weakness or paralysis in the limbs; leucorrhcea itching and burning; discharge yellow, excoriating; soreness and excessive sensitiveness to pressure over both ovaries." You may find it curative in ovaritis from suppressed menses, or from miscarriage. The symptoms of the urinary organs are quite important, showing it to be an analogue of Turpentine, Cantharis, Erigeron, etc. It caused suppression of urine; tenesmus; painful urination; scanty urination, with frequent and urging desire; cutting, burning pains in the urethra, or at the sphincter urinarius; sense of weight when passing water; urine very dark, like black tea. It seems to have caused inflammation of the kidneys and bladder, in fact the whole urinary apparatus. Such inflammatory conditions usually attend metritis and ovaritis. The last symptom-" very dark urine, like black tea "-indicates that blood was present in the urine. Such urine is very common after scarlatina, and indicates serious disease of the kidneys. It may prove useful in urethritis, gonorrhoea, gleet and orchitis. It may prove useful in lumbago, in paralysis of the lower limbs from reflex causes, as uterine or renal disease. It certainly relieves the flatulent colic of children and adults, and may be as useful as Turpentine in tympanites, whether from intestinal disease or uterine inflammation. The dose will vary with the symptoms. For its primary effects, use the 3d to 6th dilutions of the oil; when indicated secondarily, use the 1st or mother tincture from the plant. HELONIAS DIOICA. 293 HELONIAS DIOICA. It is to be regretted that botanists are frequently changing the generic names of plants. This plant has had four names; the present one, sanctioned by Prof. Gray, is Chamwelirium luteum. I propose not to change its name, as it would cause more confusion with physicians than with botanists. In the first volume you will find an account of its common names, which are, unfortunately, the same as those given to the Aletris farinosa. Provings have been made by Drs. Burr, S. A. Jones, Clark, and Paine. The latter authority is an eclectic, who gave it in large doses. He says: " When taken in doses from five to fifteen grains it acts as an emeto-cathartic, producing a griping, burning sensation in the epigastrium, and great activity of the salivary glands. Indeed, I have known the most perfect salivation to follow the use of large doses of Helonin. In doses of from one to five grains it produces an irritability of the stomach, and slight purging, with a burning sensation in the 1bowels, irritation of the urethra, pain in the kidneys, which is followed by albuminuria, indicating congestion, and large discharges of urine, with slightly increased specific gravity." It is to be regretted that such vague, general terms were used in the above. Had the symptoms been more minutely described, the observations would have been much more valuable. The remedies which the Helonias most resembles may be named in the order of their similarity: Aletris, Eupatorium purp., China, Ferrum, Hypophosphites of Lime, etc., Hydrastis, Phosphoric acid, Senecio, Sepia and Lilium. Although used extensively, and very popular with our school, it has not been sufficiently proven by women, whose organisms are most profoundly affected by it. CLINICAL OBSERVATIONS. —This medicine is a peculiar and powerful "tonic," or, as Headland would have it, "restorative." It is considered particularly indicated when the 294 HELONIAS DIOICA. disease has proceeded (1) from diseases of the generative organs, (2) or from functional disorders of the stomach; hence it is considered valuable in anemia and chlorosis, in alternation with Ferrum; and in dyspepsia, in alternation with Nux vomica if indicated. It does not belong to the China group, because it has no anti-periodic powers; nor does it cause a hyper-stimulation of the nervous and vascular systems like that powerful drug. Neither does it have much more affinity for the Nux vomica group, for it does not irritate the spinal system. It is more allied to the phosphates of Iron than any other article of the Materia Medica, while at the same time it has some points of resemblance to the members of both groups above referred to. China and Nux vomica, together with their analogues, cause a condition which may be described as increased tonicity of muscular fiber. China brings about this condition through its influence upon the processes by which the blood is formed; it probably tends to augment the quantity of that fluid, and to render it richer. Thus, by its own operation upon the nutrition of the heart, and through the agency of the enriched blood, it gives greater energy to the contractions of that organ; and hence the fuller and stronger pulse not unfrequently resulting from its moderate use. But in anaemia, chlorosis and some other conditions of the system, China will not improve, apparently, the condition of the blood, or at least the tissues do not respond to the stimulus of the improved blood. Then it is that Ferrum, or Nux vomica, given alternately with it, will place the diseased tissues in a condition to be benefited by the circulating fluid, and a cure is soon effected. Nux vomica increases the tonicity of tissues, mainly through its influence upon the spinal system. It is a spinal stimulant, and nearly all its therapeutic effects arise from this action. In a great many cases of atony of any organ or tissue of the body, this medicine will, alone, effect prompt and permanent cures; but, like China, it will sometimes fail, unless superseded or assisted~by the action of China or Ferrum. There are also other instances wherein China, or Ferrum and Nux vomica, will fail to improve the HELONIAS DIOICA. 295 abnormal conditions for which they seem indicated, and the Helonias will here come in play an1 be found very useful. Helonias enriches the blood, through its influence upon the nutritive processes; not as Iron does, for Iron is a metallic substance, and a vegetable substance can not act in the same manner. But Helonias does not act like China or Quinine, for the latter stimulates by its direct, primary action, while the former does not. Dr. S. A. Jones says: "Of its efficacy in chlorosis and anaemia I have no positive data; but there is one condition of blood-degeneration wherein Dr. J. A. Macomber employs it with unequivocal benefit, namely, in that profound debility which follows an attack of true diphtheria." Helonias has also an affinity for a group of remedies, among which stands prominently Terebinthina, Copaiva, Cantharis, Erigeron, Phytolacca, Mercurius, Mitchella, etc. The point of analogy is its action on the urinary organs, causing, by hyper-stimulation, congestive albuminuria and chronic irritation. A medicine capable of effecting'great changes in the nutritive processes must have some general action on the glandular system. The specific action of Helonias on this system is undoubted. We find that it causes excessive irritation of the salivary glands; excites the glandular system of the stomach, increasing its power of digesting and assimilating food; irritates the kidneys to the extent of causing diabetes and albuminuria, and its action on the genital organs of both sexes indicates that it acts not alone on the muscular structure, but increases the action of the ovaries, testicles and glandular structure of the cervix uteri and vagina. It will probably be found to act on other glands, as the prostate, inguinal, mammary, pancreas, etc. Its action on the muscular system is not primary, but a result of the increased nutrition brought about by the remedy. The action of Helonias on the nervous system I believe to be generally of a reflex character, or secondary. It is reflex when we have, from its pathogenetic action, an 296 HELONIAS DIOICA. irritation of the urinary and genital organs. It is secondary when from the hyper-stimulation of those organs the nervous system has been hyper-stimulated so long that it becomes exhausted, and weak and irritable. The same may be said of the mental symptoms of the drug. In its action on the mind and nerves it resembles Sepia, Pulsatilla, Platinum, Lilium and perhaps Cimicifuga. It differs from Lilium in its "desire for solitude." It differs from Cimicifuga in not causing choreic movements. You will do well to study its nervous and mental symptoms in comparison with those of the remedies above named. It is a notable fact that the primary mental state caused by all these medicines is one of cheerfulness, followed by a condition of continuous depression (Cim., Sep.), or alternate, depression and exaltation (Plat., Lil., Puls.) The head symptoms remind us of Cimicifuga and Sepia, for the pains press from within upward, while the pains of Platinum and Ignatia are from above downward. It seems to affect the occipital region, for it has " occipital headache with throbbing in the vertex, increased by stooping, and attended by vertigo." This form of headache often attends uterine complaints. In large doses, it causes intense irritation of the stomach, with burning pain, vomiting, and salivation. It ought to prove curative in both idiopathic and reflex gastric irritation. (Subacute inflammation, and vomiting of pregnancy.) A thorough proving would doubtless show that this medicine produces a long train of symptoms, beginning in hyperstimulation and ending in atony. I have found it very useful in idiopathic diseases of the stomach, and especially in those sympathetic gastric disorders, which accompany uterine and renal diseases. Loss of appetite, eructations, fullness, cramp and painful congestion, with lowness of spirits, are the chief indications for its employment. The gastric symptoms resemble those of Aletris, and it has cured similar conditions. It has arrested the " obstinate vomiting occuring in dropsy;" the dropsy was doubtless the result of Bright's disease. HELONIAS DLOICA. 297 The enteric symptoms have not been brought out fully in any proving. It is said to cause catharsis, but the special symptoms are wanting. I think you may find it useful in some diarrhceas which attend renal and uterine disorders. It caused, in Dr. Jones' proving, a yellow and mush-like diarrhcea. The action of Helonias on the kidneys has received much attention and study from eclectic and homeopathic physicians-the former in a crude, unscientific manner, the latter ill a more careful and methodic way. Dr. Paine (eclectic) asserts that it causes congestion of the kidneys with albuminuria, and claims to have cured albuminuria and glycosuria with Helonias. Some homceopathic physicians claim nearly the same power for it, and cures of diabetes, albuminuria and desquamative nephritis have been reported from its use. In Dr. S. A. Jones's experiments, he observed several facts that are worthy of notice: (1.) That it is one of the few agents that can render an alkaline urine acid. (2.) That it increases the daily amount of urine. (This increase he thinks is secondary, and that the primary effect is to diminish the renal excretion. This will explain why diabetes and chronic albuminuria have been safely cured by appreciable (crude) doses.) He says "that Helonias is a diuretic in the same sense as Apocynum cann. which I am not prepared to affirm; that it is a renal stimulant I think may be safely assumed. Let not the term stimulant mislead. The Helonias stimulation is a condition of debility, venous paresis, the result of previous arterial tonic contraction." He adds, "When this remedy is in full action, the kidneys have a burning feel, and they ache — evidence, I take it, of venous congestion, retarded blood-flow; hence the urinary plus. If this be true the Helonias promises well in diabetes insipidus. The object of Dr. Jones' proving, he tells us, was, if possible, to cause saccharine or albuminous urine. To his disappointment, it caused neither! "The urine," he says,' 20 298 HELONIAS DIOICA. "was carefully examined with the microscope throughout the whole research, and the results show that the action of Helonias upon the kidneys is purely functional. There is no evidence of any epithelial desquamation or degeneration, and Helonias as a renal remedy may be classed with Cantharis and not with Phosphorus and Arsenic. This conclusion by no means negatives the possible usefulness of Helonias in cases of albuminous urine. Renal hypermemia alone can give this condition; hence the possible efficacy of Helonias." We may find another reason why he did not get albuminuria or desquamation. He did not take "ten or fifteen grains a day, for several days," as Paine gave, but only fourteen grains in all in four days - and not quite three ounces of the tincture during the whole proving of seven days. Had he doubled or trebled the dcses he might have got what he desired. Nor is it necessary that we should get albuminuria or saccharine diabetes from proving a drug, in order to use it as a remedy in such affections. In a paper on Helonias, in the N. A. Journal of Homceopathy, May, 1875, Dr. S. A. Jones gives as a result of his recent studies of this remedy, his views of its action in diabetes, as follows: " In the Helonias-diabetes this' defective glycocrypsis' obtains; that sugar which should have been stored up in the liver cells, as a preparation for ultimate heat- and forceevolution slips through this gland, escapes organic chemolysis, and accumulating as a purposeless product, it blocks the by-ways of life, and yet again the unceasing vigilance and fidelity of the scavenger is shown by saccharine urine. " This is the kind of diabetes in which the adoption of an animal diet and the exclusion of all the starches, effects the most remarkable diminution in the quantity of sugar eliminated; and it is the only diabetes mellitus in which I believe Helonias dioica will be found curative. " From this analysis of an incomplete research, I am led to believe that Helonias dioica is homceopathic to albuminuria, and to diabetes mellitus, although the objective pathog HELONIAS DIOICA. 299 nomnonic of these diseases was not evolved in the research, and although the recorded symptomatology of this remedy does not, this day, present a similimum of either of these diseases." We do not get Glycosuria from Nitrate of Uranium, yet clinical experience has proved it to be useful in such cases. All that is necessary is to cause a pathological state that is favorable for or will lead to albuminuria, or diabetes. Dr. Jones admits as much in his remarks above quoted. As to its action on the specific gravity, Dr. Jones' table shows that it lowers it. He thinks its primary effect is to increase the elimination of urea. He believes that if proven in the dilution, it would decrease it. "Taken in equal quantities, Helonias is the direct opposite of tea, coffee and cocoa. In their primary action, they retard the elimination process; Helonias does the same secondarily." Dr. Jones is not inclined to believe the Helonias is a true remedy in Bright's disease, unless it is in a stage which he terms an "ante-desquamation stage." As an example of such a condition, he gives a case with the following symptoms, which steadily improved under its use: " Lowness of, spirits, restlessness, burning aching in lumbar spine, frequent profuse perspiration, urine pale yellow, s. g. 1,013, acid, gets up two or three times nights to urinate, debility, palpitation when going up stairs, appetite poor, sleep difficult and not refreshing." He thinks it indicated in diabetes insipidus, dependent upon congestion of the lower third of the medulla spinalis; to which I would add, the diabetes nervosa of women with uterine disorder. We have but a few pathogenetic symptoms of its effects on the organs of generation of women. Dr. Clark, of Portland, Maine, asserts that he has noticed the following train of symptoms follow its use in six or eight cases (from Helonias 1x): Pain in the lower part of the back, through to the uterus, like inflammation, piercing, drawing; breasts swollen, nipples tender, and will not bear the pressure of even an ordi 300 HELONIAS DIOICA. nary dress; nipples very sensitive and painful; great uterine heemorrhage came during the proving, and continued until the medicine was discontinued. The Helonias is one of those indigenous medicines which, from the earliest days of medicine in this country, has had a peculiar reputation —first with the aborigines, then with the early white settlers, and finally with the medical profession in the country —as being a remedy, even the remedy, for those disorders generally termed " uterine," and which depended upon an atonic condition of the organs of reproduction. I regret exceedingly that I can not present the profession with a proving upon the organism of women. I have given it to healthy women, but never observed any notable symptoms. Primarily, it always increases the tone and physiological activity of the generative organs. I therefore consider it secondarily homceopathic to those conditions or diseases for which it has been used so successfully. Were it not so, it could never have been used successfully in the doses usually administered by the opposite school of practice. It would have produced aggravations, and been by them considered contra-indicated. Before giving the clinical experience of our own school, I will quote the opinions and clinical remarks concerning the remedy, which I find in the records of allopathic literature. Prof. Lee, an acute observer, says: "Numerous trials have satisfied us that it has a specific action on the uterine organs -an alleviative, regulating influence over their functions. Hence, in amenorrhaea, marked by general atony, and an anaemic and torpid condition of the system, this plaht proves of great service: giving tone to the digestive organs, favoring nutrition and sanguification, and promoting the secretions generally. So, in leucorrhoea, associated with similar conditions of the general system, it will be found equally serviceable. Its influence as a uterine tonic is also well marked in cases of atonic or passive menorrhagia. Here, by imparting tonicity to the muscular fibers of the uterus, and by a stimulating power over the plexuses of the organic nerves which supply the pelvic viscera, the HELONIAS DIOICA. 301 exudation of blood is checked, and the predisposing as well as the proximate cause of the disease removed. If it has the power of obviating sterility and impotence, as is-alleged by some writers, it must be by a similar mode of operation. It may be slightly aphrodisiac, but there are no well-attested facts bearing on that point. It is very probable, however, that it may, in common with Senecio and other uterine tonics, produce such effects; but if it does I have no proof of the fact, except what may be drawn from analogy. It is very probable, also, that in cases of dysmenorrhoea and liability to abortion, from atony of the reproductive organs, it may prove highly advantageous by a similar mode of action, just as we find in the case of Iron and other tonics which improve the general health. Dr. Coe is very enthusiastic. He says: "No agent of the Materia Medica better deserves the name of uterine tonic. The remarkable success attending its administration in the diseases peculiar to females, has rendered it an indispensable remedy to those acquainted with its peculiar virtues. Like the Senecin, it is alike appropriate in the treatment of diseases apparently calling for dissimilar properties, as for instance, amenorrhoea and menorrhagia. Its alterative and tonic influence will account, in a measure, for its utility in those complaints. In the treatment of amenorrhcea, it will be found most beneficial in those cases arising from, or accompanied with a disordered condition of the digestive apparatus, and an ansemic habit. It has an especial influence on the organs of generation, independent of its general constitutional influence. For this reason it has proved of eminent value in the cure of prolapsus uteri, tendency to miscarriage, and atony of the generative organs; sterility and impotence have also been relieved and cured by this remedy. "Certain writers have classed it as an aphrodisiac, and stated that its continued use induces an abnormal desire for sexual indulgence. Such a statement could only have been made in the absence of actual knowledge, and as the legitimate fruit of a prurient imagination. We have probably 302 HELONIAS DIOICA. used HIelonin quite as extensively as any other practitioner, and we must confess to a want of sufficient penetration to discover any such results from its employment. The only aphrodisiac we recognize, is the natural proclivity of a sensual mind. That the Helonin is a special tonic to the organs of reproduction we are well aware, but only to a normal and healthy extent. Did its action extend further than this, it would be a disease-producing and not a disease-curing remedy. When a medicine so acts upon a diseased organ as to restore it to a physiological condition, we very naturally conclude that said organ will manifest the fact of its restoration by the resumption of its functional activity. This is precisely the case when the Helonin is employed. If administered for the cure of indigestion, the appetite improves, the food is digested, absorbed and assimilated, and thus the curative action of the remedy is manifested. If, on the other hand, the case be one of amenorrhea, sterility, menorrhagia, or impotency* secretion is restored, tone imparted, and the healthful flow of returning stimulus is manifested by the usual physical signs. The sexual appetite is sequent and not the antecedent of the restoration of the ability of the organs to perform the functions assigned to them by nature." A portion of Dr. Coe's remarks, namely, that which relates to the effects of curative doses of medicine, is in the main correct; but his general statement contains one great fundamental error, which has ever been the glaring fault of allopathic therapeutics. He states that Helonin is a special tonic to the organs of reproduction but only to a normal extent; did it extend beyond this, he remarks, it would be a diseasecreating remedy. The old school of medicine has always been willfully blind to the truth, that all medicines may be disease-producing. That a medicine is a "special tonic " to any particular organ, is the strongest proof that it is capable, if long continued, even in small doses, of causing disease in that organ. If, then, the Helonias be given for uterine atony, and acts curatively, when that organ has regained its tone, if the remedy be continued, it will urge or elevate the physiological functions of that organ, and induce an abnor HELONIAS DIOICA. 303 mal condition, the result of hyper-stimulation. If Helonias is a special tonic to the organs of reproduction, we do not doubt that, if given to a healthy individual, it would cause an excess of sexual desire, congestion of the uterus, ovaries, etc., and even amenorrhcea or menorrhagia, depend on active congestion; then, after a time, the irritability of these organs would be worn out, and according to a well-known physiological law, we shall have exhausted or atonic condition of the tissues previously over-stimulated. The conditions and diseases enumerated by Dr. Coe, as within the curative range of Helonias, are those which it would cause by its secondary action. It is capable of producing an almost equal number by its primary action. My theory of dose accounts for the curative operation of the material doses of the allopathic school; the curative action in the lower attenuations, is chiefly directed toward those atonic states which it causes secondarily. But if given for its primary effects, it must be given in the middle or higher attenuations, else we should get up injurious medicinal aggravations. Resume. - The Helonias is primarily homceopathic to the following diseases, when occurring in women of plethoric habit, strong digestion, and great muscular power: Active congestion of the uterus, causing, besides the usual symptoms of that condition, suppression of the menses (congestive amenorrhoea); menorrhagia, from active congestion; prolapsus or retroversion from congestion; abortion from undue afflux of blood to the uterus. The special symptoms which would indicate it in these diseases, can only be obtained by a thorough proving. Helonias is secondarily indicated and has proved eminently curative in diseases of the reproductive organs, occurring in persons of a lax or anaemic habit, and in which there is a loss of normal tone. As diseases of the same name may be caused by opposite states, so the primary amenorrhcea of Helonias may be due to congestion, while the secondary is due to lack of blood and normal activity of the uterus, etc. My own clinical experience coincides with that of my colleagues -especially in its power of preventing miscarriages. 804 HELJONIAS DIOICA. It is useful even in those cases which arise from ulceration of the os, with or without a bloody discharge therefrom. But its principal usefulness is in those cases which arise from a uterine atony, which can not hold on to the fruit of conception, but allows it to escape at the periods coinciding with the previous menstrual flux; or when the slightest overexertion, or irritating emotion, tends to cause loss of the fcetus. In this respect it resembles Aletris, and is just the opposite of Caulophyllum and Viburnum, which correspond to the irritable uterus, with such a sensitiveness of that organ that it is thrown into spasmodic and expulsive action upon the slightest occasion. Sabina, Secale, Ustilago and Cimicifuga stand midway between the two classes just mentioned. As a remedy for sterility and impotence, it is held in high estimation. In the absence of such an extended series of provings as to establish such conditions, we may judge from its primary symptoms that the above conditions would result. No remedy causes, primarily, an exalted state of the sexual organs without causing, secondarily, a corresponding depression. Moreover, if you will look over the cases of diabetes cured by Helonias, you will observe that in every case impotency existed. There seems to be a direct connection between abnormal secretion of urine and loss of sexual power. Loss of blood, or of any other secretion, does not seem to have so decided an effect. Now, the drugs which cause the one will pretty certainly cause the other. Phosphorus, Phos. acid, Eupatorium purp., Mercurius, Nitrate of Uranium, as well as Helonias, all have this effect, and all are useful in impotency. Nearly all functional causes of sterility and impotency have their origin in the ovaries or testicles. Helonias must cure such conditions by its honceopathic relation to the functional activity of those glands. We have seen that it stimulates glands to an unnatural activity - which must be followed by unnatural inactivity. This inactivity would induce loss or deficiency of desire, by acting on the mind in a reflex manner. We see in the mental symptoms a picture of the state in which we find most impotent persons. HEPATICA. 305 With my peculiar views of its action, I would recommend Helonias in the high dilutions, in those cases of precocious sexual development into which so many young girls are stimulated by the improper methods of education, diet, and amusements, so much in vogue at the present day. Of course, a persistence in such pernicious modes of life would have to be abandoned, to allow Helonias to exert its curative action. It may prove to be equally useful in the abnormal irritability of the female sexual organs which occurs at the change of life. Worn-out debauchees can not expect to be restored to renewed virility by this or any other remedy, but, when used in a low attenuation, it will aid in restoring to a debilitated system its normal power of reproduction. As an exciter of venereal desires and powers, it should never be used, even if it possessed such powers. Dr. Holcombe believes it is useful in prolapsus, retroversion and anteversion, and that it strengthens the uterine ligaments by invigorating the general system. But I do not see why it may not have a purely local toning action. The displacements of the uterus may all be due to local weakness; while the general system is strong enough. I think it acts curatively in both cases. It has been found very beneficial in those pains in the back, with lameness, stiffness, and weight, which are found in many renal and uterine diseases. HEPATICA. This plant is found not only in America, but nearly all the world over. Its delicate flowers of a pale blue, white, or flesh color, appear almost as soon as the snow leaves the ground in the Spring. Although delicate, small and inconspicuous, the Hepatica had once an extensive reputation in very serious diseases. The name Liverwort was given it from a fancied resemblance of its leaves to the liver; and the old physicians who practiced according to the obsolete doctrine of signatures, prescribed it in all hepatic diseases. 306 HEPATICA. The plant is scentless. Its taste is insipid, not bitter, but a little astringent and slightly acrid, which latter is disguised by the mucilage contained in the leaves. It is difficult to imagine that it has any great power over the system generally. Its supposed action on the liver I believe to be purely fanciful. Many years ago it was highly lauded in this country as a remedy for cough and haemoptysis. If I should venture to name its analogues in advance of a thorough proving, I would mention Calcarea, Hamamelis, Cistus, Hepar sulph., Senega, Phosphorus and Stannum. Nothing definite is known of the action of this plant in disease, and nothing whatever of its effects upon the healthy organism. Allopaths, eclectics, id omne genus, tell their patients to drink an infusion of Liverwort, ad libitum; but they do.not stop to observe if any effect results from such quantities. They advise the same of Hamamelis, yet the homceopathist, by careful observation, has ascertained that not only is the latter drug valuable in diseased conditions of an important nature, but it is capable of causing, in small doses even, notable pathogenetic effects upon the healthy body. A thorough proving of the Hepatica may show it to be a valuable remedial agent. The first and only mention of the Hepatica in homceopathic literature was by Dr. D. S. Kimball in a paper entitled "Scraps from Practice." He writes: "'In 1831-32 I was troubled with hoemoptysis, and a slight recurrence of it in 1836, leaving more or less chronic irritation of the throat and lungs, and two or three years previously, as well as subsequently, for a long time with dyspepsia. Three years ago, when suffering in this way, I commenced using the Hepatica triloba, by chewing a mouthful twice a day and swallowing the juice, and observed the following symptoms to arise from it: " Eyes somewhat sensitive to light; itching and swelling, slightly agglutinated in the morning. " Bloody mucus frequently blown from the left nostril, for three or four days in succession (after using it three days HEPATICA. 307 and continuing it.) Soreness of the end of the nose at the entrance of the nostrils. Uncommonly free and easy expectoration; the rough, scraping irritation and tickling sensation in the throat and fauces disappears, as also the sensation about the epiglottis and larynx as of particles of food remaining. The accustomed accumulation of phlegm, sometimes thick, viscid and tenacious, inducing frequent hawking and disposition to hawk, disappear. "The customary paroxysms of coughing, and somewhat abundant expectoration, mostly daily, about midday, a portion of the expectoration being opaque, yellowish, of the consistency of cream - the rest frothy and mucous - disappears. Apparently, a much better state of the throat and lungs is induced from its use - much stronger generally, as well as locally, and the irritation of the throat and lungs mostly gone, Digestion apparently more perfect, and a cessation of most of the remaining dyspeptic symptoms." We have in this fragmentary proving a few suggestive pathogenetic symptoms, and several interesting curative effects, sufficient to prescribe the medicine in similar conditions. In the Summer of 1865 I contracted a severe bronchitis, which became aggravated by frequent exposure, until it reached the point of purulent expectoration. An attack of circumscribed pneumonia supervened, which was followed by bloody sputa and the purulent expectoration again. This continued for two months unchecked by Lycopodium, Stannum, Phosphorus or Sulphur. The expectoration was profuse, yellow, creamy and exceedingly sweet. Some pain and constriction of the right chest. An excessively annoying irritation of fauces; a tickling, itching and scraping sensation was present nearly all the time; aggravated by eating, or inhalation of dust. At this period I met with Dr. Kimball's statement, and suspending all medicines, used the dried leaves in the same manner. I noticed a mucilaginous taste, followed by some astringency, and a subdued pungent sensation, which it gave the mouth and fauces, a little like that caused by the liquorice root. After using it four days, 308 HYDRASTIS CANADENSIS. the expectoration decreased; the troublesome irritation of the fauces improved, and in two weeks had disappeared. It certainly appeared to remove the symptoms of the fauces and throat. HYDRASTIS CANADENSIS. I believe I was the first to call the attention of our school in America to this medicine. I mentioned it in an article on the " Prevention of miscarriage, and the treatment of its consequences," in the North American Journal of Homceopathy, vol. viii. Since that time, very extensive provings of the medicine have been made by Drs. Nichols, Burt, and others. The provings of Dr. Nichols are excelled by none of our modern experimenters. The remedy was mentioned in 1858, and again in 1863, by Drs. Hastings, Bayes and Pattison, in the British Journal of Homceopathy. The use of Golden Seal as a medicine dates back into the dim traditional history of this country, when only the aborigines inhabited the continent. It was known to the first white settlers only through the Indian tribes with whom they came in contact. Notwithstanding its great and deserved popularity among the whites and Indians at an early day, the " regular " practitioner seemed to look upon it with suspicion, and we find small mention of the Hydrastis in any of the writings of the early authors, with the exception of Dr. Tully, of New England, Prof. Rafinesque, then of Kentucky, and Dr. Barton, of Philadelphia. Each of these men labored hard to substitute active and valuable indigenous remedies for the foreign ones, then as now, so much more preferred by the allopathic school. At the rise of the "botanic" practice of medicine, these remedies- the Hydrastis particularly —were taken up and used extensively. The later eclectics were not slow to avail themselves of the remedial virtues of this and other indigenous plants. Although their use of this medicine was purely empirical, and HYDRASTIS CANADENSIS. 309 based upon unsystematic observations, the success which attended its administration was highly satisfactory, both to patients and physicians. We shall give the opinions and experience of the earlier physicians, in order that its medical history may be understood. The biography of a medicine is as interesting as that of a man. We trace its development through infancy, childhood and youth, and note the additions which are yearly made to its growth as a remedial agent. We also note, too, how one after another of its supposed attributes fall away and disappear, or how certain traits of character noticed in its infancy become forgotten, and finally reappear in the future development of its history. A medicine can not be said to leave reached maturity until it has been subjected to a thorough physiological proving. In other words, it is in the hands of the homceopathic school alone that a medicine is capable of reaching complete development. Among the earliest medical writers of this country was Prof. Rafinesque, a scientific botanist and a ripe scholar. He thus writes of the Hydrastis: " It is tonic, ophthalmic, detergent, etc. It is much used in Ohio, Kentucky, etc., for diseases of the eyes; the juice or infusion is used as a wash in sore or inflamed eyes. It is considered a specific by the Indians for that disorder; they also apply it for sore legs, and many external complaints as a topical tonic. Internally, it is used as a bitter tonic, in infusion or tincture, in disorders of the stomach, liver, etc., and is equivalent to Aletris, Coptis, Frasera, Menyanthes, Sanguinaria and Jeffersonia. (But none of these is so efficacious for sore eyes, except perhaps the Jeffersonia.) It is said to enter into compound remedies for the cancer, acting as a detergent tonic, and the Cherokees are supposed to use it in that disease, but better detergents are known. The properties of this plant are not yet fully known; it appears to be slightly narcotic, and available in many disorders. Some Indians employ it as a diuretic, stimulant and escharotic, using the powder for the blistering, and the infusion for the dropsy.' 310 HYDRASTIS CANADENSIS. In this we see the earliest history' of the plant as a medicine. Used first for diseases of the eye, much as Euphrasia was used among the early Britons; then noted as an Indian remedy for cancer, and supposed to be narcotic. Its use in ophthalmia is still popular; its virtues in cancer, forgotten until revived in England by physicians of the homceopathic school; and its supposed narcotic powers proved not to exist. Howard, writing in 1836, says: "It is very useful in recovery from fever, for dyspepsia, indigestion, sore eyes, ulcers, loss of appetite, etc." Dr. Barton and Dr. Tully estimated it very highly as a "pure tonic, and as an alterative in diseased conditions of the mucous membranes." King gives it a prominent place among medicinal agents; reiterates all that previous writers have said about it, with the exception of its alleged usefulness in cancer; and adds that it is valuable in " chronic affections of the mucous membrane of the stomach, intestines, bladder, etc.," all of which will be mentioned under the appropriate heads. Scudder claims it as peculiarly an eclectic remedy, and remarks: "It seems passing strange that our allopathic brethren have not got their eyes open to its importance, as we believe that for the fulfilling of some indications it has no substitute." I shall revert to Scudder's testimony again, in other paragraphs. Allopathic authorities of the present day almost, if not entirely, ignore this important medicine. Wood, in his Dispensatory, repeats Rafinesque, but doubts if it is anything more than an ordinary tonic. In his " Therapeutics " and " Practice," it is not mentioned. Stille does not mention it in his extensive work on Materia Medica and Therapeutics! It is only after a careful study of all the provings that we can arrive at any definite estimate of the sphere of action of a medicine. After nearly twenty years of experience with Hydrastis, and an intimate acquaintance with the physiological experiments which have been made with it, by members of our HYDRASTIS CANADENSIS. 311 school, I confess that I do not feel like expressing a final opinion on the powers and qualities of this medicine. However, it is proper that I should give you some idea of its mode of action, as well as its extent, and its curative capabilities. Its general primary effects on the system when taken in material or medicinal quantities by a healthy person, will undoubtedly be that of a nutrient tonic, i.e., it stimulates the digestive processes, and increases the assimilation of food. By these means the blood is enriched, and this blood feeds the muscular system. I mention the muscular system because I believe it first feels the increased power imparted by the stimulation of increased nutrition. The consequent improvement on the nervous and glandularsystems are natural results. But, as is the case with all so-called " tonics," the condition of apparent unusual strength, may be only apparent, and will sooner or later give way to the opposite condition, which I shall designate as secondary effects of the drug. The same effects have been observed from China, Quinia, and even Iron. The increased digestive power gives way to indigestion; the increased power of assimilation to deficient nutrition, and apparent strength to real debility. But, if these secondary symptoms already exist from natural diseases, then it is that we get the real curative power of Hydrastis. The question now is all-important: Have we special indications for the use of Hydrastis in cases of debility of a general character? I believe our provings and clinical experience are now sufficient to furnish such data. But let us examine the testimony of those outside of our school of practice. In relation to its general effects on the system, there is no medicine in use in eclectic practice about which there is such general unanimity of opinion. It is universally regarded by that school as the tonic - useful in all debilitated states, and under all conditions except that of acute inflammation. This is to the eclectic school what Quinine is to the allo 312 HYDRASTIS CANADENSIS. path, and China is to our own school. The first named school looks with surprise upon the indifference with which this, their favorite tonic, is treated by the rival schools. I have known eclectics in large practice, to rely upon it almost to the exclusion of Quinine or Salicine, in intermittents and other malarious fevers. They usually prescribe one drachm of the tincture or fluid extract, or one or two grains (even as high as six grains) of the Hydrastin, every one, two, or four hours, as the case seems to demand, and assert that it always acts as a pure tonic, and that its effects are not attended with any stimulation of the circulation, or congestion of the brain, as is the case with Quinine. Yet, curiously enough, English homceopathists assert that a "few drops of the mother tincture will cause a physical prostration." It could not do this by its primary action, like China; its secondary effect may be prostration. Drs. Marsden and McLimont state that " one of us has, for upwards of a month at a time, endeavored by experiment to ascertain its pathogenesis; but we have been unable to elicit any very decided symptoms, except upon the sensorium and heart, which were affected for a very short time, by doses of half an ounce and upwards, smaller quantities appearing to pass off without any effect at all." The tincture used by the gentlemen must have been of a very poor quality, or half an ounce would have shown its effect in quite a decided manner. They state, however, that they " know of no medicine which has caused so great an improvement in the general health of our cancer patients as has this, an improvement which, in most cases, has become visible in the bettered expression of the countenances, to all who had previously known the patients." We must rank it, as to its general effects on the nutrient processes, with such medicines as China, Ferrum, Helonias, Aletris, Columbo, and Nux vomica. It differs from each, in many ways, from China (Quinine), in not being a powerful anti-periodic; from Ferrum, in not acting directly on the blood; from Helonias, in not affecting the functions of the kidneys and uterus; and from Nux vomica, in not acting as a stimulant to the spinal cord. HYDRASTIS CANADENSIS. 313 The action of Hydrastis on the glandular system must be direct and specific. It acts on the glands of the mucous membranes, namely: the intestinal and gastric. It acts on larger glands, notably the liver. Its primary effect on the glandular system is to excite to unusual secretion, when given to a healthy person. Its action on all mucous surfaces is of a similar character. The natural secretion is at first increased; then it becomes abnormal in quantity and quality. At first clear, white, transparent and tenacious, it becomes yellow, or thick, green and even bloody, and nearly always tenacious. The tenacity of the discharge, allowing it to be drawn out in strings, is analogous to the discharge caused by Kali bich., Ammon. brom. and Cubebs. It differs from the profuse mucous flux of Stannum, Copaiva, and Amm. mur., which is thick and lumpy, and falls in masses. The distance traversed by the primary mucous flux of Hydrastis passes from simple increase of mucus, to erosion and ulceration. Its secondary effects are exhaustion or destruction of the glandular sources of the mucus-a condition in which the mucous surface is dry, glazed, and its functions destroyed. A muco-purulent, or purely purulent discharge marks the ultimate primary action of Hydrastis. A total arrest of secretion from mucous membranes marks its ultimate secondary effects. What clinical deductions are to be made from these pathogenetic and pathological effects? I answer-that Hydrastis is one of the most important remedies we possess for the treatment of mucous fluxes, ordinarily known as catarrh. Now you must know that this disorder is not confined to any one portion of the body. It may exist wherever mucous membrane exists. The range of catarrhal diseases is very wide, and very many diseases which go commonly by other names might all be included under the single name of Catarrh. The only form of catarrh to which Hydrastis is not suitable is to the acute inflammatory. So long as the fever lasts it should not be used. Gelseminum, Sticta, or some other appropriate remedy must be used. But as soon 21 314 HYDRASTIS CANADENSIS. as the inflammatory symptoms subside, its use can be commenced, at first in the middle dilutions (10th to 30th); afterwards, as the catarrh nears its ultimate primary journey, to the 3d or 6th; and finally, for the secondary stage, the 1st, or mother tincture, should be freely used. There is one fact connected with the, history of the action of Hydrastis which should not be forgotten, namely: it is not a volatile medicine, like Copaiva, Cubebs, Kali jod. and the Balsams. It is not thrown off as readily through the glands and mucous surfaces. It therefore requires that it should be oftener used topically, as well as internally. In all catarrhal fluxes its local application should attend its internal administration. I hardly need enumerate the catarrhal or mucous diseases in which the Hydrastis is useful, but it may be well to do so. in order to fix them in your memory, namely: Otorrhtoa (even with obstruction of the inner ear and eustachian tubes); chronic conjunctivitis (even with purulent discharge); old nasal catarrhs, of both the anterior and posterior passages; oezema, with bloody, purulent discharge from ulcerated surfaces (if the bones are affected, use Aurum or Mercurius); catarrhal affections of the respiratorypassages; catarrh of the stomach (one of commonest causes of dyspepsia); catarrh of the gall-duct (a common cause of jaundice); intestinal catarrhs (which often go under the names of chronic mucous diarrhcea and chronic dysentery); catarrh of the bladder; of the urethra (among which are chronic gonorrhcea and gleet); leucorrhoea, even with erosions and ulcerations; uterine catarrh, etc. The selection of the dose for internal administration has been mentioned. Its topical application will have to be varied with the severity of the case and the portion affected. The most useful preparations of Hydrastis for this purpose are (1) the tincture, (2) the Muriate of Hydrastia, (3) an infusion of the pulverized root in water. The strength of the lotion may vary from a few, drops or a drachm of the tincture to several ounces of water; from a few grains of the 3d trit. of Hydrastis, or a few grains of the crude to a pint of water; or from ten grains to a drachm of the root in a quart of hot water. HYDRASTIS CANADENSIS. 315 It may be applied by means of a syringe, a douche, or an atomizer; or it may be used as a gargle; or (as in gastric catarrh) in doses of several ounces at a draught of an attenuated infusion. A drug which causes a disordered condition of the mucous surfaces, will, in nearly every instance, prove to be a good remedy for affections of the skin. The cutaneous analogue of a catarrh and its consequences is a moist, exuding eruption, with or without ulceration. Does Hydrastis affect the skin? Rafinesque says "the Indians use the powdered root for blistering the skin, as an escharotic, and as a topical application to old sores, ulcers and cancers." I have never seen severe irritation of the skin follow its local application, although it sometimes causes redness with pustulation, when a lotion has been applied several days or a week. One prover observed'" an erysipelatous rash on the face, neck, hand, and fingers, with great heat and irritation, which continued for six days, when the skin exfoliated." Another asserts that it caused an eruption like varioloid on the face. It is probably homceopathic to some acute exanthemata; also to some forms of chronic skin diseases. When chronic eruptions depend on debility for their continuance, as is sometimes the case, then the Hydrastis, by its invigorating influence, may prove curative. It has been found useful in lupus, rhagades and excoriations. It may be employed as a simple lotion, or a glycerole, or in the form of a cerate; if the patient is cachectic and exhibits symptoms indicating this remedy, its internal use will be of advantage. Dr. McLimont, of England, claims to have treated three cases of lupus successfully with the internal and topical use of Hydrastis. Dr. H. M. Saxton writes me that he has had considerable experience in the use of Hydrastis as an external application, and gives the following cases illustrating its use: Case I.-A girl, seven or eight years of age, fell, and 316 HYDRASTIS CANADENS1S. lacerated the scalp above the left temple. The wound was several inches in length, in the form of a crescent. It suppurated, and became a troublesome sore. After cleansing the surface, the Hydrastis, in fine powder, was applied. It checked the suppuration, allayed the inflammation, and under its use the ulcer healed in a few days. Case II.-Was an ulcer from a burn, on the back of a child's hand. It was much inflamed; very painful; she could hardly move her wrist. The powdered Hydrastis was applied lightly. Although the child irritated it a great deal, it soon healed, and left the cuticle smooth and without a cicatrix. Case III. —Infantile Intertrigo. "Excoriations in the folds of the neck." The dry powder was applied, and it healed in three days. I would advise you to dilute the crude powder with starch or some similar substance. As a wash, I have found one part of the tincture to ten of water, more useful in obstinate excoriations of the skin, in children, than Arnica. Glycerine is a better vehicle than water. The Glycerole of Hydrastis is used with great ad vantage in cases of intertrigo, sore nipples, and ulcerated surfaces. While Arnica seems specific for contusions, with extravasation, and Calendula for incised and lacerated wounds, even when unhealthy suppuration ensues, the Hydrastis seems the best remedy for chronic ulcers, arising from either of the above causes, or from burns, scalds, or some disease of the skin. The Hydrastis Canadensis has been used in England in the treatment of variola. In a somewhat remarkable pamphlet issued in that country, written by Dr. J. G. Wilkinson, of London, and entitled " The Cause, Arrest and Isolation of Small Pox, by a New Method," the supposed virtues of this remedy are thus vauntingly set forth: "Hydrastis is the remedy which embraces something like a specific treatment of small pox. WThere the itching and tingling of the face at the time of maturation were so distressing that I ordered the face to be dabbed with a cold infusion of the Hydrastis, a small portion being warmed for HYDRASTIS CANADENSIS. 317 each application. The relief experienced was instantaneous as well as complete and lasting. The swelling of the face also subsided quickly, and the case proceeded with more than ordinary rapidity to a happy issue. No second case occurred in the house, a point of importance which I request the reader to bear in mind." But there is another point of importance which Dr. W. forgot to mention, namely: whether the patient, and other inmates of the house, had ever been vaccinated. It is a fact well known to all practical physicians, that small pox occurring in persons who have been vaccinated, will frequently appear to pursue a severe and even aggravated type, up to the very point of maturation, and then suddenly subside as if cut short by some therapeutic power. It is this peculiar phase of disease that has led to so many unfounded laudations of new remedies, such as Sarracena, etc. The Hydrastis has since been used in this country in small pox, after the manner of Dr. W. The testimony of several physicians as to its good effect was published in the second edition of New Remedies. I do not consider Hydrastis indicated in dry, furfuraceous eruptions, in which Arsenic and Phytolacca are useful. The skin may be dry and smooth, but not scaly. The eruptions must be moist. The ulcers may discharge profusely, or may be full of unhealthy granulations, or dry and shining. This is a good place to mention the use of Hydrastis in cancer. It originated in England with two physicians claiming to be homceopathists. They evidently received the hint from Rafinesque, who mentioned its use by the American Indians, in cancer. Those physicians claimed for Hydrastis the power of destroying the cancer disease, or dyscrasia in the blood, for they wrote: " This "-the Hydrastis —" is the medicine upon which we chiefly rely in our treatment of cancer, usually putting our patient under a course of it for a month or so, before commencing the enucleation of the mass. Our doses vary from one to two drops of the 6th dilution, to drop doses of the mother tincture; the lower forms being used in those cases 318 HYDRASTIS CANADENSIS. in which the cachectic condition is fully marked; and we must confess that we know of no medicine which has caused so great an improvement in the general health of our patients as has this. We continue the medicine during the whole of the treatment, and for some weeks after." Those physicians did not, however, rely entirely upon the use of the Hydrastis alone, but consider it necessary to "enucleate" the tumor. Hydrastis was applied to the tumor after it had been incised. But it will seem strange to American homceopathists, who have always looked upon their English brethren with something akin to reverence, when they learn the manner of its application. "A piece of lint is applied to the surface, spread with equal parts of a paste composed of a strong decoction of Hydrastis root, Chloride of zinc and flour, and Stramonium ointment." The testimony of Dr. Hastings, of England, relative to the efficacy of Hydrastis in cancers, is not so favorable. Hoe says: Having for some considerable time used Hydrastis in cancer cases, I think I may without any presumption make some remarks thereon. I have now for upwards of eighteen months prescribed in about twenty cases of cancers, viz.: Cancers of the tongue, breast, lip, hand, etc., in a variety of forms, from high to low dilutions; applied it externally, as Dr. Pattison does, and even by his directions, having twice sent patients for his advice, and I regret to say in no single instance has it effected a cure, nor even appeared to check the disease. * * * In one or two cases it did seem at first to have some power of arresting the disease, but this was of short duration. * * * It is no doubt a powerful medicine, but whether it will cure cancer in any of its stages, is very questionable, at least according to my experience of it. This was written in 1860, and if Dr. Hastings had found it useful, he would most probably have informed the profession. In my criticism on this method, I denounced the mixing of Hydrastis with Caustics. Fortunately their method was never adopted by any respectable homceopathist in this country. Although many used the Hydrastis alone as an HYDRASTIS CANADENSIS. 319 application to supposed cancerous tumors. In a few cases good results were claimed, but a large majority were only palliated. I do not- think it has any more specific curative power over the cancerous dyscrasia than the Carbolic acid, recommended of late by a noted cancer doctor in this country. I do not believe the Hydrastis has any specific power on enlarged glands, certainly not in any manner similar to the Iodides. It is well known that any restorative remedy, even fresh air and a good diet, will cause the disappearance of glandular swellings. The Hydrastis may have this effect, but only by its invigorating power. Hydrastis has always been a favorite domestic remedy in "sore mouth." Many physicians use it in all forms of stomatitis of children; in simple ulceration of the buccal mucous membrane; in mercurial sore mouth, and in stomatitis materna. I have witnessed the most obstinate varieties of these affections yield to the local application of Hydrastis in decoction or powder, after the mineral acids, astringents, nitrate of silver, of the old school, and even homeopathic remedies had been tried in vain. The best method of application is to add one drachm of the tincture to half a pint of water; use this as a wash every three or four hours. The best preparation for use in diseases of the mouth and fauces, is the Muriate of Hydrastia-one grain to an ounce of water-applied every three or four hours. It is much more successful than the tincture. With it I have cured many cases of stomatitis, which have resisted other measures. In my own case it acted promptly in removing a disagreeable dryness of the tongue, with a sensation as if it had been burnt; it felt sore and raw, and had a dark red appearance, with raised papille. The gums were also dark red and swollen, as was also the muccus membrane of the mouth. The uvula was relaxed and sore, large quantities of yellow tenacious mucus was hawked from the throat, leaving a sensation of rawness. A wash of Hydrastia mur. cured the whole in two days, although it had lasted for two weeks, uninfluenced by Nitric acid, Mercurius, and Tincture of Hydrastis. 320 HYDR ASTIS CANADENSIS. It is a favorite remedy with many homceopathic physicians in the West, as a gargle in cases of simple ulcerated sore throat; also in angina with ulceration, when accompanying scarlatina; it does not, like Baptisia, remove the fcetor in a direct manner, but its curative effect over the ulceration tends to remove any putrefactive condition. The pathogenetic symptoms are quite similar to those for which Dr. Gray, of New York, so highly recommends Mercurius iodatus; and the pathological condition, namely, inflammation and engorgement, with profuse secretion of mucus from the mucous follicles of the throat, very much resemble the condition which Mercurius causes. In some varieties of chronic angina, we find the mucous membrane of the fauces studded with round, protuberant spots, of a red color, as if injected with blood, and the patient complains of an aggravation from the least exposure to cold. For this state of the throat Hepar sulphur is generally prescribed, but its permanent curative effect is very much aided by the internal and local use of Hydrastis. Dr. Lodge had excellent success with Hydrastis in a case of murcurial salivation. A man troubled with the itch was told that an ointment of Corrosive sublimate would cure it. He used it freely. As the skin eruption disappeared, severe mercurial salivation was developed. When called to see him, his jaws were set, liquids were swallowed with difficulty, power of articulation was lost, and he could only make his wants known by writing on a slate. The ulceration 8f the mouth, which followed the salivation, was soon relieved by Hydrastis (10-,) one part tincture to nine parts water, and the patient was able to speak in about a week. The recovery was rapid and permanent. Syphilitic angina has been benefited by the use of this medicine; indeed, in its action on the glands of the mucous membrane, Hydrastis is an analogue of the mercurials. There is a kind of sore throat which often attends dyspepsia; it is sometimes known as " bilious sore throat," although the name is inappropriate; it is a sympathetic disorder, arising from irritation of the stomach and lower portions of the HYDRASTIS CANADENSIS. 321 cesophagus; for this troublesome affection, the Hydrastis internally is an excellent remedy. This leads us to a consideration of its value in gastric disorders. In my first edition of New Remedies, I wrote as follows: " This remedy seems likely to prove as prominent a remedy for those conditions which are known under the name of dyspepsia, as Nux vomica, Sulphur, or Pulsatilla." This prediction has been verified by hundreds of physicians during the intervening ten years. I quoted the opinions of eclectic physicians, and they will bear repeating again. Dr. King says: "It is successfully administered in dyspepsia and chronic affections of the mucous coats of the stomach; in chronic inflammation of the stomach it is very valuable; it will be found of special advantage in the treatment of persons who are intemperate, gradually removing the abnormal condition of the stomach, and in many instances destroying the appetite for liquor." Dr. Scudder writes: "In anorexia, indigestion, and general debility, arising from a languid, or atonic state of the stomach, it is unsurpassed, restoring tone to the stomach, promoting the appetite, and acting as a general restorative. It may also be employed in those cases of chronic gastritis and chronic irritation of the stomach with altered secretion, which constitute the worst and most persistent forms of dyspepsia. In acid indigestion the Hydrastis, associated with calcined magnesia or prepared charcoal, will be found truly valuable,, especially when attended with a torpid condition of the bowels. In those sympathetic diseases of the digestive organs, arising from uterine disease, we have obtained more benefit from this than from any other agent. The cases in which we have known this plant used with most success, were atonic dyspepsia, attended with torpidity of the liver; languid circulation, and constipated bowels." The few pathogenetic symptoms which we have obtained, point to its use in dyspepsia with acidity, and dyspepsia from atony. The faint feeling with palpitation is quite suggestive of congestion of the portal system; but we should be guided, perhaps, more by the general action of Hydrastis 322 HYDRASTIS CANADENSIS. upon mucous membranes. We know that it causes (1) blennorrhagia; (2) excoriation and ulceration (superficial?); and a condition simulating chronic inflammation. I have used this medicine in gastric disorders, for several years, and my experience, together with a knowledge of its general effects, led me to consider it homceopathic to the following conditions; I use the nomenclature of Dr. Chambers-(see Disorders of Digestion:) (1) Mucous flux (chronic.) (2) Excess of epithelium (chronic.) (3) The anoemic state. (4) Chronic inflammation (mucous.) (5) Ulcer of the stomach. (6) Deficiency of gastric juice. I also predicted in my second edition of New Remedies, that the Hydrastis might "prove of value in cancer or scirrhus of the stomach, if the experience of our English colleagues should be verified." It certainly is an excellent remedy in cases which appear to be due to ulceration of the stomach. In the appendix to the second edition of New Remedies, a case is related by Dr. La Brunne, of epigastric tumor with marasmus, presenting the following symptoms: Patient an old man of 70; had pains in the stomach five or six years, then loss of strength, great sensitiveness of the epigastric region, in which pulsations isochronous with the pulse were perceived, and a flattened, resistant tumor of some two inches in diameter. In a few months the pains became insufferable, loss of appetite and sleep became more alarming, frequent vomiting and great anguish about the heart, almost permanent. The tumor was pronounced scirrhous. He had taken Nux, Ignatia, Chamomilla, Colocynth, Arsenic, and many other medicines with no benefit. He now took Hydrastis, mother tincture, two drops morning and evening in a spoonful of water. After six weeks the whole body felt improved and strength commenced to return, and in a few months was perfectly comfortable as regards pain, sleep, and digestion. The tumor had decreased two-thirds, the BYDRASTIS CANADENSIS. 323 cielic pulsations decreased three-fourths in intensity, and he now enjoys very good health. The report of this case was translated from the Journal Dispensaire, Hahnemann, vol. iv. No. 11. The intestinal symptoms, observed by the provers, are not notable in any respect. It caused light colored, yellowgreenish stools, with griping and faintness; the evacuations like those of Podophyllin were inclined to be persistent. I do not think it capable of causing watery stools, or any such severe symptoms as Podophyllum, Mercurus or Iris. It rather resembles Rheum, Senna, Chelidonium, and Aloes. If provings were carried far enough we should doubtless get the stools mixed with, or coated over with the peculiar tough mucus, constituting a mucous flux of the intestines, similar in character to that which it causes elsewhere. These are its primary effects. The secondary effects of Hydrastis can readily be imagined, namely: An obstinate constipation from one of two conditions-(1) a chronic, torpid mucous secretion from the intestinal canal which retards its peristaltic action, and the natural advance of the freces; (2) An unnatural dryness of the mucous surface, with hard, dry, knotty stools. We feel safe in asserting that Hydrastis will not be found useful in diarrhoeas of a severe character. An irritation of the mucous coats is its initial primary effect: this causes expulsion of faeces of a "light yellow color, and of a soft, mushy consistence." After this come the mucous stools, with burning pain and faintness. In such conditions it should be used highly potentized. It is also indicated in the ordinary non-inflammatory mucous flux of the bowels, in which the lowest dilutions may be used, or the 6th trit. of Hydrastin, which corresponds to about the lx dile of the tincture. Hydrastis is indicated in some forms of dysentery; in mucous enteritis, when of a catarrhal character, and the inflammation sub-acute, the Hydrastis at the third dilution will prove curative. In chronic enteritis, when the discharges are tenacious, slimy and accompanied with tenesmus; 324 HYDRASTIS CANADENSIS. or when the faeces are in the form of hard balls, coated over with yellowish, tough mucus; this medicine will be of service in the first and second potency. The topical application of the remedy must not be forgotten in these cases. Enemas of Hydrastis will be found useful, and will bring about a cure unaided, or at any rate materially aid its internal action; when the disease is located in the rectum, this form of application will be found particularly beneficial. It is certainly indicated in blennorrhcea of the intestinesas much so as the Muriate of Ammonia. In ulceration of the rectum, occurring after bad cases of dysentery, the local application of Hydrastis will effect prompt cures; also, in fissure of the anus. The cerate will be the best preparation in these cases. In hamorrhoids this plant has some reputation. Reliable practitioners have assured me that they have cured the most obstinate cases by the alternate use of Hydrastis and Podophyllum, using enemas of Hydrastis every night. In excoriation of the anus, as it occurs in little children, or even adults, in diarrhcea and dysentery, no better remedy can be advised; it should be used in the form of a glycerole. I ought to give you some information as to the manner in which the Hydrastis cures jaundice. It causes jaundice evidently by inducing a catarrhal condition of the hepatic ducts. I am not sure that it can irritate the secretory function of the liver, although the persistent yellow stool would imply that it has such an influence. But this may be coincident with the catarrhal irritation. It may cause, co-incidently, by its primary action, an increase of the secretory power of the liver, and an undue secretion bf mucus from the hepatic ducts. This increase of mucus may go on to such an extent as to prevent the flow of bile from the liver into the gall-bladder, and from the gall-bladder into the intestines. Then it may induce jaundice from suppression and from retention, the former by its secondary action, the latter by its ultimate primary effect. Clinical experience in our school shows that it is capable HYDRASTIS CANADENSIS. 325 of curing very bad cases of jaundice. Dr. Albertson, of San Francisco, reported many cases, twenty in all, for the second edition of my New Remedies, in which "the skin and eyes were of a dark, greenish-yellow; urine very dark, faeces light colored, and great debility," cured with this remedy in drop doses of the mother tincture, in some cases; in others the first and second dilutions. It seems to be a favorite remedy with English physicians for constipation. Dr. Hastings reported many cases cured by its use in drop doses of the mother tincture. Dr. R. Hughes, of England, says of the Hydrastis canadensis: " My chief experience with this drug has been in the treatment of constipation; for which it is a precious remedy, far superior to the Nux vomica usually prescribed. It is in cases where constipation stands alone, or is itself the cause of the other existing ailments, that I find the Hydrastis so valuable. I have used it in the potencies, from the first to the sixth decimal. The second has seemed to me to act most satisfactory. Dr. Massy, in his notes on New American Remedies, mentions it very favorably. In this country the testimony of many of our most prominent physicians is favorable to its curative power. In all the cases reported, as well as in the cases wherein I have found it successful, the constipation was of long standing; had been aggravated by cathartic medicines; the patients were weak and enfeebled; the complexion sallow; the tongue foul; pain in lower bowels and rectum; indigestion; stools hard and nodulated. The best results have been obtained from the tincture, 1st and 2d dilutions, repeated two or three times a day. The following case, in the second edition of New Remedies, gives a good picture of the cases which Hydrastis cures: " Mrs. H-, age 26; light hair, pale complexion, and of feeble constitution; has from childhood drank tea; for ten or twelve- years had attacks of headache with constipation. Three weeks after the birth of her first and only child, she was attacked while at stool with pains and soreness of the 326 HYDRASTIS CANADENSIS. rectum and anus; burning, smarting pains, very severe, continuing often six or eight hours after each stool, with a hot sensation in the bowels, also colic and faintness. She has only one or two stools a week, very hard, and of a natural color. She has no falling of the rectum or but little pain in that region, except at the time her bowels move, and for several hours following. " Her symptoms remained unchanged for two months under the use of Ignatia, Nux vomica, Pulsatilla, Sulphur, Nitric acid, warm water injections, and warm hip baths. " On turning my attention to the new remedies for assistance in this case, I selected Hydrastis canadensis as being the most appropriate. I gave the tincture, having no other form of the remedy at hand. Three drops in half a glass of cold soft water, one tablespoonful taken every six hours. "In two weeks the pains in the rectum were wholly removed, and the bowels regulated. Her colic, faintness and heat in the abdomen also soon disappeared, leaving her well. It is now one year and six months since she took the Hydrastis, as yet no return of her former symptoms." No mention has been made of the diuretic action of Hydrastis, yet it would seem to have such effect; it needs confirmation, however, and further provings may clear up the matter. From analogy, it is more than probable that this medicine has the same effect upon the mucous membranes of the urinary organs that it has upon the mouth, nose and fauces, above alluded to. The resinoid principle of the drug may be eliminated through the kidneys, the same as Turpentine, Copaiva and others; if so, it would undoubtedly cause those blennorrhagic conditions of the bladder, urethra, etc., for which it has been considered almost a specific. King, and every other eclectic writer on therapeutics, assert its "great value in gleet, chronic gonorrhcea, incipient stricture, spermatorrhoea, and inflammation and ulceration of the whole internal coat of the bladder." " Many cases of ulceration of the internal coat of the bladder have been cured by the decoction of Hydrastis alone. It must be injected into the bladder, and held there as long as they can conven HYDRASTIS CANADENSIS. 327 iently retain it — to be repeated three or four times a day, immediately after emptying the bladder." It may be prepared as follows: Tincture Hydrastis can., one drachm; hot water, one pint; injected about blood heat. Its internal use alone would undoubtedly cure the disease, but it would require a longer time. I have cured cystic blennorrhcea with Copaiva, Chimaphila, and Uva ursi internally. In chronic gonorrhoea, or urethral blennorrhcea, the Hydrastis is popular with some practitioners of our school. They use it after all the inflammatory symptoms have subsided, and a thick, yellow or green, tenacious discharge persists. It is prescribed internally (low dilution), and the dilute tincture, or watery extract, injected. I have rarely met with cases which appeared to indicate it, and therefore have not used it in this disease. A cachectic condition, with indigestion and constipation, would be a good general indication in such cases. It would be as fully, if not better indicated in obstinate gleet. In blennorrhcea it is an excellent remedy. It need only be used as a wash, and the diseased surface will soon be restored to its normal condition. In conjunction with Phosphoric acid, it is one of our best remedies for the debility and general derangement resulting from spermatorrhaa. If there is spinal exhaustion, it should alternate with Nux vomica or Strychnine. No provings of Hydrastis have been made by women. The knowledge which we possess relative to the value of this remedy in diseases of the organs of generation of that sex has been obtained ex uso in morbis. Reasoning from analogy, we should naturally arrive at the opinion that it would be useful in many diseases of the uterus and vagina in which a blennorrhcea is the predominant symptom. Clinical experience has verified this opinion. I have found it one of our most efficient remedies against uterine catarrh -known by its synonyms of chronic mucous metritis and chronic mucous cervicitis. The former is a disorder affecting the mucous lining of the uterine cavity, which may be eroded, and discharge constantly a purulent 328 HYDRASTIS CANADENSIS. secretion, mixed with tough, stringy mucus. The latter affects only the glandular portion of the cervix uteri, and the discharge is tenacious mucus, transparent or yellow, and often hangs in long ropes from the os uteri. In such conditions I give the Hydrastis internally, in the low dilutions, and use a lotion of the watery infusion, directly to the diseased surface. When the os is open enough to allow its ready escape, or when it can be made so by the introduction of sponge tents, I inject an ounce of Hydrastis-water into the cavity, every day. If this is not feasible, a swab of cotton, on a silver probe or sound, can be saturated in the same preparation, and the cavity of the uterus or cervical canal wiped out every day. In the majority of cases this gentle treatment suffices. In obstinate cases, or when extensive granulation has taken place, the Hydrastis applications may be followed by dilute Kali bichromicum or Chromic acid; and Kali bich., Cubebs and Phytolacca to be used internally at the same time. In epithelial abrasion of the os, cervix and vagina, it is one of our best applications. In these cases I prefer to apply it on a tampon, i. e., a ball of clean white cotton, to which a cord is attached, saturated with glycerole of Hydrastis, and placed against the os, through a speculum. [Aqua-hydrastis is best made by infusing -j of pulv. rad. Hydrastis, in a pint or quart of water, to which add half an ounce or an ounce of Glycerine. Glycerole of Hydrastis may be made by increasing the strength of the above about nine-tenths, or using 7j of Tinc. hydrastis with 5j of Glycerine and water, each.] Vaginal leucorrhoea is often successfully treated by means of enemas of Hydrastis-water, even when much irritation is present. In cancer of the uterus and vagina, it has no curative value, but appears to modify the secretions and allay the pain a little, but it does not compare in efficacy with Carbolic acid or Chloride of zinc. You must bear in mind that the general condition of the HYDRASTIS CANADENSIS. 329 patient will often give you the strongest indication for the use of Hydrastis, namely: the cachectic state, the weak muscular power, the poor digestion, and obstinate constipation. In that ob'stinate affection, vaginal leucorrhcea (catarrh), of infancy and childhood, you may have to prescribe injections of Aqua-hydrastis, while you are giving internally Calc. carb. and Sepia. Although our eclectic colleagues recommmend it in " all chronic, and even acute inflammations of mucous membranes," yet they make no mention of its use in catarrh of the air passages. The pathogenetic symptoms point directly to its effects on the respiratory tract. It causes many notable catarrhal symptoms. I would recommend it, theoretically, in acute catarrhs- nasal, laryngeal and bronchial (in the 6th dilution), also in chronic catarrhs of those passages. It is homeopathic when the discharge is thick, yellowish, very tenacious, " stringy," and profuse. In these cases the low attenuations should be used, aided, when practicable, by the topical application in the form of injection. In the bronchial catarrh of old people, with debility, loss of appetite, cachectic conditions, it should prove very useful. Dr. Small reports the case of a child affected with a chronic catarrhal cough, accompanied with febrile paroxysms in the evening and night, with debility. The cough was rough, harsh and rattling, and continued day and night. After using many medicines with but little benefit, he gave Hydrastis 2d, and the cough and fever both disappeared in a few days. Under its continuance the child gained appetite and strength. Since the introduction of the steam-atomizer and various spray-inhalers, my favorite method of obtaining the curative action of this medicine in the bronchial-catarrhs, is to throw the spray down the throat, when it is inhaled and moistens the whole bronchial mucous surface. The Aqua-hydrastis of the strength above recommended can not injure the most delicate mucous surfaces. I have often thrown the spray into the eyes in cases of chronic conjunctivitis, and the patients invariably felt only grateful relief. 22 330 HYDRASTIS CANADENSIS. I have alluded to the use of Hydrastis, and its active principle, Hydrastin, by the eclectics, in the treatment of intermittent fever. Those of that school who claim the most thorough knowledge of its curative action, assert that the yellow alkaloid or Hydrastina, is the one which possesses anti-periodic powers. This Hydrastina is the same as Berberina, obtained from the Berberis (Bayberry.) I learn that Dr. Pulte, of Cincinnati, one of the best known physicians of our school, recommends the use of Berberina in ague and fever, and other periodic affections, on the ground that it causes no stimulation or congestion of the head as does Quinine. At one time during my early practice in the most malarious portion of Michigan I tried the Hydrastin in many cases, but in none did it answer my expectations, and while eclectic physicians in my vicinity claimed to cure ague with it, I found that they generally combined it with Quinine, Salicine, or Prussiate of iron. The provings so far have not developed any characteristic febrile symptoms, nor do I believe it is a fever-remedy in any sense. If it arrests ague, it does so, probably, by its general restorative action, in a manner similar to many other bitter medicines. I have found it useful in languid states of the circulation, due to a weak condition of the muscular structure of the heart. Dr. Clifton, of Northampton, England, writes as follows of Hydrastis in dyspepsia. He gives the following indications: i. The facial expression. This is dull, heavy, of a yellowish-white color, sodden-looking, not unlike that in which Mercurius is indicated, but whiter and having less animation. Though there is in its provings no reference to the expression or complexion as affording reasons for selecting Hydrastis, I have frequently found that when the gastric symptoms calling for this medicine have been present the character of face has been that I have described. 2. Tongue. The tongue is large, flabby, and slimy-looking. Underneath the fur the tongue is of a bluish-white color, having in its edges the imprints of teeth; so far it is like the Mercurius tongue, but lacks the tremulous character of this organ, so often seen in cases benefited by Mercurius. The coating is a yellow, slimy, sticky fur. There are morbid states occurring in other organs to which Hydrastis is HYDRASTIS CANADENSIS. 331 homceopathic, but where the appearances of the face and tongue I have described are not present. In the dyspepsia it relieves, both are met with. 3. Eructations. These are generally sour or putrid, and more commonly the former than the latter. 4. Appetite.'The appetite is generally bad, the power of digesting bread and vegetables being especially weak; both are followed by eructations. 5. Stomach. There is in the stomach a sensation of weight (not as after Nux and Bryonia, " weight like a stone,") and with the weight and fullness, an empty, aching, "gone," feeling, more or less constant, but aggravated by taking a meal. The aching " gone " feeling is something like that produced by Gelseminum, but is attended with more general fullness of the stomach, and more sour eructations. Further, although the Gelseminum tongue is sometimes coated white or yellow, it is not so large and flabby as is the Hydrastis tongue. This symptom is, I am aware, produced by many other medicines besides Gelseminum, especially by Ignatia and Cimicifuga, but Ignatia and other medicines do not give rise to the other symptoms peculiar to Hydrastis. In tea-drinkers this symptom occurs frequently, but with them the tongue is generally white (except when colored by the tea), and in their dyspepsia China is often found to answer better than other medicines, especially in removing the flatulence with which they are commonly troubled. 6. Action of the bowels. This may be either infrequent and constipated, or frequent, with the stools loose, soft, light-colored, and with flatus. But as a rule the bowels are constipated, and stools lumpy and covered with slimy mucus in cases indicating Hydrastis. 7. The phthisical constitution. I say phthisical constitution, because there is a dyspepsia which often occurs in persons in whom phthisis is fully developed. They are patients, members of whose families have died of phthisis, but who, without having tubercles in the.lungs, suffer every three or four weeks or longer from what they call bilious attacks and indigestion. Such persons generally have dyspepsia marked by the symptoms I have named. Here Hydrastis in one or two drop doses of the mother tincture two or three times a day, works marvellous changes for the better. Then, again, in persons with developed phthisis pulmonalis, with cough, purulent expectoration, emaciation, furred tongue, loss of appetite, " goneness " at stomach, flatulence in the bowels, faint feeling after stool, stools generally loose and frequent - in such cases Hydrastis in alternation with Arsenicum will often prove very beneficial. Iodde or Arsenic is also useful, but where it is so the tongue is generally less furred, and there is less flatulence. The late Dr. Marston called attention to the value of Calcarea Carbonica in the dyspepsia of phthisical patients who had "fullness of the stomach, acidity, dislike to meat and hot food, with pain and pressure in the stomach, vomiting and headache." I can quite endorse his observations, but in such cases night sweats and other symptoms of Calcarea are generally present, which we do not find to have been caused by Hydrastis. I have not alluded to one symptom printed in italics, in Hale's article on Hydrastis, viz., " great sense of sinking and prostration at the epigastrium, with violent and long continued palpitation of the heart." I have never noticed this symptom to have occurred, in patients for whom I have prescribed Hydrastis, even in doses of five drops of the mother tincture, neither do I remember ever having given it for that symptom. 332 HYDROPHYLLUM VIRGINIANUM. In Hydrastis dyspepsia I have generally found the lower dilutions, such as the Ist decimal, answer best; but in catarrh of the head, nose, and fauces, indicating this remedy, I generally give the 6th centesimal, as in nearly all the proving of this medicine by dilutions, up to 30, catarrh of these parts was most marked. HYDROPHYLLUM VIRGINIANUM. The meager knowledge which we possess of the medicinal uses of this plant, was given to the profession by Dr. P. B. Hoyt, of Indianapolis, in a paper read by him before the Indiana State Society. He says: " My attention was first called to this plant in 1860, near Nashville, Tenn. While strolling on the banks of the Cumberland River, I discovered on a bluff near by, a cluster of beautiful blue flowers, which I gathered. " Not more than ten or fifteen minutes after, my eyes began to water and burn, with slight itching. This continued to increase till when I arrived at my boarding house I was suffering quite severely. I found that my eyelids were swollen and the sclerotica much injected, presenting a fiery redness, and there was some sensitiveness to light. These symptoms continued through the afternoon and evening, and kept me awake for some time. In the morning my eyelids were agglutinated, and on opening my eyes they were quite sensitive to the light. The burning and smarting was less, still, my eyes discharged water more or less for two or three days. The symptoms gradually subsided and in a week I was well again." Dr. Hoyt states that twice afterwards he had the same eye-symptoms after gathering the plant. He says he has tested it in one case of catarrhal inflammation of the eyes, which it cured " like magic." I can not find any mention of this plant except in Rafinesque's Medical Botany, and he quotes Schoepf, as stying that the " Hydrophyllum canadensis is used against the bites of snakes, and the poisonous erysipelas produced by Rhus." It would seem by this that it has cured eruptions similar to that which it causes. THE HYPOPHOSPHITES. 333 Gray says there are four species of Hydrophyllum (Waterleaf), all growing in the United States. I should judge they resembled in their effects Euphrasia, Pulsatilla, and Rhus, but this is only conjecture. THE HYPOPHOSPHITES. The salts of Hypophosphorous acid, or those known as the Alkaline hypophosphites, were introduced into the practice of medicine nearly twelve years ago, by Professor Churchill. He was very sanguine that he had discovered in them the specific remedies for phthisis and many tubercular diseases. He did not claim that they would cure advanced cases, nor such as were persistently hereditary. His theory was, that phthisis and tuberculosis was due to a deficiency of phosphorus in the system; that the hypophosphites were decomposed in the stomach, and the phosphorus was assimilated. He believed that this was the only way that free Phosphorus could be safely taken into the system. The allopathic school treated these medicines as they do all new medicines —used them in excessive quantities and in all cases. They expected too much from them, and not having any characteristic indications for their use, they failed in nearly all cases, and finally rejected them almost altogether. It remained for our school to take them up and use them in a scientific manner, selecting each one from special indications based on our provings of Phosphorus and the alkaline bases of which they are composed. Take for example the Hypophosphite of Lime (Calcis hypophosphis.) If we wish to select this medicine in a case of pulmonary difficulty, we must note down, as Hahnemann recommended, all the symptoms of the case, and then examine the pathogenesis of Calcarea and Phosphorus, or Phosphoric acid, and if they cover the totality of the symptoms, the Calc. hypo. is the homieopathic remedy. I am well aware that we can not always predict that the union of an acid with an alkali will result in a medicine which shall 334 HYPOPHOSPHITE OF LIME. comprise the qualities of both. New qualities may arise, as is the case with the Bromides; but many years' experience with the Hypophosphites enables me to assert that the action of Calc. hypo. is very similar to the action of Calc. phos. and Phos. ac. We have no systematic provings, but fortunately Dr. Churchill has left us some valuable observations, which confirm my opinion; e. g., he says of the HYPOPHOSPHITE OF LIME, that its pathogenetic (primary) action is to cause "a wellmarked increase of nervous force; a remarkable increase of health and strength, calm and profound sleep, plethora with a tendency to haemorrhages; haemorrhoids bleed for the first time, or commence under its use; profuse epistaxis, pulmonary hoemorrhages, profuse and frequent menses, great increase of appetite, fullness of the blood vessels of the hands and feet;" and he warns against the excessive use of it, for " large doses tend to cause the development of the pulmonary inflammation unhappily so frequent and fatal among consumptives." We here see pictured forth very vividly the chief pathological effects of the primary over-stimulation of Calcarea and Phosphorus. If given to prevent the development of phthisis, it may cause the very conditions you wish to avoid, if you use too large doses. For symptoms leading to plethora, haemorrhage, or pulmonary inflammation, you should not use lower than the sixth trituration. I prefer this medicine in many of that class of cases where I used to give Calcarea and Phosphoric acid. My experience with Calcis hypo. enables me to.speak with considerable certainty, for I have found it useful in incipient phthisis, with hacking cough, hectic fever, nightsweats, scanty and delaying menses, great nervous prostration, great tenderness of the outer thorax, and rawness in the chest, hmemorrhage from the lungs at the time the HYPOPHOSPHITE OF LIME. 335 menses should occur, tendency to cold hands and feet, quick pulse, etc. Given in grain doses of the 1st, 2d or 3d triturations, it.often acts beautifully in restoring the patient in a short time. Not only is it useful in pulmonary complaints, but it is one of the best remedies we have for so-called scrofulous manifestations. It answers fully Hahnemann's indications for the use of Calc. carb. in scrofulous affections, especially when occurring in children, namely: the overgrowth, the large head and open fontanelles, the distended abdomen, the tendency to swelling of lymphatic glands, the tendency to brain affections, to catarrhal discharges, abscesses, etc. It is excellent in the morbid physical development and mental precosity of young persons about the age of puberty, but in such cases it should be used in the high attenuations (30th trit.) For too late appearance of puberty, with lax fiber, and in fat, lymphatic persons with languid circulation, torpid intellect and stupid mental condition, this medicine in grain doses of the 1-10th, or even the crude, given with the meals, often acts very favorably. I have succeeded in curing several cases of incipient tubercular meningitis in children with this salt, in about the same doses. The symptoms and conditions will be found in Vol. I, " Special Symptomology." There is a condition into which children often lapse after attacks of exhausting diseases. It is called the hydro-cephaloid disease, and is often mistaken for true hydrocephalus. Adults after severe fever and prostrating maladies, often get into the same state. In this condition, the Cale. hypo., aided by a liberal diet and the careful use of stimulants, will quickly cause the patient to rally from the apparently dangerous state. After exhausting diseases of any kind, patients are often annoyed by a hacking cough, with soreness and tenderness of the chest. Calc. hypo. cures this cough. 336 HYPOPHOSPHITE OF POTASSA. In marasmus, from mesenteric disease, I know of no better remedy, especially if the child has previously been too fat, of flabby flesh, etc. In common with many others of our school, I find it, alone, or in connection with China, the most useful remedy we possess, against the effects of exhausting discharges of blood, semen, mucus, pus, or any abnormal secretion. In suspicious chronic diarrhoea, when phthisis abdominalis is feared; in wasting leucorrhoea, from the uterus and vagina; in diseases of the bones, with caries and purulent discharges; and spinal curvature in strumous children; and even in rachitis, you will find it a remedy not to be dispensed with. The Calc. carb. has been used since the time of Hahnemann, to facilitate the process of teething in children, and for deficient growth of osseous structures. Where the trouble depends on the scrofulous diathesis alone, that preparation will suffice, but in cases where the nervous energy of the child's system is deficient, the Calc. hypophos. is greatly superior. On the contrary, if the nervous and vascular system is in an excited and irritable condition, and congestions or spasms, or both, are threatening, I prefer the Calc. brom. to any other preparation of lime. HYPOPHOSPHITE OF POTASSA. This salt has a different range of action from the Calc. hypophos. The latter acts by preference on the nervous and bony structures; on the glands and the assimilative functions; while the former acts on the muscular system - as well as on the nervous-and while it has some action on the sametissues and functions as the lime, that action is not as intense. The potash-salts are all muscular-tissue-remedies. Study the action of Kali. carb, and Phosphorus, and you will find pictured forth in them the salient features of this salt. A characteristic indication for the use of this remedy, is HYPOPHOSPHITE OF POTASSA. 337 "great debility, especially when attended by marasmus and wasting of muscular tissue." Another, equally characteristic, is the presence of that condition so thoroughly described by Dr. Inman, namely: myalgia, or a painful condition of the muscles of the whole body. Under this name is included all those conditions which are erroneously called chronic muscular rheumatism, pleurodynia, spinal irritation, lameness, cramps; and it even simulates peritonitis! The potash-salt affects the bronchial mucous membrane in preference to the parenchyma of the lungs, and is most useful in asthma and chronic bronchitis. In lung affections attended with severe thoracic pains, it is, like Kali. carb., a splendid remedy. It relieves the pains from excessive coughing, and brings back a cough in patients whose thoracic-muscles have become so weak that they can not cough. Like Phosphoric acid and China, it restores the health, when broken down by loss of fluids, especially the muscular weakness from undue lactation, from loss of semen, loss of the phosphates (in the urine), and profuse expectoration in phthisis. It is an excellent remedy in that condition known as oxaluria, with dyspepsia, lowness of spirits, emaciation, etc. It is one of the best of the few antidotes we have for the effects of excessive tea-drinking, or rather for the excessive use of tea, without a proper amount of nutritious food at the same time. Tea — even green tea —can be used largely, without injurious effects, if an abundance of nitrogenous food, such as beef, mutton, fat, eggs, etc., is taken with it. The potash takes their place to a certain extent, and prevents further waste for a time. In ancemia with emaciation, this salt should always be given with the preparations of Ferrum, for it aids the action of Iron greatly. In anaemia or chlorosis, without loss of flesh, but a bloated, or dropsical tendency, the Calcarea, or Natrum salt, is more appropriate. The remedies which alternate or follow with good effect, the Kali hypophos., are China, Hydrastis, Helonias, and Aletris. In pulmonary affections it is often alternated with Rumex, Sanguinaria, and Sulphur, with good results. 338 BERIS AMARA. The Hypophosphites of Soda (Natrum), of Iron, of Ammonia, and Zinc, have been used, but not very extensively, except the Soda-salt, which is a great favorite with me in general nervous debility, uncomplicated with other ailments. A reference to Vol. I will show that in the conditions mentioned, the Kali hypo. has usually been given in doses of one quarter to one or more grains several times a day. In my practice I use the tincture in first and second decimal aqueous dilutions in doses of 10 to 30 drops. It can not be triturated, owing to its deliquescent character. The mothertincture is made by adding one drachm to nine drachms of distilled water. IBERIS AMARA. The Iberis (Candy-tuft) belongs to the family Cruciferae of which Sinapis (Mustard), Raphanus (Radish), and Thlasp (Shepherd's purse), are members. The genus was named Iberis by Dioscorides, and the name is supposed to be derived from Iberia (Spain), its place of natural growth. The habitat of all but one species is the south of Europe. The Iberis amara is a native of England, and is found in great plenty in Berkshire. None of the species are North American. The Lepidium boniraense of South America, a near relative of Iberis, has been proved by Dr. Mure, of Brazil. Its heart symptoms are notable, and resemble those of the Iberis amara. My attention was first called to this medicine by a brief observation in Wood's Practice, vol. ii, p. 184, where, in giving the treatment of hypertrophy of the heart, he mentions that " Dr. Sylvester speaks highly of the Iberis amara in that disease. He gives the seeds, rubbed to powder with Cream of tartar, in doses of from one to three grains. The remedy was first brought into notice by the late Dr. Williams, of London." Since my attention has been specially directed to cardiac diseases, I have frequently been tempted to prescribe Iberis, IBERIS AMARA. 339 but we had no proving to guide me in its selection. But in the Winter of 1871-72 I found three students in the class of Hahnemann Medical College who were willing to make provings of the drug. These provings fully verified the supposition that it had a specific action on the heart. They were published in the United States Medical and Surgical Journal, of 1872, pages 295-313. The provers were Drs. Sabin, Dodge, and Magee, and their principal symptoms agree very well. The sphere of action of Iberis is undoubtedly upon the heart and those organs most under its influence.. In its affinity for the heart it may in time rival Digitalis, Cactus, Collinsonia, and Lycopus. The primary effect of Iberis appears to be to lessen the force of the heart's action without lessening its velocity. "It possesses the property of controlling the violence and sharp action of the heart, and softening the pulse; hence its great value in hypertrophy with dropsy." (Sylvester.) The italics are my own; they give standing to the provings, for you will observe that the pulse was softened in the provers, even during palpitations. Primarily, then, it depresses the force or impulse of the heart, when given in doses of onekto three grains several times a day. It is to be presumed that the hypertrophy which it remedied in Dr. Williams' practice, was from thickening of the heart's walls, a condition in which the impulse is powerful. Hypertrophy with dilatation has impulse not powerful, but with excessive action. While it was primarily homceopathic to the latter condition, I think it would be secondarily indicated in the former, for if it depresses the heart for a long time, the reaction (or secondary effect) would be to the other extreme. I imagine that it does not act on the accelerator or the retardator nerves of the heart, but either on the nerves which supply the heart with its force, or upon the ganglia of the heart itself. One characteristic of the drug appears to be that its primary depressing action is rather transient; the secondary, or exciting, more persistent. 340 IBERIS AMARA. Its action on the liver, kidneys and chest, so far as the symptoms go, appear to indicate that it acts like Digitalis. Like Digitalis, it causes severe vertigo and intermittent pulse, but does not cause the slowing, characteristic of Digitalis. I have used it in a few cases of hypertrophy with dilatation, when there was excessive action, without much force, vertigo, scanty urine, clay-colored stools and troublesome cough. These symptoms it appeared to remove. I used the 3d dilution, in five-drop doses, every four hours. In hypertr.ophy with enlargement I should use it in the same doses of the 1st dilution or trituration of the seeds. Dr. Williams used it successfully in asthma, probably cardiac dyspnoea; in bronchitis, perhaps from cardiac trouble; and dropsy, undoubtedly cardiac. Dr. Sylvester says he has " prescribed it for ten years, in numerous instances, for these diseases- always with some benefit, and sometimes with almost magical efficiency." He admits that in his doses it " occasionally induced giddiness, sickness (nausea) and diarrhcea." The ancients made much use of Iberis. Pliny says it was used in gout. Galen used it in " rheumatic affections of the hip-joint." Archigenes prescribed it in disease of the spleen and hip. It is worth while to observe that the Nasturtium, a plant akin to Iberis, is used in dyspncea. Many of the " Cresses" are used in asthma: Iberis is a cress. It may be that it is specially homoeopathic to diseases of the heart of a rheumatic or gouty nature. Theoretically, I would advise you to try it in jaundice occurring in persons with heart-disease; in bronchial cough from a similar cause; and in some congestions of the head in young persons about puberty, in elderly persons, or women at the change of life. Since the provings were published, two years ago, no reports of its clinical use have been made, nor have I heard of its use in other hands than mine. I have been surprised at this, for our cardiac remedies are not many, and those we have are not fully developed. IODIDE OF ARSENIC. 341 IODIDE OF ARSENIC. This preparation of Arsenic has been a favorite remedy in my practice for many years. Its sphere of action is quite decided. I know of no medicine which is so certain in its curative action, when prescribed according to its characteristic indication. That indication is sharp and well defined. It is the peculiar and persistently irritating, corrosive character of all the discharges. No matter what the disease is; no matter from what source the discharge arises; if the discharge irritates the membrane from which it flows, and over which it flows, this medicine is fully indicated. In this respect it resembles Nitric acid, Ailantus, Arum, Arsenic, and a few others; but none possess the symptoms as prominently as this. The discharge is often feetid, not always; it is gener*ally watery, not always; the mucous membrane, where it has its origin, is always red, angry, and sometimes swollen. When the discharges (especially in catarrh or influenza) are attended with alternate chills and heat, I give it alone. When there is heat alone, or chills alone, especially if the chills run up the back, I alternate it with Gelseminum. (Gelseminum has a discharge, thin, watery and profuse, but not corrosive and irritating.) The diseases in which I have found it useful, and in which it generally acts speedily, are Epidemic influenza, whether a simple catarrhal fever, a "bad cold," or the "epizootic," so called. When the "horse disease" swept over this country, I carefully studied the symptoms as narrated by the newspapers, and I resolved, in case it reached Chicago, I would give the Iodide of Arsenic to my horses, if attacked. I saw many cases in all stages, and was struck with the similarity of all the symptoms, and the general condition of the animals, to the symptoms of Arsenic, particularly the Iodide. I publicly advised its use, and gave it to my horses, and to those of my neighbors, as a prophylactic. The result was that in many cases it cut short the disease when well under way, and prevented, almost 342 IODIDE OF ARSENIC. entirely, its attacks in those horses to whom it had been given as a preventive. The disease afterwards attacked men, women and children, and this medicine was the specific remedy in nearly every case I treated, although, as before mentioned, Gelseminum was of great assistance. It is the nearest to a specific for catarrhus cestivus, or hayfever, that we now possess. I have cured many cases of years' standing; I have inodified many habitual attacks so that they became bearable and did not drive the patients to Mackinaw. And in many epidemics similar to hay-fever it acted magically, sometimes arresting the attacks in a few hours. In old nasal catarrhs, when the discharge becomes bloody and fetid, scabs and pus come from the nose, and the irritation extends to the throat, the Iodide of Arsenic continued for some time, together with the use of a douche of Glycerine and water, effectually cures. In these cases it is. superior to Silica, Hepar sulph., or Kali bich., so highly praised in our text-books. It is equally valuable in chronic scrofulous ophthalmia, with ulceration; in otorrhcea with foetid, corrosive discharge; in corrosive leucorrhcea with too frequent and profuse menses (generally with ulceration of the os); in diarrhcea (so common in children and in consumptives), when the evacuations "scald," irritate, and make the parts sore and excoriated. In malignant diphtheria, scarlet fever, and small pox, it should never be forgotten, for it will effect an alteration of the malignant processes quicker and surer than any other medicine. I have found it of great value in hypertrophy of the heart with dilatation, when the patient was troubled with severe and violent palpitations, with great anxiety in the region of the praecordia, asthma and dry cough. It has been found very beneficial in aphonia when occurring in thin, impoverished persons, in whom some psoric taint manifests itself in the form of a dry, scaly eruption on the skin. IODIDE OF BARYTA. 343 Cough. It has cured a chronic dry cough in patients resembling those first described. Marasmus ought to be cured by this preparation more speedily than by Iodine or Arsenic alone. Tumors of a malignant character. Dr. L. B. Wells, of Utica, New York, cured a lady of forty-nine, of a swollen gland in the left axilla, size of a hen's egg, hard, and exuding a fluid which formed a hard, brown crust. The tumor was very painful and sensitive to the touch. The breast of the same side was also enlarged, indurated and very sore. She also had yellow, bloody and irritating leucorrhcea, with swelling of the labia. Iod. of Ars. 6th cured the whole in a few weeks. In Bright's disease with dropsy, it may prove a better remedy than Ars. alb. In obstinate eruptions on the skin, it has acted better in my practice than Ars. alb., particularly in dry, scaly, burning and itching eruptions, such as lepra, impetigo, psoriasis, tinea, firfuraceous pityriasis. Also in old, irritable ulcers, with sanious, corrosive discharge and burning pains. When these affections occur in scrofulous subjects, with swollen lymphatic glands, the Iodide of arsenic is specially useful. In those sudden attacks of erythema, affecting the head, face, neck and hands, with intolerable itching and burning, and ending in bran-like desquamation, and which I believe to be hay-fever under a masked form, this medicine acts better than Rhus. My two favorite triturations of this medicine (for I never use it in dilution), are the 3x and 6c, the former for adults, the latter for children and delicate patients of any age. IODIDE OF BARYTA. In your studies of the old remedies you will remember the recommendation given for the Carbonate of Baryta, namely: "Scrofulosis: swelling and induration of the glands, especially the cervical glands, even after suppuration has set 344 IODIDE OF BARYTA. in." Of the Muriate, it is said to be the best remedy for "stone-like induration of the glands," and a " tendency to tonsillitis." This last recommendation has been verified by a great many practitioners who are enthusiastic in its praises, not only as a preventive, but as the best remedy in acute quinsy, which it is said to arrest in the forming stage, preventing suppuration. Allopathic authorities, especially the older writers, claim that Baryta "resolves and liquifies abnormal accumulations wherever found." It is eminently a glandular remedy, and possesses specific power over the absorbents equal if not superior to Iodine and others of that class. Its use, except by homceopathists, has been greatly neglected until of late Dr. Hammond has recommended the muriate in sclerosis of the posterior columns of the spinal cord, a condition better known as "locomotor ataxia," the morbid anatomy of which consists of an atrophy of the cord, with hypertrophy of the connective tissue. This same pathological condition may occur in the brain. It is then known as cerebral sclerosis or atrophy of the brain. For these conditions, Hammond recommends the Chloride of Barium in doses of one-half or two-third grains three times a day. If you will refer to Hahnemann's recommendation for Baryta, you will find that he mentions many of the symptoms caused by cerebral and spinal atrophy, such as the diseases of old age, imbecility, paralysis, loss of coordination of motion, etc. It appears to me that Hammond has hit upon the pathological key-note for the use of Baryta, namely: an hypertrophy of connective tissue. The atrophy of nerve substance is a necessary result of such a condition. The difference between Iodine and Baryta appears to be this, that whereas the former is curative in soft hypertrophy of glandular or connective tissue's, the latter is useful in hard indurations. In this respect it is analogous to Conium. Several years ago, it occurred to me that the chemical union of Iodine and Baryta would from a medicine whose effects would be just what we desire in the treat IODIDE OF LEAD. 345 ment of cases of 6glandular enlargement with a tenden.cy to induration. I therefore procured some freshly-prepared Iodide of Baryta, and prescribed it in hypertrophy of the tonsils. The result was very gratifying. It effected a rapid diminution in the size of the glands, even when they had been indurated for some years. In one case it not only had this effect, but it greatly relieved the symptoms arising from an enlargement of the prostate gland, with which the patient had suffered for some time. It will not act as well as the Muriate or Carbonate in acute tonsillitis, but it is better adapted to the resulting hypertrophy with induration. I would strongly urge you to test its powers in entlaiged and indurated testicles and ovaries, also in goitre. In one case of indurated testicles, it diminished their size quite notably. In another, it evidently aided the action of the galvanic current in reducing the hypertrophy. I would also advise its use in enlargement of the mesenteric glands in scrofulous children. It may prove useful in some cases of mammary hypertrophy. Dr. Liebold, of New York, a celebrated oculist of our school, has been successful in its use for certain diseases of the eye. You will find his paper in the Transactions of the American Institute, 1873. In the N. Y. Transactions for 1873-4, you will also find a paper by our Professor of Ophthalmology, Dr. Woodyatt, on its use in syphilitic keratitis interstitial. He reports a case complicated with enlarged cervical glands, which was cured by this remedy. He advises it in suppurative inflammation of the middle ear, phlyetenular conjunctivitis and scrofulous ulcers. He does not give the dose. I usually prescribe the 2x or 4th trit., several times a day. IODIDE OF LEAD. This drug has been very little used by our school. It was recommended by some French physician for diphtheria, but 23 346 IODIDE OF SULPHUR-IODIDE OF AMMONIUTM. no characteristic symptoms were given. I can not imagine any Plumbum symptoms indicating its value in that disease, and believe all the effects due to its use came from the Iodine. A long time ago, in a paper on atrophic-ovarian amenorrhcea, Dr. Peters recommended it for that condition, but on purely theoretical grounds; but, upon the same grounds, I should prefer the Iodide of Barium. There are others of the Iodides which may become valuable remedies. One of them, the IODIDE OF SULPHUR, I have used a good deal in obstinate skin diseases, notably in barber's itch, for which it is almost a specific. I prescribe the 3c trituration internally, and the cerate rubbed in night anid morning. The cerate should be made of the strength of one or two grains of the Iodide to an ounce of Cosmoline or some other vehicle. It is also useful, used in the same manner, in large and painful suppurating acne of the face in young people. Dr. Scudder, in his " Specific Medicine," recommends the IODIDE OF AMMONIUM for a chronic, persistent headache in young, or full-fed persons, accompanied with a stupid, heavy look. Such headaches are often caused by close school-rooms, or confinement in-doors. He gives a few grains three times a day. We ought to prove the Iodides of Silver, Cadmium and others, for we may find in them remedies for conditions and symptoms for which we have now no specific. NOTE.-Since writing the above, I find in the Journal of Pharmacy the following by Dr. Garrod, relating to Iodide of Cadmium. He says all the other Iodides when used as external applications, have a bad odor, or stain the skin or clothing. But, he adds, the IODIDE OF CADMIUM-ILEX AQUIFOLIA. 347 IODIDE OF CADMIUM possesses all the valuable qualities of Iodine, when applied externally. It has no odor, nor does it stain. It forms a perfectly white and soft ointment, producing but little local action upon the skin, and is readily absorbed when applied by friction. Under the use of this ointment he has witnessed, in many cases, enlarged glands of a scrofulous character rapidly reduced to their normal dimensions. He has seen it give great relief in nodes and chronic inflammation of the joints. Some homceopathists do not disdain to use remedies externally. To such, this will be an improvement over the usual ointments of Iodine. One part of Iodide of Cadmium to ten of Cosmoline is the proper proportion. ILEX AQUIFOLIA. This is an evergreen tree, from ten to twenty feet high, growing in the southern United States as well as in Europe. The Ilex opaca belongs to the same genus. Rafinesque considers it merely a variety, and says that the properties of both are the same. " The decoction and wine has been used for cough, pleurisy, colic, gout and rheumatism." Browne (Sylva Americana) says the berries, fifteen to twenty of them, will cause vomiting and purgation. There is another species, the Ilex vomitoria, (Cassena) which is regarded by the Indians as a holy plant, being used by them in their religious rites for the purpose of cleansing their bodies of all impurities. It seems to possess the power of vomiting persistently and thoroughly, with but little pain or consequent prostration. The Ilex Paraguayensis, or Paraguay tea, is used by the natives of that country much as Chinese tea is used by us. It is said to " give sleep to the restless and spirit to the torpid." It is said to contain Theine. The only mention of the Ilex which I find in our literature is in vol. lxxxvii, p. 148, of A. H. Z., by Dr. Hendricks, 348 IRIS VERSICOLOR. who cured several cases of "rheumatic inflammation of the eye, with periostitis of the frontal bone, which almost always leads to staphylomatous degeneration of the cornea." He used the first dilution of the llex aquifolia, five-drop doses, four times a day for eight days. IRIS VERSICOLOR. The Blue flag was introduced into our Materia Medica by Dr. Kitchen, of Philadelphia. It was proven by Drs. Rowland, Holcombe, Burt and Sanford. It is one of the best proven remedies in use, and possesses valuable and peculiar powers. It had a great reputation among the aborigines of this country, who transmitted an account of its virtues to the early pioneers, thence to the 6" Botanic " doctors, then the eclectics, and finally it assumed a dignified position in the hands of homceopathists. I think we had no provings of Iris at the time of Dr. Kitchen's first use of it. He gave it for its well known violent effects in large doses, of which the most prominent is vomiting. I shall give, in its proper place, an extract from Dr. Kitchen's original paper. The sphere of action of Iris includes the gastro-intestinal mucous membrane, and its glandular apparatus. It alters the secretory functions of these glands, changing the secretions to a peculiarly acid condition. In this it resembles Pulsatilla, Robinia, Chamomilla and Calcarea. It was supposed that it had a specific action on the liver, but I doubt it. Its irritating action on the duodenum may account for its hepatic symptoms. I donot assert that it has no power over the secretory function of the liver, for it acts powerfully on the salivary and gastro-intestinal glands, and itis supposed to act specifically on the pancreas. It has a decided action on the skin. It produces vesicles, which dry up leaving a purulent scab; and pustules, which are sore and painful. Dr. Alabone, of England, reports cures of cases of psoriasis in irregular patches. In this respect it resembles Phytolacca, Rhus, Sulphur and Sepia. IRIS VERSICOLOR. 349 It has been found very useful in pustular eruptions on the head and face, (tinea, prurigo, crusta lactea, eczema, etc.), especially in children. I have used it successfully, and find that a characteristic indication for its use is the acid diathesis, or an acidity of the secretions. When a child has sour breath, vomits sour ingesta, and has a watery or green sour diarrhoea, and has at the same time a pustular, or even vesicular eruption on the head, face, or body, give Iris 3x, and if you wish to hasten the cure, use an Iris cerate. I do not think the Iris is properly a fever remedy. If it causes febrile symptoms, as it appears to do in the provers, it is from gastro-intestinal irritation. Dr. Kitchen used it in fever, but a perusal of his cases show them to be of a gastric or hepatic origin. You will find it a valuable auxiliary in the treatment of bilious, gastric and enteric fever, when its symptoms accurately correspond, i. e., when vomiting and diarrhcea of acid, bitter, bilious matters, with severe pain in the head, are present. Its greatest reputation has probably been that of a sickheadache remedy. It is equally useful in the bilious-headache, also in certain nervous-headaches. A majority of the headaches of Iris are reflex — proceed from acid stomach, or irritation of that organ from acrid secretions. It seems, however, to be capable of causing an idiopathic nervous headache, or neuralgia. The Iris headache generally occupies the forehead and right side of the head; aggravated by rest, and on first moving the head, but relieved by continued motion; accompanied by lowness of spirits, nausea, and acid vomiting. Dr. Kitchen, who published the first clinical experience with this remedy, says of its use in "sick headache:" "It is the most prompt and effectual remedy I have ever given in this truly annoying malady. The first dose will arrest the trouble in some patients. I have experienced this effect in several cases. I have made comparative trials with it and other remedies, telling my patients to observe, and let me know which number would relieve them the most speedily. They,have invariably sent for the number attached to Iris, on the 350 IRIS VERSICOLOR. attack; this I consider conclusive respecting this complaint, so that I need not comment on it further than to recommend it very highly, so far as my experience goes." The Iris has been tested by many homceopathic physicians, in sick headache, and the testimony is generally in its favor. From our knowledge of the sphere of action of this medicine, it would seem most likely to be indicated in those " sickheadaches" of a gastric or hepatic origin. In the purely " nervous sick-headache," or that variety arising from congestion, other remedies may prove more useful. This matter, however, can only be decided by careful observation. In neuralgia of the head, eyes, etc., Dr. Kitchen recommends the Iris: "A lady afflicted at intervals with this most distressing complaint, who had swallowed the whole allopathic and homceopathic Materia Medica, with only partial benefit, has been more relieved by the Iris than by any remedy I have yet administered to her. It is usually in the head, temples, eyes, etc., and attended with most distressing vomitings of a sweetish mucus; and occasionally, when there is much straining, with a trace of bile. It is the only medicine which has much control over the stomach, arresting the vomiting in the few trials I have made with it, very soon, and allaying iii some degree the violent pain in the head, so that I have been asked by her whether I had not given her Morphine. I have been asked the same question by patients in bowel affections, they frequently going to sleep after its administration; this is easily accounted for by the cessation of pain, which is almost invariably followed by sleep." Dr. Holcombe found by proving Iris that it caused a peculiarfacial neuralgia, which he describes as follows: " A neuralgia involving the supra-orbital, infra-orbital, the superior maxillary and inferior dental nerves; it begins after breakfast, every morning, with stupid headache, and lasts many (20) hours." He reports that he has verified these symptoms in practice. Writing of its sphere of action, he says: " The inference I draw from this' fragmentary proving is, IRIS VERSICOLOR. 351 that Iris, in small doses, often repeated, acts on the male system, sanguineo-nervous constitution-especially in the mbrning, especially on the right side -from the right to the left, from above downwards, from the animal system to the organic system; indicated in the former by facial neuralgia and copious limpid urine; in the later by flatulent colic and burning tenesmus." My own experience leads me to believe that the Iris, like Pulsatilla and Nux, has a two-fold action on the nerves of the face and head, namely: a reflex and direct; the former from deranged stomach, the latter from its direct action through the blood, as an irritant. Not only does it cause neuralgic pain in the head and face, but in other parts of the body. In Rowland's proving, the pains were called by him rheumatic, and they may have been. Every physician knows how prone are those patients who have gastric derangements to have neuralgia and rheumatic pains all over the body, and how quickly they disappear when the condition of the stomach is corrected. Rheumatalgia of the right shoulder, wrist, hand, and in the right hip, knee-joint, and foot, is cured by Iris. In commenting on the eclectic use of Iris, in the second edition of New Remedies, I used the following language, which is equally applicable now: The eclectics class this plant among the "sialagogues." Dr. Burt, who proved the fresh root in large doses, does not doubt that it would produce sloughing and deep ulceration, if continued for a long time. There is a rather curious and remarkable similarity between the action of the Iris and that of Mercury; this is all the more singular, when we consider that the former is a vegetable remedy. Not only does the Iris affect the mouth in a similar manner to Mercury, but this similarity of action extends throughout the whole glandular and mucous systems, and perhaps all the tissues except the osseous. I have taken patients from off the hands of eclectic physicians, who were so completely salivated by the Iris, that were it not for the absence of the peculiar fetor, I should have taken it for a mercurial salivation. 352 IRIS VERSICOLOR. Even the sympathetic fever, which the Iris causes, has considerable resemblance to that of Mercury. Eclectic authors thus speaks of the Irisin: "Irisin is justly esteemed as one of our most valuable alteratives. It is eminently resolvent, and exercises a marked influence over the entire glandular system. It increases the salivary flow, and has the reputation of producing ptyalism. But a careful distinction must be made between the effects produced by vegetable agencies upon the mucous and salivary glands, and mercurial salivation; the former are nothing more nor less than manifestations of a quickened physiological activity —evidence of a special therapeutic stimulus constituting oftentimes a critical conservative effort-no loosening of the teeth; no sponginess of the gums; no putrefactive odor; no sloughing of the soft parts; increased but not disordered secretion. On the other hand, Mercury induces a pathological condition of the vital constituents of the blood and fluids, and favors the formation of vitiated products; altering from good to bad, and from bad to worse; giving rise to congestions, lesions, putrefactive conversions, and disorganizations of the organic structures. In the former case we have the evidence of a direct therapeutic stimulus, operating upon the vital impressibility of the secretive apparatus, promoting increased activity of the functions for the purpose of eliminating legitimate products. In the latter instance we have an augmented flow of morbid material, resulting from the destructive conversions of the vital constituents by the remedy itself, and which are not the legitimate products of organic metamorphoses. In the former case, the remedy itself is the mother-stimulus, while in the latter instance the mercurial corruptions constitute the stimuli of excitement." To the superficial student of medicine, the above reads very well, but to the physiologist it becomes simply absurd. Only one conclusion can be drawn, namely, that the writer is ignorant or dishonest. Nothing but the gravest ignorance of the elementary facts of physiology and pathology, could lead to such special pleading. He must be aware that any IRIS VERSICOLOR. 353 departure from a normal physiological state, constitutes a pathological condition. Given to a person in perfect health, the Iris causes abnormal activity of the glandular and mucous systems; Mercury does as much. The main difference between the actions of the two medicines is in degree. The poisonous effects of Mercury are all pervading and more malignant than the pathogenetic effects of the Iris. Both cause actual pathological conditions, having their peculiarities and characteristic symptoms. When given in disease, if homceopathically indicated, and administered in proper doses, they restore the tissues, for which they have an affinity, to a healthy condition. If this author was dishonest in his statements, with the intention to prejudice the reader against Mercury, his conduct degenerates into downright meanness. Mercury, when,administered according to the law of similia, is a beneficent, and valuable curative agent. When given in this manner, it never causes any pathogenetic symptoms, gives rise to no morbid products, and disorganizes no tissues or secretions. On the contrary, it tends to prevent the very calamities which eclectics so much dread, and which he could cause to a certain degree, by the abuse and prolonged use of even the Iris. I would here make an observation relative to the action of Iris, namely: it is not owing to the acridity of the fresh root acting topically, that the pseudo-mercurial symptoms are due, but to a specific dynamic action of the drug on the constitution. It is true that the Iris does contain an acrid principle, but the fact that the dried root, and even the alkaloid, causes the above-named condition when taken into the stomach, is proof that those effects belong to the whole drug. If this was not sufficient proof, we could refer the physician to the fact, that this peculiar action may be caused by the dilutions of the remedy, up to the third, and perhaps higher. It is a strange comment on the practice of the eclectic school that they should recommend the Iris highly in mercurial cachexia, syphilis, etc.! No drug is more thoroughly homceopathic to diseases of the mouth similar to those caused 354 IRIS VERSICOLOR. by Mercury, and in the few cases in which I have used it, it has acted well. Even in Mercurial salivation it has been found useful, but it can not be relied on with as much confidence as its chemical antidote, the Chlorate of Potash. In stomatitis, with or without ulceration (canker), when there is painful burning in the mouth and fauces, Iris is strongly indicated. In these cases I would advise the tincture of the green root, administered in the third or sixth attenuations. W. H. Burt, M.D., gives the following case of ptyalism, following diphtheria, cured by Iris versicolor when all other remedies had failed: "In a very severe case of salivation in a young lady after she had been attacked with malignant diphtheria, where the parotid glands were much swollen, and the saliva discharged in immense quantities-apparently three quarts a day would be secreted and spit from the mouth-I gave Mercurius, Aconite, Belladonna, Kali bichromatum, Iodine and Nitric acid. Not one of them had the least effect. I then gave Iris, and in two hours there commenced to be a change for the better. In two days the profuse secretion of saliva had entirely ceased, with a great diminution of the glands. The fourth day she was discharged cured." Iris has probably an irritant action upon the gastric mucous membrane, as seen by its specific action upon the fauces, stomach and cesophagus. By referring to Dr. Burt's heroic provings, this action will be seen portrayed in strong colors. I know of no one of the new remedies which promise to be more useful in gastric disorders, than the Iris versicolor. Even now we have some valuable clinical observations. Dr. Kitchen, in his paper on Iris, says it is useful in vomiting: " Effectual in almost all kinds -simple sour, bilious, of food, with or without pain. In every case of vomiting or sick stomach in which I have yet given it, has been successful, and in severe cases on the administration of a few teaspoonfuls. Such has been my experience, thus far, but I would not be understood as saying that this will always be IRIS VERSICOLOR. 355 the case in future. No doubt it, like all other remedies, has its appropriate sphere, which it will take time and opportunity to make out and define correctly. I merely state what I have discovered up to the present, with the limited opportunities I have had of testing it in different forms of the disorder. I have for some years attended a little girl, now about nine years of age, who has periodical vomiting spells, coming on once every month or six weeks, sometimes not for four months, but certainly three or four times in the course of a year. I have tried in various attacks all the different remedies usually successful in such cases, but not with much benefit; the attack would last two or three days, and would seem to wear itself out. A single teaspoonful of the Iris arrests it at once. It comes on with vomiting of the ingesta, then sour fluid, and at last bile, yellow and green, with great heat of the head, some general fever, and great prostration; the perspiration is warm, caused by the efforts of straining and vomiting." The Iris is eminently homceopathic to some varieties of gastritis (mucous), oesophagitis, duodenitis, and many of those disorders of digestion which go under the general name of dyspepsia. In many points it resembles Pulsatilla, especially the tendency to "acidity of the stomach," and " rising of ingesta;" also the sympathetic disturbances having a gastric origin. The peculiar and severe symptoms elicited by Dr. Burt, and referred by him to the pancreas (see provings), and which, in all probability, were really in the gland, point to its applicability to inflammation, and other disorders of that important organ. In that disease known as " Pancreatic salivation" it ought to prove specific. A thorough knowledge of the physiology of the pancreas will lead us to define pretty clearly the derangements likely to be caused by the Iris. The pancreas is usually regarded as belonging to the group of salivary glands. "The pancreatic juice is analogous to saliva. It acts upon starch even more energetically than saliva, transmuting it into sugar and lactic acid; and upon fats, by forming them into an emulsion, so that they are readily absorbed."- (Draper.) 356 IRIS VERSICOLOR. It is generally conceded that a normal pancreatic juice (as regards quality and quantity) is necessary to the digestion of fatty food. Many of the derangements of digestion are undoubtedly due to deficiency and unhealthy conditions of this juice. There can be no rational doubt of the action of Iris upon this gland. Even had we not Dr. Burt's suggestive provings, we could judge of its effects upon that gland from analogy. A remedy which irritates and stimulates the salivary glands, must have a similar action on the pancreasa similar tissue, possessing similar functions. — (Pulsatilla, Mercurius, Iodine, Podophyllum.) Dr. Burt succeeded in killing several cats with the tincture of Iris versicolor. One of the most noted morbid appearances observed on examination was a highly congested condition of the pancreas. A portion of one pancreas was subjected to a critical microscopical examination, which proved the presence of intense congestion of the minute vessels, and even a rupture, also extravasation of blood into the tissues of the gland. Dr. Kitchen says " he cured a case of gastrodynia characterized by violent pains in the epigastric region, coming on at intervals." The Iris relieved him at once, and he had no return. He has also relieved and cured, "vomiting of food an hour after after meals," with Iris. It has been for many years one of my favorite remedies for gastralgia. Instead of prescribing Nux or Pulsatilla for all stomach-pains, in a careless, routine way, study your cases. You will find Iris equal to any medicine we have in this complaint. The Iris may be called a violent cathartic - it acts on all portions of the intestinal canal, but especially the upper portion. It causes diarrhoea, with colic and flatulence, evacuations of watery, mucous, green, and even bloody stools with tenesmus. My experience so closely accords with Dr. Kitchen's, that I again quote from his original paper: The colic of infants is benefited by it. There is a peculiar condition of the abdominal region of the adult also, IRIS VERSICOLOR. 357 which may come under this head, and which may be termed a grumbling bellyache. It is most prevalent at the changes of the seasons, Spring and Autumn, and appears to be owing to a vitiated secretion of the liver, and mucous membrane of the bowels, and consists in almost constant uneasiness and grinding in the bowels; a kind of sub-colic; a mushy passage once or twice a day, in some cases, but in the generality of cases, a very foetid discharge of wind, of a coppery smell, attended occasionally with an involuntary escape of fluid, soiling the shirt, and sometimes a passage of scybalous matter, together with fluid mucoid feeces of an offensive, putrid, and coppery odor. It was a case of this kind which first led me to a use of this remedy. I had tried several medicines without the least relief, for nearly a week, and administered the Iris at random, never having given it in any disease. To my surprise, the patient was shortly relieved, and had noreturn; his bowels soon became healthy and regldar, and he praised the good effects of the remedy very highly. The sphere of the Iris appears to be chiefly the stomach and abdominal contents. Diarrhcea.-" I have not been able to obtain with any degree of accuracy the symptonrs of those cases in which it proves to be the most appropriate. I think, however, that burning in the rectum and anus, after a passage, is one state which it will arrest almost immediately. It also seems appropriate to cases in which there are pains, and green discharges, relieving the pains very frequently in a short time, and changing the green passages after some doses have been given. There is one very curious feature which I have frequently observed, which is, that when the diarrhcea is not arrested after a few doses, it seems, after the adpministration of it for twenty-four or forty-eight hours, to produce an aggravation; there is an increase of pain and several free fcetid passages, and then the diarrhoea ceases. This has generally taken place about two or three o'clock in the morning. Whether I have given it in too low dilutions, generally from second to sixth, I can not tell, but such a feature I have frequently observed, and have administered it with perfect suc 358 IRIS VERSICOLOR. cess in a few cases of periodical night diarrhoea, attended with pain, and two or three free discharges before morning. I have also cured all my cases of cholera infantum with it this summer, and some of them within a few days. I look upon it as a very valuable addition to our remedial measures in this complaint. "In cholera morbus, I have succeeded in every case in which I have administered it, even the most violent. A single teaspoonful of a few drops in a half tumbler of water, has in many severe cases put an immediate stop to the vomiting. I consider it a specific in this form of the disease, and I would earnestly request physicians to try it in the first cases of Cholera Asiatica, which may fall under their notice, and give the result to the profession. In cholera morbus it arrests the pain which is so violent in many cases at the pit of the stomach, or around the navel, or, in some cases, still lower down in the abdominal region, at or before every fit of vomiting or purging. In fact, it seems, as far as I have as yet been able to judge, the more appropriate the more violent the pain, and in some cases, acting, as the patients and bystanders express themselves,' like a charm.'" English homeopathists have found Iris very useful in cholera morbus, and even in true cholera. Dr. Geo. Lade gives his extended experience with it in autumnal diarrhoea and cholera. He says: "Forty-three patients to whom I gave the Iris, complained of simple diarrhoea only. The evacuations were in some instances papescent, but thin watery stools were now frequently observed; the majority of them were of a dirty yellow hue; some were brown, others green; and a few were apparently nothing but water. In all the cases'there were more or less griping pains, principally in the umbilical region, which, with loud rumbling in the bowels, generally preceded the discharge. Heat in the rectum and anus was noticed in a considerable number, though not in all of the cases. For the most part the appetite was unimpaired, and in no case was there any feverish symptoms. Seldom more than three or four doses (of Iris 3d or IRIS VERSICOLOR. 359 Irisin 1st) were necessary to check the disease, and in no case had the medicine to be continued more than twenty-four hours." Twelve patients had vomiting as well as purging, and recovered under the same remedy. Three patients had decided cholera symptoms. In these the Irisin had prompt and decided curative effects. Dysentery.-" Some mild cases I have cured with Iris, but it is not the remedy in this disease. The cases which seemed to be benefited were of the nature of dysenteric diarrhcea, attended with green discharges, or slimy mucus, without blood, or much straining. (Dr. Burt's proving elicited these very symptoms, however, and quite severely.) In one case it evidently acted favorably on the secretion of the liver, producing a free flow of healthy bile, and an immediate abatement of the unhealthy passages. In those cases in which there was bloody flux, I did not rely on it, not knowing sufficient of its curative powers." The pathogenesis of Iris versicolor points directly to its sphere of usefulness in some varieties of dysentery, probably in bilious dysentery; yet there can be no doubt of the power of Iris to cause acute mucous enteritis, but the inflammation may be located higher in the intestinal canal, than in ordinary cases of dysentery. (Here it appears the opposite of Aloes and Podophyllum, which affect the lower portion of the colon, rectum, etc.) It will be seen by the provings, however, that it has many symptoms analogous to Podophyllum —" the prolapsus of the rectal mucous membrane," "pricking in the anus," etc. Dr. Kitchen's successful use of Iris in abdominal typhus, proves its applicability in some quite severe forms of intestinal inflammation, and perhaps in organic lesions of that canal. I would also simply add, by way of testimony, that many homaeopathists, with myself, have found the Iris a valuable remedy in nearly every disease of the bowels for which Dr. K. recommends it. I would also suggest its use in haemorrhoids, bilious colic, fissure of the anus, fistula in ano, etc. We have no proof, beyond the bold assertion of the eclectics, that Iris is of any value is syphilis. It may palliate 360 IRIS VERSICOLOR. some syphilitic symptoms, but that it has any specific relation to that disease I do not believe. In gonorrhcea the same opinion may be expressed, although some of the symptoms indicate its power to irritate the male genitals. It is said to cure nocturnal emissions with amorous dreams. I have never been able to cure spermatorrhcea with it. You will find in practice, that nocturnal emissions are sometimes caused by acid states of the stomach, and irritations of the bowels. In such cases Iris may be curative by reaching the cause. When consulted in a case of spermatorrhcea, the first question to be asked is, "Do you have amorous dreams, with emissions?" If the answer is in the affirmative, I consider the case one of irritation, and would treat it with Phosphorus, Cantharis, Cannabis, Pulsatilla and Iris vers. If a negative answer is received, the case is classed with one of those arising from want of tone and lack of vitality, and which calls for such remedies as Kali bromidum, Conium, Phosphoric acid, Agnus castus and Caladium. This method of ascertaining the pathology of this affection, was first laid down by the astute Lallemand, whose researches in this direction have been so valuable. No proving of this valuable' medicine upon the female organism has yet been made. Judging from its effects upon the male organs, we can safely consider it capable of deranging the female organs of generation. Eclectic physicians claim to find it useful in the treatment of " leucorrhcea, congestion of the cervix, ulceration, and other disorders of the uterine system." Coe thinks it " particularly indicated in uterine leucorrhcea, in which affection it seems to be of almost specific value." As this variety of leucorrhcea is the result of a hyper-secretion of the glandular follicles of the cervix, it is quite probable the Iris may act curatively, as its primary effect is to cause a similar condition in allglandular tissues. I ought to add that Iris is recommended in dropsy. If it is a curative agent in that condition, it will probably be JUGLAINS CINEREA, 361 found that the disease causing the dropsy has its origin in the liver. JUGLANS CINEREA, The bark of the Butternzut has been used as a cathartic, und for diseases of the skin, in domestic and irregular practice, for many years. This tree is indigenous to this country, as is the Juglans nigra or Black walnut, which is closely similar to the Jugldans regia or European Walnut. The Butternut has an oblong fruit, about two and a half inches in length by nearly one inch in diameter. The other two have a fruit nearly round. All the three species have many properties in common, but the Butternut is supposed to be the most active medicine. The provings published in my second edition of New Remedies, were made with tinctures of the bark, root, leaves and twigs. All portions of the tree are medicinal, but the inner bark of the root is the most active. Eberle says it will " vesicate and pustulate," when applied to the skin. Rafinesque says the "green rind rubbed on tetters and ringworms dispels them." This I know to be a fact from frequent observations when a boy, and I know too that the juice of the green rind irritates the skin intensely, and a drop in the eye causes intense inflammation lasting several days. Rafinesque says: "The fresh bark of the Juglans Cinerea is rubifacient and blistering," and that an extract is a mild cathartic and almost specific in dysentery, jaundice, etc. Dr. Clotor Muller recommends the Nux juglans (European Walnut) for the same conditions. A writer in the Hygea, vol. xxii, Nos. 1 and 2, commenting on the pathogenesis of Nux juglans, very aptly describes the sphere of action of all these species. He says -"In the digestive organs it causes derangement and irritation, which simultaneously call forth abnormal symptoms in other organs, especially the head. After this action, which is brief, appear various exanthematous symptoms - which ap24 362 JUGLANS CINEREA. pear late, and run a chronic course." I believe the same may be said of Antimony, Croton, and some other remedies. (Iris, Phytolacca.) Its action on the bowels is said to be somewhat similar to Jalap, but I think it more nearly resembles Iris. The following intestinal symptoms were noted by provers: Loose stool, which smells like onions; diarrhcea with burning in the anus before and after stool; tenesmus and burning after stool (primary); constipation (secondary); painless diarrhcea; four or five bilious discharges in twentyfour hours, without pain or griping. Clinical Observations.- Dr. Neidhard states that it was found curative in the diarrhcea of soldiers in camp. Although allopaths assert it does not cause irritation of the intestines, it is doubtless homceopathic to diarrhiea. I know it causes griping, as does rhubarb, which allopaths say it resembles in its action, in not causing constipation as a secondary effect. Every homceopath knows that constipation is a secondary effect of rhubarb, and the same may be said of Juglans. King says it has been found useful in colo-rectitis and several intestinal diseases, which it could not cure were it not homceopathic to them. The symptoms show it to be homceopathic to dysentery and bilious diarrhcea, in which I haye used it successfully in the 3d dilution. I would advise you to try it in those morning headaches, which resist the use of Nux. vom., Iris, Bryonia and Chelidonium. Dr. Horton, of Vermont, reports a case of " throat disease," which he calls " chronic inflammation," cured by Juglandin. He does not give the special symptoms or appearance of the throat on inspection, which renders his report of little value. The same physician makes quite a specific of Juglans (or the active principle Juglandin, which he prefers to the tincture) in many diseases of the skin. My own experience has been limited, but Dr. Martin, of Racine, values the Juglans JUGLANS CINEREA. 363 highly in chronic exanthemata. I will give you Dr. Horton's experience in full. He says: I take the liberty of sending you some of the clinical experience I have had with the Juglans cinerea, which I consider a real polychrest, so far as diseases of the muco-cutaneous surfaces are concerned. The Juglans has been used considerably by some eclectic physicians, and it was during the period that I practiced that system, that I became acquainted with it; but thus far I have never seen any reference made to it by homceopathic writers. Of this much, however, I am satisfied, that it is eminently homceopathic to the whole range of skin diseases, from a simple crythema to pemphigus, and theoretically, I should say to those of a more obstinate character. - It seems to be equally as well adapted to congestions and irritations of the respiratory and gastric mucous membrane, and its use has been attended with such decided success, that I feel anxious to have the profession at large give it a trial. I give below a few of the cases in which I used the remedy alone, for I used it a long time in combination, as is natural to eclectics, attributing the cures to other ingredients, when undoubtedly they were owing to the Juglans. I have treated cases of lichen and other mild cases of skin disease with the most positive results, but I send only a few of the more important ones, which you may add to your own and others experience, if you had any with the remedy. Case I.- Forest H., aged 2 years, had chronic ecthyma of three months' standing; eruption general and almost confluent, so large and thickly set were the pustules. Those upon the face seemed to be drying somewhat, with the steady increase and aggravation of those upon the body and extremities. Had been treated allopathically at first, when the parents becoming discouraged with the prospect, concluded to employ an old doctress, who professed to do wonders with roots and herbs. Consequently the child had to endure another month of active drugging with the same discouraging result. At this juncture I was called, and found the little patient suffering excessively. He could neither sit nor lie, with any degree of comfort; worried much of the time; slept but little; appetite poor; diarrhcea. I prescribed Juglandin, first decimal trituration, ten grains in half a glass of water, a teaspoonful every two hours. Saw the patient again the third day, at which time there seemed to be a little improvement. Continued the same treatment. At the end of the first week the improvement was decided; appetite better; slept more; bowels becoming more healthy. The crusts were rapidly drying and falling off. Continued the Juglandin two weeks more, at longer intervals, at which time there were only a few remaining pustules of small size, which rapidly disappeared, until the cure was complete. Case II.- Jenny H., aged 8 years; ecthymatous eruption upon the body, face and arms, attended with a painful itching sensation that created an almost irresistible inclination to tear off the crusts. I gave her a vial of the first decimal dilution, from a tincture made from the inner bark of the root of the Juglans, to be taken in three-drop doses, three times per day. In two weeks she was cured, with the exception of some slight ulcerations upon the arms, the result of tearing the crusts from some of the pustules; but these steadily healed, and in another week the cure was complete. 364 JUGLANS CINEREA. Case II.-A. W., adult; had been out of health some time; complained of languor; slight nausea at times, and occasional wandering pains about the limbs; was seized quite suddenly during the night with acute pain through the right hypochondriac region, darting upwards into the chest, producing considerable difficulty of respiration, and some cough. There was also some nausea and considerable fever. For these symptoms I gave Aconite, which produced ready relief. The third day following the attack there appeared on the body and extremities the most general and perfect eruption of erythema nodosum I ever saw; the patches were numerous and extensive, varying in size from that of a dollar to that of a man's hand. I gave him Juglandin, first decimal trituration; made three visits afterwards, on alternate days, when the cure was complete, the eruptions leaving the characteristic greenish-yellow color. Case IV.- John D., adult; had been somewhat indisposed a week or two; rheumatic pain in right shoulder, extending to the pectoral muscles, producing inability to draw a deep inspiration; had a single thickly set patch of impetigo figurata upon the inside of left leg, between knee and instep, which soon became crusted, discharging a purulent ichorous secretion, that irritated the surrounding skin, producing a wide, inflammatory margin; it was painful and sore, so much so that it was with great difficulty that he could walk. His little daughter had at the same time a considerable number of pustules of the sparse variety of impetiginous eruption upon the arms and hands. I gave him five drop doses of the dilution of Juglans and three drop doses of the same to the daughter, to be repeated three times per day, In ten days, both were cured. Case V.- Dec. 15, I865. Was called to see Flora B., aged I8 months. Found her as follows: An impetiginous eruption upon her chin, which had been torn and broken, producing hard crusts, which nearly covered the entire surface; some scattering crusts of the same upon the hands and arms; several large aphthous sores upon the inside of the lips and upon the tongue, bowels very much constipated, altogether making the child very fretful and feverish. The ichorous secretion of the sores had inoculated the mother's breast (she was still nursing the child), producing similar sores around the nipples. I advised the immediate weaning of the child, and prescribed 20 drops of the first decimal dilution of Juglans in half a glass of water, a teaspoonful every four hours; also a glycerole of the same applied to the eruption, three times per day, the same to be applied to the mother's breast. Dec. 20.-Very much improved; aphthous condition of the mouth all gone; crusts rapidly drying and falling off; bowels had moved natural and healthy; continue the same treatment with half the fisrmer dose. Dec. 29.- Saw the father of the child this morning; said both mother and child were cured. Case VI.- M. M., aged four years; had a patch of herpes circinatus upon the chin about the size of a dollar; had lasted two weeks, and was steadily increasing in size; gave the second decimal dilution of Juglans three times per day in three drop doses. In one week the crust came off, leaving the surface healthy but somewhat reddened, which soon assumed its natural hue, and in t\wo weeks the cure was perfect. JUGLANS CINEREA. 365 Case VII.- In my own case its use has been attended with such satisfactory results that I can not refrain from giving them. I have been troubled, from a child, with eczema of the hands, steadily aggravated of late years, one attack hardly subsiding before a fresh crop would make its appearance, often passing from the simple to the impetiginous variety, the ichorous and semi-purulent secretion oozing upon exercising; the hands would crust over again, causing the most intolerable itching and soreness -in fact, I have been awakened many a time from sound sleep, to find myself scratching the skin from my hands, only to make a bad matter worse. I have also for the last five years had dyspepsia, with bronchial irritation and cough. Have used Iris versicolor and other remedies, from time to time, without the least benefit; have taken Arsenicum a month at a time, in material doses, with but very slight improvement. During the latter part of the past Summer, I concluded to try the Juglans in my own case. It was at the commencement of a fresh attack; I took three doses of the mother tincture twice a day, and to my great surprise and gratification, the attack completely aborted, the eruption disappeared in a week. I continued the medicine once a day for three weeks more, when I was equally gratified. to find that the bronchial irritation had nearly left me, and that my dyspepsia was cured. I have since remained free from eruption or cough, except occasionally when I am exposed to the night air, when I get a slight return of the bronchial irritability. My appetite and digestion are good, and I can eat any thing that is suitable. Case VIII.- W. M., aged I4, was about the 8th of April attacked with what appeared to be a mild case of eczema of the hands and wrists. I was consulted, and prescribed Juglans, 1st decimal dilution, in five drop doses, three times a day. I did not see him again until the 14th, when I learned from his mother that she had started three days before to carry him away to school, some forty miles; but when about half way, she found the disease becoming suddenly and rapidly aggravated, so much so, in fact, that she dare not proceed, but turned about and returned home immediately. She had discontinued the medicine, fearing, as she said, that it was what caused the aggravation, which I could not conscientiously dispute. At the time of my arrival, the second day after their return, as I was out of town, the eruption had become so aggravated that instead of a simple eczema, it had assumed all the characteristics of a fully developed impetigo figurata in its pustular stage. The patches had coalesced, and the eruption had become confluent generally; the pustules were discharging and crusting over, and there was a degree of tension and pain about them that was quite unbearable. After I had looked the case over, the mother wanted to know if I thought I could cure him; said she was afraid I could not, as she had a similar attack when a child, which baffled the skill of some half a dozen physicians. I told her that the remedy he was taking was the right one, and would cure him; if it did not I should be very much disappointed. I immediately took the vial containing it, and made the second dilution from it with water: told him to take the same dose as before, three times a day. I also made a lotion by putting a drachm of the tincture into half a pint of cold water, and applying cloths saturated in it all the while. This treatment was continued without any variation except to gradually diminish the dose for a period of 366 JUNIPERUS COMMUNIS. nearly two months, at which time the cure was complete and the medicine suspended. Dr. Paine (eclectic) says: "The Juglandin, as I have previously remarked, acts as a direct stimulant and tonic to the cutaneous surface; hence, I have used it in chronic eczema, herpes, pemphigus, rupia, acne, impetigo, ecthyma, lichen, prurigo, icthyosis, molluscum, and all other forms of cutaneous diseases, and have found it to act with more certainty in these affections than any other preparation or single drug that I have used. In chronic herpes and eczema, I have found this remedy, combined with Quinine, almost a specific. My usual method of administering it in these affections is one-sixteenth of a grain of Juglandin and one-half a grain of Sulphate of quinine, four or five times a day. In some cases I have found that a large dose of Juglandin would operate beneficially, while in others a much smaller portion would be all that would be required. In the acute form of cutaneous diseases, the Juglandin appears to be very exciting and stimulating." In the same paper he says he has known it to cause "irritation and inflammation of the mucous membrane of the bowels, followed by a peculiar exanthematous eruption, like the flush of scarlatina." Dr. Small reports a cure of "noli me tangere on the nose;" and "cases of scrofulous swellings of the glands," cured by Juglans. JUNIPERUS COMMUNIS. I have often wondered why our school did not make some use of the Juniper. The Juniperus sabina, which is erroneously called " Sabina" in our Materia Medica, has a recognized value in our therapeutics. That species is a native of Europe, but the Juniperus virginiana of this country is considered by botanists as identical with the European species. The Juniperus communis and a variety, the J. procumbens, possess similar properties, but in a lesser degree. If I wished to differentiate between the J. sabina and J. JUNIPERUS COMMUNIS. 367 communis, I should say that the former has a greater affinity for the generative organs, while the latter affected in preference the urinary organs. Both, however, have similar properties; both affect the uterus and kidneys. It is not so much a difference of mode of action as a difference of degree of action. I have known cases of dysmenorrhoea and uterine hcemorrhage cured by the common Juniper, and I have treated some kidney and bladder difficulties with Sabina. The popularity of pure gin in dysmenorrhcea is owing to the effects of the oil of Juniper berries which it contains. In domestic practice, an infusion of Juniper leaves and berries is used successfully in amenorrhcea and dysmenorrhcea, as well as retention, suppression, and otlier urinary troubles. In some cases of dropsy, a tincture of the berries, or the oil of Juniper, will act on the kidneys favorably after the failure of other medicines. I would suggest that we use the J. virginiana by the side of the Sabina, in order that we may test their relative value and their similarity. I do not believe their curative effects will differ. We ought to have provings of the common Juniper, and give it a place in our Materia Medica. I would also suggest that the tincture be made from equal parts by weight of the fresh berries and green leaves. The Oil of Juniper of commerce is made from the berries alone. I have an idea that a plant or a tree, so far as relates to its medicinal qualities, is a unit, i. e., a tincture of one active portion of it does not represent all the virtues inherent in the plant. Some portions of a plant or tree are inert, but I would mix the other portions and make a tincture of all. We should then have in that officinal preparation a representation of the whole plant; of all its medical power and qualities. The tincture of Sabina, of our pharmacies, is made from the leaves alone. This probably accounts for its preference of action on the uterus. If the berries formed an equal part of the tincture, we would doubtless get its full effects on the urinary organs as well. 368 KINO. German physicians make much use of Juniper in gastric complaints, in abdominal flatulence, colics, and even in some hepatic affections. I know that the 3x of Oleum juniperus is useful in certain coughs, with scanty urine, loaded with solid matters (urates?) KINO. This, according to Wood, is the inspissated juice of the Pterocarpus marsupitum. It is called, commonly, red-gum. Dr. Blundell, in a paper in the American Hom. Review, vol. iv, says: " The Red-gum bleeds from the tree, dropping like drops of blood upon the soil, closely adjacent to the roots. It is found also within the'faults' of the timber. The tree, on the west coast of Australia, at least, is of large size, resembling the African oak." The allopathic school at one time used this powerful astringent largely in the treatment of dysentery and diarrhoea without fever. Dr. Blundell remarks: "That its peculiar virtues in chronic dysentery are due to the homceopathic law, I have long felt convinced, and determined to prove the drug to test its value." He got the following symptoms from five drops bf the lx: "Colicky pains toward evening, bearing down with inclinations to stool, without evacuation." The next day the dose was increased and twice repeated; the above symptoms reappeared and continued with increased severity. The colic was only relieved by lying on the belly. The following morning a dry, hard evacuation was passed, with a small quantity of blood at its termination. A continuation of the provings developed symptoms much like chronic dysentery. Of late, allopathists are afraid to use the Kino on account, they say, of its " violent reactions." We can surmise what they mean. My lectures on Gallic acid, Tannin, Geranium, and other "astringents," gave you my ideas of their action. Kino will doubtless help you in severe chronic, and perhaps acute cases of dysentery, if you graduate the dose properly. KAOLIN -LAPIS ALBA. 369 KAOLIN. The homoeopathic preparation of this medicine is made from the purest "pipe-clay " by triturations. Several physicians of our school have used it with alleged success in croup, even when supposed to be pseudo-membranous, with gratifying success. It has not been used extensively, however, nor do I think you will find any advantage in substituting this for the old and tried croup remedies. We have in Hepar sulphur, Spongia and Sanguinaria, medicines which cover nearly all the varieties of'croup. I scarcely need inform you that nearly all cases of simple spasmodic or catarrhal croup run their course in three days (or nights) whether you give any medicine or not. In fact, they do just as well without it. It is only in cases when actual inflammation or exudation has set in that any treatment is necessary. A catarrhal croup rarely goes beyond congestion of the mucous membrane; it becomes spasmodic when the laryngeal nerves are irritated; and pseudo-membranous only when inflammation occurs, in which case inhalations of Bromine, Iodine and Sanguinaria, according to the specific indications, with their internal administration, is usually successful. LAPIS ALBA. Dr. Von Grauvogl, whose singularly obscure, brilliant, and unique book you may have read, or may read, recommended this remedy for the cure of cancer. He claims that he was first led to its use from observing that the waters of certain springs in Germany were beneficial in the cure of malignant ulcers, cancerous sores, scirrhous tumors, etc. He found that these waters flowed usually over large beds of gneiss rock, and he came to the conclusion that the waters owed their curative power to the minute particles of this mineral which they held in solution. He therefore procured some of this gneiss and made triturations of it, and prescribed it in cancerous and scirrhous 370 LACHNANTHES. affections. In this he was imitated by several of his colleagues. A condensed report of their success with it will be found in the first volume. It may lead you to use it in such cases, and may finally be the means of relieving some patients suffering from that terrible disease. The late Dr. Bellows, of Boston, several years before Grauvogl's discovery, recommended and used, with alleged success, a similar species of rock. He believed that goitre was caused by the presence of the dissolved rock in the waters of Derbyshire, England, and in the streams among the mountains of Switzerland. LACHNANTHES. This remedy was introduced to the profession several years ago, but I do not remember to have seen any clinical reports of its use in disease, since the publication of my New Remedies. I have not used it myself, for the good reason that I have never been able to procure any. In fact, the first and only vial of the tincture I have ever seen is the one before you, and this was lately sent in to our Materia Medica Museum by one of the Chicago pharmacies. Judged by the provings, its sphere of action is similar to that of Agaricus, Belladonna, Hyoscyamus, Lachesis, Solanum and other cerebral stimulants. It causes a headache which resembles that of Cimicifuga, Sepia and Belladonna. One physician claims that he found it beneficial in ameliorating the delirium occurring during pneumonia, and which was worse during an exacerbation of the fever at 2 P.M. "The eye symptoms are peculiar, and should attract the attention of the oculist. It has a symptom similar, yet differing from, Gels., Calabar and Chloral, namely-:'On looking at an object for some time, it becomes dark.' The three remedies above named - also Coca have the same defect of vision, only "things look white." It has another LEPTANDRA VIRGINICA. 371 symptom, " A yellow spot before the eyes," which resembles the symptoms found in Phos. ac., Bell., Canth., Dig., Hyos., Sep., Amyl, and a few others. It has been used in diphtheria, and cured a case which had as an accompanying symptom, "stiff neck -it was drawn to one side." This is a common symptom in diphtheria, ulcerated throat, and after scarlet fever, but I do not believe Lachnanthes would cure every such case, because it is not a drug whose action is penetrating enough to become a similimum to true diphtheria. There are some mild cases of cerebro-spinal congestion in which we might try the Lachnanthes, for, besides the " wryneck," it has " stiffness of the neck, following pain in the occiput - the stiffness extends over the whole head." This, together with its power of causing cerebral congestion, would make it indicated in the milder types of brain fever, or meningitis. The naturalist, Darwin, mentions a curious fact, that white hogs which eat the roots and leaves lose their hoofs, while the black ones are unaffected! Is it possible that it might be useful in falling off of the toe-nails of white men, and not of black? It would be interesting to know the pathological state which causes the hoofs to fall off. Ustilago has this symptom also. If any physician or student of medicine, in the South, should observe this toxic effect of the Red-roat, I hope he will take notes and report the facts. LEPTANDRA VIRGINICA. If you look in your recent text-books on botany, you will not find " Leptandra," because it has been changed to Veronica virginica. This plant has a high reputation among eclectics, but I have of late years doubted it efficacy in many diseases in which it is recommended. If the provings made by Burt, and the clinical experience 372 LEPTANDRA VIRGINICA. of botanic, eclectic and homoeopathic physicians is trustworthy, then the sphere of action of Leptandra may be defined as follows: It first arouses the secretory action of the liver, then the secretory glands of the intestinal canal, and finally the more distant glands of the body. Let us see what other authorities say about it. The eclectic school of medicine, and even the allopathic, claim for Leptandra that it possesses a specific affinity for the liver; that it profoundly modifies its functions in various ways. King says of Leptandra: "It is a cholagogue. It causes the liver to act with great energy, and without active catharsis, and is employed with success in all hepatic affections. * * * It is indicated by an inactive state of the liver, and all functional diseases of that organ." And of Leptandrin, he says: "It is the only known medicine which efficiently stimulates and corrects the hepatic secretions, and removes functional derangements of the liver, without debilitating the system by copious alvine evacuations." Other writers of that school reiterate the same.statements, and all eclectic practitioners use it with unhesitating confidence. It is to that school what "blue mass " is to the allopathic, while the Podophyllin is considered to take the place of Calomel. But the wide recommendation of Leptandra in "all functional derangements of the liver," is too sweeping, and resembles the assertions of the allopaths, that Mercuryis the only remedy in "all hepatic derangements." We are aware that the researches of Inman and Thudichum seem to render it doubtful if Mercury acts directly upon the liver, but the great mass of the allopathic school still use it, and probably will for the next ten generations. The following symptoms are from large doses of the fluid extract: Dull aching pain in lower part of the right hypochondriac region, near the gall-bladder, with dull, aching pain in the umbilicus, and rumbling in the bowels; dull aching in the whole of the liver- the pain extends to the spine, but is LEPTANDRA VIRGINICA. 373 worse near the gall-bladder; constant, dull, burning distress in the epigastric and hypochondriac regions; dull, aching, burning distress in the region of the gall-bladder, with frequent chilliness along the spine; profuse, black, undigested stool, followed by great distress in the region of the liver, extending to the spine; the pain is of a hot, aching character, with chilliness along the spine; sharp, cutting pains near the gall-bladder; great burning distress in the back part of the liver, and in the spine; pain in the left shoulder and arm. Jaundice, with clay-colored stools. These symptoms, from Burt's proving of Leptandra, seem to establish the fact that this medicine does exercise an influence of no doubtful power over the liver and its secretions. The hepatic symptoms are well marked, both the subjective and objective, and the whole experiment goes to prove what I have so often asserted in my writings, viz.: that all the remedies successfully used by the allopathic school, are used strictly in accordance with the homceopathic law of cure; and being administered under that law, do effect cures, notwithstanding the large doses in which they are given — doses which very often produce needless and painful, and sometimes injurious, medicinal aggravations. In regard to the real action of Leptandra on the liver and secretions, I do not propose to hazard any decided opinion, inasmuch as the action of Mercury even, upon that organ, is involved in considerable mystery. The same may be said of such analogous medicines as Iris versicolor and Podophyllum. But I may throw out a few suggestions, which may be taken for what they are worth: " Calomel," says Draper in his Physiology, " increhses the fluid, but diminishes the solid constituents of the bile." It is my opinion that Podophyllin and Iris versicolor act in a similar manner. Leptandra, on the contrary, seems to increase the solid and decrease the fluid constituents of that secretion; ori in other words, Leptandra may have the power of facilitating the proper elimination of the excrementitious portions of the bile, or an excess of the non-excrementitious portions. It is at present believed that the re 374 LEPTANDRA VIRGINICA. tention of cholesterine in the blood is very injurious. That substance acts somewhat after the manner of urea, namely: as a direct poison to the nervous centers. Its non-elimination causes headache, vertigo, languor, depression of spirits, painful sensations in various portions of the body, etc. Now, it is highly probable that Leptandra increases, directly, the elimination of this substance, for under its action, when given in proper medicinal doses, the symptoms enumerated above are rapidly dissipated. The retention of other excrementitious constituents of the bile cause various morbid conditions, aud the Leptandra, by its peculiar action, seems to be the remedy most likely to be of benefit when we wish to eliminate such substances through the liver. As it does not appear to increase the fluid constituents of the bile, as does Podophyllum and Iris versicolor, its apparent tonic effect, even in material doses, may thus be accounted for. Mercury, however, seems to have in some instances a similar action with Leptandra. In minute doses, in certain states of the system, it acts as a tonic; i. e., it removes the morbid state by its homceopathic action, and the vital powers resume their normal sway. Some further suggestions relating to the action of Leptandra may not be amiss. Its primary pathogenetic action seems to be that of a stimulant, or irritant of the hepatic cells. Chambers states that "Mercury, Nitro-muriatic acid and Manganese cause an increase of yellow matter in the cells of the liver." Podophyllum may have the same effect; also Leptandra. As a consequence of this primary stimulation and irritation, we have the increased elimination before mentioned, and sometimes acute congestion and inflammation. Leptandra, therefore, is primarily homceopathic to an irritable condition of the liver, in which the discharges are of the peculiar character described under " Stool," and the pains and abnormal sensations are similar to those under "Liver." The secondary effect of Leptandra is over-stimulation, or a condition of exhausted irritability, in which the hepatic cells refuse to perform their office (particularly that of eliminating the excrementitious substances from the blood.) LEPTANDRA VIRGINICA. 375 The size of the dose, let me remind the reader, will depend on its primary or secondary homceopathicity. Dr. H. M. Warren, of Jonesville, Mich., reports the following rapid and suggestive cure of a severe case of hepatic disease. Its effects in this case would seem to show that it has a powerful and rapid action on the liver: "Mrs. W., aged 75, was one morning suddenly attacked with the following symptoms, her health up to the previous evening being good: Deliriousness, complete prostration, heat and dryness of the skin, coldness of the extremities; foetid and tardy stools; tongue thickly coated, with a black streak down the center. I have seldom seen a patient attacked so suddenly, especially with these symptoms, and with such complete prostration. I gave her Rhus and Baptisia-the latter for her fever, which was high, the pulse being quick but weak. The next morning, Friday, I thought she appeared more conscious, and could understand questions put to her. I gave her five grains of Leptandrin 2d, in a tumbler half full of water.! I never saw a more rapid recovery. The bowels became natural, tongue cleaned, consciousness and strength returned." Dr. Neidhard writes me as follows in relation to the action of Leptandra on the liver: "I would draw the attention of my professional brethren to the admirable effect of Leptandra in certain cases of livercomplaint. Four cases of this kind are now before me, characterized by the following symptoms: These states of the liver are quarterly, periodical, occurring every two or three months; yellow-coated tongue; constant nausea, with vomiting of bile; shooting or aching pains in the region of the liver; loss of appetite; urine of a brownish color, or at any rate very dark; there is also, often, pain in the transverse colon; giddiness in the head. The most characteristic symptom consists in the presence of very dark, almost black, evacuations from the bowels." It is a stereotyped phrase of eclectic writers that the Leptandra causes "copious, tar-like dejections from the bowels." They teach that when this symptom occurs, after 376 LEPTANDRA VIRGINICA. the administration of Leptandra in disease, it is a very favorable symptom, and recovery is confidently predicted. This assumption is based upon the well known fact, that similar evacuations do often occur during the course of bilious and other fevers, hepatic diseases, etc., and seems to be of a " critical " character, i.e., they relieve the system of certain morbid matters, which had caused the malady. I have treated many malarious fevers of a pernicious character, when these tar-like discharges occurred under the homceopathic use of Arsenicum and Rhus, and when the peculiar evacuations were not due to the medicine, but to the vis medicatrix naturae. I have known them to occur during an attack of supposed portal congestion, when no medicine had been taken. But the pathogenesis of Leptandra proves that those peculiar dark discharges are not always the result of natural disease - in other words, this medicine is not alone an eliminative of such morbid matters, but actually causes such evacuations when given to a healthy person. Eclectic writers erroneously teach that when the Leptandra causes black evacuations, it shows that the system was being poisoned with " vitiated bile," or some other morbid matters. It is this belief that has led to the indiscriminate routine and injurious use of this remedy in many diseases. They do not stop to ask themselves the question, whether the tar-like discharges might not be due to the poisonous action of the drug? I have known patients under eclectic treatment to be kept under the action of Leptandra day after day, until the third stage of poisoning -- namely, that stage when watery, mucus and bloody stools occur-because the physician supposed he must continue the administration of the medicine until the black discharges ceased. When they did cease, then the disease was said to "run into dysentery;" but it was the dysentery of Leptandra. So much for the blind adherence to prevailing opinion, which is the curse of all medical schools. There are some peculiarities in relation to the symptomatology of the evacuations caused by Leptandra. The catharsis caused by it may be divided into four stages: LEPTANDRA VIRGINICA. 377 (1) Discharge of black, thick, tar-like, foetid substances. (2) Thinner, brownish, often fcetid evacuations. (3) Stool of mixed mucus, flocculent, and watery matters, with yellow bile, or blood. (4) Mucus, bloody stool, mixed with shred-like substances often pure blood is discharged. Now, to prescribe a drug successfully, we should know the different stages of its pathogenetic action. This is just as important as to know the stages of disease. The catharsis of Podophyllum differs materially from that of Leptandra, and although it causes some of the varieties of stool, they occur in a different order. If we are called upon to prescribe for a diarrhoea, we should investigate its history; if that history corresponds in order and nature with the Leptandra disease, then that drug is the specific remedy. In the treatment of a dysentery the same rule holds good: dysentery occurs in the fourth stage of Leptandra-poisoning, while it occurs in the second stage of Podophyllum-intestinal-irritation. With some drugs, scanty, bloody, and mucous stools occur as a primary symptom, as in cases where the rectum is the seat-of inflammation. Dr. P. P. Wells, of New York, has lately called the attention of the profession to the characteristic symptoms of drugs; those symptoms which make it differ from all other drugs. Thus, there are many remedies for " black stools," but not all will remove that condition; the collateral symptoms must correspond. This subject will be noticed in another place. In the pathogenesis of Leptandra, it should not escape the notice of the physician, that the evacuations per anum are accompanied by some peculiar symptoms: The pains in the intestines usually occur after stool; in the Podophyllum diarrhcea they occur before, while in the diarrhoea of Mercury, and many others, the pain is severe during the stool. It will also be noticed that the evacuations are not followed by tenesmus. The provings given do not mention it, nor do I find it mentioned in any article referring to its action. In practice I have not found it useful when there was marked tenesmus attending the disease. Such 25 878 LEPTANDRA VIRGINICA. remedies as Podophyllum, Aloes, and Mercurius, are more applicable. I am inclined to believe that Leptandra does not have any direct specific effect upon the rectum. Its action on the liver and portal system undoubtedly causes it to affect the rectum and haemorrhoidal vessels, but this action is indirect. If we carefully study the symptoms of Leptandra, after the method proposed by Dr. P. P. Wells, we shall find it a drug possessing a distinct individuality, as much as any other drug in our Materia Medica. In acute diarrhcea, we shall find this medicine often indicated, and it will prove a valuable specific when administered for the pathological conditions in which it is indicated — those, and the symptoms, are well shown by the provings. In chronic diarrhoea, this drug is even more reliable for the general condition, which is shown by the following extracts from my lecture on Leptandra, delivered before the class of Hahnemann Medical College, in the Winter of 1864: "The three principal varieties of chronic diarrhcea, in which Leptandra will be found useful, are: "(a) From chronic inflammation or irritation of the mucous membrane. " (b) Dependent on hepatic derangement. "(c) Diarrhcea of debility. " Some of the indications for Leptandra in the first named variety I have already given. But I will here call your attention to one form of this affection, which bears the common name of' camp diarrhoea.' This disease is usually contracted in camp, where the soldiers are ill-protected from atmospheric changes, and are exposed to cold, dampness, and feetid exhalations from refuse matter, decaying vegetation, etc. These, together with improperly cooked foods and bad water, are the principal causes of this malady. Its onset is sometimes gradual, lasting for days and weeks before the surgeon's attention is called to it by the patient; but it often attacks its victims suddenly, and assumes the character of a cholera morbus, or acute enteritis. It is one of the most intractable diseases with which our army had to contend. Under LEPTANDRA VIRGINICA. 379 allopathic treatment it is almost incurable, and sometimes resists all medication, so long as the man remains in damp or.barracks, exposed to the same influence which caused it, and obliged to subsist upon the usual hospital diet. In the acute stages the following treatment will be found most applicable: If it is evidently caused by a cold or exposure to dampness, Dulcamara; Aconite or Pulsatilla will be found most efficacious. When caused by bad diet, and improper food or water, Pulsatilla or Podophyllum will be most useful. If hepatic derangement is evidently present, Mercurius, Podophyllum, Leptandra, or Iris versicolor, will be indicated. If the attack is choleraic in its character, Arsenicum, Veratrum album, or Euphorbia corollata, and perhaps Aconite, should be selected. But when it assumes a chronic character, and persists in spite of altered diet, change of location, etc., then Leptandra will be found an invaluable remedy. In many cases its persevering use will alone effect a cure, although there are cases in which we may be obliged to resort to the auxiliary aid of Phosphoric acid, Nitric acid, Arsenicum, Sulphur, or Mercurius corrosivus. " It is in most cases absolutely necessary that the patient (the subject of camp diarrhoea) should be removed from camp, or barracks, as soon as possible, and transferred to some healthy locality. For obvious reasons, a return to the patient's home is to be preferred. Here his military dress should be changed for his former civilian's apparel, and his diet should consist of plain, nutritious, easily assimilable substances. My experience has been that patients do the best upon a milk diet; plain bread and milk being the best form of its use. In addition, he should have a certain limited amount of good fresh beef, mutton, or game, every day. Taking the hint from the practice of an eminent Russian military surgeon, who successfully adopted the treatment in the great military hospitals, I have advised the use of raw, or nearly raw beef, and in most instances with the most satisfactory results. Tender, lean steak should be selected, and chopped very fine, a very small quantity of salt may be added if the patient insists. Of this an adult may eat one or two ounces, 380 LEPTANDRA VIRGINICA. three times a day, with his bowl of bread and milk. Potatoes, salted meats, warm bread, raw fruit, pastry, coffee, preserves, and liquors, should be prohibited. Moderate exercise will be of advantage; too much, injurious. If the chronic diarrhoea depends for its continuance on debility, and resembles the colliquative diarrhcea of phthisis, accompanied by hectic fever and colliquative sweats, the Leptandra is still useful, but should be given in alternation with Phosphorus, Arsenicum, China, or Nitric acid. The two latter are especially indicated if a lientery is developed, and the food passes the bowels unchanged, or in a state of putrefactive fermentation. " In some cases such is the debility and relaxation of the mucous membrane, that the serous and even fibrous parts of the blood escape, attended sometimes with more or less of the red coloring matter. An increased degree of the same affection constitutes passive haemorrhage. It is not unfrequently associated with a watery state of the blood, which becomes incapable of sustaining a due energy in the extreme vessels. In such conditions, Leptandra is still useful, but should be aided by those remedies which are capable of bringing back the blood to a normal condition. First in importance stands Iron. The preparation I prefer is the Phosphate, given in the form of syrup of super-phosphate of Iron, thirty drops after each meal, or a few grains of the first decimal trituration of the Pyro-phosphate. Next in value are Hydrastin, Helonin, Muriatic acid, and sometimes Nux vomica. The Citrate of Iron and Strychnine is often one of the most efficient remedies for chronic diarrhcea, when we have two conditions, namely, an impoverished state of the blood, and an atonic state of the muscular tissues of the intestines. When these states obtain, we usually find alternate constipation and diarrhcea, deficient digestion, accumulations of flatulence and hoemorrhoids." " Chronic ulceration of the intestines often occurs during the course of a chronic diarrhcea.'Dr. Chambers says:'There is no disorder in which emaciation is so marked a feature throughout its whole course, as chronic ulceration of LEPTANDRA VIRGINICA. 381 the small intestines. Ulcerations of the ccecum and colon, tubercular or not, produce as much, nay, often more, diarrhoea; but they are not, by any means, so distinguished in their power of reducing the patient. In this lesion of the ilia, even the parts which are not the actual seat of disease, seem incapacitated from absorbing nutriment, and the victuals pass through the alimentary canal in the same state as when they left the stomach, except being made putrid by chemical decomposition. All the stages of digestion are equally suspended.' " These lesions are more common during infantine life, and thousands of children are yearly carried off by this malady in every large city. In this affection Arsenicum, Mercurius corrosivus, Sulphur, Nitric acid, and Phytolacca are indicated. The Leptandrin has also been of use in my hands, when, with the usual symptoms, there was present a jaundiced hue of the skin, sallow complexion, pain in the region of the liver, lack of bile in the evacuations, and great debility. In such a condition I would advise you to use for adults, the first decimal trituration; for children, the third trituration. " When the ulceration is tubercular, you will have to resort to a different class of remedies, prominent among which I would advise the Hypophosphite of lime (calcis hypophosphis), which has all the curative properties of Calcarea carbonica, together with the recuperative qualities of Phosphorus. The second or third decimal trituration will prove the most satisfactory. Leptandra may be called for, even in this disease, if we find disorder of the liver complicating the case. I believe it increases the absorbent action of the intestinal mucous membranes, and thus prevents the excessive emaciation. In respect to the action of Leptandra on the mucous membranes of the intestine, Dr. Coe gives a case which is quite interesting. He says:' No remedy with which we are acquainted, is more to be relied upon in chronic affections of the mucous surfaces. Its value in this respect is peculiarly apparent in chronic dysentery and diarrhcea and other diseases of the bowels. When false mem 382 LEPTANDRA VIRGINICA. branous formations have occurred in the smaller intestines, produced by the gradual exudation of plastic lymph, the Leptandra may be relied upon for their removal, with great confidence. * * * We have also used it with great success in the cure of constipation and piles. We recently treated a case of the latter complaint, accompanied with frequent haemorrhage from the rectum, of twelve years' standing. A short time after commencing its use, the patient discharged considerable quantities of false membrane, in shreds and patches, and a number of pieces several inches in length, forming complete tubes. The evacuation of this matter was attended with amelioration of all the symptoms, and at the present time the patient declares himself well. The bowels are regular, appetite good, the hemorrhage has ceased, and the distressing pain, so long experienced beneath the sacrum, entirely gone.' " This is quite an important clinical fact, and although the cases were treated with massive doses (two to four grains twice or thrice a day), we can not doubt that the remedy was homoeopathic to the disease mentioned. In Wood's Practice, article " Chronic Enteritis," we find that "occasionally false membranes are discharged, and, in some rare instances, tubes of considerable length, obviously the result of a plastic inflammation, throwing out coagulable lymph upon the surface of the mucous membrane." Dr. Cumming, of Edinburgh, has given an account of a peculiar variety of pseudo-membranous inflammation of the bowels (quoted by Wood). In this variety Dr. Simpson used Arsenic, a remedy homceopathic to the disease; and Dr. Cumming used tar and "electro-galvanism" successfully. Believing, as I do, that all medicinal remedies cure only under the law of similia, it seems highly probable to me that Leptandra, in the case given by Dr. Coe, caused the expulsion of the membrane, and effected the cure by virtue of its power to cause a similar pathological state. Chronic dysentery is often associated with chronic enteritis, and it is not always easy to determine how far the two por LEPTANDRA VIRGINICA. 383 tions of the bowels are severally involved in the inflammation, nor is the decision a matter of much importance. Chronic diarrhoea and dysentery are very nearly allied in their anatomical character, and we often find cases where the symptoms of both maladies are intimately blended. But chronic dysentery, when not thus combined, is distinguished from chronic diarrhcea by the frequency and comparatively small quantities of the evacuations, their character, and the tenesmus with which they are attended. The greater number of the stools consist chiefly of mucus, sometimes mixed with pus-like matter or blood. Occasionally, however, feculent or bilious matter is mixed with the proper dysenteric discharge. When the disease occupies the rectum and lower portions of the colon, the frequent discharge is often consistent; and instead of being uniformly mixed with mucus, is either irregularly pervaded by it in layers or streaks, or enveloped in a thick coating of it, derived from the surface of the bowel with which the faeces lay in contact. There is usually more or less tormina, and tenderness on pressure; the pulse, skin and appetite are affected as in chronic diarrhcea, and there is nearly the same emaciation. Chronic dysentery is seldom an original disease; but when it occurs, is almost always in consequence of an acute attack. " Camp dysentery," and even " camp diarrhoea," may run into a chronic dysentery. In this disease we have in Leptandra a valuable and efficient remedy, but it is more applicable to those cases in which a chronic enteritis complicates the disorder. In cholera infantumrn it has proved a very useful remedy. Dr. King (eclectic) says:'" In cholera infantum, a disease which sometimes sets at defiance all the skill of the physician, I have met with excellent success by the following comrbination: Leptandra six grains, Quinia three grains, Camphor one and one-half grains, Ipecacuanha three-fourths of a grain, mixed and divided into twelve powders, of which one may be given every two or three hours, and its use continued thus for several days. Its action at first is to increase the alvine passages, and apparently augment the disease; but in a few days the character of the evacuations change, become 384 LEPTANDRA VIRGINICA. fmore and more normal, as well as more regular in their appearance; after which, one or two powders per day for a week will render the cure permanent." I have quoted the above, to show that this mixture, absurd as it is, really cured the disease homceopathically. Leptandra, the main ingredient, is eminently homceopathic to the disease in most cases, as the provings show. Quinia, for which we substitute China, is indicated by the general condition (prostration from loss of fluids), and by the special symptom (copious, dark, or light watery stool.) Ipecac is one of our best remedies when there occurs vomiting with the diarrhoea; and Camphor, as shown by Hahnemann, is quite homceopathic to choleraic symptoms with considerable prostration. By the use of Leptandra third trituration, China second dilution, and Ipecac first or second, with Camphor -, as an intercurrent remedy, the homeopathist can cure his patient, without the danger of doing the injury to the organism, especially in cases of children, that is apt to occur from such massive doses as is advised by King, who admits that the disease is apt to be aggravated at first by the medicines. Dr. B. L. Hill, when an eclectic, wrote as follows concerning the action of Leptandra in dysentery: " In'the epidemic dysentery which has prevailed for the last two seasons (1854-55), in many parts of our country, it has been of great service. It was usually given with the best success after evacuating the bowels freely, with a combination of Podophyllin and Leptandra, or Rhubarb. For this purpose give from one-half of a grain to a grain every hour, gradually lengthening the intervals as the discharges become darker. Though it may not be applicable in all cases of dysentery, it is doubtless one of the most useful articles in this dangerous disease." The epidemic referred to was of an adynamic character, quickly prostrating the patient, and often ran into a typhoid condition. For the same epidemic Dr. Hill would now advise and use, with as good results, minute doses of Leptandra, Podophyllum, Arsenicumn and Baptisia. It may be remarked LEPTANDRA VIRGINICA. 385 here that Podophyllum is indicated for a much higher grade of inflammation and irritation of the bowels than Leptandra. The following was Dr. Hill's estimate of the action of Leptandrin: " It is not strictly cathartic. It is aperient, alterative and tonic. In cases of children affected with summer complaint, where there is evidently a lack of the proper biliary secretions, but when, owing to the irritated condition of the bowels, the ordinary remedies for arousing the liver are inadmissible, this article seems to be the very thing needed. While it acts freely upon the liver, instead of purging, it seems to change the discharge from the light and water, or slimy condition, to a darkened and apparently bilious state, rendering them more and more consistent, until they become perfectly natural, without having been arrested entirely, or at any time aggravated. At the same time it seems to act as a tonic, restoring the tone of the stomach and increasing the strength and activity of digestion." Dr. Hill the homceopathist valued the Leptandra quite as highly as did Dr. Hill the eclectic, but he accounted for its action in a more rational manner. As the latter, he gave from one-fourth to one grain every hour or two, in acute cases, or one to two grains three times a day in chronic cases; as the former, he also finds -I- or T-f of a grain equally serviceable. In those severe cases of disease which clearly resemble the primary symptoms of poisoning with the fresh root of Leptandra, the 30th, if prepared from a good tincture, would doubtless act curatively. Dr. Wm. Fry, of New York, reports the following case of intestinal disease teated successfully with this remedy: " My first trial with this remedy was followed by the most prompt and satisfactory results. It was a case of dysentery of nearly a month's standing, having been brought on after a sudden change of climate. The following were the most characteristic symptoms of the case at the time the Leptandra was prescribed: Mental suffering; dizziness and headache; chills, followed by fever; pain and uneasiness in the bowels; nausea, and a constant profuse flow of saliva from the mouth during the chill; great thirst, but inability to 386 LEPTANDRA VIRGINICA. keep any food or drink upon the stomach; constant desire to urinate during the chill; urine high colored, and passed in small quantities; soreness of the rectum; htemorrhoids; painful dragging and stinging pains in the rectum; bowels bound and alternated every three or four days by a setting-in of diarrhcea, the passages consisting of faecal matter resembling raw or boiled beef after having been pounded fine, with an admixture of mucus and an intolerable foetid smell. The desire to stool was in the morning, and continued about an hour, during which time there were four or five passages, followed by tenesmus of the rectum and a feeling as if something was passing out. These are some of the most prominent symptoms of the case, and I cured it with two doses of the Leptandra-one powder of the first centesimal trituration in the evening and another in the morning, after having failed to get any effects from such remedies as Arsenicum, Colocynth, Carbo veg., Mercurius, etc. I got the best results from this remedy in the lower forms of preparation." Dr. G. W. Barnes, now of San Diego, Cal., communicates the following cases: Case I.-" During the progress of a tedious case of post-scarlatinal follicular entero-colitis, associated with a condition of general anasarca, occurring in a little boy of six years, the details of which I will not trouble you with, there occurred a condition of the alvine evacuations corresponding very beautifully with your proving of Leptandra. The stools, three or four a day, were profuse, dark-brown, almost black, of a mushy consistence, and highly offensive odor. There was difficulty in retaining the stool; he must go immediately. There was sharp pain preceding the stool and relief afterwards, but increased weakness. He usually went to sleep soon after stool. Other remedies were required to complete the cure; but Leptandra, 3d trituration, very promptly changed the stool to a normal appearance and frequency, and produced a satisfactory amelioration generally." Case II.-"Capt. H-, Ohio National Guards, had suffered nearly three months with camp diarrhoea, and had been for the greater part of that time in hospital. During a tedious journey from Washington his case became aggravated, and on his arrival at home he was hardly able to stand upon his feet. He was emaciated, his features haggard and jaundiced; his stools, previously mixed with undigested food, were now muco-purulent and bloody, quite frequent, and attended with some tenesmus and cutting pains low down in the bowels. Cold water taken internally produced a sense of weight at the stomach, cutting in the bowels and a disposition to stool. There was a state bordering on ulceration, and it was the opinion of his hospital surgeon that that condition existed. LEPTANDRA VIRGINICA. 387 "Some amelioration followed the administration of Mercurius cor., 6th and 3oth, but under the influence of Leptandra, 3d trituration, improvement was prompt and steady, and in two weeks his stools were natural in quality and frequency, and he was soon well." You must not confound the black, tarry, fcetid stools of the Leptandra diseases with melcena, a disease in which black, disorganized blood is passed the bowels - a condition in which I doubt the applicability of Leptandra, but would prefer Sulphuric or Nitric acid or Hamamelis. It has been recommended as a remedy in Dropsy. King says, "It exerts a powerful influence upon the absorbent system, and in combination with Cream of Tartar, has been successfully used in obstinate cases of dropsy." If Leptandra is homceopathic to any variety of dropsy, it is probably that dependent on disease of the liver. In order to test its value in dropsy, or indeed any disease, it should be given alone. To combine medicines is to lose all data concerning the real action of any single agent. It is doubtful if Leptandra exercises any specific action on the functions of the kidneys, yet a medicine may be useful in dropsy without being a diuretic. It may act curatively by a certain general restorative power. Thus, China, Iron, Helonias, etc., may remove dropsies, by bringing the organism up to a normal condition. Any cause which obstructs the circulation in the portal system of veins, will induce dropsy. Chronic tumefaction of the liver, and organic diseases of that organ; also inflammation of the portal vein, are the principal causes of the varieties of hepatic dropsy. You may find Leptandra useful in headaches. With the knowledge we now possess of the action of this medicine, especially on the liver, we can very properly decide its headache to be the so-called "bilious headache." It somewhat resembles the cephalalgia caused by Nux and Bryonia. A bilious headache is usually accompanied by constipation, furred tongue, bitter taste, indigestion, yellow urine, languor and depression of spirits. A free discharge from the bowels of dark-brown, or greenish, feculent matter, usually dissipates the pain. Such headaches are relieved, 388 LEPTANDRA VIRGINICA. and even cured, by the use of Leptandrin, second or third trituration. Aided by Nux vomica, it is one of our most efficient remedies against the peculiar, stupid, sleepy condition which attends portal congestion -" biliousness "- a state which often occurs during the summer months, and is often precursory of a bilious fever. As a fever medicine, its only use is as an intercurrent remedy, or for the purpose of removing the cause of the fever. Coe remarks that when the Leptandra is given in disease, and the patient is fairly brought under its constitutional influence, "the skin, which was before hot, dry and constricted, becomes soft, moist and flexible; expectoration becomes easy, the arterial excitement is lessened, and the patient, before restless, wakeful and delirious, becomes calm, rational and inclined to sleep." He considers it a valuable remedy in typhoid fevers, and in his opinion King, Jones, Morrow and others concur. Some homceopathic practitioners, as Hill, Gatchell and many of my correspondents, place the same high estimate upon its curative powers in typhoid states, when there is present great prostration, stupor, heat and dryness of the skin, calor mordax, or coldness of the extremities; dark, foetid, tarry or watery stools, mixed with bloody mucus, and an icterode condition. In intermittent fever, it is a favorite and much-used medicine by nearly all western physicians of both schools, who combine it with Quinine. They assert that it renders the action of Quinine more certain, and prevents the liability to a return of the disease, at least for the season, and is useful in periodic diseases generally, of an obstinate character, in which Quinine produces little or no result. In my experience, which at one time was very large in diseases of the character referred to, the Leptandra did really act in a very beneficial manner. My method was to use it in alternation with Quinine, China, Nux vomica, or any other medicine indicated, and always in accordance with what I considered to be its homoeopathic applicability. I do not consider that LILIUM TIGRINUM. 389 it has any real anti-periodic power, as some drugs undoubtedly have, but it removes conditions of the liver which often tend to keep up a continuance of intermittent maladies. I usually gave it for the following symptoms: Considerable prostration, loss of appetite, heavily-coated brown tongue, bitter taste in the mouth, constipation, or diarrhcea with dark, foetid stools; jaundice; yellow, saturated urine. In bilious fevers, I have given it for nearly the same symptoms, using Leptandrin, second or third decimal trituration. In infantile remittent, I have had some excellent results from its use, administering the second or third dilution of the tincture, or the third and fourth trituration, as seemed most proper. I do not see why it may not prove a good remedy in yellow fever. It corresponds to some of the symptoms. It may be good for the premonitory symptoms, or some of the sequelae. LILIUM TIGRINUM. The Tiger-spotted Lily, so common in gardens, has lately risen from its position as an ornamental plant, cultivated only for its flowers, to a high rank as a therapeutic agent. The honor of introducing this remedy into our Materia Medica belongs to Dr. W. E. Payne, of Bath, Maine. He was assisted in making the provings which go to make up the pathogenesis, by such eminent men as Drs. C. Dunham, L. M. Kenyon and Lilienthal, aided by many other physicians, medical students, men and women. Dr. Payne's elaborate and exhaustive resume' of all the provings appeared first in the Transactions of the New York State Homceopathic Medical Society, 1871. This will be found transferred into the first volume of this work (Materia Medica.) Dr. Payne, after giving the botanical description of the plant, says: " The reported death of a child in convulsions, by eating the pollen of the flower, suggested the idea of 390 LILIrUM TIGRINURM. proving the drug, and the hope of finding in it additional means of combatting the sometimes formidable convulsions arising from acute and chronic meningeal irritation, prompted the execution of the work. Though the hope is not realized in the proving, yet the promise in a class of diseases which, from their multiplicity, have become the bane of female happiness, is sufficiently strong to inspire confident expectations that this drug will henceforth hold an important place in the homceopathic Materia Medica." The sphere of action of the Liliurn is clear and unmistakable. The symptoms all point to the reproductive organs as the starting point of its pathogenetic effects. Study first its direct effect on the ovaries, the uterus, and the homologous organs in the male. In all it causes a series of pathological conditions, ranging all the way from simple functional irritation up to sub-acute inflammation, and finally, nearly all the uterine displacements. But the action of the drug does not stop here. Through its action on the reflex nervous system, which it renders excessively sensitive, a host of sympathetic symptoms occur. Nearly every organ and tissue of the body, even the mental sphere, become involved in the general and wide-spread irritation. Select almost any symptom at random from the pathogenesis, and you will be able to trace it back to its origin in the generative organs. There is such a thing as a pathological key-note to every drug, if its pathogenesis is complete, just as there are symptomatic key-notes to all medicines. I propose to point out to you both kinds of key-notes in the pathogenesis of Lilium, and at the same time give you such clinical experience and therapeutic: deductions as will be of service to you in practice. The Lilium has been used very extensively since the first appearance of any provings of it, and while many of our best practitioners are very enthusiastic in its praise, others assert that it has disappointed them. This discrepancy may be explained in several ways. First. All new remedies, with LILIUM TIGRINUM. 391 vivid and promising pathogeneses, lead us to expect too much from them. We prescribe them, expecting to see prompt and brilliant results; such hoped-for results do not come as soon as we desire, and we are disappointed. Second. It is claimed by Dr. Dunham, who has studied the remedy critically, that neither its curative or pathogenetic effects appear promptly, as a rule. "Sometimes," he says, "they do not appear for days or weeks after it is administered." If this be the case, it will account for its many failures. Few physicians are content to wait many days for the evidences of the action of any remedy, except in obstinate, chronic cases. They therefore soon change the medicine, and the new one either antidotes the Lilium, or gets the credit of the Lilium cure. The dose of this remedy is as varied as the experience or the whims of physicians. It has been used in every potency, and curative effects claimed for each. In the hands of eclectic physicians the infusion of the flowers and leaves is credited with just as brilliant cures as the im in the hands of our highest dilutionist! A study of the provings does not render it certain which organ, the uterus or ovaries, are first affected. As the ovary is the real center of the reproductive organs, it is probable that it is really the organ first affected. Both ovaries are involved in the Lilium irritation -the left in one prover, the right in others, and both together in several provers. It is homceopathic to ovarian irritation, with its consequent effects — frequent and profuse menses. In this respect it resembles Platina, Calcarea and Sabina. It is indicated in ovarian congestion, which sometimes retards menstruation and makes the flow scanty. In this it resembles Sepia, Conium, Lachesis and Pulsatilla. Sub-acute and chronic ovaritis are amenable to its curative action. It rivals Apis mel., Belladonna and Cantharis, which correspond, however, to the intenser grades of ovaritis. It is probable that a judicious use of ovarian remedies 392 LILIUM TIGRINUM. might prevent many cases of ovarian tumor. Of all these remedies, Apis has the characteristic symptom which is common in women threatened with such tumors, namely, sudden fainting without any apparent cause. Next in order is Lilium, which, if reports can be relied on, has cured many incipient tumors. I am inclined to the belief, however, that these tumors were simple enlargements of the ovary, benign in character, the result of congestions and irritations. I do not believe any medicine is capable of resolving an ovarian cyst, or an ovary enlarged by the deposit of solid matters. In simple hypertrophy, Lilium may be curative. If any remedy known to us possesses the power of removing by absorption a solid ovarian tumor, that remedy is the Iodide of Barium. In neuralgia of the ovaries I have often found Lilium useful. It is indicated for burning, stinging and darting pains, but especially when attended by cutting pains in the mammae, one or both. Lilium is not particularly indicated in dysmenorrhoea, by its direct menstrual symptoms. If it is indicated at all, it is probably in the neuralgic, or congestive variety, but I think it will never be found as useful as Viburnum, Xanthoxyllum, or Caulophyllum. In painful menstruation from uterine displacements it will probably be found most useful, for it corresponds to nearly all. Lilium has this symptom: "Menses cease to flow when she ceased walking." This is analogous to the effect of Cactus and Causticum. I have a patient whose menses cease to flow when she walks, and flow only when lying down, just the opposite of Lilium. The uterine symptoms of Lilium are of a character closely similar to its ovarian; the pathological conditions are similar. Gynecologists teach that all uterine displacements, flexions, etc., are caused by congestions, inflammations, and enlargements of that organ. Of these causes, congestion is undoubtedly the most potent. This is the reason that Lilium possesses the power (as demonstrated by actual examinations during the provings) of causing ante-flexion LILIUM TIGRINUM. 393 and version. It is reasonable to expect that a drug capable of causing ante-version, would be capable, if used long enough in provers of various ages and conditions, of causing the other flexions of the uterus. Repeated or intense congestion, occurring in a previously healthy woman, with uterus in situ, would cause ante-version, rather than retroversion. But if the prover had already a prolapsus, or if she had borne many children, and the womb was low, she would get retro-version from the same amount of congestion. The assertion that displacements are caused by relaxations of the uterine ligaments, is not founded on pathological facts. The relaxation is probably secondary, and does not belong to Lilium effects. Such medicines as Helonias, Aletris, or Ferrum, meet such a condition specifically. It is possible, then, if the symptoms correspond, to remove a flexion or version of the uterus by the aid of Lilium. I say by the aid, for I do not believe any medicine can restore a dislocated uterus to its normal position, unless we have the aid of position, or some artificial support, for a sufficient time. We may with Lilium alone ward off an impending displacement or flexion, or cure a very slight one, but not one that is fixed or has lasted long. Neuralgia of the uterus is closely imitated in the provings of Lilium, and I have often cured some severe cases. It may be useful in those conditions now known as cervicitis, mucous-cervicitis, endo-cervicitis and mucous-metritis. The leucorrhoea of LiliunL is peculiar in character, being acrid and excoriating, causing a rash on the labia, and an intense irritation of the whole vaginal canal, even to vaginitis. As this kind of leucorrhcea is indicative of mucous inflammation, it follows that Lilium is indicated in all the inflammations of the generative canal, from the mouth of the vagina to the end of the Falldpian tubes. Its primary effect in both sexes is to cause increase of sexual desire, but I do not think this is so much an effect on the mental sphere, as it is a result of the local irritation of the vagina, vulva, and other tissues near the clitoris. The sexual desire is controlled by the will, and by keeping busy; 26 394 LILIUM TIGRINUM. and it is notable that the desire to urinate caused by Lilium is controlled in the same way. The abdominal and intestinal symptoms are of a double character; a portion of them depend upon the specific irritation of the drug upon mucous surfaces; the other portion on its uterine symptoms. This will be seen readily by any physician conversant with the symptoms of uterine disorders. The symptoms of the stomach, appetite, and renal organs may be classed in the same category. It will relieve morning nausea of pregnant women, or the nausea from uterine irritation. It corresponds with some of those longings and aversions so common in women during pregnancy, or suffering from ovarian and uterine disorders. Many of the head symptoms are reflex, but it may prove curative in sick headache, in congestive headache, and some neuralgic cases. The congestive headaches simulate those of young girls before menstruation has set in. The action of Lilium on the mental and emotive sphere is purely reflex, and from the irritation of the generative organs. It is homceopathic to hysteria, to those strange and abnormal mental manifestations which occur in women with uterine disorder, or men who have abused their sexual organs by excesses, etc. I make no doubt it will prove useful in cases of insanity, when caused by disordered conditions of the genital apparatus. The mental symptoms are similar in some respects to those of Ignatia, Crocus, Platinum, and Cimicifuga. The eye symptoms would imply that the oculist may find it a valuable remedy in some functional disorders of vision. Dr. Bell says that in one form it improved a hypermetropia after aggravating it. Dr. Woodyatt suggests that it was a case of astigmatism with a weakened power of accommodation. He thinks it may have aggravated the weakness, and thus relieved it homceopathically. Its action on the eye reminds one of Gelseminum and Ciinicifuga. The Lilium may prove an important remedy in diseases of LILIUM TIGRINUM. 395 the heart. It appears to have a decidedly depressing action on the cardiac nerves by which the heart's working power is lessened. The blood is not impelled by it with sufficient force to fill the arteries; two results follow: venous stagnation and cardiac oppression. These are its primary symptoms. They indicate that it will be found useful in many weakened states of the heart, direct or reflex, but not in any organic disease, except as a palliative. It should never be overlooked in the treatment of functional heart-disorder in women with uterine trouble. Its primary heart symptoms bear a singular resemblance to those of Cactus. It was a serious omission that no record was taken of the rate or quality of the pulse, and no examinations of the heart by means of the stethoscope. The cardiac disorders in which it may be found useful are nervous palpitation, cardiac irritability, and some other anomalous symptoms due to reflex irritation. I should not be surprised if further provings and clinical experience would find it to be a remedy for chorea. It has one symptom already, namely: "Convulsive contractions of almost all the muscles of the body, and a feeling as if she would be crazy if she did not hold tightly upon herself." This certainly simulates chorea or hysteria, or both. Dr. Payne speaks very highly of Lilium in the long train of unpleasant symptoms which occur from "delayed post partum recoveries." He finds the 30th to act well. I append Dr. Farrington's excellent comparisons of Lilium with Sepia and Pulsatilla. LILIUM TIG. SEPIA. (*) Mental symptoms almost identical. HEAD. Headache from forehead to occiput. Headache from occiput to forehead, Fear of insanity. Fear of apoplexy. Taciturnity. Loquacity. (*) It is not a little singular that the isomorphic group, of which Sulphur is the type and Sepia an analogue, should find such similar drugs in the Liliacece and analogues; thus Sul. and Aloes; Phos. and Cepa.; Ars. and Allium sativum; and here, Sepia and Lilium. 396 LILIUM TIGRINUM. LILIUM TIG. SEPIA. STOMACH, ABDOMEN. Drinks often and much. Usually thirstless. Longs for meat. Averse to meat. Smarting after stool, (like a cathartic.) Tension ani after stool. Urine retained causes oppression of Urine retained; anxiety, pressure on chest. bladder. FEMALE ORGANS. Absence of feeling in head; wild looks Mania caused by too profuse menses. when menses cease to flow. Menses generally scanty; cease when Menses generally profuse; they flow sitting down, flow while moving only in the morning. about. Leucorrhcea, brown, yellow, excoriat-' Leucorrhcea green or milky, excoriing; worse after menses. ating; worse before menses. Bearing down, funneling toward the Bearing down over whole pelvis; must vulva or anus; better from support. cross the limbs. Burning (less stinging), cutting in the Stinging in the ovaries; congestion. ovaries; congestion. Slow recovery after confinement; Slow recovery after confinement; lochia too long; uterus remains lochia very foetid; become "pot large; must support the vulva to bellied;" must sit down and cross prevent everything from escaping; legs to prevent prolapsus; always at times better, at other times worse, worse riding (horseback). from riding. Mammae tender; cutting through to Mammae sore, hard lumps; stinging left scapula. pains; cracked nipples. MALE ORGANS. Sexual excitement; emissions followed Emissions followed by vertigo, irritaby difficulty in fixing the mind; bility, sensitiveness to damp weathchoose the wrong word; irritable; er; mentalexhaustion. blurred sight. CHEST, HEART. Both affect similarly the venous system; both cause congestive asthma, pulsations all over the body; congestion to heart, worse from motion, better from pressure and rubbing; ih both there is chilliness, combined with internal heat in the chest. Becomes worse if retain urine; sighing Comes on when awaking from sleep; relieves; uterine troubles, pain uterine and hysterical, followed by through left mamma to back; drag- jerking in one side. Hard, teasing ging of all the viscera. cough. Heaviness in the region of the heart, Intermitting beats of heart after eating. worse after eating. (2). (2.) The heart symptoms of Lilium occurred late in the proving, and are LILIUM TIGRINUM. 397 LILIUMI TIG.'SEPIA. Pain as if the heart were alternately Palpitating,with intense stitching pains squeezed and relaxed. in the left chest. Congestion to the heart; pulse weak; Congestion to the heart; bubbling in heart feels full to bursting; taste of left chest as if hemoptysis were blood; faint; chills run down from coming on; burning in the face; face to chest; heart feels cold in the beating felt in the pit of the stomach. open air. GENERALITIES. Both suit the weakened system, especially that of the female; fearful about one's health; hurried, nervous, fidgety; so nervous the least excitement causes cold, clammy hands, palpitation, etc. In both, the cause of the debility seems to consist in a relaxation of the ligamentous structures, serous sacs (3) and veins. The first two causes account for the empty, gone feelings; weak knees (even cracking in Lilium, from deficient synovial fluid); prolapsus, etc. The last explains the readiness to portal stagnation (Sepia), fullness of the chest, heart and veins of the extremities. The most important distinction, besides those already given, is the following; because no characteristic of the respective remedies: LILIUM TIG. SEPIA. Remission forenoon. Remission afternoon. PULSATILLA.- LILIUM TIG. Pulsatilla and Lilium, although unlike in their general indications, bear the closest resemblance in their action on the veins. They have the same fullness of veins, chest and heart; worse in the evening and better in the open air. Heart feels too full of blood, with weak, feeble pulse, fainthence very characteristic. They seem to be mostly attended with congestive symptoms, and are linked with the urine disturbances. But they occurred in both sexes and exhibit strong resemblance to organic disease. (3.) Dr. Hering taught long ago that serous membranes, containing little or no air in their sacs, acted by suction in keeping viscera in place. Acon. seems to excite them, Sepia, Iodine, etc., relax them. 398 LYCOPUS VIIGINICUS. ness, inclination to take a deep breath. Such symptoms often occur in enlargement, involving the right heart. Pulsatilla, though feeling chilly, finds relief in the open air and from walking; Lilium finds relief in the open air (except headache); but the cold air makes the heart feel icy cold; motion aggravates. If the urine is retained, the congestion seems aggravated. Lilium, like Pulsa., causes scanty menses; but the former has irritable mood; wants to die and yet knows not why; solicitude about health; absence of feeling in the head with amentia; longs for meat; diarrhcea hurries her out of bed in the morning. Pulsatilla has gentle, tearful mood; wants to die, but fears it; solicitude about health and salvation; mania with amentia; averse to meat; diarrhoea after midnight. Remission, in Lilium, forenoon; in Pulsa., midnight, until noon (except diarrhoea.) LYCOPUS VIRGINICUS. This little plant has been of great interest to me ever since I first used it. The following is the history of the Lycopus, as given by Prof. Rafinesque in 1828. It is the only clear account we have of its introduction into medical practice: " The L. virginieus is an excellent sedative, sub-tonic, subnarcotic, and sub-astringent. It has only lately been taken notice of, while the L. vulgaris was extolled in Europe for fevers. Scheeff only mentions its qualities, and it is omitted in all the books of Materia Medica, except Ives and Zollikoffer. The first inquirers on its properties were Drs. Pendleton and Rogers, of New York, who have published several cases of hsemoptysis and incipient phthisis cured by it. This has been confirmed by Drs. J. M. Smith, Ives, Lawrence and myself. It is now much used in New York and New Jersey. The whole plant is employed; it has a balsamic, terebinthaceous smell peculiar to itself, when bruised, which is stronger in the seeds. The taste is pleasant, balsamic and slightly bitter, but to some it appears mawkish and nauseating. It is described as partaking of the proper LYCOPUS VIRGINICUS. 399 ties of Digitalis, Sanguinaria, Cimicifuga and Spigelia; but it is neither diuretic or anthelmintic, and is rather one of the mildest and best narcotics in existence. It acts somewhat like Digitalis, and lowers the pulse without producing any of its bad effects, nor accumulating in the system. It is, therefore, altogether preferable to it, and not only an equivalent, but even a valuable substitute, as I have ascertained upon myself and many others. Volumes have been written upon the Digitalis, a rank poison, and this excellent substitute is hardly noticed yet. It has, however, been used in the New York Hospital, and found very beneficial; it lessens the frequency of the pulse, allays irritation and cough, by equalizing the blood. It is said to be most useful when febrile excitement has been subdued; but I have seen it to subdue it by itself, as with other tonics. I have made many experiments on this plant, and the results are, that although it does not cure the consumption, nor heal the lungs, it is very useful in haemoptysis, a plethoric habit and internal inflammation. I consider it as a very good substitute to all narcotics, prussic acid, and even to bleeding, since it produces the same state of the pulse and arterial system, without inducing any debility, nor acting on the heart or brain in any injurious manner. It may be used in many diseases, and whenever it is required to quell inordinate actions of the blood, or even other fluids. I have been informed that it has been commonly used in New Jersey for diarrhcea and dysentery, which it helps to cure. It is a good adjunct to tonics and fevers. It is also peculiarly useful in the inflammatory diseases of drunkards, in diseases of the heart, etc. I deem it the best sedative in almost all cases; it does not seem to act on the nervous system, but chiefly over the bloodvessels. The usual way to take it has been in the form of a warm infusion, allowed to cool, taken as diet drink, and without much nicety about the quantity. In heemoptysis, I prefer a lemonade made with a weak tea of it, or a syrup made with it. A very strong infusion may also be used by putting one or two spoonfuls of it in tonic or refrigerant drinks." (The Professor's English was rather faulty.) 400 LYCOPUS VIRGINIC US. Wood and Bache do not make much mention of the Lycopus. Quoting a remark of Dr. Ives, that "it is a mild narcotic," and alluding to its alleged virtues in pulmonary complaints. Stille does not notice the plant at all, and other allopathic authorities are equally silent. Authorities in the eclectic school bestow a more extended notice on the plant. Many of the practitioners of that system estimate its virtues very highly. Dr. King* mentions it in the following manner: "'The exact medicinal virtues of this plant are not well determined. It appears to possess sedative, tonic, astringent and narcotic properties, and has been successfully used in incipient phthisis, hbemoptysis, and other hkemorrhages; it soothes irritation, reduces the frequencyr of the pulse, and lessens cough. It acts somewhat like Digitalis, in reducing the velocity of the pulse, but it is devoid of the dangerous effects resulting from the use of that drug. It is decidedly beneficial in the treatment of diabetes, having cured when all other means were useless; and has been of service in chronic diarrhoea and dysentery, inflammatory diseases of drunkards, diseases of the heart, and intermittents. Dose of the powder from onle to two drachms; of the infusion, from two to four fluid ounces." Dr. Scuddert places it in his class of "Sedatives" along with Veratrum, Aconite, Gelseminum, Digitalis, etc., but admits that it differs considerably from those agents in its action on the system. He says: "It is a mild sedative-narcotic, feebly tonic, and moderately astringent." * * * It is employed in all cases of excessive vascular excitement with great advantage. Its mild and congenial sedative properties render it a remedy of great value in lessening tumultuous action. For this purpose it has been employed in febrile and inflammatory affections, more especially in the various forms of pneumonia. In these diseases its mild sedative and narcotic properties render it peculiarly valuable in lessening general irritation and diminishing exalted organic action. In * Eclectic Medical Dispensatory. Materia Medica and Therapeutics. LYCOPUS VIRGINICUS. 401 acute diseases of this character, and in the chronic diseases of the respiratory organs attended with hemorrhage, it is very useful. In those diseases of a chronic character, in cases of great weakness in the thoracic organs, in cases where there is a frequent hmemorrhage, or a tendency to haemorrhage, from these organs in the incipient form of phthisis, or even when the complaint is somewhat advanced, and even in the confirmed stages of that complaint, the sedative and tranquilizing influences of the Lycopus, together with its mild tonic and astringent properties, render it an agent of very great importance. It somewhat lessens the momentum of the circulation, the irritability and excitability of the nervous and vascular systems, and hence controls febrile excitement, and lessens the heat of the body; it lessens irritation in the lungs and consequently the harrassing and exhausting cough; and if the patient is the subject of hemorrhage from the lungs, it lessens vascular excitement and the quantity of blood that circulates in the lungs in a given time, and in this way the irritation and the cough, and in the advanced stages of the disease, when the expectoration is copious and debilitating, the sedative, astringent and tonic influences of the Lycopus point to it as an invaluable palliative remedy, if not a curative remedy in all such cases. Its properties can not injure under any circumstances of the kind, and it may be resorted to with a strong probability of at least mitigating all the urgent symptoms, and even of effecting a cure. " The same remarks will apply to its utility in haematemesis, hammaturia, uterine haemorrhage, and haemorrhage of the bowels, etc. It acts somewhat like Digitalis, says Rafinesque, in lowering the pulse without producing its bad effects and accumulating in the system. He also says it is one of the mildest and best narcotics known. It is useful in gastritis and enteritis in allaying irritation and inflammation. It has been used freely and successfully in dysentery and diarrhcea. For this purpose it may be boiled in milk, with cinnamon or some other aromatic added, and taken freely. It has been highly and very justly extolled in diabetes. It is very useful in palpitation of the heart, in hypertrophy of 402 LYCOPUS VIRGINICUS. the heart, in dilatation of the ventricles of that organ, as in cases of aneurism of any of the large vessels contiguous to the heart. In cases of palpitation, whether arising from an organic disease of that organ, or from some nervous irritation, or whether it be symptomatic of some other disease, the Lycopus is valuable in either case to lessen irritation and organic action, and consequently the suffering and great anxiety which the patient always experiences in those affections." The pathogenesis in Vol. I. is made up from provings by Dr. Chandler, of this country, and Dr. Morrison, of England, with my own observations. In the second edition of New Remedies I wrote: " I have quoted the remarks in full relative to this interesting indigenous remedy, in order that the reader may get a general view of its character and effects as viewed from the stand-point of allopathic therapeutics. All seem to accede to this, namely, that it possesses a peculiar sedative power over the circulation, and the sedation is held in check by another power which is denominated a tonic influence; also that it has some astringent, nervine, and a slight narcotic influence. This really comprises all that is at present known by other schools concerning the plant. " The Lycopus has not been used in homzeopathic practice by other physicians than myself. If any have used it, it has not come to my knowledge. My first use of the plant was at the suggestion of an eclectic practitioner, whom the friends of one of my patients suffering from symptoms of insipient phthisis, had requested to consult with me relative to the diagnosis of the case. The patient had some febrile irritation, a quick weak pulse, occasional hsemoptysis, dyspepsia, weakness, and many other suspicious symptoms. We detected a deposit of tuberculous matter in the apex of the left lung. The action of the heart was quite irritable, palpitation occuring from the least exercise. The eclectic suggested the use of Lycopus, if other means failed to retard the morbid activity of the circulation. No improvement having followed the use of the ordinary homcepathic reme LYCOPUS VIRGINICUS. 403 dies, the Lycopus was resorted to. In the absence of the tincture, I ordered an infusion to be made of the fresh plant (one ounce to one quart of water), a teaspoonful to be taken every three hours. Its beneficial action soon appeared, and in a week such notable improvement had taken place that the medicine was continued at longer intervals, and in two weeks more the patient-a lady-went East apparently cured. This favorable experiment led me to use it further in similar cases, and my experience with it has been quite satisfactory. In those cases of pulmonary disease associated with looseness of the bowels, its curative action is sometimes very marked, and in incurable cases it often acts as a useful palliative. I give the tincture, or tincture-triturations, from the first to the third attenuation, and sometimes the infusion and syrup prepared to represent the lower dilutions. This plant has not been thoroughly proven, and its pathogenetic range of action is not settled. One proving has been made, however, which is interesting and suggestive, as it proves that the curative effects observed by eclectic and allopathic physicians were due to its power of causing similar physiological disturbances." Since the above was written, now nearly seven years, the Lycopus has been used a good deal in our school. It has become one of my most favored and trusted remedies in functional diseases of the heart. There are two conditions of the heart for which Lycopus appear to me indicated, and in which I always have good effects from it. (1.) In cardiac irritability with depressed force. In these cases the pulse is very frequent, small, compressible and often irregular and intermittent. The heart's impulse is feeble, the patient is generally nervous, irritable, and his extremities are cold. In this condition slight haemorrhages from the lungs are not infrequent. He can not go up stairs or walk fast, without rapid and weak action of the heart, or heavy oppressed action, which, under some conditions, denotes the same weakness. In both the provings, this very condition of the heart was caused. It is primarily homceopathic to this state. I have excellent success in such cases with the lx, 404 LYCOPUS VIRGINICUS. 2x or 3x, in ten drop doses, every three or four hours. In a few days the pulsations decrease in average frequency from 110 to 74, and increase in strength; and the general condition of the patient improves. I have many tables of the pulse-rate, kept by my patients, which illustrates this curative action of Lycopus. (2.) The other condition of the heart in which I have found Lycopus useful, may be called a cardiac erethism-a condition in which the debility of the heart is masked by the influences of a smouldering inflammation somewhere, generally in the lungs. In these cases the heart's action is quick the pulse quick, hard, wiry, not easily compressible, and. not generally irregular or intermittent. In these cases Aconite acts well for a time, but it will not do to use it too long. The Lycopus, however, while it reduces the force and frequency, by virtue of its secondary homceopathicity, relieves the local congestion and irritation of lungs, quiets the cough, prevents the haemoptysis, and except in cases of tuberculosis, will, aided by other remedies having a tissue-affinity for the lungs, cure the whole malady. These cases require large doses — from five to ten drops of the mother-tincture or 1x, repeated several times a day, for weeks. Dr. Morrison, of this country, reported the following case for my second edition. It is so singular that I reproduce it: A woman, aged thirty-three, a teacher, of nervous temperament, light hair and eyes, inclined to hysteria, menses uninterrupted, since the third month after their first appearance. The menses would appear within three or four hours of the same time every month with a deep-seated pain, with heat in the occiput; after a few hours a pain would seize her in the forehead and temples, with faintness and nausea at the stomach, a sensation of great weakness in the lumbar region, general lassitude and debility, especially in the limbs, followed by torpor and heaviness in the limbs. When the nausea set in the occipital pain was ameliorated. There was aversion to the smell of food. With these symptoms would be an appearance of protrusion of the eyes, with a wild and strange expression. The menses would usually appear in the morning and flow until noon, then suddenly cease, or they would last from half an hour to six~ hours, intermitting in this manner for ten or twelve days. While she was usually of a cheerful, sprightly, talkative disposition; during the menses she was stupid, had a lack of expression and a vacuity of ideas. There was also tympanites, puffing of the parts on and around the pubis and vulva, a dilated condition of the vagina, and a bearing-down sensation in the LYCOPUS viRGINICUS. 405 rectum. On examination the vagina seemed very hot, the os uteri engorged and swollen. From the use of ice locally, these conditions and the puffiness would disappear. Constipation existed, the bowels acting only once in six or seven days, the stools dry and clay-like. Heart's action.-When the eyes seemed protruded, the heart would seem to act tumultuously and forcibly; it could be heard several feet from the bed. (At these times the puffing of the pubis was worse.) When the heart's action was feeble and quiet, with quiet pulse, the puffing about the genitals was better. At times, the pulse would be small, quiet, and could scarcely be counted. Urine scanty, thick and muddy, cedema of the feet. This kind of cardiac trouble seemed to be hereditary, as her mother had been similarly afflicted. With the exception of some dyspeptic symptoms, no other organ seemed diseased. All, or nearly all, the above symptoms would disappear after the menstrual flow ceased, or at the expiration of ten or twelve days. After trying many remedies for several months, without benefit, the Lycopus virginicus was given with the effect of dissipating the majority of the symptoms, and a steady improvement has since occurred until she is now quite well. REMARKS.-Dr. Morrison's case is quite suggestive, especially in relation to the abnormal action of the heart, which seems to have been the cause, and not the effect of all the patient's symptoms. It would follow that Lycopus, by its specific action on the heart, cured indirectly all the abnormal manifestations. The case was doubtless one of exophthalmus, and is one of the few instances of that strange malady being relieved by any medicine. Dr. Morrison, of England, gives us the only clinical report of its use from that country. The symptoms prescribed for resemble those in his own provings: Mrs. A. W., hysterical temperament, consulted me, on the I3th September, age 47; no appearance of menses for three years. Complained of occipitofrontal headache, debility, flushings, dyspncea, palpitation easily induced, with occasional intermissions; flatulency; giddiness, huskiness of throat on right side, interscapulary pains, pains down the lower limbs, commencing on left side; dreamy sleep. I1 Lachesis 12. I7th Sept. Complains of fronto-occipital headache, on excitement; palpitation " all over;" swelling of legs and ankles, on exertion. General symptoms unchanged. 13. Lycopus 3x om. ~ tiis horis. 23d Sept. Swelling of ankles, flatulency, and dyspncea lessened. Cardiac pulsation regular, not intermittent. Has also found relief from shooting pains in left wrist and elbow. Flushings continue. Rep. 27th Sept. Complains much of "strange feelings," with fronto-occipital headache, " as if the temples were pressed in "; seems afraid to turn for fear she would tilt forward; nausea, from epigastrium; depression; for several years has 406 LYCOPUS VIRGINICUS. dropped things fiom her hands; flushings; sudden pains at apex of heart, "causing faintness and strange sensations " ("I often wonder whether my heart is affected "); inter-scapular pain; this week, restless and dreamy sleep; less palpitation; less pain and swelling of legs and ankles; constipation; appetite good. Auscultation reveals feeble action of heart; no murmurs; pulse stronger than indicated by cardiac action, 8o sitting and standing, regular. Considering that some of the symptoms were due to drug-action, I prescribed I~ Spt. z'ini rect. 4th Oct. Still have severe pain in temples and occiput, with nausea; flushings. Other symptoms, including cardiac, much relieved. Sleep better; pulse So, sitting and standing; feeble. 1 Lycopus 3c, 4tuor in die. IIth Oct. Has had a bilious attack, with vomiting of food. Used formerly to have severe pain across hypogastrium, with such attacks, but was free on this occasion. Still has flurried feelings and flushings, but lessened. Beatings through temples to occiput, with sensation of stoppage in larynx (nervous). Sleep much better; dreams less; less palpitation; sudden pains at apex, but lessened in frequency and intensity. Pulse Io2 sitting, 1I2 standing; very feeble. tI Spt. vini rect. I8th Oct. Hysterical, with bilious feelings. Faintness, sighing. Other symptoms about the same. Pains in head and temples. Pulse 72, feeble, regular, sitting; resps. I8, ]4 Lycopus 3, 4tuor in die. 25th Oct. Less sighing; less giddiness. Pulse 8o, feeble and irregular, sitting; 92, feeble and regular standing; resps. i9. There was decided improvement in several respects; but at this point it became necessary to change the remedy, owing to the setting-in of severe bilious derangements. NOTE. - The prominent symptoms which Lyco5pus failed to relieve were - neuralgic pains in the left side of the face; flushings, with sense of heat; choking sensation in throat, and hepatic complications. I doubt if the supposed aggravation was from Lycopus. The Lycopus has been found curative in diabetes'rnellitus. Dr. Ray reports several cases in the Eclectic Medical Journal. They were characterized by the flow of a gallon or more, daily, of clear urine, of great density, containing sugar, intense thirst, great emaciation, and other well known symptoms of the disease. After trying a rigid diet and various medicines without much good result, the fluid extract of Lycopus was given, in doses of thirty drops, three times a day, with surprisingly prompt effect. All the symptoms rapidly gave way, until the patients were apparently cured. Thus we have another remedy for that serious and often intractable malady. The action of Lycopus on the Heart has not been sufficiently studied by means of experiments on the healthy. Dr. Mor LYcoPUs VIRGINICUS. 407 rison, of England, is the only one who has attempted a thorough proving with large crude doses. It is to be regretted that he was not in good health, and that his heart was not in a normal condition. The two experiments or provings he has made are valuable, inasmuch as the Sphygmograph was used in each proving, and the pulse-tracings given. The record of his first proving begins by giving his state of health at the beginning of the proving, as follows: State of Healt/.-Usually good, though not robust. For the last nine years (since residing in England), tendency to rheumatic pains,with slightly depressed cardiac action. The oppression of crowded rooms induces faintness. For about a week, tendency to diarrhcea. Slight attacks of spasm of the intercostals, which have troubled me for about a month; consequent on the effects of arsenical wall-paper. Depression of vital energy, from a long strain of work. Examiner's Report (by a hospital physician).-" Impulse of heart rather feeble. Percussion shows that the heart is of natural size. There is a distinct systolic basic murmur heard at the second left interspace, which I have no doubt is hbemic. The first sound~at the apex is not good, and rather murmurish. Occasional intermissions in the heart's beats." Clinical Observations.- Pulse 70 (sitting); temp. 36.40 C.; resps. 20. Urine clear, bright (even after standing the whole night); acid; sp. gr. IOI2; free from albumen. Proving.-Sept. 5th, I872, IO P.M., Lycopus mx-0. I append pulse-tracing as taken by the sphygmograph. The indications are those of fairly healthy action. Sept. 7. Dose 25 drops tincture. The heart has already begun to show its action in the weakened impulse of that organ, as witness the following tracing: Pulse 76; action fairly regular. Sept. 8. Took 60 drops. The pulse was 80, standing, with distinct intermissions, with some cardiac oppression. Dr. Morrison says he uses the term "cardiac oppression," to denote heavy, labored action, as if the heart were obliged to make great effort to do its work. Sept. 9. Took 60 drops. Cardiac oppression, pulse 80, sitting, with the following pulse-tracing: 408 LYCOPUS VIRGINICUS. Sept. Io. Took 60 drops. Cardiac depression when lying down, with dull, heavy beating, lasting several minutes. Pulse 74, sitting and standing, varying in volume. (Depression, indicates feeble and excitable action.) Sept. ii. Took 75 drops. On waking, intermittent action of the heart; intermissions at 7th, 8th, 6th, 9th, 2Ist, 23d and 88th beats. A few minutes after, intermissions between the 6th and I5th beats; later it beat 70 (lying.) Sept, I2. Took 50 drops. Pulse irregular and intermittent, specially so when lying, quickened by each inspiration. Sept. I3. Took 50 drops. " Pulsation scarcely perceptible to the touch." Pulse 72, regular, with this tracing: Sept. I4. Took 6o drops. Awoke at 5. Pulse 74; intermissions at 7th, IIth, 3Ist, Ioth, and 20th beats. At 8, pulse 72, not intermittent. Io A. M., pulse 74, lying and sitting; 82 standing; general debility. At noon, pulse 82 sitting; 86 standing; irregular and intermitting. Five minutes later, subacute pain at apex, extending to third left interspace. Sept. I5. Took 8o drops. Rheumatic pains about the heart. Palpitation on slightest exertion. Pulse, lying 6o, sitting 66, standing 8o. Sept. i6. Took Ioo drops. Labored cardiac pulsation in the morning. In the following tracing the jerking character of the heart's action is well expressed: Sept. 19. Examination of heart. " Heart sounds indistinct, systolic running into diastolic, action very feeble. Pulse, 78 sitting, 86 standing, not intermittent (noon). In the afternoon the pulse came down to 62 sitting, 64 standing, irregular. (Took I80 drops.) Sept. 20. (No medicine after this date.) Much darting pain at apex of the heart, with general debility. Sept. 2I. At noon, pulse scarcely perceptible, 76 sitting, regular; 84 standing, irregular. The tracing showed feeble action, obtained with difficulty: Examination showed the pulse extremely varying both as to time and volume -at first almost imperceptible, 76 to 86 sitting and standing; not intermittent. Cardiac pulsations much stronger than the pulse-indications would lead one to expect. No murmurs. Sept. 24. Examiner's Report. "Impulse feeble; heart-sounds very weak; action irregular in force and rhythm, not intermittent, no murmurs. Pulse feeble, very compressible. Sept. 25. Pulse 68 sitting. The subjoined tracing was taken with difficulty at former pressure, owing to feebleness and compressibility: LYCOPUS VIRGINICUS. 409 Sept. 26. Pulse, 62 lying, feeble, less compressible (in morning.) In evening marked cardiac depression, causing slight faintness on quickly ascending a few stairs, lasting fully half an hour; returning later on quietly ascending, with subacute cardiac pain; cardiac action barely perceptible; pulse stronger than cardiac action would indicate; regular. Sept. 27. Subacute pain over cardiac region, with cardiac distress. Pulse compressible, irritable, varying in force and rhythm, with frequent intermissions, sighing respiration, cardiac depression. Sept. 29. Labored cardiac action, followed by cardiac depression, with faintness; pulse at same time 76, stronger than cardiac impulse indicates. Sept. 30. In evening cardiac depression, causing faintness. Oct. I. Examined. Cardiac impulse very feeble; haemic mur. again distinct; no other murmurs; pulse feeble; extremely compressible, irregular in force and rhythm, not intermittent, 72 to 80 sitting and standing, quickened by movement. Oct. 3. The annexed tracing was taken last evening with a pulse so feeble as to render it being taken at former pressures a matter of considerable difficulty. Oct. 9. Cardiac depression has been the rule up to this date. To-day it is 78 sitting, 88 standing; irregular in rhythm; extremely compressible. Oct. Io. 7.30 P.M., marked cardiac depression; pulse stronger than indicated by cardiac impulse, 66 lying, sitting and standing, extremely irregular in force and rhythm; respiration oppressed; lasting till 9 P.M. The annexed pulse-tracing shows the character of the heart's action at the time. Owing to slow running of the paper this tracing is rather cramped, but the cu ves are well marked. A singular feature in this tracing is its resemblance, in main points, to one recently taken on a patient, aged 3I, afflicted with severe mitral regurgitant disease; which latter I annex for the sake of comparison. It should be mentioned that this is not the characteristic tracing of mitral regurgitant disease. For the sake of clinical comparison I append a second tracing taken from the same patient ten days after, while under the influence of Digitalis, of which Lycopus appears to be an analogue. Oct. I5. No special symptoms since last report. The faeces are gradually assuming their natural character. Cardiac action still rather depressed. Examiner's Report (by first examiner).-" Cardiac impulse feeble; haemic murmur distinct on strong pressure; systolic sounds not quite natural at apex, not amounting to a murmur; probably due to feeble action; pulse regular, very compressible, 76 sitting." Io.30 P. M., pulse 68 sitting, 72 standing, regular, 27 410 LYCOPUS VIRGINICUS. compressible; temp. 36.40; resps. 20. Urine clear; acid; sp. gr., IOI4. The annexed tracing, taken on the following morning, shows a healthy, though not vigorous, cardiac action. This completes the proving. Dr. Morrison made a second proving some time afterwards beginning with the 200th potency, one dose, and ending with the 0. April I7. Five drops of the 200th in the evening. On lying down he observed palpitation with altered rhythm, the systole being shortened and the interval lengthened, April I8 and I9. No cardiac symptoms. April 20. Cardiac depression in the evening; pulse, 68 sitting; irregular. April 29. Ten drops 0. The next day on waking, pulse 6o, feeble, irregular and intermittent. In P.M., pulse 76, feeble, regular, as shown by the following tracing: May I. Forty drops 0. No heart symptoms for seven days. May 8. 120o drops 0. Two hours afterwards had oppressed respiration, with sighing, vertigo; pulse, 80o sitting; 88 standing; regular; cardiac depression. On the gth and Ioth he felt the same symptoms. On the IIth he had acute darting pains in the heart, with complete intermissions, lasting nearly an hour. On the 6th of July, he says: " During the last three weeks, I have felt quite as well as usual; but this morning, on rising, noted slight weakness of the pulse, with slight irregularity of rhythm. He took 90 drops of the 200th. He records diminished pulse force, with occasional intermissions a few minutes after; and in the evening, pulse 66 sitting and standing; very irregular in force and rhythm." (I can not see that the 200th had any effect in this instance. The symptoms of the morning, before the dose, were simply continued during the day:) It appeared to act curatively only, as the pulse tracing of the next day shows: REMARKS.-These provings of Dr. Morrison, while they throw much light on the action of the drug, and denote great care and ability on the part of the prover, are not what we require to perfect our knowledge of the action of Lycopus on the heart. To obtain a thorough insight into the powers of a drug, the prover should be a healthy person. Dr. Morrison was not healthy; he says he " had had for years a tendency to LYCOPOUS VIRGINICUS. 411 rheumatic pains and slightly depressed cardiac action. The oppression of crowded rooms causes faintness." This latter symptom always denotes a weakened heart. The examination of the heart at the beginning of the proving showed the impulse to befeeble, with intermissions, etc. Moreover, he says: "At the period of commencing the proving, and for weeks after, he had late hours, and hard labor; all of which would induce feeble and labored cardiac action. But, admitting all these, the Lycopus, doubtless, had some pathogenetic action on the heart, for it seemed to regain its usual power when the drug was left off. It was simply an experiment upon a prover who had a condition of the heart similar to that caused by Lycopus, and the drug aggravated the existing cardiac debility. But from these aggravations we can deduce valuable information. Taking these provings, together with my own experiments and clinical observations, I believe the action of Lycopus on the heart, when taken in massive doses, may be thus stated: Primarily, it weakens the power and vitality of that organ, decreasing the blood pressure in the arteries, and consequently the tension every where. It renders the action of the heart irregular, intermittent and quicker, especially on motion. It causes oppression from labored action before it causes depression; or the two sensations appear alternately. The pains caused by Lycopus are not rheumatic, but "rheumatoid"; or, more properly, myalgic, the result of general muscular enervation. It does not appear to affect the nerves specifically, but may indirectly weaken the retardators and inhibitory cardiac. The vertigo is quite notable, and indicates decreased arterial pressure in the head. The ultimate result of a heroic Lycopusproving would be to cause hypertrophy with dilatation, if the experiment could be carried far enough. (It is doubtful if it possesses sufficient power to cause such a result in a healthy person.) Secondarily. The action of Lycopus, or the reaction from the primary symptoms, would be to cause an exceedingly irritable heart, with a tendency to hypertrophy with enlarge 412 LYCOPUS VIRGINICUS. ment, or hypertrophy with dilatation, and even valvular disease. Even " Grave's disease," or " ex-ophthalmus," might result from its secondary effects. It is difficult at this time, and with the knowledge we now possess, to more clearly define its primary and secondary action. Clinically, the value of Lycopus, in all the conditions similar to its primary and secondary action, is undoubted. It is primarily indicated in cases where the heart has become weak and irritable, from physical causes, namely: such as originate from over-strain of that organ; from a rheumatic affection with constitutional debility; from abuse of cardiac depressants, or cardiac stimulants. I do not think it will be found'as useful when the primary cause of the cardiac debility is in the nervous system. In these conditions it should be generally prescribed in the attenuations, even the higher. It is secondarily indicated in excessive cardiac hyperactivity, hyperaesthesia, hypertrophy (either eccentric or concentric), whether from muscular weakness or sympathetic with disease in other organs. (During the primary action of Lycopus on the heart, a general venous stasis occurs in all the organs of the body, notably the liver, lungs and kidneys; consequently it is secondarily indicated when the heartdisorder arises from such causes.) Even in cases where the cardiac irritability arises from erethism of the nerve-centers, the Lycopus is secondarily indicated, for reasons which will occur to any physiologist. The dose, when secondarily indicated, ranges from the lowest dilutions to appreciable quantities of the matrix tincture or infusion. In several cases of irritable heart, where the pulse was quick (140), but regular, and with sharp, jerking impulse, the persistent use of the tincture, in doses of ten drops, three and four times a day, has brought the pulse down in the following manner: When first taken, the pulse was in the morning, 120; noon, 130; night, 140; from this it dropped in a week, gradually, to 68, morning; 74, noon; 80, even LITHIUM CARBONICUM. 413 ing. This occurred under the influence of decreasing doses, and the improvement was permanent, showing that it was not merely a palliative effect of the medicine. LITHIUM CARBONICUM. The Carbonate of Lithium is not very widely diffused in the mineral kingdom. Lithium, in some form, is, however, found in certain mineral springs, namely: the Carlsbad, Franzensbrunn, Weinbrunn, in Europe, and the Gettysburg water, of this country. Hering, among other reasons why the Lithium should be proven, says that Uric acid is sparingly soluble in water — one part in ten thousand. Carbonate of Lithium is soluble in water, one part in 100. But this one part renders soluble four parts of Uric acid, increasing its solubility 400 fold. Uric acid calculi have been corroded by a solution of Carbonate of lithium (1 in 100), to such an extent as to lose five grains in five hours. It has been recommended, and I believe used successfully, as an injection into the bladder, to dissolve such calculi. In commenting on the provings, Hering calls especial attention to the eye-symptoms, the heart-symptoms, and the renal-symptoms. It certainly causes some very marked eye symptoms, such as hemiopia- the right half of objects are invisible. A Dr. L. Kenyon reports two cases of ophthalmia, with redness of the sclerotica, muco-purulent discharge, sticking pains in the eyes, photophobia, and a sensation as of a veil before them. Cured by Lithium 12th. I have frequently used Lithium in a peculiar soreness of the end of the nose - such as is described in the proving -and have cured obstinate cases that have annoyed persons for years. I used the 6th. The gastric symptoms are not unimportant. It is said to cure obstinate acidity of the stomach. It causes a disagreeable gnawing in the stomach, with 414 LITHIUM CARBONICUM. pains in the temple and orbit. This gnawing was relieved by eating. So were the pains. Lachesis has a similar symptom. I advise you to study the pathogenesis in cases of renal and cystic disorders, not amenable to ordinary remedies. Dr. T. C. Fanning reports a case of disease of the right kidney and bladder (American Homo-opathic Review, vol. v), with the following characteristic symptoms: "Soreness of the bladder, and sharp, sticking pain in the neck of the bladder, on right side, with soreness there; frequent urination, pain in right kidney, and other symptoms found in the pathogenesis." This case was cured by Lithium carb. Dr. Fanning thinks Lithium will cure ovaritis and dysmenorrhaea, especially when connected with the above symptoms. Dr. Neidhard gave it in a case of heart disease, with " induration (ossification) of the aortic valves," with a " bruit de scie," followed by a bellows sound within a small space in the region of the aortic valves, sharp pains shot through the back, through shoulder and arm, arm as if paralyzed. After taking Lithium, the case appeared aggravated, followed by improvement for many days. Hering says it relieves pain in the heart, before and at the time of the menses; also that in cases of deficiencies of the valves, aggravated after mental agitations of a vexatious character, with trembling in the heart, painful, extending to the shoulders and into the head, as a throbbing; the Lithium gives prompt relief. Neidhard says it has cured "rheumatic soreness in the region of the heart." I lhave never had occasion to use it in heart diseases. Theoretically it ought to be useful in rheumatism and gout. But the only clinical experience I can find is that of a Dr. Whitey, quoted by Hering, who cured "painfulness of the feet, ankles, metatarsus and toes; also, on the border of the foot and sole." There is a kind of sore throat, in which the pain seems to extend up to the ear (through the Eustachian tube), and back again. Lithium has this symptom. Before the Bromide of lithium was used, Hering predicted LOBELIA CERULEA. 415 that it would be useful for ear and lung diseases, and advised a proving of it. The Gettysburg water has been partially proved, but no important symptoms elicited. LOBELIA CERULEA. The Blue Lobelia was first mentioned by Dr. Hering. The provings he collected were published in the first volume of American Institute Transactions, but it has been rarely used in practice, except by the veterans Jeanes, Williamson and Neidhard. Dr. Jeanes cured a group of symptoms, of which melancholy with pain under the short ribs of the left side, from back to front, were the principal. He supposed the spleen was affected. In such a case I should have given Cimicifuga. The old botanic doctors who valued the L. infiata so highly, make no mention of this species. Rafinesque, however, says: "By their taste the species L. syphilitica (now called Cerulea) and L. cardinalis, appear to have properties somewhat similar but milder." He says the L. cerulea has been analyzed and found to contain Silex, Iron, muriate and phosphate of Lime. " It is a lactescent and nauseous plant, which has been deemed, long ago, to be diuretic, cathartic, emetic, with properties similar to L. inflata, but less active. The root has been chiefly used. Dose, five to twenty grains, in dropsy." In the provings, a tincture of the leaves was used. Either all the provers were suffering from bad attacks of catarrhal headache and catarrhal affections of the nose and throat, or this remedy is more specific for such affections than any we possess. If the provings are trustworthy, it ought to rival Iod. of ars., Hepar. sulph., Hydrastis, Gelseminum, Cistus, or Merc. iod. The head, eyes, nose, mouth and throat symptoms form a perfect picture of a sneezing influenza, or catarrhal affection. The throat symptoms, especially, give a vivid picture of that 416 LOBELIA INFLATA. variety of catarrh which affects the posterior nares, palate, fauces, and even lower portions of the throat. It does not seem to affect the larynx and bronchia, however. This variety of catarrh more generally affects young boys and girls, and people advanced in life, although I have observed it in all persons, of all ages. It is difficult to cure, and if Lobelia cerulea will cure a portion of your cases, it is worthy your high esteem. Dr. Neidhard has cured a cough of four weeks duration, day and night, with "dryness of the back part of the throat," which doubtless caused the cough. Neidhard cured some cases of pain in the back, running down the legs, which appear to have been cases of sciatica, associated with rheumatic irritation of the spinal muscles. The symptoms (see Materia Medica) resembled those cured by Cimicifuga and Nux. You will find this remedy difficult to procure at the pharmacies, but it is one that you can readily find and prepare for yourselves, for it grows everywhere. Gray still calls it L. syphilitica, a prostitution of the plant which ought not to be sanctioned, for its virtues in syphilis are purely mythical. LOBELIA INFLATA. Although this species of Lobelia has not attained anything like the celebrity, in our school of practice, that it attained in the botanic and eclectic schools, it is a medicine well worthy your study and investigation. Its medical history is very interesting. The early historians of New England inform us that it was considered a sacred plant by the aborigines, who used it in their great councils to clear their stomachs and heads and fit them for grave consultations and for battle. It is interesting to know that many of the most ancient nations - Greeks and Asiatics - used certain plants for the same purpose. The plant used by the Greeks was the Veratrum album.* The remaining Indian tribes of this country all use certain emetic plants for this purpose. *See Hahnemann's Thesis on the Helleborism of the Ancients, " Lesser Writi/ns." LOBELIA INFLATA. 417? An uneducated man, calling himself "Dr." Thompson, a native of New Hampshire, was the actual founder of that strange and ridiculous system of practice called the " Botanic," and although he claims to have discovered by accident the medicinal qualities of Lobelia, probably got his knowledge from the Indians who lived around him. From them he also got his practice of steaming the sick, for it is well known that this process is one very common among all Indian tribes for the cure of many diseases. As a literary curiosity, I quote Thompson's account of his " discovery:" 4" Sometime in the Summer of 1790, after I was four years old, being out in the fields in search of the cows, I discovered a plant which had a singular branch and pods, that I had never before seen, and I had the curiosity to pick some of the pods and chew them; the taste and operation produced were so remarkable that I never forgot it. I afterwards used to induce other boys to chew it, merely for sport, to see them vomit. I tried this herb in this way for nearly twenty years without knowing anything of its medicinal virtues. It never occured to me that it was of any value as a medicine until, when mowing in the field with a number of men one day, I cut a sprig of it and gave it to the man next to me, who ate it; when we. had got to the end of the piece, which was about six rods, he said he believed that what I had given him would kill him, for he never felt so before in his life. I looked at him and saw that he was in a most profuse perspiration, being as wet all over as he could be; he trembled very much, and there was no more color in him than in a corpse. I told him to go to the spring and drink some water. He attempted to go, and got as far as the wall, but was unable to get over it, and laid down on the ground and vomited several times. He said that he thought he had thrown off his stomach two quarts. I then helped him into the house, and in about two hours he ate a hearty dinner; in the afternoon he was able to do a good half-day's labor. He afterwards told me that he never had anything do him so much good in his life; his appetite was 418 LOBELIA INFLATA. remarkably good; he felt better than he had for a long time." Dr. W. P. C. Barton, in his Medical Botany, thus refers to the history of this drug: " The first notice I can find in print of the medical virtues of Indian tobacco, is simply a brief remark by Schcepf, that the root is astringent and used in ophthalmia. He seems to have had little knowledge on the subject, and from the manner in which the plant is mentioned by him, it may reasonably be suspected that a vague rumor only of its medical properties had reached him. The next accounts we hear of it as a medicine are by the Rev. Dr. Cutler and the late Prof. Barton." As Dr. Thompson was practicing in Massachusetts, it may be inferred that Cutler or his informant obtained their knowledge of its virtues from him. It was first introduced into the regular (?) profession in 1810, by the Rev. Dr. Cutler, of Massachusetts, whose attention was directed to it by Dr. Drury, of Marblehead, who had been cured of asthma by its use. It seems Dr. Cutler was suffering from the same difficulty; he used this drug and was cured. He published his case, which attracted the attention of the profession. It was introduced into England by a Dr. Reese. As regards its introduction into homoeopathic practice, it was first noticed in "Jeanes' Homoeopathic Practice of Medicine," Philadelphia, in 1838, in which he detailed several cases of asthma and other diseases which were cured by this remedy. But the first publication of its pathogenesis was by Dr. Alpheus Noack, of Leipsic, in his excellent treatise on the "Lobelia inflata," in the fifteenth volume of the Hygea (1841). This exhibits very extensive research; he has perhaps quoted every writer of any eminence who has mentioned this plant. The experiments of Noack were accompanied by cotemporaneous thermometrical, barometrical, and meteorological observations. Among the circumstances noticed in his ex LOBELIA INFLATA. 419 periment, on his own person, was the speedy decomposition of the urine passed on the first day of his, trial. This had taken place by the next morning, when a rose-red sediment was deposited on the sides of the vessel, in which was found a small brown urinary crystal, which under a microscope of two-hundred-fold magnifying power, had the form and size of a large currant, and formed a granular conglomerate. Another proving is found in the British Journal, vol. xvii, page 464; also in Vol. I. The first pathogenesis was published in the first volume of the Transactions of the American Institute. Notwithstanding it is claimed to be such a harmless plant by its votaries, it is capable of causing serious and fatal toxic effects. Horses and cattle have been killed by eating it accidentally. Mr. Proctor gave a grain of Lobelina, in solution, to a cat. In less than two minutes, it produced violent emesis and prostration, from which the animal recovered in three hours. Again, one grain of the substance in an ounce of water was administered directly into the stomach of the animal, by an elastic tube. Immediate and total prostration was the consequence, which in half an hour rendered the animal almost motionless. The pupils of the eyes were much' dilated. The animal gradually recovered its strength, but the effects of the prostration were evident for fifteen hours afterwards. No emetic or cathartic effects resulted. Mr. Curtis and Dr. Peterson experimented with it on hedgehogs and cats. They noticed that the heart continued to beat for some time after, breathing had ceased. Dissections revealed congestion of the lungs and venous system, as happens in case of death from asphyxia. The stomach and bowels were found to be in an inflammatory condition. Charles Whitelaw remarks that it causes cattle to become hide-bound, and affected with dandruff. On man several deaths are recorded to have occurred from the use of this drug, both in this country and Great Britain. An inquest was held in England, in November, 1853, on the occasion of a death from Lobelia, by Dr. Letheby, Professor 420 LOBELIA INFLATA. of Chemistry in the London hospital. He stated that thirteen cases of poisoning had occurred from this drug within three or four preceding years. The doctor found in the stomach of a woman who had been poisoned with it, 110 grains; in the case of a man, a tablespoonful of the seeds; and in a child three years old, fifteen grains of the seeds in the bowels. The following case of poisoning is found in Volume VI of the Massachusetts Reports: A Mr. Ezra Lovett caught cold, and sent for Dr. Samuel Thomson, of Beverly, who forthwith obliged him to take three powders of Lobelia, successively, at half an hour's interval between each. Every powder produced dreadful vomiting; in the night, longcontinued and copious sweats occurred. Two similar powders, given another day, produced vomiting and extreme uneasiness; and the same given the following day sunk the patient into a state of great depression. A few days afterwards the doctor returned, and finding his patient worse, gave him some more powders of Lobelia, which at first produced great uneasiness, but latterly became wholly inoperative. Thomson supposed that the medicine would be directed to the bowels and excite purging. However, in the evening the patient lost his senses, and was attacked with convulsions, so that two men were required to hold him. Not a whit the less, however, did Thomson continue to repeat the Lobelia, and gave his unfortunate victim two powders more. The patient grew gradually worse, and at length expired. Thomson was arrested on the charge of murder, but liberated, as the sad issue of the case could not be ascribed to malice on his part. Inflammation of the stomach and bowels have been noticed after large, emetic doses. Dr. Teste's proving, which appeared in his Materia Medica, is open to serious doubts of its trustworthiness. He says it produces an eruption similar to the itch, and he recommends Lobelia and Croton as the two grand specifics for that eruption; but no clinical experience has ever been published to verify his recommendation. LOBELIA INFLATA. 421 The homceopathic profession remember distinctly with what boldness Teste pronounced the dictum in his Diseases of Children, that Lobelia was a specific in all cases of recent itch, and that Lobelia and Croton were the specific remedies for the itch. Upon the appearance of that book, which shot like a meteor across the sky of homeopathic literature, and like an ignis fatuus, led astray those who followed its teachings, many physicians were induced to test the Lobelia in cases of scabies. What was the result? Although fifteen years have elapsed, not a single clinical case has been published or related which proved Teste's recommendation of any value. Teste's recommendation, be it remembered, was based upon the supposed pathogenetic effects of Lobelia in causing itch-like vesicles in a single instance! A recommendation based on such insufficient grounds is not in accordance with the demands of our science. This is not the only instance in which Teste erred in a similar manner. Since the appearance of his Materia Medica in this country, in 1854, I have carefully observed hundreds of cases of persons who were taking Lobelia, both in large and small doses, and I have never observed any eruption, coincident or subsequent, which could by any stretch of fancy be said to have been caused by that drug. I have also made inquiries of truthful, observing physicians of other schools, who are in the habit of using Lobelia, and their testimony is decidedly against its power of producing irritation of the skin, when taken internally. Dr. P. H. Hale, who has had ample opportunity of observing its effects, states, that with the intense nausea it causes, there is sometimes a prickling itching of the skin; acting on this hint, he thinks he has seen benefit arise from its use in suppressed urticaria, with nausea and vomiting. This, however, would not prove its homceopathicity to any organic skin disease, like itch. The intense itching caused by Opium is probably owing to its irritant action on the peripheral nerves; Lobelia causes its itching-prickling in the same manner. For three years I used the Lobelia alone in many cases of recent itch-like eruptions, but never observed the least ben 422 LOBELIA INFLATA. efit accrue, although I followed Teste's advice as to the potency to be administered. At one time Dr. Douglas recommended it in his lectures and writings. Teste says he has used it successfully in a case of " papulous exanthem, evidently of a psoric origin." Marcy and Hunt remark: " It also operates upon the skin, curing a peculiar kind of herpes, formerly called' James River Tetter.' It was common on that river, and cured by the Lobelia." Lobelia has proved an antidote to Rhus tox. A lady in Massachusetts was severely poisoned. The usual allopathic remedies were applied: Lead water, Zinc, etc., but all to no purpose. The disease extended over both hands and arms, to the shoulders, and over the entire face, causing symptomatic fever and slight delirium. At 2 P.M., one drachm of the inspissated tincture of Lobelia was dissolved in one pint of water, and cloths Wet in this were freely applied. At the first application the relief was marked; the smarting subsided and the redness disappeared. The cure was completed in one-half of the usual time of spontaneous cures. In the rapidly spreading erysipelas caused by dissection wounds, Lobelia is said to have effected several marked cures. Dr. J. S. Andrews, of Massachusetts, was severely poisoned, with two other gentlemen, on opening the body of an ox dead of a malignant disease. On the third day, the two companions died, and he had symptoms of the same disease, which produced spasms and every phenomenon that occurred in the other cases. Lobelia was used as a poultice locally, and also internally by enemas and by the stomach, in very massive doses. He recovered with sloughing of the wounded parts. In two other cases of poisoning from dissection wounds, with a dynamic fever, and a rapidly extending erysipelatous inflammation from the seat of the puncture, it was equally successful. Let us inquire into the sphere of action of this powerful drug. The direct action of Lobelia is doubtless upon the nervous system. LOBELIA INFLATA. 423 Its whole force seems to be spent upon this system. Selecting the pneumogastric, about opposite the pharynx, as the starting point, it passes in both directions, involving the phrenic, solar and cardiac plexuses, and finally the cerebrospinal system. Nerves of Sensation.- This division of the nervous system is the first to note the introduction of Lobelia. That faithful sentinel, the superior laryngeal, telegraphs to the brain, that a poison has invaded the system. The pneumogastric being made up of both sensory and motor filaments, the impression passes down the extremities of that nerve, and the brain sends a motor current to eject the drug; while this is being done the sensation has gone on to the great sympathetic, and finally it is " felt at the finger ends and toes." The sensation is felt most severely in the solar plexus. The depression upon this and the other plexuses of the sympathetic system is such that the patient imagines that death is about to ensue. The "healthy " feeling expressed by patients, who have taken this drug, is due to the reaction. It is like the exultation of joy following the depression of fear. I think this starting point of attack is the key to the use of the drug. Nerves of Motion.- This system is brought most powerfully under the action of this drug. The inferior laryngeal seems to be the first one called into action, which causes a constricted feeling at the larynx; passing over the (esophagus, contracts its whole length, then the stomach contracts from below upwards, and emesis follows; in the meantime the bronchi and breast contract, and the patient feels as if suffocation was impending. Now the voluntary muscles are called into action, and if the drug is carried far enough, convulsions and death ensue. Muscular System.- As we have already seen, this system suffers severely, the whole nervous energies being brought so completely under control of this drug. The involuntary muscular fibers are the ones first involved, as we observe by the vermicular motion of the muscular 424 LOBELIA INFLATA. fibers of the cesophagus, the contractions of the stomach and bronchi, and the lowered action of the heart. Want of power in the sphincter ani was cured in one case. (See last case under " stomach.") The voluntary muscles do not seem to be affected until the involuntary are completely under its influence. In the reduction of luxations the eclectics use it much as we do Chloroform, to relax the muscular fibers, until the patient is as "limber as a rag." This is why it is of service in rigidity of the os, rigidity of the perineum, intestinal intussusception and in hernias. It is not homceopathic to any such condition any more than is the vapor bath. The nerves of the heart are affected in the same manner as by Tobacco. Its primary effect is to paralyze, the secondary to cause spasms and pain. This shows why it is useful in certain cases of faintness, (in a high dilution), and in spasmodic palpitations and angina pectoris (in low dilutions.) The nerves of the stomach are certainly most seriously affected by the specific action of the drug. I have frequently used it in spasmodic cardialgia, in bilious gastralgia, and even in the terrible pain caused by the attempted passage of gallstones. In each of these disorders it should be used in the lower dilutions. It is certainly homceopathic to vomiting with great prostration, cold sweat, feeble pulse, etc., but the records of our school show but few cases reported. It should be used high in such cases. I believe it will prove as useful in the vomiting from fright, and other emotions, in nervous subjects, as Gelseminum is in diarrhoea (involuntary generally) from similar causes. Dr. Jeanes, one of the original investigators of the Lobelia, in our school, remarks he has been able to remove many dyspeptic symptoms with this drug. He considers the chief indications for its use are: A sense of weakness and oppression at the epi.qastrium, and at the same time some oppression at the breast. The nearer approach to these symptoms the less have I been disappointed. There are, LOBELIA INFLATA. 425 however, some cases where although the symptoms of pectoral oppression are very trifling, yet this remedy operates satisfactorily. In a case of this kind, which I have but recently treated, and which occurred in a fat, robust man about 45 years of age, who complained chiefly of a copious haemorrhoidal discharge, and consequent debility, and a sensation of tightness in the epigastrium with some acidity of the stomach. I at first gave him Nux vomica without any apparent abatement of his disease, and subsequently some other remedies with the same want of success. At length he complained of some oppression at the breast, for which I administered Lobelia a. The following day he informed me that he felt new life and vigor, and that the pectoral, gastric and heemorrhoidal disorders had all disappeared since that time, now about two weeks; he has remained free from them, and also from a feeling of want of power in the anus and rectum which was exceedingly uncomfortable to him while at stool, and to which he had been subject for many years. The Lobelia does not have that debilitating action on the stomach as an immediate defect, which other emetics cause. Most persons, after an emetic of Lobelia, can eat heartily and with relish. Its long-continued use, however, debilitates the stomach and weakens digestion. "Botanic" physicians consider it one of the best remedies for dyspepsia. They insist that small doses-five or six drops-one hour before meals, largely increase the appetite and power of digestion; but if the patient be bilious, an emetic dose must be given. I have found it most useful in the dyspepsia due to excessive use of green tea, tobacco and bad liquor. In such patients you will always find the faintness at the stomach a prominent symptom. If you consult the gastric and stomach symptoms of Lobelia, you will find quite an array of peculiar symptoms. The following are the chief symptoms, according to Dr. Jeanes, which indicate the use of Lobelia: Constant dyspnoea, aggravated by the slightest exertion, and increased by even 28 426 LOBELIA INFLATA. the shortest exposure to cold, to an asthmatic paroxysm; sensation of weakness, and pressure on the epigastrium, rising from thence to the heart, with or without heartburn; feeling as of a lump or quantity of mucus, and also a sense of pressure in the larynx; pain in the forehead from one temple to the other; pain in the neck; pain in the left side; high colored urine; weakness and oppression in the epigastrium, with simultaneous oppression of the heart. Dr. Cutler (allopath) gives his case as follows: It has been my misfortune to be an asthmatic for about ten years. I have made trial of a great variety of the usual remedies, with very little benefit. In several paroxysms I had found immediate relief, more frequently than from any thing else, from the skunk cabbage. (Dracontium fcetidum Lin. Arum Americanum, Catesby.) The last Summer I had the severest attack ever experienced. It commenced early in August and continued about eight weeks. Dr. Drury, of Marblehead, also an asthmatic, had made use of the Indian tobacco, by the advice of a friend, in a severe paroxysm early in the Spring. It gave him immediate relief, and he has been entirely free from the complaint from that time. I had a tincture made of the fresh plant, and took care to have the spirit fully saturated, which I think is important. In a paroxysm which perhaps was as severe as I ever experienced, the difficulty of breathing extreme, and after it had continued for a considerable time, I took a tablespoonful. In three or four minutes my breathing was as free as it ever was, but I felt no nausea at the stomach. In ten minutes I took another spoonful, which occasioned sickness. After ten minutes I took the third, which produced sensible effects upon the coats of the stomach, and a very little puking, and a kind of pricking sensation through the whole system, even to the extremities of the fingers and toes. The urinary passage was perceptibly affected by producing a smarting sensation in passing urine, which was probably provoked by stimulus upon the bladder. But all these sensations very soon subsided, and vigor seemed to be restored to the constitution, which I had not experienced for years. I have not since had a paroxysm, and only few times some small symptoms of asthma. Besides the violent attacks, I had scarcely passed a night without more or less of it, and often so as not to be able to be in bed. Since that time I have enjoyed as good health as, perhaps, before the first attack. He also adds: "In all cases of which I have been informed, it has produced immediate relief, but the effects have been different in different kinds of asthma. Some have been severely puked with only a teaspoonful, but in all cases some nausea seems to be necessary. The asthma with which I have been afflicted, I conceive to be that kind which Dr. Bree, in his practical inquiries on disordered respiration, etc., calls the first species, a conclusive asthma from pulmonic irritation of effused serum. My constitution has been free, I believe, from any other disorder than what has been occasioned by an affection of the lungs, anxiety of the praecordia, and straitness of the breast and other symptoms, produced by that affection." LOBELIA INFLATA. 427 Although Lobelia produces a kind of dyspnma by its primary effect, it is not true asthma, but rather a difficulty of breathing from faintness and sinking at the stomach. The dyspnoea seems to come from the stomach, and not from thoracic or bronchial constriction. The asthma which Lobelia has attained such a reputation in, is a purely spasmodic affection of the motor nerves which supply the bronchi, the larynx, and other portions of the respiratory apparatus. It is a secondary effect of Lobelia, to cause just such a condition of the nerves of motion, as we find in the severer cases of asthma. If any thing was wanting to prove this theory, it is the fact that appreciable doses are required to palliate or cure the affection. You may be able to relieve a primary dyspncea like the one I just mentioned, with the sixth or twelfth dilution; but to relieve a true asthma you will have to resort to the mother tincture, or the first decimal dilution. I have found that it is not necessary to vomit the patient in any case; nor is it necessary in all cases to cause nausea; and the majority of cases can be relieved without nausea. Begin with a single drop, and increase a drop every dose (repeated every fifteen or twenty minutes in bad cases), until the patient begins to breathe easy; then decrease the dose in same manner. In spasmodic croup, asthma of Millar, and other spasmodic affections of the throat, even in spasms of the larynx of hysterical patients, Lobelia is a remedy upon which you can generally rely. In the country, and often in the city, it is always kept in the houses of the people, who look upon it as a panacea in all cases of croup. They give it on the first appearance of the stridulous breathing, ringing cough, and dyspncea. These symptoms it always relieves, and if the attack is spasmodic, it cures. But if it be catarrhal, or pseudo-membranous, it palliates only; and in the latter affection it does positive injury, by depressing the vital forces, for it has no 428 LOBELIA INFLATA. specific power over any inflammatory process involving the organs of respiration. In domestic practice it is given in all kinds of doses, from a drop to a teaspoonful. As a good illustration of the specific action of Lobelia in spasm of the larynx, I give a case reported by Dr. Knowles, of Avoca, Iowa: " A young woman, after washing nearly all one cool day, exposed to sudden alternations of temperature, was seized suddenly with a paroxysm of coughing and choking. The constrictive sensation seemed to be in the locality of the larynx. In half an hour after the beginning of the seizure, the woman seemed to be dying, the dyspncea was so terrible. A constant cough tormented her all this time.'" When I first saw her, about an hour after her seizure, she was gasping for breath, her face livid and expressing the greatest anxiety. There was apparently but a few seconds' interval between the paroxysms. She could speak but a word or two at a time, and could swallow only at rare intervals. " Any one who has ever witnessed a case of this distressing disorder, in an adult or child, has witnessed a scene of the most frightful suffering known, aggravated with an intense fear of death. " In this case, ten drops of the 2x dilution, was repeated every five or ten minutes, as I could get her to swallow it. She was relieved after the third dose, and had no spasm after the fourth." This may be considered a rapid and brilliant cure; but such cures are often made with Lobelia. In homieopathic practice, the effectual dose for croup, will lie between a few drops of the tincture, and a few drops of the second decimal dilution. In diseases of the organs of generation of women it has not been used except in cases of labor, but the discovery of Ether has superseded its use in most cases. You may, however, find it of value in certain rigid or spasmodic conditions. Many country practitioners of our school value it very LOBELIA INFLATA. 429 highly in slow and difficult labors from want of relaxation. Dr. Paine (eclectic) uses it to allay those skirmishing pains before parturition; to ward off threatening convulsions in approaching eclampsia. Where the old school resort to the lancet, he uses an enema of Lobelia with happy results. It is of much use in rigidity of the os, which often exists, to the great annoyance of busy practitioners. The same dose (3j or ij, by enema) is here given, which not only relaxes the rigid os, but all the muscles of body. Rigidity of the Perineum. —Often, says Paine, have I had to bring my instruments to deliver a patient (and the Dr. too) where this condition of affairs, the head thrust against the perineum, had existed for hours, the attending physician using teas, fomentations and patience without avail. A single enema of Lobelia has worked like a charm, relaxing the parts, and the child was born. It is doubtful if Lobelia is primarily homceopathic to any of the above conditions, excepting, perhaps, the false pains before parturition. The tincture in drop doses, or more, will have to be used. You may have occasion to use the Lobelia in certain obstinate and annoying cases of convulsions. I allude to the hysterical convulsion. In the great majority of cases no attenuated remedy will arrest the paroxysm. The cure of hysteria must consist of a constitutional treatment for the removal of the cause. But the treatment of the paroxysm must be " short, sharp and decisive." If a firm, decided and imperative command does not arrest it, do not allow yourself to be kept by the bedside, hour after hour, as you will be importuned to, but immediately give Ether, Chloroform, Chloral or Lobelia. A teaspoonful of Lobelia has a magical effect in such cases. The nausea or vomiting, with its consequent relaxation, arrests the most violent hysterical spasm. If you can not get her to swallow it, give it in an enema. It is, however, homceopathic to many of the premonitory symptoms of hysteria, especially the anomalous sensations in the throat or cesophagus-the "globus hystericus," etc. I have often relieved such symptoms with attenuated doses. 430 MITCHELLA REPENS. Dr. Scudder, although in the eclectic school, is as good a homceopathist as the most of us, gives the following as his experience with Lobelia: Recognizing the fact that it primarily causes great cardiac depression, he declares that in small doses it is a cardiac stimulant. He says it is indicated in nearly all diseases where we find'prcecordial oppression, with enfeebled circulation; a feeble, empty, oppressed,'doughy' pulse;" a "fullness of tissue, with loss of elasticity;" or precisely such a condition as Lobelia causes when taken in large doses. In asthma, angina pectoris, cardiac neuralgia, uterine catarrh, (with swollen, flabby uterus), in agues, and many other diseases, he finds Lobelia to be specific, if the above characteristic indications are present. This is the true doctrine, and Dr. Scudder has hit the key-note of the remedy. His doses are rather large (five to twenty drops, every hour or two), but he gives many cases illustrating the prompt curative action of such doses, without causing any'" aggravations." Perhaps the same doses of the lx or 2x dilutions would have done as well; but the size of the dose is a minor matter, provided the medicine cures. MITCHELLA REPENS. Very little is yet known, with certainty, of the properties of the Partridge-berry. A fragmentary but suggestive proving by Dr. P. H. Hale, and a more extended proving by Dr. T. C. Duncan, are all we have in our school. The latter did not develop many characteristic symptoms. The drug is one of feeble power; quarts of the infusion are drunk by the country people, without any unpleasant effects observable. This is what eclectic authorities say of it: It said that the squaws drink a decoction of the plant, for several weeks previous to their confinement, for the purpose of rendering parturition safe and easy. (King.);It has long been a domestic remedy for uterine diseases and menstrual irregularities. MYGALE LASIODORA. 431 This remedy is peculiarly American, not being noticed or used by foreign practitioners. Dr. King writes: "Partridge-berry is parturient, diuretic and astringent. Used in dropsy, suppression of urine, and diarrhoea. It seems to have an especial affinity for the uterus, and is highly beneficial in all uterine diseases. It appears to exert a powerful tonic and alterative influence on the uterus. Dose of the strong decoction, from two to four fluid ounces, two or three times a day. The berries are a popular remedy for diarrhcea and dysuria. It is highly recommended as a cure for sore nipples, used as follows: Take two ounces of the herb, fresh if possible, and make a strong decoction with a pint of water, then strain and add as much good cream as there is liquid of the decoction, boil the whole to the consistency of a soft salve, and, when cool, anoint the nipples with it every time the child is removed from the breast. The Uva ursi, a near relation of Mitchella, has been proved to be a mild uterine-motor stimulant, similar to Caulophyllum,. Eupatorium purp., Secale, Pulsatilla, etc. There must be some property of this plant which has an action on the uterus. I would recommend it forfalse pains, uterine irritability, scanty and delaying menses, dysuria, scanty urine with profuse sediment. In urinary disorders it resembles Uva ursi and Chimaphila. MYGALE LASIODORA. This medicine is prepared from the virus of a poisonous spider found in Cuba. The species of the same genus found in the United States are supposed to be poisonous. The symptoms obtained from provings and cases of poisoning show that it resembles in toxic effects the Tarantula. It deranges the motor side of the spinal cord, causing chorea and choreic spasms. You will find it useful in some cases of St. Vitus' dance, after Cimicifuga, Agaricus, Hyoscyamus and Stramonium have been unavailing. One characteristic 432 MYRICA CERIFERA. symptom of the Mygale chorea is that the patient is quiet during sleep, and worse in the morning. I have only used it in one case, but it was a case of many years' standing, and it did not seem to do much good. The English physicians, however, have been quite successful with it. By referring to the cases of Drs. Blake and Spooner, in Volume I., Materia Medica, you will get an idea of its power in chorea. MYRICA CERIFERA. The Bayberry is a near relation, both chemically and therapeutically, to Hydrastis, Berberis, Coptis and Geranium. It contains Berberina, united with a very large percentage of Tannin. A study of the pathogenetic effects of these drugs will show them possessed of similar qualities. The Myrica was first brought into use and notice as a medicine by Samuel Thomson. This man, although uneducated, had in him the elements of a great reformer; and had he had the literary advantage of some of his allopathic persecutors, would have done more for the advance of medical science than most any other man of his day. He was born in Alstead, Cheshire County, New Hampshire, February 9, 1769. Dr. Hollemback declares that he was " one of the greatest and best of medical benefactors, whose crude system of practice broke the mysterious chains which had bound the people of America and Europe for about two centuries." Certain it is that Thomson was the first to publicly attack allopathy in America, and his attack may be said to be the first that shattered the foundations of that school, and made way for such scientific reforms as homceopathy. In every state of the Union the "botanic " practice of medicine preceded the homceopathic, and broke down those legal barriers that allopathy had placed round her. That crude practice is now nearly extinct, or has been merged into " eclecticism." Dr. Thomson observed that Myrica " has the power of disengaging the thick viscid secretions of the mucous membrane of MYRICA CERIFERA. 433 the stomach." He named it "canker powder," and used it very extensively. It was the principal ingredient in the ever-famous " composition powder," with which many people tortured themselves, in preference to the calomel and bleeding of the allopaths. Thomson advised it in all discharges from mucous surfaces, especially in leucorrhcea, dysentery and nasal catarrh. From Rafinesque, I find that the Bayberry was used at an early day for "uterine hemorrhages, hysterical complaints, palsies, colics and scrofula." He says the leaves are "pectoral, emetic, astringent, nervine, sub-narcotic, cephalic, vermifuge, emmenagogue, stomachic, etc." "The bark chewed, is a good sialagogue; made into a snuff it is a powerful errhine." (It forms the basis, now-a-days, of all the " catarrh snuffs" sold in the country.) " The taste of the bark is acrid and stimulating; in large doses of a drachm it produces a burning sensation and vomiting, sometimes diuresis." Dr. Fahnestock announced in 1822 that it was a specific for typhoid dysentery. This valuable property has been confirmed. I have verified it on myself in diarrhcea, and on others in cholera morbus. The wax procured from the berries is removed from them by boiling in water, upon the top of which it floats. It is a concrete oil, or fatty substance, of a pale green color, about the consistency of beeswax, but more brittle and not so unctuous to the touch, of a faintly balsamic and pleasant odor. It can be made into candles, and burns at a temperature of 109~ F., emitting a pleasant perfume. It has also been used as a simple salve for cuts and ulcers; also as a vehicle for other medicines. One bushel of the berries will yield about four pounds of wax. When the properties of the medicine are fully understood, the wax may come into use as an external application, when it is indicated. Dr. Coe (eclectic) says, "while it possesses specific and decided therapeutic properties, it is entirely innoxious in itself." This assertion is preposterous! A medicine can not have therapeutic action, and at the same time no pathogenetic effects. The Myrica can not be taken as a food, and if 434 MYRICA CERIFERA. not, is a poison, or an agent capable of deranging the normal action of the organism. The same writer says also, " with the exception of a mild diuretic action, it is never visibly evacuant, except in very large doses, when it sometimes proves emetic." If Dr. Coe would make an experiment, as did Dr. Walker, he would change his opinion relative to its "innoxiousness." Among the diseases for which Coe recommends the Myrica, are: Aphthous affections of the mucous surfaces, scrofula, diarrhoea and dysentery (but not until the morbid accumulations have been expelled and the functions of the liver regulated), jaundice, leucorrhcea, suppression of urine; also ulcers, chancres, fistulous passages, in all of which latter he advises the local application. " But perhaps the most remarkable feature of the Myrica is its power, in connection with Lobelia, of allaying false labor pains. The peculiar therapeutic property here manifested is the result of the combination. Neither will answer the purpose alone. As soon as the pains are ascertained to be spasmodic, place the patient in bed, and administer the following: "Myrica, 15 grains; Wine tincture Lobelia, one-half ounce; boiling water, one ounce. "Add the Myrica to boiling water, and after a few minutes the tincture of Lobelia. Exhibit at one dose, and repeat in two hours if necessary. This will seldom or never disappoint the practitioner, and rarely is a second dose necessary. It allays the pains, quiets the nervous system, and postpones parturition to the proper period. Delivery will frequently be delayed from one to four weeks, and the matured energies of the system will then insure a safe and easy accouchement." I quote the above entire, in order that the homceopath may see what delectable mixtures an opposing school prescribe! How many women in the eight month of pregnancy, threatened with premature labor, could bear such a dose? If Dr. Coe practiced entirely among the lowest order of people, he may not have seen dangerous aggravations. MYRICA CERIFERA. 435 Yet how can we account for the fact that Dr. Wilkinson, of England, who is said to be a homoeopathist, quotes this prescription, with his sanction (!) Any physician who has ever seen a patient under the action of half an ounce of tincture Lobelia, need not be told of the distressing nausea, vomiting and prostration caused by that drug. Imagine it, then, given to a delicate woman threatened with premature labor! Away with such vile poly-pharmacy and crude drugging. The second or third alternation of Caulophyllin, Cimicifuga, Secale, or Aletrin, is all-sufficient in such cases. This drug was proven several years ago by a Dr. Walker. Twice he brought himself under its pathogenetic influence, and its effects were characteristic and decided. An analysis of its symptoms will show that many of its old applications were according to the law of similars. The head, nose and throat symptoms show unmistakably its applicability to catarrhal disorders of those organs. The gastric, intestinal and hepatic symptoms were of the greatest importance. At first there was unnatural hunger, then indigestion, then jaundice, with bronze-yellow skin, fullness of the hepatic region and abdomen; scanty, yellow, frothy urine; loose, mushy, clay-colored stools, destitute of bile, much debility, drowsiness, almost amounting to stupor. This jaundice appeared in both provings. A very suggestive fact occurs in this relation, namely, the statement of old Botanic physicians, that the Bayberry has cured many cases of" black jaundice." I have ventured the opinion in my previous lectures that the jaundice was from suspended secretion, and not from obstruction. I believe, however, that the Myrica is homceopathic to both. The astringent principle causes suppression, and the berberina the catarrhal condition like that caused by Hydrastis. The jaundice in this proving was not relieved by Podoph., Leptandra, Nux vom., or Mercurius, but was promptly cured by Digitalis lx dilution. This remedy was selected because of the slowness and irregularity of the heart's action-an infallible indication for the use of that remedy in many diseases. 436 MYRICA CERIFERA. I would recommend you to try it in chronic intestinal catarrh; for chronic, offensive, irritating leucorrhoea; and all profuse catarrhal discharges of long standing. Its topical use should aid its internal administration. It has a reputation in old coughs, with profuse expectoration, and much irritation of the throat. It should be used by means of a spray, or gargle, to granulated eyelids and throat, and ulcerated mouth and throat. In diphtheria as a local application it rivals Guiacum. In Dr. Farrington's comparison of Digitalis and Myrica, he says:-By diminishing the secretion of bile, both develop symptoms of cholemia; drowsiness, stupor, languor, slow pulse, jaundice, yellow eyes, swollen, heavy lids, clay-colored stools, frothy, brownish-yellow urine, etc. In both we find indifference, sadness, irritability. Only Myrica has, " thinks himself better than any one else." Digitalis causes serous or jelly-like secretions from the mucous membranes, easily detached. Aphthae, stomatitis with fretid or sweetish saliva. Myrica causes thick, vitiated mucous secretions, difficult to detach. Stomatitis with spongy gums, fctid mucus, mouth coated with an adhesive coating difficult to loosen. Both give weak, sinking feeling in the epigastrium after eating; Digitalis, specifically after breakfast; Myrica, better from rapid walking. In jaundice, Myrica has ash-colored stool, drowsiness, slow pulse, but increased in intensity; dull aching liver; dragging in back; tongue dirty, yellow; catarrh of posterior nares. Digitalis differs in having clean tongue, or tongue covered with easily detached slime; pulse slower than the beating of the heart; hardness in region of liver; yellow in corners of eyelids. Both cause palpitation while lying on the left side; constriction of chest; tickling cough, made worse by lying or by talking. But Myrica produces an audible pulsation (more like Chelidonium); Digitalis exhibits the quick, but small pulse of the weakened heart, laboring under the superadded pressure of the body. MYOSOTIS SYMPHITIFOLIA. 437 Myrica, with its slow but intensified pulse, shows the system temporarily weakened by blood poisoned with bile, health returning with the resumption of hepatic activity; Digitalis gives us an enlarged liver made so by organic heart disease, the enervating bile but intensifying the weakness of organic defect. MYOSOTIS SYMPHITIFOLIA. Dr. M. Funk, to whom belongs the credit of discovering and introducing this plant to our Materia Medica, gives it this name, and, for the present, we shall recognize it as a new species of the Myosotis. Dr. Funk writes: The plant grows in low, marshy grounds, and also on high ground among the trees, and on the hillsides on rich ground. The stalks grow from one to two and a half feet high, either single or in bushes of from five to six. The leaves are lanceolate, not slim; distinct median vein; smaller veins running out to near the edge of the leaf and branching from the median alternately, not anastomosing; both sides of leaf hairy. Flowers grow on branching stems at top of stalk in small clusters, are very small, are whitish, or tinged with a faint red or blue shade. (A closer description I can not give you from the dried specimen in my possession.) The seeds are perfect globules, and covered with stiff hair, or almost prickles The root is at largest parts hollow, the pith seemingly having rotted; smaller ones woody and tortuous. Dr. Delamater writes of it in Amer. Hom. Observer as follows: I have submitted a specimen to several distinguished botanists, among them Prof. Babcock, of this city, who says it evidently belongs to the Myosotis family, and resembles the Arvensis more closely than any other, but the leaves are altogether too large for it; and he does not want to give an opinion without further investigation. Prof. Hale thinks that it belongs to the Myosotis family, and that it is the Arvensis, the large leaf owing to the rich ground from which it was taken. It may be a hybrid or cross, being changed, as we know many plants are, by locality, and by uniting or marrying (as it were) with some other plants of the same family growing in their near vicinity; or what I think is more likely, is an example of the well-known fact, that some plants, on changing localites, tend to form new varieties from causes not accounted for as yet. I will give you Dr. Funk's own report of his discovery and clinical experience: During the Winter of 187I-2 I was (in Evansville) called to a sick boy. On this occasion I saw a few dried roots lying upon the table, and upon my inquir 438 MYOSOTIS SYMPHITIFOLIA. ing thereabout, the father of the patient, Mr. Graupner, informed me that he had gathered these roots two years ago, in the woods near Evansville. He had learned the use of this really precious remedy many years ago in Germany, from an old woman who had saved mary human lives thereby, and also his own, after several skillful physicians had given him up and predicted his certain death within twenty-four hours. He had been suffering over two months with a severe attack of pneumonia; had been bled, blistered, nauseated, narcotized, purged, and tormented in every possible way. He had coughed and expectorated such immense quantities of mucus and corruption that he was reduced to a skeleton, and was unable to find a minute's rest either day or night. His parents had then called an old woman, who had the reputation of having cured many such desperate pneumonias and pleurisies by a certain root. She had brought a certain quantity of this root, which was to be powdered, mixed with honey, and with unsalted butter to be fried in a pan over the fire. This paste had to be eaten with a teaspoon. By following these directions, the patient's cough had within twenty-four hours nearly disappeared, and in a remarkably short time he had fully recovered. He is now a healthy and robust man. Of course I was anxious to learn the name of this precious root. He called it "Schwarzwurz " (black root), and his description of the plant convinced me, beyond doubt, that it was nothing else but our " Symphytum officinale," of which, however, we knew heretofore nothing more than its value for bone fractures. After Mr. Graupner's emigration to Evansville, Ind., he soon searched the surrounding forests for the " black root," and imagined he had found it. He said he would never be without it; and he had with this American root already cured several just as desperate cases as his own, and many others in the old country. Only about two weeks before he had given to an old lady, suffering with consequences of badly-treated pleurisy, nearly the whole balance of his supply of " Schwarzwurz," and only the few I saw upon the table were left to him. He willingly divided this little balance with me, which, as he suggested, would be by far insufficient for another case; but I was convinced in my mind that only a truly homaeopathic remedy could have such wonderful effects, and that such one would do the same service in small homeopathic doses, and without the admixture of honey and butter. Therefore I prepared this root partly in a decimal and centesimal trituration, and partly with alcohol and water in a tincture. I used this preparation in given cases, in doses of one drop or one grain. and checked thereby several times the most copious mucous expectoration of phthisical patients within twenty-four hours, after Stannum, Ipecac, and many other of the indicated remedies had utterly failed. Dr. E. J. Ehrmann, to whom I communicated my experiences and gave some of the trituration, found the remedy equally effectual in many such cases. I will however, by no means insist that I have thereby permanently cured cases of phthisis pituitosa of many years' standing, but I have very materially relieved them, and further experiments must teach us what we can expect from the remedy in such cases. The following Spring I requested Mr. Graupner to show me the place where he gathered the " black root;" but I saw at once that only the large lanceolate MYOSOTIS SYMPHITIFOLIA. 439 &aves of the plant resembled those of the Symphytum officinale; but the ffowers are entirely different, and resemble those of the " Vergissmannicht " (Forget-menot, Myosotis palustris); they are, however, far smaller, and less beautiful in shape and color, than that. But the characteristic of the genus Myosotis is unquestionable; the name of this particular species I have hitherto not ascertained. I have prepared a tincture of the fresh root, and have hesitated heretofore to introduce the new remedy into the profession, because I wished to try it first in some desperate case, so that I could refer to my own practical experience. This I am now enabled to do: One case of neglected pneumonia (a young man of about twenty years of age, Wm. King), in Mount Vernon, Ind., I cured last winter. The patient was without medical attendance until he was nearly dying from the copious expectoration, which was perfectly relieved within two days, by grain doses of the Ist centesimal trituration of Myosotis. The other case occurred with me in the beginning of the past month (October). A boy, Wm. Downey, about fifteen years old, whom I had cured of typhus abdominalis by the usual remedies (chiefly Rhus and Bry.), relapsed after going several days to school (probably in consequence of intemperate eating), and lingered nearly three weeks, getting weaker and poorer from day to day; a very troublesome cough, sometimes dry, sometimes with scanty expectoration, wasted rapidly his life-powers away; profuse day and night sweats hastened his dissolution; the eyes and cheeks were sunken: nose pointed and whitish-a fair specimen of facies hipipocratica, and for the indication of the last resort-Carbo veg., which, however, proved ineffectual, like all other previously applied remedies. The patient's mother and sisters were fully prepared for his death; and more for a hopeless experiment (since the expectoration was not copious) than with the real hope of success, I administered the Tincture of Myosotis, five drops every two hours. The following morning I was prepared to find him dead. But lo! what a wonderful change had taken place! With bright eyes and smiling face he welcomed me; the cough had nearly abandoned him; appetite had returned, so that I had no need to give a good prognosis-this had given itself! Within four or five days the profuse sweats gradually abandoned him, and within one week recovery was perfect! and I hesitate no longer to recommend this valuable new acquisition to our professional brethern, for which purpose the present meeting of the Indiana Institute of Homceopathy offers the most appropriate opportunity. Both Dr. Delamater, my associate, and myself have used it, but not with as brilliant results as Dr. Funk. The only published verification is by Dr. Cushing, in the American Observer, for 1874, which I give you in full. He says: Let me say a word for Myosotis in the East. In July, I873, I was called to see Miss —, aged about thirty, Found her sick in bed; said she was tired out from hard work in a shop; was emaciated, feverish, sunken cheeks, pale face, glassy eyes, quick pulse, bad cough, profuse expectoration of large grayish 440 MYRTUS COMMUNIS. lumps, looking much like small oysters; loud mucus rattling; gurgling in both lungs; no appetite, and some diarrhoea. Father died of consumption; brothers, sisters and mother are tall, slim and feeble looking. Diagnosis: consumption. Prognosis: death. After two months' treatment she was able to walk around the streets. During Fall and Winter the skin on her face and hands turned dark brown and thick, and looked like fish skin without scales. In February, I874, the skin-had, without external applications, assumed nearly its natural appearance, and she was seized with convulsions, several in twenty-four hours-continuing for several days, very like puerperal convulsions. Another prognosis of death. After this she improved somewhat, when she became insane, in May, without any apparent cause. She was God —all the God there was. She had died, been in her grave till she stank, then went to the third sphere, and had now returned, etc., etc. Then she took a notion to drown herself; was quite violent at times, although greatly emaciated and feeble. After two weeks she became quite simple, then was better, still the same old cough followed her. I had given a number of remedies, but more of Calcarea phos. than any other remedy. When I received pure Myosotis tincture, I began to give her the first decimal attenuation, at first night and morning (as she did not like to change the method of taking her medicine), but after two weeks gave it her oftener, and I am happy to say that her cough is better, appetite improving, is gaining flesh, and looking and feeling better. Another symptom I forgot to mention-she has been unable to smell or taste anything for five years; but now, since taking the Myosotis, she can taste and smell quite well. She has not menstruated for two years, and I am waiting for that to return and complete the cure. MYRTUS COMMUNIS. This drug, although it has no proving, has a very useful sphere, but a very limited one. Dr. Hering first published an account of it in the first volume of the North American Journal of Homeeopathy, over twenty years ago. The one characteristic symptom given as a guide to its administration, is -" Stitches in the left breast, running to the shoulder blade." Whenever this symptom occurs, especially in neglected pneumonia, phthisis pulmonalis, tuberculosis, etc., the Myrtus is specific, i. e., it cures all the symptoms connected therewith; or, if the case is incurable, it relieves that peculiar symptom. Dr. Wahle, of Rome, reports several cases of suspicious NAPULUS SERPENTANIA-NAJA TRIPUDIANS. 441 cough, with tickling and pain in the upper portion of the left lung, cured promptly by this remedy. It is rather singular that this medicine has not been thoroughly proven. It might develop symptoms of such importance that it would rank with Rumex, Bryonia and Phosphorus. It has generally been used in the third dilution. NAPULUS SERPENTANIA. This indigenous plant is a good deal used in domestic practice, in the treatment of diarrhcea and dysentery. A fragmentary proving, of little value, is to be found in Vol. I. It may deserve further investigation, but I have never used it in my practice. NAJA TRIPUDIANS. The virus of the terrible cobra de capello has been partially proven by English physicians. The late Dr. J. R. Russell valued it very highly as a remedy in diseases of the heart. His opinion of its sphere of action is doubtless correct. He says: " Naja acts primarily upon the nervous system; especially upon the respiratory nerves, the pneumogastric and the glosso-pharyngeal." In this respect it closely resembles Lachesis, another serpent-poison. Dr. Russell considers Naja very useful in the acute stage of rheumatic carditis; and afterwards in organic changes in the valves giving rise to tumultuous action of the heart; violent, sudden throbbing, attended with endocardial murmurs. But the key-note for the use of Naja, according to Dr. Russell, is the irritating, sympathetic cough, occurring in heart diseases. It is useful, however, in many spasmodic, nervous laryngeal disorders, nervous headaches, dyspnoea, etc., and will prove a useful remedy in practice, when indicated. 29 442 NITRATE OF URANIUM. NITRATE OF URANIUM. Nearly twenty years ago I happened to see a brief notice that a French physiologist had observed that in animals poisoned with the Nitrate of Uranium, the urine was found to contain sugar. Having several cases of saccharine diabetes on hand just at that time, I procured, with considerable trouble, a few grains of the salt, and triturating up to the third, gave it to my patients. The results were so satisfactory that I published them some time after. This led to the use of the remedy, and my own favorable reports were confirmed. Afterwards several English physicians, notably Drs. Blake and Drysdale, made provings and experiments on animals with the drug. These experiments were published in an admirable monograph by Dr. Blake. The symptoms, as arranged by him, are to be found in Vol. I., Materia Medica, together with a brief enumeration of the curative results of its clinical use. One unexpected result of Dr. Blake's experiments was the failure to find sugar in the urine of any of the animals poisoned with the Nitrate of Uranium! Nor was it found in the urine of the provers! But it caused albuminuria, and in nearly every case (of poisoning) the kidneys were seriously affected. The urine was increased in quantity, and was voided more frequently. Dr. Blake, in commenting on these experiments, says: "The results put glycosuria quite out of the court, as a condition theoretically calling for this medicine." He adds, however: " It ought to be useful in Bright's -Diseases, and kindred renal maladies; in contracted kidneys with gastric disturbances; in irritable condition of the renal plexus of the sympathetic. It seems singular that it should have cured cases of sugar diabetes, which it undoubtedly has done." We can not properly assert that a medicine will not cure certain diseases, because the symptoms of those diseases are NITRATE OF URANIUSM. 443 not found in its pathogenesis. We do not know that any drug has beenfully proved. A more extended and exhaustive proving may evolve the very symptoms which we have looked in vain for. The many cases of diabetes (saccharine and insipidus), cured by the Uranium, abundantly prove that it is useful in maladies of that nature. But it has other curative powers. It ought to be useful in some cases of neuralgic headache. Dr. Blake says it will cure ulceration of the mucous membrane of the nose. It is indicated in certain kinds of dyspepsia, and in cardialgia. It caused ulceration of the stomach in three out of ten rabbits; this seems to be a specific effect, for it appeared even when the drug was introduced under the skin of the leg. The ulceration was near the pylorus; even in nonulcerated rabbits, the mucous membrane of pylorus was found diseased. Dr. Blake suggests its probable usefulness in extensive cutaneous burns, with ulceration of duodenum. When we consider how generally severe irritations of the duodenum will cause hepatic derangements, does it not occur to your mind that some of the irritations of the liver which may be caused by Uranium might result in glycosuria? I believe Dr. Blake does not mention the appearance of the liver in animals killed with this drug. Dr. Drysdale reports a case of ulceration of the stomach cured by the Uranium; and another physician claims to have cured with it " hematemesis from gastric ulcer." Dr. Cook, of Buffalo, reports curing a case of incontinence of urine, in a young girl, who had been troubled from infancy. ~You will find in Volume I a brief r6sume' of the cases of diabetes cured by the use of Uranium, and I have given the authorities as far as possible. Do not use the drug lower than the 1st centesimal or 3d decimal. Make or obtain a careful analysis of the urine of your patient before prescribing it, and watch the changes in the urine daily. In this way only can you gain definite knowledge of its value in renal diseases. 444 NUPHAR LUTEA. NUPHAR LUTEA. The root of the yellow Pond-lily has been used in medicine by all nations. According to Dr. Masters, quoted by Lindley and Moore, the Nuphar lutea is a native of England. He says "the flowers have a perfume of brandy —hence the name of brandy-bottles, applied in some countries to this plant. The root stalks, bruised and infused in milk, are said to be destructive to cockroaches, and when burnt to be particularly obnoxious to crickets. The leaves and roots have a somewhat bitter and astringent taste. The flowers are used by the Turks in the preparation of cooling drinks, like the sherbet. The leaf-stalks are traversed by a great number of minute air cells, whose arrangement is the same in both organs. A small variety occurs in the north of Britain, also in Siberia, Canada, etc. It is sometimes considered as a distinct species, under the name of Nuphar minimus. The Nuphar kalmiana does not differ materially from this." From the last remark it would appear that the last named is but a variety, if it is not identical with the Nuphar lutea. Medical History. — The ancient physicians, among them Dioscorides and Pliny, mention the depressing action of this plant on the generative functions. Among the physicians of the fifteenth and sixteenth centuries, it was placed among their most valuable "an-aphrodisiacs." No reliable experiments, however, were made, or placed on record, in relation to its effects on the human system, until Dr. Pitet, a homoeopathist, made a proving of the plant. This proving was made with the fourth, sixth, seventh and eighth dilutions. Many of the symptoms elicited are characteristic, anrd ought to be important. Since the third edition of this work, however, I regret to record that but little clinical experience has appeared to add thereto. The sphere of action of the Nuphar appears to be upon the intestinal canal,'especially the lower portions: the generative organs, the cerebral nerve-centers, and perhaps the skin. NUPHAR LUTEA. 445 Dr. Pitet, referring to its intestinal symptoms, says: In the chronological order of the symptoms, those which are seated in the digestive organs do not commence until a number of days after the disturbance had been manifested in the nervous functions. Their seat, so far as can now be judged, is in the lower part of the digestive canal. Thus the pains which accompany or precede the stools are principally seated in the rectum. The appetite is not at all disturbed, still the strength is not renewed, nutrition languishes, the face becomes pale, the eyes dark colored. The stools are sometimes soft, generally languid, yellow, most frequent between four and six o'clock P.M. It is indicated in acute or chronic cases of entero-colitis, when the aggravation takes place in the early morning, and generally in cases where there is depression of the virile functions. Case I.- Having administered a dose of Nuphar 6, for several evenings in succession, to a patient convalescing from typhoid fever, whose feeble state was aggravated by nocturnal emissions, these latter diminished in number from the first day, and gradually disappeared. Case II.-In another case I gave the drug to a man who for nine years had had involuntary seminal losses during sleep, at stool, and when urinating, with complete erections; he was pale and languid, and had been treated in vain, for several months, at the Hospital St. Marguerite, by Opium, Quinquina, and the pretended tonics. The first evening, he had violent headache, accompanied by vertigo, as if from intoxication, extending into a part of the night, with soreness, nausea, epigastric pains, and bitter mouth. The next morning, general bruised feeling, as if he had been beaten with a club. There is a connection between these pains and the bruised pains produced by Nuphar in the brain and thorax, which are sensibly aggravated by the shock of every step. During the following evenings the patient, who was taking the remedy twice a day, experienced heaviness in the head, vertigo, as if from intoxication (similar, he declared, to those he had felt while taking Opium), and bitterness in the mouth. For a month he took the Nuphar at two different times. His paleness diminished, his general weakness disappeared by degrees, and his digestive functions took a new start. At the same time the pollutions ceased, erections came on, accompanied by a decided propensity for the generative act, and before the thirtieth day of the treatment, he was able to satisfy it with success, and without fatigue. Care III.-M. B., bet. 28, had had a morning diarrhcea for three months. He had to rise every morning towards five o'clock, several times for the purpose of going to stool — never any colic. Bryonia and Sepia did no good in a fortnight; the diarrhcea continued of the same character, and the slightest error in diet aggravated it. Nuphar cured it rapidly. —(b.) Case IV.- M. Louis B., bet. 2I, Professor of Literature, had scarce returned from the country, towards the end of last Autumn, when he was taken with a morning diarrhoea, with colic. Between four and six A.M. he had two or three stools, and commonly one in the evening. This state had lasted eight days. After first dose of Nuphar, taken at night, the diarrhoea ceased. 446 NUPHAR LUTEA. Case V.- M. L., et. 43, musician, had suffered three years from entero-colitis, contracted by excesses at the table, and venery, and domestic troubles. He had exhausted the resources of the old school, and of quackery, without benefit. When he consulted me, towards the end of last November, he presented the following case: Appetite good, sometimes excessive; frequent regurgitations of an acrid and corrosive taste; digestion slow; colic and rumbling every night, awakened several times from five to seven, every morning, to go to stool, which was liquid or soft, yellowish, and either sour or feetid; the least excess, of any kind, produced an aggravation of this state, and generally obliged him to remain in bed for a day or two (ordinarily he was enabled to attend to his affairs); his sleep was agitated; heat in the palms of his hands; frequent pulse; at times a dull pain in the left renal region, which was sensitive to the touch. From the first doses of Nuphar he derived more benefit than he had previously experienced from any treatment, and in two months he was well. —(b.) Case VI.- M. L., a jeweler, at. 33, had had a diarrhcea for a fortnight, which obliged him to get up several times for stool, towards five or six A.M. He had no colic, but experienced burning at the anus, together with general depression. The diarrhoea ceased from the second day.-(lb.) Case VII.- M. B., bet. 37, a wood carver, consulted me on the 27th of last May. He had been sick for three months. His tongue was white, mouth pasty, and his stomach the seat of a painful sensation of weariness; digestion slow. He had a wind colic, principally early in the morning, with liquid or soft, soursmelling stool. For several years the virile functions had been badly performed; he had tolerable frequent pollutions during sleep; constant itching of the scrotum and perineum; small desire for coitus; infrequent and feeble erections; the diarrhoea, colic, digestive troubles, and general weariness, were aggravated on the day succeeding sexual connection. I prescribed*Nuphar, and eight days after the first consultation, the patient not coming to visit me, one of his friends told me he was better. -(b.) Dr. Shipman, of Chicago, says he has used the Nuphar successfully for ten years, in painless morning diarrhoea. Dr. Blaikie, of Edinburgh, in his "Clinical Experience with New Remedies," writes: "Nuphar was successful in some cases of obstinate diarrhcea, particularly when the attacks come on early in the morning, and were unattended by much pain or griping. The 2d or 3d decimal dilution seemed to answer best." The brain symptoms are peculiar, and you may find it useful in some headaches attending depressed conditions of the generative organs. One of the provers thought it caused an eruption like psoriasis, but a careful study of the circumstances makes it doubtful. NYMPHEA OL)ORATA. 447 The root of the small yellow pond-lily is the one used, but the larger yellow pond-lily is only a variety, and doubtless possesses similar properties. NYMPH(EA ODORATA. It is not strange that this beautiful and odorous flower should have been selected as an emblem of purity, and that the ancient physicians supposed it to have the power of repressing and entirely dissipating venereal desires and sexual power. It is said that the priestesses and vestals in temples devoted to the worship of Diana, used to sleep on beds made of the odorous water-lily, in order to keep themselves chaste and pure. In later times, an infusion, syrup, or distilled water of the root was given internally for excited sexual desires. Even as late as the time of Culpepper, it was advised in "nocturnal pollutions and amorous dreams." Allopathic physicians have not made much use of this plant, except where they have borrowed its use in diarrhcea, leucorrhcea, etc., from domestic practice. Eclectics have used it to greater extent, but their knowledge of its qualities is quite meager. King mentions its use in ulcers of the mouth and throat. He says: " I recollect a lady who, several years since, was pronounced by several physicians to have uterine caneer, and which resisted all their treatment. She was permanently cured by a squaw, who gave her to drink freely of the decoction of a root, as well as to inject it into the vagina, which proved to be that of the White-pond-lily." Nothing is said by any American writer in relation to its action on the functions of the sexual organs. Dr. P. H. Hale informs me that he has prescribed an infusion of the root as an enema in many cases.of acrid, corrosive leucorrhcea, supposed to be caused by ulceration. The tincture was given at the same time internally, and the leucorrhcea was cured with surprising rapidity. I have been informed by many women that they have 448 ENOTHERA BIENNIS. cured themselves of an obstinate leucorrhcea by the use of an injection of an infusion of the fresh root. If the root will act as a rubefacient when applied externally, it requires no stretch of imagination to believe it acts homceopathically as a topical application in chronic inflammation, erosion or abrasion of the vagina and cervix uteri. I conjecture that it acts very similar to the lotions so popular in such cases, with our school, namely: a mixture of the tincture, or Aqua Calendula with Glycerine; or more nearly still, to Hamamelis, Calendula and Glycerine. In order to ascertain whether it had any influence in repressing unnatural sexual desires, I once administered the tincture of Nymphoea to a hysterical woman, who was much troubled by amorous dreams, voluptuous sensations in the genitals, and uncontrollable flow of sensual thoughts. She took ten drops every three hours for a week, with no perceptible effect on those sy'mptoms. In the Winter of 1865-6, one of the class in Hahnemann Medical College proved it under my direction, but no symptoms of sexual depression were induced during the experiment. If the drug had any effect it was to slightly excite the genital organs. The only noteworthy symptoms related to the urinary organs, lumbar region, and throat. It caused, apparently, some soreness of the throat in both experiments. This proving, however, needs to be substantiated by others before its symptoms will possess much value. (ENOTHERA BIENNIS. Dr. J. S. Douglas, of Milwaukee, was the first to use this remedy in homceopathic practice. He has been quite enthusiastic in its praises in cholera infantum and in other watery diarrhaeas of children. The late Dr. Perrine reported some successful clinical experience in similar affections. I can not learn that any other practitioners of our school have had any success in treating bowel complaints with this medicine. Dr. T. R. Nute, of Chicago, is now about the only physi CENANTHE CROCATA. 449 cian who uses the CEnothera much. He regards it as a sort of panacea for " all the ills that flesh is heir to." He read a long paper, lauding its virtues, before the Illinois State Homoeopathic Society, in June, 1874. The same paper, with some additions, was published in the United States Medical and Surgical Journal, a few months afterwards. I think Dr. Nute has a monomania in favor of the drug. As it is a harmless one (i. e., both the drug and the monomania), he may be allowed to keep them both. At present, whatever virtues are actually possessed by the CEnothera are buried under such fulsome praise, and its position as a nostrum, that I do not think it worth while to try and rescue it. (ENANTHE CROCATA. This is one of the most poisonous and deadly of all the plants which have their home in the temperate zone. It is a native of Europe, and I think of the United States, although our Botanical text books do not mention it as indigenous. Cases of poisoning occur very often, owing to the ignorance of the people, who mistake it for harmless plants of the same family, which it closely resembles. In the July number of the British Journal of Homceopathy, appeared an exhaustive study of the poisonous effects of CEnanthe, by Dr. Bloc. It first appeared in the Art Medicale, and then in the Dublin Medical Journal. One of the editors of the British Journal appends his observations to the paper, which, owing to its prospective value, I give entire. Dr. Bloc begins by a narration of cases of poisoning: Obs. I. - An inhabitant of Amsterdam, April 20, I677, went into his garden with a friend, about 7 A.M. He pulled up some roots to eat on his return, taking them for Macedonian parsely, Bubon macedonicum. In order to ascertain at once the nature of the plant, he and his friend tasted it. Soon after they felt a burning heat in the throat and stomach; and with that, disturbance of intellect, vertigo, cardialgia, and nausea, followed' by alvine evacuations. The first had bleeding at the nose, the second violent convulsions, and the one who 450 CENANTHE CROCATA. had eaten most died in about two hours, the other in three. The plant proved to be (Enanthe crocata. Obs. III. - A woman of a certain age, after having eaten one of the roots, along with parsnips, became almost mad and furious, as if.drunk. She came to herself after having taken breath and drank a little vinegar. Obs. VII.-Amatus Lusitanus tells us that a child of eleven, who had set out from the town of Pisa, after having eaten, when fasting, some tops of this plant, was seized with convulsions, followed by profound sleep; on awaking she neither saw nor heard anything, and on being carried home died immediately. Obs. IX.-In I748, eight Irish boys, having taken this plant for water parsnip, ate several of the roots; four or five hours after the eldest fell suddenly on his back and died in convulsions; four others died that day without having been able to utter one word from the instant the poison seemed to attack the nervous system. Of the three others one went mad, but came to himself next morning; another lost his nails and hair; the third was the only one who escaped, because he had run two miles and drunk hot milk, which produced copious perspiration. In the preceding cases we see that the roots, eaten *raw, produced vertigo, nausea, madness, convulsions, and most frequently speedy death. In the following instance the root was eaten boiled, as an ingredient in soup. Of all those who partook of this, some were merely ill after it; one died. Obs. XII.-March 30, 1758, seventeen soldiers of the citadel of Ajaccio poisoned themselves. One of them, having a mind to treat his comrades with good soup, had gathered a plant of which he had cut the leaves and roots. They ate it with avidity, but in one hour some fell into syncope and convulsions. One died before the doctor arrived, two hours after supper; a second was expiring; a third showed no signs of life, but trembling and convulsions. The activity of the poison was so sudden that I saw two fall into a swoon, whilst, at perfect ease about themselves, they were busy lavishing attention upon their sick comrades. Guillaume Trelacheau, a man of strong and robust constitution, who was the author of this deadly feast, seemed the most hopeless. The upturning of his eyes, the contraction of his lower jaw, the feebleness of the pulse, the inability to move, feel, or know anythiag, with an universal chill spread over his whole body, seemed to be so many signs of death. After vain attempts to give an emetic, I had him rolled over and well shaken in a blanket by eight men for two hours. He recovered warmth, and then insensibly, movement and life. The first signs were efforts to vomit, which, aided by the emetic, were effectual. The vomitings went on for days, take what he would. He fell asleep for fifteen hours. On April I his tongue was extremely sore and swollen from biting during the convulsions; I left off giving any medicine. The 2d, 3d, 4th and 5th of April his nose bled twice, and I bled him three times from the arm. The following days his sufferings abated. On the Iith, as no appetite appeared, I gave him some doses of Juniper, which soon enabled him to eat all his rations. He went away perfectly cured, April 21, the twenty-third day after the accident, remembering nothing that had befallen him from the first to the third day of his illness, nor of the circumstances that had accompanied, nor those which had caused it. We do not report the other cases, which were similar but less violent. Let us CENANTHE CROCATA. 451 only remember the sudden convulsions, trismus with the biting of the tongue, followed by slumber and oblivion of the circumstances. Obs. XV. —This is a case of a whole family having eaten soup made of the roots, mistaken for turnips. They suffered from puffs of pungent heat on the head, rose-colored spots on the face, breast and arms. There were no convulsions, and these symptoms disappeared after the administration of mucilage, oil and millk. An infant of three or four months, at the breast of one woman, showed the same symptoms, several hours later. Obs. XVII. —A man about forty, when fasting, tasted this root; he very soon complained of great heat in the throat; half an hour he was speechless, fell down unconscious, and then was seized with terrible convulsions for three-quarters of an hour, and died without the possibility of giving medicine, his teeth being closed by trismuf, which lasted the whole time. Obs. XIX. External use.-A family of five-father, mother, farm servant, two children, the one eight years, the other four months-being attacked with the itch, were rubbed with a decoction of CEnanthe. They soon experienced all the symptoms of violent poisoning. The boy and the children sank under the most cruel pain; the others were saved. Obs. XX.-February 4, I843, twenty-one condemned criminals in the Royal Arsenal, Woolwich, ate CEnanthe by mistake for celery; nine were seized with violent convulsions and loss of consciousness three quarters of an hour after. One named Williamson, with his face swollen and livid, and bloody froth issuing from his mouth and nostrils, stertorous and convulsive respiration, insensibility, and prostration, died in half an hour. Another, Knight, a prey to the most violent convulsions, was in a kind of apoplectic state; insensible, speechless, with pupils dilated, face puffed and livid, respiration laborious, limbs contracted, and trismus. On his recovering consciousness the convulsions were renewed, he fell into a coma, and died in an hour, in a fresh fit of convulsions. In two individuals (Salt and Williams) the convulsions gave place to maniacal delirium, with tossing. One named Jones died in convulsions, an hour after the commencement; malgre tracheotomy performed at the last. Others felt numbness and feebleness of the limbs. Salt and Burgess, having left the hospital on the fifth day, believing they were cured, returned, having been seized anew with syncope. Purgatives made them pass the debris of the poisonous root after the sixth and seventh days. The former succumbed on the ninth, the second on the eleventh day, after the poisoning. Thus, out of six deaths, four tdok place within one hour; two at the end of several days, and always by the effect of the primary symptoms- the disposition to syncope and the prostration. It is probable that these symptoms depended on the continuation of the influence of the peccant matter during its progress through the alimentary canal. We will now give, in toto, the result of all the post-mortems which took place. Exterior aspect. -Very marked rigidity of the corpse; the hand strongly bent with the thumb applied forcibly to the palm of the hand; the nails bluish; livid patches of small extent on the front of the trunk, all the back part presented a tinge of deep'purple except at the edge of the troughs, where the discoloration was redder, and the edges of parts submitted to pressure where there was no discoloration. The scrotum and penis equally livid; the face too 452 (ENANTHE CROCATA. was injected and puffy, eyelids slightly apart, conjunctiva rather congested, pupils widely dilated; lips, gums, and ears tinged purple; tongue showing through the teeth and bitten at the tip; froth issued from the nostrils. Ner-vous system. - An incision of the integuments of the cranium let out a great quantity of black and liquid blood. The veins of the pia mater greatly distended, form numerous arborescent patterns on the surface of the convolutions and in their intervals. The cerebral substance is strongly injected, especially the white matter. It is the same with the cerebral protuberance and the medulla oblongata. Serous effusion pretty abundant in the cellular tissue under the arachnoid and the ventricles and principally the base of the cranium. The sinuses of the dura materdistended with a great quantity of fluid blood. As to the spinal cord, its membranous sheath is strongly injected, the vertebral tissues are full of black fluid blood, and tre medullary substance is redderSand more congested than usual. In one case (Jones, who died in an hour,) we found beneath the pia mater an escape of blood which covered both hemispheres. Respiratory system. - The epiglottis is the seat of a very deep discoloration, with considerable injection of the network of veins covering it. The glottis, the ventricles of the larynx, the larynx itself, the trachea and bronchi, even to their ultimate ramifications, present a deep red and are coated with a thick layer of reddish frothy mucus. The lungs are dull and blackish. A great many small extravasations (pulmonary apoplexy) were noticed. Citculating system.-Heart: bulk normal, but contained much black fluid blood. Digestive apparatus.-The papilla at the base of the tongue turgid and vascular. The velum palati, tonsils, and pharynx coated with glairy mucus and deeply livid. (Esophagus the same. Stomach and intestines scarlet inside. Interior surface coated with viscous mucus, under which the mucous membrane is strongly injected and looks mammillated, owing to the numerous follicles which are prominent and swollen. There are also points of extravasation and black lines along the venous trunks of these organs. The report of these six post-mortems contains the substance of many others, which, being made much less carefully, we omit as useless. We will give a few more observations, noticing only the principal symptoms and circumstances. Obs. XXII.-Of three boys, the eldest about thirteen, died after eating a root as big as one's little finger, which they pulled up in a field. They first felt the effects on coming home, one (Evans) stumbled and fell; as the two were trying to help him they fell also; the first had a severe bruise on the forehead. Emetics and other remedies failed because of obstinate trismus. They lived but a few hours. Obs. XXIV.-Two children, of the same age, ate the same roots. The first took vertigo and fell, the other tried to carry him on his back and fell also. Suitable hospital treatment cured them shortly. Obs. XXX.-Two children who ate the root boiled were seized with convulsions, etc. Cured by forcing a large dose of dissolved butter down their throats. Obs. XLV.-Seventeen prisoners escaped from the Port of Lorient, and suffering from hunger, ate these roots by mistake for radishes. They soon experi (ENANTHE CROCATA. 455 surface, indicating incipient gangrene. The mucous membrane of the cacum partly detached; the ileum much injected, jejunum less so: duodenum only inflamed at the pylorus; the surface of the stomach little injected. Stomach.-At the opening bright red, with injection over the whole of the large cul-de-sac; the mucous membrane bloated; the lesser cul-de-sac less injected. The pyloric orifice is choked by an cedematous puff of a bright red. The cardiac is equally inflamed, and the congestion extends to the extremity of the cesophagus; the interior of the buccal cavity red, with spots such as above named. Spleen a little congested. Kidneys congested; no urine in the renal pelvis. Liver nothing peculiar; vena portoe contains some clots. Gall bladder very little bile. Respiratory organs.-Lumgs injected, crepitating; float well. Trachea normal, some ganglions congested. Larynx-Mucous membrane slightly edematous. Circulating system.-Heart very bulky, right ventricle contained a very large blood clot, fibrinous at the upper part, and entangled in the tricuspid valve; the auricle contains a small blackish clot; numerous clots in the pulmonary artery. Left side normal; except a marked violet tint on the columnoe carneae; slight endopericarditis. Brain.-Considerable effusion of bloody serosity between the brain and dura mater; injection up to the edge of the interior lobes. Vieussieux's centrum ovale pointed. Ventricles.-Serous effusion abundant; cerebellum normal, except the peduncles, which are injected. Spinal cord.-Marked injection all the way to the cauda equina; at the edge of the olivce there was some serosity, indicating inflammation. 7th.-A dog above ten months old was poisoned with thirty drops of the alcoholic tincture in Ioo grammes of distilled water. The first day anxiety, agitation, nausea, burning thirst. The second day, forty grammes of tincture mixed with broth; same symptoms, with tottering gait besides; can no longer run, but drags along; after this he reels and falls if forced to walk; trismus. The third day the animal is better, and we let him rest. The fourth day, at 7 A.M., twenty drops of the fresh juice mixed with his broth. Almost immediately, violent shaking of the head and limbs; the same nausea and vomiting; extreme prostration; foetid and frequent stools. At II:3o he died. A postmortem took place, and nearly the same alterations were found as in the preceding case. In these experiments the poison was given in small doses, in order to study the effects better. All the symptoms stated by authors were confirmed: trismus, convulsions, retching, vomiting, evacuations of all sorts; eruptions more or less circumscribed. Morbid Anatomy. We report verbatim this chapter, as a resume of the alterations observed in several post-mortems, of which we have given but one, which was more extensive than the rest, and because it comprehends the post-mortems made on animals. External appearance.-Strongly pronounced rigidity of the body; hands strongly clenched, the thumb forcibly applied to the palm. Face livid, sometimes injected, but rarely, pupils widely dilated; reddish tinge of the body, especially marked on the parts lying undermost. Scrotum and penis livid. Abdomen tympanitic. Digestive system.-Trismus very difficult to get over (a constant symptom). Labial mucous membrane red, with ecchymotic spots, varying from bright rose 456 CENANTHE CROCATA. to gangrenous black; bloody foam at the nose and mouth; velum pendulum palati, the two columns and back of the fauces, red, injected, and also exhibiting brown spots; glairy ropy mucus almost always present. Tongue bitten at the tip (constant symptom). Papillke on the base of the tongue turgid and vascular. Gums purplish-red. CEsophagus nothing exterior, vinous-red tinge on the interior; ropy mucus, red and brown spots. Stomach.-When death supervened rapidly, nothing at all was found in the stomach. This is the exception. Most frequently it presents a more or less deep tint of red; its mucous membrane is mammillated, and its follicles prominent and tumid. The pyloric and cardiac orifices verybright red; their mucous coat raised, cedematous, and can be raised with the handle of the scalpel. If the subject has been long ill there is softening of the parietes of the stomach, and wide ecchymotic spots capable of proceeding to perforation. The stomach is generally empty; sometimes contains debris of the root, or a milky-yellow juice, or else dirty gray; in which, with a lens, one can find little drops of the gum-resinous juice or the fecular grains of the poison. It is sometimes tympanitic, and the contained gas has the scent of fried celery, which characterizes the CEnanthe. In the large intestines the vessels are injected with broad ecchymotic spots, distended and mostly empty. The small intestines almost always contain the debris of the poison under the appearance of a yellowish matter in the jejunum, browner in the ileum. Liver normal, the gall bladder flabby and mostly empty. Spleen and pancreas.-Nothing special. Kidneys.-Marked injection of the cortical coat; very little urine in the renal pelvis. Nervous system.-Effusion of bloody serum and sometimes of blood at the occipital foramen. On cutting the meninges, the veins of the pia mater distended and highly arborescent at the edges of the convolutions; apoplectic foci in the cerebral mass, which is strongly injected and speckled (piquet6). The annular protuberance, medulla oblongata, and peduncles of the cerebrum and cerebellum inflamed, and present (especially the latter) a certain degree of softening. Serous effusion in the cellular tissue beneath the arachnoid, the ventricles, and at the base of the brain. The sinuses of the dura mater are distended with blood. Spinal cord.-The integuments strongly injected; the vertebral sinuses filled with blood, soft and fluid. Medullary substance red and congested. Circulating system.-Heart.-Bulk normal, sometimes serous effusion, due to pericarditis. Heart always gorged with black blood, containing fibrinous clots; left side generally bloodless; there exist also brown spots on the parietes of both sides of the heart; the large vessels contain black blood, quite fluid. Respiratory system.-Larynx, epiglottlis.-More or less deep coloring of the mucous lining, with more or less injection of the venous network which covers it. It contains a frothy, whitish fluid. Trachea.-Injection; bronchial glands gorged. Lungs.-Bulk normal, generally crepitant, presenting some petechie and nucules of pulmonary apoplexy; bronchi sometimes gorged with thick mucosities. The vessels are filled with black blood, liquid and ropy; some obstruction was also ascertained at the back; but this, we think, was the result of incipient decomposition. In short, the symptoms produced by poisoning with C(nanthe crocata are as follows, according to authors in general and Dr. Bloc in particular. The attack presents two forms: first, sudden; second, consecutive. ENANTHE CROCATA. 457 I. Some minutes after swallowing it, the subject utters a cry and falls a prey to convulsions. 2. These symptoms do not appear again for about an hour. Local symptoms.-Some time after ingestion, spots appear on the hands, face and limbs; at first rose-colored, then becoming deep red, like the stings of Urtica urens. This eruption may extend over the whole body; it is preceded and accompanied by a sharp itching. In about two days the redness abates, the eruption decreases, leaving a scurfy desquamation. But the progress of this eruption is not always so gentle. The dermis is inflamed, the glands are gorged, and there appear shortly signs of a phlegmon, which runs its usual course, ending either by resolution or suppuration. Observe that this eruption sometimes shows itself in subjects who are poisoned, but especially from the application of the juice on the hands. General Symptoms. —. Regarding the nervous system; shivering at the outset and horripilation; loss of consciousness and of memory; agitation brisk, sh.king, and intermittent -or rather with remission; acute cries; delirium more or less prolonged; stupor, vertigo; convulsive movements of the muscles of the face, jaws and limbs; sometimes opisthotonos. Well marked trismus proceeding from mere cramp to impossibility of opening the jaws, or having them opened by force. Dilated pupils, contraction of the muscles of the eyelids, spasms of the muscles of inspiration, fainting fits, sometimes horrible convulsions followed by general insensibility and death. We rarely observe hallucinations. 2. As to the alimentary canal, an acrid sensation, biting and burning on the tongue, mouth, and fauces; sensation of constriction of the pharynx. Appearance of red and brown spots on the parts directly in contact with the poison. Bloody froth at the nose and mouth. Tongue projecting and almost always bitten. Acute burning pain of the cesophagus, stomach, and intestines; pressive pain in the epigastric and abdominal region. Nausea, efforts to vomit with or without effect. Virulent smell of fried celery. Loss of appetite. Obstinate constipation, or frequent stools. 3. As to the circulatory and respiratory symptoms: irregular beating of the heart; small pulse, and thread like; respiration short, with long intervals, and sometimes appearing to cease entirely. Brisk expirations are made from time to time to expel masses of bloody mucus. 4. As to secretions.- at first, cold clammy sweats; then dryness of skin. Excretion of urine.- In general, there is retention, and very little is passed each time. Of all maladies, epilepsy has most resemblance to this poisoning; but epileptic attacks last on the average ten to twenty minutes, whereas the sufferings produced by the poison are of long duration, extending beyond eight hours and even for days and weeks. In epilepsy the trismus never lasts longer than the fit, and is not always present. In poisoning cases it not only appears during the general attack, but lasts very long, even so as to prevent emetic treatment from impossibility of introducing liquid into the mouth, and they have to inject it by the nostrils with the oesophagean catheter. Out of 124 poisoning cases whose phenomena have been recorded in this work there were fifty-five deaths. As a result of all that we have related (almost verbatim) it is the opinion of other authors, and of Dr. Bloc himself, that CIEnanthe crocata, and especially the 30 458 OLEUM SANTALUM. root, gives rise in man to all the symptoms of epilepsy. According to experiments on animals with the fresh juice, or aqueous or alcoholic extract, or even with the tincture in small doses, it provokes in them also symptoms analogous to those of epilepsy. The lesions of the dead body ascertained by post-mortem examination present in each case precisely the same alterations. From this similitude of symptoms ascertained during life, and of the organic lesions found after death, may we not hope that this plant can be administered beneficially to epileptic subjects? This is what we wished to try in the case of one of our dispensary patients. This young man, about 22, presented frequent epileptic vertigo, and sometimes biting of the tongue and involuntary urine during the fit, with total oblivion of all that had happened during the crisis. We prescribed, for four months, CEnanthe from the 6th dilution to the "mother tincture" in drops. Sometimes we observed retardation of the attacks, which, from fortnightly, became monthly, and retardation and diminution of the vertigo. But at other times the vertigo and fits reappeared as often and as intense as ever, though we could not positively prove that the strong doses produced aggravation. This patient left off coming. I ought to add that, having taken his medicine from a druggist's shop, where I was not quite sure that they had the mother tincture of CEnanthe crocata, and not from Messrs. Catalan, where I had verified its presence, I can not feel certain as to this experiment. OLEUM SANTALUM. This oil is extracted from the wood of the &Santalum album, a tree growing in the Indies, China, Hindoostan and Ceylon. In " A Materia Medica of Indian Drugs," published in 1826, in London, written by Dr. Ainslee, who was of the " Medical Staff of Southern India!" I found the following account of its uses. He says: "Sandal-wood in powder is prescribed by the Vytians in'ardent remittent fever' from its supposed sedative and cooling qualities; they look upon it as a valuable medicine in gonorrhoea, given in cow's milk (a virtue that it is considered to possess by Rumphius.) In cases of morbid thirst it is recommended to be taken in cocoa-nut water, and in hot weather, after bathing, the powder is rubbed over the body, equally to cool it and check a too copious perspiration. The Mahometans are in the habit of preparing, with the most yellow and finer parts of the wood, an oil which they value highly as a perfume. The yellow is the inner part of the tree, and is of great hardness and fragrance, particularly OLEUM SANTALUM. 459 near the root of the tree; the white is the exterior part of the tree, is less firm and has but a faint odor. Perfumes from this wood, says Lourerizo, are highly esteemed by Eastern nations, being useful remedies, they suppose, in vertigo, palsy, and restraining vomiting and fluxes. The Arabians place Sandal-wood among their class " Cardiaca." Our knowledge of the virtues of this agent came to us through East Indian physicians, or travelers in Asiatic countries. The general testimony is to the effect that it is considered very useful by native physicians in the East, for all affections of mucous surfaces, especially those of the respiratory and urinary organs. You will find no mention of it in the allopathic text books, although it is used very extensively by that school in the treatment of gonorrhaa. Probably the reason why they do not mention it, is because the vendors of quack medicines, seized upon it and prostituted it, just as they have done with Buchu, and many other important medicines. I look upon the Oil of Sandal-wood as a very valuable medicine. It is analagous in effect to Copaiva, Cubebs, Erigeron, Turpentine, Stannum, and perhaps Sepia and Pulsatilla. We ought to have provings of this oil, but none have been undertaken. I believe that in the treatment of gonorrhcea, or any catarrhal state of the urinary passages, it is superior to the above named medicines, in many cases. We can not give definite indications for its use yet; and the only indication I can give you is this: It is useful in cases when the apparerntly indicated remedies have been used with little or no benefit, the discharge continuing in large quantity, and is painless, thick, yellow, or green. I sometimes give it for these symptoms before I try Copaiva, Cubebs, or Erigeron, and after the inflammation, pain, and scalding has been removed by Gelseminum and Cantharis or Cannabis. My usual dose is a drop or two of the pure oil, or ten drops of the lx dil., or a few grains of the 1x trit., every four or six hours. Allopathists prescribe it in capsules — each containing 15 or 20 drops-three or four times a day. They consider it necessary 460 OLEUM CAJUPUTI. to combine it with Oil of Cinnamon, to prevent " nausea and gastric derangement," which show that it is homceopathic to nausea, vomiting, and other morbid conditions of the stomach, the exact character of which provings only will show. I have found it curative in one case of catarrh of the bladder, and in another where some disease of the kidneys had existed for years, characterized by a peculiar white sediment in the urine. It removed this symptom, while the patient was under its use for a gleet, which it also cured. I expect it will be found useful in old mucous coughs, in laryngeal and bronchial catarrhs, and probably in some uterine and vaginal discharges. OLEUM CAJUPUTI. This odoriferous oil has not been used as a medicine in homeeopathic practice except by a few physicians. The pathogenesis in " Symptomatology" was made up from provings made by Dr. E. C. Parsons, then a student in Hahnemann College, Chicago. This, together with a proving by Dr. Ruden, which I overlooked (but which is appended hereto), are the only provings I have found. I have named its analogues hesitatingly, for not sufficient is known of it to justify us in estimating with precision its sphere of action. It seems to resemble in its effects Cocculus, Asafcetida, Camphor and Valerian. I have often called your attention to the fact that provings of any drug will show that the cures heretofore made with it, in any practice, are homceopathic cures. The Oil of Cajuput has cured nervous vertigo, headache, nervous'vomiting, dysphagia, spasmodic stricture of the oesophagus, hiccoughs, flatulent colic, suppressed menses, epilepsy, hysteria, paralysis (probably hysterical), and other nervous affections. The fragmentary provings we possess show that vertigo, stricture of the cesophagus, vomiting, hysterical symptoms, are among its prominent pathogenetic symptoms. I once prescribed it in a case of spasmodic hiccough, after OLEUM CAJUPUTI. 461 an attack of apoplexia nervosa. It relieved in a few minutes, in doses of 5 drops of the lx. In one case of persistent "sensation of choking in the throat," a few doses removed the symptom, which had lasted several weeks. Dr. H. N. Martin, commentating on Dr. Ruden's proving, says: "The white, moist, sour-bitter, rough tongue in the morning, with sensation as if scalded, and no thirst, reminds us of Pulsatilla, so also does the position of the arms when sleepping. Sadness and downheartedness, with disposition to cry, and the peculiar desire for food, with disgust at it when brought to him, are all similar to Pulsatilla. If the eruption like measles was the result of the proving, it ought to divide the palm with Pulsatilla in the treatment of that disease. Other symptoms will be recognized which are quite similar to Baptisia, especially the symptom' Felt as if I could not get myself together.' Several of the symptoms are also similar to Natr. mur., especially'he does not want to be spoken to.' It ought to be valuable in the treatment of typhoid fever." I agree with Dr. Martin, and predict that it will relieve the tympanites in typhoids. DR. RUDEN'S PROVING. August, I869. Weather warm and dry. The experimenter being in a healthy condition, and all the functions of the body normal. Temperament lymphatic. Pulse, 72. August Io, A.M. Took 5 gtts. Burning in the throat, down to the stomach; pain in the right lung. After four hours: Erections, with great desire for an embrace. After five hours: Intense itching, aggravated by scratching, lasting two hours. Sleep with amorous dreams, without emissions. At I2 o'clock (midnight) on rising in bed, stiching pain through both knees, lasting a quarter of an hour (never had such pains before.) On going out of doors at midnight, could not see; rubbed his eyes to bring sight. Wanted to sleep with his arms locked under his head, for the first time. Augzust I2, A.M. No appetite; tongue moist, feels as if scalded, looks white and rough; pulse 70; sensation as of burning in the face (had same sensation last night.) On retiring at night, sleep full of amorous dreams. Was called at midnight, and on rising, passed water freely. After visiting my patient, retired again and slept soundly until 6 A.M. Augusi 13, 8 A.M. Took 7 gtts. After ten minutes: Sticking pain above 462 OLEUM CAJUPUTI. the orbital arches, relieved by pressing the hand on the parts; worse on removing the hand. After one hour: Soreness across the chest, with pain in the left shoulder; sensation in the arms as if they were tied to the body, especially in the left one; feel cold, and cold sweat all over the body; no thirst and no appetite; pain across the chest. I2 P.M. Took Io gtts., followed by nausea and pain in the right side, below the ribs. 6 P.M. Pain over the left eye and through the left malar bone. On going to supper, it was with great difficulty that I could walk, from weakness and pain in both knees. Went to bed without supper, and was better on lying down. Was called at Io P.M. to go in the country; felt as if I could not get myself together, and could not find my clothes for some time, although they were quite near; better in the open air, but on riding, my lungs felt as if they were loose, and that I must hold them together by pressing on them. August I4. Passed water this A.M. at 6 o'clock, the first for thirty hours. The urine is dark red, and smells like that of cats. Very (uncommonly) profuse and weakening sweat. Felt very much offended on being called last night. g A.M. Joints feel enlarged, with some pain; same kind of pain in both shoulders. Feel all over as if I had been poisoned. Taste in the mouth between sour and bitter; much water in the mouth; want to spit a great deal. Always had salty taste, nozs have sweetish taste. Smoking tobacco makes me feel like vomiting. No appetite; have eaten nothing since yesterday. 12 P.M. Some appetite, but when I get what I had previously desired, ther I do not want it. Feeling as if I did not want any one to speak to me. Auzgzst i5, o9 A.M. Took lo gtts. Tongue looks white and rough; feels as if it were scalded, and as if the skin would peel off; it looks like a calf's tongue; pulse 74, languid. " He looks around the eyes as if he had taken too much liquor" (Dr. Moore.) I was met by an old acquaintance this morning: who asked me if I had not "been on a drunk." On looking down, my nose is most prominent; it looks as if it were large and extending out from the face. II:2 A.M. Feel sad and downhearted, as if I could cry; do not want to be spoken to; feel better in the society of ladies; do not like to talk with the men, but can laugh and make free with the women (am naturally bashful). Left arm feels as if it were out of joint; can not raise it without pain; pressure on the inside of the shoulder-joint gives sharp pain, which seems to act most on the left side; pain in the right eye. On riding into the country last night had griping pain in the bowels. Augzs-t I6. While taking the medicine I was costive, but nowhave diarrhoea, watery, yellowish, with itching around the anus; no pain; feel tired and sleepy. Diarrhcea by day, and worse by night.; bowels moved about ten times; no appetite or thirst. August I7. An eruption has made its appearance as thick as measles, all over the arms and body, and upper portion of legs. Frontal headache, worse on bending forward, especially in the eyes. OLEUM RICINI. 463 OLEUM RICINI. This oil is extracted from the seed of the Ricinus communis, or Castor bean. It has been in use as a laxative and purgative ever since its discovery. I have collected and arranged in my Materia Medica the symptoms caused by the seeds when eaten, and from the oil. It is evident that the whole seed, if eaten, is narcotic and poisonous, but the oil, purified as it is by the processes adopted to fit it for commercial and medicinal uses, can not cause the serious symptoms produced by the whole seed. The most that large doses of the oil can do, when taken internally, is to irritate the coats of the bowels sufficiently to cause nausea, griping, with loose, feculent or papescent stools. If its use be continued, especially in children, it causes slimy and bloody stools, with tenesmus. You are aware that the favorite treatment of dysentery, with many allopathic physicians, is to give small and repeated doses of castor oil; or one larger dose (a tablespoonful) in the beginning of the attack, " guarded " by some preparation of opium. This plan is often quite successful, and it is doubtless due to the homceopathicity of the oil to enteric irritation. Several physicians of our school inform me that they rely upon Castor oil in doses of 10 or 15 drops, repeated every few hours, in mild cases of dysentery, or acute mucous enteritis. For several years I have used a preparation of Oleum Ricini -the lx trit.- made by triturating one drachm with nine of sugar of milk. In the diarrheas of children, when the evacuations are feculent, papescent, or slimy and bloody, or all these varieties combined, without fever, thirst, or much pain - only a little griping and tenesmus; this preparation of the oil, about 10 grains every two hours, often acts very satisfactorily. For therapeutical observations on the leaves and seeds of this plant, see " Ricinus Communis." 464 OLEUM JECORIS ASELL1. OLEUM JECORIS ASELLI. The formal introduction of the Cod-liver oil into homceopathic therapeutics, was due to the venerable Dr. Neidhard. When his papers relating to this medicine first appeared in the United States Medical and Surgical Journal, they were received with indifference by some, and incredulity by many. It had been suggested by a few in our ranks that the fact of the presence of some of the "antipsorics" in Cod-liver oil, in very minute quantities, was what gave it its real value in certain diseases of a chronic (psoric) character. It cures the same class of diseases for which we prescribe Iodine, Bromine, Phosphorus, Phosphoric acid and Calcarea, and the oil is said to contain all these substances. The quantity of each substance is so minute that the oil may be said to represent a high potency of them. Even the Iodine never exceeds one part in two thousand. It has been taught by allopathists that the oily principle alone was what gave it its value, for they asserted that the medicinal constituents are too minute in quantity to be of any value in disease. But many experiments, made with great care, have proved that no other oil, or even glycerine, has the same curative action in disease. They may fatten, but the disease itself goes on unchecked. The same failure to cure diseases occurs with Cod-liver oil when it is given indiscriminately. If the diseased organism does not call for its constituents and the oil, it will not cure. In other words, it must be selected according to the law of Similia. The totality of the symptoms for which it is prescribed, must be covered either by the Iodine alone, or by Iodine and the other remedies it contains. It is not the oil alone that corresponds to the emaciation, which is said to be one of the key-notes for its adrhinistration. The emaciation must bear a resemblance to that caused by Iodine and Phosphorus. OLEUM JECORIS ASELLI. 465 If it is asked - could we not successfully imitate Cod-liver oil, by adding to glycerine, or some oil, the medicines above named? I reply, No! for this contains many acids, besides certain biliary principles, which make it a very complex substance, which it would be almost impossible for the chemist to imitate. Dr. Neidhard, following the fundamental law of our school, instituted provings of Cod-liver oil, and watched closely its effects on the sick, even when given in small doses. The results of his investigations prove that it should be treated as any other remedy, namely: selected according to one law, and given in small doses. I will try and give you some general indications for the selection of Cod-liver oil. After which I will mention certain diseases in which it has been found useful. For the special symptomatic indications I refer you to the pathogenesis in the first volume. One of the most important indications for the use of Codliver oil, is the presence of ancemia; under which term I include all conditions of the blood where there is a deficiency of red globules. This ancemia must not be the result of losses of blood, or that chlorotic anamia which is accompanied by an anasarcous condition, or without emaciation. I doubt if the oil will prove of any benefit in leucocythcemia. We are therefore restricted in the use of the Aselli to those cases of anmomia not due to haemorrhages, cancer, renal diseases, or chlorosis. The anaemia must be caused by (1) want of proper nutriment, (2) conditions which prevent nutriment from being converted into healthy blood (diseases of the liver, digestive apparatus, stomach or intestines, especially mesenteric diseases), (3) conditions which tend to deteriorate the blood, namely: scrofulosis, tuberculosis, etc. It has been shown by eminent authorities that the proportion of red globules is materially increased in patients to whom the oil is given for any length of time. In speaking of the dose, I shall refer to this fact again. 466 OLEUM JECORIS ASELLI. Another important general indication for use of Cod-liver oil, is that condition of system in which, with general lowered tone, there is a tendency to cellular hyperplasia; to the formation of exudations composed of imperfectly developed cells, which, in the great majority of cases, from the very beginning, are incapable of development into perfect entities, having only one potential quality, that of dying. There are various types of this diathesis or condition of the system. In one of them there is a tendency to increase in the lymphatic glands; to multiplication at the expense of development of their cellular elements, i. e., to the formation of numerous imperfectly developed cells, and, finally, to the destruction of them. The death of the cells is partly due to their inherent qualities, and is partly the result of the pressure which they exert on one another, and upon their sources of food-supply. If they undergo a slow fatty degeneration, with desiccation, cheesy deposits are formed; if a rapid fatty change, with abundance of moisture; pus and abscesses are produced; in either case ulceration is the final result. This is the so-called scrofulous diathesis - scrofulosis. In another of this group of diatheses, the tendency to cellular hyperplasia affects the mucous membranes of the air passages, and the patient, on the slightest provocation, suffers from catarrh, until finally a multiplication of cells occurs so rapidly as to fill up a greater or less number of the air vesicles of the lungs, generally those of the apex, and "consumption" results; or else an attack of pneumonia being produced by some exposure, the exudation is cellular rather than fibrinous, and catarrhal pneumonia, ending in the majority of cases in a more or less rapid phthisis, occurs. It is asserted that the general experience proves that the Oil is more valuable in affections of the internal, than in those of the external lymphatic glands. There is one point upon which all allopathic observers agree, namely, "that in proportion as the local scrofulous disease affects a person who has been subjected to bad hygienic influences, and especially to the use of coarse and innutritious food, does the action of the Oil appear to be prompt and OLEUM JECORIS ASELLI. 467 decided. When, on the other hand, it has become developed in spite of favorable external conditions of living, and when the digestion is very feeble and imperfect, the Oil is seldom tolerated, and rarely produces good effects." But the latter class of cases are just the ones in which the small (similimum) doses are suitable, and will bring about curative results without causing indigestion or gastric irritation. Baehr, in his practice, admits its value in scrofulosis. He says: "Cod-liver oil is decidedly useful if the digestion is impaired; if the stomach seems disinclined to retain food, and if frequent diarrhceic discharges set in; if, moreover, nutrition is impaired, the body is emaciated and destitute of animal juices; if the appetite is good, the digestion regular, and there is a marked disposition to adiposis, the Oil is decidedly hurtful. H. C. Wood makes the following excellent remarks, viz.: "The value of Cod-liver oil, in what is very often incorrectly called the' pretubercular stage of phthisis,' has already been alluded to, but is so important that it will bear reiteration. There can be no doubt that consumption often commences with catarrh, and is often developed slowly as the result of frequently'catching cold.' Whenever a patient is feeble, pale, somewhat anaemic, complains of his liability to catch cold on the slightest exposure, even though no local disease exists any where, or rather because no local disease exists any where, there is cause for alarm; and it is of the most vital importance that the patient be put upon a tonic treatment whose basis is Cod-liver oil; be fed upon a nutritious diet; and have the hygiene of his daily life regulated, especial care being taken to avoid any exposure to cold. In the advanced stage of chronic phthisis, the remedy is less efficacious, in that it much more rarely effects a cure than in the pretubercular stage; yet it does more good than all the other remedies of the Pharmacopoeia combined — alleviating the cough, increasing the strength, weight and general health of the sufferer, often retarding or even arresting the pulmonic disorganization, almost always greatly 468 OLEUM JECORIS ASELLI. prolonging life, and sometimes, in conjunction with other measures, effecting a cure." If you will consult the provings of the Oil, as given by Neidhard, you will find that it causes the same "tendency to catch cold upon the slightest exposure," so strongly dwelt upon by Wood. Neidhard's clinical experience proves the correctness of this indication, and he gives many illustrative cases of its power, in attenuated doses, of preventing this tendency. Among the diseases for which Cod-liver oil is specially indicated is chronic catarrh, whether occurring in the nasal, laryngeal or bronchial passages, or the intestines. When you have thoroughly tried Hepar sulphur, Hydrastis, Copaiva and other remedies, and the patient is not rid of the discharges, and is, moreover, anuenmic, thin, and catches cold easily upon the slightest exposure, and thinks he "would get well if he did not catch a new cold every few days;" in such cases you will find the oil a specific. It will restore the general tonicity of the patient, and prevent the susceptibility to catching cold, and a cure will result. An extensive experience in the treatment of catarrhal affections incident to a residence near the Great Lakes, proves to me that Cod-liver oil is the best radical remedy we possess for that disease. Chronic rheumatism. It was in this disease that the oil first gained its reputation. It will not cure, however, unless the general indications for its use are present. It remained for Dr. Muller to point out distinctly the two kinds of chronic rheumatism which it will cure. (1.) "Musculo-fibrous rheumatism, arising in a state of abject poverty, and produced by crowded dwellings, insufficient air and light, an originally feeble and impaired constitution, a scrofulous constitution, and inherited proclivity to this disease. "This form of rheumatism begins with dull pains in the limbs, extending gradually to the spine, and as high as the neck, producing stiffness and more or less permanent rigidity of the muscles of the trunk and limbs. It presents no in OLEUM JECORIS ASELLI. 469 flammatory phenomena, but is accompanied with cedematous swelling without redness, and may terminate in paralysis. (2.) "Fibrous rheumatism, produced by protracted residence in damp and cold localities, and differing from the first variety in being confined to the joints. It, however, gradually exhausts the strength and impairs the nutrition of the patient." In these two forms only of rheumatism did Dr. Muller find the oil of any service. In other words, Cod-liver oil is not a remedy for rheumatism as such, but for a cachectic state of the body which sometimes sustains and protracts indefinitely the rheumatic disorder. Stille says that in such cases the oil at first aggravates the pains. He explains it thus: " It is only at a later period, when the oil has begun to improve nutrition, that it triumphs over the state of morbid sensibility by enabling the system to get rid of its cause." I would explain it differently. All homceopathic remedies, if given in too large doses, at first aggravate. So with Cod-liver oil, which, if given in smaller doses, will cure more promptly and without the aggravation. I have alluded to its use in scrofula. It has been observed that in scrofulous enlargements of the parotid, thyroid and submaxillary glands, and of those seated in the neck, axillae and groin, Cod-liver oil was of little use. But when, with such swellings, caries of the bones exist at the same time, the caries is rapidly cured while the glands remain unaffected. It is in caries and strumous osteitis that Cod-liver oil has made its most brilliant cures. Swelling, softening, and disintegration, with ulceration of contiguous soft parts, external abscesses, hectic fever and marasmus, have all disappeared after the use of the oil. The more chronic and torpid the disease, the more efficacious does the oil appear to be, and it always improved the general health before the general affection. It is most useful when the caries attacks the epiphises of the long bones, and less so in caries of the shafts of these and of the flat bones. 470 OLEUM JECORIS ASELLI. It is of doubtful value in necrosis and vertebral caries. In hip-joint disease, it has cured a large proportion; but it is said to be more valuable when the disease originated in the bone itself than in the synovial membrane. It is more successful in the cure of fistulce and abscesses around the joints than in affections of the joints themselves. Chronic arthritis of the ankle joint is oftener benefited than is arthritis of the hip joints. In rachitis, its curative power is often wonderful. Trosseau found it useful in children with imperfect ossification of the bones, enlargement of the cranium with persistence of the fontanelles, tardy or premature dentition, enlargement of the liver, and abdominal dropsy. Sometimes, after four or five days of treatment, the pains in the limbs ceased, and at the end of a fortnight, bones which before were flexible acquired a good degree of firmness. In softening of the bones in adults, the oil produces equally surprising cures. Not only in ulcers and softening of the bones is it useful, but in ulceration of the glands. Although the oil may fail to benefit swollen glands, so soon as those glands are attacked by scrofulous abscesses and ulceration, or when an indolent ulcer with excoriated edges remains, or one extending under the skin and beneath the muscles, nothing promotes a cure so certainly as Cod-liver oil. This curative power is signally manifested in cold abscesses; the serous is replaced by a purulent discharge, healthy granulations cover the indolent surface of the sore, and cicatrization ensues. Tabes mesenterica is often relieved and sometimes cured by this remedy. The children are pale, cachectic, greatly emaciated, with large, tumid abdomen, enlarged liver, and swollen mesenteric glands. I have cured several such cases, when inanition seemed inevitable, by the administration of Cod-liver oil (with and without Phosphate of lime), in doses not exceeding fifteen drops three times a day, assisted by the inunction of a few teaspoonfuls into the abdominal cutaneous surface. If, however, the glands are greatly enlarged and evidently tuberculous, it is doubted if the oil will cure. OLEUM JACORIS ASELLI. 471 Diseases of the skin are often benefited by this medicine, if they are engrafted on a scrofulous or cachectic state of the system. If an inflammatory element prevails, it is worse than useless, unless used in the high potencies. Lupus is more apt to be cured by the oil than any other. Emery treated seventy-four persons affected with this disease; of these, twenty-eight were cured, and all greatly benefited. Other authorities give as favorable reports. The doses used varied immensely. Some prescribed a pound or two a day for months! Others a teaspoonful three times a day. The small doses cured as readily as the large, showing that it was the medicinal action of the constituents of the oil, rather than the nutrient, which effected the cures. The only other cutaneous disease which is as promptly cured by the oil is ichthyosis. Two English physicians report cases cured in a short time by the oil, used internally and externally. I have cured two cases in children, by giving small doses internally, and its inunction into the diseased surface. It is in phthisis, or pulmonary consumption, that the Codliver oil has been most extensively used - and abused. The amount that has been poured down the throats of the unhappy victims of this disease is simply incredible! Like all new remedies for consumption, its powers and virtues were once lauded to the skies. An immense experience, both in public and private practice, during the last thirty years, has greatly modified the early and extravagant estimate of its value. It is estimated that when judiciously given (in allopathic practice) about eighteen per cent. are cured; sixty per cent. benefited; while the balance are injured, or indifferent to its action. It is known, however, that the death rate from consumption has certainly diminished since its use. In homceopathic practice it has not been used sufficiently to enable me to give you any statistics of its value, when prescribed according to our law. Owing to prejudice, lack of confidence, or what is more probable, an ignorance of the 472 OLEUM JACORIS ASELLI. special indications for its use, our school have rarely prescribed it in phthisis. The time has come when we should ascertain definitely its sphere of action, and the characteristic symptoms and conditions calling for it. We can attain this knowledge by (1) a careful study of the experience of trustworthy and honest allopathic practitioners; (2) a study of the symptoms of its constituent elements in health and disease, and (3) a record of its effects when prescribed in small doses. The homeeopath who will not prescribe Cod-liver oil in tuberculosis because it is abused in allopathic practice, is unworthy the name of physiciafi. If it cures, it does so because its constituents are homceopathic to the disease, aided by its powerful nutrient qualities. Some of our authorities are liberal enough to advise its use in appropriate cases. Baehr, after giving the special indications for Iodine, Phosphorus, etc., says: "As regards Cod-liver oil, even the physiological school admits that it acts well in phthisis. The Iodine it contains being present in only a small quantity, the boldest conclusions were resorted to for the purpose of substantiating the theory that the oil alone was the curative agent. That this theory is erroneous, can easily be shown by some other oil being substituted for Cod-liver oil, the same effect will not be obtained. The small quantity of Iodine is sufficient for the homceopath to account for the action of the oil. That it should be used with caution has already been stated, at the conclusion of our chapter on Scrofulosis. The same maxims that were laid down on that occasion are likewise applicable to phthisis, so much more as it is decidedly injurious to phthisicky patients to have their appetite and digestion interfered with. The dose should likewise be carefully measured; a teaspoonful in the morning is sufficient. It is decidedly improper to prescribe a spoonful morning and evening. A morning dose is sufficient. In the evening the oil disagrees with most persons. No other medicine should be given with the oil." I do not agree with Baehr in relation to dose, n6r his pro OLEUM JACORIS ASELLI. 473 hibition of other medicines. I think three small doses a day are better than one large one. Dr. Mayhofer, of Nice (see Diseases of the Respiratory Organs, Vol. I), says: " Cod-liver oil justly merits the high reputation which it has acquired in correcting those deficiencies of nutrition commonly comprehended in the terms scrofulosis and tuberculosis. But, on the other hand, there is perhaps no remedy which has been so much misused, and thereby effected so much harm, as this animal oil. Ask any adult afflicted with a scrofulous disease how many medical practitioners have been consulted for him in his childhood, and the answer will be that, if their number was great, their unanimity was still more marvelous, as they, one and all, recommended Cod oil as a ne plus ultra for his complaint. The quantity of oil that many of these unfortunate children are made to swallow, is often truly amazing, yet a great number of them are not only none the better for it, but, on the contrary, all are worse. Some reflection on the two principal types (irritable and torpid) of the scrofulous diathesis, and the all-important physiological part which fat plays in the animal economy, would have prevented these sad results. "In patients exhibiting a strumous diathesis, of a slender and lean figure, and thin, transparent skin, we generally find combined a frequent pulse, great excitability of the nervous system, with high specific gravity of the urine- all signs of an accelerated metamorphosis. It is in this condition that the action of Cod-liver oil has obtained its anti-scrofulous fame. In a short time after its use the angular forms acquire more roundness, and the general susceptibility, as well as the morbid phenomena, gives way to its influence. Scrofulous individuals, however, who exhibit a fatty, puffy, leuco-phlegmatic body, swollen nose and upper lip, slowness of the cardiac contractions, defective irritability of the nervous system, and low specific gravity of the urine, far from being benefited by Cod oil, are the very victims who have been made to swallow it by quarts, and to no purpose. The reason of this is obvious: fat requires nearly double the 31 474 OLEUM JACORIS ASELLI. amount of oxygen for its combustion (100: 292.14) to that demanded by albumen (100: 153.31), and as it evinces a greater tendency to the generation of acid than the latter, acts, when introduced into the organism, the part of a moderator to the metamorphosis of nitrogenous substances. On the other hand, that part of the oleaginous matter which has not furnished its share toward the production of animal heat by combustion, does so by its accumulation under the cutaneous surface, or enters as a necessary element into the formation of cells. It is thus evident that Cod-liver oil can only be of service when the destructive nutritive process prevails over the constructive one, and that otherwise its agency must rather increase than diminish a lymphatic tendency of constitution. " But the virtues of this animal product are, by a great number of physicians, attributed in a measure to the Iodine contained in it. There can be no doubt as to the salutary influence exercised by this metalloid over some special scrofulous affections; but this does not destroy the fact that Cod oil, like any other fatty substances (the fat of dogs is a popular remedy in Germany for scrofula and phthisis), produces its best effects on lean persons, who, as physiology teaches, consume more oxygen and excrete more CO2 and bile than fat ones; while on those who show a disposition to the formation of adipose'tissue, it effects a contrary result to that which is desired, in spite of the Iodine which it contains. Cod-liver oil is a specific only in a limited number of morbid conditions; in the majority of instances it derives its importance from its value as a nutritive agent arresting a preternatural waste." We now turn to the best testimony, relating to its use in phthisis, afforded by the allopathic school. The great and enlightened experience of Dr. Walshe led him to conclusions which we will now proceed to quote. You will observe that while he concedes to the oil all of the nutrient qualities which have been claimed for it, he is not prepared to regard it in any sense a cure for tubercular consumption. He asserts: OLEUM JACORIS ASELLI. 475 (1.) That Cod liver. oil more rapidly and more effectually induces improvement in the general and local symptoms than any other known substance. (2.) That its power of curing the disease is undetermined. (3.) That the mean amount of permanency of the good effects of the oil is undetermined. (4.) That it relatively produces more marked effects in the third than in the previous stages. (5.) That it increases weight in favorable cases with singular speed, and out of all proportion to the actual quantity taken; that hence it must in some unknown way save waste, and render food more readily assimilable. (6.) That it sometimes fails to increase weight. (7.) That in the great majority of cases where it fails to increase weight, it does little good in other ways. (8.) That it does not relieve dyspnoea out of proportion with other symptoms. (9.) That the effects traceable to the oil in the most favorable cases are: increase of weight, suspension of colliquative sweats, improved appetite, diminished cough and expectoration, cessation of sickness with cough, and gradual disappearance of physical signs. (10.) That in some cases it can not be taken, either because it disagrees with the stomach, impairing the appetite (without itself absolutely nourishing), and causing nausea, or because it produces diarrhoea. (11.) That in the former case it may be made palatable by associating-with a mineral acid; and in the latter prevented from affecting the bowels by combination with astringents. (12.) That intrathoracic inflammations and heemoptysis are contra-indications to its use, but only temporarily so. (13.) Diarrhcea, if depending on chronic peritonitis, or secretive change, or small ulcerations in the ilium, is no contra-indication to the use of the oil; even profuse diarrhiea caused by extensive ulceration of the large bowel, is not made worse by it. (14.) That the beneficial operation of' the oil diminishes, cmteris paribus, directly as the age of those using it increases. (15.) That the effects of the oil are more strikingly beneficial when a small extent of lung is implicated in an advanced stage, than where a relatively large area is diseased in an incipient stage. (16.) That where chronic- pleurisy or chronic pneu 476 OLEUM JACORIS ASELLI. monia exists on a large scale, the oil often fails to relieve the pectoral symptoms. (17.) That it often disagrees when the liver is enlarged, and probably fatty. (18.) That weight may be increased by it, the cough and expectoration diminish, night sweating cease, the strength which has been failing remain stationary, under the use of the oil, and yet the local disease be all the while advancing. " Singular proof," says Dr. Walshe, "of the nutritive power of the agent," and, we may add, of its inefficiency as a medicine. "' This admirable exhaustive summary of the knowledge which is possessed of the subject to which it relates, confirnled, as it has been, by the conclusions of competent observers, shows a wide difference between the anticipations which were indulged respecting the virtues of Cod-liver oil and the sober realities of experience. But enough remains to prove that among all the remedies that have been proposed for pulmonary consumption, none can be compared with this in efficacy. More than any other it mitigates the symptoms of the disease, and delays its march; while in some cases it appears permanently to arrest the degeneration of tubercles already deposited, and so to improve the nutrition as to prevent the formation of new ones." (Stille.) Dr. Anstie has called attention to the usefulness of this medicine in the treatment of chronic convulsive diseases, namely: paralysis, agitans, simple epilepsy, mercurial tremor, and chorea. Doubtless, if the general condition of the patients was such as called for the oil, they would be benefited by it. The second formula I shall give at the close of this lecture, is very highly praised by many physicians, noted for their successful treatment of nervous diseases. It is useful in insanity, dementia, hydrocephaloid states, cerebral exhaustion, spinal exhaustion, neuralgia, etc., if the general conditions of low vitality indicate it. Dr. Holcombe once reported an interesting case of chronic diarrhcea, caused, as he supposed, by ulceration of the mucous membrane, which he cured with Cod-liver oil in teaspoonful doses. He thought the local soothing effect of the OLEUM JACORIS ASELLI. 477 oil partly contributed to the cure. Bat its specific action was probably as important. I have stated that diarrhuea, unless inflammatory, was no contra-indication for its use. I have cured with the oil several cases of chronic diarrhoea in adults, with great emaciation, poor digestion and depressed nutrition, after Arsenicum, Nitric acid, and Phosphorus had been used unavailingly. The Dose.- The usual quantity of the oil prescribed by the allopathic school is rarely less than a tablespoonful three times a day. This amount is sometimes doubled and trebled. The results of these massive doses is the same as follows the administration of large doses of any drug. Pathogenetic effects are caused, and the disease instead of being benefited is often aggravated to a serious degree. It seems to be a rule with that school, that the dose must be as large as possible, without doing serious injury. It is this disregard of the disease-producing effect of the oil, that has driven it into disuse in some quarters, and led to its abuse everywhere. I have previously stated that it increases the proportion of red globules in ancemia. This increase, under the use of large doses, may become abnormal. Stille admits that "the continued use of the oil may sometimes predispose to parenchymous congestions," and quotes Benson, who found " a consolidated and congested condition of the lung frequent in consumptives treated with the oil." He also quotes Gluge and Theirnesse, who "produced pneumonia artificially in certain animals by feeding them exclusively on Cod-liver oil. The lesions found were hepatizations of the lung, accumulation of fatty fluid in the parenchyma of the lungs, liver, kidneys and in the blood." It is not strange then that such acute observers as Stille ar-d Wood should caution against its use in "some cases of phthisis." Does it not seem strange that they did not think of decreasing the dose in all cases, instead of advising to " use it (in large doses) with caution?" There is abundant proof, and you will meet with such proof frequently in your practice, that abuse of Cod-liver oil will cause heemoptysis, inflammation, fever, and many un 478 OLEUM JACORIS ASELLI. pleasant symptoms, which tend to hasten the death of patients, instead of curing them, or prolonging life. If the Cod-liver oil is homceopathically indicated, a draehm three times a day should be the maximum dose for an adult. In a certain class of cases, when its constituents are closely indicated, the dose should be very small; a few drops of the pure oil, or the lower triturations or dilutions. Dr. Neidhard uses a tincture made by adding -ix alcohol to ~j of the oil. This he prescribes in drop doses, when it is "closely affiliated." I prefer the triturations of the brown oil because it is the richest in medicinal constituents, and I have seen excellent effects in infants suffering from marasmus, from the 2x and 3x. I rarely prescribe over fifteen drops to young persons, and this dose should not be repeated oftener than three times a day. In these doses, especially if given in the form of emulsion, or in capsules, it rarely disagrees with the stomach, and the disagreeable symptoms of gastric irritation it often causes, in large doses, are avoided. It is not always necessary that the oil should be administered internally. You may find some patients with stomachs so sensitive that a few drops will nauseate and cause gastric disturbance. In such, try the triturations or dilutions, but if you see no good effects, and you feel sure that this is the remedy, do not hesitate to try the inunction process. It was proven by Polloch and Klenke that animals who are rubbed with the Cod-liver oil daily (on the shorn skin), increase in weight as fast as when it is administered internally. In some of the hospitals of England and this country this process has been adopted with good results. In the case of children, especially, this plan is productive of excellent cures. For many years, I have treated those cases of marasmus which occur in children under five years of age, with the 2x and 3x trituration internally, and inunctions of the oil on the abdomen and stomach. In very young infants, I rely upon the inunction alone. I can recall to memory sev OLEUM JACORIS ASELLI. 479 eral infants who had been given over to die by eminent physicians of both schools, but who recovered in a few months under the patient and regular daily inunction of half an ounce. Adults become tired and disgusted with the odor, and it is difficult to get them to persevere; but children rarely seem to be discommoded by it. It is well known that young children rarely object to the taste of the oil; they even become fond of it. Many methods have been devised to disguise the taste and smell of the oil. The enormous doses prescribed by other schools have seemed to make this necessary, although as has been stated, children do not generally object to it. Given in the small doses which are used in our practice, the necessity of such disguise is not so important. We shall, however, be obliged in many cases to recommend various devices for that purpose. A few drops, or the first trituration, is as offensive to some as a teaspoonful. The best method of taking the pure oil is to drop it into a little table beer or porter. If the juice of a lemon is sucked just before and after the dose, a teaspoonful or less can be readily taken by most patients. It is said that chewing a piece of smoked herring is the best expedient. I strongly protest against the use of whisky or brandy for such purpose. When it is taken in equal or double the amount of the oil, as a disguise, or a stimulant, it soon creates a taste for the liquor, which will grow into a necessity, and you make a drunkard of your patient before either he or you are aware. Many emulsions have been made with the oil. They all contain lime water, phosphate or hypophosphite of lime, and are flavored with oil of bitter almonds. Wilbour's oil is the most popular, although many other manufacturers imitate it. One of the most palatable, and I will say the most useful, of all these emulsions is made after the following formula: 480 OLEUM JACORIS ASELLI. Hypophosphite of lime, - 3 j. Aqua calcis, - - vi Oleum aselli morrhuoe, @ @. Syrup, balsam Peru, - - - - Mucilage acacia, - ---- - @ ~ J Oleum amygdala amara, - - - gtts. 5. M. Of this the dose is a teaspoonful or less -rarely a desertspoonful, even to adults. It rarely disagrees with the most sensitive stomachs. The objection to its compound character may frighten a good many purists, but it is hardly more complex than the oil itself; and when the life and health of our patients are at stake, we should not be too stringent in our ideas of "the single remedy and the minimum dose." Another formula, which has been called the Phosphoric acid emulsion, is very popular with physicians who specially treat insanity, nervous diseases, and cerebral exhaustion: Cod-liver oil, - - iv. Glyconin, - - - - - - - - ix. Jamaica rum, - - ij. Dilute Phos. acid, -3 ij. Oil bitter almonds,- gtts. x. M. Glyconin is made by thoroughly triturating Glycerine and yolk of egg, equal parts. Add to this Glyconin the Oil of Almonds, drop by drop, slowly, stirring it vigorously. Add the Cod oil to the Glyconin. Then add the Rum and Phos. acid. Dose: 15 to 60 drops. It is generally recommended that the oil be taken after meals, or midway between; but my experience and observation go to show that small doses, at least, are better borne if taken just before sitting down to meals. In treating patients constitutionally with the oil, we can adopt the same rules in regard to intercurrent remedies as when we are giving an antipsoric, i.e., if any remedy seems indicated by symptoms which spring up and require attention, the indicated remedy may be prescribed without suspending the oil. OPUNTIA VULGARIS-OXALATE OF CERIUM. 481 The presence of fever, a bilious coated tongue, or decided gastric derangement, calls for the suspension of the oil until these conditions disappear. Rarely does diarrhea, unless it is inflammatory, contraindicate the use of the oil. On the contrary, some of the worst forms of diarrhcea have been cured by it. OPUNTIA VULGARIS. This member of the Cactus family is the only species which grows as far north as the Great Lakes. I have seen it blooming luxuriantly on the shores of Lake Michigan. We have only a fragmentary proving, in which it seemed to affect the intestinal mucous membrane, and perhaps the abdominal nerves. It has cured attacks of diarrhcea with extreme nausea. Its relationship to the Cactus grandiflora suggests the possibility that a thorough proving might evolve some cardiac symptoms. I would suggest a careful proving of the tincture of the whole plant. OXALATE OF CERIUM. This medicine was introduced to the profession by Prof. J. Y. Simpson, of Edinburgh (see "Simpson's Memoirs.") He recommended it in very obstinate cases of vzomiting during pregnancy, and also in some particularly intractable cases of chronic vomiting, which he imagined to be caused by some eruption on the mucous membrane of the stomach. The allopathic school have used it quite extensively in such cases, and their testimony is, that while it gives prompt relief in some cases, in others quite similar it seems to have no effect whatever. No proving has been made by the homeopathic school, but it has been resorted to by many in obstinate cases. In the Homceopathic Medical Society of Pennsylvania, 1872, during a discussion on "morning sickness," Dr. Charlton 482 OXALATE OF CERIUM. stated that for several years he had used the Oxalate of Cerium in all cases of morning sickness of pregnancy with unvarying success. Dr. B. W. James had experience in its use. He said: " It very seldom fails in relieving the vomiting of pregnancy, when given in good-sized doses of the 2x trit." Dr. McClelland had tried it and got no good effects. Dr. Moore relieved some cases with it. Dr. J. E. James used it in three cases without results. Dr. McClatchley had the same results from its use. Scattered through our journals a large amount of testimony, for and against this drug, is to be found. All agree that if it does no good, it does not aggravate the symptoms. My experience with it is, that in the worst cases of vomiting of food, half digested matters, mixed or not with blood, with great pain during or after vomiting, it sometimes affords material relief. In some cases it arrests the vomiting, but the nausea remains. This would seem to indicate that its action was on the motor nerves of the stomach (or perhaps the oesophagus.) In mild cases of morning vomiting, it often affords prompt relief. It is probable that the reason of the uncertainty of its action lies in the fact that we have no proving to disclose its characteristic indications. A characteristic indication is often discovered by close observation during the empirical use of a medicine. Some acute observer may observe the key-note of Oxalate of Cerium. -Dose.-Allopathic physicians give about five grains of the crude drug before meals. Homceopaths have usually used the lower triturations. I have obtained the best results from the 1st decimal trituration. Believing that, like Bismuth and some other agents, the drug has to come in contact with the coats of the stomach, in order to act on that organ, I think it should be given suspended in water, or some bland liquid. (Two or three grains of the 1st, before each meal.) ORIGANUM VULGARE-PAULLINIA. SORBILIS. 483 ORIGANUM VULfGARE. The Wild Marjoram is not indigenous to this country, but may be found in all the older states, introduced from England, where it is a native. It differs botanically from the Sweet Marjoram cultivated in gardens. The provings from which the pathogenesis in Vol. I is composed, were made by Dr. Gallasardin, of Lyons. According to his provings, verified by the cures he made with it, it appears that its principal sphere of action is upon the generative organs, stimulating the seat of erotic impulses, and thence affecting the brain and nervous system, just as sexual over-excitation does from any cause..It resembles Cannabis indica, Platinum and Valerian, and possibly Collinsonia, Helonias and Hedeoma in its primary action. It causes and has cured lascivious ideas and dreams, hysteria from excessive irritation of the genitals. Dr. Gallasardin cured with the 3x several cases of onanism, masturbation, leucorrhoea with sexual irritation. Dr. Emory cured similar cases with the 30th. Dioscorides says it cures sterility, leucorrhcea and " flatulency of the uterus." Culpepper recommends the cultivated Marjoram for the same complaints. No English author mentions its power of exciting erotic desires. PAULLINIA SORBILIS. This is comparatively a new medicinal remedy in this country; a small quantity only having been brought from France, and known to but very few practitioners. For several years its valuable properties have been known and appropriated in the principal cities of Brazil, South America, and on the Continent of Europe, where it is used in a variety of acute and chronic diseases, as a general popular remedy, and by physicians in regular practice as well. Dr. Gavrelle, physician to Don Pedro, employed it very often while in Brazil, and afterwards in France, and consid 484 PAULLINIA SORBILIS. ered it a valuable remedy. He found it advantageous in the diarrhcea of phthisis, sick headache, paralysis, tedious convalescence, and generally as a tonic. Dr. Ritchie, surgeon in the English navy, says: "It is held to be stomachic and anti-febrile, and is used in dysentery, diarrhoea, retention of urine, etc. It stimulates and at the same time soothes the gastric system of nerves. It is indicated in fever, reduced vital powers, in grief, depression of spirits, colic, flatulence, anorexia, nervous hemicrania." Severe cases of neuralgia, and diarrhcea with pain, have been most gratefully relieved. Affecting directly the mucous membrane, its application is very general and presents large expectations. Dr. Macdonald, of Edinburgh, Scotland, has an extended and carefully-written communication in " The Practitioner," published in London, and reprinted in New York, September, 1873, establishing the reputation of Guarana for sick headache. Its effects in neuralgia, sick headache and diarrhcea are sometimes almost immediate and wonderful. The term Guarana is derived from the name of a tribe of Indians who are dispersed between the rivers Parama and Uruguay, by whom it is very commonly used as a condiment or medicine, and also brought into the cities on the coast as an article of commerce. It is prepared from the seeds of a climbing plant, " Paullinia sorbilis" (according to Martius), by the natives. The seeds are dried, pounded, mixed with tapioca, and with water made into rude cylindrical masses, which, by drying, become very hard. Johnson, in his "Chemistry of Common Life," says the seeds are used as we use cocoa, as a beverage. They contain an alkaloid said to be identical with " theine," found in tea and coffee. In the Miateria lMedica of Trousseau and Pideaux is an account of its use in migraine. It has lately been called up by Dr. Wilks, of Guy's Hospital, London. It has been successfilly used by Dr. Ward, of Montreal, and Dr. Helmshew, of British Columbia. PAULLINIA SORBILIS. 485 It has become a popular remedy with the allopathic school, not only in sick headache, but in colic, diarrhoea, and even in chronic rheumatism and neuralgia. Its sphere of action appears to be upon the sympathetic nervous system, upon which its primary action is that of a sedative. In this respect it resembles Valerian, Scutellaria, Pulsatilla, Coffea, and perhaps the Bromides. It may be found to resemble Iris and Dioscorea. I have cured a few cases of sick headache with the powder. It appears to be best suited to those persons who have used tea and coffee to excess, or in whom nervous headaches, followed by vomiting, are excited by any error in diet or depression of mind. It has been recommended in that unpleasant and uncontrollable sleepiness. drowsiness and heaviness of the head, with flushed face, which occurs in persons of sedentary habits, after eating. If it will remove this symptom, it will be a boon to many students and literary men. Dr. Geo. A. Hall, of Chicago, tested its value in the Summer of 1874, in the "summer complaints" of children; in diarrhoea from teething; in vomiting and diarrhoca from improper food; and he reports that in many cases its use was followed by surprisingly good results. In one case of chronic diarrhoea, nearly to marasmus, it cured the child in a short time. He gave teaspoonful doses of a solution of ten drops of the tincture or fluid extract in half a glass of water, repeating the dose every few hours. Dr. Scudder, in the Eclectic Medical Journal, gives the following candid account of his experience. He says: "I will report two cases showing its non-curative action. Mr. B. had suffered for years from attacks of mpst intense headache, of which sickness of the stomach was a common feature. A physician suggested Tincture of Guarana, in half teaspoonful doses, every two hours. He procured it, and took the dose as ordered; the pain became almost unbearable, and nearly the entire night he suffered from delirium. The experience was so unpleasant that he decided to take no more new remedies. 486 PAULLINIA SORBILIS. "Mr. A. O. T. has suffered for the past nine years with asthma of the severest form, and has tried almost every remedy suggested for this most obstinate complaint. Having exhausted my remedies, I concluded to try Guarana, as possibly a nerve stimulant would be of advantage. " Of the tincture prepared by H. M. Merrell & Co., I ordered fifteen drops every four hours. Taking the first dose, he went out to the stable, and in probably not more than five minutes the difficulty of breathing became so great that he was forced to grasp the manger and struggle for breath. It passed off in the course of half an hour, but it was the severest paroxysm he had ever experienced. Not thinking that the medicine had anything to do with it, he repeated the dose, which was followed by another bronchial spasm. This was witnessed by the family, and described as most fearful, and from which recovery seemed almost impossible. The face was flushed with blood at first, then became purple and livid, the eyes bright and staring, and the struggle for breath almost agonizing. I need hardly add that the medicine was not repeated. "The Guarana acts upon the nerve centers, probably upon the brain, spinal cord, and especially upon the sympathetic and its associate cranial nerve-the pneumogastric. Its action is very decidedly stimulant. I have used it in cases of headache, with enfeebled circulation-want of stimulus, with most marked benefit; and in some other affections characterized by enfeebled innervation, and it is in such cases that I would suggest its trial. The two cases reported were just the,opposite, and required sedation instead of stimulation. In the case of Mr. T., the evidences of an irritable and excited nervous system were marked, and giving Guarana simply added fuel to the flames. The case of headache was of the same character-it would probably have been relieved by Gelseminum. I am satisfied, further, that the dose advised is too great, at least of the tincture I have used. Try it in doses of five drops, and repeat, if necessary. It is always well to commence a new medicine with the minimum dose." In relation to its use in chronic rheumatism: PAULLINIA SORBILIS. 487 Mr. E. A. Rawson states (Irish Hospital Gazette, April 15, 1874,) that when suffering severely from lumbago, and other remedies failing, he tried Guarana as an experiment. He took fifteen grains in hot water with cream and sugar, and experienced entire relief from pain for twenty-four hours. When the lumbago returned, he took another dose, with the same result. "I gradually," he says, "increased the dose to forty grains, and took it regularly once a day for about a week. The lumbago disappeared. I gave up the Guarana, and in a few days the pain in the back returned. A forty-grain dose removed it, and it did not return for several days afterwards. Now, whenever it does, I have my remedy at hand. During the last month I have experimented largely with Guarana, on a variety of patients, rich and poor. The results vary. When the pain is acute, coming on with sharp stings, Guarana acts like magic; when it is of a dull, aching character, the drug is slow in its action, and several doses must be taken before any decided benefit can be perceived. "I have come to the following conclusions, viz.: that whenever the fibrous envelopes of nerves, the aponeurotic sheath of muscles, the fasciae or tendons, are the parts affected, Guarana gives, if not instantaneous, at least very immediate relief, which will last from twelve to twenty-four hours; and I confidently expect that perseverance in the use of the drug, gradually increasing the dose up to forty grains, will entirely remove any of the above-mentioned kinds of rheumatism. " Of the good effects of Guarana on nervous hemicrania there is no doubt; and I trust it will prove in other hands as valuable against rheumatism as it has in mine." You will, all of you, have obstinate cases of nervous disorder, where the ordinary remedies fail. In such cases, try the Guarana, and report the results. PASSIFLORA INCARNATA. 489 to see an old lady in a distant part of the country, who was reported to be "having fits." I found her able to be up most of the time, but, while examining her, convulsions came on, affecting mainly the trunkal muscles and drawing the head back. I gave her instantly a dose of the Passiflora. The convulsions subsided, and she has never had one since. I continued the use of the medicine, in small doses, for a few days. I have used it treating tetanus in horsesa disease usually considered as inevitably fatal to that noble animal. It has never failed to cure the horse. Let one case suffice to illustrate. In I85I, early one morning, one of my horses was found to have trismus. A number of remedies failing, and the spasm becoming general, apparently affecting all the muscles-tetanus erectus-I abandoned him. He was down,his legs extended, and every muscle so tense as to be immovable by any force that could be safely applied. After some hours at night, I concluded to try him with the Passiflora; gathered a quantity-stems, leaves and flowers- pounded, moistened with water, expressed ten or twelve ounces, and poured down his throat through a tube introduced at the side of the mouth. He was then apparently dying, and no one believed he could survive half an hour. I saw him no more till next morning, when he was well and grazing at a distance from the place where I had left him the night before. During the late war, my son, Dr. J. H. Phares, had occasion many times to prescribe the Passiflora for tetanus in horses, with one invariable result-prompt, perfect, permanent cure. He fortunately saw no case in the men. The leaves are gathered in May, or as soon as the plant blossoms, but before forming fruit. In fact, the whole plant may be used. It must be pounded, and the juice expressed through a strong cloth, into shallow glass or porcelain dishes: to dry as rapidly as possible in the shade, with free circulation of air. When dry, it is reduced to a powder by the use of mortar and pestle, bottled and closely corked. The dose of this powder is from one to four teaspoonfuls, repeated pro re nata. I have made ethereal, aqueous and alcoholic preparations, and perhaps others; but the inspissated juice reduced to a powder is the best I have ever used. The size of the dose renders it somewhat objectionable. Some eight or ten years ago, I requested a manufacturing chemist of New York to prepare the concentrated active principle of the Passiflora incarnata, which he promised to do, but he has never reported progress. If a concentrated solution could be obtained, I have no doubt it would supersede morphia and atropia for hypodermic medication, its action being so much more pleasant and safe. I have never seen the least unpleasant effect from it in any dose, however large, although I have given it in quite large doses. When gathered later than May, the juice can never be sufficiently inspissated to be pulverized. It then contains too much sugar and gum. For external use, the whole plant may be boiled for an hour, then thrown out, and the extract thus obtained boiled down to a proper consistence for the object in view. For this purpose, the perennial roots answer well, gathered after the first frost in autumn. The incarnata may be easily distinguished from the other species of Passiflora. This and the luteo are the only two species found in the United States north of Florida. Three other species are found in Florida; but all these, like the P. luteo, are small, and bear fruit less than half an inch in diameter, while the P. incarnata is much larger, and grows in the open fields, bears a fruit about 32 490 PEPSIN. the size and shape of the Muscovy duck, and has serrated trillobate leaves. From the sharp report emitted by the immature fruit when crushed, it is very generally called the May-pop. Since the foregoing was written, I have treated with the fluid hydro-alcoholic extract of Passiflora, obtained from the dried leaves by displacement, several cases of neuralgia, and one of sleepless, incessant motion and suicidal mania. With the same extract, during the current week, Dr. J. H. Phares has treated, with the most prompt and satisfactory success, a very virulent and hopeless case of tetanus, with opisthotonos, trismus and convulsions, in a child two years old. Other most potent remedies, in heroic doses, having failed to produce any effect in this case, he thinks nothing but the Passiflora could possibly have saved the child. It has never been used by homceopathists, but deserves to be proven and used in our practice. PEPSIN. This agent can not properly be called a medicine, for by this term we understand an agent that is capable of causing his chapter on " Digestants," that "it is evident that any pathogenetic symptoms in a healthy person. But it can be called a remedy. It is very properly observed by Wood, in influence for good which it possesses is dependent upon its solvent power, and that this, therefore, is a measure of its value." When we consider the statement of physiologists, that the best article of Pepsin is capable of dissolving only "four times its weight of fibrin at the temperature of the body," aided by muriatic acid, and that "fifteen grains will only effect the solution of ninety grains of boiled white of egg in twelve hours," we may well exclaim with Wood, who, in commenting on the fact that "grave doctors prescribe for men, Pepsin as an artificial solvent, in doses of ten grains," says: "Evidently one of two things is certain; either the present practice is ridiculously absurd, or else Pepsin acts upon the stomach itself in some way as a stimulant." I confess I am at a loss to account for the high estimate which some physicians place upon it. I know many of both schools who habitually prescribe the " Wine of Pepsin" PEPSIN. 491 in spoonful doses after each meal, and claim good results from its use. But the best physiological chemists assert that alcohol destroys its digestive power. It must be, then, that the apparent benefit is due to the action of the wine alone. Pepsin has been thrown upon the market in various combinations. The "Elixir of Iron, Bismuth, Strychnia and Pepsin," has been lauded in extravagant terms. But chemists assert that the combination of Pepsin, in solution with any of the above drugs, destroys its value. I agree with Wood and other authorities, that it rarely benefits loss of digestion in adults. I have thought it aided digestion in delicate women. But the benefit may have arisen from the regulation of the diet and habits of the patient. Generally, other remedies (medicines) are given along with the Pepsin, which still further throws a doubt upon its value. In a few cases of slow and imperfect digestion in adults, I have given the Pepsin in powder, alone, for weeks, and the testimony of the patients went to show that their digestion did improve under its use. The vomiting of food wlich occurs very soon, or an hour or two after meals, is often arrested by the administration of ten or fifteen grains of good Pepsin just before or during meals. The ingesta thus expelled is usually undigested, or undergoing an acid fermentation. In the vomiting of pregnancy, Pepsin often acts with singular efficacy. It does not always cure, but it arrests the vomiting for days or weeks, and affords a grateful alleviation of a distressing symptom. In lientery, even of adults, and when resulting from serious gastro-intestinal disease, where no cure is expected, the Pepsin in 20 or 30 grain doses will often change the undigested character of the evacuations. It occasionally happens that the saccharated powder of Pepsin does not act when decidedly indicated. In such cases the failure is due to the lack of muriatic acid in the stomach. If we now prepare a solution of Pepsin in water (gr. v. to 3j), and add dilute muriatic acid in the proportion 492 PEPSIN. of a drop or two to each drachm, and administer it in one or two teaspoonful doses, we shall get satisfactory effects. I have in many instances given it in combination with Nux vomica, Strychnia, or Bismuth, and believe that when thus administered it resulted in more benefit than when it was given alone, or when the medicines were given singly. My plan has been to add to 100 grs. of Shaffer's Pepsin, 10 grs. of Nux vomica, 2x, or 10 grs. of the Citrate or Subnitrate of Bismuth (crude), or 10 grs. of Strychnia ic. The mixture was carefully triturated twenty minutes. Of these preparations a 5 or 10 grs. dose is ordered to be taken immediately before or after meals. The selection of the medicine is made according to the symptoms of the patient. In a few cases I have combined Pepsin with Pulsatilla, Ptelea, or Hydrastin, and believe I have seen good results. The testimony as to the value of Pepsin in diseases of young children is very strong. Remember that this agent is in no sense a drug. You can not injure a child by giving any quantity. If it does not digest the contents of the stomach it does nothing at all. I believe the use of Pepsin is much more rational in children than adults. It certainly has a better reputation in the chronic indigestion, and consequent diarrhcea of infants, than the same condition in adults. I have found it particularly useful when the caseine did not coagulate in a loose, flocculent manner, but formed large, solid masses in the stomach, causing great distress, vomiting or painful diarrhcea. It will not always remedy this condition, for the reasons given in that excellent little brochure on " Inzfant Diet," by Dr. Jacobi. Vomiting or diarrhcea of undigested food in infants will often disappear after the administration of a few grains of Pepsin, given before nursing the breast or bottle, or with its regular meals. If it fails to do this when given singly, prepare it with Calcarea 3x, Pulsatilla 3x, Nux 3x, or China lx, and you will get better results than when either medicine is given alone. The action of Pepsin is principally exerted upon fibrin, albumen and caseine, but PANCREATINE-PHOSPHIDE OF ZINC. 493 PANCREATINE is supposed to have the power of converting starch into sugar, and to emulsify fat. It assists in the digestion of starch and fat, and is recommended in those cases of dyspepsia or indigestion where the patient can not eat those substances. The dose is the same as Pepsin. It is sometimes combined with that agent. It is often prescribed for the purpose of aiding the digestion and assimilation of Codliver oil. PHOSPHIDE OF ZINC. Since the introduction of this remedy into our Materia Medica, no provings have been made of it, and the clinical experience has been scanty. I have used it a good deal for the secondary effects of cerebral congestion, or apoplexy. Hammond asserts that it removes the debility, mental depression and paralysis, following such attacks. In a few cases it seemed to have the desired effect, but it utterly failed in others. Taking the indications for Phosphorus and Zinc, as a basis for its selection, I have given it in "brain fag" of business men who become haggard, pale, sleepless, and suffer from depression of spirits and causeless worry. In such cases it acts well. It has cured aggravated cases of mercurial tremors. It ought to cure chorea with imbecility. I believe it will be found useful in some varieties of delirium tremens. Impotence of a cerebral origin, i. e., when caused by overstudy and nervous debility, or when resulting from previous abuse of the sexual function, ought to be removed by this remedy. I think the Phosphide of Zinc has not met the expectations of allopathic physicians. At first they used it largely, and perhaps indiscriminately, but meeting with no unusual success, they became disappointed and dropped its use. 494 PHOSPHIDE OF ZINC. I find no recent mention of the remedy in our literature, except a brief article in the Medical Investigator, by Dr. J. A. Young, of Hopkinsville, Ky. I quote his paper entire: The object of this paper is, in the absence of a systematic proving, to give some vague indications drawn from clinical observations, and thus aid in the development of the powers of a remedy destined to play no subordinate part in the treatment of nervous diseases, and that promises to fill a long-felt vacuum in our Materia Medica. Without attempting to theorize in regard to the method of the action, there is ample testimony to justify the assertion that it is a speedy and powerful nerve tonic, or stimulant. Numerous clinical reports testifying to its beneficial action in cases arising from lesions of nerve structures. Dr. Hammond, in his work on Nervous Diseases, claims to have first introduced this remedy to the notice of the American profession, and under the influence of the popular chemical school, recommends, in cases where Phos. is indicated, and attributes its effects to that element of its composition alone. The testimony of English physicians is, that as a substitute for Phos. its action is not satisfactory. The deduction formed from clinical observations is, that while its action resembles that of each of its chemical constituents, yet its chosen analogue is Nux vore., and that it will be specially beneficial in those cases where both Phos. and Nux, apparently indicated, have been used without satisfactory results.'Dr. Hammond recommends it in strong terms, in doses of I-Io grains (often in combination with Nux or Strychnia) in cases of cerebral congestion (passive), spinal anzemia, etc., and says: " My experience with this remedy has been extensive. I have never known it to produce the least unpleasant effects." In three cases under my observation the use of the 3d has produced positive and unmistakable excitement of the sexual desire, manifested in two cases by erections of penis accompanied by unusual voluptuousness and desire for embrace; and in the third case by nocturnal emissions accompanied by voluptuous dreams and intense nervous thrill-I would be apprehensive of unpleasant effects from any lower potency-especially so in one of the cases, for the aggravations are manifest even from one dose of the 3d. In addition to this sexual excitement, in one case, a larger dose than usual will cause a pleasant nervous excitement, with sleeplessness after 3 A.M.; says that "it wakes me at 3, and I feel as if under the influence of pleasant and quick music." This wakefulness differs from that of ATux and other remedies, in that the patient does not feel fatigued or unrefreshed by his loss of sleep. It also produced bursting headache. I give a short risuumd of the symptoms from two cases that have been greatly benefited by the use of this remedy, remarking that special interest attaches to them from the fact that both had tried many remedies in vain to find prompt and permanent relief from the Phosphide of Zinc. Case I.-J. B. McK., merchant, about forty years of age, nervous-bilious temperament. I copy from a note of his to me: " For five or six years I have suffered from extreme nervousness, affecting my head mostly, and upper part of spinal column; pain sometimes in my neck and up into the back part of head; then again pain in my temples as if something was pressing in from one side to the other on the brain; vertigo or dizziness always present; weak digestion, PHYTOLACCA DECANDRA. 495 torpid liver; hands and feet always cold; one of the most distressing symptoms is that of fear." His mental condition was very annoying, being oppressed with an indescribable anxiety, or indefinable fear-a fear of something he knew not what; was easily startled. A prominent feature of both case No. I and No. 2 was that a recumbent position always relieved the vertigo and improved the other symptoms. The above is but the outline of a series of unpleasant symptoms that medicine had failed to relieve. In February, I875, I put him upon Zinciphospfhide 3. Under date of April 12, he says: "So much better have discontinued the medicine." Case II. —A physician, aged about sixty; in early life a sufferer from dyspepsia; was engaged in a large and arduous practice when taken. In the Fall of I863, when walking on the street, he was suddenly attacked with vertigo, and from that a train of nervous symptoms manifested themselves until the patient was compelled to give up, in a great measure, his practice. The more prominent symptoms were headache, with binding feeling across brows, twitching of single nerves, a feeling of dizziness or unsteadiness, not amounting to actual vertigo, but more a dread of falling, such as is produced by looking down from a great height; weight and oppression in head; difficulty of thought; nervousness affecting particularly his handwriting; could with great difficulty write a very scrawling hand; an intensely bitter taste in mouth and throat at night; would often wash out the mouth during the night without relieving this " such bitter" taste; pain in sacral region; weakness of limbs, with great heaviness; cold hands and feet, with other nervous symptoms. After many consultations with his medical colleagues, in I872 he commenced the use of Phosphide of Zinc, with prompt relief. PHYTOLACCA DECANDRA. This is one of our most valuable and powerful indigenous remedies. Until subjected to scientific experimentation by our school, and its effects on the healthy discovered by means of provings, but little was known concerning its range of curative powers. The eclectics used it only in chronic diseases, such as chronic rheumatism and syphilis, under the vague idea that it was an " alterative." It always had a reputation among the common people as an excellent remedy for the former disease. The provings of this plant show why it gained a reputation in certain chronic diseases. I refer you to the remarkable accidental proving in the first volume of this work. You will then find the reason of its usefulness in some severe cutaneous diseases. But its curative power is not limited to chronic diseases. 496 PHYTOLACCA DECANDRA. It has proven one of our best remedies in many acute affections of the severest character. I will give you some facts concerning its physical and chemical qualities, and narrate a few cases of poisoning, which will give you some idea of its powerful character. It is said that Caustic potash exists in this plant as a neutral salt, combined with some vegetable acid. This acid has been called Phytolactic acid, and is nearly related to Malic acid. The ashes of the plant is said to contain over 50 per cent. of Caustic potassa. The ashes have been applied to fungous and cancerous ulcers as an escharotic, and the inspissated juice of the plant (leaves, stem and berries) acts in a similar manner. The presence of Caustic potash in this plant is quite suggestive. It throws some light on its poisonous effects. Many of its symptoms and pathological effects resemble those of Causticum and the caustic alkalies. Taken into the stomach, this is probably soon freed from the acid, and enters the circulation as Kali causticum.'The plant, however, has other dynamic effects; it affects the nervous system powerfully, also the fibrous and osseous tissues. These chemico-dynamic effects cause deep seated and important lesions, as diphtheria, paralysis, periostitis, etc. The early sprouts are often used for greens, but become cathartic as they advance to maturity. The officinal parts of this plant are the roots, leaves and berries. The root, which is more commonly employed, should be gathered in the latter weeks of autumn, cleansed from dirt and impurities, sliced transversely, and carefully dried. As met with in this shape, it is of a pale-brown color, rather darker externally; hard, corrugated, and distinctly marked internally with concentric rings of considerable thickness. It is inodorous, with a mild, rather sweet taste, succeeded by considerable acridity. Water at 212~ F., or alcohol, extracts its medicinal qualities. The tincture made from the fresh root should be prepared with the strongest alcohol. If the dry root is used, the alcohol should be one-fifth water. The leaves should be gathered just previous to the ripen PHYTOLACCA DECANDRA. 497 ing of the berries. Dr. Pope, of Washington City, informs me that he got prompt and excellent curative effects, in diphtheria, from a tincture made from the leaves gathered late in the season. The berries must be gathered when they are fully matured; they have a disagreeable mawkish taste, with a faint degree of acrimony, and are nearly inodorous. They contain an abundance of a beautiful dark purple juice, which is the most delicate test of acids hitherto observed. An alkali turns it yellow, while an acid reinstates its purple color; but it is of a very fugitive nature, changing in a few hours, and losing its delicacy as a reactive. No mordant has yet been discovered to fix it. It appears to contain sugar, will ferment, and yield a fluid from which alcohol may be obtained. The tincture should be made by adding equal parts, by weight of the bruised. berries and strong alcohol. The following case of poisoning from eating the berries is quite suggestive: I was called in, September 25, I865, to see a boy about eight years of age who was suffering intensely from causes unknown to the parents. When I saw him he was in great agony; he complained of his stomach, saying that it was pinched together; nausea and violent vomiting. I examined the ingesta and found the seeds and skin of the berries of the Phytolacca; the ingesta was of a dark red color; he told me after he vomited that he had eaten poke-berries - " a whole lot of them." After the vomiting ceased he had severe purging; the stools were thin dark brown; severe pain in the stomach on pressure, causing him to cry out. The vomiting and purging stopped in half an hour after I saw him. lie afterwards complained of slight nausea, burning, griping pains in the umbilical region; dimness of vision; tongue coated white, and spasmodic jerkings of the arms and legs. He was put to bed, and slept well all through the night. In the morning he was as well as ever. I forgot to mention that his throat felt sore, the fauces were congested and of a dark color; dryness of the throat; the tonsils were a little swollen. Wood, in the United States Dispensatory, says: While the most prominent effects of Phytolacca appear to be produced on the stomach and bowels, the skin, the nervous system, and the urinary and genital organs of both sexes share largely in its influence. When given to animals in large doses, it produces vomiting, purging, bloody stools, perspiration, drowsiness or stupor, cough, tremors, convulsive motions, increased urination, and distention of the abdomen. As an emetic, it is slow in its operation, frequently not beginning to vomit in less than one or two hours after it has been 498 PHYTOLACCA DECANDRA. taken, and then continuing to act for a long time upon both the stomach and bowels. The vomiting produced by it is said not to be attended with much pain or spasm, but narcotic effects have been observed by some physicians, such as drowsiness, vertigo and dimness of vision. In over dose it produces excessive vomiting and purging, attended with great prostration of strength, and sometimes with convulsions. Some eclectic authorities record its effects as follows: This remedy (Phytolaccin), when taken by a healthy person, in half grain or grain doses, every two or three hours, for two or three consecutive days, produces a burning sensation in the stomach, with tenderness of the bowels, and a peculiar heat in the rectum, which is soon followed by tenesmus, mucous and bloody discharges. If continued, it produces permanent hemorrhoids, and sometimes dysentery. It will be observed from this, that the specific influence of the Phytolaccin is manifested on the mucous membrane of the stomach, bowels, and rectum, especially upon the latter, and in small and medicinal doses is a most reliable remedy for chronic affections of this portion of the alimentary canal. The sphere of action of Phytolacca includes the skin, mucous membranes, fibrous tissues (perhaps the muscular), the periosteum, and the cerebro-spinal nerve-centers. In diseases of the skin it has been quite successful in removing some severe lesions. It appears to be useful in those which resemble the manifestations of secondary syphilis. It has cured psoriasis, pityriasis, tinea capitis, lupus, and the squamous eruptions in general. In this respect it resembles Arsenicum and Mercurius, particularly the former. It resembles the latter in its power to cause, as well as cure, certain eruptions similar to the syphilitic. Dr. Searle, of New York, has found it specific for a tendency to boils, especially when they are very painful, and appear on the back and behind the ears. It is equally useful in carbuncle and malignant pustule. It has caused and cured lichen-like eruptions with great itching of the skin. It appears to produce similar lesions on the mucous surfaces, and it is eminently successful in ulcerations of that membrane in any part of the body, but particularly in the nose, throat, and rectum. One of its earliest pvpular uses, and one which has been verified by the experience of many physicians, is its curative power over affections of the fibrous tissues and the periosteum. PHYTOLACCA DECANDRA. 499 These affections are generally rheumatic or syphilitic in their nature. It not only affects the fibrous coverings of muscles, but the fibrous envelopes or sheaths of the nerves. In this respect it bears a close resemblance to Mercury, the Iodide of Potassium, and Caiisticum. In the various forms of chronic rheumatism affecting the the before-named tissues, and even the synovial, it has effected some notable cures. I have known some remarkable cures of this diseasp to be made by the domestic use of the berries macerated in whisky. Of the many cases reported in our journals, I will mention a few of the most notable. The late Dr. Kendall mentions a case of periosteal rheumatism in a young girl, who had suffered several weeks from nightly pains in the tibia, cured by a few doses of the lx. Dr. Kimball, of Sackett's Harbor, N. Y., writes: " In two cases of rheumatism of the lower inter-costal, extending to the abdominal and lumbar muscles, from exposure to cold and dampness, the Phytolacca operated like a charm, two doses of the mother tincture being sufficient. In another case, ushered in by a diarrhzea, one dose, suffered to act 24 hours, gave no relief, although it caused considerable irritation of the throat and fauces. This case was afterwards cured by Ranunculus bulb. 30th." In the Boston Quarterly, vol. i, No. 4, is a case in which the Phytolacca decandra was used by Dr. S. M. Cate, with good effect, for occasional spasms of the stomach and diaphragm for some years, and for the last six months a severe pain in the hip-joint, mostly behind the trochanter major. The pains were sharp, cutting, and drawing, and commenced at 4 or 5 o'clock in the morning, driving the patient immediately from his bed. On first rising, the leg was drawn up so that only the toe would reach the floor. Rubbing and heat would afford some slight relief, but energetic walking was the only means of rendering it endurable. After a few hours in the morning, the severe pains passed off, and only a soreness and dull pain disturbed him till the 500 PHYTOLACCA DECANDRA. next morning. The pains sometimes appeared in the middle of the tibia and fibula, and down to the great toe. Dr. O'Brien, of South Shields (England), in his mention of Phytolacca, says: " In a case of syphilitic rheumatism, with enlargement of the parotid and sub-maxillary glands, it produced prompt relief, and a rapid subsidence of the glandular tumors," also, " In a case of rheumatism of the right frontal region, accompanied by a nausea and aggravation of the pain in the morning, relief was afforded after one dose of the Phytolacca, 3d dec., dil." Dr. P. H. Hale reports the following cure of a severe case of chronic rheumatism, treated with Phytolacca. Mrs. S, aged about 40, had a severe attack of inflammatory rheumatism fifteen years ago, which ran into a chronic form, affecting the left hip-joint, which she lost the use of. Upon examination, the synovial membrane was found implicated, with considerable tumefaction from the effusion. The patient was of a scrofulous diathesis. I ascertained she had enlargement of the glands of the neck and axillae, which had existed since she was a child. There was no swelling of the limb; the pain was obtuse, heavy, aching, generally worse in damp weather. She complained of coldness of the limb, and the pain was aggravated by warmth. She was very much emaciated, and had night sweats having an acid reaction. Urine scanty most of the time, but sometimes very clear. She had not walked without assistance for fifteen years. Prognosis unfavorable; but concluded to give the Phytolacca a fair trial. Gave the tincture of the ripe berries; 30 drops, three times a day. In two weeks I saw her for the second time, and she seemed very much benefited; less pain, the tumefaction of the hip had nearly disappeared, the muscles of the thigh had relaxed, and she had greatly improved. In a few weeks, under decreasing ddses, she recovered the use of her limb. In this case the Phytolacca not only relieved the pain and PHYTOLACCA DECANDRA. 501 tumefaction, but dissipated the glandular enlargements and arrested the night sweats. In all my ten years' practice, I have never witnessed a more satisfactory cure. Dr. Neidhard finds it useful in arthritis vaga, or wandering gout; passing from one joint and place to another, with swelling and redness. He uses the 6th dilution. Dr. Cushing, of Lynn, Mass., sends me two cases: Case I.- Mrs. B., aged 45; has had rheumnatism for several years; the past year the joints of all the fingers have been badly swollen and very painful, hard and shining. Gave Phytolacca 3d, six globules (No. 4), four times a day; pains and swelling better, but complete loss of appetite; gave four globules, night and morning; appetite returned; gave four globules, four times a day; is much better and improving; general health much better. Case II.-LMr. H., aged 40, blacksmith; chronic rheumatism; severe for several months; gave Phytolacca 3d, six globules (No. 4), night and morning In ten days nearly well. Went to the war. Dr. A. R. Smart, of Hudson, Mich., writes as follows: "The sphere of Phytolacca in rheumatic affections appears to be in the fibrous tissues covering the bones and nerves. In the rheumatic irritation of the sheaths of the nerves, as in sciatic rheumatism, it is specially useful; also in periosteal rheumatism and in periostitis. A leading indication for its use in periosteal rheumatism, is the presence of a syphilitic taint, which may be supposed to originate the troubles in the osseous structures. The preparation used in the following cases illustrative of its action, was a concentrated tincture of the berries. This seems to vary in its action from the preparations of the root. I have failed in accomplishing cures with tincture of the root, and afterwards have succeeded with tincture of the berry. This difference in effect and sphere I have never noticed in any of the affections to which the Phytolacca seemed homoeopathic other than those above mentioned. Case I.-A man, aged 40, somewhat predisposed to rheumatic difficulties, presented these symptoms: He had nearly constant pain in the outer and back part of the right limb, worse at night, but never going away entirely; unable to bear any weight on the limb, or to move it without extreme pain, which he describes as dull, aching, and at times lancinating in character. The pain first came on in the hip, and from thence into the lower portion of the limb. Says he had a similar attack 14 years previous, from which he did not recover in over 502 PHYTOLACCA DECANDRA. one year. General health is very good; has tried cold friction to the limb and Iodine lotions, etc., and has used Colchicum, Cimicifuga and Arnica, without benefit; gave Phytolacca (concentrated tincture of the drug), beginning with Io drops, and gradually increasing to half a teaspoonful. After using the Phytolacca four 4ays, he reported himself better, and steadily progressed to a cure, although it was six weeks Alfore he could resume his business. Case II. —A boy IO years of age, after exposure to cold and wet, was taken with periostitis of the right femur. He was treated by a neighboring physician (allopath) for rheumatism. The" inflammation was partially subdued, and the case ran on for five months, when he came into my hands. I found the limb greatly swollen, surface red and shining; inability to stir the limb; considerable pain, more in the latter part of the day; chills occasionally, and nearly constant fever; no appetite; furred tongue. After a trial of several remedies, which seemed to fail to reach the case, I prescribed Phytolacca (same preparation as before), 20 drops every four hours, and a fomentation of the same to the limb. Under this treatment the swelling in the limb subsided, leaving some necrosis, which gradually came away, under nearly the same treatment, with the addition of some supporting medicines. Case III.-A man who had syphilis a year before, complained of pain in the arms, and always about midway between articulations, especially about the attachment of the deltoid, has suffered about a month; does not think he caught cold; can assign no reason for the difficulty. Pain is not severe, but of a dull, aching character, aggravated at night. Gave him Phytolacca, 20 drops, three times per day. Four days after he reported freedom from pain after the first day's use, and six weeks after he still continued free from difficulty. In regard to the dose given, I would say that I have repeatedly failed in deriving the advantage from doses of one to two drops, that I afterwards found, in the same cases, from the use of IO to 30 drop doses. Dilutions of the tincture of the berries I have never used. Nervous Tissue.-The Phytolacca has been known to cause convulsions in men and children. Dr. Burt's experiments on animals elicited many convulsive symptoms. According to Dr. King, it causes "a tingling and prickling sensation over the whole surface." In its pathogenesis we found many neuralgic pains, which are clearly distinguished from the myalgic. No post-mortem examinations have been made of men or animals poisoned with this plant, with sufficient accuracy to point out the peculiar pathological conditions it causes. The case of poisoning resulting in tetanus, would indicate its probable usefulness in that disease. Vascular System.-Heart, Pever, etc.-Neither of our provings contain any mention of the effects of Phytolacca upon the vascular system. I find no " fever symptoms," and but PHYTOLACCA DECANDRA. 503 one "heart symptom." " Occasional shocks of pain in the region of the heart; as soon as the pain in the heart ceases, a similar pain appears in the right arm." This is quite a valuable symptom, as it appears in some rheumatic affections, and may indicate grave cardiac disease. I find no mention of its use in any form of fever except scarlatina; it is probable, however, that a remedy of such power will be useful in some febrile diseases. It is esteemed very highly in glandular affections. In our pathogenesis we find the following symptoms: "A very peculiar tension and pressure in the parotids; hardness of a gland on the right side of the neck, suppuration of a tumor behind the right ear, with a discharge of matter and blood." Dr. Burt found the Phytolaccin to cause swelling and inflammation of the tonsils. Several homeeopathic physicians, with myself, have found it useful in swelling and induration of glands; it seems to have a specific affinity for the mammary glands. The root excites the whole glandular system, and has been highly extolled in syphilis, scrofulous and cutaneous diseases. It is said to hasten the suppurative process; it has been used with alleged success in bronchocele. The Phytolacca is an analogue of Mercury, Iodide of Potash, Baryta, Podophyllum, Arsenicum, and other similar drugs. It is strange that a vegetable remedy should be so analogous in its action to the Iodide of Potash. One symptom is quite notable —the loss of adipose tissue in birds which have eaten of the berries. Kali hydriodicum has this power of causing absorption of adipose matter in a great degree; so also both are useful in periosteal, mercurial, and so-called syphilitic rheumatism. " An inspissated juice of the leaves has been recommended in indolent ulcers, and as a remedy in cancer." According to Coe, "Phytolaccin has been much employed in the treatment of carcinomatous affections. It is undoubtedly as efficient an alterative as can be safely employed in that disease; its beneficial effects are most apparent in cases of open cancer. The patient's system should be freely brought under its constitutional influence, and the dry Phytolaccin 504 PHYTOLACCA DECANDRA. applied to the ulcer. The Phytolaccin applied either in the form of a paste with water, or in strong alcoholic solution; has been found quite effectual in that species of cancer known as lupus, when used in the early stages." Eclectic physicians advise the use of Phytolacca decandra in old, indolent and fistulous ulcers, both as an external and an internal remedy. I have found it fully equal to our best anti-psorics, in the treatment of old ulcers, even when of a syphilitic nature; in this respect it is a congener of Silicia, Lachesis, Arsenicum, Kali hydriodicum, Kali bichromicum, and Sulphur. The symptoms of the sensorium and head are worthy a close study. In rheumatic and syphilitic (possibly mercurial) affections of the cranial envelope, it will be found one of our best remedies. The Phytolacca has a large number of -symptoms of a prominent and suggestive character, relating to the eye, and affecting its various tissues; it is eminently indicated in rheumatic, catarrhal, scrofulous, mercurial and even syphilitic ophthalmia. I have used it with success in one case of rheumatic pain in and about the eye, and another of chronic conjunctivitis with granulation. In the Chicago Medical Examiner is the following mention of the curative virtues of Phytolacca in granular conjunctivitis. Although from allopathic sources, the testimony is worthy our consideration. In this cure, as in all others, the pathogenesis of the medicine proves its homceopathicity to the disease. Dr. C. S. Fenner, of Memphis, Tenn., in the N. A. Med. Chirurg. Review, January, 1857, highly extols the efficacy of the Phytolacca in preventing relapses of inflammation in granular lids. "Regarding," he says, "these exacerbations, accompanied with circumorbital pain, soreness in the periosteum and scalp, as of rheumatic origin, about two years ago I was induced to try the Poke, from its well-known efficacy in rheumatic inflammations, and the result has far exceeded my most sanguine expectations. With the aid of this remedy I have been enabled to effectually cure cases of granular PHYTOLACCA DECANDRA. 505'conjunctivitis, that, without it, would have resisted all my efforts; indeed, with me it has almost proved a specific for the exacerbations attending this complaint. Patients fully under the influence of Phytolacca often expose themselves, and take a severe cold, without affecting the eyes in the least. I use the root in the form of a simple decoction or tincture, and give it in large enough doses to produce fullness of the temples and head; I have not yet seen a severe recurrence of acute inflammation in this disease, where the patient was kept fully under the influence of the Phytolacca." An allopathic physician claims to have effected several cures of fistula lachrymalis with Phytolacca. I can not find the paper which makes mention of it in such cases, and therefore the manner in which it was used is not known to me. But, as in granular conjunctivitis, it was probably used topically and internally. I hav.e cured with Phytolacca several cases of granular disease of the lids, which had resisted the best treatment of several oculists of both schools. Give five drops of the o or lx (fresh-root tincture) four times a day, and a few drops in the eye of the following mixture: Simple syrup Sj, tinc. Phyto. 3j. In scrofulous swellings of the glands of the eyelids, it rivals Hepar sulph. It is efficacious in ulcerated sore mouth, toothache (rheumatic or neuralgic.) A well-known physician writes me: "I have made considerable use of Phytolacca in difficult dentition. Have found it to act in most cases like magic. In one very bad case (my own child), I had for a long time tried everything that promised to be of service, without any permanent relief. The following symptom, in its pathogenesis, suggested its use to me:'irresistible inclination to bite the teeth together, etc.' Its administration was followed by prompt relief. I have since used it in other cases with equal benefit. I used it in the 12th dilution." If you will consult the pathogenesis of this drug, you will 33 506 PHYTOLACCA DECANDRA. be surprised at the severity and gravity of the symptoms of the throat and fauces. They give a very good picture of diphtheria, follicular tonsilitis, ulcerated sore throat, and catarrhal pharyngitis. Since the appearance of the first edition of this work, the value of Phytolacca in diphtheria has been verified by thousands of physicians of the homceopathic school in England, Austria, Australia, Germany, and other countries, as well as our own. To Dr. Burt rightfully belongs the honor of first recommending this remedy in the treatment of diphtheria. As stated in the first edition, his recommendation was made to me during his heroic proving of the medicine. Those who undertook to sneer at the claims Dr. Burt set forth for this medicine, may well feel abashed when they see the great amount of evidence in its favor. Future generations of physicians, and innumerable patients, will remember Dr. Burt with heartfelt gratitude. The kind of diphtheria to which the Phytolacca is homceopathic is probably not that known as malignant. There is one symptom which is rarely present in the Phytolaccadiphtheria, and always present in the malignant variety, namely: the peculiar fetor of the breath. When this is present, I prefer Lachesis, Merc. cyanuret, or Merc. bin-iod. It has been alleged that Phytolacca will not cure true diphtheria. Those who have tested its value know the assertion to be untrue. True diphtheria is not always malignant. The malignant variety is usually caused by exposure to noxious gases, sewer emanations, etc., and requires the above-named remedies, together with gargles of Carbolic acid, Borax, Muriatic acid, or Baptisia. The diphtheria in which Phytolacca is indicated is generally epidemic. It usually has a catarrhal or rheumatic origin — is brought on by exposure to a cold and damp atmosphere, or sleeping in damp, ill-ventilated rooms. The symptoms partake of a rheumatico-catarrhal character. It commences with very severe pains all over the body, apparently in the bones. The soreness and pain in the limbs, PIHYTOLACCA DECANDRA. 507 back, neck and head, is very severe. There is high fever, mixed with chilliness, and accompanied by great weakness. The pain in the throat is chiefly at the root of the tongue and in the tonsils, extending to the ears. The exudation, or pseudo-membrane, is pearly-white or grayishwhite; rarely is it brown or yellow, like chamois skin (Kali bich.), or ash-colored (Lach., Lyc.), or greenish-black, (Mere.) In this estimate of the value of Phytolacca in diphtheria, I agree with Dr. Hughes, of England (" Manual of Pharmaco-dynamics "), who says: "But they (the Phytolacca cases) seem to bear to the really dangerous form of the disease much the same relation as scarlatina anginosa to scarlatina maligna." Even in the malignant variety, I believe the Phytolacca may be of service, if alternated with more powerful remedies. But in whatever kind it is given, I advise you to rely on appreciable doses, not less than 20 or 30 drops of the 1x tinc. of the fresh root in half a goblet of water; a spoonful every hour or two. Doubtless many practitioners carelessly, or ignorantly, mistake cases of ulcerative angina or folticular tonsilitis for diphtheria. A casual glance-and that is all that is often given —may disclose no difference in appearance; but a close examination of the fauces, or of the membrane under the microscope, ought to leave no doubt. Many of the cases reported as diphtheritic, doubtless belong to other conditions. Phvtolacca corresponds to the ulcerative process every where, the suppurative process, also to inflammation of glandular structures. It is therefore indicated, pathologically, in quinsy, follicular sore throat, and ulceration of the tonsils andfauces. I have seen cases of catarrhal inflammation of the head and throat which closely simulated diphtheria. On exposing the fauces, I have seen what appeared to be a large patch of diphtheritic membrane upon the posterior wall of the throat, but a close examination would prove it to be a tough, white mucus from the posterior nares, clinging tightly there. 508 PHYTOLACCA DECANDRA. Phytolacca is curative in this condition; so also is Lobelia cerulea and Bromide of Ammonia. The observations of Dr. Sherwin, of Sydney (Australia), go to prove that another species of this plant is also useful in diphtheria. He writes: Phytolacca octandra, grows in great abundance all around this city, but not indigenous. This is a most valuable plant, used either internally or externally. It is specific in diphtheria-given in decoction or infusion-applied very assiduously to the fauces as a gargle, and used hot and frequently repeated, as a poultice to the throat; all stiffness disappears; the membranaceous formation is thrown off, and is not reproduced; perspiration follows; fever subsides; all aching, general pains, and headache disappear, and the patient eagerly seeks for food. The gastro-intestinal symptoms of Phytolacca bear a close resemblance to those of Arsenic, Veratrum album, Podophyllum and Ricinus. The following cases of poisoning illustrate its toxic effects: DR. BAHRENBURG'S ACCIDENTAL PROVING.-I ate a small piece of the root, about the size of a common cherry, and also gave small portions to several of my friends. This was a little before twelve o'clock. Soon after, all who had eaten it began to vomit. The matter rejected was first of the aliment, and then a dark bilious substance, which came away with as little effort as vomiting in Asiatic cholera. Vomiting and purging continued all the afternoon, with considerable griping pains and cramps in the abdomen. The emesis took place every fifteen or twenty minutes. Toward evening we were confined to our beds, and the Whole family alarmed, thinking we would die. The extremities were cold; pulse very low; eyes deeply sunk in their orbits, and vomiting and purging still continuing. I was asked if I knew any antidote. I told them there was no danger; but toward night, as our situation became rather serious, I ordered some black coffee, and after this the vomiting ceased, but the purging continued. We all passed a restless night, with some fever, as reaction had taken place. There was considerable thirst, and the passages were without pain. The next morning all the dangerous symptoms had passed off. We felt very weak, especially in the abdomen, with little or no appetite for several days, during which time the diarrhoea continued. One of the persons, who had suffered from sick headache for several years, which occurred once a week, had none for four months, when it returned, but much modified and lighter. Another experiment had from an over-dose: " Vomiting of undigested food, and violent vomiting at intervals of ten or PHYTOLACCA DECANDRA. 509 fifteen minutes. Pain in the forehead, increased by vomiting; nausea, relieved by vomiting. Dull, bruised pain in occiput. Constant flow of salivary secretion, from mouth, throat, salivary glands, much increased, and of a thick, tenacious, ropy consistency. At twenty minutes past six o'clock, I vomited an acrid substance, which caused a feeling of scraping and excoriation in the throat. Cool perspiration, especially on the forehead and hands. Great muscular debility, lassitude, and desire to lie down.'Until seven o'clock P.M., continued acrid vomiting. Drank a glass of warm water to prevent the empty retching, which was becoming very painful. Muscular weakness increasing. Cool perspiration. Headache through the whole head, of a dull pressing character. Feeling of warmness and excoriation in the throat. All symptoms were worse on motion and in the open air, except the headache, which was better in the open air. At half-past seven o'clock drank another glass of warm water, and in ten minutes vomited again —at this time, vertigo, dizziness, and, dimness of vision began to be manifested; objects appeared dim and indistinct." These cases give a good picture. of cholera attacks. In fact the Phytolacca is ones of our best remedies in cholera mnorbus, cholera infantum, and those choleraic cases caused by bad atmospheric. conditions, and properly designated as gastro-enteric catarrh. Instead of causing copious dejections upward and downward, the Phytolacca sometimes spends all its primary force on the cerebro-spinal system. In a case of poisoning reported by Dr. Griggs: "His extremities were stiff; hands firmly shut; feet extended and toes flexed; eyes bleared and dancing; pupils contracted; lower lips drawn down; teeth clenched; lips everted and firm; muscular rigidity was general and opisthotonos established. The circulation numbered 85 beats per minute; pulse soft and unresisting; temperature nearly natural; respiration difficult and oppressed; mucous rale distinct and audible anywhere in the room. The contraction of the masseters precluded the idea of addressing reme 510 PHYTOLACCA DECANDRA. dies by the mouth, and the amount of mucus in the bronchiae that of administering anaesthetics. After an hour he had increased muscular rigidity generally, with convulsive action of the muscles of the face and neck (the chin drawn closely down to the sternum), which condition would last five or ten minutes, to be succeeded by partial relaxation, and return in twenty minutes more with the same violence." In this case the child recovered without emesis or catharsis. There was retention of urine for a day. Attacks similar to this often occur in children - as a substitute for cholera infantum. In other words, if the morbific influence which causes that disease, does not act on the gastro-intestinal canal, it strikes the cerebro-spinal system. Phytolacca has rendered good service in dysentery, hcemorrhoids, fissure of the anus, and ulceration of the rectum. It is homceopathic to albuminuria, especially after diphtheria and scarlatina, and may prove useful in morbus Brightii and other chronic renal diseases. The Phytolacca ought to prove curative in many diseases of the uterus, ovaries, testicles, and other portions of the genital organs. In my estimation the sphere of action of Phytolacca is principally upon (a) the glandular system, (b) the serous and fibrous tissues, and (c) the mucous membrane. Phytolacca has a specific effect upon the thyroid and mammary, also parotids and other glands of the throat, and by analogy ought to act powerfully upon the ovaries and glands of the cervix (also the testes). Accordingly it ought to prove curative in ovaritis, and other affections of those glands, such as neuralgia, etc.; in uterine leucorrhoea, or that variety which proceeds from the c landular portion of the cervix. Its powerful Influence over ulceration should make it curative in ulcerated os-uteri, whether of a non-specific or specific character. Finally, it should cure rheumatic affections of the uterus. The metrorrhagia and frequent menstruation mentioned above, may have proceeded from ulceration of the os; dysmenorrhcea from rheumatic irritation, and PHYTOLACCA DECANDRA. 511 the leucorrhcea may have had a glandular origin. In organic affections of the uterus, as tumors, cancer, scirrhus, ulceration, I would strongly advise the Phytolacca, internally and locally applied, and its use persevered in for some time. The action of Phytolacca on the mammary glands is specific. In No. 84, page 201, of the British Journal of Homceopathy, will be found an article from my pen, which covers this subject as much as the present state of our knowledge will permit. I would urge upon physicians to test its virtues in the various diseases of the mammae. Since the article was published, I have used it successfully in many cases of inflammation of the mammue, as well as tumors and nodosities in these glands: " It is the intention of the writer to call attention to only one particular use of this remedy, viz., in certain diseases of the mammary glands. "' The various writers on Materia Medica of the dominant and other schools not homieopathic, while they recognize its value in diseases of the glands, do not mention this particular sphere of its action. In the provings we find the following symptoms: "' Inflammation, swelling, and suppuration of the mammae.' But I am not aware that this symptom has ever been put to practical test by homoeopathists, with the exception of Dr. Hill, who recommends it in some diseases of the breast. (See Hill and Hunt's Surgery.) My experience with the drug dates back nearly fifteen years, before I had seen the proving referred to, or indeed any published statement of its value as a medicine. " When I was a student of medicine in my father's office (he was then an allopath), a neighbor had a valuable cow, which, after a clandestine confinement, was brought home from the woods with amost enormously swollen udder. It was as hard as a stone, intensely hot, painful, and sensitive, and not a particle of milk could be drawn. In much anxiety the owner came to his office and asked my father to suggest something to discuss the swelling and engorgement. A dose of Epsom salts was administered, but after twenty-four 512 PHYTOLACCA DECANDRA. hours the cow was worse than before. At this juncture an old woman of the neighborhood brought in a piece of a large, white, succulent looking root, which she called scoke, and ordered the farmer to cut a portion of it up finely and give the animal in some "bran mash." Another, the larger portion, was made into a decoction, and the cow's udder washed with it frequently. The effect was magical! In less than twelve hours the milk could be drawn, the gland. softened, and in a few days the morbid condition was removed. " This incident was nearly forgotten until a few years after, when I was engaged in practice, and was having trouble with mastitis and abscess of the breast in persons of my patients. I found the remedies laid down in our books notoriously and obstinately inefficient. In spite of Aconite and Belladonna in high and low attenuations, the inflammatory engorgement would run on to suppuration. I then tried larger doses and other remedies, among which the Kali hydriodicum was most valuable; also topical application of Belladonna, Arnica, Iodine, etc., after the manner of the dominant school, and will give them credit of preventing much suffering and deformity. But I determined on making a trial of the virtues of Phytolacca, and before I commenced its use, made inquiry among the farmers of my acquaintance, and found to my gratification that it was considered a specific in all cases of inflammation and engorgement,' caking' of the udder of cows, and even mares. "The next case of engorgement of the mammae which came under my care was an aggravated one. The woman, the mother of several children, had had' broken breasts,' with every confinement, and the cicatrices in the glands bore testimony to the truth of her assertion. About four days after delivery she had a severe chill, followed by some fever, and in a few hours both mammue were hard, swollen and painful. The child made ineffectual efforts at nursing, the nipples became very sensitive, and she was in much distress for fear of the inevitable sufferings apparently in store for her. Here was a case wherein to test the efficacy of the Phytolacca. Ten drops of the first decimal dilution were PHYTOLACCA DECANDRA. 513 administered every hour, and a lotion was prepared by adding one-half ounce of the tincture to one-half pint of water. This was applied constantly by means of folds of cotton cloth laid upon the breasts. In the course of the next twenty-four hours I had the satisfaction of finding some signs of resolution. The heat, pain, and swelling became less, and in a few days, with the aid of low diet, and careful extraction of the milk, the woman recovered with only a small abscess at the side of an old cicatrix, instead of extensive suppuration as usual. Since that time I have used it in very many cases, with the same excellent results, and it is only in the severer forms accompanied with erysipelatous inflammation, that I have had resort to Belladonna internally and externally. " But the Phytolacca is not only useful in simple and inflammatory engorgement, causing rapid suppuration, but it is valuable in those cases where suppuration is already commenced. Here it reduces the inflammation, increases the activity of the absorbents, and will often condense an apparently large abscess in the smallest dimensions. " It is often the case that neglected or ill-treated mammary abscesses degenerate into ill-conditioned, fistulous ulcers. In such cases I have seen the best effects follow the judicious use of this remedy. "Case I.- A young woman, a primipara, very corpulent, with very large mammary glands, was taken with chills and fever a few days after confinement. The family were poor, and lived a long distance in the country; no physician was called, and nothing was properly done, but very improperly the breast was poulticed for nearly two weeks, when several large abscesses opened spontaneously, and discharged enormous quantities of unhealthy pus. Six weeks afterwards she came to me for advice. The breast affected was a loathsome sight, long, pendulous, distorted, the seat of large fistulous ulcers, discharging a watery, foetid, ichorous pus; the gland was full of hard, painful nodosities, of the size of a walnut and larger. I suspended the breast by the application of long strips of adhesive plaster, placed in various directions across and around the gland, and prescribed ten drops of Phytolacca first, four times a day; also a preparation of one-half ounce of the tincture to eight ounces of distilled water, to be thrown in the fistulous canals with a small glass syringe; this treatment, together with better diet and a little wine, so much improved the case in a week, that but one small ulcer remained open; and in a fortnight the treatment was suspended. The gland will never return to its normal condition, but will probably retain its irregular shape and knotty feel. 514 PHYTOLACCA DECANDRA. "Case IT.- A woman, aged forty, applied to me to be treated for what had been declared an' open cancer' of the breast. It originated one year previously, after the birth of her seventh child, and was the result of a neglected abscess. The ulcer was an inch in diameter, gaping, angry, filled with unhealthy granulations; a probe passed obliquely downwards until it reached a hard sensitive tumor about the size of a hen's egg; the discharge was offensive and sanious. The case was treated by suspension and compression, and the use of Phytolacca as above. Cured in two weeks. "Many similar cases might be cited, but these will suffice, as they are good examples of the many cures made with this remedy. " It may be here mentioned, that the local application of this remedy is useful in cracked and excoriated nipples. It should be given at the same time internally. If the fissures are syphilitic in their origin, this remedy is still useful. I once treated a case of irritable tumor of the breast as described by Sir Astley Cooper. It had been present several years, and was very sensitive and painful, most especially at the menstrual periods; the pain extended down the arm of the affected side, and at times causing a sympathetic enlargement of a gland in the akilla. I administered Belladonna, Conium, Phosphorus, and Iodine, but without any good result, and the patient left me. A few months after, I learned, to my intense mortification, that an old woman had cured it with a plaster of the inspissated juice of the berries of the Phytolacca. Since that occurrence I have treated several cases successfully with the Phytolacca internally, giving the lowest dilution, and sometimes the mother tincture. In one case I permitted the patient to use a salve of the juice of the berries mixed with mutton tallow. This she applied constantly over the site of the tumor. Whether it hastened the cure or not I can not say, at least its application did no harm, although it seemed capable of causing some vesications on the skin. " The same old lady above mentioned had quite a reputation for curing' cancers,' and with no other application, as I was assured, than the extract of Phytolacca. I have known the finely powdered root, when applied to fungous growths, have the effect of changing such abnormal, into normal or healthy ulcers which soon healed. PHYTOLACCA DECANDRA. 515 "I have found it useful in encysted tumors; in recent indurations; and even in scirrhus of the breast; nor should I be surprised if further trials should show it to be useful in cancer of the mammae. "In those cases of irritable mammae where there is no swelling, induration, or tumor, only a painfulness at the menstrual period, I have found it specific in a few cases. The menses became more natural, and the pain in the mammae ceased. The question here arises: Why will it not *prove valuable in certain diseases of the testicles or the ovaries? When we consider the physiological relation of the ovaries to the mammae, we should incline to predict it will be found useful in many ovarian diseases." To the above article I would add, that the root is in general use among dairymen in the country, to regulate any abnormality in the milk of cows. If the milk be scanty, thick, watery, curdy (flocculent), or contains blood or pus, or becomes in any way unnatural, they give the green root, or a decoction in small quantities, and the effect upon the milk is generally favorable. This should suggest its use in abnormal conditions of the milk in women, giving it in the lower dilutions. The higher might be tried in some peculiar cases. In neuralgic affections of the breast it has been found curative. Irritable mamme'is one of the most distressing of all disorders; but the internal and external use of the Phytolacca will often give prompt relief, as it did in this case " Mrs. -, aged 22 years, second child, delicate, nervous temperament, was affected the second day after confinement with excessive flow of milk, the secretion being so profuse that it would saturate a large sized napkin every two or three hours, besides what a large healthy child nursed. "Her nipples were so sensitive that when she put the child to the breast, it produced intense suffering, seeming, as she said, to start from the nipples and radiate over the whole body, going to the back bone and streaking up and down it, causing unbearable pain. 516 PODOPHYLLUM PELTATUM. "The profuse discharge was causing great exhaustion, and she was feverish and restless, and unable to nurse." I once suggested the Phytolacca as a remedy in fatty degeneration of the heart, and fatty heart. (Birds which feed on the berries lose all their adipose tissue.) Some physicians allege that they have seen good results from this medicine in the above conditions. I believe it has relieved cardiac disorders duie to rheumatic irritation, especially when the pain is felt in the right, instead of the left arm. PODOPHYLLUM PELTATUM. Of all our indigenous remedies the Mandrake has perhaps the greatest popularity, even with allopathic physicians. With the people, and the other so-called systems, namely, the eclectics and botanics, its use can be traced back to the early history of this country. A variety termed Podophyllum montanum, by Rafinesque, grows in the South. Mandrake grows throughout the United States, in low, shady situations, flowering in May and June, maturing its fruit in September and October. The root is the officinal portion; the proper time for collecting it is in the latter part of October, or early part of November, soon after the ripening of the fruit. Thefruit possesses slightly laxative and diuretic properties, the rind and seeds being the medicinal portions. The leaves are deemed poisonous, probably possessing the same properties as the root. Podophyllin is the resin obtained from Mandrake, and is very extensively used instead of the crude root. Dr. King, the eclectic, claims to have discovered and introduced this preparation to the notice of the medical profession. It is a yellowish or yellow-brown powder, insoluble in water, oil of turpentine, diluted Nitric acid, and diluted alkalies. It is said to be composed of two resins, both of which are purgative, one is soluble in alcohol only, the other in alcohol PODOPHYLLUM PELTATUM. 517 and ether. It has no alkaline or acid reaction, but forms a saponaceous compound with the alkalies. It has a bitter, nauseous and acrid taste. From four to eight grains act as an emeto-cathartic, with griping, nausea, prostration and watery stools. From two to four grains as a drastic-cathartic, with nausea and griping; even one-half a grain often acts as an active cathartic. Medical History.-According to Rafinesque, the Cherokee Indians made great use of this plant. It was probably in use among all the Indian tribes, and by them introduced to the earls white settlers. The aborigines used the root to expel worms. "The Cherokees," says Rafinesque, " use it as a vermifuge, also drop the fresh juice of the root into the ear, as a cure for deafness. The Osage Indians consider it as a cure for poisons, by driving them through the bowels. All the tribes are fond of the fruit. The history of the medical use of this plant is mainly confined to the early botanic and later eclectic physicians. A few allopathists like Barton, Tully, Zollicoffer, and others, used'it considerably, but it never has been a favorite drug with that school. In the hands of incautious or ignorant physicians, the Podophyllum and its active principle have been productive of an immense amount of injury to the people of the West. I have treated many painful, severe, and incurable diseases of the stomach and intestines, uterus and urinary organs, which could be dated distinctly to over-dosing with this potent drug. Next to Mercury, it is capable of inflicting more injury to the human organism, when abused, then almost any other drug in common use; yet eclectics denounce Mercury in all its forms, while pouring this poison down their patients. The original proving was made by Dr. Williamson, of Philadelphia, and published in the "Transaction of the American Institute of Homceopathy, Vol. I." I shall make that the basis of this article, and add thereto the pathogenetic and clinical symptoms which have been collected since that publication. It has been used more extensively, perhaps, than any of 518 PODOPHYLLUM PELTATUM. the new remedies, and is alread.y looked upon by our school as a valuable polychrest. Eclectic physicians, and of late, many of the allopathic school, have come to look upon the Mandrake as a kind of panacea for nearly all acute diseases, and useful in almost all chronic affections. With its enthusiastic admirers it ranks with Calomel. Medical adjectives have been exhausted in describing its powers and virtues. It is said to be cathartic, emetic, alterative, anthelmintic, hydragogue, sialagogue, deobstruent, febrifuge, anti-periodic, diuretic, etc., etc. It is a fact, that like Mercury it penetrates every nook and cranny of the organism, and there is scarce an organ or tissue of the body but feels its malign influence when it is introduced into the system in toxical doses. It has been used in nearly every disease in the nomenclature, and it is said to have proved curative in those of the most opposite character. I shall try to show in my clinical remarks the real sphere of action of this medicine, and shall not only give my own opinions, but those of the best observers of all schools of medicine. Nervous System.-Podophyllum does not act specifically upon the nerves, as does Aconite or Nux vomica. In this respect it ranks with Bryonia, Aloes, and other medicines of the same class. The pains induced by the Mandrake are probably myalgic in their character. In idiopathic neuralgia, or indeed neuralgia in any form, it is of doubtful utility. Muscular System.-We have not sufficient proof, nor do we find anything in the pathogenesis which would lead us to suppose that Podophyllum acted directly upon the muscular fiber, as does Bryonia, Cimicifuga, or Helonias. To fully understand the action of Mandrake and other similarly acting and depressing drugs, one should read that instructive book, "Inman on Myalgia." I would suggest that Podophyllum causes pains, cramps and other sensations and affections of muscular tissue by (a) its irritating action upon mucous membranes, and (b) by a depressing action upon the vital power. According to Inman, all drastic purgatives may cause myalgia, and even cramps, and wasting of muscle. Viewing the action of this medicine as I do, I can not con PODOPHYLLUM PELTATUM. 519 sider it indicated in rheumatism affecting muscles or tendons. If it has been found beneficial in that disease, it has been from some indirect action, and not from any specific effect. I have known it to cause severe mylagic pains and soreness, and have found it curative in similar conditions, but never in true rheumatism. The Podophyllin has the power to cause other pains besides those referred to the bowels, stomach and other portions of the digestive tract. I have known it to cause pains in various parts of the system, but I believe them to be generally myalgic. Dr. Coe, whose testimony is sometimes valuable, says: "Podophyllin is sometimes very tardy in its operation, not acting under eighteen or twenty hours, and frequently it will operate more freely during the second twenty-four hours than during the first. In cases of chronic disorders of the liver, at others in the spleen, and other viscera, considerable pain will frequently be experienced in the diseased organs during the operation of the medicine. Sometimes the pain will be in the liver, at others in the spleen, again in the kidneys (medicinal aggravation), also in the back of the neck and head, in the pleura, intercostal muscles, etc. (myalgia); but these symptoms will subside with the operation of the medicine." He thinks those are favorable indications, "showing that the remedy is at work arousing the dormant energies of the system. It is not necessary, however, to cause these pains. Mucous Tissues. In its action on mucous membrane it ranks with Mercurius, Iris versicolor, Veratrum album, and other drastic cathartics. It is powerfully irritant to this tissue, especially those of the digestive tract. It is not directly specific in its action upon the mucous membrane of the respiratory and urinary passages. It will, however, irritate and inflame any mucous surface when brought in contact with it, sometimes acting as a powerful escharotic. Of its power to cause inflammation of any and all portions of the mucous membrane, from the. mouth to the anus, there can be no doubt. Such effects have been too often observed in practice, by all physicians who have had an opportunity to notice its action when administered in material doses. It 520 PODOPHYLLUM PELTATUM. even causes ulceration of this tissue, and may be said to act, as Dr. Freligh asserts of Mercury —" as a solvent of the living solids," but not to the extent of the former poison. Podophyllum is homeeopathic to enteritis, gastritis, etc., and even to bronchitis and urethritis, under certain circumstances, which will be noticed under appropriate headings. Serous Tissues.-It is said to affect, by its "alterative action," the serous membranes of the body, and prove curative in pleuritis, peritonitis, synovitis, and even meningitis; but its action in this direction is not, in my opinion, specific or direct, as is the case with Bryonia. Glandular System.-It is here that Podophyllum is a close analogue of Mercury, Iodine, Iris versicolor, etc. When taken up into the circulation, it is eliminated by the glands, and is thus rendered capable of causing irritation, inflammation, and even suppuration of almost any glandular organ or structure. But it can not be termed a "glandular remedy " in the same sense that we estimate Iodine, Baryta, and Phytolacca. The glands principally affected by Podophyllum are the liver, salivary and gastric glands, and perhaps the ovaries. The mammary, lymphatic, thyroid and mesenteric do not appear to be under its direct influence. Fever.-By referring to the Symnptomatology,Vol. I, you will see that a large number of febrile symptoms are arranged under that head, but the compilers of the original pathogenesis did not designate the purely pathogenetic, or separate them from the curative. Dr. Williamson observes that Podophyllum is indicated in quotidian, tertain, and quartan organs, and for " periodical diseases" generally. The practitioner, however, must not expect too much of this remedy in intermittents. It can not be ranked with Nux vomica, China, Quinia, Cornus Cedron, or any of the " anti-periodic " group of medicines which act curatively by virtue or that power, but rather with Mercurius, Leptandra, Iris versicolor, etc., which act as curative agents in intermittent fevers, by another power, namely, of correcting the condition of particular organs, as the liver, PODOPHYLLUM PELTATUM. 521 and thus removing the obstacles to a recovery. In my practice, which was at one time extensive in a district cursed with ague, I had ample opportunity to observe the action of Podophyllum in this disease. I never found it of benefit unless the hepatic, intestinal, and gastric symptoms corresponded with those of the drug; when given for the symptoms of the fever alone, enumerated above, it was not curative. In fact it would remove all the other symptoms, and the paroxysms of fever would still occur in a modified form. But if alternated with Ipecac., China, Quinia, Cornuus, or Nux vomica (in quotidian), Arsenicum, Cedron, or Nat. mur. (in tertian), the cure would be prompt and permanent. Those who are opposed to alternation of remedies can use the Podophyllum first, and the remedy afterwards. As the testimony of eclectic physicians may be interesting on this point, I will quote: " In bilious fevers, either remittent or intermittent, it not unfrequently arrests the disease, at the first prescription, if given in the proper manner, or it so far modifies the attack that the case becomes mild amd manageable." -(King.) Morrow makes the same statement, but says it is only indicated when there is evident hepatic torpor or congestion. "During the early stages of most febrile diseases, particularly intermittent and bilious remittent fevers, Podophyllin is an agent of superior efficacy. A single dose often arrests the severest attacks of fever."-(Jones and Scudder.) "In the treatment of fever and ague, we almost invariably precede the employment of the other remedies by the free exhibition of Podophyllin. By so doing, in this climate, we cut the disease short at once, and oftentimes have no occasion for further medication. We have known many cases of intermittent fever yield to a single dose of the Podophyllin, and we have no doubt but the credit of the cure is frequently due to this agent, where it is attributed to other means."-(Dr. Coe.) The above embodies the general estimate of the eclectic school, as regards the value of this medicinein agues. No writer pretends that it has any a6tual anti-periodic power. It has been noticed in many of our provings that certain febrile and even painful symptoms 34 522 PODOPHYLLUM PELTATUM. were decidedly aggravated, or had a tendency to recur at certain hours in the day, or alternate days. This peculiarity renders a drug an " anti-periodic." In the proving of Podophyllum, we find that certain febrile and other symptoms tend to occur in the morning, but this I consider rather an indication of its remittent action. Future experiments will decide. In biliousfever, this medicine is an excellent hoinceopathic remedy. No other drug so often corresponds with the symptoms, particularly when there is much intestinal irritation. It is admirably indicated in the various forms of remittent fever which in the West are considered "bilious " in character. The febrile symptoms are quite strongly marked, and may afford some data for the selection of this drug, but we should be guided principally by the general symptoms. As above stated, eclectic physicians, and of late many allopathic, are enthusiastic believers in the power of Podophyllum, when given at the outset of nearly all fevers, in cathartic doses, of arresting or " breaking up " such attacks. But I need not acquaint the homceopathic physician that such practice is sometimes fraught with the most deplorable consequences. When the patient is strong and robust, the vitality of the organism may rally from its depressing action, or medicinal aggravation of the malady; but if such reaction does not take place, the fever, which may have been mild in its character, is changed to a serious and intractable one. The intestinal irritation which the Podophyllin sets up, will go on and withstand all the rude means of the eclectic to arrest it. In this way I have known simple remittents changed into enteric or typhoid fever. In irritative fever, and infantile remittent, no remedy will give better satisfaction, not even Mercurius. But it should be used with caution in all fevers accompanied or caused by intestinal or gastric irritation. In these cases it is primarily homceopathic, and should be used in the fourth and sixth dec. dil.; but should symptoms denote inactivity of the liver and glandular system of the intestines, and constipation with jaundice exist, then the second or third dec. trit. may be used safely. PODOPHYLLUM PELTATUM. 523 In typhoid and typhus fevers (enteric), the Podophyllum is often indicated. It is quite as homeopathic to the irritation, inflammation, and even ulceration of Peyer's glands, as Mercurius and Arsenicum; but it is not so well indicated by the general symptoms, namely: the condition of the blood, etc., as Baptisia, Phosphoric and Muriatic acids, or even Leptandra or Iris. Dr. Hill (Epitome), says Podophyllin is the best remedy for the diarrhoea of typhoids. But homceopathists can accept no such wholesale assertion. If the diarrhoea, in a case of typhoid, corresponds to the Podophyllum-diarrhcea, then, and only then, is it a specific remedy. The best writers in the eclectic school are aware of the danger of giving large doses of Podophyllin in typhoid and other low fevers, and all are particular to warn the physician not to use it when there is much prostration or intestinal irritation existing. Notwithstanding this, the physicians of that and the old school, are generally so ignorant of disease, and so reckless of consequences, as to give this powerful drug in typhoid fever. The consequences are, that few patients under that treatment have vitality to resist the toxical effects of the drug and the disease. If Podophyllin is prescribed in true enteric (or typhoid) fever, it should be only the middle and higher potencies-the tenth and upwards. The Podophyllum may be used lower, in the third or sixth. These general remarks, I deem sufficient to point out the applicability of the remedy in the various forms of fever. They will serve to guide the practitioner in the selection of the drug by the special symptoms. Even the exanthematous fevers form no exception. The action of Podophyllum on the skin has never been fully investigated. Although eclectics claim to cure some chronic eruptive diseases with it, I doubt if it has any specific action on that tissue. The provings do not show any irritation of the skin, nor have I ever observed any skin symptoms arise from its internal use. The topical application will cause redness, vesication, and pustulation, but I do not consider this effect as specific. The gastro-intestinal and hepatic symptoms and pathologi 524 PODOPHYLLUM PELTATUM. cal conditions caused by Podophyllum are of more importance to us than any other. Its effects on all these tissues is the foundation and origin of nearly all the symptoms belonging to the drug. Beginning with the buccal cavity, we find the following symptom: Copious salivation; *offensive odor from the mouth; *offensiveness of the breath at night-perceptible to the patient; taste of fried liver in his mouth at night; souriiess of the mouth and tongue on waking in the morning; white fur on the tongue with foul taste; putrid taste in the mouth. Dr.Williamson contributes the curative symptoms marked with a star. The effect of the Podophyllum upon the mouth is quite specific and noteworthy. All writers agree that it will cause symptoms like salivation. I have known it to cause severe ptyalism in numerous cases, when abused by eclectic physicians. Even in the 3d trit. this effect is quite noticeable in persons who are subject to stomatitis, or have been mercurialized. Dr. Coe says: "It has been said that Podophyllin is capable of producing ptyalism, but we have never seen any evidence of the fact in persons who had never taken mercury. The only symptoms of salivation we have ever observed have been in those cases where mercury has been taken at some previous time. Podophyllin is powerfully resolvent, and by its peculiar excitation of the glandular system will sometimes dislodge deposits of latent mercurial atoms, and so bring about a season of mercurialization. Lobelia, Irisin and Phytolaccin will frequently do the. same." This is a species of special pleading, often resorted to by eclectic practitioners, but it is untenable. If these drugs will cause ptyalism when Mercury is in the glands, it will cause the same symptoms when Mercury is not present. The only difference will be that the presence of Mercury renders the glands more susceptible to the action of these agents. Podophyllin is homceopathic to ptyalism, even mercurial; to stomatitis and many inflammatory affections of the gums and buccal mucous membrane. It has been found PODOPHYLLUM PELTATUM. 525 curative in "nursing sore mouth," "canker in the mouth." I have cured with the dilutions, used as a wash, a case of chronic inflammation of the tongue, which was red, dry, cracked and often bleeding, and somewhat swollen. It seemed idiopathic, as no gastric derangement was noticeable. The throat symptoms imply a greater degree of inflammation, namely: Sore throat, commencing on the right side and then going to the left; soreness of the left side of the throat, especially painful when swallowing liquids, and worse in the morning; dryness of the throat; soreness of the throat extending to the ears; *rattling of mucus in the throat; *goitre; *sore throat, commencing on the right side and going to the left. The three curative symptoms are contributed by Dr. Williamson. The first is due to the irritant action of the Mandrake upon the tonsils and mucous follicles of the throat. This medicine has made undoubted cures of goitre in the hands of homceopathic as well as eclectic physicians. The testimony on this point seems conclusive, but I can not say that I have ever seen much benefit from its use in my hands, at least no such decided effects as follow the use of Iodine, Bromine, and their salts, even in minute doses. Nor have I found it of much value in tonsillitis, in which it is inferior to Phytolacca or Baryta carbonica. The effects of Podophyllum on the stomach and bowels are now quite well understood. By referring to the symptomatology of this remedy, you will see that I have attempted to arrange the symptoms into primary and secondary. They begin with a lax state of the bowels; then follows soft, mushy diarrhoea, then watery and slimy, and finally mucous and bloody with tenesmus. After these primary conditions we get the secondary, namely: constipation, piles, prolapsus recti, etc. With the primary symptoms we get a great many concomitant or reflex symptoms, which can only be learned by a careful study of the pathogenesis. One instance will suffice, namely: the reflex brain-symptoms, which occur during the primary intestinal irritation. 526 PODOPHYLLUM PELTATUM. In adults we find headache, vertigo, and confusion of mind. In children, owing to the sensitive condition of the brain, we get actual cerebral irritation manifested by rolling of the head and grinding of the teeth, with moaning. The head is not primarily affected, but cases of actual cerebral irritation have been cured by Podophyllin in the middle and higher attenuations. I quote Dr. S. Ringer's observations on this drug. (See Ringer's Therapeutics. "The action of Podophyllum on the gastro-intestinal and hepatic system has been thoroughly investigated by Dr. Anstie, who has studied the action of Podophyllin on dogs and cats, and has found that in from two to ten hours after the injection of an alcoholic solution into the peritoneal cavity, and after the effects of the alcohol had ceased, Podophyllin excited vomiting and almost incessant diarrhcea. " Dr. Anstie does not usually describe the character of the stools; but in one experiment he states that they consisted of glairy mucus, and in two other experiments the stools were highly colored with what looked like blile.'In many of the experiments the stools contained blood. The animals suffered great pain, and soon became exhausted. " At the post-mortem examination, the cesophagus was healthy, but the stomach somewhat congested-induced, as Dr. Anstie suggests, by the violent efforts of vomiting. The small intestines, especially at the lower part of the duodenumn, were intensely congested, and in some instances the lower part of the duodenum was extensively ulcerated. The large intestines were but slightly inflamed. Although the injections were poured into the abdominal cavity, the peritoneum itself was not at all inflamed, not even around some unabsorbed granules of podophyllin. The contents of the intestines were liquid. In all the instances in which the effect of the medicine on the heart and respiration is mentioned, respiration ceased before the heart stopped. " From these experiments it was evident that Podophyllin has an especial affinity for the small intestines, and chiefly for the duodenum. " The results of these experiments, and the fact Podophyllin produced no apparent change in the liver, led Dr. Anstie to conclude that it is not a cholagogue. The Edinburgh committee carefully investigated the action of Podophyllin on healthy dogs. The reporter, Dr. Hughes Bennet, states PODOPHYLLUM PELTATUM. 527 that doses of Podophyllin, varying from two to eight grains, diminished the solid constituents of the bile, whether they produced purgation or not, and that doses which produced purgation lessened both the fluid and solid constituents of the bile. " But, assuming that Podophyllin is incapable of increasing the secretion of bile in health, it by no means follows that in this respect it is inoperative in disease. It is quite conceivable that Podophyllin and other remedies may remove certain morbid conditions of the liver which arrested the secretion of bile, and so act indirectly but efficaciously as cholagogues; and surely it is far better to promote the secretion of bile by restoring the liver to health, than to give a drug (if such exist) to compel a diseased liver to secrete. In the one case we remove the hindrance to the secretion of the bile; in the other, if it is possible, we compel the secretion in spite of this obstacle. " The experience of those who have largely used this drug is strongly in favor of its possessing cholagogue properties; and the author's experience leads him to a like conclusion. "For instance, its effects are very marked on the motions of children, with the following symptoms: During the early months of life, and especially after a previous attack of diarrhoea, obstinate constipation may occur, with very hard motions, crumbling when broken, and of a clay color, often mottled with green. Sometimes the passage of the hard stools through the sphincter of the rectum occasions great pain, causing the child to scream at each evacuation. At the same time there may be much flatulent distension of the belly, which excites frequent colic; this, in its turn, making the child cry, often without cessation. The morbid condition of the motions is frequently observed in children of one or two months old, who are fed instead of suckled. The author knows nothing so effectual in bringing back the proper consistence and yellow color to the motions, as podophyllin. A grain of the resin should be dissolved in a drachm of alcohol, and of this solution one or two drops are given to the child on a lump of sugar, twice or three times in the day. The quantity administered must be regulated by the obstinacy of the bowels, which should be kept open once or twice a day. Under this treatment the motions often immediately become natural, the flatulent distension of the bdlly gives way, and the child quickly improves. The restoration of the color to the motions is probably owing to the increased secretion of bile by the action of the Podophyllin. 528 PODOPHYLLUM PELTATUM. " That disagreeable cankery taste, unconnected with excess in alcoholic drinks, generally occurring only in the morning, but sometimes continuing in a less degree all day, gives way usually to Podophyllin; and if it fail, Mercury generally answers. It is true that this symptom, when due to constipation, is removable by many purgatives, but Podophyllin and Mercury answer best. " Small doses of Podophyllin are highly useful in some forms of chronic diarrhoea. Thus a diarrhiea with highly colored motions, with cutting pains, is generally relieved by small doses of Podophyllin, the bowels becoming regular, and the pain speedily subsiding, This medicine is especially indicated if this form of diarrhcea occurs in the early morning, compelling the patient to leave his bed several times, but improving after breakfast, or by the middle of the day; or sometimes diarrhcea does not occur after breakfast, but returns early next morning. Indeed, Podophyllin will generally cure this morning diarrhoea, even if the motions are pale and watery. By means of Podophyllin the author has cured chronic diarrhoea of watery, pale, frothy motions, with severe cutting pain, even when the diarrhcea has lasted for many years. Two or three minims of a solution containing a grain of Podophyllin, in two drachms of rectified spirit, should be given three or four times a day. " Podophyllin is very useful in some forms of sick headache. The nature and the order of the symptoms differ greatly in different cases of sick headache. Some, for instance, are accompanied by constipation, others by diarrhoea, and in each of these kinds the stools may be either too light or too dark in color. There are, besides, many other varieties of sick headache. Wl ere the headache is preceded, accompanied or followed by a dark colored, bilious diarrhcea, Podophyllin generally does good. Two or three minim doses of the solution just mentioned, given three times a day, will restrain the diarrhcea, lighten the color of the motions, and, if the medicine is persevered with, either prevent the attacks, or considerably prolong the intervals. When the diarrhcea is of a light color, and the motions evidently contain too little bile, it is considerably benefited by a hundredth part of a grain of Bi-chloride of Mercury, given three times a day. Again, when the headache is accompanied by constipation, and the motions are of a dark bilious character, a free Podophyllin purge every day, or alternate day, is very useful. Even in those nervous headaches occurring either just before, at or directly after the menstrual period, if associ PODOPIIYLLUM PELTATUM. 529 ated with constipation and dark colored stools, purgative doses of Podophyllin often give relief. "I know that it is now generally held, and on conclusive evidence, that in sick headaches, or as they are often termed, nervous headaches, megraine, hemicrania, the origin of mischief, is situated in some part of the central nervous system, and it is asked, therefore: Of what use is it to give medicine to act on the stomach, liver, or intestines? " It is further urged, that when sickness, diarrhoea, or constipation accompany or follow the headache, they are the result and not the cause of the attack. Granted that the central nervous system is the seat of the complaint, yet it is excited in various ways in various people, one cause producing an attack in one person, but failing to excite one in others. Thus a single or several articles of diet will with some surely bring on an attack. In some persons the fit is preceded by diarrhcea, bilious or pale; in others, by constipation; again in others, it is clearly traceable to uterine derangement. It is true that even in anyr of these cases certain circumstances, common to all, will precipitate an attack - as fatigue, over-excitement, or nervous exhaustion. Yet these patients, in many of their attacks, experience, almost unfailingly, warning by symptoms due sometimes to the stomach, or the bowels, or the womb. It appears therefore to me that the treatment of this disease must be of three kinds. One treatment should be directed to the removal of the affection of the nervous system; another, by the prevention of the exciting cause; and lastly, a third treatment to the subdual of an attack, as, for instance, by means of applications to the seat of pain, and also, as I believe, by means of medicines which act on the stomach, liver, intestines, or womb. "' Experience certainly leads me to hold firmly that the foregoing directions, with respect to treatment, are correct; that where the attacks are preceded by hepatic or intestinal disturbances, Podophyllin or Mercury are very useful agents; nay, I am inclined to believe that they are serviceable even when the symptoms only accompany the pain, and are probably the result, and not the cause, of the attack. Although it may be urged that it is folly to treat the effects in order to remove the cause, still, as we have seen in the section treating of counter-irritants, that local applications to the seat of pain appear to control the central nervous disease, there is no reason why the remedies which affect the terminations of the other affected nerve, namely: the vagus, should not also be able to modify the central affection. 530 PODOPHYLLUM PELTATUM. "Some American physicians go so far as to say that this drug fulfills all the indications of Mercury. In America it is called vegetable Mercury. "The injection of Podophyllin under the skin has been recommended. It is readily soluble in equal parts of liquor potassae and water; and if the drug is pure, this solution is not precipitated by the addition of water. The injection of this solution to the extent of one-third to one-tenth of a grain, quickly purges- sooner, it is said, than when given by the stomach - and causes no pain. " Podophyllin is a rather uncertain purgative. The pure drug causes very little griping. In too large doses it is very apt to produce slimy and bloody stools, particularly in children. Dr. Anstie's estimate of the curative powers of Podophyllin does not differ greatly from those of an eminent English homceopathist, Dr. John Moore, of Liverpool, whose observations I shall quote. I think Dr. Moore is a little too sanguine as to the permanent good results from material doses of the drug, but as he is undoubtedly judicious and cautious in its administration, no bad results may attend its use in his hands. In the practice of less careful and observant physicians its free use in all cases might be followed by secondary symptoms of an unpleasant character. Dr. Moore has doubtless hit the chief pathological keynote of the hepatic action of this powerful drug. He says: "Lactic acid is an effectual antidote to its effects. Fifteen grains. have been given, and immediately afterwards a draught of sour milk, and the effect of it has been nil. Sugar antidotes it somewhat; salt increases its action; acetic acid does not affect it. " In gout it is useful after acute symptoms have subsided, or in cases where the attack is preceded by premonitory symptoms it is indicated at once. It will ward off an impending attack of gout. It had good effects in jaundice, when it had returned again and again, after China and Mercurius. The following inferences are drawn from the facts related: " First. That it is a very active and penetrating medicine, resembling Calomel in its specific action on the liver and glandular system, but beyond that the similarity ceases. " Second. That its direct sphere of action is on the entire 532 PODOPHYLLUM PELTATUM. deubtedly myalgic. The curative symptoms of fullness, etc., have been so often verified by Dr. Williamson and others of our school, that we may safely say that it indicates hepatitis, or congestion of the liver. The "chronic hepatitis with costiveness," is also a valuable observation. It is not necessary, however, that constipation should be present; it is as useful when that disease is attended with diarrhoea, or the two states alternately. From many years' experience with, and observation of, the use of Podophyllin in diseases of the liver, I feel qualified to venture the following observation relative to its pathogenetic and curative action upon that organ. I believe the Podophyllum and its active principle to be a direct stimulant of the liver. I am aware that some of the most astute investigators of the allonathic school deny that Mercury has any direct or specific action on that organ. They would probably allege the same of the Mandrake, but there are certain reasons, which I shall give farther on, why I consider the arguments against Mercury not valid in the case of Podophyllum. The primary action of Podophyllum in large doses, is generally to cause vomiting and diarrhcea of undoubted bilious matters. I have examined the evacuations caused by Podophyllin, in cases of jaundice, which before its administration were completely free from bile, and found that the green color was actually due to that secretion. The examination was made with the most approved chemical tests. The patient felt the action of the drug upon the liver, before it nauseated or caused any intestinal irritation. (The dose was one-fourth of a grain of the pure resirfoid, triturated with ten of sugar of milk.) In still smaller doses, third trituration, it will cause bile to appear in the previously clay-colored stools. I consider this medicine therefore primarily homceopathic to acute irritation, congestion and inflammation of the liver, bilious diarrhcea, and hepatic pains. A further proving is needed to give special indications. The powerfully irritating effect which this drug has upon the secretory functions of the liver, enables it to cause such excessive action as may pass over into passive congestion, chronic inflammation, PODOPHYLLUM PELTATUM. 533 suspension of function from exhaustion, suspension of biliary secretion, and even retention of that fluid. Podophyllum. has been abused in the hands of eclectics as badly as Mercury in the allopathic school. I have known it to cause chronic hepatic diseases, as jaundice, enlargement, and even some organic affections. There is scarcely an acute or chronic disease of this important viscus, in which this medicine may not, in some of its stages, be found useful. A careful study of our proving, together with the observations of physicians of both schools, will give us much information as to its sphere of action. The dose in hepatic diseases is a matter of great importance. I believe an adherence to the following rules will give the physician greater success with the medicine than he could obtain without them: (1.) For the primary (acute) conditions, similar to those caused by large doses of Podophyllum, give the highest and middle attenuations. (The third or eighteenth of Podophyllum, and sixth or thirtieth of Podophyllin.) (2.) For symptoms and conditions (chronic) simulating the secondary effects, give the lower attenuations, and in rare cases even the one-tenth of the resinoid. (3.) In a few cases, as in retention of the bile from obstruction of the gall duct, or in cases of gallstones, we must have the direct mechanical effects of Podophyllum. In such cases crude doses are required. This is best illustrated by the following case of " Expulsion of Gallstones," reported by me to the "North American Journal of Homceopathy," vol. xii, p. 258: "In vol. vii, p. 304, of this journal, my industrious colleague, Dr. Marcy, made mention of'an empirical remedy for gall-stones,' and says:' For the violent spasmodic pains which accompany their passage to the intestines, we have found the following treatment, derived from an empirical source, eminently efficacious: As soon as the pains have declared themselves, we give the patient six ounces of tepid Olive-oil, and then prescribe Nux vomica and Aconite in alternation every half hour. We also apply hot water fomentations, and occasionally a warm bath, when the par PODOPHYLLUM PELTATUM. 530 about half the time, to get relief from the intense spasmodic pain; urine more scanty, and of a deeper color; slimy, white diarrhoea, not a trace of bile in the discharges; vomiting of mucus; no bile had been vomited for several weeks. I ordered a hot bath. In the attempt to take it, a very severe chill set in, with fainting; this was followed by some fever. In the evening she became stupid, would not answer questions, and I feared she would go into coma. Dr. Coe gives the following treatment for gall-stones:' He gives at bedtime a powder composed of Podophyllin, grs. ij., Euphorbin, grs. j., Caulophyllin, grs. ij. The next morning,'as soon as the nausea attending the operation of the powder has subsided, administer eight ounces of pure Olive-oil.''We have known,' he asserts,'as many as two hundred of these concretions, varying in size from that of a small pea to that of a hazel-nut, to be passed after the administration of a single dose of Podophyllin and the oil.' My patient was rapidly sinking, and I knew that if the obstruction was not soon removed, the blood would become irretrievably poisoned with bile. I did not deem it necessary to follow Coe's practice. Podophyllin is the real agent which dislodges the concretions from the duct. This it does, I believe, by increasing the expulsive power or peristalic action, so to speak, of the gall-bladder and its duct. The Olive-oil may aid in relaxing and dilating the duct, and it carries the concretions through the bowels, after they have been expelled. I accordingly gave one grain of Podophyllin in the evening; she was allowed Chloroform during the night. In the morning she swallowed three ounces of Olive-oil at 6 o'clock. At 9 o'clock she vomited bile; at noon she had a free evacuation from the bowels, of a bilious appearance. At 3 P.M., another bilious stool, and with it a discharge of several gall-stones — they fell into the vessel with a metallic sound - as the nurse informed me. All pain ceased about the time she vomited, and did not return. The concretions were round, about the size of a cherry, rough externally, yellowish, and when broken in two, showed a radiating appearance from a common center. No account was kept of 536 PODOPHYLLUM PELTATUM. the number passed, as the nurse was somewhat negligent, and failed to collect them. In a few days, under the use of Aconite and Nux vomica, the jaundice had nearly disappeared; her appetite returned, and in two weeks she was able to ride into the country, and has since enjoyed good health. " In the words of Dr. Marcy, I assert' that this affords an example where the consistent homceopathist is justified in employing a chemical and purgative agent to rid the system of foreign substances, which nature is struggling to throw off. It is not disease which we are to remove; not a therapeutic agent which we' are to administer.' I recognize three methods of restoring health: viz., the chemical, the mechanical, and the homceopathic. By the first we can remove an irritating cause of disease, as by the use of Nitric acid in Oxalic acid urine; by the second we can expel a biliary calculus with Podophyllin and Olive-oil; and by the last - the only law of cure -we remove, with Aconite and Nux., the hepatic inflammation consequent upon the passages of the stones. I maintain that my treatment was as rational and scientific as that of the surgeon who removes the spiculae of bone or the musket-ball, and then uses his specific remedies, with his surgical appliances. "It is amazing to witness the vast confidence which the eclectic physicians have in Podophyllin in nearly every disease of the liver. They use it almost indiscriminately, in the most opposite states and conditions, and functional organic affections of that organ. I have not space to quote their observations and praises, but would refer the reader to their works on Practice and Materia Medica. In congestion of the portal circle, this medicine appears to have an immense curative power, in which it is only equalled by Mercury, Chelidonium and Leptandra. In diseases of the spleen the Podophyllum has been found useful. It may be tried in acute inflammation, or chronic enlargement." In jaundice, from a catarrhal affection of the gall-ducts, it does not equal Chelidonium or Carduus. In jaundice, from failure of the hepatic cells to perform their functions, it is PODOPHYLLUM PELTATUM. 537 more suitable, but may have to be aided by Myrica, Leptandra or Mercurius. The primary diarrhoea, caused by Podophyllum, I have already described. Dr. Bell, in his monograph, has admirably given the characteristic indications. There are only two forms of diarrhoea in which this medicine is secondarily indicated. I allude to that form which is accompanied by complete jaundice, and in which the evacuations are clay-colored and very offensive; and the diarrhoea which alternates with constipation, in some chronic hepatic disorders. In these varieties it will be found necessary to use the lower dilutions and triturations, while in the former affections the middle and the highest potencies will act curatively. Dr. Jeanes has cured many cases of relaxed bowels, when the stools were too frequent but natural, with the highest attenuations of this remedy. Acute and chronic colitis is a disease which calls for the Podophyllum. The symptoms of the drug and disease bear a remarkable resemblance, as a comparison will show. Dysentery is one of the diseases in which this medicine has been found most useful. An abuse of this drug, and even its moderate and careful use, in some cases, is sure to bring symptoms of acute dysentery. It is useful in chronic or acute dysentery, and in many cases will be found more beneficial in all the stages than any other agent. One feature of the Podophyllum-dysentery, is the almost invariable presence of prolapsus ani, or a tendency thereto. I once attended two children, aged respectively three and six years, who had been dosed with Podophyllin by an eclectic. Dysentery was present in both patients, and also prolapsus recti. The mucous membrane of the rectum. was red, inflamed and exquisitively sensitive. Drs. Jeanes and Williamson noticed similar pathogenetic effects. I cured the children with Nux and Nitric acid. Many cases of prolapsus recti have been cured with Podophyllin, even when of six years' standing, and accompanied all that time with diarrhcea. Dr. Gatchell gives the indications for this remedy in dysentery, " commencing with a watery diarrheea, terminates in a 35 538 PODOPHYLLUM PELTATUM. muco-sanguineous dysentery, accompanied with sickness at the stomach. If the diarrhoea, which preceded the dysentery, especially manifested itself early in the morning, the case will be more appropriate." He advises six drops of the tincture in six ounces of water, a teaspoonful at a dose; which is to be repeated after each stool, until improvement commences. This prescription will cure many cases of dysentery. This remedy is chiefly indicated in the so-called bilious dysentery, in which the stools look like pea-soup, and consist of a yellowish, greenish, or bloody mucus, having a disagreeable odor, and accompanied with violent pains in the region of the colon, rectum and anus; it causes and aggravates huemorrhoids and severe tenesmus, with prolapsus ani, especially in children; sometimes nausea and vomiting go with the above symptoms. The active principle or Podophyllin, at the 3d trituration, is often more effectual and prompt in its action than the tincture. Altogether, it is one of the best remedies we possess for the cure of dysentery, enteritis, and many other inflammatory diseases of the intestinal tact. Cholera morbus is sometimes treated very successfully by the use of Podophyllum. It causes, in large doses, similar watery, flocculent discharges, very profuse and exhausting, accompanied with cramps in the abdominal and flexor muscles of the extremities. In this respect it is the analogue of Elaterium, Jatropha, Euphorbia cor., Arsenic, and Veratrum. Asiatic cholera, in some of its phases, ought to find a specific remedy in this medicine. So abundant are the alvine evacuations of serum caused by Mandrake, that eclectics use it as a hydrogogue cathartic in cases of dropsy. In cholera infantum it was found by rs. Jeanes and Williamson to be eminently useful. I have used it in a good many cases of this disorder, as well as in diarrhoea from teething, and nearly every intestinal disease to which children are subject, and have found it as useful as Mercury, Chamomilla, or Pulsatilla. In the bowel complaints of children, the practical physician is cognizant of the colic with spasmodic retraction of the abdominal muscles, the spasmodic tenesmus, PODOPHYLLUM PELTATUM. 539 and tending to prolapsus ani; all strong indications for this medicine. Hcemorrhoidal affections are admirably under the control of Podophyllum. The specific affinity which this drug has for the liver, portal system, and rectum, as shown in the pathogenesis, enables it to cause hemorrhoids from portal congestion; chronic hepatic affections; and primary irritation, congestion, and even inflammation of the veins and mucous membrane of the rectum. It will be found useful in external piles —for those which bleed and those which do not. The sensations it causes in the rectum, anus, and hmmorrhoidal tumors are similar to the effects of Aloes, of which it is a oongener. Dr. Richard Hughes says: "' My experience with this drug is limited to its action on the alimentary canal and its associated viscera. There is one form of that very vague affection known as' biliousness,' in which it is very useful. This is characterized by sickness and giddiness, bitter taste and rising, tendency to bilious vomiting and purging, and dark urine. Podophyllin, firom the first to the third irritation, has generally, in my hands, rapidly removed these symptoms. On the other hand, when biliousness means dull pain in the right hypochondrium, pale and costive motions, loss of appetite, and depression of spirits, it will resist Podophyllum, and yield pretty quickly to the third decimal trituration of Mercurius solubilis. I can not, therefore, agree to the generalization which styles Podophyllum' the vegetable Mercury.' " What is the precise natur6 of the physiological action of Podophyllum upon the biliary apparatus seems to be very doubtful. It is certain, however, that it exerts a specific action of an irritant nature upon the mucous membrane, especially upon that of the small intestine and the rectum. Our provings are confirmed in this particular by the experiments of Dr. Anstie on animals, recorded in the Medical Times and Gazette, for 1862. I have found it act well in a case of chronic duodenitis. In inflammatory irritation of the jejunum and ileum, it is invaluable, for I know of no other potent drug which affects, specifically, this part of the alimentary canal. The influence of Arsenic and Kali bichromicum becomes weaker as the duodenum is passed, to be renewed in the case of the latter at the colon, with the 540 PODOPHYLLUM PELTATUM. former hardly till we reach the. rectum. Mercurius corrosivus affects the large intestine only. Podophyllum might be cautiously tried in the enteric lesion of typhoid fever, with which it has at least a local affinity. The same reason which makes it so valuable in affections of the small intestine, renders it unsuitable in ordinary dysentery, which has its seat in the colon. In cases, however, where a dysenteric diarrhoea appears to depend upon inflammatory irritation of the rectum, Podophyllum will give rapid relief. Such a malady is not uncommon in children, and is accompanied with painful prolapse of the rectum at each stool. Here I give Podophyllin at the third trituration; but in the simple prolapsus ani from debility of infancy and childhood, I have almost invariably seen beautiful results from the tincture of Podophyllum in the twelfth dilution. In the same form, following Dr. Jeanes (see Hale, p. 346), I have given it with perfect success in cases where, in children, the stools are too large and frequent, but natural in color and consistence. " In acute or chronic mucous orfollicular enteritis, it is specifically and primarily indicated. No drug, not even Mercury, so surely causes these conditions. Whether the disease be present in children or adults, the Podophyllum will be found promptly curative. "Diarrhoea, in nearly all its varied manifestations, finds a similimum in the pathogenesis of this potent drug." Dr. S. M. Schell, of Chesterville, Pennsylvania, communicates the following experience with this remedy and Leptandra in diarrhoea: Case I. —" A boy, three years of age; chronic diarrhcea of three months' standing (treated allopathically), without any good results. The evening and night previous to being called to see the child, he had fifteen passages, of a very disagreeable odor, and of the color and consistence of tar. Gave four drops tincture Leptandra, in two-thirds glass full of water, desertspoonful every hour for four hours. The next stool natural. Cured in 12 hours, and well since -now one year. Case II. —" Mr. -; had chills, and had taken great quantities of allopathic medicines. When I saw him he was much debilitated, sallow complexion, bad night-sweats. Gave a few powders first of Carbo veg., with some effect, and on examination again, gave Leptandra 1st in powder, and the cure was rapid." Diarrhceas occurring in the early morning only, cured PODOPHYLLUM PELTATUM. 541 with Podophyllum 3d, no failures. In one case, a boy, the stools were tar-like, but occurring in the morning. Gave Leptandra, with no effect. Then gave Podophyllum 3d; cure rapid. Drs. Hering, Jeanes, Ringer, and many others, lay much stress on.the tendency to morning aggravation of the intestinal and indeed all the symptoms of Podophyllum. I have not yet been convinced that this remedy specifically and distinctly affects the uterus, any more than does Aloes, Nux vom. or Collinsonia. I believe it affects that organ, as well as the vagina, by its action on the circulation in the pelvis. Besides the symptoms marked as curative and pathogenetic, Drs. Williamson and Jeanes have cured the following: "Prolapsus uteri —many cases; numb, aching pain in the region of the left ovary, with heat running down the left thigh, in the third month of pregnancy; ability to lie comfortably only on the stomach in the earlier months of pregnancy; swelling of the labia during pregnancy; after-pains, attended with flatulency." Other homeopathic practitioners have found the Podophyllum useful in many of the diseases'of women, especially when involving the uterus and ovaries. It is still an unsolved question, in what way the medicine affects the uterus; in some cases it would seem to do so by its action on the bowels and rectum, as is the case with Aloes. It is well known that any drug which powerfully irritates the lower bowel will cause congestion and even inflammation of the womb, by extension of effect through contiguous tissues; thus Aloes mlay cause the above, as well as uterine cramps, menorrhagia, prolapsus, etc. It is thought by some that Podophyllum has a similar action, but it would seem, from our proving, as well as numerous clinical cases reported, that the medicine must have some direct action on the uterus and ovaries. Prolapsus Uteri et Vagina. Case I.-A lady who had lately given birth to a still-born child, of large size, with a serious loss of blood, and had undoubtedly the symptoms of a severe prolapsus of the womb; Arnica was given a few days, followed by China and Carbo veg.; these greatly increased the strength of the patient, after which I gave Mercurius 3d, four powders, and Podophyllin 542 PODOPHYLLUIJM PELTATUM. 3d, four powders, on alternate days. In four or five days she was completely cured. Case II. —A lady had been confined about four weeks previously, but had been suffering ever since with violent bearing-down pains in the region of the womb; intolerable pain in the back; great degree of weakness; aphthoe; and several scrofulous swellings about the neck. On examination, I found a moderate degree of prolapsus, swelling and induration of the os uteri, a profuse excoriating leucorrhcea, and great ardor urinwe. I gave, in this case, Mercurius sol., and Podophyllin, in alternation daily, which relieved in ten days the prolapsus, and reduced the os uteri to its normal size. The aphthoe yielded at the same time to a great extent, Belladonna relieving this symptom; Sulphur, Sepia, and Mercurius iodatus removed the leucorrhcea, and swelling of the glands, in three weeks' time. The 2d attenuation was used. Case III.- Prolapsus uteri, brought on by a violent strain, seven years ago; she was emaciated from violent suffering, loss of appetite, cold and debilitating night sweats, violent burning in hypochondriac region, extreme low spirits. Mercurius vivus 3d removed the night sweats permanently; Podophyllin 3d removed the other symptoms, with the prolapsus, and she remains cured -more than one year. Dr. D. G. Klein writes me: I have cured a few cases of chronic prolapsus with the Podophyllum peltatum. I will cite the most important case: Symptoms.- Great costiveness, stool once in three days, with great difficulty, frequent micturition, had to get up three or four times every night; great weakness and soreness of the back, especially after washing, etc. Prescribed Podophyllum peltatum, a tincture prepared by myself, from green root, not very strong, three drops a day in six tablespoonfuls of water, taken in three doses. In three weeks' time the case was entirely cured, bowels regular, no difficulty with the urine, and the back strong and without pain. Induration of the Os Uteri. —Dr. Gatchell mentions, incidentally, that Dr. Brown, of Cincinnati, cured with a trituration of Podophyllinl, an induration of the os, which had resisted the efforts of the distinguished Prof. Morrow, until he abandoned the case in despair. According to some physicians, Podophyllin is useful in swelling and inflammation of the ovaries; its general specific action on the glandular system would lead us to suspect it of the power of causing disease of those organs. I once PODOPHYLLUM PELTATUM. 543 found it beneficial in a case of chronic ovaritis, with symptoms like those in the proving. It is also useful in many of the disorders of pregnant females, especially when caused by a congested condition of the pelvic viscera; the morning sickness, or excessive vomiting of pregnant women, will often be relieved by this medicine. Eclectic physicians praise it highly in simple, recent amenorrlheea, but they use it as the allopathist uses Aloes, not homeeopathically; in congestive amenorrhcea, however, it is homieopathic to the condition, and in minute doses will act curatively. Dr. J. T. Talmage, of Brooklyn, N. Y., communicates the following experience with this medicine: Podophylluln peltatum and its active principle, Podophyllin, I have found curative of almost every morbid condition for which Mercurius sol., Mercurius dulcis, and Mercurius vivus have proven the homoeopathic specifics. I have to that extent made them substitutes for the latter remedies. They are more radical and rapid in their cure than the minerals. I have especially found Podophyllin valuable in hsemorrhoids, both internal and external, for acute and chronic constipation, and all the morbid sequelae attendant upon that condition, both during pregnancy and its absence. Mrs. M., 45 years of age, sanguine temperament, full habit, not through the "change of life," being sensitive to all atmospheric changes, with no tubercles in substance of lungs, with a large vomica, the remnant of an abscess, many years since; has suffered for 14 years from the consecutive stages of uterine disease, congestive inflammation, ulceration and induration of os uteri, also from retroversion, dysmenorrhoea, menorrhagia, and chronic constipation; only palliated, with few exceptional instances, by her allopathic adviser, Dr. Delafield, of New York, or his homoeopathic successor. By a proper homceopathic treatment, she was cured of all her ills, except induration and constipation. The former was much relieved, but having been so long chronic, had become organic and is incurable. Her constipation, in addition to the usual discomforts, had the characteristic of waking her almost every night, not always at the same hour, with a severe abdominal colic, in the umbilical region, which lasted from one to two hours. The only relief she could obtain was Prophylactic, a laxative, the day prior. Homceopathic remedies had no effect, either in high or low dilutions. Finally, I prescribed Podophyllin, the first homoeopathic trituration, a small powder every four hours. The constipation of years yielded, and an evacuation came the second day. Subsequently powders of the same were given A.M. and P.M. They made a permanent cure in ten days, both of colic and constipation. Mrs. R. F., a lady in affluent circumstances, during the last two years passed through the hands of six physicians, three of whom were allopathic, and the other half homeopathic. They all treated her for dyspepsia, debility and constipation. Obtaining no perceptible benefit from treatment, she finally put her 544 PODOPHYLLUM PELTATUM. self under my care. Judging from symptoms that her sufferings were the sequence of uterine disease, I proposed an examination with the speculum. It was acceded to, and I found extensive hypertrophy, ulceration and prolapsus, (the os uteri readily admitting the first two fingers of the right hand to the second joint, and presented itself very near the vulva.) In a few months I cured the, hypertrophy, both of the os and fundus uteri, and the ulceration, and thereby much relieved the prolapsus. The patient, within six months after the commencement of my treatment, became enceinte, and is now nearly eight months gone. With the cure of her uterine trouble she improved every way, in returning regularity of organic function, muscular and adipose development, increased strength and freedom from hypochondria, one of her dependent complaints. Chronic constipation, dysentery and hoemorrhoids remained, and gave her frequent attacks of tenesmus uteri, tenesmus vesicae, and tenesmus recti, abdominal colic, and severe sick and nervous headache. After a protracted trial of all the remedies, with but little effect, I at last, upon the patient becoming completely discouraged, prescribed, as an experiment, Podophyllin Ist trituration, every four hours. In two days she had a natural evacuation, and relief of all her troubles. Since then, two months, she has been daily regular, with one or two exceptions, when she stopped the medicine, thinking it no longer necessary. She now, and has, most of the time, taken one powder a day. The following symptoms would seem to indicate that it it affected the heart in a specific manner: Inclination to breathe deeply; sighing; shortness of breath; sensation in the chest, as if the heart was ascending to the throat; sensation of suffocation when first lying down at night; palpitation of the heart, from exertion or mental emotion; *palpitation of the heart, with a clucking sensation rising up to the throat, which obstructs respiration; sticking pain in the region of the heart; palpitation of the heart from physical exertion, in persons subject to rumbling in the ascending colon; heavy sleep, and a feeling of fatigue on walking in the morning, followed by drowsiness in the forenoon. The first curative symptom above was a case reported by Dr. Ward. It is to be regretted that a physical examination of the heart was not made, that we might know the condition of that organ. Such omission is to be deprecated in all clinical reports. The last heart-symptom is not marked with an asterisk in the original pathogenesis. Dr. Hempel, however, placed it in the Symptomen Codex, probably upon good authority; in fact, the remark in parenthesis in the PODOPHYLLUM PELTATUM. 545 original (" Jeanes' Numerous Cases") would seem to imply that he had cured that symptom in numerous cases, although it might imply only that it had been indicated as a pathogenetic symptom. The condition of the heart which gave rise to those symptoms needs elucidation; taking the collateral symptoms into account, we should say it was a sympathetic derangement of that organ, from disease of the liver, occurring in a debilitated subject. I do not think the Podophyllin is capable of curing (although. it may palliate) any seated or organic disease of the heart. As a palliative, however, and as an aid to Digitalis, it is very efficacious in those congestions of the liver with venous stasis and great torpidity. An appreciable dose of the 1x trit. will promptly remove the congestion, starting the flow of bile, and relieve the over-taxed heart. I will conclude my lecture by giving you the estimate of the value of Podophyllum from two representative men, one belonging to the eclectic, the other to our own school of practice. I hope you will see therein some hopeful indications of the coming medical millennium, when physicians shall meet on the common ground of scientific truth —a time when bigotry and prejudice shall have been banished from professional life. I will first quote the practical and investigating Dr. Scudder, editor of the Eclectic Medical Journal, who has for several years adopted the homoeopathic practice, in part, and who is a close observer of the action of medicines, and believes in the value of " characteristic symptoms." Within the year 1874, he has written several articles on the use of Podophyllin. He decries its abuse also, and condemns its routine use for the one indication, namely: constipation. He says he has found several characteristic conditions and symptoms which always indicate the medicine, and given either indication, it will cure the whole ensemble of symptoms with which the patient is afflicted. This is the same doctrine taught by our believers in "key-note indications." 546 PODOPHYLLUM PELTATUM. The most prominent indication for Podophyllin, he says, is ".fullness of the superficial veins." This condition, he thinks, indicates an impairment of innervation of the sympathetic system of nerves. When this condition is present, he gives appreciable doses- from one-tenth to one onehundredth of a grain every few hours. This is correct, for the condition is similar to the secondary effects of the drug. He says the Podophyllin should not be given in the opposite state, cold skin, imperceptible veins, pinched expression, etc. Why? Because he (Scudder) does not yet believe in attenuated doses. The fact is, that his contra-inidication is one of my key-notes —a condition similar to the severe primary effects of the drug, and for that condition the 6th or 12th dilution or trituration is perfectly indicated. We find that condition in cholera infantum, dysentery, dyspepsia, enteritis, and many other diseases characterized by prostration. Dr. Scudder will find, if he tries the higher attenuations, that they will often act with surprising efficacy, when indicated by the primary toxic effects of Podophyllin. He gives other characteristic indications for its use, some of which I had observed in my own practice before I read his papers. I quote his words, italicizing his indications. In his case, where he mixes Podophyllin and Hydrastia, I should alternate them, only for the reason that a tenet of our school teaches that it is best not to use double medicines. I will add, however, that it has not been logically proven, as a scientific fact, that double medicines are inefficacious. One of the most successful of German homceopathists, Dr. Leutze, habitually prescribed double medicines, and I know that many physicians in our school in this country do the same thing; There may yet be discovered some law which will permit the union of two remedies, and guide us in the administration of such medicines; but as yet I am not sufficiently convinced of the value of such a method, except in a few peculiar instances. But to return to Dr. Scudder. He says: "A certain class of diseases of organs'supplied from the 548 PODOPHYLLUM PELTATUM. digestion and blood-making. Some of our readers should rather keep this in view as the leading idea, and give it when such stimulation was necessary. This is well enough, but I like to prescribe for special symptoms; it gives the best result." These special indications are valuable, and I advise you to make a note of them. I have among my patients a lady who, once or twice a year, has attacks of severe pain and swelling of both ankle joints. For many years she suffered weeks, and often months, under the treatment of various physicians of both schools, before she recovered. Finally some physician gave her one-tenth grain doses of Podophyllin thrice a day for a few days, followed by one grain doses of Quinine, four times a day, for a few days. This treatment acted specifically and cured promptly. She has tried the Podophyllin alone, and the Quinine alone,'but neither cured; only when used together is an attack promptly arrested. We have often observed the same thing to occur in other diseases with other remedies. It would seem that it is a natural law that some remedies should proceed or follow others. Hahnemann implies as much in many of his comments on the medicines in his Materia Medica Pura. Dr. W. S. Searle, of New York, in a paper entitled, " A glance at the effects of Podophyllum," observes: Upon the sensorium no marked primary action is discernible. As secondary effects, however, we find depression of spirits with fatalistic ideas, and vertigo with a tendency to fall forward.. Secondarily also, it produces other decided disturbances in the head. The prover complains of dull, heavy, pressing pains, which are confined to the forehead, temples and vertex, and are relieved by external pressure. These pains generally occur in the morning on waking, and grow less during the forenoon. (The diarrhcea has also this morning aggravation.) As accompaniments of the pain, we observe drawing sensations in the eyes, and at times, soreness at the seat of distress. It is noticeable that the headache may alternate with the diarrhcea, which the drug also produces. In the eyes some hyperoemia of the conjunctiva is visible with drawing, smarting, aching, and heavy sensations. These symptoms occur equally whether the prover has ingested the drug or only been exposed to its dust. The tongue exhibits a moist, white coating, and salivation is copious. The breath is offensive even to the prover himself, and a foul putrid taste disgusts him. The pharynx is at first full of mucus, but afterwards becomes dry. Then deglutition becomes painful, especially when swallowing liquids, and soreness, PODOPHYLLUM PELTATUM. 549 appearing first upon the right side, extends to the left, and upwards through the Eustachian tubes. The appetite is diminished and soon satisfied, while a strong desire for acids is developed. What little food is taken is not well digested, for burning, acid eructations soon appear and after a short time, nausea sets in, rapidly increasing to vomitings. Some of the food seems to undergo putrefactive fermentation, for the ejecta have, at times, a putrid taste and odor. The vomiting is very protracted and often very severe, being accompanied by agonizing epigastric pain. Even after the stomach has been thoroughly emptied, the inverted peristaltic action continues, and extends also to the duodenum, so that bile, mingled perhaps with blood, is ejected. Sometimes colic now puts in an appearance, but not seldom; the disturbances in the abdomen are unaccompanied by pain. When colic does occur it is aggravated by lying upon the back, and relieved by bending forward. The intestines become distended with gas, and a profuse diarrhoea sets in. Before the stool there is often a sensation of heat in the abdomen, while after it comes a feeling of great emptiness. Both colic and diarrhcea are worse in the morning. In the region of the liver, fullness, soreness and stitching pains are developed, and similar feelings are complained of in the splenic territory. In the morning aggravation of the bowel symptoms, Podophyllum resembles Aloes and Sulphur, but may easily be differentiated from these. The stool of Aloes is a windy spurt of watery or slimy, yellow faecal matter, the desire for which can hardly for an instant be controlled from a seeming if not real weakness of the internal sphincter. Sulphur demands equal haste from tenesmus. It has a brown stool, not especially flatulent, and neither so scanty as that of Aloes, nor so profuse as that of Podophyllum. Podophyllum gets its victim up early, but not in so great haste as the others (probably because the internal sphincter alone is affected), and has a very profuse, yellow or greenish stool-so profuse indeed, that one wonders whence so much can come. It often contains undigested food, and is very offensive to the smell, having sometimes the odor of carrion. Not seldom it is preceded by prolapse of the rectum. Accompanying it are excessive prostration, simulating even the collapse of cholera; constant, heavy, dragging pain in the back which increases during and after stool; flashes of heat running up the back, and sometimes severe tenesmus. At a later stage mucous and muco-gelatinous stools occur which may be streaked with blood. The whole alimentary canal becomes so irritable that the ingestion of food or drink at once renews the desire for stool. As secondary and reverse effects, the stool becomes dry and hard; is voided with difficulty, and is covered with yellow mucus. This condition alternates with returns of the diarrhoea. Similarly to the bowels the kidneys are affected. First comes enuresis with, at times, involuntary nocturnal discharge, and then follows diminished secretion. A sediment occurs, but its nature has not been determined. Little is known of its effects upon the male organs. An eclectic druggist, however, states that those engaged in preparing the resinoid suffer from a pustular eruption upon the scrotum. Topically applied it produces similar effects upon other portions of the skin. 550 PODOPHYLLUM PELTATUM. Upon the female organs its influence varies with the time of its administration. Given at or near the time of menstruation, it hastens and increases the flow of blood as well as of vaginal mucus. But, if sufficient interval occurs between the dose and the menstrual nisus for the primary effect of the drug to disappear, the secondary and reverse symptoms obtain, viz., amenorrhcea and dryness of the vagina. It is noticeable that it produces prolapse of the vagina as well as of the anus. Upon the respiratory organs its influence is slight and purely reflex. This is also true of the few symptoms which are developed in the extremities. It is susceptible of physiological interpretation. It attacks the involuntary muscles, particularly those of the blood-vessels, which supply the alimentary canal with its adjacent and contributing organs. In this way it affects the kidneys, uterus and the heart itself. Of the involuntary sphincters, moreover, it.causes a paresis. Beginning with the mouth and salivary glands, the result of such a paresis of the blood-vessels would cause stasis, passive congestion. The capillaries are relaxed and over-distended; their lattice-like tissue opens, and out pour floods of serum and protoplasmic masses; epithelial activity is stimulated, and an imperfect, half-elaborated and abundant secretion is the result. The same conditions uroduce like effects in the mucous membrane, and glands of the stomach, and hence a similarly inefficient gastric juice is deluded upon the flood. This, together with the directly irritant effect of the drug upon the surface of the stomach, induces nausea and vomiting. The same results are seen in the intestinal canal. It pours forth a superabundant secretion: the decomposition of the undigested food, and perhaps also the irritated mucous membrane itself furnish the gas which distends the intestine and pains its irritated nerves; and hence the colic and the flood of faecal discharge. Upon the liver, spleen, kidneys and uterus its effect is the same in kind, and therefore each discharges profusely its half-elaborated production. Upon the muscular fibers of the heart the action of the drug is particularly powerful. The beat becomes feeble; the pulse weak - then scarcely perceptible; the surface of the body is bathed in a cold and clammy sweat; and thus death by collapse steals on. The involuntary sphincters are enfeebled, so that the rectum and vagina prolapse and the sphincter vesicae fails to perform its whole duty. All the glands above mentioned have their parenchyma distended, and hence come the sensations of weight, dragging, fullness, soreness, etc., in them all. Nothing but secondary symptoms remain for which to account. The heavy, dull frontal headache with which the prover awakes from a stupid sleep is easily explicable. The secretory organs, which have lately been so active, have now reacted against the influence of the drug: their capillaries have contracted and secretion has fallen below the normal standard. Such a condition produces just these kind of head symptoms. In confirmation, we may refer to the fact that, after the diarrhoea has ceased and constipation begun, occasional returns of the former occur, and with the recurrence of the loose stools, the headache disappears. We have only a few outlines of the secondary picture; but these, together PODOPHYLLUM PELTATUM. 551 with the primary picture and our clinical records, complete the drawing. Here also Podophyllum is often valuable. Beginning with the head, and coming to the mouth and throat, we find a dry, yellowish tongue; a foul, bitter taste, and thirst, with very little appetite. The pharynx is dry and deglutition painful. The stomach is irritable, and the gastric juice small in quantity. Owing to the diminished secretion of bile (or perhaps rather to its retention and reabsorption), there is more or less jaundice, and the stools become pale, dry and hard. T he urine is scanty, charged with sediment, and colored yellow by the biliary acids. There is also, in women, amenorrhoea, with its train of consequences. Crowning all, and growing out of the irritable condition of the heart itself, together with the stimulus reflected upon it from other excited organs, comes general fever. To this congeries of symptoms Podophyllum is secondarily homceopathic. What does this practically mean? I confess I do not know. Hale would tell you it fmeans that, to be curative in these conditions, it must be administered in small doses. But some facts are decidedly against Hale's law of dose. For instance, Dunham, in his lecture on Graphites, says he has been equally successful in the treatment of the diarrhcea and constipation which are cognate to this drug, with the two hundredth attenuation. Multitudes of similar facts can be adduced from our clinical records, and we must therefore remit the whole matter to those who feel competent to deal with this vexed question of the dose. To what diseases is it applicable? First, and most accurately, to bilious fever. With this as a type, we shall not go far wrong in its admninistration. It has been praised for its curative power in typhoid forms of fever; in the genuine zymotic fevers it may be given as an intercurrent in persons of a bilious temperament. In intermittent fever it may, at times, be useful in a similar way, but it is better adapted to the remittent type which is generally bilious au fond. In the treatment of gall-stones its use is, of course, purely toxical. Is there any warrant in the pathogenesis for supposing that it is more than a mere function remedy? If my physiological reading of it be correct, I think there is. In such condition of vascular stasis as have been described, the white blood corpuscles, and other more minute particles of protoplasm pass through the meshes or stomata of the capillaries, and wander by their inherent power of locomotion, into the various neighboring tissues. Here they grow and multiply, and by their transformations bring about the series of phenomena Nxhich we call inflammation. Hence, we may prophecy that it will be useful in gastritis, hepatitis, enteritis, dysentery, and perhaps even in nephritis and metritis. However, should it ever be appropriate in such forms of disease, we should expect to find in the history of each case an incipient stage when the symptoms corresponded to those existing in the proving. I have thus endeavored to characterize Podophyllum, and if it has afforded you as much information as the study of the drug has me, I am fully repaid for my trouble. Lactic acid is an effectual antidote to the effects of it. Fifteen grains have 552 PODOPHYLLUM PELTATUM. been given, and immediately afterwards a draught of sour milk, and the effect of it has been nil. Sugar antidotes it somewhat; common salt increases its action; acetic acid does not affect it. In gout it is useful after acute symptoms have subsided, or in cases where the attack is preceded by premonitory symptoms it is indicated at once. It will ward off an impending attack of gout. It had good effects in jaundice when it had returned again and again after China and Mercurius. The following inferences are drawn from the facts related: First. That it is a very active and penetrating medicine, resembling Calomel in its specific action on the liver and glandular system, but beyond that the similarity ceases. Second. That its direct sphere of action is the whole portal system, and indirectly all other systems connected with that either by nervous or vascular ties. Third. That while the liver and gall-bladder are directly acted upon by this medicine specifically, and led by it to discharge their contents, great relief is given to the lungs and the brain, when oppression of these vital organs is connected with inactive and irregular action of the liver. Fourth. That torpidity of liver rather than vascular congestion is the chief sphere of it; in other words, a non-secretory state, or a state of non-expulsion of the secretion of bile, is the indication for it, and this state is indicated by sallow complexion, furred tongue and constipation. Fifth. That the curative dose in such cases must be brought near to the physiological, viz., the Ioth, 5th or 4th of a grain given once, or, at the utmost, twice a day, and immediately arrested if diarrhcea appears. Sixth. That the middle dilutions ought to be prescribed for the other diseases in which it is indicated- diarrhcea, dysentery, prolapsus ani or uteri, etc. Seventh. That the diseases in which it has been found most serviceable by the writer are gout, erysipelas, spasmodic and bronchial asthma, and chronic bronchitis, and in all these diseases only as an intercurrent. (The writer has not had any personal experience of its benefit in syphilis and goitre, and can not therefore affirm or deny its power in these diseases.) Eighth. That it is not specially indicated in hepatitis, nor in any of the early stages of acute disease, save in the diarrhoea and dysentery, for which it is homceopathic. Ninth. That it ought never to be given where a simple aperient is required, as in cases of undigested food, lodgments in the caecum and colon, etc. Its use should be restricted to liver constipation. Lastly. While a specific has been defined by Dr. Drysdale as a remedy in which the whole physiological is absorbed into its therapeutical action, there are some exceptions, and this I believe to be one of those where the boundary line between the physiological and therapeutic action is not easily defined, and where we are most certain of the therapeutic efforts when we touch the physiological sphere. PODOPHYLLtUM PELTATUM. 553 I quote the valuable differentiation of the analogues of Podophyllum, by Dr. Farrington: PODOPHYLLUM. MERCIRIUS VIVUS. MIND. Low spirited; fears he is going to die; Fears loss of reason, fears he will behypochondriacal. come insane; anxious. HEAD. Throbbing temples, eyes ache, head Splitting frontal fullness, head hot; hot, morning. evening, night. Rolling head; grinding teeth; whin- Fontanelles open; restless sleep, moaning at night; head sweaty in sleep, ing, groaning; sweat all over, clamflesh cold. Dentition difficult. my, cold, sour. Dentition difficult. EYES. Ophthalmia scrofulosa, even perfora- Ophthalmia scrofulosa, pustules on the tion of the cornea; worse in the cornea; lids crusty; worse evening morning, (I). and night. MOUTH, THROAT. Breath smells foul. Breath smells fetid, (2). Tongue white, dry. Tongue yellow, moist, flabby. Saliva copious. Saliva copious, fetid. Throat sore; worse right side; swal- Throat sore; worse left side; swallowlowing liquids; in the morning. ing saliva and liquids; evening air. STOMACH, ABDOMEN. Nausea, gagging; vomit of blood, bit- Nausea; vomit bile, bitter, or sweetish ter; or, painful retching. (as from worms). Flatus in the right abdomen; palpita- Flatus not so marked as in Podophyl.; tion, sleepy mornings, (3). fullness in stomach, and hypochondria. Liver feels hot, sore; twisting pains; Liver so sensitive he can not lie on the better from' rubbing that region; right side or bear the least touch; costive; stools hard, dry, difficult. costive, with ineffectual straining. Colic (as from lead), with retraction of Colic as from worms; sweet taste; the abdominal walls. hard, tender, distended abdomen. Stool chalk-like, offensive with gagging; Stool tenacious, crumbling, small in clay-colored; black; watery, profuse. shape; grayish-white; black, pitchpainless, gushing, exhausting; mealy like; not gushing, but burning, wasediment; bloody, green, yellow, tery, corrosive; bloody mucus, slimy, mucus, smelling like carrion; worse with much tenesmus; odorless or towards morning, in the morning. simply sour; worse usually evening and night. (i.) In compounding mandrake pills, the dust causes inflamed eyes, perforating ulcer; itching eruption, worse about the genitals. The morning aggravation is marked; Merc. is worse from the glare and heat of the fire. (2.) This foetor comes from ulcerative processes; the foulness in Podophyl. is indescribable. (3.) A group many times confirmed by Dr. Jeanes. 36 554 PODOPHYLLUM PELTATUM. After stool exhaustion; cutting pains; After stool cutting and great tenesmus; weak even after natural stool. sweat; trembling; burning in anus. Prolapsus recti from any exertion; Prolapsus recti; inflamed, black; when with diarrhoea. straining. URINE, GENITALS. Urine scanty, frequent at night (preg- Urine scanty, with constant, violent nancy). urging. Dragging pains in the ovarian regions. Shooting from ovaries to hips; suppuration. Prolapsus uteri, with backache at Prolupsus uteri et vaginae with soresacrum; after confinement; from ness of the genitals externally and inwashing; withprolapsus ani; with ternally (4); much urging in the amenorrhcea; stool frequent, though rectum; stools crumble or slimy, natural. bloody. Pregnancy. Can lie comfortably only Pregnancy. Stomach very sensitive to on the abdomen (early months); fre- touch or pressure; scorbutic sympquent urination; prolapsus uteri toms, sore gums, etc.; lochia, with after. sore genitals, (4). CHEST. Cough in remittent fever; loose during Cough with burning and rawness, moist dentition; whooping cough with but phlegm does not loosen; so conconstipation and loss of appetite. vulsive can not speak; whooping cough in two paroxysms. Palpitation from any exertion with Palpitation on awaking, thumping, agiflatulence; heart as if it came into tation; trembling or feeling as if life the throat. were ebbing away. FEVER. Pulse slow; scarcely perceptible; pulse- Pulse usually full, strong; pulseless less, collapse, chill 7 A.M.; forgets with hot body. Chill A.M. (5) but the words. more evening.' Heat with delirium and loquacity; Heat with ebullitions, constriction of afterwards forgetful of what has the chest; anxiety. passed. Sweat warm on the legs; feet cold; Sweat cold, clammy on the legs; cold head sweat with coldness of the sweat on the forehead; skin burns; skin; sleep during sweat. - sweat never relieves. Flashes up the back and abdominal Chiliiness between or after stool. pains during stool. GENERALITIES. Worse from walking on uneven ground; Worse from any form of motion. mis-step. (4.) This soreness is very characteristic, and indicates Mercury in scarlet fever, etc. (5.) The morning chill is after rising from bed; but the evening attack is most important. This collect of symptoms is invaluable in bilious fevers. PODOPHYLLUM PELTATUM. 555 Worse in the morning. Worse evening and night. Worse from acid fruit with milk (6). Worse from sweets, from sugar. PODOPHYLLUM. SULPHUR. Anxiety; fears he is going to die. Anxiety; despairs of salvation. DENTITION. Rolls the head, grinds the DENTITION. Child lies in a stupor, teeth; child whines at night, restless eyes half open; or sleeps in cat-naps, sleep, half open eyes; head sweats, jerks the limbs; fontanelles open, legs cold, face cold; vomiting frothy pale face, cold sweat on face, cold mucus, green; or food; or onlygag- extremities; vomiting sour smelling; ging; stools profuse, gushing, green, stools watery, green, involuntary, watery, or white; offensive; from white, sour or offensive; irresistible, midnight, but worse in the morning sudden urging in the morning. STOMACH, ABDOMEN. Eructations hot, sour; smell like rot- Eructations sour; taste like rotten ten eggs. eggs. Worse from acid fruits with milk. Worse in every form from milk. Tongue white or brown. Tongue white, red tip. Flatus in the right abdomen; palpita- Flatus mostly in the region of the sigtion; sleepy forenoon. moid flexure. Bowels move after being washed. Aversion to washing; generally worse therefrom. Colic with cramp-like knots or retrac- A similar cramping as if the'intestines tion of the abdominal walls. were in knots; pains go to chest, to groins. The stools are very similar: changeable, watery, green, mucous,.white, undigested; with colic, cramps in the thighs; vomiting, purging; with prolapsus ani (more marked in Podophyl.). They lneet, hence, in cholera infantum, cholera, summer diarrhceas. Suzph. has, with Podop5hyl., the profuse, gushing, painless stools, but has more marked the excoriation and redness of the anus. It pictures. according to Hering, the whole course of Asiatic cholera; hence becomes a prophylactic; Podophyl. may apply in painless cholera morbus and in cholera when cramps, profuse discharges, prostration, etc., are present. In cholera infantum Sulph. shows its supremacy as a nutritive remedy: Drowsiness or restless sleep, rolling the Stupor, suppressed urine (hydrocephahead; flesh is soft, flabby; sallow- loid impending); flesh wrinkled, yelness. low, dry; child looks like an old man. FEVER. Remittent or intermittent type; for- More a continuous remittent type; begetful during the chill; loquacious tween chill and heat delirium sets delirium in the heat, violent head- in; prostration increasing with the ache. congestion and heat; headache. (6.) Podophyllum has received the name of Vegetable Mercury. It helps promptly in dyspepsia caused by Calomel. 556 PODOPHYLLUM PELTATUM. Tongue coated uniformly white, yel- Tongue dry, if coated, more yellowlow or brown; jaundice. brown center; jaundice. After the hot stage forgets all that has Fever if continuous, causes slowness in passed. responding, (I). PODOPHYLLUM. NUX VOMICA. HEAD. More depression of spirits. More irritability, anger. Morning headache; hot vertex. Morning headache; heat in the forehead. EYES. Ophthalmia worse in the morning; Ophthalmia worse evening and mornperforation of the cornea. ing; ecchymosis of sclerotica, FACE. Complexion sallow, dingy. I Complexion yellow with a red flush. MOUTH, THROAT. Breath foul (night). Breath offensive, morning. Throat sore; worse from swallowing Throat sore as if rough, scraped; worse liquids. after eating, from solids. STOMACH, ABDOMEN. Tongue white or yellow, coated. Tongue red, sore and coated yellow at the base. Dyspepsia from abuse of calomel. Dyspepsia from abuse of drastic medicines. Vomit hot, sour, bilious, bloody. Vomit sour or bitter, of dark blood. Fatus in the ascending colon; palpita- Flatus in the hypochondria, pressing tior; drowsy forenoons. upwards or down on to the bladder and rectum. Region of the liver sore; relief fJom Region of the liver worse from presrubbing the right side; stools black sure; must loosen the clothing; stools or clay-colored; jaundice; stool diffi- black, large, ineffectual urging, jauncult. dice. Stool difficult from inactive bowels; Stool difficult from spasmodic action; prolapsus ani even with loose stool hence ineffectual urging; prolapsus ani. Stool watery, gushing, profuse, green; Stool thin, brown, dark water, small, with sudden urging, often painless; frequent, offensive; ineffectual urgoffensive; worse in hot weather. ing, worse in cold changes. URINE, GENITALS. Urine scanty, frequent; or frequent Painful, ineffectual urging to urinate; urination during pregnancy. even in pregnancy frequent urging. Prolapsus uteri after washing; after parturition; has frequently yielded to either. (I.) The latter is an observation of Dr. C. Wesselhceft. PODOPHYLLUM PELTATUM. 557 PODOPHYLLUM. NUX VOMICA. Prolapsus with falling of the rectum ~ Prolapsus with urging to stool; stools stools are naturally formed, but too large; backache worse turning in frequent and - weakening; sacral bed; tightness in the hypochondria; pains; aching in ovaian region. cough dry, teasing. After pains with much bearing down, After pains too long lasting; pressure flatulency. on the rectum. In pregnancy (early months), must lie In pregnancy (especially later months) on the abdomen; (later) pains above diffcuity of breathing from upward the right groin. pressure. LARYNX, CHEST. Whooping cough, with costiveness, Whooping cough with costiveness, loss of appetite; cough in intermit- nose bleed; "stomach" cough; tent fever; cough during dentition. cough of students. Palpitation of the heart from physical Palpitation of the heart, the heart feels exertion; flatulence; drowsy fore- tired; palpitation lying; wind from noons. the stomach. SLEEP. Whining in sleep (teething children); Awakens 3 A.M., ideas crowd upon languid on awakening in the morn- him; if he falls asleep, he re-awaking. ens much fatigued. (I.) FEVER. Chill 7 A.M.; forgets words he wishes Chill P.M.; goes to sleep between to use. chill and heat. Heat with delirium and excessive Heat with over-excited senses, worse loquacity, thirst, headache; forget- from external impressions. ful afterwards. Sweat warm on the head, with cold Sweat clammy, sour or offensive; oneface (dentition); sleep in sweat. sided sweat. GENERALITIES. Debility, (especially with bowel dis- Debility, with over-sensitive nerves. turbances.) Complaints of teething children. Complaints of " high-livers." Abuse of calomel; eating acid fruit Abuse of purgatives; indulging in with milk; poisoning with lead. liquors; poisoning with lead, copper. PODOPHYLLU M CHELIDONIUM. MIND, HEAD. Forgetful during the chill. Difficult thought; forgets easily. Low-spirited; imagines he will die or Troubled, weeps, must move from be very sick; liver affected. place to place; liver affected. Dull headache, with pain behind the Neuralgic pains from occiput to left eyes (liver affected.) ear; occiput heavy (liver affected.) (I.) rNux vomica has a whimpering and moaning in sleep; waking from troubled, busy dreams frightened, as if some one were in the room. (Typhus, mania-a-potu.) 558 PODOPHYLLUM PELTATUM. FACE. Eyes inflamed in the morning; scro- Lachrymation with fistula, with neufulous ophthalmia. ralgia; when looking fixedly. Complexion sallow as in jaundice. Sallow or sunken, gray, blue around the eyes. Not yet given in neuralgia of the face. Right supra-orbital neuralgia; eyes water. MOUTH, THROAT. Tongue white furred or yellow. Tongue narrow, pointed, or thickly furred. Throat sore; worse right side; in the Constricted feeling above the larynx; morning; swallowing liquids. sensation as after swallowing too large a morsel. STOMACH, ABDOMEN. Taste foul; breath foul. Taste bitter. Dyspeptic symptoms from abuse of Dyspeptic symptoms, with liver comMercury; liver torpid, with soreness, plications indicated by pain unfullness in the right hypochondrium, der angle of right shoulder-blade better from rubbing; costive, clay- congestion of the liver, with sharp colored stools; sallow complexion, stitching pains, throbbing; costive, putrid breath, furred tongue; dull clayey stools; jaundice; pain from headache; aching behind the eyes; occiput to left ear; longing for loathing or regurgitation of food; milk, coffee, they agree; better (pains) worse after eating. after eating. Diarrhea from acid fruit and milk, Diarrhcea better from milk; during during dentition; discharges yellow, pneumonia; capillary bronchitis; green, slimy. discharges bright-yellow. CHEST. Loose cough, rattling on the chest dur- Rattling cough with capillary'broning dentition. Whooping cough, chitis; bright yellow diarrhcea. with constipation and loss of appe- Whooping cough, with forcible extite. Cough associated with remit- pectoration of lumps of mucus. tent fever, lessening during the re- Pneumonia with one cold ear and missions. foot, one warm; great oppression; fan-like motion of the alhe-nasi; pain under the right scapula. Palpitation of the heart from physical Palpitation so violent as to shake the exertion; as if the heart were bed; stitches in the heart; great ascending into the throat; rumb- anxiety; often associated with conling in the right abdomen; morning gestion of the liver and portal drowsiness. system. BACK. Lumbar backache after washing; J Pinching, spasmodic pain on the inner withprolapsus uteri; diarrhea. edge of the right scapula. SLEEP. Whining, moaning in sleep; rolling Sleepy, yet can not sleep. (I.) the head, (teething.) Sleepy in the forenoon, with flatus in Heavy sleep all day in patient's sufferthe ascending colon. ing from portal congestion. (I.) All the papaveraceae have this symptom. PLANTAGO MAJOR. 559 PLANTAGO MAJOR. The oldest common name of the Plantain, is " Waybread." The characteristic symptoms, in Vol. I, were taken from Dr. F. Humphrey's Monograph, to which Dr. Hering contributed from his immense and apparently exhaustless stores of pathogenetic lore. My industrious coadjutor, Dr. S. A. Jones, once published in the Amer. Hom. Observer, a supplement to Hering's Classical History of the plant, which covers its history during a period dating from A.D. 1,000 to the dawn of the 18th century. The ancients used it in intermittent fevers. An infusion was prescribed, to be taken two hours before the expected paroxysm. The provings do not give us a clear picture of intermittent or remittent febrile paroxysms, although some of the symptoms bear some resemblance to miasmatic fever. Dr. G. Washburn (homceopathist), claims to have cured agues with the tincture and lx dilution. The testimony relating to ague-remedies can not always be considered reliable, owing to the singular character of that disease. Plantago seems to exercise a specific irritant action on the skin, when taken internally. The irritation takes the form of prurigo, urticaria and papulca, accompanied by severe itching, pricking and burning sensations. It does not seem capable of causing actual lesions of the skin. In domestic practice it is constantly resorted to as an application in all affections of the skin, with irritation, pain and heat. The leaves are wilted and bruised, and applied upon the affected part. It certainly possesses some other than a simple emollient influence, for the testimony that it relieves pain and ameliorates the inflammation, is almost universal. By reference to the clinical cases published in the pathogenesis (Vol. I), you will see that the external application of a lotion of the tincture, infusion or leaves, has been of 560 PLANTAGO MAJOR. great benefit in erysipelas, rhus-poisoning, erythema, burns, scalds, inflammation of glands (notably the mammae), bruises, incised wounds, bites of animals, frost-bites, chilblains, etc. The surgeon shquld not disdain the use of this simple herb, for the testimony of Drs. Washburn and Cressori shows it to be a powerful curative agent in some very severe and painful injuries. It is recommended for worms, and it has one sleep-symptom which is very suggestive of verminous affections, namely: " Grinding of the teeth at night." The mental symptoms are of the same character that we find in children afflicted with helminthiasis. It appears to be a grand remedy for odontalgia. It had a reputation for the relief of toothache, even among the ancients. In the Herbal of Dodoens, A. D. 1558, we read: "' The juice or decoction of the leaves or roots do cure and heal the naughtie ulcers of the mouth, the toothache, and bleeding of the gums." John Parkinson, in his " Theater of Plants," A. D. 1640, says: "The root, taken fresh out of the ground, washed and gently scraped with a knife, then put into the ear (!) cures the toothache like a charm." In the provings you will find that it causes toothache in sound and carious teeth; also sensitiveness of the teeth to cold air and contact, and they feel very greatly elongated. The symptoms resemble those of Mercurius. Dr. Reutlinger narrates the singular manner in which they cure toothache with the Plantain in Switzerland. The leaffibers are frayed out and put in the ear of the affected side. " Curiously enough, in cases benefited by the remedy, these fibers become black, and are then renewed, while, if no relief is experienced, they remain green." Dr. R. states that with the 2x dil. of the plant he cures seven-tenths of all cases of odontalgia, in about fifteen minutes! Dr. Humphreys confirms this statement. I was at first inclined to doubt its efficacy, but have been obliged to admit its value, for, of all homceopathic remedies for toothache, none can compare with the Plantago. POLYGONUM PUNCTATUM. 561 It cures when taken on the tongue in the attenuations, and applied to the cavity of a carious tooth on cotton. I have never tried the plan of putting it in the ear. It is alleged to be useful in otalgia, applied in the same manner. The warm juice of the leaves, or a wilted leaf, rolled up and put in the ear, is a popular remedy for earache. It has been used successfully in colic, diarrhoea and dysentery, and some physicians of my acquaintance value it highly in summer complaint and cholera infantum. The urinary symptoms are noteworthy, and I predict a sphere of usefulness in that direction. It has only been used successfully in enuresis. It appears to be especially applicable to the nocturnal enuresis of children, particularly when depending on laxity of the sphincter vesicle. The urine in such cases is pale, profuse and watery. When actual paralysis is present, or when the urine is scanty, it is not so effectual. It acts better in children than adults. I suggest that it may be useful in wetting the bed, from the irritation of worms. I have seen the happiest effect from the application of warm, wilted Plantain leaves in mastitis. It allays the pain and mitigates the heat and swelling. To make them more effectual, spread on them a piece of oiled silk, or oiled paper, to prevent evaporation. POLYGONUM PUNCTATUM. This species, commonly known as Smart-weed, from its peppery, pungent taste, is quite popular as a domestic remedy, in all parts of the United States. Applied externally, it causes a gentle stimulation of the skin, not as severe as that of mustard, but enough to produce an erythema of the surface, if applied for a long time. This action on the skin is taken advantage of in cases of internal pain, cramp, etc., and the application of the leaves of Smart-weed, saturated with hot water, is quite generally resorted to in such cases. You will find it difficult to pre 562 POLYGONUM PUNCTATUM. vent nurses, and your patients generally, especially in the country, from using these applications; and I see no reason why you should oppose their use, nor the use of mustard, for they often do good and can do no harm, and the idea that they interfere with the action of our medicines, even in the highest potencies, can not now with reason be urged against them. We have extended provings of the Polygonum, made by some of the best physicians of our school. These provings go to show that its sphere of action is on the mucous surfaces, the nervous system, and fibrous tissues. Perhaps the disorder for which it is most popular is colic. The provings give a very good picture of flatulent colic. Dr. W. E. Payne says, that in the only instance where an opportunity was offered for testing the truth of either of the therapeutic indications above deduced from the provings of the Polygonum, there were cutting, lancinating, griping pains, with great rumbling, as if the whole intestinal contents were in a fluid state, and in violent commotion; the movement proceeding from below upwards, producing nausea, and disposition to vomit, with liquid feces, which were discharged with considerable force, together with pain in the loins. This case, in both its symptomatic and pathologic manifestations, was an exact representation — an exact counterpart of the abdominal affection as it appeared in the above proving. The Polygonum, therefore, was selected as the remedy. Two teaspoonfuls were taken at once, of a mixture of fifteen drops of the tincture to eight ounces of water. A sensation of warmth diffused itself throughout the abdomen, with immediate diminution of the symptoms, and at the expiration of about an hour the whole disease had disappeared, except soreness on pressure, which gradually passed away. A fomentation of the leaves, or the application of the tincture to the abdomen, doubtless aids in removing the severe pains of enteralgia. The provers were all men; but a large amount of clinical experience has been obtained which seems to prove that it acts somewhat like Pulsatilla in diseases of women. PROTOSULPHIDE OF MERCURY. 563 Drs. Tully, Eberle, Wood and others, class it among the emmenagogues. Dr. Eberle states that it causes the following symptoms: "Warmth, and a peculiar tingling sensation throughout the whole system; in most instances, slight aching pains in the hips and loins; a sense of weight and tension within the pelvis." He states that he has used it in about twenty cases of amenorrhoea, and says: "I can affirm that with no other remedy or mode of treatment have I been so successful as with this. I have seldom found it necessary to continue its use for more than six or seven days, before its emmenagogue powers were manifested." He says that those to whom he has recommended it found it effectual. He used it in the form of a saturated tincture, in doses of a teaspoonful three times a day. The warm infusion is used successfully in domestic practice - a wine-glassful every few hours. I have known this simple treatment to prove effectual after all the tried remedies had failed. PROTOSULPHIDE OF MERCURY. The use of this medicine in typhoid fever is attracting the attention of English and European homceopathists. Dr. Serres, of Paris (allopathist), was the first to use it, but in the crude form. Dr. Petros was the first homceopathist who used it in typhoids, and always in the 12th potency. He left on record two cases which illustrate its action, and give the groups of symptoms for which it is indicated. Dr. Von Tunzelmann, of London, has lately brought it again to notice, and gives some additional indications for its use. I have collected all the known indications (no provings have been made), and arranged them in the following groups: Febrile heat, pungent, pulse small, weak, 120-130; great weakness; paleness or flushing of the face in the middle and after part of the day. Drowsiness, or wakefulness, with restlessness, unconsciousness with delirium. Headache in the forehead. Eyes with dark circles under 564 PROTOSULPHIDE OF MERCURY. them; lips dry and shrunken; tongue shrunken, covered with a dark brown crust; stiff, dry and black. Abdomen tender, particularly in the ccecal and epigastric regions, distended (tympanitic.) Urination frequent, scanty. Diarrhoea-bilious, dark-yellow, watery, preceded by colic; followed by fainting; not profuse or frequent, only two or three evacuations a day. Patholog#cal indications.-Dr. Petroz says this remedy is unsuitable in the first stages of typhoid. Dr. Von Tunzelmann says: "I should say that the place of the Protosulphide of Merc. in typhoid fever is between Baptisia and Arsenicum, in cases where Baptisia has not been able to arrest the progress of the disease, or where the case has not been seen within the first ten days, and the local lesion in the solitary and aggregated glands of the ileum, nor had time to become distinctly developed; at the same time the absence of marked diarrhcea, showing that no great amount of ulceration of the mucous membrane at the seat of the inflamed glands has taken place." I should say that Mere. sulphide comes after Baptisia and before Terebinthina, for generally Arsenicum is not indicated until after Turpentine has beenl used. I have lately seen a singularly high encomium of the antiseptic powers of the " Ethiop's Mineral," as this is called, in a Spanish medical work by Dr. Murino. The following extracts from Dr. Murino's book are given: " Professor Socrates Cadet, for a long time devoted to the study of contagion, in order to discover an efficient means to annihilate or neutralize it, found that Ethiop's mineral (black sulphuret of Mercury) possesses the two virtues above mentioned, namely, to abolish the contagion, and yet to prove innocent in regard to the person using it. He subjected it to every proof; wrote to his colleagues in the profession; and the solemn and indisputable facts have confirmed his theory. And that Ethiop's Mineral is truly an anchor of safety, in such diseases, by the testimony of solemn and well known facts, and of men the most learned and distinguished, is also proved by the special nature of contagion, which being parasitic, can not but be subdued by that salutary agent, which is par excellence an antiparasitic. PROTOSUILPHIDE OF MERCURY. 565 "Then with a full consciousness of what I am uttering, with my' soul in my pen,' if an antiquated expression will be pardoned, with a profound conviction, the result of a varied experience instituted by myself in cholera, in croup, in diphtheria, and in convulsive cough, I call upon all parents, all instructors, those in charge of institutions, and in general all heads and directors of industrial establishments, arsenals, colleges, and schools, who wish to preserve themselves, their children and dependents, from communicable diseases, on every invasion of contagious maladies, to provide themselves with Ethiop's Mineral, and to take it and administer it every day to those under their care, with a view to preserve them wholly from the threatening contagion. "I know that many, even among physicians, will smile at the idea of Ethiop's Mineral producing such marvelous effects, but let those deride who have not seen, as I have seen, cholera in ten persons cured with Ethiop's Mineral in less than one hour; who have not seen, as I have seen, an entire religious community preserved by the same agent, though living in a convent where there was lazaretto containing not less than a hundred cholera patients constantly. Let those deride, who have not seen, as I have seen, many children attacked with croup, cured in less than two days; who have not witnessed, as I have, more than seventy children with diphtheria cured by the use of Ethiop's Mineral." If half the virtues alleged of this medicine belong to it, we shall reap great benefit from its use. It might be used as a prophylactic of typhoid fever. It might be tested in private practice where there is danger-in typhoid epidemics-of the disease spreading through families or villages; or it could be tested in hospitals into which typhoid fever patients had been introduced. It may prove a valuable aid to Baptisia, in preventing a disease which the latter remedy is so powerful to arrest in its incipient stage. PULSATILLA NUTTALLIANA. 567 instead of the foreign species. In fact, I see no necessity for using the latter while the indigenous species grows in such abundance. You may be interested in its chemical and medical history. The first mention of this plant in the annals of medicine was by A. W. Miller, a German pharmaceutist, of Philadelphia, who introduced it to the profession in an inaugural essay, presented to the Philadelphia College of Pharmacy. In this essay, the writer refers to his brother, Dr. W. H. Miller, of St. Paul, Minnesota, as having used the plant in various diseases. This physician (an allopathist) is probably the first who used it in the United States. The author of the above mentioned essay subjected the plant to an exhaustive chemical analysis, all of which may be quite interesting to the scientific chemist, but is not of sufficient importance to the practical physician to be herein detailed. Mr. Miller used the flowers and herb; he does not appear to have made use of the root in any of his experiments. We do not find any reason given in his paper for rejecting the root, which, doubtless, possesses the active virtues of the plant in a high degree. The results of Mr. Miller's experiments, which are of especial interest to us, are, namely1. It was found that in the process of drying, the flowers lost 85 per cent. in weight, as compared with their weight in the recent state. 2. The active principles of.the plant seem to be extracted thoroughly by alcohol of the strength of 95 per cent. 3. A portion of the peculiar acrid, volatile principle, which is one of the most important constituents of the plant, seems to be lost by the process of drying. 4. The same principle, termed by chemists Anemonin, seems to be capable of isolation from the fresh plant, but not from the dry, and is volatile at ordinary temperatures. 5. In the course of the experiments, the substances extracted possessed a very acrid and almost caustic taste. When volatilized they produced a very irritating, pungent 568 PULSATILLA NUTTALLIANA. vapor, affecting the eyes and causing sneezing. Also these extracts had a well marked " camphoraceous odor." In the analysis, grape sugar, gum, resin, an alkaloid and anemonic acid were found in appreciable quantities. 6. The inorganic constituents of the plant were found to consist of Sulphate of Potassa, Carbonate of Potassa, Chloride of Potassium, Carbonate of Lime, Magnesia and "a protosalt of Iron." The following practical deductions may be drawn from the above experiments: (a.) Tinctures should be made from the fresh plant, if we would retain all its medicinal constituents. (b.) Every precaution should be taken to prevent the escape of the volatile principle, which is doubtless one of the most important, especially in the treatment of irritable conditions of mucous tissues. (c.) In certain cases the vapors of this medicine may be used with advantage as a topical homceopathic remedy, especially in affections of the respiratory passages and the eyes. Certain deductions, which may be termed theoretical, may not be amiss in this place. We find among the organic constituents of this plant, three, at least, of our most valuable remedies, namely: Calcarea carbonica, Kali carbonicum and Ferrum. In the introduction to Rumex crispus, in this work, we mentioned the presence in that plant of Sulphur; Phosphorus and Calcarea, and suggested that certain pathogenetic symptoms produced by Rumex, and its curative powers in similar affections, may have been due to the presence of those agents. No one who has studied and used the Rumex can fail to see the close similarity in effects. So with Pulsatilla. It is highly probable that the Pulsatilla nigricans, now in use, contains the same inorganic constituents as the American variety. Who has not noted the close similarity of many of the symptoms of Pulsatilla with that of Calcarea, Kali carbonicum, and Ferrum? It has been curative in certain intestinal and gastric derangements, in affections of the respiratory passages, and for the chlorotic conditions in which the above trio are also indicated. The chemico-physiological portion of our school can readily PULSATILLA NUTTALLIANA. 569 accept this explanation of the curative powers of Pulsatilla. Even the believer in high dilutions may not reject the theory, for these salts are held in solution in the plant, are given up to the alcohol, and.then conveyed into the circulation of the patient in the dilutions administered. We have not been able to obtain a chemical analysis of the European Pulsatilla, but there is doubtless such an analysis on record somewhere in the annals of pharmacy. We are aware that a portion of our school make no account whatever of chemical analyses of plants, contending that the true and only medicinal or remedial principle is dynamic, and a unity. We shall not here discuss the question; the " golden mean" of truth doubtless involves both the dynamic and chemical theories. Dr. W. H. Miller, of St. Paul, Minnesota, struck with the many points of similitude between this plant and the European Anemone Pulsatilla, conceived the supposition that in chemical composition and therapeutical effects they were also closely allied, if not synonymous. He instituted numerous experiments with a view of verifying the latter surmise, and, according to his statements, they proved to be entirely successful. He claims to have established the value of this remedy in many chronic diseases of the eye, particularly cataract, amaurosis, and opacity of the cornea. Very decided advantage was also experienced from its employment in cutaneous eruptions and in secondary syphilis. "These results," says Dr. Miller, "in conjunction with the investigation of its chemical constituents, are sufficient to warrant its substitution for the European Anemone Pulsatilla, which, though not often administered by regular practitioners, is very frequently resorted to by the homceopaths." Dr. Miller thus describes his method of using it: " A tea of the dried flowers and herb was sometimes employed, as well as the juice of the fresh plant bruised and expressed, and then either preserved by the addition of one-fourth of its bulk of alcohol, or evaporated to the consistence of an extract. In preparing the latter, the presence of some volatile 37 570 PULSATILLA NUTTALLIANA. acrid principle was clearly manifested by the highly irritating vapors arising from the juice on the application of gentle heat, producing a very painful impression on the eyes of the operator. As the preserved juice had not been subjected to the deteriorating influence of evaporation, it was supposed to contain the greatest amount of active principle. It was, therefore, most frequently administered, and the most marked effects of the drug were observed to follow from its use." The above experience coincides with that of Stoerk, who probably used the same variety afterwards proved by Hahnemann. Stoerk prescribed it successfully in amaurosis and other diseases of the eye, in secondary syphilis, and in cutaneous eruptions. There is no sufficient reason why Jahr and other Continental homceopathists should banish the Pulsatilla vulgaris so completely from our Materia Medica, for it has been employed by various European and English physicians of the allopathic school, for diseases similar to those in which the genuine Pulsatilla has been used successfully. It has even been used with good results in whooping-cough and rheumatism. From certain inquiries which have been made, we are inclined to believe that much of the Tincture of Pulsatilla which is used by our school is made from the latter plant, and even from other members of the Anemone family. Even the various species of the Anemone should not be left unnoticed. Nearly related to the Pulsatilla, they have many medicinal qualities in common. One of them, the Anemone nemorosa, or wood-anemone, indigenous to this country and Europe, has, according to Wood, "been found a speedy cure in tinea capitis, applied externally to the head." Also, "that it is said to act as a poison to cattle,,producing bloody urine and convulsions." The history of American Pulsatilla in Homceopathy is as follows: In May, 1865, I published a brief article in the Medical Investigator, entitled, "Have we an Indigenous Aconite and Pulsatilla?" in which I gave a botanical description of the American Pulsatilla, and solicited specimens of the plant. This inquiry was responded to by Dr. Doug PULSATILLA NUTTALLIANA. 571 las, of Milwaukee, who, together with several other physicians, sent me dried and fresh specimens. (See Engraving.) On the 15th of May, 1865, in the Illinois State Homoeopathic Medical Society, as Chairman of the Committee on Materia Medica, I read a report, in which I gave a minute description of the plant, and its chemical and medical history up to that time, This report was published in the Investigator for June, 1865. I also called the attention of the Western Institute of Homceopathy to this plant, at its annual session in St. Louis, in May, 1865. On the 20th of June, 1865, Dr. Burt, of Lincoln, Ill., commenced proving the plant. This proving was sent me several months after, and published, with some clinical observations, in the United States Medical and Surgical Journal, January, 1866. A few other provings have been made and their symptoms given in Vol. I. It has since been used by hundreds of homeopathic physicians, but the records of its use have not been published. I have, however, gathered from some of my colleagues a few clinical cases, illustrative of its curative action. The standard preparation used should be a tincture of the whole plant, made by adding to the fresh plant an equal weight of 95 per cent. Alcohol, allowing it to stand three weeks, then decant and filter, and put up in glass-stopped bottles, and kept in a dark, cool place. Make the dilutions with pure homeopathic Alcohol, unless such dilutions deposit a sediment, in which case add, drop by drop, distilled water, until the precipitate is taken up. If it should be ascertained that a precipitate uniformly deposits upon using strong Alcohol, substitute Alcohol diluted with one-twentieth or one-tenth its bulk of distilled water. It is probable that the sediment contains some of the valuable constituents of the plant, and should for this reason be kept in solution. Of late I prefer the tincture-trituration. The symptoms of a drug are not all that you should know of it, especially if such symptoms have been caused by provings made with the attenuations. You should study its toxic effects, and investigate its method of action, both in health and disease. PULSATILLA NUTTALLIANA. 573 school. His observations are suggestive, and although couched in the antiquated phraseology affected by him, are well worthy our careful study. "Perhaps," he says, "the medicinal species of the genus Pulsatilla, which I believe have been reported by some to be narcotic, of a non-sedative, and non-stupefying character, may in fact be erethistic after the manner of the Aconite. I am inclined to think they are, but I have no certain knowledge on the subject. These articles, in excessive quantities, are certainly capable of producing constitutional irritation, with jactitation; and I do not doubt if pushed to a sufficient extent, they would also occasion rapidly progressive exhaustion of the powers and energies of the nerves of chemical action, nutrition, and reproduction." I imagine Dr. Tully meant to convey the idea that the Pulsatilla (also the anemones), may cause death by their erethistic (irritant) effect (primary), on the whole nervous system (the spinal cord); and cause exhaustion and general paralysis (secondary). Homceopathic writers assert that the action of Pulsatilla is almost entirely spent on the skin and mucous membranes, causing profuse discharges of mucus and sweat, and eruptions. But these effects do not by any means include all the pathological actions of the drug. The Pulsatilla has a decided action on the fibrous tissues of the body, also on the nervous system. The action of Pulsatilla, (by which I mean to include the indigenous with the foreign species,) may be thus arranged: ON THE NERVOUS SYSTEM. Nerves of Motion. — Pulsatilla is not a tetanic irritant like Nux, Ignatia and others of this group, nor a paralyzing sedative like Gelseminum and its analogues. It causes a state of erethism. This condition does not result in spasm, tonic or clonic. Transient jactitation, twitching, tremors, and perversions of the motions of the body, being the extent of its action on the motor nerves. Both the indigenous and for 574 PULSATIHLA NUTTALLIANA. eign species cause "great weakness, heaviness, and trembling of the limbs." The foreign species has cured paralysis of the lower limbs, and the indigenous species is indicated in the same condition. The primary action of Pulsatilla resembles the secondary action of the so-called "Nervines "namely: Asafcetida, Valerian, Scutellaria and Cypripedium. The nerves of motion are deprived of their normal tone; they become irritable, and their action perverted. Whether the Pulsatilla acts directly on the nervous centers, or indirectly, by irritating their periphery, I am not prepared to decide. Nerves of Sensation.-These nerves are equally irritated and their functions perverted by Pulsatilla, as are the nerves of motion. We thus get abnormal sensations of heat and cold, neuralgia, hyperaesthesia, etc. Ganglionic System.- The action of Pulsatilla on these nerves is, firstly, excessive reflex irritation, followed by a condition bordering on paralysis. Clinical Observations.- Pulsatilla, in common with some of its analogues, has a specific power to cause those reflex irritations of the nervous system which we so often see in disease. It may induce nausea and vomiting by its action on the uterus; palpitation of the heart, from this and other causes; functional affections of the eyes, amaurosis and the like, from distant irritations; vertigo, headache, toothache, paralytic sensations in the extremities, etc., all from causes remote from the apparent seat of the disease. The chlorotic condition which Pulsatilla is capable of causing, is not always the result of idiopathic indigestion, but oftener a debilitated and irritated condition of the nerves which govern nutrition; digestion and assimilation are thus prevented, and we have a chlorosis of a purely trophicnerve origin. Muscular System. —Its action on this system is never direct, but only through the nerves of motion, or from a metastasis of catarrhal rheumatic poison. Mucous System. — The Pulsatilla has a distinct and specific action on the mucous membranes, causing intense irri PULSATILLA NUTTALLIANA. 575 tation, followed by more or less profuse discharges of a blennorrhagic or catarrhal nature. Its action rarely goes on to ulceration. If these discharges are prevented, or suddenly arrested, as in natural diseases, the serous and fibrous tissues take on an active inflammation. Thus, a Pulsatilla-catarrh may result in a synovitis, more rarely a pleuritis — or a pseudo-rheumatic affection of the periosteum, and the fibrous portions of the muscles. In the same way a Pulsatilla blennorrhcea may change its location from one portion of the mucous surface to another. A leucorrhcea may change to a conjunctivitis, or bronchitis. Such is the protean and erratic character of the Pulsatilla-catarrh, that it may suddenly change to a neuralgia, a chorea, an arrest of nutrition, or a swelling of some of the glands —generally the testicles or ovaries. Glandular System.- As intimated above, the Pulsatilla may affect the glands indirectly, we believe never directly. Vascular System.-(See fever.) The Pulsatilla does not appear to affect the heart and arteries directly. Venous System. —It causes many symptoms of venous stagnation, and has been used successfully in varicosus, and other diseases of this system, but in what way it acts on these vessels I can not say. It causes eruptions on the back, legs and ankles, of a dark, bluish, red color, attended, through the day, with more or less itching, but at night the itching is most intolerable. The eruption stands out prominently from the skin, and is from the size of a three-cent piece down to a miliary eruption. This eruption resembles measles. It is homeeopathic to urticaria, pafpulle, or an eruption which begins as one of the former; but instead of disappearing, changes to pustules. In this respect it resembles its relatives, Clematis, Ranunculus, etc. The observations above set forth may be found to be crude and incorrect, but in the absence of any pathological provings, they are the best that I can give. It is to be hoped the homeeopathic profession will make the American Pulsatilla an exhaustive study, both by path 576 PULSATILLA'NUTTALLIANA. ogenetic (symptomatic) and pathological (toxical experiments) in such a thorough manner as to arrive at its real sphere of action. Skin.-Its action on the cutaneous surface, is as specific as its action on mucous surfaces. It has one head-symptom almost identical with one found in the pathogenesis of Pulsatilla nigricans, viz.: " Headache arising from the nape of the neck and upwards." The headaches of Puls. Nutt. would seem to be both rheumatic and gastric, taking the form of hemicrania, " clavus hystericus," or from indigestion, in all of which it may prove useful. I have used this remedy in three cases of headache, one of which was cured by it. It was that of a lady in the country, whose case was described to me by the husband as " sickheadache," commencing in the middle of the day, with intense pain in one side of the head and one eye, accompanied by chilliness, lowness of spirits, and finally vomiting. The vomiting usually relieved the pain-after which she could go to sleep. Those paroxysms had occurred, usually, twice a week for several years. She took five drops of the 2d dilution three times a day, for four weeks. After commencing the medicine, she had but two attacks of headache-the last paroxysm very light. It is now three months, and there has been no headache of any severity since. The eye-symptoms are very decided. I have had better success with it than with its European relative, in conjunctivitis, hordeolum, and swelling of the edges of the lid (ophthalmia tarsi). There is a peculiar inflammation of the eye, occurring in persons of blonde complexions, light hair and blue eyes, brought on by taking cold. (I have not observed it in brunettes.) The eyelids are puffed, almost like cedema, and with the surrounding skin, assume a livid, light purple hue. This affection comes suddenly, and after lasting a day or two, a profuse mucous secretion sets in from the conjunctiva, followed by improvement more or less rapid. In scrofulous subjects it often degenerates into a chronic state, accompanied by pustules and granulations. This Pulsatilla is specific for the disorder, and will hasten the favorable PUL4ATILLA NUTTALLIANA. 577 termination and prevent a chronic condition. Dr. Miller, of St. Paul, writes that he has cured several cases of opacity of the cornea of long standing, in which the loss of sight was nearly complete. He used a decoction of the plant, but does not mention the dose, but says " two fluid ounces were used in two weeks." The provings would indicate its usefulness in catarrhal and neuralgic affections of the eyes. I have known the most happy results follow its use in catarrhal otitis and otorrhoea. In catarrhal angina, when the fauces and pharynx, as far as can be seen, are of a purplish or livid color, puffy, and the seat of stinging pains. Its throat-symptoms somewhat resemble those of Hamamelis and Gymnocladus, and the first stage of the Apis-angina. In cough it acts as well as the other species. In gastro-enteric disorders, such as dyspepsia, indigestion, diarrhcea, colic and vomiting, I find it acts very promptly. The same may be said of its action on the urinary and genital organs. I do not believe there is any difference in the quality of action of the indigenous and foreign species of Pulsatilla, but I believe the quantity differs; i. e., the former is a much more powerful plant, and affects the organism more profoundly. As intimated, when speaking of the action of Pulsatilla, I believe we would be more successful with this remedy if we thoroughly understood its method of action. From a careful study of it, I believe the key-note of its action is its power to cause catarrhal affections with peculiar concomitants, namely: neuralgic or rheumatic pains preceding catarrhal discharges, or following upon their suppression; and inflammation of glandular structures resulting from suppressed catarrh. Pulsatilla catarrhs result in leucorrhoea (vaginal and uterine), and even ovaritis, mucous-metritis and mucous-cervicitis. The amenorrhoea of Pulsatilla generally results from a suppressed catarrh; also the delaying menses, which are generally painful and scanty. 578 PULSATILLA NUTTALLIXNA. In the provings we find that it causes sharp pains in the uterus, from side to side, accompanied with chilliness, trembling weakness of the legs, urging to urinate, and diarrhea. "Menses more regular since proving the drug." Dr. Miller (allopath) writes that he has used it successfully in leucorrhcea and irregular menstruation. I have sent the tincture to many of my colleagues, requesting them to use it in uterine diseases. The general testimony is that it acts more promptly than the European species. In retention of the menses from a cold, or other incidental causes, and in recent cases, the Pulsatilla Nuttalliana has proved curative in many instances. The following case was published with the original proving, and the experience of several physicians has since confirmed its clinical value: Case I. —A young lady, on a visit to this city from Boston, who had previously been subjected to retardation of the menses-postponing three or four weeks beyond their usual time-applied to me for relief from the following symptoms: Constant chilliness; coldness of the hands and feet; loss of appetite; sour eructations; nausea after meals; hemicrania; toothache; melancholy and general malaise. The menses were retarded two weeks beyond their normal time. She said the precursory symptoms of menstruation occurred while on her way to this city, at which time she caught a severe cold; no menstrual symptoms now. This was a case in which any physician of our school would have prescribed the European Pulsatilla. I thought it a good opportunity to try the American plant. Thirty drops of the first dilution were mixed with half a glass of water, a spoonful to be taken every two hours. After the fourth dose the menses appeared without the usual pains, and with a permanent disappearance of all the constitutional symptoms. I think this may fairly be set down as a curative effect of Pulsatilla Nuttalliana. Since the above was published I have used it in several cases, only one of which I shall narrate, as it is similar to the rest. In some cases of amenorrhoea it has failed, and the menses had to be brought on with Senecio and Sabina. Case II.-A young woman, usually healthy, plethoric, had the menses delay two weeks. Symptoms: Severe headache PULSATILLA NUTTALLIANA. 579 all the time; a heaviness and fullness, aggravated by movement or stooping; dimness of sight, increasing to blindness when stooping or rising suddenly; sensation of weight in the uterine region, with considerable aching pain extending to the back, very severe at times, especially in the evening; hands and feet cold; weakness in the lower extremities. Cimicifuga was given a few days, but no improvement followed its use. Pulsatilla Nuttalliana was given, five drops of the one-tenth, every three hours. Improvement commenced the next day, and the menses came profusely, but without the uterine pain-about two days before the expiration of the eighth week. In this case a higher dilution would probably have acted better. Dr. A. E. Small reports the two following cases of acute amenorrhcea, in which this remedy seemed to act in a very prompt and powerful manner: Case 1.-A stout, middle-aged married woman had the menses delay five days. This was so unusual that she applied for medicine to bring them on. No symptoms were complained of. Pulsatilla Nuttalliana was prescribed, ten drops of the tincture in half a glass of water, a spoonful every hour. After the sixth dose the menses came on profusely, but without pain. Case II.-An unmarried woman, aged 18; menses had delayed three weeks beyond their usual normal period. Pulsatilla Nuttalliana, given as in Case I, brought on the menses after the tenth dose. A physician informed me that he gave the Pulsatilla Nutt. to a stout healthy woman, aged 35, who applied to him for a retardation of the menses-ten days past the natural time; no unpleasant symptoms resulting. Five drops of the mother tincture every three hours brought on the menses, after the fifth dose, with "headache, nausea and diarrhoea." The action of Pulsatilla on the muscular and fibrous tissues is well known, but its use in rheumatism is not sufficiently appreciated or understood. It is of no use in idiopathic rheumatism, but is specific for that variety which is relieved by a catarrhal discharge, or follows the suppression of a catarrh. The pains are generally flying, wandering, and rarely fixed, except on the dorsum of the feet. 580 PULSATILLA NUTTALLIANA. Since I have prescribed the Pulsatilla according to this indication, the most excellent results have followed its use. I give the lowest dilutions or the matrix tincture, repeated until decided improvement sets in. I have known it to cause the reappearance of an intestinal or vaginal catarrh after they had been absent weeks, and had caused the severest rheumatic neuralgias. The following symptoms are especially noteworthy: Frequent flying pains in the wrists and fingers, during the whole proving. Hard drawing pains from the first to the second joint of the right middle finger. Stiffness of the fingers. Drawing pains in the left metacarpal bones. Hands hot and dry-constant symptom. Sharp, neuralgic pains passing from the hip joint, down to the middle of the thigh, along the course of the ischiatic nerve. Severe, dull pains in the right knee joint, for two hours in the morning, while in bed, during a rain storm. Sharp, drawing pains along the outside of the left knee, passing half way down the leg. At noon began to feel great weakness in the legs, could scarcely stand, and walking became difficult; it was a " trembling weakness," with a sensation of great weariness and heaviness. It cured the following case of rheumatismus fugax: A strong, healthy looking man applied for relief from wandering rheumatic pains, principally located in the dorsum of the right foot, and in the loins, thighs, chest, arms and head. The pain in the head was a dull, heavy pressure in the vertex, nearly constant, with occasional sharp pains. Some febrile disturbances, but no local inflammatory action in the joints or muscular tissues. The urine was scanty and deposited lithates. There was acidity of the stomach; bowels normal; appetite good. After other remedies had been tried for a week, Pulsatilla Nuttaliana -I was given, and removed all the symptoms in three days. Another, but a little different attack occurred a few months after, and was removed again by the same remedy. I have found it useful in melancholy, sleeplessness, and extreme nervousness in women and children. PTELEA TRIFOLIATA. 581 My advice is to use it for all the ailments for which the European species is recommended. I carry in my case the two species side by side, in the 2x dilution. I am favorably impressed with the action of the triturations made from the mother-tincture of the fresh plant, not triturated long enough to dissipate the volatile principle (10 minutes is ample time). PTELEA TRIFOLIATA. None of the new indigenous medicines were more thoroughly proven than this; but, for some unaccountable reason, it has been but little used, except by the original provers and myself. If there is any clinical experience on record, it has not come under my observation. It is a powerful remedy, not violent in its action like Podophyllum or Iris, but slow, pervading, and possessing the power of causing many chronic abnormal conditions. It is an analogue of Bryonia, Nux vomica, Arnica and Hydrastis, and has some affinities with Ruta, Myrica, Sulphuric acid and Turpentine. Dr. Tom. Nichol, of Montreal, one of the provers, values it very highly in hepatic difficulties, and those erysipelatous and urticarious eruptions so often concomitant with affections of the liver. It must exert some profoundly injurious effect on the blood, for it causes a condition similar to purpura. I have found it useful in bilious headache, dyspepsia, gastralgia, congestion of the liver, chronic hepatitis and chronic erysipelas. It has been recommended for chronic rheumatism, dysentery and constipation. Some English critic intimated that it had been a waste of time to prove Ptelea. He certainly could not have used it in practice, or he would not have made such an absurd assertion. So highly is this medicine valued in eclectic practice, in indigestion and gastric debility, that a preparation called 582 PTELEA TRFOLIATA. "Elixir of Wafer Ash and Pepsin," is very popular with that school. Dr. Farrington has compared Ptelea with Nux, Brvonia and Arnica, giving us, at a glance, their differences: " Ptelea trifoliata has many symptoms in common with Bry. and Nux vom. All have weak mind, with bodily languor; peevish, irritable; senses too easily impressed by external objects; hence, worse from noise, light, smells, conversation, smell of food, etc. Gastric headache; stomacace; pharyngitis; disgust for meat; hepatic congestion and hepatitis; ascites (except perhaps Nux); dysenteric stool; constipation with hard, dry stool; jaundice; catamenia too soon; urine red, high colored; red sediment, (except Bry.); stitches in various parts, worse moving, speaking, breathing; headache with cough; rheumatism, wandering pains; nettlerash with gastric disorder; languor, must lie down; limbs weak with nausea, etc. " Ptelea stands between Bry. and Nux v., and Arn., in gastro-bilious diseases. Like Bry., it has hepatitis better lying on right side; but the stitch pains do not appear with the least attempt to breathe, only in deep inspiration; and the stool is dry, hard, small, while Bry. has stool large, dry. Nux v. is worse lying on painful side, and has large stool. " With Arnica, it has eructations like rotten eggs; aversion to meat and longing for acids; but eating causes epigastric pain and sensation of goneness; not fullness, as in Arn. " Nux vomica has a similar periodic aggravation of gastric symptoms (3-4 A.M.); but Ptelea has aversion to fat; Nux a longing. Ptelea, predominating bitter taste; Nux, more sour taste; Ptelea, feels the effect of food at once; Nux, an hour or two after a meal. (Duodenal Digestion.) " Ptelea causes dysenteric tenesmus, appearing before and after stool; in Nux, tenesmus ceases after stool. Ptelea, stool small; hard balls; Nux and Bry., stools too large." I will add that the oily constituent of Ptelea has many resemblances to Turpentine, and I predict it will prove valuable in typhoid fever (tympanites,) renal diseases (morhus Brightii.) It also resembles, in its action on the blood, Phosphorus, Sulph. acid and Arsenicum. PICRIC ACID. 583 PICRIC ACID. Owing to an oversight, the characteristic symptoms of this drug were not incorporated in Vol. I. I therefore give them here. The following symptoms are selected from the provings reported by Dr. L. B. Couch, for which he was awarded the gold medal by Prof. Allen, of the New York College, in the Spring of 1874. Picric. acid, also called Carbazotic acid, Welter's Bitter, Nitro-phenisic acid, Nitro-phenolic acid, is the product of the action of Nitric acid upon Coumarin, Indigo, Salicine, Carbolic acid, oil of Gaultheria, and several other substances, aided by heat. It forms in whitish-yellow prisms, with rectangular bases, which in thin layers are almost colorless. It reddens vegetable blues, and has an exceedingly bitter taste. It is fusible and volatile, and burns with a yellow flame, leaving a residue of charcoal. It is nearly insoluble in cold water, but soluble in hot water, alcohol or ether. Head. Heavy, throbbing pains in the head, extending from behind the ears, forward to the supra-orbital notch, thence downward to the eye. All head-pains relieved by bandaging tightly. Heavy pain in occipital region, extending down the neck and spine. Heat and congestion of the head, with bleeding at the nose. Severe sharp, intermitting pains in the left temple. Full, preqsive sensation in the head, from within outward. Pains in the head, aggravated from motion. Eyes. Burning, throbbing pains, with dilated pupils, conjunctivitis and lachrymation. Every thing seems blurred, as if looking through a fog, or a thick veil. Can read only with the book about five inches from the nose. 584 PICRIC ACTD. Great heaviness of the lids; can't keep them open. Eyeballs sore to the touch, with photophobia. Severe, sharp shooting pains in center of eye, extending back to occipital region -seems to follow the course of the optic nerve. Lids sore, and slightly swollen. Mouth, Throat and Ears. Ears burn, look puffy, with sensation as of worms crawling on them. Bitter taste in the mouth. Throat feels raw, scraped, stiff and hot, as if burnt. Collection of thick, white mucus on the tonsils. Great difficulty of swallowing; sensation as if the throat would split open. Dry cough, as from dust in the throat, followed by nausea. Stomach. Nausea, bitter eructations after breakfast; sensation as of something in lower portion of oesophagus. No appetite; bitter taste in mouth; aversion to food. Abdomen and Stool. Stools, light colored, and passed with much burning and smarting in the anus. Scanty, soft stools, with burning at the anus. Crawling, stinging pain in the abdomen. Rectum and Anus. Smarting, stinging burning of the anus after a passage from the bowels. Urinary Organs. Urine profuse, very hot when passed; urethra feels as if burnt. Urine dark, high-colored, sp. gr. 10.25 to 10.28. Generative Organs. Great sexual desire, and painful erections, with emissions. Lewd dreams, with emissions. Very hard erections; terrible erections. -Erections, with severe pain in the left testicle, as if bruised, extending up the cord, as far as the external abdominal ring. PICRIC ACID. 585 Chest. Heavy, throbbing pain under tenth and eleventh ribs on left side. Dull, stunning pain in the chest. Back. Heavy, throbbing pain in the region of the kidneys, extending down the legs, especially the left. Small of the back sensitive to pressure. Extremities. Legs feel heavy, and very weak. Legs below the knees feel very sore and tender to the touch. Severe pain in the anterior portion of legs when touched. Legs heavy, like lead. Great coldness of the feet. Great heaviness in the arms and legs, especially on exertion. Shooting pain in the left arm, at elbow. Skin. Small, painful, reddish elevations like furuncles around the mouth and face; when opened they exude a thin, clear serum, which soon dries into a transparent scab; they then become pustular and very painful, and contain a thick, opaque pus. Fever. Great thirst for cold water; drank in large quantities, without relief. Fever; great chilliness; can't get warm; followed by cold, clammy sweat; chilliness predominates; pulse 50, weak and small. Sleep. Sleep sound, but unrefreshing. Restlessness. Generalities. Throbbing and jerking of the muscles in the different parts of the body, with severe chills and great pain between the hips. 38 586 PICRIC ACID. Profuse cold, clammy sweats, with great chilliness. Very tired on going up stairs. General lassitude. Rheumatic stitches in different parts of the body, with great muscular weakness. Drs. Moffat and Grace-Calvert mention the following properties and uses of Picric acid (in allopathic practice): "It is tonic and astringent, the latter influence being effected by improving the general tone of the system. It has been efficaciously used in convalescence from acute diseases, cephalalgia, chronic diarrhbea, gastric irritability, dyspepsia, anamia, and intermittent fever —in which last disease it is considered a valuable substitute for Quinia. As the free acid is apt to occasion cramps in the stomach, the Carbazotate of ammonia and Iron have been found the best. The Carbazotate of ammonia and Gallic acid, one grain each, with one-sixth of a grain of Opium for a dose, and repeated three times a day, in obstinate diarrhcea. By the use of these agents the skin and conjunctiva become colored, so as closely to resemble jaundice, and would deceive the keenest observer; the acid has been detected in the urine, even when this has been kept several days. The dose of these is from half a grain to a grain, repeated three times a day." I (Hale) have had no personal experience with this medicine. Dr. S. A. Jones, in " A Fragmentary Commentary on the Pathogenesis of Picric Acid," read before the N. Y. County Homrn. Med. Society, Oct. 28, 1874, says: Grauvogl's doctrine of the "constitutions" commends itself to the practitioner because it affords such a classification of a remedy, and is to some extent expressive of the pathological nature of its action. Guided by his data, I shall first endeavor to determine what "' constitution" is induced by Picric acid. Hasty observation will lead one to class this drug in the hydrogenoid group. At first I fell into this mistake; but a little " reading between the lines" will enable one to assign this remedy to its proper place. Great chilliness-can't gSet warm —followed by cold, clammy sweat. Chilliness predominates; are certainly symptoms suggestive of the hydrogenoid constitution. Besides this, I have known the wet weather pains of a patient with locomotor ataxy to be markedly relieved by Picric acid. And, farther, in a case wherein PICRIC ACID. 587 my friend Dr. Lilienthal gave this remedy, it induced a sensation of freezing coldness; each successive dose being complained of on this account. However, with our remedy, all these phenomena are pseudo-hydrogenoid. In the animals poisoned with Picric acid, the blood was black and fluid; a condition which suggests a privation of oxygen. In the symptoms of the human provers we find ample evidence of congestion; a perversion of nutrition, wherein the balance between waste and repair is disturbed, and which tends toward incomplete oxidation of the blood. Our " homceopathic " habit of differentiating also assists in assigning Picric acid to its proper constitution-group, for we find the remedy-to be characterized by an aggravation from motion; motion meaning tissue disintegration, accelerated histolysis, and blood still farther charged with effete material. We observe also an amelioration from rest; the quietude reducing tissue change to a minimum, and thereby economizing the oxygen. And still. farther, we must note the amelioration from cold (air and water); the temperature aiding the embarrassed circulation by the tonic effect of cold upon the vaso-rntotor system. From such considerations, I am led to regard Picric acid as belonging to the carbo-nitrogenoid group; but that it may be only thus classified I am not prepared to assert, remembering that, at least curatively, Nux vomica 3d and 3oth, is respectively an hydrogenoid, and a carbo-nitrogenoid remedy. I can but regard deranged innervation as the first link in the chain of the action of Picric acid, when I remember that the best of the several provings was made with the 30th potency —a proving in which the symptoms are well marked, the modalities clearly evinced, and the tout ensemble stamped as genuine by the parallelisms educed from other provers, with other potencies, even as low as the Ist. When we survey the whole action of Picric acid, and take in its subtlety, observing how comparatively soon such insignificant doses undermine the organism and sap its strength, we can not avoid the conclusion that the derangement of innervation occurs in a highly vital territory. In the proving to which we have just referred, the first symptom produced by the drug is: " Ears began to burn and look puff', with a sensation as if worms were crawling on them. These symptoms lasted two hours." Schr6der Van der Kolk says redness of the ears indicates congestion of the posterior half of the base of the brain; and you may depend upon it, if the prover had completed the record, " redness of the ears " would also have been noted; for pathology tan supply a prover's omissions. Van der Kolk also gives redness of the nose as an indication of congestion of the anterior half of the base of the brain; and the second prover, in three hours after the first dose, notes " bleeding of the nose, with heat and congestion of the head," Evidently, the first act of this pathogenetic drama is cerebral congestion. Where is its location, or rather where is the congestion specializing itself by effect? The "sensation as if worms were crawling on the ears " signifies something amiss in the pons varolii. If still further evidence is needed that cerebral congestion is the pathological status, we find it in the sleep symptoms. In a brief proving on myself, an inability to fall asleep until long past my usual time was a disagreeable feature; 588 PICRIC ACID. and from Durham and Hammond we learn that sleep requires cerebral anaemia; that a certain degree of cerebral congestion gives insomnia; that an intense degree is coma. As it is not my purpose,.on this occasion, to specialize the symptomatology of this remedy, I turn at once to the post-mortem record of the poisoned animals. In the cat were found the following conditions: "Membranes of the brain gave no evidence of inflammation; cerebrum slightly softened; the cerebellum, medulla oblongata, and upper part of the cord were soft, pulpy, and apparently completely disorganized; in the lower portions of the cord no lesions were discovered." In the dog, " the cortical substance of the cerebrum, the whole of the cerebellum and of the medulla oblongata, and a portion of the cord were apparently cormpletely disorganized." I regret to say that these "apparently disorganized" structures were not submitted to an unquestionable microscopical examination, and as a result, we are embarrassed in the attempt to read the riddle of the physiological action of this agent. By classifying Picric acid with the carbo-nitrogenoid group, we are placing it among the agents which most especially de-vitalize. We do not find in its action any of that'destructive energy, that true erethism, which characterizes the oxygenoids, and we need only exercise a little circumspection to avoid mistaking the indolence of the hydrogenoid for the languor of of the carbo-nitrogenoid. The condition of the blood also tends to confirm this classification. It is " black andfluid," and we are aided in properly estimating this by the following symptom which was observed on the dog: " Profuse frothy saliva hanging in long strings to the ground." We are reminded of Kali bichromicum and its stringy mucus; and when we recollect Babington's experiments on the effects of alkalies on albuminous fluids, and know that liquor potassae transforms laudable pus into a transparent, tenacious, and stringy plasm or mucus, we are led to regard this black and fluid blood as a blood in which some alkali is in excess; as it is in the blood of enteric fever, of diphtheria, and of all (?) diseases characterized by adynamia. With such a blood-condition we are prepared to appreciate the significance of the symptom, "pulse 50, weak and small." When to this blood condition we add the structural degeneration in the brain, medulla oblongata, and upper part of the cord, we easily perceive why it is that the pathogenetic genius of Picric acid-its prostrating power- is so readily discerned, and we can but be struck by the correspondence between its symptomatology and its pathological anatomy. In a slow poisoning with Picric acid, the victim appears as smitten by a blight, ab initio. A languor steals over the whole organism, gradually deepens into torpor, and makes it more and more difficult to arouse the waning energy, until, like an exhausted lamp, the last faint, flickering spark trembles and is gone. This torpor at first dulls, and finally extinguishes the intellect; coetaneously the motor function is impaired - weariness, profund debility, complete inertia being the grade and order of its progress. In brief, an universal prostration, psychical and physical, is the distinguishing feature, and speedy exhaustion from slight PICRIC ACID. 589 exertion the grand characteristic of this remedy. One single word portrays the generic action of Picric acid: ASTHENIA. The intense excitement of the genital apparatus, as evinced by violent and long continued priapism and profuse seminal emissions, will not suggest the exuberance of lusty vigor to him who is aware that such evidences of quasi strength in that department of the economy, are the best proof of weakness - of a specific debility, and of which, if the cause be not removed, the sequel is cardiac hypertrophy, consumption, or insanity, and the end, premature death. All drugs in their action induce disease, pervert function, and derange structure, but the feature of the action of Picric acid with which I am most impressed, is that, beside bringing such discomfort as attends all drug action, it initiates a profound derangement from the very beginning of its operation - it seems to be in deadly earnest from the very first. The incompleteness of the pathogenesis which we now possess, will not enable such a differential study of this remedy as the proper exercise of our art demands. And indeed such a study, if we had the necessary material, is " for other hands than mine." I trust, however, that I may presume to offer you a contrast by which the prime feature of this remedy will be fastened in the memory. Both Picric acid and Silicia are signalized by a condition which is best expressed in the incisive vernacular of the street as " played out." A fragmentary citation from Marshall Hall, will enable us by this " played out " feeling to fix the location of the action of these two remedies. This great physiologist says: "Another function of the cerebral system is the sense of fatigue. * * * * As the true spinal system does not sleep, so it is incapable of fatigue."* In the Silicia patient, this "played out " feeling is very marked, but he can become interested, and then he works with both mind and body as well as ever; in fact he will outdo those who are working with him - the very continuance of effort which seems to exhaust them appearing as if it only reinforced him: therefore, we may say of the Silicia patient that while at work he is not only unconscious of any inability, but by a seemingly awakened ardor irresistibly impelled into a paroxysm of over-doing.t From a short proving of Picric acid on myself, I learned to recognize the difference between these remedies. While under the influence of the drug. I was copying from a volume before me, and when upon the fifth sheet of manuscript I found that after reading a line in the book I could not remember it long enough to write it down; two words of three syllables seemed about all that my memory could carry, so that I was constantly obliged to be recurring to the printed page. I am so accustomed to transcribing, that I can ordinarily retain * On the Diseases and Derangements of the Nervous System, p. 26. f For a knowledge of this " inside history " of Silicia - a knowledge which I should never have obtained from the pathogenesis of this remedy - I am indebted to Dr. Carroll Dunham. I have so often shared in the fruits of his discriminating insight, that my many obligations would be burdensome did I not know that from his fullness he can enrich others without impoverishing himself. 590 PICRIC ACID. two or three lines of type; indeed, I did this when I began work on this very occasion. Now, I had previously observed, as an effect of Piric acid, that a walk, which ordinarily I would make no account of, produced a great weariness in the lower extremities, and I had jotted down, soon wearied by slight exertion, as a feature of the action of this drug. From this last experience, then, I learned that the same modality is as true of the mind as of the body. Then, the contrast is this: the prostration of Silicia comes only after the endeavor has been made; that of Picric acid supervenes while the endeavor is being made. The Silicia patient resembles a thoroughbred who runs the race, wins it, and then dies in the stable. The Picric acid patient is like a low-bred cob who falls and dies upon the track. These are by no means mere figures of rhetoric; on the contrary, they recognize a pathological fact which is the essence of the difference between these remedies, namely, the action of Picric acid is to extinguish that quality which we call grit, while Silicia leaves it intact. As we have employed figures to illustrate a contrast which may aid us in selecting either of these drugs as a remedy, nevertheless, as physicians, we must attempt to determine the physiological import of the idea which is clothed in those figures. We may then ask, what is the physiological meaning of grit? In the sense in which we employed that word it is matter obeying mind, or, if you will, volition compelling function. The will is a stimulus which excites the irritability of a neurine cell in thought, and of a muscular fiber cell in motion. Now, can we say that Picric acid acts directly on the will, enfeebling it? If I did say this, Samuel Lilienthal, M.D., Professor of Pyschological Medicine, would not let me share his office another hour. When I was copying from the book before mentioned, I had a good will to have finished my task at one sitting; but when I willed my memory to retain a line at a time of the printed page, the brain cells had become so fagged that one or two words made a faint impress, and the rest faded. The stimulus of the will was of little avail, because the organs on which it sought to act had lost their irritability- they no longer responded, or only feebly responded to the stimulus. Evidently, then, the ultimate pathological difference is that Picric acid exhausts the irritability. The profound sense of fatigue in Picric acid is genuine debility; the sense of prostration in Silicia is a delusion. Said Dr. Dunham to me once: " The Silicia patient feels as if he could not possibly do this or that, but when urged to the doing, he goes off in a spasm of over-doing." Writer's cramp affords a good instance of this Silicia condition, and in such over-doing, we see wasted strength -a prodigality of doing — rather than waning strength, and inability to do. Silicia exalts and intensi fes the normal irritability, Picric acid depresses and extinguishes it. Because we have spoken of the action of Picric acid on nervous tissue especially, do not receive the impression that this is its only sphere. From its action on brain, medulla oblongata, and spinal cord, we must deem it capable of secondarily inducing universal havoc. The type of its secondary action will be that of deranged nutrition. By its action on the encephalic mass, the inhibitory nerve of the heart is stimulated, so that a young man under the influence of this remedy records a PICRIC ACID-POPULUS TREMULOIDES. 591 pulse of only 50, weak and small; but when we ascribe this to the cardiac inhibitory, how do we know that the general adynamia is not paralyzing the accelerator nerve, or the ganglia whose ramifications envelope the auricles and ventricles? I can not close without a word about the wasted muscles of the inferior extremities which were found in the poisoned dog. Of the nature of the pathological change in them, we unfortunately know nothing; but the significance of the naked fact must not be overlooked so long as nosology recognizes a progressive muscular atrophy. P. S.-This postcript is penned in the light of clearer knowledge. Dr. Erb's monograph on Picric acid has been read, and through the courtesy of L. B. Couch, M.D., the writer has had the opportunity of examining a dog which was slowly poisoned (thirty days) with this agent, by Dr. C. In the possession of fuller knowledge, the only absolute error of the commentary is found to be in regard to a conjecture which was expressed in these words: " From a consideration of the pathological condition of the brain, and medulla oblongata, I am disposed to think that small doses of Picric acid occasion hyperaemia, and large ones anaemia." The process of reasoning by which this conclusion was reached, is as follows: Softening is the pathological condition of the affected tissues. Anaemia is the causative condition. The animals received large doses. Ergo, large doses occasion anaemia, etc. As we can starve a man (or a tissue) as readily by changing the quality of his food as by reducing the quantity thereof, the possibility of softening from spanaemia, or, to be critically precise, from oligocythoemia, was not considered, and therein the closet commentary has, indeed, come to grief. But, despite this, it may encourage the student to know microscopical examinations demonstrate that deranged innervation is the first link in the chain of the action of Picric acid, and also that the type of its secondary action is deranged nutrition. It may not be amiss to add that both a microscopical analysis of the poisoned tissues, and the clinical use of the remedy, combine in awarding to Picric acid a position between Phosphorus on the one side and Argentum nitricum on the other - the closer relationship being to the silver salt.-S. A. J. POPULUS TREMULOIDES. As we have no provings of this agent, I will quote the testimony of physicians of other schools relating to its physiological (toxic) action, also their estimate of its medicinal powers and virtues, with such clinical experience as they have gained from its use. After which I will give my own experience with the remedy in a few abnormal conditions. 592 POPULUS TREMULOIDES. Toxical Effects. — Dr. Paine (eclectic) says of his experiments with Populin: "In doses of five to ten grains, in a healthy person, it produces a warm, pungent sensation in the stomach, followed by a glow of heat on the entire surface, and copious discharges of urine, and if the dose is repeated every.two hours, until forty or fifty grains are taken, it causes nausea, vomiting, and slight purging of bilious matter, with fierce, burning sensation in the stomach, very copious discharges of urine, irritation of the bladder and urethra, with slight fullness about the head, and general nervous excitement." Medicinal Effects. —" It has been decreed to be tonic and febrifuge, and has been used in intermittent fever with advantage. An infusion has been reputed to be a valuable remedy in emaciation and debility, lumbricoid worms, impaired digestion, chronic diarrhcea, etc. As a diuretic it has been beneficially used in urinary affections, gonorrhcea, gleet, etc. Dose of the powdered bark, one drachm, two or three times a day." (King.) "It is a mild and not an unpleasant bitter, very well adapted to cases of general debility, dyspepsia attended with torpor of the liver, or an unhealthy biliary secretion. * * Notwithstanding this agent has received no especial attention from the profession as a medical article, and none at all as an alterant, yet we regard it as a very useful remedy in those shattered and broken down states of the constitution arising from the use of Mercury, from syphilis, chronic, hepatic and dyspeptic affections, scrofula, etc. It has been used with advantage, it is said, in jaundice, renal obstructions, chronic diarrhaea and dysentery." (Scudder.) Prof. Hollenbach recommends it for gonorrhcea and gleet. Dr. Coe, in his " Conc. Org. Remedies," recommends Populin for the following: "Indigestion, flatulence, worms, hysteria, jaundice, fever, cutaneous diseases, scalding and suppression of urine, night sweats, etc." He writes -"As a remedy for indigestion, accompanied with flatulence and acidity, we know of no single agent more to be relied on. " In hysteria it is mainly useful as a tonic after the urgent symptoms are quelled. It will be tolerated by the stomach POPULUS TREMULOIDES. 593 when other tonics are rejected, and tranquilize the sympathetic disturbance arising from uterine excitement. It is for this reason an excellent remedy for the dyspeptic symptoms accompanying pregnancy." "It is one of the most reliable remedies for the relief of night sweats that it has ever been our good fortune to become acquainted with. We refer its curative action in this instance to its power of restoring and giving vigor to the secreting vessels of the skin." "Suppression and retention of urine are readily relieved with the Populin. * * Paramount to all the rest is its property of relieving painful micturition, heat and scalding of the urine. Did it possess no other curative value, we should esteem it an indispensable constituent of our Materia iMedica. Its value in this respect is most apparent when the symptoms above named occur during pregnancy." If Dr. Coe had used the Populin uncombined, his statement would be more valuable. It was mixed, however, with Gum 7Myrrh. Such a practice is to be regretted, as it renders doubtful any clinical deduction. It is probable, from the knowledge we have from other sources, that the Populus was the principal agent in the curative process. In the recommendations given for its use in jaundice, constipation and dyspepsia, Dr. Coe combines it with Leptandrin, Podophyllin, etc., which robs his recommendations of much of their reliability. Notwithstanding Dr. Paine (eclectic) found it to cause great irritation of the bladder and urethra, (see toxical effects) he remarks: "In diseases of the bladder, urethra and prostate, I have found the greatest benefit from this article. In several most inveterate cases of catarrh of the bladder, I have found that two or three grains, administered four or five times a day, produced a most favorable impression. In the case of an old gentleman who had been troubled with this affection, together with ardor urinoe and chronic enlargement of the prostate for many years, and who was not able to obtain benefit from any of the ordinary remedies, relief was promptly given by the use of two grains of Populin three times a day." (The medicine was continued four or five months.) 594 POPULUS TREMULOIDES. The same writer says: "I have used the Populin with great success in chronic gleet. In several cases, when all other remedies had failed, I have succeeded in entirely removing the disease by the use of this drug for several consecutive weeks." Dr. Paine tries to avoid the evident deduction favorable to homoeopathy, by explaining that the Populin "acts as a tonic to the bladder, urethra, etc." According to Dr. Paine (eclectic), the Populus has been "highly recommended and extensively used in many chronic diseases of the uterus and vagina, especially in prurigo, with aphthous condition of the mucous membrane of the vagina, and an irritable condition of the lining membrane of the uterus." Its irritant action on the urinary organs would render it very probable that the Populus would cause the above mentioned conditions in the generative organs of women. The Populus has not been used by practitioners of the homceopathic school -at least such experience has not come to my knowledge. I have observed many apparent cures of debility from prostrating fever, dyspepsia, hysteria, etc., in domestic practice; and am confident that it is a medicine capable of becoming a polychrest of wide range. Its analogues are theoretically given.(Vol. I,) and I believe its pathogenesis, when obtained, will sustain my idea of its sphere of action, which seems to include the digestive organs, the urinary and genital apparatus, and indirectly the sympathetic nervous system. I have prescribed it, in a few instances, for symptoms similar to those mentioned by Paine in his record of its physiological effects. In one instance of dysuria, due probably to debility, its curative action was quite satisfactory. Many physicians complain that our Materia Medica is already overloaded with remedies, and some are hasty enough to declare that they could throw them all away and practice successfully with a dozen. I can not comprehend the cynicism or conceit which prompts such aremark. One's knowledge of the myriad forms of disease must be very limited, if he will entertain such absurd opinions. POPULUS TREMULOIDES. 595 In my " Characteristics of New Remedies," I made mention of the eclectic clinical use of this remedy in diseases of the prostate gland, in which vesical tenesmus was the prominent symptom. Since that was written, I have had many opportunities of verifying the value of that clinical observation. I have not confined my prescriptions to cases of prostatic diseases alone, but to all cases where this one distressing symptom was prominent. In three cases of extensive disease of the bladder and prostate, where the urine was scanty and contained a large proportion of blood and pus, and the tenesmus was exceedingly painful, the Populus in doses of five drops of the lx dil. every three hours, relieved in a very short time. It had no curative effect on the structural lesion, but made the patients more comfortable. In several cases where the tenesmus occurred in women, and the symptom was due to reflex irritation, the 2x dil. afforded prompt relief. In three cases of inflammation of the neck of the bladder in women, it removed the inflammation after Cannabis and Cantharis had caused but little improvement. A lady who had been under my care for metritis, accompanied by vaginismus and cystitis, was discharged, apparently cured, but a ride in the cars all day brought back some of the symptoms of weight, pressure and aching in the pelvis, and worst of all, vesical tenesmus with frequent desire to urinate. I sent by mail some pellets saturated with Populus 3x, of which she was to take six every three hours. In a few days she reported that all the symptoms disappeared in two days after taking the remedy. This sensation called vesical tenesmus, seems to depend on a spasmodic contraction of the muscular fibers of the bladder, more especially those near the neck. In large doses, Populus causes "ardor urinoe, irritation of the bladder and urethra, with copious discharge of urine." In the cases cured by me, there was little pain during urination, but as soon as the last drops were voided, or a little before, a severe, cramp-like pain set in just behind 596 POLYPORUS OFFICINALIS. and above the pubes; this pain often lasted ten or fifteen minutes. I believe the Populus to be a medicine well worth an extensive trial, both by provings and clinical use, for only by both combined can we attain to the largest knowledge of a drug. POLYPORUS OFFICINALIS. This remedy is prepared from a fungus found growing on the Larch-tree, in all countries. It was formerly called Boletus laricis. It grows in masses, varying from the size of an apple to that of a large nutmeg melon. It contains 72 per cent. of a resinous matter, some Benzoic acid, and various saline compounds. The Indians of the Rocky Mountains use it habitually as a purge. It requires twenty or thirty grains to act as a cathartic. Forty grains in divided doses, taken in twenty-fours, is said to check the night sweats of consumptives. Dr. Burt collected the provings-one of which was made by the late Prof. F. A. Lord-and published them, together with clinical cases, in the form of a monograph. The chief reputation of this medicine has been gained in the treatment of obstinate intermittent fevers, or those agues which have been aggravated by exposures and neglect, or abuse of quinine. Dr. Lord reported many cases of ague, all previously drugged with quinine, which were promptly cured by Polyporus. He also reported a few cases of ague which had not been subjected to any treatment. Some were benefited by the remedy; in others, no apparent effect was observed. He incidentally remarks that in one case it had no other effect than to remove a jaundice. Many other physicians in the West communicated the results of their use of this fungus in malarial fevers. A large amount of testimony was collected both for and against its value. Some were quite enthusiastic, and believed it would POLYPORUS OFFICINALIS. 597 rival quinine; others thought they had found an ague-specific at last. Many claimed to have tested it thoroughly during a year or more, and found it wanting in any curative powers. Other, still, found it to act finely in one epidemic and fail in the next. Such was Dr. Burt's own experience, as well as my own. I quote Dr. Burt's clinical results, also his opinion as to its sphere of action. His views correspond very nearly to mna own. He says; The first six months I commenced using the Polyporus I had universal success with it. Gave the remedy in more than one hundred cases, with but five failures. The cases where it failed were four of them tertian type, one quotidian, a desperate case, that tried me three months. Could only suppress it for one or two weeks at best, when it would return again. Last Fall, when intermittent fever became an epidemic, and raged almost everywhere, my Polyporus commenced failing me. I could not cure more than one case out of five. I finally abandoned its use altogether for three months, then I commenced using it again with the same universal success that I had at first. I am using the remedy now, with the best results. The cases that the Polyporus will give us the best satisfaction in are those of long standing, that have been thoroughly saturated with Quinine and all kinds of remedies; where there is more or less disorder of the liver and abdominal viscera, with anaemia; sallow, jaundiced appearance of the skin; the bowels loose or torpid; but does better if the bowels are costive. Type quotidian, or tertian; acts better in quotidians.'During the apyrexia the patient is far from being well; has headache; bitter taste in the mouth; tongue coated white or yellow, or may be anaemic; loss of appetite; more or less pains in the abdominal viscera, and especially the liver. Is very languid; may or may not perspire after the paroxysm; if he perspires very profusely it is rather against the remedy. Also, I have noticed in those cases where the patient perspires a good deal during the fever, the Polyporus will have but little, if any, effect upon the disease. If the food passes the patient undigested, the Polyporus is strongly called for, and will cure the lientery like magic. Those cases where the patient seems to have almost continued fever, the intermissions are very short, can hardly be noticed, the fever is not very high, the remedy in my hands has acted like a charm. In acute cases I have had the best results with the remedy in quotidians, where the fever lasted a long time-might almost be called a remittent fever; during the apyrexia the patient feels very ill, with loss of appetite or canine hunger; has more or less gastric symptoms; with dull headache and great langour. During the paroxysm has more or less gastric symptoms; may or may not vomit; has severe headache, with pains in the back and limbs. The chill is generally light and short, the fever of long duration, and followed by perspiration, but not profusely; may or may notwant water during the chill and fever, but not during the sweat; never craves water intensely during the paroxysm, like they do in fevers that call for Arsenicum. If the patient has a hard 598 POLYPORUS OFFICINALIS. chill, strong fever, and profuse perspiration, has no gastric symptoms, and gets up as soon as the sweat is over, feeling well, the Polyporus will not cure him: at least that is my experience. In sporadic cases the type may be quotidian or tertian, but better in quotidians, the remedy will be found to be one of the best now known to the profession, ranking equally with Quinine. But when intermittent fever becomes epidemic and rages over large sections of the country, the Polyporus can not be depended upon. If the patient is more or less jaundiced, it is a good indication for the Polyporus. Also I have noticed that in consumptive patients the remedy will cure most every form of intermittent fever that they may have. If the patient has a bilious temperament, it is a strong indication for its use. I have given it with excellent success in double quotidians. I think that the remedy will act better if the paroxysm comes on in the forepart of the day; if it comes on in the evening or at night, I have not had such good results from its use. Acts best in the Spring, Summer and Winter; acts poorly during the Fall. As we might expect from the nature of the medicine, it has cured many cases of periodical headache, appearing at a regular hour every day; also cases of prosopalgia of an intermittent character. One physician reported a case of "bilious sick-headache," in a woman past the climacteric, cured by drop doses of the mother tincture. Dr. Burt believes that its effects upon the liver are similar to those produced by Leptandra. He says he has given it in many cases of jaundice, with good results. The enteric symptoms of PQlyporus give a very good picture of malarial, epidemic diarrhcea and dysentery. It has been found successful in such cases, by Drs. Holcombe, Wood and others. Even in chronic cases it has been used advantageously. You will find that diarrhoea and dysentery of an intractable character often attend epidemics of ague. Sometimes the ague-paroxysm-i. e., the chill, fever and sweat-are replaced by intermittent or remittent attacks of diarrhoea or dysentery. In such cases, no remedy will prove of any service unless it corresponds to the anti-malarial genius of the malady, and possesses anti-periodic powers. Often have I had the most brilliant success with China, Quinine, Arsenicum and Gelseminum when the ordinary remedies failed. They were only indicated by the periodical appearance of the symptoms, not the special ones-the stool, pain, etc. The periodicity of the disease is often masked, POLYPORUS PINICOLA-QUINIA. 599 and will require your closest scrutiny to discern it. When you do, treat it as you would any ague. In this form of disease the Polyporus has made many excellent cures. The presence of Benzoic acid in the Polyporus may give it some power over urinary and rheumatic affections. POLYPORUS PINICOLA. This species of fungus grows upon the trunk of the White Pine. Its general properties are similar to the larch-agaric. Dr. P. H. Hale first used this medicine in homceopathic practice. He got his knowledge of its anti-periodic power from the lumbermen of northern Michigan. It is also used as a remedy for ague by the people of the middle and southern states, who macerate it in whisky and take it during the intermission. I place about the same estimate upon its powers that others place upon the P. officinalis. The general testimony is, that the best effects obtained from the pine-fungus have been observed in intermittent fevers of quotidian type. The fungi found upon the oak and other forest trees possess medicinal properties. Some are very powerful, and a few resemble the poisonous species found growing in the earth. QUINIA. The salts of Quinia, an alkaloid prepared from the Cinchona (Peruvian bark), called " China" in our school, are very extensively used, and abused, by all schools of medicine, not excepting the homceopathic. Although China is extensively used by our school, and its symptomatology well understood by our physicians, the same can not be said of Quinine. Therefore I consider that I am justified in placing it among the New Remedies. 600 QUINIA. If Hahnemann had experimented with the alkaloid instead of the bark, he would have seen more decided febrile effects, and his belief in its power to cause fever, even intermittents, would have been confirmed by more decided results. I will quote from Stille's Materia Medica the following clear and distinct account of the action of Quinine on man: When Sulphate of quinia is administered to a healthy person, in quantities not exceeding six grains daily, in doses of half a grain or a grain, it produces effects very analogous, if not identical with those of the simple bitters. At first no sensible effects whatever may be experienced; but, after a short time, the appetite is increased, the food appears to be more rapidly digested, the pulse becomes somewhat fuller and stronger, if not accelerated, the temperature of the surface is correspondingly elevated, the processes of sanguification and nutrition are promoted, and other vital functions are moderately stimulated either directly or indirectly. In other words, the medicine operates as a pure tonic, according to the definition of the term given in this work. In irritable states of the digestive organs, or of the system at large, these effects are sometimes exalted, by the free use of the medicine, into a moderately febrile state, with anorexia, gastric oppression, thirst, a furred tongue, accelerated pulse, heat and dryness of the surface, and headache or other cephalic uneasiness. This condition, however, is probably not the direct result of the action of the medicine upon the system at large, but indirect, and symptomatic of some local irritation produced by it, especially in the stomach or other parts of the digestive apparatus. This state of excessive excitement is rarely experienced in health; because, with an increase in the quantity of Quinia administered, other effects are developed, of a contrary tendency, which overcome its general excitant influence. Given to the amount of from six to twelve grains daily, in divided doses, or to a less amount in a single dose, Sulphate of quinia evinces a tendency to act specially upon the brain, and often produces very decided effects upon that organ. The quantity, however, necessary to the production of obvious cerebral symptoms, varies greatly in different individuals; some evincing an extraordinary susceptibility to the influence of even small doses, while others scarcely feel the largest quantity above mentioned. The first cerebral phenomenon usually presented is abnormal sounds, such as buzzing. roaring like that of a strong wind or of a cataract, singing, hissing, ringing, etc. Along with this there is generally more or less hardness of hearing, which, indeed, is one of the most characteristic effects of Quinia. Uneasy sensations in the head are also frequent, as of weight, fullness, tension, and sometimes positive pain, though very seldom severe. The circulation is not much affected; the pulse being sometimes increased sometimes diminished in frequency, but for the most part little altered. When, instead of the quantities above mentioned, from twelve to sixty grains or more are given daily, in divided doses, the effect upon the cerebral functions is increased, and a decided sedative influence upon the circulation produced, as evinced by a diminution of the frequency and force of the pulse, proportionate to the amount of the salt used. Along with the abnormal sounds before referred to, there is now giddiness or dizziness; the individual, if erect, often staggers; QUINIA. 601 occasionally there is irregular muscular movement; the hardness of hearing is not unfrequently increased to positive deafness, and in a few instances vision is disturbed, and blindness induced. At first, if the individual dose is large, there may be flushing of the face, headache, and sometimes epistaxis, indicating decided sanguineous determination to the head; and occasionally, though very rarely, active delirium occurs. In experiments upon dogs, even meningitis has in some relatively few instances been brought on by very large doses. (Briquet, Traite Thdrap. du Quinquina, p. i6I.) But these evidences of over excitement of the brain give way to others indicating a reduction of nervous power, such as diminished hearing and sight, uncontrollable tremblings, depressed spirits, sighing or yawning, and very rarely a kind of mental disorder, compared by Dr. James McCaw, of Virginia, to delirium tremens. (Slethoscope, ii. 666.) In some instances a tendency to drowsiness or stupor is evinced; in others, morbid wakefulness; but in the greater number, neither the one nor the other. Though the pulse is at first sometimes temporarily excited by these large doses, probably in sympathy with the excited brain, it in general soon becomes slower, and always feebler. The pulsations of the heart are often reduced ten or twelve in the minute, sometimes as much as twenty or twenty-five; and the whole num,. ber in the minute to forty, but seldom if ever lower. In strength, the pulse is diminished very nearly in proportion to the dose, as shown by the experiments of Briquet upon dogs, by means of Poiseuille's hxamadynameter; and, in extreme cases, it may be so much reduced as no longer to be felt at the wrist. The skin at the same time becomes cool, pale and moist, and the face pale or livid, and shrunk. This prostration under the use of Quinia may be carried so far as to constitute real poisoning. Death has often been produced in dogs by excessive doses; and in one case cited by M. Guersent, the same result is said to have taken place in the human subject. In this case, M. Bazire, a practitioner of medicine, in an excited state of imagination bordering on insanity, believing himself to be attacked with pernicious fever, took within a short time 6o grammes (very nearly two ounces Troy) of Sulphate of quinia by the mouth and rectum. Symptoms of great prostration, with loss of sight and hearing, came on, which he unfortunately ascribed to the pernicious fever, and hoped to counteract by a continuance of these enormous doses. In the course of nine or ten days, he took additionally five ounces of the salt. Another physician being then called in, found him covered with cold sweat, completely deaf and blind, with difficult and rattling respiration, profound stupor, and an expression of countenance like that of drunkenness. Though partially roused with much difficulty, so as to give rational answers, he quickly became delirious, and died. (Dict. de Med., 2e ed., xxvi. 570.) Giacommini, who first called attention to the powerful sedative influence of Quinia, records the case of an individual who took by accident about three drachms of the Sulphate. Extreme prostration came on, with an almost absent pulse, cold skin, slow respiration, feeble voice, and apparently imminent danger of death, which was, however, averted. In these prostrate cases, the pupil is often dilated, and there is sometimes coma. From Wood's Materia Medica I take the following relating to its 39 602 QUINIA. Poisonous Effects.-The earlier historians of Cinchona did not fail to notice that ill effects occasionally arise from its use, such as gastric derangement, colic, diarrhcea, headache, restlessness, sleeplessness, and deafness; but these symptoms were always temporary, and seldom reached so high a degree as to excite alarm. But after the discovery of Quinia, which contained in a small bulk the principal powers of the medicine, cases occurred which were distinguished by very alarming symptoms, such as delirium, coma, blindness, deafness, gastralgia, epileptiform convulsions, dyspnoea, aphonia, paralysis, congestion of the lungs, and haematuria. Trousseau speaks of a young woman who was delirious for a whole day after taking twenty grains of Sulphate of quinia. In another case, that of a male, forty-six grains rendered the patient blind, deaf, and delirious, and so giddy as to be unable to walk. He also vomited continually. A case is reported by G6linau of a delicate and nervous lady, who, after taking ten grains of Sulphate of quinia, on an empty stomach, was ittacked in about two hours with violent abdominal pains, rigors, and general prostration with cold sweats. The face was pale, the eyes sunken, the pupils dilated, the teeth clenched and the limbs stiff; confused answers were given to questions; the respiration was calm, the pulse 6o. In about an hour the pulse rose to 8o, there were ringing and buzzing in the ears, and the catamenia, which were not then due, made their appearance. The next day the patient was as well as usual, except that she suffered from dullness in the head and heaviness of the limbs. Giacomini reports the case of a man of middle age who took by mistake about three drachms of Sulphate of quinia at a single dose. He gradually became giddy and feeble, and then insensible. Nine hours after taking the medicine he lay motionless and pallid, the fingers were bluish and cold, and the whole surface cool, the respiration slow and suspirious, the pulse regular, but slow and hardly perceptible, the pupils widely dilated, the sight and hearing almost extinct, and the voice extremely feeble; the thirst was great, the tongue pale and moist, and the breath cold. The patient could not leave his bed until the fifth day. A similar case is narrated by Dr. Baldwin, in which sixty-eight grains were taken in the course of about twenty hours. A case is reported of a man who after taking three doses of Sulphate of quinia, each of eight grains, and at intervals of four hours, experienced the usual phenomena of cinchonism, then became drowsy, and afterward, by degrees, hemiplegic.. He did not recover the use of his limbs. Graefe, of Berlin, met with two cases of amaurosis which he attributed to Quinia, and Simon several of hoemoptysis following the administration of this substance to persons affected with intermittent fever. But the evidences of the poisonous properties of this drug are also furnished by cases in which it proved fatal to life. Four such cases are collected by M. M6lier. In one of these the patient was affected with delirium and coma, and died on the second day. Guersant has given an account of a physician and his wife, both of whom were poisoned by this preparation, the former fatally, after taking nearly five ounces of Sulphate of quinia within the space of eight or nine days. The symptoms were such as have been detailed in the case of Giacomini. Dr. Baldwin has reported the case of a child, six years of age, who died from taking eight grains of this salt, in two doses, with an interval of three hours between them, and with symptoms like those already described. Whenever, in such cases, the body has been examined after death, the same lesions have been QUINIA. 603 found as upon dissection of animals destroyed by the same cause, viz., congestion of the lungs and brain, and in some degree also of the stomach. A fatal effect, it has just been stated, may follow the administration of comparatively small quantities of Quinia. Such doses, when continued, have occasionally produced toxical, but less serious consequences. Dr. Van Buren saw partial loss of hearing result from taking two grain doses of Quinia for a period of weeks, and a case of amblyopia of three weeks' duration, and quite intractable, follow the use of four grain doses every four hours for a week. But in some cases, it should be borne in mind, enormous doses have been taken without fatal or even alarming consequences. In the case of the lady related by Guersant, and referred to the above, about 600 grains were used within the space of a few hours. Banquier states that one of his patients took seventy-two grains of Sulphate of quinia by mistake, and without hurt; and Tomasi di Spineto asserts that ninety grains may be given several times a day without danger. " A medical friend in Alabama," says Dr. Dickson, "assures us that he had administered thirty grains of the solution of Quinine every hour for seventeen successive hours; and we have heard authentically of a Western physician, who emptied into the stomach of a patient laboring under bilious remittent, an ounce bottle of Sulphate of quinine in one night. From thirty to fifty grains are now spoken of as not unfamiliar doses, and even one hundred grains are occasionally given at once, and, we are assured, both with safety and striking success." Dr. Drake mentions a man at Memphis, Tenn., who took eighty grains of Quinia at a single dose, and another at Montgomery, Ala., who consumed an ounce in the course of three days, and recovered. At Plaquemine, La., an old lady used ten grains every two hours, until an ounce had been taken. No bad effects followed. It must not be forgotten that Sulphate of quinia is often largely adulterated.* The fact may help to explain the innocuousness of the medicine in some of the many cases resembling the above, which are said to be of frequent occurrence in the western and southern portions of the United States. You see in these descriptions an excellent picture of the primary and secondary effects of the drug. At first, from moderate doses, all the normal functions appear to be simply increased. Afterwards, from larger doses, these functions become strikingly abnormal, until the brain and other important organs are congested and inflamed. Death may result from its ultimate primary effects, namely, from meningitis or apoplexy, or from general internal congestion. * I have seen specimens of Quinine, especially the Quinine supplied to the army during the late war, which contained nearly 70 or 80 per cent. of Salicine! It was probably a similar spurious substance which was given in massive doses without causing fatal consequences.-(Hale.) 6104 QUINIA. If the drug is continued too long, the hyper-stimulation and congestion is succeeded by failure of nervous power (secondary), as above delineated. You will remember that when describing the primary and secondary action of drugs, I mentioned that we may get secondary effects, without the primary, from very large doses. You see this illustrated in the effects of massive doses of Quinine, which cause extreme prostration, almost absent pulse, cold skin (pale, moist, livid, shrunken), slow respiration, feeble voice, coma-and in many cases collapse unto death. This it causes by its paralyzing action on the nervous centers without previous stimulation. The homceopathicity of Quinine to fever is clearly set forth in its primary effects. But I must impress it upon your memory, that the febrile symptoms there described belong to no other class of fevers but the malarial, sometimes called the miasmatic and paludal. As to the exact nature and origin of the causes of these fevers, the medical world is not unanimous. It is my belief, however, that such fevers have a cryptogamic origin; that the spores of certain cryptogamic plants, invisible to the naked eye, are absorbed into the system, probably through the respiratory or digestive organs, and are carried into the blood, where they cause by their fermentive (propagative) force, febrile manifestations. I believe with Salisbury, Bartlett, and others, that the prodroma, and the febrile paroxysm (chill, fever, sweat), are the efforts of the organism to throw off the accumulated poison. I believe that Quinine destroys the spores of the fungi in the blood, and is also homceopathic to the symptoms of the fever itself. I will take up, in regular order, the symptoms of malarial fever, and show the close similarity between such symptoms and those of Quinine poisoning. (1.) The prodroma. It is a singular but well known fact, that persons under the influence of malaria (marsh miasm), experience, for days, even weeks, previous to the attack, an unwonted exhilaration, an exuberance of healthy QUINIA. 605 sensations. The appetite increases, food is intensely enjoyed, the digestion is strong, and the physical strength is actually increased. But right in the height of this apparent excess of health, comes, unexpectedly, the chill, often congestive, followed by the other febrile symptoms. Now, if you will remember the symptoms of Quinine, when given in moderate doses, you will see an excellent picture of this prodromic state. It would seem as if the fermentive force of the poisonous spores in the blood actually stimulated the functions of the body (primarily), until the excessive fermentation ended in the explosive paroxysm. (2.) The chill. An ague-chill may be a simple coldness, or coldness with shivering, or a condition of general congestion, known generally by the names of congestive chill, sinking chill, or syncopal chill. This last condition may occur when the patient believes himself in perfect health, without any unpleasant warnings. It resembles the collapse of cholera in all but the colliquative discharges, and sometimes these are not wanting. It resembles also the poisonous effects of Quinine when taken in massive doses (fifty to two hundred grains.) The reaction from this collapse, or from a simple chill, results in a febrile paroxysm (intense heat, congestion, etc.), and is followed by profuse sweat. In bad cases no reaction occurs, but the victim dies in spite of all efforts at stimulation. Sometimes the sweat is absent after the fever. In such cases no clear apyrexia obtains, but an erethistic fever smoulders until the next attack (one, two or three days.) In cases of Quinine poisoning we can get all these stages, with more or less intensity, depending on the amount taken into the system, or the constitution of the experimenter. So in malarial poisoning. The intensity of the fever will depend on the amount of poison in the blood, and the strength of the patient's constitution. What therapeutical deductions can we make from these facts? I will try to explain. QUINIA. 607 by paludal fevers. It has been found that a few grains a day will prevent the access of the disease. I believe that a few grains of the 3x trituration would act as a preventive, unless we must rely upon the antiseptic action of the drug upon the fermentive process going on in the blood. During the paroxysm, Quinine should be given in a high trituration or dilution, from the 6th to the 30th, according to the intensity of the fever, congestion, and nervous phenomena. I know from actual experience that the use of Quinine during the paroxysm, in this manner, greatly mitigates the symptoms at the time, and I am certain that it requires less of the medicine to be given through the apyrexia. At one time the allopathists recommended that Quinine be given during the paroxysm, "in order to more effectually break the fever; " but although they prescribed it in doses of one-twentieth or one-fortieth of a grain every hour, the aggravations were so painful that the practice was abandoned. I once supposed that the congestive chill, which is often met with in bad cases, corresponded to the secondary effects of this drug. But I am now satisfied that it is an ultimate primary effect. If Quinine is used at all during the chill, it must be used in small doses (one-tenth or one-twentieth of a grain every half hour.) But the treatment of such attacks with Quinine is not very successful. I have known doses of all sizes to be given during the collapse, without the slightest effect, even when aided by large quantities of brandy and other liquors. I do not believe you will find it the best remedy in this condition. The best treatment for the sinking-chill, in addition to the use of medicines primarily indicated, namely, Arsenicum, Veratrum, Aconite, etc., is the use of the hot mustard bath. Strip the clothes from your patient, or leave them on if he is very weak, and place him in a bath of hot water (1200 to 130~), in which has been dissolved an ounce or two of powdered mustard. Rub the patient well while in the water, and do not take him out until reaction has set in, and the skin 608 QUINIA. is red, and warm, and the external blood vessels filled. If a bath is not obtainable, rub the patient with dry mustard, or cayenne pepper, or any substance which will bring back to the surface the blood which is stagnating in the central organs of the body. The radical treatment of malarial fever must be applied in the apyrexia. During the intermission, let the type be what it may -intermittent or remittent - give the Quinine, if indicated, in doses graduated to suit the age, sex, constitution, or idiosyncrasy of your patient. No time should be lost, in cases of malignant malarial fever, after the first paroxysm or congestive chill, in getting the patient under the influence of Quinine. We now come to the consideration of the doses to be used in the apyrexia. The symptoms of the apyrexia resemble the secondary symptoms and pathological condition caused by Quinia, namely: great debility resulting from the primary congestion, fever, and sweat. The nerve centers are left in a very weak condition, and the normal reflex functions are semiparalyzed. In such condition, large or appreciable doses are required. Large experience has enabled physicians to decide with great accuracy the quantity necessary to be used to arrest the paroxysms. Twenty grains of Quinia, in ordinary cases, is the maximum quantity. This will vary from five grains in susceptible persons with paroxysms of moderate severity, to fifty grains in cases of pernicious congestive fever, when death would probably result if another paroxysm was permitted. The manner of giving Quinine varies with the whims and experience of the physician. Some prefer to give five or ten grains just after the paroxysm, and the same quantity just before. In severe cases, where the apyrexia is short, this is a good plan. But in ordinary cases, my experience has taught me that it is best to begin about six hours before the expected paroxysm, and give one or two grains an hour until the QUINIA. 609 chill comes on, or the chill-time is passed. If I were called to a case of malignant congestive ague, and was informed that another paroxysm was expected in an hour or two, I should not hesitate a moment before giving twenty or thirty grains immediately. In no other way can you be sure of warding off the impending paroxysm. The relations of the dose of Quinine to age, I have studied as in the case of the Bromides. I have ascertained that the proper quantity is about one-tenth of a grain for each year of a child's age until five years, provided the dose is repeated every hour. If a single dose is to be given, and not repeated, the quantity would rise to one grain. For every five years until the age of twenty, I would double the dose to be given hourly, and quadruple it if only a single dose is to be given, as in desperate cases. It may be asked, Are there no substitutes for Quinia? There are, but they are not perfect substitutes. Ague remedies may be divided into two classes, namely: those which have the power, like Quinia, of poisoning protozoa, infusoria, and cryptogamic fungi, and those which have not this power. In the first class I shall place Quinine, Gelseminum, Eucalyptus, Nux vomica, Arsenic and Cedron. In the latter class I shall place Eupatorium, Cornus, Salicine, Arnica, Natrum mur. and Hydrastis (Berberina.) All these correspond to the periodicity of the ague paroxysm, but there is another class which does not, while they possess the power of the first class, of destroying animal or vegetable germs, namely: Carbolic acid, Sulphite of soda, Silicylic acid, and a few other chemical compounds. The medicines in Class I, will always remain the chief remedies for malarial fevers. They will have to be used in more or less appreciable doses. If you have read Hahnemann, you will remember a suggestive observation, that in many cases neither China (attenuated) or any other remedy will prevent the recurrence of fevers due to marsh-miasm. This is true at this day, for many cases cease to be influenced by any remedy, and only a residence in a non-mias 610 QUINIA. matic district will eradicate the disease. We can do better, however, than could Hahnemann, for we have a larger number to choose from. The medicines in Class II. will not be found useful in epidemic malarial fevers, especially if of the pernicious type. Boastful homieopathic physicians often claim that they can cure any case of ague with the high potencies of this or the first class. But those who have practiced many years in malarious districts know that such assertions are false. I need only refer you to the writings and experience of such men as Holcombe, Ellis, Douglas, Marcy, Pulte, and hundreds of others in this country; also Hughes, Baehr, Roth, Kafka and others in England and on the Continent. I have personally known and been a close observer of the practice of many high dilutionists. Some I believe to be honest, and they thought they cured veritable cases of epidemic ague, when the patient. had cured or arrested the paroxysms with Quinine, taken sub rosa. Others I know to be dishonest. They gave attenuated doses as long as they dared to, and then resorted to Quinine, or allowed the patient to pass out of their hands. I do not deny that agues can be cured by the high potencies, or attenuated medicines. On the contrary, I affirm that such is the case. But we must sharply define the kind of ague cured by appreciable and non-appreciable doses. If the blood of the patient is saturated with the malarial poison, appreciable quantities of the medicines in Class I or III are required. If the blood contains only a small quantity, i. e., if the paroxysms are slight, the medicines in Class II will suffice, or the remedies in both classes, in attenuated doses. There are many cases of chronic or persistent ague, in all its protean forms, which do not depend on the presence of poisonous germs in the blood. These have long ago been cast off by the organism. The ague paroxysm, the periodical attacks of pain, malaise, etc., are kept up from habit. The profound impression made upon the nervous system by the original malady is continually perpetuated by that QUINIA. 611 strange tendency to habit which adheres to animal and vegetable organisms. In this class of cases many very striking and notable cures are made by the highest dilutions. I have known of, and have myself cured, old, obstinate agues with Sulphur 30th and 200th, Arnica 6th and 12th, Arsenicum 30th and 1000th, and Natrum mur. 30 and im. I have also known similar cases to be cured by other dynamic forces, such as diversion of mind, the influence of hope and joy, the excitement incident to an intended journey, and even a mistake as to the time of day. And such cures are often just as good and veritable as when made with dynamized medicines. I can not too strongly condemn the habit common with allopathic, and even with homceopathic physicians, in malarious districts, of giving Quinine indiscriminately, whenever a patient has a chill and fever resembling ague. Unless the physician is absolutely certain that the attack is due to miasmatic poisoning, he should wait until the disease shows its true character. There are certain rules which should be followed in order that the use of Quinine, in appreciable doses, should be attended with safety and success. The one important rule is that Quinine, in doses below the 3x, should not be given (except in dangerous cases) until the tongue is clean or cleaning, the pulse open and soft, and the skin moist and cool. If given in other conditions, Quinine does not generally act favorably. It will change an intermittent or remittent into a continued fever; and I have known it to cause a typhoid. How shall we bring about the condition of tongue and pulse? I answer: By prescribing the specific remedies to remove the functional disturbance of the liver and gastric organs. The proper use of Aconite, Verat. viride, Mercurius, Podophyllin, Leptandrin, and Nux vomica, will usually remove the coat on the tongue, and bring about the desired condition of the circulation. 612 QUINIA. Then you can suspend the use of all other medicines, and give Quinine, if Gelseminum, Arsenic, Eucalyptus or some other remedy will not cure the patient, or if Quinine is the indicated remedy. Aside from its curative power in the class of diseases I have mentioned, the curative sphere of Quinine is limited. I utterly deny its so-called "tonic " power in all cases. It is only when malaria lies at the bottom of the debility that Quinine does any good. The apparent tonic influence is only a temporary stimulation, which soon leaves the patient weaker than before. Nor do I believe it is of any value in true pymemic poisoning, with or without fever. Although it is said to destroy bacteria and infusoria, experience has not proven that its value in septic poisoning is in any way superior to other "tonics," or equal to the Sulphites or Carbolates or Arsenic. The Carbolate and Carbazotate of Quinia, have been recommended in such cases, and bid fair to prove very efficacious, if used with judgment and in.proper doses. The action of Quinine on the ears may be taken advantage of in our practice. It causes, with the fullness, tightness, and congestion to the head; ringing, roaring, and other noises in the ears, sometimes of a distracting nature, and often complete deafness for days and weeks, and sometimes for life. The aurist will find Quinia more valuable than China in the treatment of congestive and nervous affections of the ear. Many cases of tinnitis aurium cured promptly by the use of Quinia 3x are on record, also many cases of nervous deafness. Quinia acts on the eyes no less perniciously, when given in large doses, than on the ears. It causes dimness of sight and temporary blindness. The defect of vision is sometimes limited to one eye, or begins in one eye. The pupil of the affected eye is very generally dilated, objects appear double or unnaturally small, and the eye is injected and suffused. In toxic doses it has caused amaurosis, ending in total loss of sight. QUINIA. 613 It remains for the oculist to study and define the true sphere of action of this medicine in diseases of the eye. Although Quinia seems homceopathic to congestive headache, meningitis, and cerebro-spinal congestion and inflammation, it has not been used by our school in those diseases to any extent. I have used the 6th in congestive cephalalgia, when ringing in the ears was present, and it seemed to act favorably. In neuralgic headaches it is more generally useful; and when periodic will cure them promptly. Ringer says "it has long been recognized that Quinia has most influence on the supra-orbital branch of the fifth nerve. This branch is most often affected with malarial neuralgia; but even non-periodic neuralgia of this branch is probably more amenable to Quinine than neuralgia of the other branches of the fifth or other nerves." In such neuralgia the smallest doses will often promptly cure. The 3x trit. will sometimes make surprising cures. No drug, with the exception of Mercury, has been so fearfully abused, and has worked such injury to the human race. It has been used without sense or reason in nearly every disease mentioned in the prodigious Nosology of Dr. Good. It is still a pernicious habit, not confined to allopathists, to give Quinine in fever so soon as a remission occurs. It is a habit fraught with the most injurious consequences. The same may be said of the habit of prescribing it after any disease has run its course, leaving the patient weak. Unless it is specifically indicated in such cases, do not give it. The natural recuperative forces of the organism, or a more appropriate remedy, will insure a good convalescence. Hahnemann, with his deep insight into the curative power of drugs, gives the following symptom, indicating China in debility: The patient sweats profusely, especially on the back and neck, when he sleeps. This is the characteristic indication for Quinia; and, when you find this symptom, the lowest triturations of this medicine will remove the debility. Dr. Wood (allopath), in his "Practice of Medicine," RHUS GLABRUM. 615 Quinine to pregnant women, but no authentic case of miscarriage or premature labor has yet been reported from its use. It was also alleged that it acted during labor as a uterine motorstimulant. This, too, has been denied. I am of the opinion, however, that in cases of protracted labor, when the pains have become feeble, and a general condition of prostration sets in, with no tendency to convulsions, a few grains of Quinine will revive the failing energies, and aid in bringing the labor to a favorable termination. Several cases under my care, in which it acted well, tend to confirm this recommendation. Some German physician, believing in the infusorial origin of " hay-fever," claims to get good results from throwing a weak solution of Quinine up the nasal passages. This recommendation was largely published in the newspapers and medical journals, but it has utterly failed in my practice, and I have never heard of its proving of any value in the disease as it appears in this country. Having said all in favor of this powerful drug which I can consistently, I will close by again cautioning you to use it with great care and discrimination. RHUS GLABRUM. There are several varieties of this plant, as the R. typhina, staghorn or velvet Sumach; the R. copallina, mountain, or dwarf Sumach; and R. aromatica, which possess similar virtues. These must be carefully distinguished from those which possess poisonous properties. The non-poisonous species have their fruit clothed with acid crimson hairs, and their panicles are compound, dense and terminal; the poisonous varieties have axillary panicles and smooth fruit. We have but a fragnqentary proving of R. glabrum, by Dr. Marshall, of Vermont, which, however, gives us some characteristic symptoms. I will quote some eclectic authorities, that you may see what they think of this species. 616 RHUS GLABRUM. Rafinesque, with his usual dogmatic brevity, remarks: "Roots, anti-syphilitic, used in dropsy, and externally in rheumatism. Leaves, good astringent for all fluxes; gum, similar to copal, cures toothache when put in hollow teeth. Berries used in dysentery, rheumatism, dyspepsia, sore-throat, putrid fever, hlemorrhage, gangrene. Seeds, in powder, used for piles and wounds. The juice cures warts and tetters." Dr. King says: "Sumach bark is tonic, astringent, antiseptic. The berries refrigerant and diuretic. The bark of the root has been found useful in gonorrhea, leucorrhcea, diarrhoea, dysentery, hectic fever, and scrofula.'" His estimate of its virtues is nearly the same that he would accord to any simple astringent medicine. He does not seAm to intimate any thing peculiar about its physiological action. Dr. Paine says of Rhusin: " This remedy exerts a healthful influence upon the blood and digestive organs. In many cases of obstinate diarrhcea, where the gums are spongy, the tissues soft, appetite vitiated, belly prominent, and other symptoms of a strong scorbutic diathesis, this article has been very beneficial. It is valuable in many cases of cholera infantum. In a case of sea scurvy, of malignant character, I administered ten grains of the 1st trituration with one-half gr. Ferri carb., every three hours, each dose being followed by a teaspoonful of lemon syrup. This treatment was followed by prompt relief, and in a short time a permanent cure was effected. "In dysentery, resulting from the presence of zymotic poison, as hospital and camp dysentery, great benefit has resulted from this drug in combination with Gelseminum and Quinine. "In many cases of chronic ulceration of the bowels, and disorganization of the tissues, resulting from typhus and typhoid fevers, I have combined Rhusin with Ptelin and Sulphate of potassa, and obtained valuable results. Externally, this remedy serves as one of the most valuable applications we possess in violent ulcerations and haemorrhoids. Ten grains, triturated in an ounce of glycerine, forms a valuable ointment. This mixture is quite serviceable in aphthous sore mouth, ulcerations of the throat following scarlatina and diphtheria, and in chancres and syphilitic ulcers." RHUS GLABRUM. 617 Dr. Scudder remarks that the decoction is useful in profuse perspiration arising from debility; also that a free use of the bark will produce catharsis. Dr. Coe defines the properties of Rhusin as tonic; astringent, and anti-septic. He employs it in diarrhoea, dysentery, aphthous and mercurial sore mouth, diabetes, leucorrhoea, gonorrheoa, hectic fever'and scrofula. He says "Rhusin may justly be classed among the most valuable of the astringent tonics. It exercises a peculiar sanative influence over mucous membranes, and is invaluable in the treatment of many forms of disease affecting those surfaces. Being powerfully anti-septic, it is particularly useful in all cases manifesting a tendency to putrescency. In diarrhoea and dysentery, after the morbid accumulations have been removed by appropriate remedies, and the sthenic symptoms are measurably controlled, the Rhusin will be found of essential service in restraining and toning the action of the bowels. For this purpose it may be given in two grain doses, every two hours. " The remedial value of Rhusin is best displayed in the treatment of aphthous and Mercurial affections of the mucous surfaces. The various forms of stomatitis afford a wide range for its employment. " We know of no more useful agent in the treatment of the distressing sequelae that sometimes follow the use of Mercurials. It has been employed with advantage in hectic fever. In scrofula also, particularly those cases involving the mucous surfaces. The Rhuuin is an appropriate remedy in the diarrhoea of typhoid fever, and in all cases where a putrescent tendency is manifested." To the above medical history I will add some observations of my own. The infusion of the root has a wide popularity among the country people for the cure of diarrhcea and dysentery, especially adynamic dysentery, when the discharges are fretid and bloody. I have known several apparently severe cases cured by this medicine, in the hands of nurses who took the cases from allopathic physicians. I never used it in such cases, being well satisfied with the success of our tried remedies. The berries have a large popularity as a remedy for chronic hoarseness, wheezing coughs and laryngeal asthma —so-called. 40 618 RHUS GLABRUM. I once had a patron who was subject to attacks, every Spring, of laryngeal cough with dyspncea and almost complete loss of voice. He always resorted to a tincture of the berries, (the whole panicle was used —he called them "Sumach-bobs.") The farmers are in the habit of placing these " bobs " in the mangers, or mixing them with the food of horses that have the "heaves." A confidence in their efficacy in such cases is quite common. As heaves is a kind of asthma, probably from disease of the larynx (or emphysema,) it would seem to show that the Sumach had really some specific relation to the pulmonary organs. The only proving I have obtained is given in Vol. I. It is quite suggestive, and if verified by others, will place this medicine in a higher position than it has heretofore occupied. [The proving of Dr. Marshall, although only fragmentary, is another verification of the principle I have always contended -for, namely, that a proving of any drug will show that all the cures made by physicians of, other schools, with such drugs, were homoeopathic cures. For example, Dr. Marshall gets " night-sweats," " ulcers in the mouth," "diarrhoea" and "hmemorrhages," and these symptoms are those which Eclectics declare the Sumach will cure.] Dr. Lilienthal reports somewhere several cures of very severe occipital headaches with the Rhus glabrum; this is one of the cases where we get a curative symptom before we do the pathogenetic. Although this Rhus does not, in the proving, develop any of the peculiar skin symptoms, yet it seems, in this headache, and some other of its symptoms, to possess some of the properties which would lead us to consider it as having the same or similar effects on certain of the nervecenters as the Rhus tox.; in fact, I think it could not belong to the Anacardiaceae, unless it had some effects in common with other plants of the same family. RHUS VENENATA. 619 RHUS VENENATA. This species of the Rhus has been but little used. The old school nca knowing how to administer it, stand aloof from it, and our own school, impressed with the idea that it is so much like the Rhus tox. there is no use of making any change. On this point Dr. Hoyt says: "I have no doubt that its use often affects those on whom the Rhus tox. has but little influence; at least this is the case with myself, for I handle with impunity the Rhus tox., while with the greatest degree of caution, I was violently affected with the Rhus ven. Again, in using the Rhus tox. in a case of angina, in which Rhus was almost the only remedy indicated, I had very little response from it, while from the Rhus ven. I obtained a most perfect victory over the complaint." Another reason why it has not been used is, that we had no extended provings of it until recently. Our school are naturally sceptical; they must know the "range" of the weapons they use. The attention of the profession was first called to this drug by the published toxical provings of Dr. P. B. Hoyt, of Danbury, Conn. It was made by exposing himself to contact with the aroma of the plant. He seems to have been very susceptible to its influence. (The profession will be sorry he did not leave on record a description of himself, his temperament, etc.) The next proving was made by Dr. Burt, of Lincoln, Ill. This proving was made by taking the drug internally. He commenced with the third dilution, and finally took the mother tincture until an ounce was taken. The next published provings were made by Dr. F. G. Oehme, of Plymouth, Mass., in 1858-9. These experiments were made both by contact and by taking the drug internally. He made two trials of it —a year apart. He has made use of it in several cases of disease with most happy results. (See his "Clinical observations upon erysipelas, ucticaria, prurigo, erythema, morbilli, scabies, impetigo nodosum, andfarunculi.") 620 RHUS VENENATA. He thus sums up his article: "Before closing, we must say that there are but very few medicines which will cause so many, so well marked, and so complete diseases as Rhus vernix (ven.); but in spite of this fact, it is very little used. Perhaps some consider its properties of the same nature, but inferior to Rhus tox. This opinion is not correct. I need scarcely say that I have by no means exhausted the list of cutaneous diseases in which this species of Rhus might be used with success, as, for instance, in eczema solare for which it is frequently indicated." The first knowledge we obtained of the medicinal virtues of this plant was by hearing or seeing cases of poisoning, or being called to treat the same. Upon some individuals or temperaments its influence is powerful. Dr. Bigelow considers that the "following circumstances have considerable influence in varying in the same person the aptitude to the reception of the poison ": First.-A warm or cold climate; in Southern more active than in Northern. Second.-Different seasons of the year. The Rhus vernix (he means the yen.) never affects me in the smallest degree, except on very hot days in Summer. Third.-Infancy or manhood: children are more readily poisoned than adults. Fourth.-Exposure before or after a meal. Dr. Barton, in his edition of Cullen's Materia Medica, states that the plants more readily poison immediately after than before a meal. Fifth.-The presence of moisture: country people generally believe that the effluvia of plants, when combined with moisture, are most apt to produce the eruption. Sixth.-A state of increased perspiration at the time of exposure has a most powerful influence in favoring the eruption; "if my skin was perfectly dry while collecting the juice of the Rhus vernix (ven.), it had not the least effect upon me." The most formidable cases in persons subject to this poison usually commence within twenty-four hours after exposure, sometimes longer, more frequently shorter. The 622 RHUS VENENATA-RICINUS COMMUNIS. 22d.-Diarrhoea at 3 o'clock, a copious stool of a lighter color than that of the night previous. Another stool at 7 A.M., not as copious, and again at 9 o'clock. Pain in the hypogastrium before every stool; have but little warning before each stool. Hands and wrists are much worse this morning; face also more swollen. The itching and burning continues with unabated vigor, and are aggravated by the warmth of the bed, and in a warm room. Mental labor increases the pains - even the recording of these symptoms aggravates them. Mouth feels rough, as though sand was under the mucous membrane, which is very red. I experienced no feelings of despondency at first, for several days previous to my poisoning, a sense of dullness and weight in it. (I notice in the proving of Rhus vernix, given in Jahr, " intolerable heaviness in the head," as a prominent symptom, which indeed was the case with me after the first week of the proving.) Evening -my wrists and hands are still more swollen, and excessively painful. Face a little less swollen and rather less painful. Incrustations appeared to-day on the inside of my thighs, extending down one-half the length of the femur. A feeling as if from flea-bites, on different parts of the body. Slight dimness of sight; lachrymation, and a livid circle under the eyes; considerable deafness, which is quite troublesome. Chills run up the back, even when warm, and in a warm room, or in bed. The rough feeling in the mouth increases, with redness; same appearance of the fauces; difficult deglutition; throat feels sore and swollen; the eruption also appeared on the gums of the upper incisors. About nine o'clock, smarting and burning of the eyes, as though washed in alcohol, attended by profuse lachrymation. Colic quite severe in the umbilical region. Very restless all night. 23d.-Dull feeling in the head; headache in the fore part of the head, sore head, so severe that I took Belladonna with some relief. The severity of all the other symptoms had somewhat abated, except the diarrhcea, which is more severe, and the stools of a dark brown color. (This was the only time they were of this color, although attended with the same pain in the hypogastrium, which accompanied the lighter colored stools.) A feeling of general malaise. The glans penis is much swollen, the prepuce covered with a vescicular eruption, which extends to the inside of the thighs. During the first five days the pulse was increased from ten to twenty strokes. The poison seemed to have a considerable effect in relieving me from dyspeptic symptoms, and also benefited a chronic inflammation of my eyes. RICINUS COMMUNIS. The Castor oil plant is a native of Asia, where it attains the size of a tree; but in temperate climates generally, and in the United States, it is an annual plant, rarely over six feet high. In treating of this plant and its medicinal action, I shall mention three portions, namely: (1.) The Oil. (2.) The Seed. (3.) The Leaves. 624 RICINUS COMMUNIS. but "causes a depletion of congested vessels," and exerts " an almost specific power " over the morbid state. " Canvane states that by only rubbing the navel and hypochondria with this oil in childrenwhom he could not get to take any medicine inwardly, he often procured one or two loose stools. The odor alone is said sometimes to produce a purgative effect upon weak and delicate children. By repeated friction with the oil the skin is reddened, and ultimately vesicated. In the dose of one or two ounces it occasions an uneasy feeling in the stomach, and not unfrequently vomiting. But when taken in divided doses, as half an ounce, at intervals of four hours, it seldom occasions vomiting, but more generally nausea, and the bowels are apt to be moved before the second dose. The second, or even the third, may sometimes be required for this purpose. It seldom produces much griping, unless the bowels are in a morbidly sensitive condition. The action of the pulse is lowered meanwhile, a sense of peculiar discomfort is felt in the abdomen, there is also an inclination to sleep, and general debility. The evacuations which it produces are, after the first one, generally liquid, but they contain more or less of the oil in the form of globules, and unchanged; or, as Dr. Bird has pointed out, converted into caseous flakes, or a soap-like scum, floating in the more fluid parts of the dejection. More generally it is found mixed up with the freces as a kind of emulsion, and in some few instances it has been discharged under the form of solid tallow-like masses. Long continued use of the oil disorders the digestion, and occasions habitual nausea, with a furred tongue, etc., particularly if the oil is acrid from having been kept, or from imperfect preparation. Cullen states that when taken habitually as an aperient, the dose may be gradually diminished. This statement is confirmed by Burne, who says that it acts quickly, does not produce a subsequent costiveness, and the longer it is given the less is the dose of it required. If taken daily, the quantity may be gradually reduced to half a teaspoonful (Dr. Thompson says to a few drops), and yet the full effect be maintained." (Stille.) This does not look as if it was so very harmless. If the odor of the oil will cause purging, why may it not act in the attenuations as a homceopathic remedy? Wood almost hits the truth when he intimates that it has an almost specific action in irritation and inflammation of the bowels. RICINUS COMMUNIS. 625 The fact is, that Castor oil is nothing more than an attenuation (probably nearly the 3x) of the poisonous principle ol the seeds of the Ricinus. Oil is the vehicle. It is as if the root of the Veratrum album contained an oil which on being expressed contained a minute quantity of Veratria. The two poisonous principles are very analogous. When allopathists get curative effects from Castor oil, they get its homeopathic action. Look at the facts: (a.) It is admitted that it may cause irritation, pain, and diarrhcea. (b.) They use it with good effects in diarrhcea, dysentery, and enteritis. A Dr. Thompson, quoted by Stille, recommends it very highly for infantile diarrhoea, and for symptoms which have a marked resemblance to its pathogenetic effects, and the effects of the seeds. He says: " It is most beneficial in the aphthous diarrhewa, which occurs during the first year of life, especially among children who are improperly fed. It commences with sickness, frequent and griping evacuations, varying in color from greenish-yellow to dark, grass-green, then becoming more liquid, and more or less mixed with slimy or gelatinous mucus mixed with blood, each evacuation accompanied with pain and tenesmus, the mouth dry and aphthous, the anus inflamed, the belly tumid and painful, the child becoming more and more feverish, emaciated, and somnolent." I must acknowledge that before I used the Castor oil as a homceopathic remedy, I have been discomfited many times by seeing such diarrhoea cured by small doses (half a teaspoonful), repeated threeor four times a day, by old nurses or impatient mothers. For several years I have treated the diarrhoea of infants, similar in character to the above, with very small doses of the cil, and often with marked success. I give it in doses of five, ten or fifteen drops, in glycerine or mucilage, or five to ten grains of the lx trit. of the oil with sugar of milk, repeating the dose every few hours, as you would in giving Pulsatilla or Ipecac. In chronic diarrhoea, or chronic dysentery, I have known of some positively brilliant cures with small doses of Castor oil. RICINUS COMMUNIS. 627 excellent effects from small doses of the oil frequently repeated. Dr. Hering says that since the interdiction of the oil, after childbirth, by homceopathic physicians, the " puerperal fever has been much less frequent in Philadelphia, where it was previously very frequent." If you will note symptoms caused by the seeds, you will observe that they resemble closely severe and dangerous cases of enteritis and peritonitis. Hence the danger of the oil. In cholera infantum, the attenuations of the oil may be of value. I would advise you to give it a trial. It would be indicated by about the same symptoms as Veratrum album. It could be given singly, or alternated with Iris, Cuprum, or Arsenicum. In very young infants the oil might suffice, but if the patients were adults, or children a few years old, I should prefer the attenuations of some preparation of the seeds. (2.) The seeds of the Castor Bean are undoubtedly poisonous. If we examine the relationship of this plant, we shall not be surprised at the fact. The Euphorbias are in the same family with the Ricinus. The seeds of the Iatropha and Curcas, two genera belonging to the same family, also abound in an acrid and purgative oil. The oil from the seeds of Iatropha glauca is often sold as Croton oil, as its purgative powers are nearly as intense. If you will read the provings of Iatropha, or consult the brief pathogenesis, you will find that the symptoms closely correspond with the poisonous effects of the Castor Bean, which I will narrate. These seeds when eaten have caused dangerous and painful symptoms, and even death. Three of the beans have been known to cause the death of a man. The symptoms do not usually come on until from two to five hours after the ingestion of the poison, when severe abdominal pain is felt, and is accompanied by violent vomiting and purging, which after a time may become bloody. This purging soon ushers in a state of collapse, with or without severe muscular cramps, with cold sweating skin, contracted features, thirst, restlessness, small, rapid pulse, and sometimes the general appearance of Asiatic cholera. 628 RICINUS COMMUNIS. After death, intense redness and even abrasion of the small intestines are found. As the oil probably derives its purgative action from the principle which renders the seeds themselves so harsh and even poisonous, it may be well to describe their effects more particularly. M. Mialhe proved that an emulsion made with the kernels of the seeds is violently emeto-cathartic in the dose of one hundred and fifty grains (from seven to ten seeds), and that even a tenth part of that quantity produces both vomiting and purging. He hence inferred that the active principle of the seeds is yielded but slightly to those varieties of the oil which are obtained by pressure alone, without heat. This is more fully proved by instances such as the following: Giacomini relates that when a child he experienced a violent attack of vomiting and protracted exhaustion from eating nine or ten of the seeds. Bergius records the case of a man in full health who ate a single seed of Ricinus, which, however, left an acrid taste in his mouth. Early the next morning he was seized with violent vomiting, which continued alternately with purging throughout the entire day. Lanzoni saw a young woman attacked with violent cholera morbus, and in excruciating pain in the bowels, from eating three of the fresh seeds. Dr. Taylor records a fatal case of poisoning from this cause. Three young women ate of the seeds, one about twenty of them, another four or five, and a third two of them. Upon the two latter persons the effects were those of a violent cathartic, but the first was seized with vomiting and purging, and looked like one in an attack of malignant cholera; the skin was cold, pale and shrunken, there was pain in the abdomen, and the mind was in a drowsy, half conscious state. The dejections consisted of bloody serum. No reaction took place, and death occurred within twenty-four hours. On examination, the gastro-intestinal mucous membrane was found to be abraded and inflamed. A soldier in Algeria is said to have died from eating only three Castor oil seeds. The whole intestinal mucous membrane was found after death coated with blackish blood, the lining membrane of the stomach was somewhat reddened and softened. RICINUS COMMUNIS. 629 A case is related by Bergius where only one seed prod.uced symptoms of poisoning, namely: nausea, vomiting and diarrhcea. After twenty seeds, gastro-enteritis and death, preceded by convulsions and general collapse. A young and strong man, after eating two grammes of the residue of the seeds from which the oil had been expressed, was seized with such violent vomiting that his life was in danger. Devergie states that two patients who had taken each an ounce of Castor oil died in three hours. (!) From these quotations it will be seen that the seeds of the Castor plant contain a poisonous principle analogous to Veratrum album, latropha, Iris versicolor, and perhaps Arsenicum and Cuprum. The following case of poisoning by the seeds shows something worse than mere enteric inflammation, for they appeared to cause albuminous urine and jaundice: Bean, a sergeant in the 7th company of engineers, enters the hospital at halfpast five, July Ioth, I87I. He ate the same day, in the morning, some Ricinus seeds, as a purgative. The seeds were perfectly ripe, dry, and gathered in the Fall of I869. As he did not find the taste very disagreeable, he ate I7 of them. No accident happened immediately after eating them, and he took some beef tea with appetite. Three or four hours afterwards he passed several loose stools, and suffered soon afterwards from pyrosis, cramps in the stomach and nausea, followed by vomiting, which contained fragments of the seed and drops of oil floating on it. The stools became at the same time more numerous and copious, were passed without tenesmus, or colic, formed of serous liquid mixed with mUCUS. About 4 P.M. the diarrhcea became incessant, with cramps and chilliness; at 5$ P.M. he entered the hospital. Pathology.-Present state: Pale face, the forehead covered by cold sweat, and features drawn; the eyes are convulsed and drawn upward in the orbita, the conjunctiva injected, and copious lachrymation; the pupils only moderately dilated; pulse normal in frequency, but so small that sometimes it can hardly be felt at the radial artery. Intelligence perfectly clear; patient complains of headache, vertigo, buzzing in the ears, and a sensation as if a bar laid over his stomach, with profound anguish. Burning thirst; pyrosis, nausea, vomiting, the vomiting matter is fluid, lightly colored by some bile, and holds some glairy filaments suspended; epigastrium very sensitive, and the pains radiate toward the navel and hypochondria; neither light nor strong pressure aggravates the pain, at the same time the patient feels a sensation of violent constriction in the 630 RICINUS COMMUNIS. intestines; the diarrhcea becomes colliquatic, and the stools look like in cholera. Complete aneuria since Io A.M., voice very veiled; profound adynamia, it takes two persons to hold the patient. The time for antidotes had passed, and the only indication remained to combat the coldness, the muscular contractions, the stoppage in the circulation - in one word, to remove the pseudo-choleric symptoms consecutive to the enormous loss of water the patient had sustained. Frictions with Camphor were ordered, sinapisms to the thighs, and hot flaxseed tea given in large quantities. Anti-spasmodics could not yet be given, on account of the constant vomiting. Heat returns; but the chief physician, Dr. Peray, orders, on account of the vomiting, iced drinks, an anti-spasmodic potion, emollient injections in order to empty out the last traces of the poison, poultices on the abdomen, and continued frictions. The vomiting lasts till 3 A.M. July ii.- Some fever, tongue hot and dry, anorexia, pyrosis. Vomiting again; the epigastric and abdominal pains, as well as the diarrhcea, continue; more cramps; extreme lassitude; absolute aneuria. At IO A.M. he passes a small quantity of dark-colored, thick, and highly albuminous urine. July I2.- Fever and diarrhcea continue, cramps in long' intervals; severe headache; urine still scanty, with large precipitates, by heat or Nitric acid. The same treatment. July I3.- Pulse normal; face slightly congested; tongue white; no appetite; pyrosis; vomiting and abdominal pains; moderate diarrhoea without tenesmus or colic. Icterus fully pronounced. Urine still very albuminous. July I4.- Some diarrhoea, and great lassitude. July I5.-Only two stools; appetite returns; urine ceases to be albuminous; discharged. An analysis of the seeds shows they contain an alkaloid, Ricinine, which is soluble in water and alcohol. Three acids, Ricinic acid, Elaiodic acid, and Margaristic acid, all very acrid and soluble in alcohol. Also a volatile principle, which passes off by heat, and while bruising or triturating the seeds. The method of making the oil by decoction, doubtless extracts the alkaloid, which is probably the most virulent quality which the seeds possess. It is probably this alkaloid which causes a large portion of the choleraic symptoms. The acids are expressed with the oil, and assist in evolving severe symptoms. For homeopathic preparations, the oil obtained by decoction would be the best-or any oil highly colored and of crid taste -this might be called "Oleum Ricinus." RICINUS COMMUNIS. 631 The preparation for homoeopathic use in cases presenting choleraic, or enteritic inflammatory symptoms, corresponding with the poisonous symptoms, should be made from the whole seeds bruised, or, what would be better, from the residue after expressing the oil without heat or alcohol, as is the plan adopted in this country. This should be called "Tinctura Ricini Sem." This tincture should be made with hot water and alcohol, in proportion of one part of the former to three of the latter. The therapeutics of the Tine. Ricinus seed has yet to be written. Dr. Emery, of Lyons (France), introduced the Ricinus into homceopathic practice. He recommended it in diseases of the liver and intestines. I have not been able to find any of his clinical reports, except one, in whicl he claims to have cured or relieved gall-stone colic with Ricinus 3; a rather dubious report, I imagine. I am amazed that Hahnemann, or some of his cotemporaries, did not institute provings of the seeds. They must have been aware of their poisonous action. Knowing its botanical relationship, and the almost universal use and abuse of the oil, it is surprising that Ricinus did not, in their hands, become a polychrest. It is certainly as capable of occupying such a place as Euphorbia, Iatropha, Croton tig., or Veratrum. It ought to be useful in cholera Asiatica, cholera morbus, and infantum. It will doubtless prove a specific in many cases of mucous enteritis, in the forms of diarrhoea and dysentery. One of the cases just quoted proves it be homoeopathic to choleraic attacks with albuminuria, and probably urcemia, a dangerous form of disease, especially in infants; also in jaundice supervening upon cholera. (3.) The leaves. The medical history of the leaves of Ricinus is very interesting. The first mention of their use was by Dr. J. O. McWilliam, in 1850. While in the Cape de Vere Islands, in 1846, he learned that in cases of emergency this remedy could be successfully applied to increase the flow of milk in nursiqng women, when it was scanty or tardy 632 RICINUS COMMUNIS. in appearing; also, that in cases of emergency, it would produce milk in the breasts of women who are not childbearing, or who even have not given birth to, or suckled a child for many years. In cases of childbirth, when the appearance of milk is delayed, a decoction is made by boiling a handful of the leaves of the plant (" Bofareira," as it is there called) in six or eight pints of water. The breasts are bathed with this decoction for fifteen or twenty minutes. Part of the boiled leaves are thinly spread over the breasts, and allowed to remain until all moisture has been removed from them by evaporation, and probably in some measure by absorption. This operation of fomenting with the decoction, and applying the leaves, is repeated at short intervals until the milk flows upon suction of the child, which it usually does in the course of a few hours. In cases where milk is required to be produced in the breasts of women who have never given birth to a child, or not suckled one for years, the mode of application is more thorough. Two or three handfuls of the leaves are taken and treated as before. The decoction is poured, while yet boiling, into a large vessel, over which the woman sits so as to receive the vapor over her thighs and generative organs, cloths being carefully tucked round her so as to prevent the escape of the steam. In this position she remains for ten or twelve minutes, or until the decoction cooling a little, she is enabled to bathe the parts with it, which she does for twenty minutes more. The breasts are then similarly bathed and gently rubbed with the hands, and the leaves are afterwards applied to them in the manner before described. These operations are repeated three or four times a day for ten days, when a child is put to the nipple, and in the majority of instances it finds an abundant supply of milk. Women with well developed breasts are most easily affected by the plant. When the breasts are small and shrivelled, it is said to act more upon the uterine system, bringing on the menses, if their period be distant, or causing immoderate flow if their advent be near. RICINUS COCMUNIS.- 633 Dr. Tyler Smith experimented with the leaves, and was successful in causing the flow of milk in many cases. Dr. Rauth pronounced a favorable judgment upon the value of this medicine as a galactagogue. He was the first to administer it internally in the form of decoction, and afterwards in the tincture and extract. Subsequently, Dr. Gilfillan produced equally striking effects by teaspoonful doses of a fluid extract of the leaves. Lately, Dr. Woodbury, of Boston, and many other physicians (of our school) have used the fluid extract or tincture with good results in scanty milk-flow, suppression of milk, and when the milk was of poor quality. I have been informed by nurses that the Castor oil rubbed on the breasts, warm, will hasten or increase the flow of milk. It is supposed that the oil administered internally, in small doses, on the fourth day after confinement, favors a free flow of milk. I have used the leaves as above recommended, and prescribed the extract internally in suppressed milk in many cases, but they were nearly all cases of suppression from child-bed fever, convulsions (puerperal), or when the milk had long ceased to flow. I have not succeeded well in but one case. I suspect, however, that my directions were not followed as thoroughly as necessary. You must not expect uniform success with the so-called galactagogues. Coriander will increase and enrich milk in some women, and not in others. Electricity will prove successful in some cases, and fail utterly in as many. Assafcetida is often efficient. Amenorrhoea has been successfully treated by the same plan as before narrated. It is not known if its internal administration will restore the menses. Scanty menstruation has also been removed in the same manner. In Dr. Tyler Smith's cases its external application caused swelling of the breasts, throbbing and other pains in the breasts, swelling of the axillary glands, with pains running down the arms. Pains in the back, like after-pains, were caused in every case. Leucorrhoea was increased. Serous discharges from the breasts became milky, and the menses came on too soon. 41 634 ROBINIA PSEUDO-ACACIA. I have somewhere read that a decoction when administered caused similar symptoms. The dose of the fluid extract is 10 or 20 drops every two or four hours. The tincture a little more, and a decoction, in wine-glassfuls. Dr. Hering writes me that East India physicians allege that the leaves cause ulcers in the mouth and throat, painful pustules and abscesses on the skin; and are used in swelling of the testicles and ankles; also for pain in the hipjoint with stiffness. The seeds and leaves need careful and thorough provings on the healthy, in order to develop characteristic symptoms, so that the indications can be distinguished from those of its near allies, namely: Iatropha, Croton tig., Iris ver., Veratrum album, Arsenicum, Euphorbia, etc. Meanwhile I urge you to test Ricinus sem., in practice, and report the results to our various periodicals. ROBINIA PSEUDO-ACACIA. The fragmentary proving of Dr. Burt may be considered reliable, and a few of the symptoms from Houatt. The pathogenesis of the latter, however, is too extensive, too tragic, and too much like his other provings to be true. It seems to be an analogue of Calc. carb., Iris vers., Pulsatilla, Magnesia carb., and Rheum. It produces pre-eminently an acid condition of the secretions. It has been found curative in sick headache with acidity of the stomach, sour eructations and vomiting. In dyspepsia, manifesting itself at night and preventing sleep. In heartburn and acidity of the stomach at night on lying down; also in the sour stools of infants, with sour smell from the body, and the vomiting of sour milk. I think I have somewhere seen it recommended in some varieties of typhoid fever, cholera infantum, and cholera morbus. RUMEX CRISPUS. 635 RUMEX CRISPUS. This plant has been in common use among physicians and laymen for hundreds of years. It has had a reputation which has outlasted many more powerful drugs. Allopathists have decreed the Rumex crispus to be alterative, tonic, astringent, and discutient. Dr. Joslin comments on the allopathic use and statements concerning this medicine. He remarks: "Its only definite and well ascertained property was its power of curing the itch, when administered internally and applied externally. This was as well known to the laity as to the profession." He goes on to say that the allopathist confounds the medicinal properties of the different varieties of Rumex, and would have us consider their effects nearly the same. Ignoring, as they do, the necessity of proving each drug, in order to ascertain its true action, they grope in the dark. They reverse the true order of investigation. " But these," he remarks, " are not specially the fault of the professor (Wood); they are almost inseparable from the school." Dr. Wood remarks: "We have placed together the three officinal species of Dock (i. e., R. aquaticus, R. brittanica and R. obtusifolius), because their virtues are so nearly alike' that a separate consideration would lead to unnecessary repetition. All the other species may be used indiscriminately with those which are considered officinal. The medical properties of Dock root are those of an astringent and mild tonic. It is also supposed to possess an alterative property, which renders it useful in scorbutic disorders and cutaneous eruptions, particularly the itch. It is said to have been useful in scrofula and syphilis. The roots of some species unite a laxative with a tonic and astringent property, resembling Rhubarb, somewhat, in their operation." Dr. Paine, in his judicious compend of the allopathic Materia Medica, comes to the conclusion that Rumex is similar, but inferior to Rhubarb. Our school, after a comparison of the provings, would consider the difference to be more RUMtX CRISPUS. 637 sion to it in the first and second volumes of the Philadelphia Journal of Homceopathy, afterwards in other journals, and finally in the American Homc3opathic Review, in which he published the " verified symptoms of Rumex Crispus." The original provings and clinical contributions, were made by some of the best men in our school, namely, Drs. Joslin, Sr. and Jr., Bowers, Bayard, Kellogg, Houghton, Payne, Rhees, and others. We may implicitly rely upon the accuracy of their observations. I can not omit in this place to render my tribute of respect and reverence for the genius, virtues and sterling qualities of Dr. B. F. Joslin. He was one of those representative men of our profession and school, ranking. with Hartmann, Hempel, Neidhard, Hering, and a few others whose "mighty footsteps" will ever " Echo down the Corridors of Time." Among his many excellent qualities, the most to be admired were his industry, honesty and consistency. In the domain of Materia Medica and Therapeutics, no man has done more in this country. He has given us some exact and reliable provings, and a volume on " Epidemic Cholera," which is one of the finest monographs ever published in our school. He was rigorously honest in that he allowed no prejudice to sway his judgment, but examined carefully the testimony relating to drugs, from any and all sources, selecting the reliable, no matter from what source it emanated, or how obtained. He also recorded his observations with that truthfulness and candor which commands our highest regard. Although a staunch champion for the "high potencies," he did not allow his enthusiasm to degenerate into bigotry, or his preference into prejudice. He was thoroughly consistent, always relying upon the higher dilutions even in cholera, and his success in their use was something astonishing, but probably owing to his carefulness in selecting his remedies. We can admire such a man, as much as we can despise others, who, constantly harping upon the highest potencies, habitually resort to the lower, and even cruder drugs. For myself, allowing the largest latitude, I can sincerely respect 638 RUMEX CRISPUS. the consistency of a Joslin, even though I can not adopt his practice altogether. According to Dr. Joslin's enumeration of "verified symptoms," and clinical experience, the Rumex crispus is closely analogous to Sulphur, Phosphorus, Causticum, Calcarea, Mercurius and Spongia. In fact it has many symptoms which are to be found in the pathogenesis of these remedies. This may partly be accounted for by a fact too little heeded by our school, namely, that the chemical analysis of a plant is some clue to its pathogenetic effects. Rumex c. contains, besides starch, mucilage, lignin, etc., Sulphur, and various salts, among which are the Phosphate of lime. Here we have three of our best remedies represented indirectly in the Yellow-dock, namely, Calcarea, Phosphorus and Sulphur. Its use in the old school, for diseases of the skin, and other obstinate affections, all of which are covered by the symptoms of the medicines above named, and its undoubted success, should have led us, without any proving, to decide nearly the sphere of action of this plant. The published provings, however, show its real properties, and proves the reliableness of the above assertion. The provings were made with the mother tincture, lower and higher dilutions; the thirtieth causing the same or similar symptoms, that were aroused by the crude drug. Its following characteristics are thus specially enumerated by that careful observer, the late Dr. Joslin: " The left chest has more verified symptoms than any other region; they are generally sharp pains. The other regions which afford a considerable and nearly equal number of symptoms, as compared with each other, are the head, stomach, abdomen, and inferior extremities. The symptoms of the head are, generally, dull pains in the frontal region. The symptoms generally appear to be either in a mucous membrane, or in a muscular locality, and to be about equally numerous in both. I leave it for others to decide whether the latter are neuralgic. They present about the same number as the former. Conditions.-" Headache worse on movement; sensation of RUMEX CRISPUS. 639 weight, or of a hard substance in the stomach, or pit of the stomach after a meal; liquid diarrhcea, evacuation in the morning; pain in the chest when in bed at night; unquiet sleep, with dreams of danger or trouble, early in the morning; itching of the skin, worse on uncovering and exposing it to the air, especially on going to bed in the evening, or at night." No clinical records of cures of skin diseases, treated with Rumex, have yet appeared in our school; but Dr. H. M. Payne, while experimenting with Rumex, got the following notable symptoms from the crude tincture: " While undressing, and for some time after, considerable itching of the surface of the lower extremities." This occurred several nights, when he says: " There is no appearance of an eruption until after irritating the skin by scratching, and then rather a diffused redness, which soon disappears. Frequent scratching of the surface has produced a number of little sores (which, however, readily heal) on the calves of the legs, and about the knees, especially the posterior surfaces; the rash is not usually troublesome until after the surface is exposed to the air while undressing at night, or on getting up in the morning; the warmth of the bed soon relieves the itching." (The contrary occurs in most cases of skin diseases, the itch especially: also the provings of Mercurius, the opposite obtains.) Many persons are troubled with a peculiar irritability of the skin, like the condition above described. Exposure to air, working in water, scratching, wearing flannel or new cloth, will get up considerable irritation, and even cause erythematous and other eruptions. In such cases the Rumex will probably form an admirable remedy. I would also suggest its persevering use in those eruptions which seem constitutional, and which, when suppressed, or not appearing upon the surface, are replaced by cough, hoarseness, and other lung symptoms. May not a peculiar irritation which Rumex causes in the bronchial mucous membrane be analogous to the condition of the skin noted above? It has been used with alleged success in dyspepsia. Many of its symptoms would seem to indicate its applicability in 640 BUMEX CRISPUS. some forms of gastric derangement. Dr. Joslin reports the following cases in the Review: "A young lady complained of shootings from the pit of the stomach into the chest in various directions; sharp pains in the left chest; dull aching in the forehead, and slight nausea; ordered her to take Rumex, thirtieth, morning and evening. She called next day; all her symptoms had been removed by a single dose, and her appetite, which had been defective, improved; having eaten an unusually full dinner, there is a partial return of the shootings; gave Rumex thirtieth, evening and morning; there was no further complaint." "'A lady about 50 years of age, who had suffered about three weeks with pain in the pit of the stomach, aching in the left chest, flatulence, eructations, pressure and distention in the stomach after meals; was permanently cured of these dyspeptic symptoms in two or three hours by one dose of Rumex, two hundredth." " A young lady has a sensation of fullness and pressure in the pit of the stomach, extending up towards and to the throat, and afterwards carried down again towards the stomach when she swallows, and then rising again to the throat. This curious alternation has been observed in the proving of Rumex. She was cured by Rumex two hundreth." "A gentleman, not accustomed to the use of tea, took a cup of it, very weak, of the black kind; then followed aching in the pit of the stomach, and aching and shooting above it in the chest, at, and especially on each side of the lower end of the sternum. The symptoms were removed in a few minutes by one dose of the Rumex 30th. It is considered by allopathists, as similar in its action to Rhubarb, and has been used by that school in diarrhoea and dysentery. It is homoeopathic to some forms of intestinal disorder. Dr. A. E. Small informs me that at one time he found it very useful in the bowel complaints of children. Dr. C. Dunham, writes (Am. Hom. Review, vol. ii, p. 533): I have noticed in one case the cessation of a brown, watery diarrhawt after the administration of Rumex. A boy of five years had brown, watery diarrhcea, chiefly in the morning, having five stools from 5 to 9 A.M., attended with moderate griping pain in the lower part of the abdomen; this continued several days, RIUMEX CRISPUS. 641 notwithstanding two prescriptions which I made for it. Observing that the boy had a cough which presented the characteristic features of the Rumex cough, I gave that remedy, and both diarrhoea and cough were speedily cured. A lady, about the turn of life, had diarrhoea in the morning, four evacuations between 6 and Io A.M.; foeces very thin; evacuation painless; nausea on movement in the night, preceding the evacuations; mouth dry, tongue slightly coated yellow; the day previous had dull pain on the right side of the sternum; sharp pain on the left. Gave Rumex thirtieth, in solution, once in three hours. The next day all the symptoms were removed." "'Diarrhcea in the morning with cough-a lady, about fifty years of age, has had diarrhoea every morning for four days; the evacuations profuse, offensive and thin, and have even become watery; she is also suffering from a cough, excited by a sensation of tickling in the throat pit. It is usually dry, but when expectoration takes place, this is tasteless; the cough shocks the stomach, and is attended with a sensation of excoriation in the chest; it keeps her awake at night. Rumex thirtieth, every four hours, on the 3oth of March, in the evening the cough was immediately and decidedly improved, so that she slept all night. Next morning she awoke with the most severe headache she had ever suffered; it was a continuous aching in the temples, forehead and eyebrows, and lasted all the morning; the cough and diarrhcea were removed without any other medicines. All the above symptoms, except the fcetor of the famces, have been observed as pathogenetic of Rumex. A mother and daughter, aged respectively about thirty-five and twelve years, had for four days a'diarrhoea in the morning, with cough.' The diarrhcea occurred in the latter half of the night and early morning-three to five evacuations, which were liquid, dark, copious and offensive. The evacuations were preceded by a violent dry cough, provoked by a tickling in the throat-pit, and sensation of excoriation under upper end of sternum; nausea on movement; severe griping in the lower part of the abdomen; tongue slightly coated and of a yellowish tinge. Having with me Rumex c., 2d dil., I gave to each one drop in a teaspoonful of water, the dose to be repeated every two hours, till 9 o'clock P.M., discontinued during the night, and resumed in the morning, to be taken as on the preceding day, and so on till I saw them. Called again in two days, and found that after the first dose the diarrhcea had disappeared, and seemingly taken with it the dry cough and its accompaniments, the nausea and the abdominal pain. Appetite had returned and convalescence was established. Was called to see a lad about I4 years of age, who had been ill already ten days. Had aching pain of the scalp, darting pain of the neck, the integument of which was reddened and the muscles swollen and rigid; lancinating pain of a shifting character, affecting the walls of the chest; a dull or pungent pain affected the hips and extremities, all of which were aggravated by pressure or movement; pulse Ioo and upwards; skin hot and dry; thirst considerable; dry cough excited by a sensation of tickling in the sternal extremity of the trachea, which was annoying at night; several thin, brownish, free evacuations towards morning, preceded by nausea on moving, and cutting pain in the lower abdomen; tongue coated and yellow, with bitter taste. Under the use of Aconite, Bryonia, and Mercurius, the fever, rheumatism and abdominal pain were removed in due time. But there remained a slight disposition to scrape, and the occasional expectoration of a little whitish tena 642 RUMEX CRISPUS. cious mucus; a painless diarrhoea, the evacuations now having a considerable consistence, were dark and offensive. After making two or three prescriptions for the diarrhoea without avail, I gave Rumex c., 2d dec. dil., a drop every two hours, in a teaspoonful of water —the remedy to be omitted during the night. The patient took the same dose every three hours on the second and third days. After the first dose he had no evacuations from the bowels for three days, and his laryngeal and tracheal irritation passed off at the same time. On the third day after taking the first dose of Rumex c., he had a good appetite and was fairly convalescent. The Rumex c. seems to have a specific affinity for the laryngeal and bronchial mucous membrane; the recorded clinical experience with this remedy is quite extensive. Dr. C. Dunham makes some valuable observations concerning its therapeutical properties. I copy a portion of his article (see Amer. Hom. Review, vol. ii., p. 530): I have used the Rumex chiefly in acute catarrhal affections of the larynx, trachea, and bronchi. In these cases it seems to me to present a close analogy in its action to Belladonna, Lachesis, Phosphorus and Causticum. Without assuming to present an exhaustive analysis of the action of Rumex on the respiratory organs, I proceed to state the indications for its use to which my studies of it have thus far led me. Rumex diminishes the secretions, and at the same time exalts, in a very marked manner, the sensibility of the mucous membrane of the larynx and trachea, exceeding in the extent of this exaltation any remedy known to us. The cough, therefore, is frequent and continuous, to an extent quite out of proportion to the degree of organic affection of the mucous membrane. It is dry, occurs in long paroxysms, or, under certain circumstances, is almost uninterrupted. It is induced or greatly aggravated by any irregularity of respiration, such as an inspiration a little deeper or more rapid than usual; by an inspiration of air a little colder than that previously inhaled; by irregularity of respiration, and motion of the larynx and trachea, such as are involved in the act of speech; and by external pressure upon the trachea, in the region of the supra-sternal fossa. The subjective symptoms are, rawness and soreness in the trachea, extending a short distance below the supra-sternal fossa, and laterally into the bronchi, chiefly the left; and tickling in the supra-sternal fossa, and behind the sternum, provoking the cough; this tickling is very annoying and very persistent, and is often but momentarily, and sometimes only partially relieved by coughing. The cough occurs chiefly, or is much worse, in the evening after retiring, and at the time the membrane of the trachea is particularly sensitive to cold air, and to any irregularity in the flow of air over its surface; so that the patient often covers the head with the bed clothes to avoid the cold air of the apartment, and refuses to speak, or even to listen to conversation, lest his attention should be withdrawn from the supervision of his respiratory acts, which he performs with the most careful uniformity and deliberation, and all in the hope of preventing the distressing tickling and the harassing cough which RUMEX CRISPuS. 643 would ensue from a neglect of these precautions. I have frequently witnessed this state of things during the last three years, and have invariably given prompt relief with Rumex. In the group of remedies in which I have placed Rumex (along with Bell., Lach., Phos., Caus.), it stands pre-eminent in respect to the extreme sensibility of the tracheal mucous membrane. All of these remedies produce symptoms identical in kind; the characteristic of each is to be found in the relative degree in which each symptom is pronounced in the different remedies, quite as much as in the possession by any one of them of symptoms not produced by the others. Thus, Belladonna, Lachesis and Rumex produce each a dry cough, induced by tickling in the larynx or trachea, and provoked by deep inspiration, by speaking, and by external pressure on the.larynx or trachea. The cough of each is spasmodic and long continued, and is worse at night after retiring; but apart from the fact that Belladonna and Lachesis act more upon the lower part of the trachea, we observe that in the case of Lachesis, the slightest external pressure on the larynx or trachea produces violent and long continued spasmodic cough; the patient can not endure the least constriction in that region, not even the ordinary contact of his clothing. There is, moreover, a sense of fullness in the trachea, and a very painful aching in the whole extent of the os hyoides. In the case of Belladonna not only is cough produced to a moderate extent by pressing upon the larynx, but. soreness and pain are experienced with a sense of internal, fullness and soreness which at once suggests the presence of acute laryngitis submucosa. In Rumex, on the other hand, there is no sensibility, strictly speaking, of the trachea, but simply such an instability of the mucous membrane that cough is produced by the change of position induced in that membrane by external pressure on the trachea. As regards the extent and intensity of this symptom, Rumex holds a lower rank than the other remedies named. But the irritability of mucous membrane by virtue of which cough is induced by hurried or deep inspiration, or by speaking, while it is common to Bell., Lach., Rumex and Phosphorus, is produced in the most exalted degree, as we have already seen, by Rumex, which, as regards this symptom, takes first rank. A sensation of rawness or roughness in the larynx, trachea and bronchia is produced by each of the four remedies above named, but the locality and the degree in which it is produced, vary in such a manner as to serve in some measure as a characteristic of each. It is most marked in Phosphorus and Belladonna, less prominent in Rumex, and least of all in Lachesis. In Belladonna and Lachesis it is most marked in the larynx - indeed it is almost confined to that region. Rumex produces it in the trachea and upper part of the bronchia, while Phosphorus induces it in the whole mucous tract, from the larynx to the smaller bronchia, and bronchi; and, moreover, in the Phosphorus proving, this " rawness " of the air passages is accompanied by a no less characteristic sense of weight and constriction across.the upper part of the thorax, which indicates an affection of the finer air tubes, and of the air vesicles, of such a character as seriously to impede the function of respiration. In considering this last symptom, we must mention Causticum also, which produces " rawness," extending the whole length of the sternum. All five remedies, again, produce hoarseness; Phosphorus, Causticum and Belladonna most eminently, Rumex less decidedly, and Lachesis in a still less degree, As regards complications, Belladonna and Lachesis apply especially to 644 RUMEX CRISPUS. those which involve the fauces and pharynx, and are acute - the one of a sthenic, the other of an asthenic character; Phosphorus, those of the pulmonary tissues of a definite inflammatory character; and Rumex, to certain affections of the lungs and their envelopes, of which their nature is not clearly defined in the proving. They are indicated by pairs, generally sub-acute, in the upper part of the lung, near the clavicle and axilla and more frequent in the left than in the right lung. The following case from my clinical record will illustrate the character of the Reumex cough:. M-., aged twenty-two, of feeble constitution, strumous, subject for several years to sub-acute rheumatism, has had a severe cold for several days, and is now confined to the bed. The- pulse is quick, not hard, one hundred and ten, skin moderately hot and dry; face somewhat flushed; respiration embarrassed, not so much by any constriction of the chest as by the violent and long continued cough, which follows any attempt to make a full inspiration. A physical examination of the chest reveals no abnormal condition. The patient complains of roughness and soreness in the lower part of the trachea, and behind the upper third of the sternum, much more perceptible when she coughs. The cough is dry, slightly hoarse, very violent, and fatiguing to the patient. It is provoked by a tickling in the supra-sternal fossa, is induced by pressure on the trachea in that region, and especially by talking, and by deep inspiration, or by the inspiration of cool air. This irritability of the trachea increases very remarkably after 7 P.M., so that the patient suffers exceedingly from the constant tickling and violent cough. Can prevent it only by respiring with very great caution and deliberation, by avoiding all distractions of speech and conversation, and finally she draws the bed clothes over the head, in order to avoid inhaling the cool air of the chamber. This patient states that she has frequently had such coughs as this, and they have proved very obstinate, although under skillful homceopathic treatment. I gave Rumex I2th, in solution, a teaspoonful every two hours After the second dose there was complete relief. The next evening a very slight disposition to cough. No further symptoms. I supplied the patient with Rumex 3oth, and advised, her to use it at once, on the occurrence of such a cough, and I am informed that she always succeeded in subduing the cough within twelve hours. The following cases in the practice of Dr. P. P. Wells, of Brooklyn, were communicated in a letter to Dr. Joslin, some years since. We regret that these are the only cases of Dr. W.'s that we can at present report, but hope that at some future time we shall be able to publish more, as the Doctor's experience with this remedy has been very satisfactory: Mrs. - had been subject to eight miscarriages, all in the early part of pregnancy, which in each case was early attended with dry, shaking, spasmodic cough, in paroxysms of great violence, which was regarded by herself and friends as instrumental in producing the abortions. At the beginning of the ninth pregnancy she came to Brooklyn to be under homceopathic treatment. She had her cough, which was very dry, harsh, loud, shaking, worse at night, preventing sleep, excited instantly by pressure on the trachea, The cough was relieved promptly by Rumex crispus, 30th. The following marked and rather important group of symptoms were relieved promptly, in the treatment of the case of our friend D., by Rumex 2ooth, Lehrman's preparation. Thinking a knowledge of the fact RUMEX CRISPUS. 645 might interest you, to whom we are indebted for our knowledge of this interesting drug, I send it: The cough begins with tickling behind the top of the sternum, and sometimes in paroxysms of from five to ten minutes' duration. Trachea sore to outward pressure; feels excoriated through its whole extent, as do also the whole fauces; cough excited by pressure on the throat pit; cough is violent, with scanty, difficult expectoration; shocks the head and chest, as if the head would fly in pieces, and he feels as if he might raise blood at any minute. He is greatly exhausted after the paroxysms of coughing; head aches during the cough. You have the group above in the order as written dow.i for me by his brother, and upon which I prescribed the medicine, which was followed with the happiest results. Dr. J. M. Rhees reports several cases of aphonia, one a Case of three months' standing, with sore throat during deglutition; posterior surface of pharynx irritated, and in places excoriated; edges of soft palate and uvula red and somewhat swollen, and covered with an eruption of minute red pimples; slight, hacking cough, produced by a tickling in the larynx and upper part of the trachea. Under Carbo veg., Causticum and Mercurius she grew worse; her cough became almost constant; tickling at the root of the tongue; Hyosciamus and Rhus were given, but gave no relief. Rumex 6th was then given, and she commenced to improve the day after. On the third day her cough was much better, and the pharynx looked almost natural. The eruption on the palate had almost disappeared, but there was still some redness on the edges; Rumex 5th, as before. Cured. Dr. B. F. Joslin reported eleven cases of cough cured with the 30th dilution of the Rumex crispus. I give a brief abstract of the cases: Case I.-Dry cough; tickling in the throat pit; excoriation in the larynx and behind the upper portion of the sternum; cough worse on working; pain in the chest. Rumex 3oth cured the case; three doses only were given. The cough had lasted several weeks before the Rumex was prescribed. Case II.-Fluent coryza, with cough excited by tickling in the throat pit; sensation of excoriation behind the upper part of the sternum, while coughing; Rumex 3oth, morning and evening. Cured promptly. Case III.-A hoarseness in the evening; cough; excoriation behind the whole of the sternum on coughing and inspiration, and coldness of the fingers; Rumex 3oth, three times a day. Cured in a few days. Case IV.- Severe, dry cough, excited by an irritated pressure in the throat pit; excoriation in the larynx and chest; Rumex 3oth, morning and evening. Cured in a few days. Case V.-Cough excited by pressure on the tkroat, and attended with excoriation in the larynx and chest, and hoarseness, He took one dose of Rumex thirty drops, in the morning; in the afternoon of the same day was much better; no cough next day, nor did it return. 646 RUMEX CRISPUS. Case VI.-Violent cough in evening, worse about II o'clock at night; aggravated by lying down; excited by a tickling behind the sternum, and with accumulation of mucus in the fauces, near the posterior orifice of the nares. One dose of Rumex 30oth removed the paroxysm in a few minutes, and did not return. Case VII. —A young lady complained of shootings from the pit of the stomach into the chest, in various directions; sharp pains in the left chest; dull aching in the forehead, and slight nausea; Rumex 3oth, morning and evening. Cured in two days. My own experience with Rumex has been mainly with the third dilution. I have cured many coughs where Phos., Merc. and Caust. seemed indicated but failed. The remedy has not been used as much by the profession as its merits seem to demand. Dr. Hughes, of England, writes concerning Rumex: " I would call attention to the remarks of Dr. Carroll Dunham on the action of this substance on the air passages, cited by Dr. Hale, in New Remedies. It is a model of delicate application and discriminative comparison. Nor is it fanciful; for I have never seen any curative action so prompt and certain as that of Rumex crispus over the cough described by Dr. Dunham. Twice already I have seen an incessant racking cough of days' duration extinguished by one or two doses of the sixth dilution of this drug. I give it thus high, because the provings of the drug which have led to this use of it were instituted with very small doses. " I hope that these few notes may stimulate others toward the clinical verification of the provings of the new remedies, while they serve in themselves as a slight contribution toward this object. "Rumex has been an admirable remedy in my hands in many cases of acute bronchial affections. I recall one case in which there was dry tickling, spasmodic cough, with tenderness in the larynx and trachea, rendering the cough quite painful. I have used it only in the 30th potency." Dr. M. A. Tinker sends us the following cases of cough: Case i.- Charles S-, aged 26, nervous, sanguine temperament; dry cough; tickling in the throat pit; continued desire to cough on breathing cold air, worse after retiring to bed; obliged to cover the mouth with bed clothes, and RUMEX CRISPUS. 647 use every effort to prevent coughing; has occasional pains through both lungs, extending up into the trachea; feels weak and exhausted in the morning; very frequently a rawness of the throat in the morning; Rumex 6th relieved in two days and no return. Case II.-Augustus D., aged 23, nervous temperament, been subject to severe, dry cough at times for several years, and thinks himself consumptive; cough worse in the evening; unable to breathe the cold air of his sleeping room, and has a severe coughing spell in the morning, on rising, and at times during the day, and especially on taking a deep inspiration; is thin and rather emaciated; has night sweats frequently; tickling in throat and down at the top of the sternum; after coughing for some time, a rawness in the throat of a very disagreeable character, extending from the pharynx down beneath the upper portion of the sternum, accompanied by a burning sensation through the upper lobes of both lungs (the clavicular region), with loss of appetite, and considerable prostration of general strength. After a long and careful physical exploration of the chest, I could find no indication of actual presence of tubercles. I am fully satisfied on this point. I prescribed Rumex 3d. In 24 hours much improved, and has continued to progress, and is now at his usual occupation, and considers himself about well, coughing only occasionally. I find Rumex, in this form of irritation, is the great remedy; it succeeds when Phosphorus and many other remedies have failed with me. I have used it with unbounded success where these dry titillating symptoms occur. Some of the provers, especially Dr. Rhees, experienced some peculiar and severe cardiac symptoms, which we could hardly, at first thought, expect from this remedy. Yet we have no right to judge, before we prove a remedy thoroughly, of its probable effect on the body. It does seem, however, if Rumex thus affects the heart, that of the thousands who have taken the dock in large doses, some of them would have had dangerous heart disease; but we hear of no such instances. Dr. M. J. Rhees, one of the original provers of this remedy, furnishes the following interesting case of cardiac disorder: Joseph H., aged I3 years, subject to violent attacks of infjammatory rheumatism. In the Spring of i858 I attended him in a severe attack, in which the disease concentrated itself on the heart with so much violence that I almost despaired of his recovery. Pulsatilla cured the disease at that time. In December, i858, he was again attacked, but the heart was the principal seat of the disease from the first. On the 24th December, his symptoms were: violent palpitation of the heart, with throbbing of the carotid, and throughout the body, visible to the eye, and shaking the bed; pulse I20; violent aching pain in the 648 SANGUINARIA CANADENSIS. region of the heart; great dysfpnzea, especially while lying, so that it was necessary to prop him up in a sitting posture in bed; face red and somewhat puffed up, especially about the eyes, which were red, heavy and lustreless; tongue coated with white fur, with red tip and edges; excessive thirst; no appetite; bowels costive. I commenced the treatment by giving Aconite 3d, and Pulsatilla 3d, alternately. Some relief followed the administration of these remedies, but the improvement was slow. From December 28th to January 9th, I859, various other remedies were used, as they seemed to be indicated, but without decided improvement on the whole. On the latter date the patient complained of a stinging pain in the region of the heart, which was increased by lying down and by breathing deeply. In my arranged proving of Rumex crispus the following symptoms may be found: "No. 41, burning stinging pain in the whole of the left side of the chest, suddenly, when taking a deep inspiration while in the act of lying down in the bed at night." " No. 49, burning, stinging pain in the left chest near the heart; came on soon after lying down in the bed at night. These symptoms were fresh in my memory, and I accordingly gave Rumex crispus 6th, in water, two teaspoonfuls every three hours. January ioth, considerably relieved of the pain in the chest, and otherwise improved; continued Rumex. January IIth, the pain in the chest is almost removed. Rumex was continued several days after this, with the effect of entirely relieving the pain in the chest; but the improvement in other respects ceasing, Rumex was discontinued, and other remedies substituted. Belladonna 3oth and Phosphorus 3oth eventually cured the case, and there has been no return of the disease." This case is in many respects a marked one. But it will require further clinical experience to prove satisfactorily that Rumex will cure serious heart affections. SANGUINARIA CANADENSIS. This is one of the most powerful of all our indigenous plants, rivaling in medicinal effects the most active mineral poisons. The following observations illustrate its toxic effects: In doses of from eight to twenty grains of the powdered root it acts as a poison, producing nausea, heat or burning sensation in the stomach, tormenting thirst, faintness, vertigo, indistinct vision; finally, violent spasmodic efforts of the stomach, free vomiting, followed by alarming prostration. When the dose is very large, the vomiting may not take place. Prof. Samuel L. Mitchell, of New York, published the following case of poisoning from the tincture of blood-root: "Four men who had been employed to clean out and whitewash the apothecary shop of Bellevue Hospital found a demijohn containing what they thought to be brandy or some other spirit, and they each took a good drink of it. They were all soon seized with severe racking and burning pains in the stomach and bowels, with intense thirst. They all died." SANGUINARIA CANADENSIS. 649 " In moderate doses, Sanguinaria is regarded as an emetic, nauseant, expectorant, and diaphoretic. " In large doses it is in some degree narcotic, sedative, stimulant, alterant, emmenagogue, escharotic and errhine. In small doses, its effects on the pulse resemble those of Digitalis. It is remarkable, however, that it seldom influences the pulse, either in frequency or tension, until it has been used for five or six days; and in a majority of cases the effect is not seen for eight or ten days. (Tully.) Zollikoffer says it is " sudorific, emetic and purgative." Smith, Thatcher and Allen compare it to Digitalis. Tully says it unites the properties of Scilla, Ammonia, Senega, Digitalis and Guaiacum, without their violent operations. Rafinesque says it is "acrid, narcotic, emetic, deobstruent, sudorific, expectorant, vermifuge, escharotic, stimulant and tonic. The diseases in which Sanguinaria has been hitherto thought most useful are those of the throat, chest, stomach and liver. It has been most frequently employed in incipient phthisis, bronchitis, catarrh, influenza, pneumonia, asthma, croup, diphtheria, cynanehe maligna or putrid sore throat, in which it produces the best effects when applied locally. It has also been useful in scarlatina, pertussis, dyspnoea, dyspepsia, hydrothorax and jaundice. In the latter disease it was approved by Colden, and it formed the basis of Rawson's specific for that disease. Dr. McBride, of South Carolina, says that he used it with great advantage for " torpor of the liver, attended with colic and yellowness of the skin," a disease very prevalent in that climate. Dr. Ives, of New Haven, also used it for diseases of the liver, and in the first stage of croup. Western practitioners have carried it much farther. Some "specifics" are composed of it. It has also been successfully used in dysentery, amenorrhea, inflammatory rheumatism, and rheumatic gout. "Blood-root is an acrid emetic, with narcotic and stillllant properties, it is also expectorant, sudorific, alterative, emmenagogue, tonic, antiseptic, detergent and escharotic, according to the mode in which it is employed. It is a very active agent, and is capable of exercising a powerful influence on the system. When given in small doses it stimulates the digestive organs, accelerates the circulation; in large doses it occasions nausea and consequent depression of 42 650 SANGUINARIA CANADENSIS. the pulse; in a full dose it produces active vomiting; in over doses it causes violent emesis, a burning sensation in the stomach, tormenting thirst, faintness, vertigo, dimness of vision, alarming prostration, and even death."-King. "Sanguinaria is emetic, expectorant, diaphoretic, acronarcotic, sedative, alterative, and in small doses tonic and stimulant. In full doses it induces nausea'and vomiting, with a sensation of warmth in the stomach, acceleration of pulse, and slight headache. It acts on the fauces, producing an acrid impression, and in some cases it proves cathartic. The leaves and seeds possess similar properties. The seeds, however, are said to exert a marked influence upon the brain and nervous system, occasioning torpor, languor, disordered vision and dilated pupils; in large doses the emesis is violent, there is a burning sensation in the stomach, faintness, vertigo, dimness of vision, and alarming prostration. —Ib. Effects of Sanguinaria. —The late Professor R. P. Thomas, of Philadelphia, experimented with this substance, and obtained the following results: In doses of from one-twelfth to one-eighth of a grain, it acted merely as an expectorant, without disturbing the stomach. In doses of one-sixth to one-fourth of a grain, every two hours, it produced nausea, and sometimes caused vomiting. In doses of one half grain in solution, every ten minutes, it almost uniformly caused vomiting after the second or third dose. In doses of one-eighth to one-sixth of a grain every three hours, continued for two days or more, it generally reduced the pulse from five to fifteen beats per minute. It is thus seen that the general pathogenetic effects of the chief alkaloid contained in the root were essentially, perhaps, the same as those long known to belong to the entire substance; but our professional, as well as our positive knowledge, is almost entirely derived from experiments with the powdered root, the tincture, or other preparations from it. Like most of our best remedies, it is indeed a very multifarious combination. SANGUINARIA CANADENSIS. 651 The toxical and pathogenetic effects of Sanguinaria indicate that it has a profound effect upon the nerves of sensation and motion, but the exact nature of this action has not been sufficiently investigated. Among the symptoms we find, " a quickly diffused and transient, but at the same time a very peculiar nervous thrill, which is often extended to the minutest extremity." In large doses it causes " torpor, languor, and dilatation of the pupils." There are a few drugs, like Pulsatilla, which seem to affect the mucous tissues of the whole system; others, like Squills, have a specific affinity for the pulmonary mucous membrane; Sanguinaria is an analogue of the latter to a certain degree, although it more nearly approaches the action of Tartar emetic. It was known as an expectorant long before the allopathic profession brought it into use, and now both that and the eclectic school value it highly for that purpose. Blood-root does not seem to notably increase the secretions from the intestinal mucous tissues. It is said to be useful in pleuritis and synovitis. Sanguinaria seems to cause pains of a rheumatic or myalgic character. It is difficult to decide which of the two affections were cured by this medicine in the reported curative symptoms. I am inclined to the opinion, however, that Sanguinaria, although it may cure some neuralgia, will not, like Colchicum and Cimicifuga, act specifically in rheumatic affections. Sanguinaria has not been used in fevers generally, but it has been administered successfully in hectic fever. In the pathogenesis of no other medicine, except perhaps Phosphorus and Lycopodium, do we find the hectic paroxysm as perfectly delineated; generally the hectic is associated with cough and other symptoms of lung affection, but there are exceptions. Dr. Bute cured: (1.) In a lady, coldness of the feet in the afternoons, at the same time the tongue was painful and sore upon being touched, like a boil, and there was stiffness of the knee and finger joints. (2.) Burning of the palms of the hands and soles of the 652 SANGUINARIA CANADENSIS. feet, compelling him to throw the bed clothes off the feet for the purpose of cooling them. These paroxysms generally come on in the P.M. or evening. (3.) Paroxysm of fever in P.M., with circumscribed redness of the cheeks; cough and expectoration. Dr. Morrow relied on Sanguinaria as a remedy for hlemorrhages in general, because of "its power of quieting excessive, or depressing the natural circulation." He advises it particularly in hmroptysis; it has also been used in menorrhagia, epistaxis, etc. We can sometimes comprehend the sphere of action of a drug, by comparing the ensemble of its symptoms withl that of other drugs; a careful analysis of the symptoms and toxical effects of Sanguinaria show its marked resemblance to three of our most important medicines, namely: Arsenicum, Phosphorus and Tartar emetic; more remotely it resembles Belladonna, Lachnanthes, Veratrum viride and Iris versicolor; Lycopodium, Sulphur, Kali carbonicumn and Rumex crispus, have some symptoms in common with Sanguinaria. The blood-root has been used successfully for scal, eruption, old indolent ulcers, ill-conditional ulcers with callous borders and ichorous discharge; the powdered root is escharotic, and when applied to fungous growths causes their rapid disappearance. I consider it the best application we have for this purpose; it has also cured warts, and }iolypi, when given internally and applied topically. Dr. Sholl uses it externally and internally for carbuncle with alleged success. Dr. Bute found Blood-root curative in h]eadaches with "distension of the temporal veins which were painfully sensitive to the touch," also with " feeling of soreness on sinall spots on the head, especially in the temples." Other physicians have cured cephalalgoias with " pains in the head, in rays drawing upward from the neck." Dr. Hering considers it homceopathic to the so-called North American sick headache. He has cured, with the hiTgh dilutions, the following symptoms: "Severe pains in the head, with nausea and vomiting, frequently with bilious vomiting, in attacks, with SANGUINARIA CANADENSIS. 653 hebdomadal or longer intervals from very different inducements commonly beginning in the morning, increasing in violence during the day, only diminished by lying quiet, and when possible, by sleep." Dr. Hering also gives the following indications for Sanguinaria: It is the best remedy in most cases of migrane or sick headache. Still, it must prove most useful when the attacks occur paroxysmally, viz., every week, or at longer intervals; or when the pains begin in the morning, increase during the day, and last till evening; when the head seems to feel that it must burst, or as if the eyes would be pressed out, or when the pains are digging, attended with sudcldenpiereing, throbbing lancinations through the brain, involving the forehead and top of the head in particular, and being most severe on right side, followede by chills, nausea, vomiting of food or bile, forcing the patient to lie down and preserve the greatest quiet, as every motion aggravates the sufferings, which are only relieved by sleep: Case I. —A man was attacked with frightfully severe headache; the only relief he could obtain was from pressing the back of his head against the head-board df the bed. An infusion of Sanguinaria root removed the headache permanently.-Herinrg. Case II. —A lady suffered with frequent and severe attacks of headache, with such sensitiveness during the paroxysm, that no one dared to walk across the room. Sanguinaria 6th was given, but the first dose produced such an aggravation that the patient became almost beside herself; after the second dose, she fell into a pleasant sleep, from which she awoke refreshed. Dr. Helfrig always gave Aconite and Belladonna during the paroxysm of sick headache, and used Sanguinaria 30th, during the- interval, unless some other remedy was more indicated. —Ibid. Many of the symptoms of Sanguinaria are similar to those pains which Inman describes as belonging to myalgie headaches; particularly the superficial sensitiveness and drawing pains. Congestions of the head are controlled by this medicine, when the temporal veins are distended. It is probable that it is also homceopathic to some of the varieties of apoplexy. 654 SANGUINARIA CANADENSIS. Its known curative influence over hcemorrhage from congestions, would suggest its use in sanguineous apoplexy. The symptoms would seem to imply that venous congestions (if the tefm may be allowed) are most under the control of Sanguinaria. Dr. C. Neidhard says: "One of the most important indications for the employment of Sanguinaria canadensis is this symptom: Pain like a flash of lightning on the back of the head." Dr. E. W. Beebe reports the following remarkable cases of "sick headache," cured with this medicine: Mrs. P., aged fifty-five, blue eyes, dark brown hair, of nervo-sanguine temperament, full habit and somewhat corpulent. The history of the case is as follo0,rs: Has been subject for a period of fifteen years to attacks of " sick headache," which commenced in the morning on waking, and increases during the day, and are only relieved by sleep at night; the pain is confined chiefly to the temples and vertex, and so violent as to cause the patient to cry aloud. Nausea generally commences in the morning, followed by vomiting, first of the contents of the stomach, and afterwards of a substance that seems to be pure bile, with occasionally a considerable quantity of an acid mucus, with great distress in the stomach, of a burning character; with great weakness or " goneness," as the patient described it, not amounting to a real pain, but which was even worse to bear than the headache; not the least quantity of food or drink could be taken without its being immediately vomited. The attacks came on irregularly, sometimes once in a week, or ten days, then again perhaps not for three or four weeks. The health of the patient is good otherwise, with the exception of slight constipation at times. She has been treated by a number of physicians of the eclectic, homoeopathic and old schools of medicine, and has, as she informs me, received no benefit. I diagnosed the case as one of dyspepsia, from the use of highly seasoned and rich food. I found also that the patient was in the daily habit of using strong coffee, which I prohibited, regulating the diet, etc. I then prescribed Nux and Bryonia, night and morning, expecting these medicines to relieve, but, to my great surprise, the patient did not improve under the remedies, and after continuing them until I became satisfied that I had not made a right selection, I changed them for others, such as Ars., Puls., Chin., etc., which, together with the others generally used in such cases, were continued for some four or five months, at the end of which time I had found I had not lessened the frequency of the attacks in the least, nor had been able to relieve, for the time being, the vomiting, though I had administered Ipecac, Tartar emetic, etc., etc., till I had become about discouraged. The only good I could perceive I had done was to relieve the sour-risings from the stomach, which I did with Sulphuric acid. About this time I procured a copy of Hale's " New Provings," and upon reading the symptoms of Sanguinaria canadensis, I said to myself here is an exact counterpart of that troublesome " headache case." Upon meet SANGUINARIA CANADENSIS. 655 ing my patient a few days afterward, I said to her, "if there was any truth in the homceopathic law, I now have a remedy that will cure your headache," and accordingly prescribed four pellets to be taken night and morning, medicated with the mother tincture. She had no more attacks for upwards of two months, and then had but a very slight one. I accordingly prescribed the same remedy again, and have had no further trouble with the case. I have since used this remedy in similar cases, and with the same success. It has cured the following symptoms when occurring during other affections: "A red cheek, with burning of the ears," "redness of the cheeks, with cough," "cheeks and hands livid in typhoid pneumonia." These symptoms are also found in the provings of Phosphorus, Lycopodium, Sulphur, and Lachnanthes. No drug so surely produces intense irritation of the nasal mucous membrane, when inhaled, as the Sanguinaria. Even its internal administration causes coryza. It is not strange, therefore, that homceopathists have found it curative for acute and chronic coryza, also for "loss of smell." It has cured "influenza, with rawness in the throat, pain in the breast, cough, and finally, diarrhoea." This last is a characteristic peculiarity of the drug, and as many catarrhal affections tend to result in intestinal irritation or diarrhcea, the Sanguinaria should be remembered in each instance. Dr. Barton (allopathic) says he has " heard of the application of the powdered root to afungous tumor within the nostril, with the effect of producing detumescence, and bringing away frequently small pieces of the fungus, which, in the first instance, impeded the progress of the air through the nostril, and was supposed to be a polypus." Dr. Smith (botanic) says: " Applied to fungous flesh it proves escharotic, and several polypi of the soft kind were cured by it.' Dr. Becker (homceopathist) states that a polypus of the nose ceased to grow from the time the powder of the root was snuffed. Several physicians of my acquaintance claim to have cured nasal polypi by the internal administration of the tincture of Blood-root. It was used in the lower dilutions, in some cases. The finely powdered root forms one of the ingredients of many of the "catarrh snuffs" sold in the shops. It is often used as a domestic remedy for chronic 656 SANGUINARIA CANADENSIS. catarrhal affections of the nose. Dr. D. C. Powers, of Coldwater, Mich., was very successful in the treatment of obstinate nasal catarrhs, and ozoena. He prescribed the 2d trit. of Blood-root, as a " snuff," to be forcibly inspired up the nose, and gave at the same time Sanguinaria 3d, or Nitric acid, internally. It has cured, in my hands, many cases of ulcerative ozcena, with epistaxis. It is homceopathic to catarrhal ophthalmia, granular lids, and even ulcers on the cornea. I once cured a case of the latter, very happily, by the use of Sanguinaria 3d, internally and topically. The case had proved obstinate under ordinary treatment, and I bethought me of the beneficial effect of Bloot-root in indolent ulcers. A wash of about the strength of the 3d dilution was prepared in distilled water, and used as a collyrium. Under its use the ulcers healed in a week, leaving but a slight opacity. Blood-root is useful in expulsive gingivitis, in cases where the gums become very spongy, bleeding, and fungoid. Dr. Woodyatt, Professor of Ophthalmic and Aural Surgery in this College, uses the Sanguinaria very successfully, internally and topically, for catarrhal affections of the inner ear and Eustachian tube, and for the many throat affections which are so often the cause of deafness and otalgia. It has cured angina, and a species of pharyngitis. Also ulcerated sore throat. I have been informed, by intelligent persons, that they have been permanently cured of recurring quinsy, with ulceration, by using a gargle of Bloodroot. Upon testing it in practice, I found it quite equal to Hepar sulphur in its power of preventing attacks of tonsilitis; also in actual ulcerations of the throat. The lower dilutions were used. Dr. Thomas Nichol reports the following concerning the use of Sanguinaria canadensis in pseudo-membranous croup: Being busy at the time, I neglected contributing to the first edition of Dr. Hale's admirable work, though I had a few items which might have proved of interest. When I received the book, I turned at once to the article on Sanguinaria canadensis, expecting to find a dissertation on the use of this remedy in pseudo-membranous croup, and was disappointed on finding that it said nothing SANGUINARIA CANADENSIS. 657 as to its use in this disease. In the region in which I then resided, we had many cases of pseudo-membranous croup-not the mere spasmodic variety, but the kind characterized by the deposition of a fibrinous membrane in the larynx and trachea -and the mortality had been very great. Under allopathic treatment —the usual routine of purgatives, emetics, blisters, bleeding and Calomel -almost every case died; and even under homceopathic treatment, aided by the appliances of the so-called hydropathy, the mortality was perhaps 25 to 30 per cent. I l7ad tried, in succession, everything suggested in our works on therapeutics, from the orthodox Aconite, Spongia, and Hepar s., of Hahnemann, to the apparently heterodox application of Nitrate of silver to the larynx, recommended by Dr. Marcy, in the first edition of his work on practice, and the result was as I have stated. Despairing of help from our treatises on therapeutics, which, after all, merely present to us the views and experience of one man, and calling to remembrance the grand lessons taught me by Dr. Constantine Hering, I applied myself specially to the study of the homceopathic Materia Medica, and guided by the star of simnilia, I decided that Sanguinaria canadensis possessed, both in its symptoms and in what Prof. Walter Williamson calls " the run of the remedy," all the properties which would make it a true remedial agent in this disease. The symptoms which guided me were: " Chronic dryness in the throat and sensation of swelling in the larynx, and expectoration of thick mucus. Aphonia, with swelling in the throat. Continual severe cough, without expectoration, with pain in the head, and circumscribed redness of the cheeks. Tormenting cough, with exhaustion; and circumscribed redness of the cheeks. Croup." Shortly after, I was called to a case of true croup, and having no preparation of the Sanguinaria in my office, I gave minute doses of the pure Sanszuinairn in a little water, giving an occasional dose of Aconite, and the result was most gratifying, and I was equally successful in a number of cases, to the diagnosis of which I paid great attention. I am in the habit of regarding the literature of the eclectic school of medicine as being a vast mine of gems and precious metals, which can be best explored by the conscientious physician, lighted by the torch of the similia, and in the course of my studies I perused Prof. Paine's " Epitome of Eclectic-Practice," and his testimony is as follows: " The Sanguinarin is one of the most valuable remedies known in the treatment of pseudo-membranous croup. It has proved as much of a specific for that disease as Quinine has for ague. I have seen it used in a great number of cases, and have never known a single failure. It should be made into an acetic syrup, by adding twenty grains of Sanguinarin to four ounces of vinegar; steep, and add one ounce of sugar to form a syrup. Dose, one teaspoonful as often as indicated." I have frequently given the remedy in the form of an acetous syrup, as Prof. Paine directs, though I found the dose he mentions to be far too large, and I found that one grain, or even less, in two ounces of vinegar, to be a better preparation. I have seen better results from the acetous preparation than from the watery, and I refer those who may object to using vinegar, in preparing the Sanguinaria, to the fact that Hahnemann gave his infinitesimal doses of Opium to scarlatina patients in beer. (Essay on the Cure and Prevention of Scarlet Fever, in " Lesser Writings," page 375.) I regret that I kept no note of the greater number of my cases, but I give the record of one of the cases I attended lately. 658 SANGUINARIA CANADENSIS. On Feb. I7, r866, I was called to see W. G-, aged five years. He had been from home visiting some friends, fourteen miles distant, when he was taken sick. An allopathic physician who had been called in, pronounced it a case of pseudo-membranous croup, advising a local application of Nitrate of silver to the larynx, but the mother preferred to hurry home and trust him to homceopathy. I found him with a hoarse muffled cough, complete aphonia, and the pulse was T32. On examining the fauces I found the soft palate and fauces covered with a continuous coating of pearly fibrinous exudation, and on auscultating the larynx, the characteristic hissing sound was heard. The difficulty of breathing was very great; the child stretched back his head and grasped hlis throat in his agony, while the dark and swollen features added to the gloom of the prognosis. I commenced with the Sanguinaria, as directed above, and in fifteen hours the symptoms had undergone a notable modification; and in forty-eight hours the patient was out of danger. No other remedy was used, except an occasional dose of triturated Aconite, as became a rigid Hempelite. I have also found Sanguinaria a leading remedy in tracheitis; and in the July number of the " American Homceopathic Observer," I recorded seven cases of diphtheritic croup successfully treated by this remedy. By reference to the "gastric symptoms," as well as the above, it will be seen how closely the symptoms similate those of Arsenicum, Phosphorus and Tartar emetic. It will cure, according to Dr. Tully, " atonic, sub-acute, and chronic inflammations of the stomach." No remedy, however, is more decidedly homceopathic to acute gastritis. We have the terrible burning, the unquenchable thirst, the pain, vomiting and prostration, which mark that disease. In acute gastritis, the sixth or thirtieth should be used. In chronic gastritis, the lower dilutions may be as useful. It ought to be useful in zlceration of the stomach. Blood-root is fully indicated for nausea, or vomitingfrom irritation of the coats of the stomach. Allopaths have cured vomiting of food, or bilious vomiting, with small doses of the tincture. It is doubtless homceopathic to many functional and organic diseases of the stomach, and I would suggest its use in gastric disorders not amenable to the ordinary remedies. Dr. F. W. Hunt, in an article on " Dyspepsia, or Diseases of the Stomach," thus speaks of the virtues of Sanguinaria canadensis: This is one of the most important remedies for various diseases of the stomach, throat, liver, lungs, etc. In almost every form of indigestion, for many years, it has given me satisfactory results. It is especially useful in deficient gastric secretion, with loss of appetite and periodic nausea; heartburn, nausea SANGUINARIA CANADENSIS. 659 and irregular chills; torpid state of the liver; dyspeptic headache, terminating by regurgitation and vomiting of bitter greenish fluids; soreness in the abdomen, increased by eating; feeling of heat in the stomach; chronic gastritis; red tongue, which burns as if from contact with something hot; lips red and dry; throat hot and dry: tickling at the entrance of the larynx, which excites cough; cough peculiarly severe, not relieved by expectoration, with pain in the chest and redness of the cheeks. When digestion is imperfect from deficiency of the true gastric fluid; when the food undergoes chemical decomposition, and gas is evolved in large quantities, Sanguinaria will generally change the action of the stomach, and digestion becomes more complete. When the mucous membrane is congested, the flatus formed by fermentation is retained by a spasmodic constriction of the cardia. Its irritation is reflected through the pneumogastric nerve, upon the lungs, exciting a feeling of " tickling " in the entrance of the trachea, with sympathetic cough. This peculiar, dry cough does not yield to expectorants, but often persists for hours, and is only relieved by eructations. Aromatics and stimulants fail to expel the gas; they only increase the erethism of the coats of the stomach. The Sanguinaria affords a better resource. It not only relaxes the constricted cardia, permitting the flatus to escape, but excites a healthy, homceopathic reaction on the whole surface of the fauces, cesophagus and stomach, superseding the morbid state by a healthy one. Dr. Coe and others (allopathists), caution against the use of Blood-root when there exists " gastritis and enteritis, and whenever we have occasion to suspect ulceration or abrasion of the mucous surfaces of the bowels." This caution suggests to the homceopathist that the medicine will cure such conditions, if administered in dynamic doses. Dr. Fairbanks, of Chicago, reports the case of a patient, a woman aged 56, who had been subject to pyrosis, a rising of burning corrosive fluid from the stomach, with flatulence, for twenty years. She now gets prompt relief from the first attenuation of Sanguinaria, in pellets. It is the only remedy that will arrest a paroxysm. Eclectic physicians claim that Sanguinaria has a specific action on the liver. The liepatic symptoms in the provings were collected from allopathic sources: (Barton, llMcBride and Tully.) It is doubtful if they should have a place in the provings at all, as by reference to the original it will be seen that they were mere assertions of the above named physicians, and not pathogenetic symptoms. It may not be amiss, however, to quote the statements of eclectics on this point. King says it has been used successfully in "jaundice, and other hepatic affections. In torpid conditions of the liver it is very valuable." Jones asserts that it "arouses SANGUINARIA CANADENSIS. 661 a lady, pain in the left hypochondrium, which was rendered worse from coughing, but was better from being pressed, and by lying on the left side; very copious urination at night." The whole group of symptoms may have been of renal origin. According to Dr. Coe, Sanguinaria is very useful in many functional disorders of the kidneys. Our provings are, however, too meager to give us any clue to its action on those organs. I can not ascertain who reported the curative observation of "gonorrhoea." Dr. Coe advises it for chancres, buboes, secondary and tertiary syphilis, but says nothing of its use in gonorrhcea, nor does any other writer. I can readily imagine it might be useful in phagadenic chancre, used internally and as a topical application. It has been used successfully in amenorrhoea. Dr. O'Connor (allopathist) writes:-" For the last twelve years I have used tincture of Sanguinaria, exclusively, in cases of amenorrhara, and have recommended it to others, who speak favorably of its effects. In that time I have treated as many cases of this disease as usually falls to the lot of a village practitioner, and as yet have no cause to find fault with the efficiency of the remedy. I consider it superior to Eberle's great remedy, the tincture of Polygonum hydropiper. I commence a fortnight before the expected return of the menses, and give teaspoonful doses of the tincture, three times a day, and a teaspoonful on going to bed, (preceded by a warm foot-bath). If the secretion is not restored at the time, I remit the use of the remedy for a fortnight, and proceed as before. When the full effect of the remedy is produced, it is characterized by slight nausea, pains in the loins, extending through the hypogastric and iliac regions, as well as down the thighs. These symptoms sometimes manifest themselves once or twice before the discharge is completely established." The symptoms which I have placed in italics are worthy of being noticed, as purely pathogenetic. I esteem the blood-root a good remedy in suppressed menses, but chiefly indicated when the suppression 662 SANGUINARIA CANADENSIS. has been followed or preceded by pulmonary disease. Its use in such cases has generally been attended with good results. Dr. Miller (eclectic) advises it in dysmenorrhla, when occurring in torpid subjects, but says it'is " contra-indicated in patients of plethoric habit." This would indicate to us that it would be useful in dynamic doses in dysmenorrhocea, when the menses are too frequent; also when there is a tendency to congestion of the brain or lungs. It is homceopathic to threatened abortion, when the symptoms mentioned by Dr. O'Connor are present, accompanied by some haemorrhage. It is used for a criminal purpose in domestic practice, and by unprincipled physicians. Dr. Bute reports the following case cured by the bloodroot, " a female who had distension of the abdomen in the evening, and flatulent discharges per vaginum, from the os uteri, which was constantly open, at the same time a pain passing in rays from the nape of the neck to the head." This was probably an instance of that rare disease in which the lining membrane of the uterus secretes a gas. Dr. Bute also reports cases of affections of women at the climacteric period, characterized by "burning of the palms of the hands and soles of the feet, compelling her to throw the bedclothes off the feet for the purpose of cooling them." Used internally and topically (by injection) it has cured ulcerations of the os uteri, corrosive and fcetid leucorrhoea, and polypi of the uterus. Sanguinaria has always had an extensive reputation for the cure of cough. The aborigines of the Eastern States often astonished the early settlers by the cures they effected with this remedy. It is said that the most obstinate coughs disappeared during the use of the blood-root. The physicians of an early day seemed to have used blood-root more frequently than their successors. Rafinesque, Barton, Tully and others, all assert its great curative power in many varieties of cough. They even assert its power to cure pulvmonary consumption. Besides the above curative symptoms, the following are reported: "Cough, with coryza; then SANGUINARIA CANADENSIS. 663 diarrhea;" " tormenting cough with expectoration and circumscribed redness of the cheeks." Several instances have come under my observation where the -blood-root really appeared to cure incipient phthisis. Eclectic physicians use it in thoracic diseases where the allopath considers Tartar emetic indicated. In this they are not far from the truth. Sanguinaria, in affections of the lungs, occupies a place midway between Phosphorus and Tartar emetic. It has many symptoms in common with both, and others possessed by neither. I have used the blood-root for.many years in bronchitis, pneumonia, and other diseases of the respiratory organs, and have obtained from it some very satisfactory results. In the massive doses of the old school, given to nausea and emesis, it was productive of great injury, but in dynamic doses its use is never attended with any aggravations; a few drops of the mother tincture may be used in some chronic affections of the pulmonary organs, while in acute diseases, with a high grade of irritation, the 3d is the safest and best attenuation. In the majority of cases of pneumonia, there occurs a group of symptoms for which we have generally used Phosphorus or Sulphur with good results, although the convalescence under those remedies was apt to be lingering. But when those symptoms and conditions are met with Sanguinaria, 2d dilution (decimal), or Sanguinarin, 4th trit., a rapid subsidence of the diseased' action occurs. At the second, and during the existence of the third stage of the inflammation, we have as physical signs: dullness on percussion, bronchial respiration, etc., denoting the presence of red, or even gray hepatization, and purulent infiltration of the pulmonary parenchyma. Watson considers it doubtful whether recoveries take place from the third stage of pneumonia; but under homceopathic treatment, I do not believe such recoveries impossible. The general symptoms indicating Sanguinaria are extreme dyspncea, short, accelerated, constrained breathing, the speech ceases to be free, the sputa becomes tenacious, rust-colored, and is expectorated with much difficulty. The position of the patient is upon the back; there 664 SANGUINARIA CANADENSIS. is not much pain in the chest unless the pleura are involved, and then it is of a burning, stitching character. The pulse is quick and small, the face and extremities inclined to be cold, or the hands and feet burning hot, with circumscribed redness and burning heat of the cheeks, especially in the afternoon. Under the use of this remedy, the dyspnoea subsides, the bronchial breathing disappears, we hear afresh the small crepitation, first alone, then mixed with the natural respiratory murmur, which in its turn becomes alone audible. The sputa becomes again less tenacious, less red, but, yellow and more like the expectoration of catarrh, and is expectorated in large, heavy masses; the febrile symptoms gradually abate, and a favorable convalescence is established. I give the medicine every two hours, generally alone, but occasionally in alternation with Phosphorus or Tartar emetic. In its powers over chronic bronchial or laryngeal coughs, it rivals Lycopodium and Sulphur. It relieves, and often cures, " coughs with chronic dryness in the throat, and sensation of swelling in the larynx; continual severe cough without expectoration, with pain in the breast, and circumscribed redness of the cheeks;" " cough, with coryza, then diarrhoea." This last symptom is an important indication for the use of Sanguinaria. After a severe cold, or undue exposure, some persons are attacked with coryza, catarrhal headache, severe pains in the chest, with tightness of breathing, and dry, harassing cough, all of which subsides upon the recurrence of diarrhcea. In such cases Sanguinaria is eminently indicated, as it causes a similar group of symptoms. Dr. Morrow praises it very highly in hcemoptysis. In one case which came under my observation, it seemed to correct the bleeding promptly. Cases have been reported to me where the tincture of blood-root cured spitting of blood which had resisted other means. It will undoubtedly be found useful in some cases of asthma, croup, laryngitis, and perhaps pleurisy, but we have no homeopathic testimony of its effects in those diseases. Dr. Wolff claims to have used the 200th potency with success in "syphilitic pulmonary inflammation." SANGUINARIA CANADENSIS. 665 Dr. Tom Nichol, of Montreal, writing of its use in acute cedematous laryngitis, says: In the sixth volume of the American Observer will be found an essay on acute Edematous laryngitis by the writer, in which he said, " I have never had an opportunity of testing the virtues of Sanguinaria in this disease, but would expect considerable from it." I have lately had the long looked for opportunity, and hasten to lay the results before the readers of the Observer. On Friday, April I7th, I was called to Mrs. C., aged 59, who had been complaining for some few days. I found an inflammation of the cervical glands of the right side, involving the parotid gland to a limited extent, and accompanied by extensive inflammation of the subjacent cellular tissue. The parts were hot, tender, swollen and red —in fact, the well known calor, dolor, tumor, ruborand there was reddening of the fauces, with slight pain on deglutition. I prescribed Belladonna 6th decimal trituration, and advised rest, quiet and silence. On the following day the situation was but little changed, and Mercurius iodatus ruber, 3d decimal trituration, was prescribed. At 6 o'clock of Sunday morning, April I9, I received an urgent call to the patient, who, I was told, had hardly been able to breathe all night. I found her sitting up in bed, with a characteristic sawing and rasping sound issuing from the larynx - a sound somewhat difficult of description, but which once recognized can never be forgotten. The tonsils and pharynx were swollen, but auscultation showed that the sawing and rasping sound issued from the larynx. The cough was dry and harsh, relieved by sitting up in bed, aggravated by eating and lying down, and it was accompanied by difficult expectoration of tough and glairy mucus. The voice was low and suppressed, and it was with difficulty that I could make out the hurried, whispered sentences. The pulse was feeble and fluttering, and the lips were pale; but on both sides of the cheeks there was a circumscribed redness. The pathognomonic symptom which made the pathological state quite clear to me was the fact that expiration was performed more readily than inspiration. M. Thuillier's test was decisive as to the diagnosis, for "when the forefinger was passed into the larynx, there is the perception of a cushion formed by the tumefaction of the sides of the glottis, a soft, pulpy body, quite distinct from the ordinary hard feel of the parts." The diagnosis was acute cedematous laryngitis of the supra-glottis variety - all the more dangerous because it was an intercurrent disease, and the peculiar respiration arose from the fact that the cedematous membrane which fills the glottis closes like a valve against the entrance of air, but readily permits it to pass out. I prescribed Sanguinaria Ist decimal trituration, a dose every half hour. At I P.M. I found that improvement had commericed almost as soon as the medicine was given. The sawing and rasping sound was now much diminished, the respiration was comparatively easy, inspiration and expiration were performed with the same facility; the cough was less frequent and less severe; the voice was quite audible, and the patient had slept much of the time since morning. The tonsils and pharynx were still red and swollen, but the glottis was clear of the tense and rounded swellings present in the morning. The Sanguinaria was continued in the same dose. 43 666 SANGUINARIA CANADENSIS. At 7 P.M. I again saw the patient, and found that the very serious pathological state had almost wholly disappeared. The Sanguinaria was continued all night, and in the morning, as the acute cedematous laryngitis was no longer present, treatment was directed against the inflammation of the cervical glands and cellular tissue. I can not leave this medicine without calling attention to the relationship between it and Chelidonium. It belongs to the same botanical family. Its chemical constituents are similar. Both contain Chelidonin; both affect the liver, the right lung, and the right side of the head. Both have throbbing in temporal arteries; and in both the headache and prosopalgia are periodical. It would seem that the Chelidonin common to both plants was the agent which caused the above group of symptoms. Chelidonium has no Sanguinarin in its composition. The former is the agent which most profoundly affects the liver; the latter seems to affect both lungs more intensely than the former, and has greater influence over the circulation, as in hmemoptysis. I can not omit Dr. Farrington's comparisons of these two remedies, which, although not as complete as I should like, will prove an excellent guide to their administration, and their differential diagnosis. CHELIDONI UM. SANGUINARIA. MIND, HEAD. Anxiety; must move about; weeps and Anxiety; irritability; can not bear to knows not why. hear persons walk across the room. Headache from occiput to forehead, over Headache from occiput to forehead, right eye; periodical. (Hale.) over right eye; periodical; worse Occiput so heavy he can hardly lift his from noises, light, stooping, motion, head; pressure to the left ear; head eating; better from lying still and worse from sneezing, stooping, open after sleep. air; better from eating. (F.) EYES, FACE, EARS. Pupils contracted. Pupils dilated. Profuse lachrymation with neuralgia, Burning lachrymation as a symptom using eyes, and as a result of fistula of catarrh, coryza, raw throat, cough, lachrymalis. diarrhoea. Rushing as of wind out of the ears. Tinnitus from congestion; ears hot; Deafness during cough. over sensitive to noises. SANGUINARIA CANADENSIS. 667 Mostly dry coryza, one side obstructed; Mostly fluent right-sided coryza; hot or fluent with thick blood in the discharge, eye waters, throat raw, morning. finally diarrhcea. Polypus. Face yellow; gray, sunken, blue Face pale, swollen around the eyes; around the eyes. Face dark red in bright red circumscribed cheeks; or pneumonia, cap.-bronchitis. livid in typhoid pneumonia. Veins swollen. Supra-orbital neuralgia; worse right Supra-orbital right-sided neuralgia; side, copious lachrymation. relieved only by holding the head tight to the floor. MOUTH, THROAT. Toothache worse in bed, better from Toothache, decayed tooth, worse from cold water. cold drinks. Tongue narrow, pointed (dyspepsia); Tongue as if scalded; coated white furred. (loss of appetite). Taste bitter; food tastes natural. Fatty, slimy taste; sweets taste bitter On the throat the two remedies have but little similarity of action. Chelidonium inflames the fauces, but, as will be seen, its main action is on the larynx. Sanguinaria, on the other hand, causes ulceration of the mouth and fauces. Mouth, gums and roof sore, burning; throat feels as if scalded, tonsils swollen, worse the right; pearly diphtheritic exudation; worse from swallowing sweets; throbbing in the head, red cheeks; distended temporal veins. STOMACH, ABDOMEN. Longs for milk, hot drinks, coffee; Loss of appetite, with craving for they agree. piquant food. Aversion to cheese, boiled meats. Aversion to butter. Gastralgia, with gnawing pains in the Gastric catarrh, burning; tongue and stomach, made better from contin- lips red; throat hot; eating relieves ued eating. the sensation of nausea. Hepatic congestion, with sharp stitch Hepatic symptoms less marked; like a pains; pains under the right scapula; hot stream from breast to liver; yelclay-colored or bright yellow, thin low stools less characteristic than in stools; colic from portal congestion, Chelidon.; colic, with much flatuwith great heat, contraction of the lence and torpor of the liver; sick navel; headache behind the eyes headache over the right eye; nausea, and in occiput. vomiting of bile. Stool bright yellow, thin; or dry, in Stool yellow, thin, undigested; much hard lumps; white, clay-colored. offensive, flatus; terminates the catarrh. URINE, GENITALS. Sharp, spasmodic pains in the kidneys Pain in the left hypochondrium, with and bladder; urine greenish (bile), copious, pale urine; urine yellow or deposits red sediment. (bile); reddish sediment. Menses too late, profuse and last too Menses too early, black offensive blood; long; pain under angle of right sick headache, from -occiput over scapula. right eye. Burning in the vagina periodically at Discharge of flatus from the vagina; the same hour. climacteric changes. Milk vanished. Nipples sore, burn. 668 SANGUINARIA CANADENSIS. LARYNX, CHEST. Hoarse periodically every day 5 P.M.; Aphonia, with swollen larynx; rawdry, hard, spasmodic cough as from ness, burning; ulcers; dry, cough dust in the larynx; spasm of the ceases when flatus is passed up and glottis in expiration; constriction down; or as soon as diarrhawa ensues; across the upper part of the larynx; wheezing, whistling cough; worse at worse in the morning (cough). night and lying with the head low (I). Pneumonia or capillary bronchitis, with Pneumonia, with marked vascular disbilious complications; loose rattling turbance; rust-colored sputa; little cough; bright,yellow, thin diarrhca; pain or simply burning; circumin severe cases, dark red cheeks, scribed red cheeks; great dyspncea; great dyspnoea, with fan-like motion in severe cases, livid face and hands; of the alke-nasi, one hot and one cold quick, small pulse, weak feeling at foot. the heart; extensive hepatization (2). Heart beats so forcibly as to raise the Palpitation violent, felt in the head, clothing (bilious complaints). constriction of the stomach, deathly nausea. Pulse full, hard, but not much acceler- Pulse frequent, full; or quick, small; ated; or small and rapid (cap. bron- frequency and force reduced (pneuchitis). monia). BACK, LIMBS. Pain under the angle of the right scap- Pressure and pain along the inner borula. der of the left scapula. Rheumatism not so well marked as in Rheumatism, especially of the right Sanguin.'Fearing pains, parts will deltoid, muscles of the back; parts not bearthe least touch; sweat gives sparely covered are sensitive to touch; no relief. sweat relieves the pains; pains shift (3). Nails blue, joints of the fingers yellow, Livid hands (pneumonia); roots of the cold. nails ulcerate one after the other. One foot cold, one hot (pneumonia). Feet generally burn. SLEEP. Sleepy, yet can not get to sleep. Restless, dreamy sleep; awakens frightened, as if falling. (I.) Sanguin. corresponds more to inflammation and ulceration; Chelid. offers more spasmodic symptoms. Sanguin., with its peculiar cough has cured croup (J. B. Bell), and is similar in pseudo-membranous croup to Kali bich. (Nichol.) (2.) It is now known that one great danger in pneumonia is heart failure. The symptoms of Sang. point to its use in just such an emergency. (3.) Sanguin. is an excellent remedy in acute rheumatism, worse from motion, at night; pains are throbbing, burning, and there are spasmodic pains in the joints. When metastasis to the heart occurs from external application to the affected joints, Sanguin. or Kalnlia (according to Hering) will be of great service. SANTONIN. 669 FEVER. Irregular circulation; dark red face; Irregular circulation; hectic red cheeks; one cold, one warm foot; one ear' hot streaming from chest to abdocold, one warm; palms hot; veins men; flushes of heat at climaxis; of hands and arms swollen. feet, hands burn'; veins swollen, especially temples. Chilly in the open air, even in Summer. Chilly and hot alternately. Heat with the colic; heat with dark Flushes of heat; hectic with bright red red cheeks; cold feet; short breath; cheeks; nausea, sick headache; nausea. dyspncea. Sweat ceases on awaking. Profuse sweat; cold sweat. GENERALITIES. Itching, with jaundice. Itching precedes the nausea (4). Old, putrid, spreading ulcers (Lippe.) Indolent ulcers, no pain, dry, sharp cut edges (W. Wesselhoeft). (4.) Bute proposes Sanguinaria as the quickest antidote to Rhus radicans. SANTONIN. This powerful agent has sulerseded the oil of Wormseed. Both are prepared from the plant which is called in our old Materia Medica, " Cina." It has a double action, when given to the human subject. It is a direct poison to any intestinal parasite with which it comes in contact, and at the same time it exerts a powerful effect on the general system. You are probably aware that Hahnemann's provings of Cina developed the curious fact that its pathogenetic symptoms simulated in a wonderful manner the symptoms caused by the irritation of worms. The same may be said of Santonin, which gives it a double value, for, when given in appreciable doses, it destroys the parasites which are causing the direct and reflex irritation, and at the same time acts dynamically in removing those irritations by its homceopathicity. In cases where it is necessary to expel, as well as destroy the worms in the intestines, it is advised to give it mixed with Castor oil. I remember to have seen in Braithwaite's Retrospect an account of some very interesting experiments, 670 SANTONIN. for the purpose of ascertaining the relative toxic power of various anthelmintics. The Santonin was tested, with many other drugs, and it was found that when it was dissolved in Castor oil, in very minute proportions, it destroyed the life of the common round worm sooner than any other agent. The time occupied was but a few minutes. As I have stated in Volume I, the Santonin is one of the most powerful parasiticides, and will destroy the life of almost ally species of intestinal worms. It seems to have the most decided power over lumbrici (long, round worm); less on oxyuris (pinworm), and least on tcenia (tapeworm). For the destruction of lumbrici, no better remedy is known. Two or three grains of the one-tenth trituration should be given in a spoonful of sweetened milk, at a time when the stomach is empty, as before each meal, or, in infants, before nursing. For young infants, the 2d and 3d triturations should be prescribed. A few days of this treatment will remove the worm symptoms. It must not be expected that the worms will be seen in the evacuations, for when they die in the stomach, they are digested. If the child has diarrhcea, then the worms, or portions of them, may be discovered in the alvine evacuations. In some cases of oxyuris, Santonin will prove useful, but it should be injected into the rectum, as well as given by the mouth. It is a late discovery, that if injections of warm lard are used for a few nights, the pinworms disappeartheir propagation is arrested. If a few grains of Santonin, in the lowest trituration, is added to each injection of lard (one-half or one ounce), the destruction of these parasites is rendered still more certain. I do not know that this medicine has ever destroyed a tapeworm, although instances may have been placed on record. You will often meet with cases in practice where children present symptoms which resemble those caused by worms, yet no worms have ever been discovered in the evacuations. Some of these symptoms simulate cerebral irritation, and it will not be safe to give material doses of Santonin, unless SANTONIN. 6-71 you are certain that such symptoms are actually caused by worms, for Santonin, in large doses, has caused intense cerebral irritation, with spasms. In such cases give this medicine, or Cina, in the high or middle attenuations. The 10th of Santonin is about equal to the 3d of Cina. By consulting the symptomatology of Santonin, you will see that it presents a magnified picture of the pathogenesis of Cina, and may be used instead, for more serious symptoms. Santonin is homoeopathic to many other conditions anddisorders than those caused by, or which simulate the effects of worms. It has been used successfully in some forms of headache with vomiting and delirium, and in cerebral congestion. It may prove useful in cerebral- and cerebro-spinal meningitis. It affects specifically the eyes, causing singular abnormalities of vision, which you will find described in Vol. I. Dr. Rose, of Berlin, who has experimented largely with Santonin, says these abnormal deviations of sight are caused by " an altered perceptivity in the nervous organ of vision itself," i. e., a dynamic effect. Its homceopathic relation to disorders of the internal eye, is proven by the fact that it has been found to be curative in amaurosis and blindness. In the Reports of an English Hospital it is recorded that Santonin cured many cases of " nervous failure of sight." It appears that the discovery of this curative power was accidental. An old man, quite blind, was given Santonin for worms. Under its influence his sight partially returned. This led to its administration in thirty-six cases of weakness of vision-or, as the writer terms it, "nervous failure of sight," a kind of paralysis of the optic nerve. Of the thirtysix cases, twenty-seven recovered more or less perfectly, the rest were not much benefited. It was also used in nine cases of cataract, of which four were cured, the rest not benefited. It has cured many disorders of the urinary organs, namely, urging to urinate at night; enuresis nocturna; dysuria; stran 672 SCUTELLARIA LATERIFLORA. gury; chronic cystitis, chronic catarrh of the bladder. In this last affection it has made some very brilliant cures. Youwill find it useful in infantile remittents, whether from worms or from ordinary gastro-enteric irritation. SCUTELLARIA LATERIFLORA. This plant is, in the domestic practice of this country, what Valerian is in the domestic practice of Europe. Its calming or sedative effects on the nervous system have been known ever since the settlement of New England. In the original botanic school, it held a very high place as a remedial agent. Dr. Beach has published many cases cured by its use. Rafinesque quotes Barton and many eminent physicians of his day, who extoled it highly in all diseases of the nervous system.. Dr. King says: Scull-cap is said to be tonic, nervine and antispasmodic. This is one of those valuable agents which a certain class of physicians consider inert; yet it has proved especially useful in chorea, convulsions, tremors, intermittent fever, neuralgia, and all nervous affections. In delirium tremens, an infusion drank freely will soon produce a calm sleep. Where teething has impaired the health of children, an infusion may be given with advantage. The Scutellaria is one of our most valuable nervines and tonics, and is especially useful in cases of depression of the nervous and vital powers after long sickness, over-exercise, excessive study, or from long continued and exhausting labors. One grain will frequently produce its quiet and soothing effect, controlling nervous agitation, and inducing a sensation of calmness and strength. Dr. Scudder has a high estimate of its powers. He writes: It has been found remarkably efficacious in chorea or St. Vitus' dance. Dr. Beach states that he has cured a great number of cases with it. We have used it in several instances with apparent benefit. In cases of great nervous excitement, with severe tremors, also in attacks of delirium tremens, it has in several cases afforded prompt relief. It has been extolled in many of the nervous and spasmodic affections so very common among women. It has attracted much attention in hydrophobia, and at one time it enjoyed a high reputation in the treatment of that formidable disease, although the same reliance is not placed on it that was some years ago; still, it is resorted to, both as a prophylactic and curative agent, in cases of canine madness. Testimony is not wanting to establish the fact that many persons have been bitten by rabid animals, and avoided the development of the disease by the SCUTELLARIA LATERIFLORA. 673 free use of Scutellaria; while others, bitten at the same time, by the same animal, became hydrophobic. So many circumstances may concur to prevent the inception of the canine virus at the time of the bite-as the interference of clothes, or the speedy removal of it from the parts bitten, and thus preventing it from being absorbed- that we must view many of the cases said to have been cured by the exhibition of this article, as highly equivocal. " A physician bitten by a mad dog, has assured me," says Rafinesque, "that himself, alone, had avoided the disease by using it, while others bitten by the same dog died." Dr. Vande.sveer, who is said to have introduced it to the notice of the profession in I772, or rather, to have discovered its prophylactive powers against hydrophobia, is said to have prevented 400 persons and Iooo cattle from becoming hydrophobic; and his son is said to have relieved or cured forty persons who had been bitten, by the use of the same agent. These favorable reports of its efficacy are strongly questioned, and even denied by eminent physicians, while many of the botanic school report very favorably of its efficacy in that disease. It would seem that there ought to be some grains of truth among so much testimony. My observations have not fallen upon any such cases; but in one patient to whom I gave the Scutellaria, the first decimal, for a nervous affection, its administration was always followed by the symptom -" spasmodic or constrictive closing of the jaws, and a tightness of the muscles of the face." A proving might elicit symptoms which would account for its efficacy in hydrophobic conditions. I have used it successfully in several cases of tremors, and twitchings of the limbs, in typhoid fever; also in mild form of hysteric spasms, and nervous irritation in pregnant females, etc., etc. For my estimate of the general therapeutic and pathogenetic effects of this plant, I would refer the reader to my notice of the (ypripedium pubescens; not that I consider these two remedies as possessing identical properties, but they are such close analogues, and affect the system in such a similar manner generally, that many of my remarks applied to' Cypripedium will be applicable to Scutellaria. I have used the latter in diseases of children, and affections of the nervous system, similar to those in which I recommended the former, and with like good results. That a careful proving would elicit different symptoms, I do not doubt. If I were to attempt a differential estimate of the two remedies, I should say that the Scutellaria affected the spinal cord more, and the brain less, than the Cypripedium. I believe this statement will be verified by experience and observation. Professor Paine remarks of Scutellaria as follows: It appears to manifest itself more particularly upon the gray nerve tissue, and hence it is adapted to, and exerts a wonderful power in, most of the difficul SCUTELLARIA LATERIFLORA. 675 prompt curative effects; in others it ameliorated symptoms which Coffea did not reach. In my second edition I wrote: " I am disappointed in not receiving any clinical testimony friom the members of our profession relative to its use. This may be owing to the absence of a proving, and to the fact that our school are averse to using a medicine empirically. I believe it to be better to do so, however, than to use Chamomilla, Coffea and Belladonna, in a careless, routine manner, for the nervous affections of children and adults." When my third edition appeared it had been very largely and successfully used. It has now been fifteen years since I commenced using the Scutellarin, and every year increases my confidence in it as a remedy in many of the disorders of delicate, nervous subjects. Not only have I found it useful in sleeplessness, nightterrors, hysteria, delirium tremens and nervous agitation from pain, or exciting emotions, but it is valuable in cerebral irritation in teething children, or from intestinal irritation. I am glad to say that the homoeopathic school are now using the remedy very extensively and satisfactorily. In a proving by Dr. Gordon, many important symptoms were evolved. That proving shows conclusively that the Scutellaria is by no means an inert or feeble plant. It evidently caused considerable derangement in the central nervous system. (See Symptomatology.) We note several important symptoms evolved, which seem to substantiate its alleged value, and prove it to be homceopathic to the symptoms for which it has been especially used. (1.) The nightly restlessness; sudden wakefulness; frightful dreams. (2.) The headache, one form of which, while it was apparently congestive, was probably nervous derangement. It resembles very much the cephalalgia of Cimicifuga. (3.) The irregular action of the heart is due probably to derangement of the cardiac plexus. In the cerebral diseases of infancy, this irregularity is often noticed. It may prove useful in angina pectoris. 676 SENECId. (4.) The tremulousness and twitching of the muscles, show it homceopathic to chorea and nervous jactitations. I have used Scutellarin lx, in many cases of cardiac irritability, nervous palpitation, etc. It somewhat resembles Lycopus, but has not its depressing action, while it has greater power over the hypercesthesia. SENECIO. This indigenous remedy has become quite popular with a portion of our school. It is one of those plants which has gained its common name from its regulating power over certain uterine disorders. It is known to the common people by the name of "female regulator." It is even said that the Indian name "Uncum," means the same. Its sphere of action is mainly upon the mucous system and the nervous system. Specially, it has an affinity for the generative organs of both sexes, the urinary organs, and the bronchial mucous membrane. Although its influence on the nervous system is not mentioned by any writer, yet my observations have convinced me that it ranks with Coffea, Chamomilla, Valerian and Ambergris, and it is in many respects a " nervine." It has been suggested by those familiar with its use, that it acts as a nervine, by subduing the irritation of the uterine organs, and thus prevents the nervous irritation which might have been of a reflex character. This may be the true explanation of its action. It has a great reputation among the country people, who designated it " Wild valerian." They use it extensively for nervousness, hysteria, lowness of spirits, and sleeplessness, especially when these conditions occur in females. It has the following suggestive symptoms: " About the middle of the afternoon, sensation as if a ball was in the stomach, rising up into the throat, lasting for about an hour; sensation of tightness in the throat, with a disposition to attempt to relieve it by swallowing." I am strongly impressed with the idea that this remedy SENECIO. 677 acts upon the mucous tissues similarly to Pulsatilla. It causes increased secretion from the bronchial, intestinal and vaginal mucous membranes, and has been found curative ill abnormal conditions characterized by mucous discharges. It seems to me to be indicated when a catarrhal affection has appeared in one organ, and caused, or is consequent upon the suppression of natural discharge in another; thus, profuse leucorrhoea, or a bronchial, and even a nasal catarrh will set in upon the suppression of the menses, or appear in place of the menses. A catarrhal diarrhoea aften appears at such times. It is in these conditions that Pulsatilla and Senecio prove so successful as curative agents, by curing the catarrhal discharge, and permitting the natural functions to appear. The Senecio has also proved useful in haemorrhages from mucous surfaces, appearing upon the suppression of habitual discharges. A catarrh was cured by the proving of the drug. It has the following symptoms: "Sense of fullness in the nostrils, with excessive secretion of white transparent mucus in the nostrils and bronchi; sneezing; hoarse, but the trachea and bronchi seem to be clear; sense of fullness in the nostrils, but no mucus; sneezing and sense of fullness in the nostrils, relieved after a while by a copious flow of mucus; frequent hawking of tough, white, transparent mucus; secretion of mucus in the nose and trachea; sense of burning and fullness in the nostrils, with a little mucus; coryza." The symptoms of the digestive tract would seem to indicate that it will prove of value in catarrhal affections of the stomach and bowels-in catarrhal diarrhcea or dysentery, and the later stages of mucous enteritis. This medicine has long had an extensive reputation in domestic practice as a diuretic, and used as such in cases of dropsy, suppression of urine, and irritable bladder. Eclectic writers say: "As a diuretic it has been employed with advantage in calculous affections, to subdue the irritation." -(Scudder.) " It is said to be diuretic and specific in strangury."-(King.) In those anasarcous states which attend chlorosis, or attacks of women at the climacteric age, and 678 SENECIO. seem to be caused remotely by some disorder of the generative organs, the Senecio gracilis may prove a very efficient remedy; also in ovarian dropsy, or dropsy occurring after suppression of the menses. To illustrate its action, I quote the following cases reported by Dr. A. E. SImall: Case I. —A young woman applied for relief of dropsical symptoms, namely: abdomen much enlarged, very tense, with an evident large amount of water in the peritoneal cavity; lower extremities very edematous; urine quite scanty and high colored — not more than eight ounces a day; considerable pain in the lumbar region, and in the ovaries. With the exception of constipation, no other abnormal symptom was manifest. Upon examination with the speculum, the cervix uteri was somewhat congested, and there was present albuminous leucorrhcea, but uterine pain was not much complained of- only a sense of weight, which may have been due to the peritoneal effusion. Apis mellifica 2d was prescribed and taken for a week with no benefit, except to relieve the ovarian pain. Apocynum cannabin I-th was also taken for a week, but contrary to its usual effects, it did not seem to increase the amount of urine. Senecio aureus was then prescribed, ten drops of the 1- th in water every four hours. In two days the urinary secretion was up to its normal amount, and the cedema, ascites, and lumbar pain diminished rapidly. The peritoneal effusion did not altogether disappear, nor did Arsenicum remove it completely. Case II.-A woman about 30 years of age had the following symptoms, which had increased since their accession, six weeks before: Face bloated, abdomen enlarged, feet cedematous; urine alternately profuse and watery, or dark colored and scanty; frequent desire to urinate, day and night. No other abnormal symptoms of importance. In this case Senecio aureus was prescribed at once, without trying other remedies. Ten drops every three hours (mother tincture) for two days; then three times a day for a week effected a cure. This remedy has also been useful in my hands in the dysuria of women and children, when the symptom was evidently of a catarrhal origin. In dysuria, associated with uterine displacement, it is often useful. The presence of a mucous sediment in the urine is an indication for its employment. Case III.-Mrs. H., aged about 30, of lymphatic temperament, had been suffering from chronic inflammation of the neck of the bladder for six years, from which she had received only temporary relief from treatment. At times she suffered greatly from tenesmus of the bladder and urging to urinate. She supposed herself to be afflicted with the gravel, as she sometimes passed bloody urine. Senecio aureus was prescribed, one drop of tincture, which she took at intervals of six hours for several days. She felt sensible relief from the difficulty after using the remedy two days. She continued its use for several days after, when she found herself entirely free from the suffering. She discontinued the medicine, and was agreeably surprised at the non-return of the difficulty, as it had before done after temporary relief. She had no indications of return for SENECIO. 679 several months, when some exposure occasioned its reappearance. The remedy was again resorted to, and prompt relief was obtained. She has remained entirely well of the disease since - a period of eighteen months. Case IV.-A gentleman of nervo-sanguine temperament, aged about 50, had been subject to renal inflammation, affecting particularly the right kidney, causing intense pain, and general febrile disturbance and great prostration. On one occasion his suffering was intense, and the bladder seemed to be implicated. Every time he passed urine he experienced great pain, which caused him to cry out in agony; his bowels were constipated; the urine was of a reddish color; very hot and acrid; he complained of dull headache, dryness of the mouth and throat, disposition to chilliness, fever and perspiration. Twenty drops of the tincture were put in half a tumbler of water, and a dessert-spoonful was taken. A mitigation of suffering was the result. The dose was repeated every hour, until it entirely subsided. More than a year has elapsed since, and he has no return of the malady. This gentleman having some acquaintances whom he knew to be victims of a similar disease, was prompt to furnish them with this remedy, and in some instances with like curative results. Case V.-A merchant, 45 years of age, nervous temperament, inclined to be bilious, was attacked severely with renal inflammation, attended by general feverishness, chilliness, and pain in the lumbar region, and particularly in the left kidney. In this case there did not appear to be any very perceptible implication of the bladder; the quantity of urine passed was below the normal amount, and very red, and on standing awhile a brick-dust sediment was precipitated. The arterial excitement was considerable; the skin hot and dry; motion very greatly aggravated the suffering of the patient, and caused him to cry out with pain; bowels were constipated. Aconite was first given, and repeated at intervals of an hour until the skin became moist, and the arterial excitement was somewhat subdued.'Pain still severe; urine hot and scanty. Gave Nux. vom. No relief; patient complained of soreness and pain in the lumbar region. Gave Arnica, and moved the bowels with an enema of warm water. Partial relief followed for a time; pain returned; gave Senecio aureus. No relief.for some hours from pain; urination, and every effort to urinate, attended with pain; urine tinged with blood. Gave Cantharis 3d dilution. No change. Gave Senecio two hours after, in an increased dose, after which the pain gradually subsided and passed off entirely; the urinary secretion became increased to the usual quantity in health, and recovery soon followed., Case VI.-An attorney, aged 34, of a leuco-phlegmatic temperament, after a prostrating attack of fever, exhibited a marked cachexia and tendency to general dropsy; urine rather scanty, with a blackish sediment, which, on examination, proved to be broken down blood corpuscles. Senecio, in drop doses of the tincture, was given at first, and afterwards in a more attenuated form, with no satisfactory result. (Terebinth. caused a disappearance of the sediment, and Erigeron also, in another similar attack.) In a letter from Dr. Gray, of New York, a confirmatory statement is made of the powers of the.Senecio aureus: " I have used it," says the Doctor, " in renal disturbances, with satisfactory results." SENECIO. 681 Dr. Paine coincides with the opinion held by Eclectics concerning the affinity of Senecio for the uterus and ovaries. " It is," he says, " especially adapted to the defective uterine function arising from a vitiated state of the system. In scrofulous and phthisical patients I give the Senecin in doses of from one-half to one grain, combined with one or two grains of Carburet of iron, four or five times a day. There is, perhaps, no emunctory of the body that exerts a more powerful influence over scrofulous and consumptive patients, than the uterus." In these diseases Paine considers the Senecin useful, because it corrects irregularity of the menses, as to either time or quantity. " In cases of weak habit, when the catamenial period is protracted, and the blood appears to be poisoned or contaminated by the retention of zymotic catamenial poison," he gives Senecin and Hypophosphite of iron in combination. The quantity of Iron he prescribes (two grains five times a day) is, however, dangerous. Dr. Churchill, of Paris, who introduced the medicine, says it will bring on pulmonary hkemorrhage in such doses. The best allopathic authorities advise against the use of Iron in phthisis. Some homceopathic physicians have cured incipient phthisis with Ferr. hypophosphis, 3d trituration. It should not be used any lower. " Senecin has proved eminently successful in the treatment of amenorrhaa. When the obstruction has arisen from cold, this remedy in connection with warm alkaline pediluvia is generally sufficient. When the affection is uncomplicated, we know of no remedy so generally reliable. It operates kindly and without excitement, and the catamenial flow is restored in a manner so natural that the patient is scarcely aware of being under the influence of medicine." " We have derived equally happy effects from the employment of Senecin in the treatment of dysmenorrhea. The most beneficial results are obtained by exhibiting it during the intermenstrual period. It acts as a special tonic upon the uterine system, invigorating the menstrual function, and restoring equilibrium of action. If the menstrual secretion be profuse, use Trillin in combination. If scanty, Macrotin or Baptisin may be employed." (alternated.) " We have been equally successful with the Senecin in the treatment of menorrhagia. It may seem somewhat paradoxical to the reader that we should prescribe the same remedy in what are generally conceived to be opposite states of the system. No matter in which direction the scale may be turned; if we can but restore and equalize the functional activity of the parts, we shall effect a cure. For this purpose we employ the Senecin simply because it possesses the power of recalling or restoring lost or healthful action. This then explains the seeming paradox of giving the same remedy in dissimilar derangements of the same organ."-(Coe.) " Chlorosis is another of those incidental female affections in which Senecin will be found an excellent remedy. It is particularly serviceable when chlorosis occurs in a strumous diathesis, and is associated with chronic catarrhal disorders." Many old remedies have this regulating effect, especially Sepia. Pulsatilla also resembles Senecio. I think too frequent and profuse menses is a primary effect of Senecio; while scanty, irregular menses is its secondary. 44 682 SEKECIO. The following case, treated with Senecio gracilis, has been reported to me by one of my colleagues: A lady, aged 48, presented the following symptoms: inability to sleep, nervous irritability, loss of appetite, coated tongue, bowels constipated, constant feeling of lassitude, disinclined to move about, wandering pains in the back and shoulders; had been in this condition six months, during which time the catamenia, which, previous to this, had been regular in appearance, have not appeared; has been treated allopathically for the last three months, with no permanent benefit. I gave Macrotin, Sepia, Secale cornutum, Zincum valerianas, Pulsatilla, Cypripedium, etc., with but little or no success. At last the Senecio was given in doses of 20 drops, three times per day; this was followed by a marked improvement, and after the lapse of one week she reported herself able to sleep well all night. Under the continued use of the remedy all the symptoms disappeared in the space of two weeks longer. A relapse presented the same phenomena, which occurred about six months later, was in like manner cured by the Senecio. The following case is a type of many I have cured with Senecin: A lady, the mother of one child, had had an abortion three years ago, and another — at the second month of pregnancy — four months since. Since the date of the last abortion she had suffered much from painful menstruation, which had not been the case previously. The menses came on too soon - every three weeks; were very profuse, lasting eight or nine days, and were accompanied with a great deal of pain, of a cutting character, referred to the region of the sacrum, hypogastrium and groins. She was pale, weak and " nervous," and had a slight cough, generally at night. Thinking this a good case in which to test the vaunted virtues of the Senecio aureus, I prescribed five drops of the mother tincture three times a day, and continued its use until the next menstrual period. To the patient's gratification and my own, the menses appeared at their proper time (in 29 days), and were normal in quantity, and unaccompanied with pain or suffering of any kind. Since reporting the above case I have treated several cases of a similar nature, and with success. In one case the first decimal dilution was used; in another, the first of Senecin, and in still another the second decimal. I have used it in many cases of amenorrhcea, where Pulsatilla failed to restore the discharge, but Senecin 2d generally had the desired effect. It affects the respiratory organs in a manner somewhat similar to Asclepias tuberosa, Copaiva and Pulsatilla. SENECIO. 683 In coughs, colds, and other complaints of the chest, Senecio is one of the most valuable remedies we possess. It is especially serviceable in mucous coughs. It has acquired considerable reputation in chronic coughs, catarrhal affections, haemoptysis, incipient phthisis attended with troublesome cough, the result of obstructed menstruation, with unequivocal advantage. I have used it in a few cases of cough occurring in females, according to the indication' given above. It seemed to act admirably. These suggestions may seem bare and valueless, unless backed up by more pathogenetic symptoms. But it must be recollected that many of our best remedies started from just such small beginnings. The following case, reported by Dr. Thomas Irish, seems to prove that it ranks high as a remedy in pulmonary affections: In the year 1822, in the State of New York, I was taken suddenly with profuse hzemorrhage from the left lung. Physicians were sent for; consultation took place; they manifested much wisdom in endeavoring to stay the red current of life by tapping my arm. The blood refused to flow in that direction, but the lung continued to perform its office in opposition to these endeavors to change its current by cutting the cephalic vein. All to no purpose; the life current continued to flow until it would hardly stain a white cloth. They gave me up as lost, without hope, and then gave rules and ordered medicine taken. I refused to take medicine. I became a living skeleton; the dry, hacking cough, the hectic flush and sleepless nights were my companions for day and night for about five months, and still living in opposition to the wisdom of the prophets, I was in the daily habit of wandering about the fields on my father's farm, and pulling and testing of roots and herbs. The Senecio was before me, near a small stream. I tasted and was impressed to try its virtues. I had it gathered, roots and tops, and prepared a decoction, of which I took half a tablespoonful four times a day. Improvement set in soon after commencing the use of the Senecio. In six weeks the cure seemed complete. This was in the Fall. I continued well through the Winter; in the Spring went to work; in a month was prostrated by hemorrhage from the lung again; continued to work until Fall. Again the " life root " was taken, chewing the root and drinking a tea of the same. Again, contrary to the expectation of all, health was mine. In the Spring of I824 I came to Michigan; worked hard all Summer; in Fall was taken sick; continued feeble until Spring. At every attack of the disease the lungs would sympathize, so as to have it terminate in a lung fever, with bloody expectoration. I employed no physician, but always used the "Cure-All," as I often called it. In the too free use of the green root it proved a laxative, which was not favorable to the healing process. At every attack, for ii years or more, of lung fever, which were many, I always used the same remedy with the same 684 SARRACENIA PURPUREA. success. I have never known it used in such attacks without some benefit, and the number would be hundreds. I saw the blood spirt the size of a common straw from a cut in the leg. The Senecio, roots and tops bruised and applied immediately, stopped the blood; it was the only dressing. The person was not kept from his work an hour in all. It was a bad cut, and healed in a few days. It is the best dressing for cuts, bruises and sores, known to me. It has more power over diseases of the uterine organs, than any other medicinal plant, in my opinion. In erysipelas it has with me proved a useful remedy, internally and externally. It would seem by the last paragraph to have a general curative influence over heemorrhage, making it analogous upon some points with Erigeron, Trillium, and Lycopus. An interesting case lately came under my treatment, which illustrates very well the action of this remedy upon the pulmonary tissues: A lady, aged 40, passing through the climacteric period, applied to me for a remedy to relieve a troublesome cough. She was cured promptly by Senecio Ix. Her symptoms were: Considerable debility; no appetite; flashes of heat at times during the day; redness of the cheeks in the afternoon; occasional night sweats; menses have been very irregular for a year. It is now two months since they have appeared. Six weeks ago she caught cold, got a cough, at first dry, then loose, with copious expectoration of a yellowish, thick, sweet mucus, often streaked with blood, attended with a sensation of rawness and soreness in the chest. The paroxysms of coughing were quite severe and exhausting. SARRACENIA PURPUREA. This curious plant was first used as a medicine by the Indians, who, according to the reports of certain British officers, cured nearly every case of small-pox, in an epidemic of that disease which raged in Nova Scotia. So glowing were the accounts of its success in that dreadful disease, that it was used extensively in English and American hospitals, for a time, with the most varying success. It is difficult to account for the conflicting reports relative to its value in that malady, some pronouncing it absolutely inert, others asserting it to be a specific. In the first edition of New Remedies, I published only allopathic testimony. In the second edition, appeared a large amount of homceopathic SARRACENIA PURPUREA. 685 testimony from English, Continental and American physicians, nearly all of whom reported favorably of the value of the Sarracenia in the treatment of variola. Some additional allopathic experience was also reported, but it was as conflicting as that previously given. Several provings have been made by European homceopathists; one by Houatt, which is "too good to be true." The provings made by the American provers, Drs. Duncan and Thomas, do not throw much light on its applicability to small-pox, although some of the symptoms, according to Lilienthal, verify Houatt's pathogenesis. After summing up all the testimony for and against the value of this medicine in small-pox, I am inclined to give it credit for possessing a specific power over that disease. It appears to shorten and mitigate the eruption, and prevent serious complications. It appears to have been successful when administered in infusion (-ss -of the root and leaves to'viij of hot water; a spoonful every two hours). Also in the lower dilutions, a few drops every two hours. It is alleged to have curative effects in various pustular eruptions unattended by fever, such as crusta lactea, prurigo, etc. It has been recommended in scrofulosis and tuberculosis, but upon rather doubtful authority. I have never had a good opportunity to test its value in varitla, as I rarely treat the disease. I have given it in varioloid, but can not assert that it actually modified it because. it is impossible to know what will be the extent of a varioloid. Nor have I used it enough in other cutaneous disorders to enable me to speak favorably of it in any. As a matter of interest, I present the first notice of the plant, which appeared in 1860. The American Medical Times had the following letter, by Fred. W. Morris, M.D., Physician of the Halifax Visiting Dispensary: SIR -You have by this time, in all probability, heard something of an extraordinary discovery for the cure of small-pox, by the use of " Sarracenia purpu 686 SARRACENIA PURPUREA. rea," or Indian cup, a native plant of Nova Scotia. I would beg of you, however, to give full publicity to the astonishing fact, that this same humble bogplant of Nova Scotia is the remedy for small-pox, in all its forms, in twelve hours after the patient has taken the medicine. It is also as curious as it is wonderful that, however alarming and numerous the eruptions, or confluent and frightful they may be, the peculiar action of the medicine is such that very seldom is a scar left to tell the story of the disease. I will not enter upon a physiological analysis now; it will be sufficient for my purpose to state, that it cures the disease as no other medicine does-not by stimulating functional reagency, but by actual contact with the virus in the blood, rendering it inert and harmless; and this I gather from the fact that if either the vaccine or variolous matter be washed with the infusion of the Sarracenia, they are deprived of their contagious properties. The medicine, at the same time, is so mild to the taste, that it may be mixed largely with tea or coffee, as I have done, and given to connoisseurs in these beverages to drink, without their being aware of the admixture. Strange, however, to say, it is scarcely two years since science and the medical world were utterly ignorant of this great boon of Providence; and it would be dishonorable in me not to acknowledge that had it not been for the discretion of Mr. John Thomas Lane, of Lane's Park, County Tipperary, Ireland, late of Her Majesty's Imperial Customs of Nova Scotia, to whom the Mec-Mac Indians had given the plant, the world would not now be in possession of the secret. No medical man before me had ever put this medicine upon trial; but in I86i, when the whole Province of Nova Scotia was in a panic, and patients were dying at the rate of twelve and a half per cent., from May to August, Mr. Lane, in the month of May, placed the "Sarracenia " in my hands to decide upon its merits; and, after my trials then and since, I have been convinced of its astonishing efficacy. The only functional influence it seems to have, is in promoting the flow of urine, which soon becomes limpid and abundant, and this is owing perhaps to the defecated poison or changed virus of the disease exclusively escaping through that channel. The "Sarracenia" I have reason to believe a powerful antidote for all contagious diseases, lepra, measles, varicella, plague, contagious typhus, and even syphilis, also a remedy in jaundice. I am strongly inclined to think it will one day play an important part in all these. This remedy was believed by the'Indians to be so efficacious, that if given to them when attacked with small-pox, they looked forward with confidence to a speedy and effectual cure. An old weird Indian woman was the fortunate possessor of the remedy in question. She had always been know'n as the doctress of her tribe, and had enjoyed celebrity for many years, in consequence of her reputed knowledge of medicine, and wonderful acquaintance with the herbs and roots of the woods. So well established was her fame among the Indians, that when sick, they resorted to her in preference to the white doctors, whom they considered to be " no good." Captain Hardy, of the Royal Artillery, an accomplished and intelligent officer, who had been for years among the Indians, says that "the old squaw's remedy had long been known to them as an infallible cure for small-pox," 690 SARRACENIA PURPUREA. I gave her the decoction with directions to give a dessert-spoonful four times a day. On the fourth and eighth days the visits were repeated, each time speaking in laudatory terms of the efficacy of the medicine. On the eleventh day of the eruption she made her last visit, making at the same time the following pertinent remarks: " I have called to thank you, sir, for your great kindness. My child is now quite well; all the scabs have fallen off, and the skin has not a blemish on it. That medicine must be very valuable, sir; for a little girl, the daughter of one of my lodgers, caught the small-pox three days before mine did, and it has not changed a bit; the pock is all over the body yet, in great mattery heads, and here is my child with her skin nearly as clean as when she was born." I was somewhat incredulous as to this perfect clearance of the skin; but in half an hour she brought the child for my inspection, and the appearance fully corroborated all she had said. She had not been vaccinated. One man took it on the fourth day of the eruption, up to which time the disease had progressed in exactly the ordinarymanner, the vesicles containing clear lymph; but here they were arrested, they never went on to suppuration, and there was no odor perceptible. Prior to his getting the infusion he complained much of restlessness and sleeplessness at night, but after he commenced taking it he slept well. Another patient, aged 25, was a man of full, plethoric habit. The symptoms were severe, and the eruption abundant, quite of the confluent form on the face; the mouth and fauces were also covered; delirium was present. The treatment by Sarracenia began on the fifth or sixth day. Relief was almost instantaneous; he slept soundly the next night without delirium, and continued rapidly to improve, and soon recovered. Dr. Bilden (homceopathist) reports his clinical experience: Early in the Spring of I864, the small-pox made its appearance in this vicinity. Fifty-eight cases came under my treatment, four of which were fatal. More than half were malignant-confluent. All were treated strictly homoeopathically. The disease had somewhat abated when I heard for the first time in my life of the Sarracenia purpurea as a specific in small-pox. I at once ordered a package of the dried plant, and not knowing how to prepare or to use the same, I began by careful experiment. First, I filled a gallon pot full of the crude plant, on which I poured boiling water, to which it yielded its properties readily. I then put alcohol (equal parts). When it had macerated forty-eight hours, I began using the tincture. Mr. S- had two children, a boy of eight, and a girl of ten years of age; confluent pustules, well filled; vaccine virus had never taken effect. Gave the boy five drops on a lump of sugar, every two hours. Called several times during the day, to watch the effect; could discover none; discontinued all other medicines. The next morning, found that the scabbing had commenced, which was followed by a rapid convalescence. I questioned the boy from time to time, but could learn nothing satisfactory of his symptoms. The girl lingered along, as all the others had done. I began to feel a strong confidence in my unofficinal tincture; carried an ounce-vial of it continually with me. Mrs. D-, a young married lady, was taken with violent headache, nausea; with pain in the loins; had been vaccinated, but did not think it had taken SARRACENIA PURPUREA. 691 effect. Commenced by giving one drop of the tincture every hour, carefully watching the effect. On the second day she appeared to be much worse. I began to think the medicine was aggravating her symptoms, but thought I would continue it a while longer. On the third day found an abatement. A burning rash made its appearance on the skin, which mostly disappeared in the course of forty-eight hours, leaving some twenty pustules on her face and neck, which soon filled and scabbed, and she was well again in a short time. I began to use the medicine as a prophylactic. Sac. lac. one ounce; mother tincture, five drops; triturated in a wedgewood mortar. From this I made the second trituration. Was called to see many who had the premonitory symptoms; had no more cases of small-pox, although Dr. ~, an allopathist, had quite a number of cases among his patrons for several weeks later. Should the small-pox ever make its appearance in this vicinity again, the Sarracenia purpurea will be my " Samson," and I shall try to learn the best method of administering it. In my opinion, it is like Gelseminum, a homoeopathic medicine in every sense of the wcrd. What Gelseminum is in bilious fever, Sarracenia purpurea is in small-pox. The following is the adverse opinion of Dr. James Watson on the action of Sarracenia purpurea: The cases occurred in the Edinburgh Royal Infirmary. In one of the smallpox wards, under Dr. Haldane's charge, the Sarracenia purpurea, in infusion, was administered to eight patients, the effect carefully watched in each, and the result in all was that the disease ran its natural course. The Sarracenia purpurea was found absolutely inert; it produced no effect whatever. Dr. Watson then reports one case which he especially watched, and observes: " In this case, it is most certain that the Sarracenia purpurea did not in the least shrivel or wither up the eruption, nor did it seem to affect the patient in any way. It has the virtue which happily many - unfortunately not all —new drugs possess, of being perfectly inocuous. So much, and no more, can we say in its favor." The following testimony adverse to the reputed virtues of the Sarracenia purp., we select from English practice, with the.desire of ascertaining, if possible, where the truth may be found: In the Autumn of I862 an epidemic of small-pox broke out in the City of London, and Dr. Marston (then surgeon of the small-pox hospital) selected fifteen cases, which were treated with the Sarracenia. Those were selected which from the severity of their symptoms he believed would not recover under ordinary treatment. He says: " The cases were selected on admission in the early stage of the disease on account of the severe symptoms manifested, and because I felt it was of no use to try the efficacy of the Sarracenia on mild or vaccinated cases, which I knew very well would recover under ordinary treatment, suitable diet, etc. I can not say that the Sarracenia had any effect whatever. It did not save life, for of the fifteen, all died. It did not modify the small pox erup 692 SARRACENIA PURPUREA. tion in the least. It did not influence any of the secretions, not even to increase the urine; in only one case did it seem to act on the bowels, and this seeming effect might have been from other causes. The remedy was administered in the form of a decoction, made by simmering an ounce of the root in a pint and a half of water for four hours, until reduced to a pint, and a quarter of this given at a dose, twice a day for two days or more. The liquor Sarracenia was also given in some cases, in drachm doses, every four or five hours. Two cases were admitted who had taken the Sarracenia decoction. The first, a mild case, had four vaccine cicatrices, which I believe highly modified the disease. The second was not vaccinated, was not severely confluent, and was wholly unmodified. They both recovered. The recovery might, perhaps, by some, be attributed to the Sarracenia, but I believe it had nothing to do with it, as about half our confluent unvaccinated cases recover under ordinary treatment. As corroborative of the clinical history, I will quote to you the following paper on Sarracenia, by Dr. Cigliano, of Naples, Italy, a translation, which was published in the Am. Observer, 1871, pp. 467, by Prof. S. Lilienthal, M.D.: Eruptions similar to crusta lactea; on forehead and hands papular eruptions, changing to vesicular with the depression, as in small-pox, lasting from seven to eight days. Dr. Cigliano gives five cases of small-pox, in which the Sarracenia appeared to act very promptly, to which he adds: From our own observations and those of other colleagues, whose communications we can not give for want of space, we draw the following conclusions: I. Soon after giving the remedy the temperature increases a little, but finally diminishes in direct proportion to the fever; usually in a few hours. 2. Sarracenia shows its influence at every stage of the disease. In the prodromal stage it breaks up the fever and the disease. 3. In the stage of eruption the temperature oscillates between 37 and 39. The whole disease is over by the ninth day, without any suppurative fever. 4. The pulse always diminishes about ten beats a minute. It does not always coincide with the abatement of temperature, but will always be found in direct ratio of the individual frequency. 5. The variolous papulke become vesicular, without becoming enlarged at their base. 6. The vesicles never pass in perfect pustules, but dry up, assuming a semispheric form, and in consequence of it the suppurative stage does not set in, and no depression will be found. 7. The contents of the vesicles are always serous, or at most sero-purulent. 8. Sarracenia not only develops a curative power, but it is also a preventative against the variolous infection, diminishing greatly the individual disposition to catching the disease without entirely extinguishing it. STILLINGIA SYLVATICA. 693 STILLINGIA SYLVATICA. Since the third edition of New Remedies but little clinical experience with Stillingia has been reported. Dr. Preston's case, recorded in Vol. I, is the most striking, and verifies its power over syphilitic periosteal rheumatism. I have found it of great value in chronic rheumatism. It appears to be similar in action to Phytolacca and Iodide of PVtassa. In old cases, when Rhus seems indicated, but does no good, I advise you to try Stillingia in the high dilutions - changing to the lowest, if no benefit' arises from the use of the former, in a week. The head symptoms, also the catarrhal (nose and eyes), will strongly remind you of Kali iod., which it follows or precedes with favorable effect. The action of Stillingia is on the periosteum, and closely resembles Kali iod., Phytolacca, Mezereum, Mercurius and Corydalis. It has cured bony tumors on the head and face (exostoses). Dr. Simons reports the following case in which Stillingia was given alone, and effected a cure: The patient was a little girl who had an enlargement of the tibia to such a degree as to deprive her of all power of motion. Enlargements also existed in various other parts of the body, resembling nodes, upon the olecranon process, upon the head, and one in particular, upon the forehead, of the size of an egg. The bones of the nose were much affected, inasmuch as to cause considerable depression. The condition of this patient was in a high degree distressing; seated in a chair, with the limbs contracted and swollen, she bid fair to pass a miserable and protracted existence, a burthen to herself, and a source of anguish, distress and trouble to her parents. Various remedies, alteratives, mercurials, had been tried by a physician long in attendance, with but little benefit. I determined upon a trial of Stillingia. The infusion was employed. Recent Stillingia root, four drachms; water, one pound; simmered till one-third was dissipated. This quantity was drank during the twenty-four hours, in such doses as not to nauseate the stomach in any degree. The medicine was continued for some months, and at the expiration of several, she was so much improved as to be able to move about with the aid of a stick, have the free use of her limbs, and the swellings, particularly those on the forehead, considerably reduced. The patient has every appearance at the present time of being speedily restored to a considerable degree of health. 694 STILLI.NAL SYLVATICA. In this case the medicine had a fair and unfettered trial, and it certainly accomplished a great amount of curative action, as no one can suppose that nature could do all that was done during the use of the remedy. The Stillingia has not been used to any extent in homceopathic practice. Few cases have been reported in our periodicals, treated with this medicine. I have used it in many cases where Mercurius, Aurum or Thuja were indicated but did no good, and its effects seemed beneficial. No record was kept of these cases, and the particular symptoms have escaped my memory. Dr. M. Preston reports a case of secondary syphilis, which had resisted all the usual homceopathic remedies. The man suffered extreme torture from bone pains. "It had a wonderful, and I might almost say, an instantaneous effect. He has slept well ever since he had it. The immense nodes have gone from the head and legs; and from the most deplorably down-hearted (sometimes almost raving, from derangement), miserable, thin-looking object, he is changed into a buoyant, joking, rotund-looking fellow." This will compare well with Dr. Simons' case just quoted. The former used the attenuations, while the latter gave the infusion. Both preparations acted curatively. My treatment of syphilis comprises but few remedies. I have never had any trouble in destroying the virus, and conducting the patient through the baleful secondary effects, and even through the tertiary. For the primary chancre, slight applications of Arg. nit., with dressings of dry calomel, are all that is necessary. So soon as I am satisfied that the chancre is an indurated one, I proceed to combat the inevitable secondaries. This I have never failed to do successfully with the Iodides of Mercury, or the Iodo-hydrargarate of Potassa. I much prefer the latter when the disease occurs in strumous constitutions, or there is any tendency to phagadena. I do not use the ordinary preparation. I know of no chemical agent which fully represents the preparation I use, and I have therefore always prescribed the following formula: STILLING(IA SYLVATICA. 695 1) Iodide of Potassa, 3 ij. Merc. Bin-Iod. gr. ij. Aqua Gaulth, 3 viij. Mist. One teaspoonful four times a day, before meals and on going to bed. I have tried the Potassa iod. and the Mere. iod. separately and alternately, but I could' never get the decided curative action from those agents separately, which I get combined. I sometimes substitute the Mere. cor. for the Mere. iod. in less strumous subjects. Under the use of this formula the angina rapidly subsides, the eruptions disappear in due time, and all serious tertiary symptoms are prevented. In fact, I am inclined to believe, with some authorities, that the so-called tertiary syphilis is, in nearly all cases, the result of mercurial poisoning. I will here assert, without fear of contradiction, that such a thing as mercurial poisoning is impossible in the use of the above formula for any reasonable length of time, i. e., until every vestige of the syphilitic poison has disappeared from the system. In a few rare instances patients are, from some idiosyncrasy, intolerant of the Potassa, and as I do not like to continue any preparation of Mercury for a long time alone, I resort to Phytolacca or Stillingia to promote a cure. The reason why Mercury in combination with Potassa does not poison the system, is, that the latter unites with the former in such a manner as to carry it out of the system before it fixes itself in any tissue, as it is apt to do when given alone, or in the form of an Iodide. I do not doubt the value of Stillingia in some cases of uncomplicated and mild secondary syphilis, but I should not like to trust to it alone. But for some chronic syphilitic eruptions, torpid, scaly, and obstinate, it is an excellent remedy. In congenital syphilis it often acts better than Iod. potassa or Mercury. It goes well with Aurum, which removes the disease of the bones of the nose, while Stillingia removes the cutaneous manifestations. STRYCHNIA. 697 spasms (primary) or paralysis (secondary) of the spinal nerves. Before entering upon a consideration of the therapeutical application of Strychnia according to the law of Similia, it will be proper and important to study its general physiological and toxical action on the human organization, and, to a certain degree, upon the animal. When taken in quantities just sufficient to produce sensible physiological effects, Strychnia induces a feeling of restlessness, perhaps accompanied by trembling in the limbs, and some stiffness in the neck and jaws. When a somewhat larger amount has been given, there may be general muscular twitchings and startings, with stiffness and stricture of the throat and chest; formications or other abnormal sensations under the skin may or may not be present. After poisonous doses the symptoms usually come on in from fifteen to twenty minutes-rarely after the hour-with great suddenness. Sometimes the convulsions are preceded by partial spasms of the muscles of the extremities, but more often the patient is thrown down by the general tetanic spasm. In this the body is bent backward, and rests upon the heels and head, in a condition of profound opisthotonos, the legs are rigidly extended and the feet everted, the arms bent and the hands clenched, the eyes staring, wide open, the corners of the mouth often drawn up so as to produce the risus sardonicus. Sometimes previous to the attack there is a feeling of restlessness and soreness of the limbs, shooting pains like electric shocks occur in various parts of the body, often first in the back, and down the arms and legs. After the tetanic and paroxysmal contractions of the muscles set in, they rapidly grow worse, until the respiratory movements are arrested. In this condition the face becomes bloated and livid, the jugular veins stand out in the neck, the eyes are staring and prominent, the jaws firmly clenched, and the pupils dilated. Each spasmodic attack lasts from a few seconds to a minute or more, and then generally cease altogether for a time. Throughout the paroxysm the mind is quite unaffected, and the patient's sufferings are agonizing. A breath of air, a slight noise, movement of the bedclothes, the most trivial cause, will excite tetanic spasms. Sometimes, however, a firm grasp or hard rubbing of the muscles is grateful. All the senses are sharpened to an intense degree, and even the mental operations are more vivid. In a fatal case, death is rapid; and if the patient survives 45 STRYCHNIA. 699 cles, or else none at all." Wood considers it proven that the functional power of the motor nerves is destroyed in Strychnia poisoning, but he asks, "Is this destruction a direct action of the poison, or is it simply the exhaustion of over use, due to the intense activity of the nerve during the stage of spasm?" Kolliker thinks the latter is the sole cause of the nerve paralysis, but Vulpian and other observers controvert his theory by experiments which prove that " enormous doses of Strychnia kill the frog without the induction of spasms, by general paralysis with total loss of power in the nerve trunks." Evidently, in such case, the paralyzing action of the poison on the nerves must be direct. There is another peculiarity of secondary Strychnia action which is of great diagnostic importance, namely: It paralyzes the efferent but not the afferent nerves. This it appears to do before it paralyzes the spinal nerve-centers. In other words, the peripheral portions of efferent nerves die before their roots, or before the nerve-centers from which they spring, are completely exhausted. Wood's assertion, that "the general collapse (paralysis) of frogs from Strychnia poisoning is largely due to the affection of motor trunks, and not to exhaustion of the spinal cord," is only partly true. Its ultimate secondary action is spinal exhaustion, and is as much a Strychnia. effect as its ultimate primary excitation and congestion. Harley's experiments show that Strychnia acts on all parts of the spinal cord. "Its effect on this organ," he says, "appears to be two-fold. It dilates the vessels, and thus increasing the supply of blood, augments the activity of the functions of the cord. But apart from this property of dilating the vessels, it is supposed that Strychnia exerts a direct stimulating influence on the spinal cord, although, as Harley has shown, it can act only through the blood, and does not, as was formerly supposed, exalt the functions of the cord when divested of all its vessels, and when a solution of Strychnia is brought into direct contact with its elements. The experiments of Spence seem to prove just the opposite of this; for when he supposed he had drained all the blood from the body of a frog, and placed a piece of Nux vomica upon the exposed brain, convulsions occurred from above downward, as fast as the poison permeated the substance of the cord. Strychnia differs from many other poisons in this - that it is only in increasing the reflexfaculty of the spinal cord that 700 STRYCHNIA, it causes convulsions. This vital property of the cord reaches such a very high degree that any external or internal excitation brings on a reflex tetanic contraction, the violence of which, according to a well known law, is in proportion to the degree of the reflex faculty. So long as the spinal cord does not receive some kind of excitation, however powerfully poisoned by Strychnia it may be, there is no convulsion. In other words, the cord may be ever so much congested, but the abnormal reflex irritability is not shown, unless it is excited by the touch, or some other form of irritation. There are many other drugs which cause spinal congestion, but none which cause this peculiar abnormal condition in the tissue of the cord. If Strychnia causes this two-fold condition of the spinal cord by its primary action, it causes, as the results of poisoning in animals show, a secondary action just the opposite, namely: an ancemia of the cord, with paralysis, from exhaustion, of the facuilty of the reflex motor nerve cells. Not only this, but it causes a paresis of the trophic (nutrient) nerve cells, and as Hanfield Jones believes, may cause paresis of the cerebral nerve-centers. Therapeutically considered, the action of Nux vomica and Strychnia differ only in degree. Nux will cause all the symptoms of Strychnia, but Strychnia will not cause all the effects of Nux. As I stated in treating of Atropine, an alkaloid is but one constituent of a drug, and only represents a part of its power. But in its sphere an alkaloid is often better than the drug from which it is isolated, because its action is more direct and intense. The therapeutics of Strychnia, without being absolutely confined to disorders of the nervous system, is certainly best manifested in that system. The question which meets us at the onset is a momentous one, namely: What are the diseases and symptoms for which Strychnia is primarily indicated? Among the most prominent I must name tetanus. As Baehr says — " If there is any truth in the homceopathic law, Nux vomica ought to cure tetanus." So I assert in relation to Strychnia. Baehr says he can not find any record in homceopathic literature of cases of tetanus treated with Nux vomica, nor have I been more successful in my researches. Our literature is particularly barren of cases of tetanus. Baehr, in commenting on this fact, suggests that homceopathists rarely treat the disease. STRYCHNIA. 701 One would suppose that the treatment of tetanic spasms with Nux would be published with considerable flourish of trumpets, as a brilliant illustration of the truth of the homceopathic law. On examination of our works on Practice, I find that Nux is recommended theoretically, but no cases illustrative of its efficacy are reported. Marcy and Hunt recommend Nux, Belladonna, Arnica, Stramonium, Cicuta, Hyoscyamus, Pulsatilla and Sulphur. Of these none have the slightest positive value except Arnica, and perhaps Cicuta; and the recommendation of Pulsatilla and Sulphur is absurd. The same authors mention the following as having cured individual cases-" Tobacco, Nicotine, Aconite, Atropine, Belladonna, Conium, Henbane, Cannabis indica, Opium, Camphor, etc." But these are all secondarily homceopathic to tetanus, or, according to some, antipathic. Now, until we can cure true tetanus and trismus with Strychnia, we should be careful about boasting of the universality of the law of Similia. The value of Strychnia in tetanus, singularly enough, received its confirmation, not from the homoeopathic, but from the allopathic school. In Stille's Materia Medica, I find that Strychnia has been used successfully in tetanus. Stille says: " The diseases characterized by excessive, or, rather, disordered action, in which Strychnia has been employed with benefit, are more numerous than those which have been noticed. Even in tetanus its power has been unequivocally displayed. In 1847, Dr. Fell, of New York, published seven cases of tetanus, six of which were of the traumatic variety, and all recovered under its use. His plan of administering it was to give one-eighth or one-tenth of a grain, and in two hours one-sixteenth of a grain, then reducing the dose still further, and only to the extent of producing specific signs of its influence after each one. Dr. Kalloch, also, relates a case of traumatic tetanus, occurring in a negro girl, which was cured by Strychnia, given in doses of one-twelfth of a grain every two hours." Hammond, in his work on Diseases of the Nervous System, does not allude to these cases! We can hardly account for this omission on the part of such a thorough investigator, except on the theory that he doubted their trustworthiness. It can not be possible that he omitted them for fear of giving testimony that would prove the truth of the fundamental law of homceopathy. 702 STRYCHNIA. I can not believe that in these cases the condition of the spinal cord was the same or similar to that caused by Strychnia. Hammond says nothing about any difference in the pathological appearance in the cord, occurring in traumatic and Strychnia tetanus. But there must be a difference, and in that difference we must look for the reason of the cures by Strychnia in doses of one-tenth or one-sixteenth of a grain. Dr. Fell admits that each dose caused aggravations, and those who are familiar with the action of homceopathically indicated medicines, know that quite appreciable doses will cure primary symptoms, but in so doing they always cause aggravations. My belief is, that traumatic tetanus, while it presents many of the outward symptoms of Strychnia tetanus, does not arise from the same pathological conditions in the cord. A careful study of the differential diagnosis of the symptoms forces one to this conclusion. The fact that the doses used by Dr. Fell did not kill, is also proof of the same conclusion. It is absolutely certain that if the identical condition existed in Dr. Fell's cases which obtain in Strychnia tetanus, a dose of one-thousandth of a grain would have caused terrible if not fatal aggravations. I should not dare to prescribe Strychnia under the 6th centesimal attenuation in true tetanus, if I believed there was intense congestion of the cord, together with the peculiar excitation of the reflex motor nerve cells so characteristic of Strychnia tetanus. Idiopathic tetanus has its origin in the cord or its membranes. Traumatic tetanus commences at the periphery of the body. Now it is difficult to imagine that tetanus of a central origin is the same as tetanus of a peripheral origin. No record has been found of the treatment of idiopathic tetanus by Strychnia, and the treatment of Strychnia tetanus by Strychnia is out of the question. This narrows the use of appreciable doses of Strychnia in tetanus to the traumatic variety (possibly the hysterical). I have frequently prescribed the 6c of Strychnia in the tetanic spasms of cerebro-spinal meningitis (which is an idiopathic tetanus) with the best results, and I should have equal confidence in the higher attenuations. In Chorea, when the convulsive motions are due to perverted action of the motor portion of the spinal cord, and when the convulsions do not cease during sleep, Strychnia is primarily indicated, and should not be prescribed lower than the 12th or 30th attenuations. If the chorea is due to disease of the heart, to rheuma STRYCHNIA. 703 tism, or from mental emotion, or from cerebral irritation, it corresponds to the secondary action of Strychnia, and that remedy may be given in the doses used by Trosseau and Hammond. The former gives one twenty-fifth of a grain, one or two doses a day; the latter gives one-fiftieth of a grain three times a day. Trosseau considers it necessary to cause slight stiffness of the jaws and neck, and some jerking in the limbs. Hammond does not think it necessary to cause such symptoms. It is not only unnecessary, but criminal, to give a drug to the extent of causing toxic symptoms, especially such a poison as Strychnia. Under no circumstances is it necessary to give Strychnia lower than the 3c trit. in the treatment of functional chorea. The primary Strychnia-constipation is due to spasmodic contraction of the circular fibers of the intestines. Strychnia 30th will promptly cure this variety, after Nux vomica has been used unavailingly. Acute myelitis and spinal meningitis, although not usually caused by Strychnia, may come under its primary curative power. It causes intense congestion of the cord and its meninges, which, if persistent, results in inflammation and softening. As an intercurrent remedy, it will be of value in alternation with Veratrum viride or Belladonna, even in the acute stage. In the later stages it alternates well with Cannabis indica or Ergot, but I would not advise it to be given lower than the 6th or 12th centesimal. The same may be said of paralysis, when caused by any organic disease of the cord or brain, such as effusion (sanguineous), congestion, softening, etc. Allopathic authorities are particular to caution their readers never to give Strychnia in paralysis from actual lesions of the cord and brain, until after all signs of irritation have disappeared, or unless the paralysis is of reflex origin. This is a very proper caution from the allopathic stand-point. But the homceopathist is not confined to such narrow limits. Strychnia is primarily homceopathic to paralysis from the causes enumerated by Brown-S4quard, as contra-indicating Strychnia, namely, myelitis, meningitis, pressure on the cord, hemorrhage in the spinal cord, congestion of the cord, softening of the cord. In all of these conditions, BrownS6quard says Strychnia ought to be avoided, because it increases the flow of blood to the cord, and aggravates the paralysis. It is evident that it did not occur to Brown 706 srRYCHNIA. trouble, but in very old cases they fail. Then the -Strychniia is of great value, for it can be injected into the cellular tissue near the anus (one one-thousandth of a grain), and a brilliant cure often ensues from a single application. In other cases small injections, each containing the same quantify of the drug, are very successful. Incontinence of urine or retention of urine, when both conditions depend on impaired power in the muscular coat of the bladder, from habitual distension or pressure of the uterus, is often cured promptly by a few doses of the 3x, or even the 6x. Sexual impotence is treated very successfully by our school with Nux vomica; but there are cases, especially when the condition is purely from spinal exhaustion, in which Strychnia is more useful. Usually the impotency cured by Strychnia is attended by more or less paralysis of the lower extremities; but cases are on record where the paralysis appeared to be confined to the penis alone. In the latter instance Strychnia does not perform a cure, it only removes the disability for the time. This power, however, even if limited, may be of great importance, as in cases where the possession of an heir is necessary to the perpetuation of a family or the retention of an entailed estate. If I should be called upon to mention any particular class of disorders in which the Strychnia was most important, I should name those dependent on perverted or excessive reflex action. We have seen how it exalted to an abnormal condition the functions of the reflex motor-nerve cells, and I have mentioned its value in reflex paralysis. There are many serious and troublesome reflex disorders which are more successfully treated by Strychnia than by any other remedy, but these disorders are primary, and the medicine must therefore be used in the smallest doses. Of these affections I will mention particularly headache, prosopalgia, cardialgia, vomiting, dyspepsia, cough, etc. No other drug so uniformly causes hypercesthesia of the reflex faculty by its primary action. Consequently no drug is so homeeopathic (primarily) to reflex neuroses. To be successful in the treatment of these affections with Strychnia, all the modalities and concomitants of its action must be studied, and it must be prescribed in the most attenuated doses. Then we shall make very brilliant cures. Bromide of potassa is just the opposite of Strychnia in this respect. It is secondarily indicated. But it will make STRYCHNIA. 707' as brilliant cures in the same reflex affections if given in appreciable doses. In some of the cardiac neuroses, which depend on paresis of the motor-nerves, you will find Strychnia a potent remedy. These neuroses are either spinal, direct, or reflex. In either case, there is always a constitutional debility, attended with poor circulation, feeble cardiac action, and a quick, small and feeble pulse. The slightest emotion, physical exercise, or derangement of digestion, causes oppressed action of the heart, with great nervousness and prostration. It acts in these cases in a manner apparently similar to Digitalis. I say apparently, because both increase cardiac power, but the Digitalis acts from the center, i. e., on the cardiac ganglia, while Strychnia acts through the cord. In special cases they can be alternated with excellent results. Some cases of Asthma are said to have been cured by Strychnia. I imagine the asthmatic symptoms were probably due to a kind of paralysis of the muscles concerned in respirationi, more than to any affection of the lungs. In addition to these special indications for the use of Strychnia, there are some general indications which you should fix in your memory. (1.) Strychnia is primarily indicated whenever the reflex nervous system is in an excessively irritable condition; when all the senses are in a state of hyperoesthesia; and when the mental sphere partakes of the same abnormal sensitiveness. In this condition the 30th attenuation will be found to be most appropriate. [Hahnemann gives the same indications for Nux (also for China and Phosphorus). This condition may occur in chronic, as well as acute diseases, and Strychnia will be found to be better than Nux, in cases specially involving the reflex nervous system.] (2.) Strychnia is secondarily indicated in spinal exhaustion, when the reflex nervous system, the cerebro-spinal nerve-centers, and even the trophic nerves, are in a condition of paresis. [In this condition the whole organism, or a portion of it, may be paralyzed, or in a state of paresis in which the functional activity is far below its normal condition. There may be present cerebral paresis, with resulting dementia, idiocy, melancholy, and even softening of the brain; or spinal paresis, with paraplegia, hemiplegia, chorea, cardiac weaknesses, dyspeptic states, constipation, chronic diarrhoea (often involuntary), eneuresis, impotence, etc. When the nutrient nerves 708 STRYCHNIA. are affected, there is marasmus, from deficiency of assimilation. The nerves may lack nutrition, and then will occur the various forms of neuralgice, spasmodic disorders, such as epileptiform fits, catalepsy, masked ague, and many other neuroses kept up from force of habit, a condition always present in spinal paresis. In these conditions and disorders the lower attenuations are required, and sometimes appreciable doses - even as low as the one-tenth of a grain.] A few words as to the antidotes of acute Strychnia poisoning. If the patient is seen immediately, make him drink large quantities of melted lard, olive oil, or milk. These seem to prevent absorption. As special antidotes, Tobacco, Nicotin, Opium, Morphia, Curare, Wourali, Chloroform, Camphor, Aconite and Chloral, have all been recommended. Of these, all but Chloral are very objectionable, on account of their depressing effect on the heart and other organs. Chloral is the least objectionable, but I would not give that alone. It is more efficient when combined with the Bromides. Doses of 30 to 50 grs. of Chloral, with the same quantity of Bromide of Soda or Potassa, repeated every three or four hours, has saved many desperate cases. The Bromides are, on the whole, the safest and most efficacious antidotes. Of the Potassium, or Sodium salt, two or four drachms, in severe cases, can be given every twenty minutes, for an hour; after which smaller doses should be frequently administered. In cases where persistent trismus exists, it may have to be administered by injection. Generally, however, there are intermissions between the paroxysms sufficient to allow of a dose being swallowed (3j of water will dissolve 3j of the Bromide of Soda, or Potassa). If the Passiflora should prove upon full investigation to possess the virtues claimed for it by Dr. Phares, it will be an excellent antidote to Strychnia. Nitrite of Amyl may be found to be an antidote in some cases, but it should be used cautiously. Of course all these antidotes to toxic doses act by antagonizing the specific poisonous effect of Strychnia on the spinal cord. They paralyze the nerve-centers which are irritated by that poison. This paralysis must be kept up until the danger is over. Of the various preparations of Strychnia, the ASulphate is generally used. It is probably the most certain of all. I often use the Phosphate when the cerebral functions are 710 STICTA. It is' said to have cured whooping-cough, croupy-cough and catarrhal asthma. Dr. Lilienthal reports "sick headache" cured with it. Miss A. M., eighteen years of age, delicate from childhood up. * * She menstruated for the first time when thirteen years old, and since then she has suffered continually from sick headache. When these dreadful attacks come on, she has to lie down; light and noise aggravating it; perfectly impossible to swallow any thing; nausea and vomiting, nearly to faintness. These paroxysms commonly last several days, and leave great debility in their train. She never was a good eater, as her stomach seems deranged; but enjoys, otherwise, pretty fair health. No cough whatever, although she looks like a phthisical patient. Allopathy and homceopathy have, until now, tried in vain to alleviate these attacks. Being on a visit to an aunt here in the city, she had one of her migraines' Sticta being a great favorite in that family, the young lady was prevailed on to try the new reiedy, and for a wonder she appeared that evening, at dinner, free from headache and enjoying the meal. She took a bottle of Sticta home with her, and we hope her joyful anticipations of eradicating her troubles with it may be verified. It has some singular nervous symptoms, like those of Ambergris, and Dr. Burdick, of New York, says he has cured hysteria by its use. It is one of those remedies that you will find indispensable during the months of February, March and April, in this climate. I usually prescribe the Ix dil., and the general testimony appears to be that the lowest dilutions, or the tincture, is the most efficacious. The cases of rheumatism cured by Sticta are of sufficient interest to warrant me in quoting a few of them: Case I.- Male; aged 45. During the latter part of last Winter and the fore part of Spring, suffered severely with rheumatism in right shoulder joint, deltoid and triceps muscles extending at times to the forearm, commencing to pain me in the night. Toward morning, my arm becoming nearly helpless, could not put on my coat without help; during the day lameness nearly disappearing; this condition lasting nearly two months; no heat or swelling. Cimicifuga racemosa, Phytolacca decandra and Colchicum were used in succession in small and larger doses, with but temporary relief. I now resolved to try Sticta, first dilution, four drops four or five times per day. Improvement commenced at once. Discontinued medicine in a few days; difficulty permanently removed. Case II.- Edward P., aged 48, rheumatism in the right ankle joint, swollen and very painful, could only get around with the help of a cane; had applied domestic treatment for several days, without benefit. Gave him a drachm vial of SEMPERVIVIJM TECTORUM. 711 Sticta Ist, dose four drops five times a day; cured in four days. Says he used no other medicine. Case III.- Mrs. C., aged 41; taken very suddenly with pain reaching through the chest from sternum to spinal column; constant, worse on movement; the arms powerless from extreme pain, if an attempt was made to move them. Gave Sticta Ist, three drops five times a day. The first dose gave relief; well in three days. Together with the above symptoms, there was difficult breath ing and speaking for some time. Treatment commenced about twelve hours after attack. In these cases no other medicine was used to my knowledge. Case IV.- Mr. F., aged 50 years, came to me, saying he had rheumatism all over him, and could get no relief; said he had tried everything, had been to two or three allopathic physicians, but was getting worse every day. His troubles commenced about six months ago, with sharp, darting, lancinating pain, first in the knee joints, then in the elbow and shoulder. The finger joints were next involved, and it gradually extended to every joint in the body; the pain in the neck and head were intense. At the present time the joints are all swollen and stiff. He can not sleep for the pain, and can scarcely walk. By comparing the above with the provings of Sticta pubzonaria, I found a perfect type of the disease before me in this drug, and I at once determined to test its curative power; the following are the results: I gave Sticta Ist, five drops to a tumbler of water, table-spoonful to be taken every hour. Aug. 23. Mr. F. reports himself greatly improved; pains not so severe — has slept better. Sticta Ist, as before. Aug. 26th.- Reports a great deal better; can walk better than at any time during the past five months; pain in the head and neck gone; all the pains are less severe, and the joints are not so much swollen. Continued Sticta Ist, as before. Aug. 28.- Reports himself entirely well; has no pain; swelling all gone; says he feels better than at any time during the past nine months; stiffness of the joints all gone; he is getting young again, and walks as sprightly as a young man. Case V.- Mrs. G., aged about 40, rheumatism of the wrist joints. She had been under treatment for nearly three months, with very little if any improvement. The wrists and hands with but little redness; very painful on moving them. I had given her nearly all the remedies that are usually given in rheumatic troubles; none of them had afforded relief to any extent. After the results produced in the last case by Sticta, I determined to try it in the case of Mrs. G. I accordingly gave her five drops, Ist, in a tumbler of water, a teaspoonful every two hours. On the day after I called, and on entering the room she exclaimed, "Doctor, you have done it this time!" To my great surprise I found her sewing. The pain and swelling were nearly gone. Sticta Ist was continued for a few days, and the cure was permanent. SEMPERVIVUM TECTORUM. The House-leek is a very old domestic remedy, used for nearly the same purposes as the Plantain, (Plantago.) It is applied to painful ulcers, boils, felons, and the like. 712 SILPHIUM. Several notable cases of ulcers in the mouth, suspiciously like cancer, have been reported cured by the local application, and internal use; alo an ugly ulcer on the shoulder. It is recommended for burns, erysipelas, warts, corns, and ringworms. The thick, succulent leaves are full of a cool, mucilaginous juice, that would be grateful to an irritable, painful surface, and palliative if not curative. SILPHIUM. This common plant of our prairies contains a large quantity of balsamic and resinous juice. Physically and medicinally it resembles such remedies as Copaiva, Turpentine, and Cubebs. It also resembles Stannum and Sambucus. It has been found useful in catarrhal asthma, chronic bronchitis, and catarrhs of the respiratory organs generally. Some of our physicians value it very highly in catarrh of the bladder. I have used it quite successfully in a few cases of asthma that reminded me of the " heaves " in horses —(horses are often cured of heaves by eating the leaves.) It is considered curative in gonorrhoea and gleet. All the mucous surfaces of the body seem to come under its influence. The high dilutions are adapted to the acute stages; the lower to the chronic. Dr. Geo. A. Hall, of Chicago, once published the following fragmentary proving, and clinical cases, in the Investigator: About ten years since, my attention was first called to the above remedy, in the treatment of "mucous asthma," "bronchitis," "catarrh," and other diseases involving mucous surfaces. Proving.-I have attempted several provings with Silphium which have been unfortunately interrupted, but succeeded in eliciting the following primary symptoms: (The ist dec. trit. was given in doses of two grains, gradually increased to ten grains every two hours.) It produces a scraping, tickling and irritation of the fauces and throat, nausea, sick, faint feeling, and a sense of goneness in epigastrium -a desire to hawk and scrape the throat, throwing off a thin, viscid mucus. Irritation extends up posterior nares, involving mucous membrane of nasal passage, producing sneezing, followed by a discharge of limpid,'acrid SULPHATE OF NICKEL. 715 SULPHATE OF NICKEL. This preparation of Nickel was first used by Dr. J. Y. Simpson, in periodical headaches of a peculiarly severe character. You will find in Vol. I, several cases recorded, illustrating its curative power. Nickel very much resembles Arsenic in all its qualities, toxic and therapeutic. It also appears to have qualities analogous to Zincum, Quinia, and the Bromides. It has gained some popularity in the treatment of neuralgia. You will doubtless find it valuable in some of those obstinate periodical neuralgiae, even when due to malarial poisoning, which have resisted the ordinary remedies. I have generally got the best effects from the 2x triturations. Allopathists make good cures with one-half grain doses, three times a day. The 2x trituration can be given every hour or two during the paroxysm, and three times a day during the intermissions. Like all anti-periodics, its curative value is best tested by giving it between the attacks. SUMBUL. This medicine is prepared from a singular root found growing in Central Asia. It has an odor so similar to musk that it is largely used in the adulteration of that expensive perfume. We here have one of those strange similarities between the animal and vegetable, which baffles the curiosity of investigators. Are the ultimate atoms of the perfume of Sumbul and Moschus identical? Axe the dynamic effects of these atoms the same? Is their curative power similar? These and many more questions arise and confront us when we contemplate the strange similarity of their perfume. Old Prof. Tully asserts that odor, as well as taste, gives us a clue to the curative power of drugs. I believe it is partly true. The odor of Aralia and Eryngium are very similar, and both are useful in asthmatic affections. TANACETUM. 717 more especially in the spasmodic (hysterical), perhaps also the cardiac. The cardiac symptoms are so unique and characteristic, that I have carefully arranged them in the pathogenesis, in systematic order. I believe it will be found a superior remedy for many functional disorders of the heart which are not amenable to ordinary medicines. I doubt its power to cause or cure structural lesions — although the prover got "murmurs, bellows sounds, and purrings "-but, as Dr. Cattell observes, they may have been due to "muscular contractions." I think I have observed in many cases, "murmurs" and various abnormal sounds, which were caused by irregular contractions of muscular fibers in the heart. I expect to use it successfully in nervous palpitation, occurring in hysterical patients, or at the change of life. It is homoeopathic to the flushings of that period. It seems to affect the left side in preference to the right. The venous system is more under its control than the arterial. (Its action on the heart may be mostly on the venous side.) Dr. Cattell, the original prover, found it useful in typhoid fever, as an intercurrent remedy; in prurigo in an infant; also in epilepsy, fainting, dropsy, and chorea. TANACETUM. Although Tansy is one of the oldest of medicines in domestic practice, and a plant possessing powerful toxic properties, there has never been any systematic proving of it until very lately. In Vol. I, is given a pathogenesis arranged by Dr. -, and compiled from various provings and cases of poisoning. The symptoms were obtained from the tincture of the plant and from the oil. Cases of poisoning from the use of the oil for the criminal purpose of causing abortion, have often been reported to medical journals, but the special symptoms and conditions of such cases have not been as carefully observed as they should have been. 718 TANACETUM. It is a violent poison -an acro-narcotic - and has produced clonic and tonic spasms, coma, delirium and death. It resembles, on the one hand, Sabina, Turpentine, Hedeoma and Ruta; on the other, Stramonium, Cimicifuga, Cicuta and Cuprum. Its sphere of action includes the brain, spinal cord, kidneys, bladder, uterus and ovaries. It will be found most useful in diseases of women arising from disorder of the generative organs, and presenting severe reflex spasmodic or cerebral symptoms. Theoretically I would recommend it in threatened abortion, prernature labor, morning vomiting, puerperal spasms (from disease of the kidneys), metrorrhagia, etc. It has been found curative in amenorrhoea, dysmenorrhcea, menorrhalgia, uterine cramps and metritis, especially when spasmodic symptoms threaten. The indications for its use in the last named disorders nearly resemble Sabina. Scanty menses is a secondary effect of the drug. I have relieved several cases, when, with the scanty flow, headache and stupor was present. The dose required was a few drops of the 2x of the oil. It may prove useful for dysuria, nephritis, and perhaps the urcemia of pregnancy. In cases of poisoning by Tanacetum the heart grows weaker, the pulse more irregular, until death. Its action on the heart is probably through the cord. It may prove useful in some reflex cardiac disorders. A crystallizable acid has been extracted from Tansy, which is identical with Santonin. This explains why it has always had such a reputation in domestic -practice for the removal of worms, and the alleviation of worm-symptoms. It is homceopathic to spasms from the irritation of worms and uterine disorders, and possibly reflex paralysis, which sometimes occurs from the same causes. It is said to have cured St. Vitus' dance, with symptoms like Stramonium. It may in time prove a useful remedy in many nervous disorders. TARANTULA-THERIDON. 719 TARANTULA. The singular accounts of the effects of the bite of this spider are so mixed up with superstition and exaggeration, that it is almost impossible to extricate the true from the false. I make no doubt that the bite of all the venomous spiders causes, sometimes, very singular nervous phenomena. I have myself witnessed some strange aberrations of the mental and nervous spheres from the venom of the field spiders of this climate. In the tropics all venoms are more intense. The Tarantula is accounted the most poisonous of all, and in sensitive organizations may cause some very extraordinary manifestations. The most striking phenomena of Tarantula-poisoning are the choreic disorders, more severe and terrible than are caused by any other poison. It is said to have cured the worst cases of St. Vitus' dance. It is alleged to have cured some spasmodic, hysterical symptoms in women, arising from uterine irritation. It appears to affect the motor side of the cord in a manner different from any other known remedy, unless we except the Mygale. THERIDON. This is another spider-poison. It seems to have a sphere of action differing from that of Tarantula. Drs. Hering, Neidhard and Barlow have reported some cures made with it, but it is rarely used by the majority of physicians. It appears to have cured headache, vertigo, neuralgia of the face and eyes. The headaches resemble those of Belladonna, Sepia and Spigelia. It is homceopathic to the headaches so common to many women, which always begin with " flickering before the eyes." It also cures that symptom when unconnected with headache. Its action on the stomach seems not to be direct but reflex. It cures a vomiting when closing the eyes, and when it resem TRILLIUM. 723 infusion was continued, but given at rather longer intervals, and in two hours from the time I was called in, the hmemorrhage had ceased altogether; pains returned during the following night, and the fcetus was expelled with but very trifling loss of blood. Case II.-Was called in at 4 o'clock P.M., to see Mrs. S., at the full term of pregnancy; os uteri dilated to the size of half a dollar; no pains; flooding excessive. Administered the Trillium as in the preceding case; it acted promptly, so that in an hour from the time of giving the dose, the bleeding had entirely ceased. In about four hours labor pains came on, and she was shortly delivered of two healthy children, with no more than the usual amount of haemorrhage. Case III.-Mrs. M., at about the third month of pregnancy, had had slight uterine hkemorrhage, for two or three days previous. At 8 o'clock in the evening of the third day, she became alarmed by sudden and excessive flooding. I was immediately called in, but her fainting turns were so frequent and so protracted, that I could not give the remedy as fast as I desired; and notwithstanding I brought all the means to my aid that I could command, I greatly feared I should lose my patient; in about three hours, however, she had taken an infusion made with about three drachms of the bruised root, as nearly as I could judge, and the haemorrhage was perfectly controlled. Thirty-six hours after this. pains came on, and the foetus was expelled without any further trouble. It may not be amiss to state, that I think I have found this remedy of decided utility in facilitating labor. I have treated cases of leucorrhoea satisfactorily. The plant I made use of is the Trillium atro-pur2pureum. It is decreed by some writers that the Trillium is most useful in passive haemorrhages, but the cases above reported were of an opposite character. We have no proving of this remedy showing its pathogenetic action upon the generative organs of women, nor can we decide with any certainty, as to the pathological states which it would induce in the uterine tissue. To say it acts by giving tone to the uterus, would not convey any exact idea, although it actually has that effect; it stimulates the uterine nerves to healthy action, and as a consequence we have muscular tonicity, and a healthy condition of the mucous membranes. Haemorrhages from the uterus either arise from relaxation or laceration of the blood vessels of that organ, or from abrasion or relaxation of its mucous coats. Any drug, therefore, whose symptoms correspond, will possess the power of causing just such pathological changes, and will, therefore, cure similar lesions. The analogues of Trillium are Terebinthina, Sabina, Pulsatilla and Erigeron canadensis. 724 TRILLIUM. Dr. Chamberlain, of New Hampshire, recommends the " Trillium in cases of uterine hemorrhage, and profuse flooding after confinement." He prescribes half a teaspoonful of the powdered root in molasses, repeated every ten or fifteen minutes. Dr. Freeland has used it for thirty years, with success, in the same conditions. The following clinical cases occurred in my own practice: Case I.-Menorrhagia.- Mrs. M., aged twenty-eight, had been subject for several years to frequent and profuse menstruation. The menses came on every fourteen days, and lasted seven or eight. In the intervening periods there was profuse leucorrhcea, of a yellowish color and creamy consistence. The blood was once bright red, and but lately; owing to her anaemic condition, has been pale and mixed with a leucorrhoeal discharge. She took Crocus, Platina and Sabina, but with no apparent benefit. Trillium second dec. was then given, in doses of one grain, four times a day. The first effect noticed was a diminution of the leucorrhcea, then the menses delayed one week. The medicine was continued, and the next menstrual period came on at the end of four weeks, and was not followed by leucorrhcea. She was then put upon the use of Ferrum met. Ist dec., and Helonin Ist dec., one grain of the former after taking meals, and a similar dose of the latter before eating; and in a few weeks her strength and color returned. Several other similar cases were treated with the same medicine, and all recovered. Case II.-Metlrorrhagia.- Mrs. S., aged forty-six, passing through her climacteric, had occasional attacks of a profuse flooding, at irregular times, so profuse as to bring her down very low; the blood was thick, dark and clotted, and would continue several days. The attacks had been partially controlled by the use of Sabina and Crocus, but being called during the first day of a seizure, I determined to test the Trillium. Ten drops of the Ist dec. dilution were given every half hour; in a few hours the flooding had decidedly diminished, and subsided completely in two days. This was continued, in alternation with Sanguinaria 3d, and she had no more attacks, but menstruation ceased normally. Case III.- Mrs. T., aged fifty, had been subject to attacks similar to the above, but was anaemic, dropsical, and much debilitated. Apis 2 relieved the dropsy promptly; Helonin gave her more strength and better digestion than she had had for months; and when her attack of flooding came on, Trillium 2d decimal, arrested it in two days. These attacks were of a peculiar character; the discharge was pale, watery, only slightly tinged with blood, but very profuse, accompanied with prostration, vertigo, dimness of sight, palpitation of the heart, and a painful sense of " sinking at the pit of the stomach." All these symptoms, which usually lasted eight or ten days under allopathic treatment with Sulphuric acid and Mur. tinc. iron, subsided in two days under the action of minute doses of Trillium. In this case the discharge was reallyblood, as much as if it had been red; but such was her anaemia, that the red globules were very deficient. She had become jaundiced, but under the use of Leptandra 2d decimal, the liver resumed its normal functions, and her increased appetite and digestion soon brought some color to her pallid cheeks. TRIFOLIUM PRATENSIS. 725 Case IV.-H-emorrhage after abortion.- The foetus and placenta came away properly, but imprudence kept up the hemorrhage, which was dark, sanious, and accompanied with pain in the back, dragging in the loins, and soreness in the hypogastric region. All these symptoms subsided after using Trillium 2d decimal for a few days. The late Dr. J. C. Peterson reports his experience with this drug in uterine hcemorrhage: Case I. —Mrs. C., abortion in the fourth month, with retention of the placenta. I was called in haste about midnight, and found her flooding excessively; extremities cold, face pale and anxious; the os dilated and the body of the uterus firmly contracted -so much so that it was impossible to remove the placenta by force. Gave Trillium pendulum, two drops every fifteen minutes. She responded at once to the action of this remedy. The next day the removal of the placenta was attempted by means of the placenta forceps, but after an hour's trial I was forced to abandon the attempt. It ultimately became disorganized, and passed on the sixth day. She had several attacks of flooding during this time, but the Trillium succeeded in arresting it at once. China, Secale, and Pulsatilla were given for other conditions. The patient fully recovered. Case II.- Miss A., aged forty-eight. Menorrhagia at change of life. Was called to visit her in haste, and found her almost exsanguinous. She had been flowing freely for some ten days, and for the last few hours the hzemorrhage had been active. She presented all the physical symptoms of excessive haemorrhage. Gave Trillium pendulum tincture, three drops every fifteen minutes, which within an hour had completely controlled the flooding. Secale corn. 3d followed the Trillium. The patient has since that time (Nov., I864) been well. Case III.- Mrs. B. Post partum haemorrhage. Was confined with her third child. Her labors with the previous children had been attended with almost fatal haemorrhage. Immediately following the birth of the third child she was seized as in her former confinement. Gave Trillium pendulum, a drop every five minutes, which arrested the flooding immediately. In short, without citing other cases, I will say that I know of no remedy in the Materia Medica that so certainly controls active uterine haemorrhage. It excels Sabina, Secale and Hamamelis. TRIFOLIUM PRATENSIS. The common red clover of the fields has long had some reputation as a remedy for cancer. A paste, or solid extract is made from the blossoms, and this is applied to the ulcer constantly. 726 TRIFOLIUM REPENS. You will often hear of wonderful cures made by means of this simple preparation, but you will find it difficult to trace the reports back to a reliable source — at least, I have not been able to do so. I do not believe it possesses any more curative action in such cases than any simple poultice. In relation to its efficacy in whooping cough there seems to be a greater amount of positive proof, and some indications of its homceopathicity. It is well known that the inhalation of the odor, or impalpable dust arising from the dried blossoms, will cause in some persons a severe spasmodic cough and asthma, and in horses it causes that disorder known as "heaves." (" Heaves" may be either an emphysema, a chronic laryngitis, or a simple asthmatic affection). It certainly causes horses to cough violently. It is supposed by some that this cough is due to mechanical irritation from spores, or dust, from the dried flowers. Certain it is that musty clover is more likely to cause cough and asthma. In fact, many farmers and horsemen deny that properly dried clover ever causes these troubles in horses. In the provings of Duncan and others, however, the tincture caused a severe cough, somewhat spasmodic. Eclectic writers assert that it " exerts a specific influence in some cases of whooping cotugh and in the cough of measles, also in the spasmodic coughs of laryngitis, bronchitis and phthisis." They use a tincture of the recently dried blossoms. We have but little recorded experience of its use in these disorders, but it seems worthy a trial after Ipecac or Drosera fail. The TRIFOLIUM REPENS, Or small white clover, has been recommended by Dr. J. S. Douglas for salivation. It causes profuse ptyalism in horses, and probably would in men, if they would chew enough of the fresh blossoms to excite it. Its secondary effect would probably be undue dryness, or suppressed saliva. Dr. Doug TRIOSTEUM —URTICA. 727 las thinks he saw benefit from it in a case of suppressed salivation (" druling ") in a teething infant. It may prove useful in such cases, especially where a diarrhzea follows the suppression. TRIOSTEUM. This remedy, commonly called Fever-root, has not been used as much as it appears to deserve. It has been partially proven by Drs. Williamson, Neidhard, Tallmadge and Gatchell. Many of its symptoms resemble Aconite and Mercurius. Dr. Tallmadge, an eminent homceopathic physician of Brooklyn, New York, informs me that he finds it of great value in typhoid as well as gastric fevers. He says he was informed by Dr. Matthews, of Rochester, that the Triosteum had proved, in his practice, to be one of his most reliable remedies in gastric affections, with or without fever. It is one of the ingredients of a fever-powder largely used by the Eclectics. I advise its use in bilious headache with gastric irritation, also "sick-headache." It has cured bilious colic, dyspepsia, diarrhoea, and dysentery. It appears to be indicated in rheumatism, and urticaria. URTICA. The Stinging-nettle has many points of resemblance to Apis. It also resembles Formica, as it should, for its stings contain Formic acid. Its chief use in our school is in the treatment of urticaria, for which it is prescribed internally, and as a lotion, or cerate. It seems best adapted to that variety called urticaria nodosa, in which the skin appears elevated, with a white central spot and red areolhe, and attended by stinging and burning. It is also useful when the eruption recedes, and causes vomiting, fainting, and sometimes diarrhoea. This result often occurs in children, when we do not suspect such an origin. It has been used for dysentery, enteritis, strangury, gravel, haematuria, suppression of milk in nursing women, USTILAGO MAYDIS. 729 am of the opinion that Ergotin, or some analagous constituent, would be found in all of the fungi which grow upon the cereals. It is highly probable that the frequency of abortion in cows and other domestic animals, may be due to the presence of these fungi in their food. Ustilago is not identical with Secale, however, for it contains active principles which the latter does not. We can not substitute the one for the other in all cases, e. g., Ustilago will probably not prove as potent as Secale, in cases where we wish to cause the uterus to contract upon the foetus in labor, at least it has not yet been used for that purpose; while in chronic, passive hsemorrhages the Ustilago is claimed to be superior. The sphere of action of this remedy includes (a) the generative organs; (b) the skin and analogous structures (hair, teeth, nails); (c) the vessels and tissues of the generative organs specially. It probably acts upon the spinal cord in a manner similar to Ergot, but not as intensely. It would seem that it affected the trophic nerve-cells in a special manner. No published experiments on animals have come under my observation, illustrating its action on the cord and brain. Its action on the skin appears to be very intense. Dr. Burt's statement of its supposed effects on the scalp, where an eruption appeared, discharging a watery serum, matting the hair together, and causing it to fall out, seems to confirm the statement of the authorities above quoted relating to its effects. But Burt's case has not been verified by others, for the Ustilago has been given to patients in similar doses for a long time, without causing any such results. The statement of Tully, Roulin and other trustworthy writers, that it " causes mules to shed their hoofs, and men and animals to lose their hair and teeth," must be accepted. The hair, hoofs, nails and teeth, are but prolongations of the true skin. Any drug which profoundly affects the skin, will probably affect similar structures. Ustilago appears to act by preference upon the thickest and hardest of the dermoid tissues. Its action in this 47 USTILAGO MAYDIS. 731 this primary action we get uterine spasms, cramps of the broad ligaments, ovarian pains, miscarriage (with slight active heemorrhage) and premature labor. From its secondary action would occur passive congestion of the uterus with passive hlemorrhage, hypertrophy, displacements, and tumors of that organ. The ovaries would be affected in the same manner, causing enlargement, irritation, tumors, and finally paresis-leading to sterility. Dr. J. H. Woodbury, of Boston, in a paper contributed to the New England Medical Gazette, gives such a clear idea of the general therapeutic action of Ustilago that I quote it entire:This substance has many points of similarity to Ergot, and also some of radical difference, to which I propose to call attention in the course of this article. Perhaps there is no drug in the whole scope of the Materia Medica concerning whose value and efficiency there is a greater diversity of opinions among physicians than the one under consideration. While some are loud in its praise as a medicine of undoubted energy and efficiency, others have come to look upon it as altogether inert and worthless. Two causes have doubtless contributed to this widely different estimate. First, a truer knowledge of its sphere of action may have enabled some physicians, in the absence of any thorough and reliable provings, to prescribe it more successfully than those less familiar with its peculiarities and characteristics; and second, the quality of the drug used has, in many cases, I am fully convinced, made all the difference between a perfect success and an entire failure. Like the Ergot it deteriorates rapidly with age, and I feel very little confidence in any specimen more than a year old. Great care also should be exercised in gathering this fungus. It should be selected in the field, at maturity, before it has been injured by the heavy autumnal rains and winds. Very little value remains in this drug after having undergone the heating process incident to the gathering and husking of the corn, hence it should never be obtained either from the shock or the bin. The properly selected specimens, shortly after being gathered, should be made into a tincture or carefully dried and triturated. But however carefully prepared, it soon begins to lose its strength, and in a few mohths becomes nearly or quite inert. One can not but feel that this was the condition of the drug used in some of the published " provings " of this medicine, contained in various reports and journals. Having used this remedy quite extensively during the past three years in the treatment of various uterine diseases, I will add a few therapeutic hints, with cases illustrating its action. As before observed, it has a general resemblance to Ergot in its physiological action. It controls uterine heamorrhage and induces uterine contractions in a manner similar to Ergot, but not with the same promptness or vigor. Somebody has called Conium "the Aconite of chronic diseases," with only a moderate degree of accuracy, however; but Ustilago 732 USTILAGO MAYDIS. is pre-eminently the Ergot of chronic uterine hoemorrhages and passive congestions. I would not give it in active hemorrhages from an enlarged uterus with dilated os and cervix, when the blood is of a bright-red color, and readily coagulates; in such cases, even if Secale was not deemed the similimum, our Materia Medica would furnish many remedies efficient and more prompt in their action than the Ustilago; but where for many days there has been a slow but persistent oozing of dark blood with small, black coagulae; when the finger, upon being withdrawn from the vaginal examination, is covered with a dark semifluid blood, as though partial disorganization had taken place; when the uterus is enlarged, the cervix tumified, and the os somewhat dilated, but swollen and flabby, indicating that the whole organ is in a most passive and congested state; when in spite of all treatment the blood continues to ooze day after day simply from lack of some means of overcoming its "invincible inertia," the Ustilago is, in such cases, a remedy of most gratifying promptness and efficiency. It has shown itself able in several cases not only to control the heemorrhage, but to remove the entire pathological condition upon which the haemorrhage depended. Case I.-Mrs. D., a brunette, stout, and inclined to corpulency, two years married, had, about one year since, a severe haemorrhage; abortion was suspected but no ovum discovered. Since then she has had frequent and long lasting attacks of haemorrhage of dark, very offensive-smelling blood; the menstruation was of a similar character, and during her intermenstrual periods she had a copious and most offensive, yellowish discharge. Any unusual exercise was followed by flowing, lasting for several days. The cervix uteri and fundus were greatly enlarged, but not sensitive to the touch. Various remedies were administered, among which were Sepia, Trillium, Crocus, Secale, Ipecac, and Sabina, all of which had a fair trial, but without any appreciable effects. Applications were made to the os of pledgets of cotton saturated with glycerine, pure and also in combination with iodine and carbolic acid. These produced their usual, characteristic, copious serous discharges, but without sensibly diminishing the size of the womb. At this juncture I determined to dilate the cervix in order that I might obtain an accurate idea of the condition of its cavity; since from the character and frequency of the discharges I feared the existence of some form of neoplasm. it was necessary to postpone this operation, however, some four weeks on account of some engagements of the patient, and during this time I gave her a package of powders of Ustilago, Ist trituration, with directions to take one three times a day for the next twenty days. At the expiration of that time she returned with a most favorable report. The leucorrhceal discharge was much diminished in quantity and its odor less offensive. She now took long walks without a recurrence of the flowing, and her menstrual period, which she had just passed through, lasted only five days, instead of eight or ten, as previously. On examination I found the hypertrophy considerably lessened. The same treatment was continued for four weeks'longer, the patient meantime making a visit to New York, which she had deferred a long time on account of her liability to excessive flowing from extra exertion. On her return she pronounced herself well, and treatment was discontinued some four months ago. Up to this time there has been no return either of the haemorrhage or of the leucorrhcea. It may be asked, Upon what data was Ustilago administered in the above case? In USTILAGO MAYDIS. 733 reply I would say, that in the absence of any reliable provings upon the female organism, I gave it upon the hypothesis that if this medicine was capable of curing haemorrhage resulting from chronic congestion or simple capillary engorgement, why might it not remove the engorgement itself. The result proved the correctness of my reasoning. Case II.-Miss S., blonde, tall, slender, sanguine temperament, subject to copious menstruation, was attacked with hkemorrhage at a wedding reception, which she had made great exertion to attend, traveling to New York and back in two days for that purpose. The hkemorrhage was not very copious, the effused blood being of a dark color, with slight, stringy clots. She suffered great pain in the uterine region and through the inner portion of the right thigh half-way down to the knee. She took opium and astringents from an allopathic physician for ten days without benefit. When she applied to me I found the symptoms as above stated. A digital examination revealed a considerable enlargement of the cervix uteri and fundus, with great tenderness to the touch, both internally and externally. The haemorrhage, though not very copious, was persistent. The stain left by the blood upon my finger after the examination was of a dark-brown or mahogany color. She had occasional attacks of very severe pain through the uterus and extending down the right limb, alternating with intervals of entire freedom from suffering. I gave her Ustilago every three hours. The next day I found her manifestly improved; continued the same medicine for six days, when she reported to me that she was entirely well. No other medicine given. Case III.-Mrs. H., brunette, mother of four children, subject to irregular menstruation. It was sometimes absent for three or four successive months, then too frequent and very copious for a week, after which it was continuous, scanty, and dark-colored for an indefinite time, frequently for ten or twelve days, as at present, with a great deal of pain in the uterine region, " not spasmodic and cramp-like, but a steady hard ache." Digital examination revealed hypertrophy of the uterus, with a soft spongy os and cervix, which was sufficiently dilated to easily admit introduction of the finger. The blood was dark, but so thin as scarcely to color my finger, though some small, black clots were found in the vagina. She had taken from her " domestic" case, Crocus, Hamamelis, China, Platina, and Pulsatilla, each one day, but with very little relief to the pain, and no diminution of the flowing, which had now continued seventeen days. Ustilago was given in powders every two hours. Next day the pain was much less and the flowing nearly ceased; two days after, both had entirely disappeared. Believing the menstrual irregularities to be due to the long-continued, passive congestion of the womb, I continued the use of the Ustilago twice a day during the intermenstrual period, and twice each week applied glycerine to the os and cervix. The next menstruation was regular in time and normal in quantity, and has so continued since March last, now six months. Case IV.-Mrs. F., a blonde with auburn hair and blue eyes, has always suffered from excessive menstruation; has never been pregnant. Three weeks prior to my being called, her menstruation came on with unusual copiousness and pain, and has continued, scarcely lessened, ever since. Has taken a great variety of remedies, allopathic, homoeopathic, and domestic, but without much benefit. The blood was bright, fresh, and without coaguloe, but examination revealed the same hypertrophied, sensitive condition of the uterus, and this de 734 USTILAGO MAYDIS. termined me to try the Ustilago, which I did as before, the first trituration, every two hours. Improvement was manifested within twenty-four hours, and the flow ceased at the end of three days. I might cite many more cases of a similar character, but these are sufficient to clearly indicate what I deem to be its sphere of action, and that is, briefly this: haemorrhages caused by or attendant upon passive, chronic uterine congestion, characterized usually by hypertrophy of the cervix and frequently of the entire organ. With oozing of dark blood, slightly coagulable, though forming occasionally long, black, stringy clots similar to those indicating Crocus. How much more ample its sphere may be remains to be learned from future investigations, aided, I trust, by the thorough provings to be made by the coming Female Provers Union. Before closing this paper I must acknowledge the valuable aid I derived in the beginning of my investigations from a very brief report by T. Bacmeister, M.D., contained in the report of the American Institute for 1872, and which I think strikes the " key-note " of this medicine. Dr. H. K. Bennett, of Fitchburg, writes, " I have used the Ustilago successfully in several cases of menorrhagia and in one case of abortion where the flowing had lasted for several days, greatly reducing the patient; the effect was apparent at once and the hkemorrhage arrested in six hours. In post partum hoemorrhage I much prefer it to Secale or Macrotin." The cases cited by Dr. Woodbury, and the special indications given for its use, all simulate the secondary effects of Ustilago. All of Burt's cases (9 or 10) presented symptoms of the same character. Ustilago will rarely be used for its primary haemorrhagic symptoms, for there are other remedies-as Woodbury says — which appear more appropriate, but used in a high attenuation, it will promptly cure the spasmodic, and others of its primary symptoms. Many cases of dysmenorrhoea have been cured by Ustilago. Some of them were of the variety known as pseudo-membranous, in others the pains were spasmodic. Dr. Burt failed to cure cases of congestive dysmenorrhcea, with violent spasmodic pains, for the good reason that it is not homeopathic to active congestion. It is claimed that Ustilago has reduced the size of some ovarian and uterine tumors. I doubt its value in ovarian tumors of any kind, except in an incipient stage-as a preventive-but the Ergotin it contains may make it curative in uterine fibroids in an early stage, also for the expulsion of polypoid growths. It is primarily homoeopathic to scanty menses, with spas VERATRUM VIRIDE. 735 modic pains, but no active congestion. Use the 12th trituration. It is secondarily indicated in profuse, premature, and long lasting menses, from passive congestion, paresis (atony) of the uterine tissues. In such cases use the lowest triturations. In uterine atony after labor, as well as on any other occasion, I should expect to find Ustilago, in appreciable doses, very efficacious; also, in sub-involution of the uterus. I believe it will prove one of our best remedies in a tendency to miscarriagqe. I.allude to an habitual tendency to abort at periods corresponding to the menstrual; or to loss of the foetus from the slightest over-exertion, at any time, or from the shock of mental emotions. When ulceration of the os is present as a cause of the abortion, Ustilago will not prove as effectual, unless the lesion is cured by local applications. In these conditions I should use it in the 3x trituration, but when used to prevent premature labor I would advise a higher attenuation. I do not believe it will ever prove equal to Caulophyllin in such cases. VERATRUM VIRIDE. This indigenous species has attained great popularity in all schools of medicine, not only in this country, but in all others where medicine is progressive. It is a little singular that the two species, the viride and album, although said by chemists to possess similar constituent principles, should be used in almost diverse conditions. Homceopathists who use both very extensively, never use the album for fever, and rarely, if ever, the viride for choleraic symptoms, or collapse. This shows conclusively how valueless the results of chemical analyses are when we wish to know the exact powers of drugs; and, that a thorough series of experiments only, can give us exact knowledge of their curative power. The medical history of this plant may be of interest: Dr. Osgood states that this plant was known to the abor VERATRUM VIRIDE. 737 that two grains of the powder caused him to vomit, and observed that the act was at first unattended by nausea, and seemed to be performed by the contraction of the stomach and oesophagus alone. But in another person, who also presented this peculiarity, emnesis was subsequently persistent and violent, and attended with bilious dejections. Norwood says that it is one of the most certain and powerful emetics, but may produce extreme nausea, as well as vomiting which is sometimes continuous. Robert, a French physician, says that the pulse may be reduced by the drug as low as thirtyfive beats per minute, without nausea or vomiting! Osgood, Norwood, Raynor and others, assert that it does not cause cantharsis, while Pendleton, Platt, and others quoted by Stille, assert it to cause "copious, watery evacuations, per anurm." The same authorities have known it to cause the following conditions: Faintness, somnolency, coma, dimness of sight, dilatation of the pupils, vertigo, headache, rarely delirium, impaired muscular action, general numbness, slow and infrequent respiration, hiccough; a pale, cold skin, covered with clammy sweat, persistent vomiting, excruciating pain in the proecordia; profuse, watery diarrhoea in some cases, and a small, infrequent, and generally feeble pulse. Alarming and apparently dangerous as these symptoms are, it does not appear that they have terminated in death —on the contrary, they have generally been dispelled by administering diffusible stimulants. The action of American Hellebore strongly reminds us of the " Helleborism of the Ancients," so graphically described by Hahnemann. It is said that very few persons died from the apparently dangerous effects of Veratrum album. This case was reported by Dr. W. H. Woodbury: Prescribed for a gentleman about (orty-five years of age, as an expectorant, forty drops of the tincture of Veratrum viride in an ounce of water, and directed a teaspoonful of the mixture to be taken every three hours. The first dose was taken as directed, the patient waited an hour, and not perceiving any particular action from the medicine, concluded that the dose which I advised was much too small to affect him, and that it would be perfectly safe to take any quantity of the medicine, or even take the whole contents of my pocket case at one dose. He took a tablespoonful of the preparation, in all twenty drops of the tincture. From ten to fifteen minutes after taking the enormous dose, he experienced a burning sensation in the throat, cesophagus and stomach, dizziness and pain in the head, with dimness of vision, dilatation of the pupil of the eye, severe nausea, but very little vomiting. I was called about half an hour after the last dose 738 VERATRUM VIRIDE. had been taken. Found the patient in great distress, very pale, with a cadaverous look, convulsive breathing, almost to suffocation, pulse very small, about forty per minute; extremities cold, to the elbows and knees; a profuse, cold perspiration over the hands and face; weakness and stiffness of the limbs, with frequent efforts to vomit, and extreme prostration. I ordered an application of mustard and vinegar to the chest, and prescribed Ipecac, which produced full emesis of mucous and bilious substances; vomiting profusely five or six times, after which I prescribed Camphor and whisky, a teaspoonful every ten minutes at first, and continued as the case required. Narcotic symptoms were now more manifest; the patient became somnolent, soon followed by lethargy, which continued four hours, from which he awoke feeling much better, though very weak, and complained of an indescribable sensation, more manifest in the limbs than elsewhere. I advised exercise in the fresh air, which he took by the aid of an assistant, which produced beneficial results, and the following day he was able to attend to his usual business. Dr. G. N. Edwards, Assistant Physician to St. Bartholomew's hospital, reports the following case: On Thursday evening, December I8S, I was summoned to see a gentleman, a scientific chemist, who had taken, experimentally, one drachm of tincture of green hellebore (equal to about twelve grains of the powder.) On my arrival, I found him sitting in the water-closet, vomiting into the pan. His features were sunken: skin cold, and covered with a profuse, clammy sweat; his pulse quite imperceptible. He complained of intense pain about the epigastrium. The vomited matter appeared to consist at first of the food and contents of the stomach, afterwards of glairy mucus. I gave him immediately about an ounce and a half of pure brandy, which at once checked the vomiting. At this time I was joined by Mr. Buxton Shillitoe, the patient's usual medical attendant. As he had slightly rallied, we had him removed into a room a few yards from the water-closet, and laid on a couch in front of the fire. The surface of the body was still very cold, especially the extremities. The clammy sweat continued, but the pulse could be felt indistinctly, beating very feebly and irregularly, fortyfour in the minute. A dose, containing sp. aether, sulph. co. ~ dr., and sp. ammon. arom. I dr., was given, but immediately rejected by the stomach; but some brandy, given directly afterwards, was retained. A large mustard poultice was applied to the epigastrium, and a hot water bottle to the feet. Two or three efforts at retching afterwards took place, and he once or twice vomited food, mucus, and a small quantity of blood. Warmth gradually returned to the surface, and the pulse became somewhat better in volume and power. Brandy was given at short intervals, and after about an hour a second dose of aether and ammonia, which was retained. The patient then fell asleep, slept for about a quarter of an hour, and awoke with the expression, " I am all right now," and appeared comparatively well. There was no diarrhcea throughout. He had two or three times a slight return of the symptoms; did not sleep during the night, but was quite easy; and the next morning only felt the discomfort arising from the mustard poultice, and the soreness of the muscles caused by the retching. He then gave us the following account of his feelings during the attack: VERATRUM VIRIDE. 739 Before taking the dose of the tincture, I had consulted Pereira, and finding Dr. Meade's dose of the tincture Helleborus niger to be two teaspoonfuls, twice a day, and knowing the green Hellebore to be of the same tribe, I considered, in taking one teaspoonful, I was rather under than overdoing it. The drachm of the tincture was taken about half-past four or a quarter to five o'clock P.M., and my stomach soon afterwards whispered that I had admitted a troublesome guest. I went up stairs and sat down, thinking a cup of tea would set all right; but the uneasy constriction of the stomach continuing, with a tendency to sickness, made me retire to the water-closet. The sickness, once commencing, soon became alarmingly violent, with the most excruciating pain in the lower part of the stomach, the pain extending to about the size of my hand. The feeling at the seat of the pain was, that all the warm tea, water, etc., that I took to provoke the vomiting, went under the pain, making the constriction more and more violent. Finding the case getting desperate, I sent off for medical aid. The pain continued to increase, and the ejection of the stomach was now glairy mucus with blood, with running from the nose and eyes. The most painful and profuse cold sweating now came on, and the difficulty of breathing became more and more labored. I could not help wondering at the presence of any thing like heat or constriction of the throat; my mind was perfectly calm; and, although I thought it more than probable that I should die, I did not feel alarmed. Hearing and recognizing the voice of one of my medical friends, is all I recollected for some time afterwards. Immense circles of green color appeared round the candle, which, as vertigo came on and I closed my eyes, turned to red. The pain continued excruciatingly at the pit of the stomach, and a slight tendency to cramp existed when my legs were touched. It was some hour or more afterwards when I awoke and found myself comparatively well. The sting of the mustard I can well recollect, and the horror of being forced to swallow brandy is even now with me. My bowels were not at all acted on. A case of poisoning is reported by Dr. W. H. Burt': My little girl, aged twenty-one months, got hold of my pocket-case, and I found her sitting down eating medicine. She had a vial of Veratrum viride in her hand, with the cork out, and its contents emptied. It contained one-eighth of a drachm of the tincture. She could not have had the case more than five minutes before I discovered her, but in about two minutes she commenced vomiting. I immediately gave half a cup of coffee, and then went for some Camphor; returned in about five minutes. -Her jaws were then rigid and nothing could be put in her mouth; pupils of the eyes widely dilated; face blue; hands and feet cold; no pulse could be found at the wrist. Bathed her bowels and back with Camphor for a few moments, when she went into a spasm, with violent shrieks: body bent backwards; arms rigid and thrown over her head; face dark blue; breathing suspended for several seconds; lasted about two minutes; remained easier for a few moments, and then went into another spasm similar to the first. I then placed her in a tub of warm water, which soon relaxed the whole muscular system; vomiting kept up, with severe retching every few minutes, for three hours, when it gradually subsided. The matter vomited was a white, ropy mucus. The interval between vomiting for three hours, was not at 740 VERATRUM VIRIDE. any time longer than five minutes, and most of the time did not exceed one minute. She remained pulseless all the time, with a blue, hippocratic face; hands and feet shriveled up, as if they had been in water for a long time. When she was not vomiting she lay in a stupor; pupils of the eyes widely dilated. After three hours the pulse could be counted; it was thirty-six; very feeble. In three and a quarter hours after taking the Veratrum she went to sleep, and slept quietly and soundly for three hours, and then awoke well, except being a little weak. The leading symptoms in this case were: Constant vomiting of a white, ropy fluid; dilatation of the pupils; comatose state of the brain; great congestion of blood to the lungs; blue, pinched up, hippocratic face, with cold nose, hands and feet; spasms; trismus; no pulse for three hours; pulse 36, very weak and soft. I would call especial attention to the spasms, and the effect it had on the brain and lungs. When I proved the Veratrum viride, one of the leading symptoms was, constant aching pains in the back of the neck and shoulders, so that it was almost impossible to hold the head up. I believe the Veratrum viride has a special affinity for the cervical portion of the spinal cord and base of the brain, but especially the spinal cord. The spasms my little girl had were in her thorax and back. (Opisthotonos.) The amount of medicine taken must have been small, probably only a few drops; the whole amount of medicine in the vial would have poisoned her fatally in a short time. In Jones and Scudder's Materia Medica, is the following case of poisoning: Mr. Worthington took one-quarter of a grain of the alcoholic extract. It caused an acrid, burning sensation in the mouth, and communicated to the throat and fauces a sense of dryness and heat, which finally reached the stomach. In the course of an hour this dryness and burning sensation in the throat and stomach became intense, and a disposition to hiccough was excited, which soon commenced, gradually increasing in frequency, until it reached fifteen or twenty times in the minute. This was attended with some sickness and retching, until vomiting took place. This was violent and seemed to come on about every ten or fifteen minutes for the space of an hour. During this time dizziness and tremor were created, which passed off with the dose. With the hiccough there was a copious secretion of saliva and.discharge of mucus from the stomach and nose. During the action of this dose the pulse was weakened so as to be scarcely perceptible, and reduced from 68 to 52 pulsations per minute. We have observed, says Dr. Scudder, similar synlptoms, only more severe, in a case where half a fluid drachm of the tincture was taken by mistake, instead of tincture of Gelseminum. In this case the pulse was reduced from about IOO to 40 beats a minute. The prostration was extreme, and there was such great irritability of the stomach that it seemed for a while that he must die from the impossibility of retaining the necessary stimulus. The fever did not return, though for some days the patient was much prostrated, the irritation of the stomach continuing for some time. 742 VERATRUM VIRIDE. sant. It causes a profound paresis of the whole circulatory apparatus, and its ultimate primary effect is to cause an equally profound paralysis of the cerebro-spinal and reflexmotor nerve-centers. The action of Veratrum viride can be stated in a few words as follows: (1.) It acts on the heart in a manner the reverse of Digitalis. [It is a direct and primary poison to the cardiac ganglia and the heart-muscle. The heart after death is relaxed and full of coagulated blood.] (2.) Its action on the spinal cord is just the reverse of Strychnia. [It primarily paralyzes the spinal cord and the reflex-motor nerve-centers.] Burt says: "Veratrum viride, by affecting the pneumogastric nerve (vagus), and by paralyzing its functions, produces congestion and inflammation in every organ and tissue to which it is distributed." I deny that Veratrum viride causes inflammation by its primary effect. The only inflammation (primarily) caused by the drug, arises from its local irritating effect on the skin and mucous membranes of the esophagus and stomach. It is by its secondary effects that Veratrum causes the peculiar congestion and'inflammation to which it is homceopathic. The congestion is an intense capillary hyperaemia. The inflammation is the result of pressure in and rupture of the capillaries, and is as much mechanical as dynamic. It is quite unlike the inflammation of Belladonna, Tartar emetic, Phosphorus or Sanguinaria. The first experiments of Wood and others shed some light on its action. "The rapidity of the pulse and the arterial pressure were at first decidedly lessened. After a time, the pulse still remaining very slow, the individual heart-beats became endowed with four times their pristine force, and the arterial pressure became normal; then, suddenly the pulse-rate quintupled itself, the individual cardiac beats losing much of their extraordinary vigor, but the arterial pressure rising 744 VERATRUM VIRIDE. If this secondary action did not occur, Veratrum would be antipathic tofever, and our claim for the universality of the homceopathic law would have to be abandoned. That it is not a mere " reaction of the organism," is proved by the statement of Wood, based upon many experiments - that " an excess of poison changed a condition of inhibitory excitation into one of inihbitory paralysis; or, in other words, whilst a small dose of Veratrum excites, a large one paralyzes the pneumogastrics." This I have always believed to be the fact. I believe that all drugs capable of causing secondary symptoms have a similar modus operandi, and that in no case is there such a thing as a "simple reaction of the vital principle against the drug," but that primary and secondary action are both positive medicinal effects. Burt and others are singularly oblivious of this secondary action when treating of Veratrum. To say that " congestion and inflammation is caused by Veratrum acting upon the pneumogastrics, in depressing their functions," is only stating half the truth. Moreover, it is doing injustice to the physicians of our school, for, at present, only a small portion accept the doctrine of primary and secondary action, and the law of dose based thereon. Consequently, acting upon the bald, unqualified assertion, that Veratrum causes inflammation of the brain, lungs, liver and spinal meninges, they use the dose ordinarily used by them in practice. If this dose is below the 2x, it will cure; if above (and nearly all would naturally use it above), no certain curative results are obtained, and the medicine is blamed as useless or inert. During the primary effects of Veratrum, no such conditions as above named could obtain. Congestion and inflammation can not occur during a period of lowered blood pressure; the only condition of the circulation then notable, is that of venous stasis or passive engorgement. We have no medicines whose primary action resembles the secondary of Aconite, Gelseminum and Veratrum, unless it be Quinine. Therefore, we have no primarily indicated VERATRUM VIRIDE. 745 remedies for general sthenic fever, resulting in acute inflammation. There are remedies which cause local inflammation, with resulting fever, as Cantharis, Belladonna, Mercury, Phosphorus or Tartar emetic, but they are not indicated in idiopathic fevers. Physiologically and pathologically, Quinine is primarily homzeopathic to a general febrile state, with inflammation in every organ and tissue of the body; yet it is never used by our school for such conditions. It acts on the brain and spinal cord in a manner very similar to Veratrum viride, only in a reverse order, i. e., its primary toxic effects are like the secondary effects of Veratrum. If any other proof is wanting of this secondary action, it will be found in the clinical results of the use of Verat. viride, namely: that minute doses do not have any curative action over congestion or inflammation of an active, sthenic type. In the lung tissue, examined by Prof. Chas. Adams, taken from animals poisoned by Verat. v., " the microscope revealed intense congestion and a large number of the capillary vessels ruptured.' Burt says "sections of the lung were so completely hepatized, that when thrown into water, they immediately sank to the bottom," and " the smallest air-cells were completely filled with mucus." Now, no such congestion and inflammation could occur during the period of decreased arterial pressure (primary), consequently it must occur during the secondary action, described in Wood's experiments. As I shall inform you, when treating of the use of Veratrum in pneumonia, it has been found that if large doses are given after the congestive stage, the later stages are prolonged. This goes to prove that it is not secondarily homceopathic to any but the first stage. Why? Because, during the stage of red and gray hepatization, softening and suppuration, the condition of the heart simulates the primary action of Veratrum. It is now known that death from pneumonia results ultimately from heart-failure. What shall we deduce from these facts? This-that Ve48 746 VERATRUM VIRIDE. rat., if used at all during the later stages of pneumonia or any inflammation, must be used in minute doses. I am not sure, however, that it should be used at all in such conditions. There is no clinical proof of its value there. Remedies which are secondarily homceopathic to cardiac debility must be chosen, namely: Phosphorus, Digitalis, or China (Quinine), aided by wine, beef tea, milk, and other nutritious substances. Its primary action on the brain is to cause venous stagnation, with lessened-arterial pressure. It depresses the functions of the cerebellum, giving rise to abnormal movements, jacitations, clonic spasms, etc. Its secondary action is intense arterial congestion. Dr. Adams' microscopical examination showed " intense capillary congestion of both the white fibrous structure and gray cineritous substance-there being more congestion of the cerebellum than the cerebrum." A clot was found at the origin of the pneumogastric, and effusion along its course. He also found great capillary congestion of the pons varolii. According to Nothagal, the " convulsive center " is " located on the floor of the fourth ventricle, in the pons varolii." This illustrates why Veratrum vir. is so useful in convulsions of a congestive nature, and why it is only useful in material doses, i. e., in the dilutions below the 2x and in small doses of the mother-tincture. H. C. Wood, in discussing this subject,* says: " On account of the violence of the convulsions, it has been asserted that Viridia is a spinal excitant. The convulsions are, however, really of brain, and not of spinal origin, as they do not follow poisoning by Veratrum viride when the cord has been previously cut." No record of the pathological appearances in the cord or its membranes, in cases of poisoning by Veratrum, are on record, so far as I know. It is highly probable that it causes the same condition in the cord and meninges that it causes in the brain and its meninges. Clinical proof is also afforded in the case of Strychnia* Philad. Med. Times, vols. ii. and iii. 748 VERATRUMI VIRIDE. prompt and reliable remedy I prefer it to Aconite in hysterical, epileptifori, or puerperal convulsions; also in the convulsions of children. I have succeeded with the first decimal dilution, rarely having to resort to the mother tincture, and then only giving it in one and two-drop doses. The following allopathic experience with the Veratrum viride in nervous and spasmodic affections is worthy of place here. It is stated that animals poisoned with the Veratria from Veratrum viride " lost the power over the locomotive muscles, and after death the galvanic current did not cause the same convulsive movements as in cases of death from other causes."* Experimenters all notice a peculiar "weakness and inability to move the muscles;" also, stiffness of the voluntary muscles. In Dr. Burt's cases it caused trismus, opisthotonos, and other spasmodic symptoms. Dr. Baker, in the Southern Medical and Surgical Journal, gives an account of the value of the drug in the treatment of certain neuroses. Case I.-The patient was a stout, healthy man, of sober habits. I found him sitting on the side of the bed, seemingly well and perfectly intelligent, unaware, however, that he had had convulsions. All that I could ascertain of his previous history was, that he had been similarly affected in childhood. While conversing with him he was suddenly, and without apparent premonition, seized with a frightful convulsion, occasioning frothing at the mouth, and the most violent jactitations of all the voluntary muscles. I immediately opened a vein and bled him profusely, but without the desired result, for, after the lapse of a certain period, with as perfect a return of consciousness as before, there occurred another convulsion of equal severity. In this emergency, the excessive muscular relaxation capable of being produced by the Veratrum viride occurred to my mind, and I reflected that such an effect could only be produced by an influence primarily exerted upon the cerebro-spinal system of voluntary nerves. I administered the Veratrum in full and repeated doses, desiring, and confidently expecting to produce the same train of distressing symptoms that so alarmed me some years previously; these were nausea, vomiting, purging (rarely observed), muscular relaxation, and coldness of the surface. In this I was disappointed; for, though the convulsions were arrested, there occurred no other symptom than a relaxed skin, with profuse perspiration. Since then I have administered the Veratrum in numerous cases of eclampsia of children, with such satisfactory results as to establish, beyond all doubt, the power of this agent to arrest convulsions. In this case the cure was as certainly homzeopathic as if made with the third dilution. * American Medical Times. VERATRUM VIRIDE. 749 Dr. Baker, in June, 1858, undertook the cure of a case of chorea in a young lady. It had been gradually coming on for two months. When first visited, her symptoms were distressing to the last degree, the entire muscular system being in continuous and tumultuous motion. The case passed on from bad to worse, notwithstanding the most assiduous attention and energetic treatment. Tonics, anti-spasmodics and anodynes were exhausted without avail; the spine and nucha were cupped and blistered, without benefit; chloroform was administered internally and by inhalation; opium and its preparations seemed to make her worse; so, after all the family had given up all expectation of recovery, upon the suggestion of a medical friend, who had twice used the Veratrum viride, in three cases of chorea, with the most satisfactory results, he at once commenced its administration, and as she was gradually brought under its influence the turmoil began to cease; the face, which had been worked by its muscles into the most ludicrous and horrible distortion, became placid and intelligent; the head ceased its everlasting jerking, the extremities lay still, the body left off writhing, and the patient quietly passed into a peaceful and profound slumber. This sleep was deep and long, as it was the first, with few and slight exceptions, that she had had in nearly two weeks; and the quiet that the muscles now received was all that had occurred, save during those few and short slumbers. At a subsequent visit, I found the family cheerful and hopeful, and the patient quiet and sleeping, the pulse but little depressed. There had occurred no vomiting. I roused her, and, to my great satisfaction, when awake, there was no jactitation of the extremities, and but very little twitching of the muscles of the face. The Veratrum was continued; and for the first few days, if withheld, the commotion began to return. Under the quiet induced, the sleep was so continuous at the outset, that the family called the preparation " the laudanum mixture." After a time the convulsions ceased altogether, and the patient was restored to health under a course of tonics. Dr. Terry reports three cases of chorea in which the Veratrum viride was employed. The first was a child aged twelve. It had been confined to bed for three weeks, and was reported to have been under treatment for about six weeks; first, for worms, with Spigelia, Worm-seed, etc.; and subsequently for chorea, with Cimicifuga racemosa, Iron, Quinine, and the usual routine treatment, until the child was apparently dying. It is not in the power of language to convey a proper conception of the truly pitiable state in which I found this child. It had slept none, neither taken any nourishment for days. It was evidently dying from exhaustion and inanition. The muscular commotion was violent, universal and unaffected by sleep; the lips embossed with foam, worked up by a continued champing of the teeth. Three drops of the tincture of Veratrum viride were administered every three hours, the vehicle being gum water. In twenty-four hours I had the gratification to see the symptoms greatly improved; the muscles were much quieter, and the child could swallow without difficulty. The trouble in this respect had constituted the greatest embarrassment in the treatment. At the end of the fourth day, all convulsive action had ceased. 750 VERATRUM VIRIDE. Case II was an ordinary one, in a girl of I5. After purging, four drops of the Veratrum viride were given every three hours. Prompt convalescence ensued. Case III.-A woman, aged 36, childless, and subject to menorrhagia, immediately after an attack of which she had a continual nodding of the head and violent convulsive action in one arm, together with jactitation of one leg. In this case, six drops of the tincture of Veratrum viride were given every three hours. The fourth dose occasioned slight nausea, and after the fifth dose the convulsive action ceased, when the Veratrum was withheld. In eight or ten hours the symptoms returned. Upon resuming the medicine, they again disappeared; the doses were then reduced. The case recovered. Dr. S. W. Green, of Manchester, Iowa, in a letter to Dr. Burt, relates a case of chorea in which the use of Veratrum was very satisfactory: A lady, married, about 30 years of age, nervous temperament, quite intelligent, and under easy circumstances. She has had chorea more or less from childhood up, and has been worse ever since the age of puberty, which, as near as I can learn, is in consequence of continued, intense, sexual excitement-and after marriage too. She had always had homoeopathic treatment, but with little benefit, until I gave her Veratrum viride, which has been permanent. She had constant movement of the head, lower maxillary, larynx and tongue; twitching and light jactitation of the muscles of the neck, organs of speech and face; so much so that it required considerable effort often to converse; constant movement, and sometimes slight jerking of the chest, arms, fingers and lower extremities; sometimes there would be one slight jerk of single muscles in different parts of the body. But now comes the singularity of the case. The symptoms gradually subsided, and to all appearance she was well for several months, when all at once she was taken with violent palpitation of the heart. I was called in, and found her laboring under symptoms caused by the lungs and brain receiving far more blood than was compatible with their normal conditions. Her heart was beating more than I6o beats per minute. I gave her Veratrum viride, first decimal trituration, which reduced the heart to its normal action in twelve hours. There has been, once or twice, since, a slight recurrence, which was speedily relieved by the same remedy. This case would seem to imply some influence upon the superior cervical ganglion. The allopathic journals abound in reports (since 1870) of grave cases of puerperal spasms cured by Veratrum, given in 10 to 30-drop doses of the tincture. Dr. Baker also mentions a case of puerperal convulsions, in which chloroform by inhalation, copious bleeding and forceps were employed; the child dead; weighed eleven and a half pounds. Patient was left quiet and comfortable. Seen after four or five hours had elapsed; she was found in a most violent convulsion, which was said to be the seventh since delivery. Fifteen drops of the tincture of Veratrum viride were given, and ten more were directed to be given in two hours, after which the intervals should be prolonged to three or four hours. There occurred no more convulsions, and the woman recovered perfectly. 752 VERATRUM VIRIDE. Dr. Wood came in, and the decision of all was that she must die. During this time, the pupils continued dilated, bearing the strongest light without changing. It was a complete case of opisthotonos, like that produced on the dog by Gelseminum. Not having any Gelseminum, I did not give it. During the spasm the heels almost touched the head, forming a hoop of the body. From the third to the fifth day, the body was covered most of the time with a cold, clammy sweat. On the fifth day there was a marked febrile action; came on about noon, and went off in the evening. The sixth, seventh and eighth days it was the same, when I concluded to put her on Veratrum viride. Accordingly, about two o'clock in the afternoon, commenced with one-half drop doses every hour; continued this course until twelve o'clock, when there was some nausea. On a close examination, found that the muscles were somewhat relaxed; continued the Veratrum viride until morning, when there being no fever, I stopped it. I found then, however, that the muscles of the trunk were completely relaxed and the spasms ceased. In the afternoon there had occurred no return of fever, but the muscles of the neck still continued contracted; pupils were natural, but very sensitive to light. I again gave the Veratrum viride, as before, and to my joy the next day found her able to lie on either side or back. Improvement went on from this time. I gave her Nux vomica and other medicines, and in two weeks discharged her. We had supposed that the opisthotonos was produced by an irritation of the stomach and bowels, and thus acting sympathetically on the spinal cord and base of the brain, but I have found out since that she had a fall, striking the lumbar vertebrae against the corner of a trunk, three days before she was taken sick. Now, then, what action has the Veratrum viride on the spinal cord or brain? Dr. M. A. Tinker, of Schenectady, N. Y., reports a number of cases of cerebro-spinal disease, in which the administration of Veratrum was followed by the most gratifying results. These cases are so suggestive and interesting, that I give them in full; Case I.- The patient, my son, now (Dec. Ist) fifteen months old, of a nervosanguine temperament, light complexion and hair, fair, clear skin, blue eyes, fully developed, and healthy previous to the Ist of June, when he had the measles rather mildly and made a good convalescence. On the 5th of July he was taken with scarlatina; had it very mild and made a rapid recovery, to all appearances. On the 28th of July he became feverish and restless, and gave evident signs of irritation of the brain. On the 29th much worse; burning fever; frequent vomiting; tongue coated whitish: bowels sluggish; urine high colored, of usual quantity; very restless, and sleeps or nurses but little; cries out on attempting to move him; irritation extending down the spine, and both ears discharging a thick, excoriating fluid. 3oth.- Every symptom aggravated in spite of Aconite, Belladonna, Bryonia, Pulsatilla, Gelseminum, etc.; worries, with a peculiar moan, most of the time; draws the head backwards; rolls up the eyes; puts his hands back of his ears VERATRUM VIRIDE.- 753 and rolls the head from side to side; pulse about I50; respiration rather hurried. 3Ist.-Continues to grow worse; head buried deeply in the pillow; eyeballs still turned upwards; other head symptoms about the same, only increased in violence; bowels and urine as last reported; discharge from the ears has become purulent and more abundant; can not bear to be moved at all. The pulse, towards evening, began to flag in strength, and at times amounts to little more than a flutter, and then the face and front of the body and extremities are quite pale and covered with a cold perspiration; on examination, I found a strip about six inches wide extending from the crown of the head to the bottom of the spine, very pungently hot and dry, reddish in appearance, with several large and small petechia like musquito bites-scattered over this inflamed strip. August Ist.- Child very low; the pulse at times scarcely perceptible; the case passed this day very much as he appeared last night, as reported. August 2d.- Appears to be gradually sinking; do not think that he can survive the day; no alteration whatever for the better, and can not be moved at all; the spinal muscles are very strongly contracted. At about I o'clock P.M., I again took up your New Provings to see if something more could not be done. On examining Veratrum viride, a single remark there determined me to try the remedy at once. (Clinical remarks under Head.) He had cut his front teeth the week before he was taken sick; there was no apparent irritation here. I at once prepared a solution, four drops of fluid extract, in half a tumbler of water, and gave a teaspoonful every hour. In two hours the pulse began to steady, and there was less restlessness. At 6 P.M. (5 hours) improvement began to be quite evident, and he slept about 20 minutes quietly. At 9 P.M., nurses; can be moved, and turns his head; the head and spine cool and perspiring freely. At I2 M. is sleeping; hands away from the head; lies naturally on the pillow, and in a free, general perspiration. August 3d.-Appears like another child entirely; the bowels regular from the first, and at the second movement quite natural in appearance; urine normal also; tongue cleaning, and pulse 12I. August 4th.- Child slept very well last night, and the natural functions are all becoming regular. From this he made a very rapid convalescence. I changed the medicine once, but restlessness and head symptoms showed themselves. On returning to the Veratrum viride, all subsided. On the 5th of September, long after we had stopped all medication, the child manifested strong cerebro-spinal symptoms again, with high fever, loss of appetite, etc., etc., as before. I gave Aconite and Belladonna, to no purpose. When I had dropped all, and had recourse to Veratrum viride, same strength as before, in ten hours all was right, and the child playing about the floor. This child has had two similar attacks since, both of which readily yielded to the Veratrum, Case II.- Sept. 7th, was called to see a child aged three months, the first born alive of several pregnancies, and had suffered much from its birth; of scrofulous parentage. I found the child emaciated to a mere skin-covered skeleton, with the head much enlarged and mis-shapen, and the sutures separated; head was drawn back as far as possible. The child also had double inguinal 754 VERATRUM VIRIDE. hernia; the pulse about I6o and feeble; respiration feeble and sighing; tongue coated whitish yellow; posterior portion of head and spine very hot; there was so much contraction of the spinal muscles, that the child was compelled to lie on his side; the eyes rolled upward; rolling the head, and by turns moaning and screaming; most of the time nursed but little. He had a watery diarrhcea, mixed with white and green portions of undigested milk, and at times the discharges were quite green; the urine scanty and high colored. This state of things had existed for some time, as the child had been abandoned by two attending physicians to die. I at once concluded to try Veratrum viride, four drops to a half tumbler of water, and had the pleasure of seeing my little patient amending daily, to the great delight of the parents, and in less than one week the child could lie on his back with ease; the more alarming symptoms all disappeared, and in the course of three weeks the child had improved so much that his mother said, "a very worrisome child has become a very good baby." I called to see the child but a day or two since, and found a very healthy, fleshy looking fellow. I have had two other cases, similar as to symptoms, but not in severity, to those above reported, both of which recovered rapidly under the use of the Veratrum viride. Case III.-A boy, aged four and a half years, had for several days a croupy cough, and at night considerable fever. The cough yielded to Phosphorus, but the feverish state increased until it became nearly or quite a continuous one; tongue coated white; urine scanty and bowels irregular, and pulse I6o to I70. About six days after the attack, he had in the evening a very violent convulsion. which lasted about fifteen minutes, and considerable insensibility for an hour afterwards; after this had passed off mostly, the fever began to increase very rapidly, and in four hours the pulse ran into a flutter, and the respiration had increased to 76 per minute. I determined to try Veratrum viride, which I prepared at the rate of six drops fluid extract to one-half tumbler of water, repeated every hour, one teaspoonful; in three hours he was asleep, and in the morning quite comfortable and wanted to eat. Continued the medicine from one to three hours during the two following days, and has had no fever since the night in which he had the convulsions, which was decidedly epileptiform. He has made a good convalescence, and is now quite well. The particular symptoms relieved by the Veratrum viride in all the cases reported by me, were of a cerebro-spinal character. In some cases hydrocephalic symptoms were present and had existed for some time. I have no doubt of its relieving the same symptoms, arising in connexion with all other diseases, that affect spinal or cerebral, or both classes of nerves combined, which we so often meet with in warm weather. The cases reported were from children of very large, active brains. I have used the Veratrum alone in congestion and inflammation of the lungs, with very general satisfaction, my patients making speedy recoveries. I hold that in lung irritation the spinal nerves are very extensively complicated, and by using this cerebro-spinal sedative, the irritation at once begins to subside, and soon all danger is past. I have the most unlimited confidence in the use of this remedy in all diseases where the spinal nerves, as well as cerebral, are concerned. VERATRUM VIRIDE. 755 I have just relieved a case of this kind - a case of scarlatina - I tried it as an experiment; and found, in a few hours, these peculiar symptoms all gone and fast disappearing. I have found Veratrum viride to act almost specifically in cases of convulsions in which there is a tendency to opisthotonos, and the more strongly marked this symptom, the more decidedly is this remedy indicated, and the more obvious its action, whether convulsions are present or not. In one case recently, I produced a well marked proving of this, and in another a very striking aggravation, even with my usual dose, four drops tincture to half a goblet of water. Mrs. C., aged 85, nervous temperament, been a sufferer for years with cataleptic spasms of the opisthotonic variety; was relieved in a few hours of severe spasms, and has had no return for some weeks; continued the Veratrum viride once or twice a week. Considers herself cured. Four other physicians to whom I mentioned the action of this remedy have used it, and report the results very satisfactory -confirmatory of my previous statements. I here present Dr. Burt's case of Strychnia poisoning which I have referred to:Two years ago I was called to a most heart-rending case of poisoning by Strychnine in a noble little boy of six years of age. An old school physician had prescribed Strychnine sugar-coated pills, each containing I-32 of a grain, to the boy's uncle for ague. How many he ate we never could learn. When I reached him he had been in spasms two hours; the least touch of his body, the noise made in shutting the door, or the movement of his body, would bring on the most frightful spasms, lasting from one to five minutes; his arms and legs were rigid; the muscles of the chest so rigid that respiration would cease; face livid, and bloody saliva running from his mouth. I immediately gave him nearly one teaspoonful of the fluid extract of Veratrum viride, and then two drops every ten minutes. He had nine spasms the first hour, the second but two, which were the last. The Veratrum had completely relaxed his muscular system, so that he could hardly move a limb. The third day he was up and playing about the house. The wonderful action of the Veratrum in subduing those fearful tetanic spasms caused by Strychnine gave me more confidence in the remedy than I can express. The sleep-symptoms of Veratrum are quite commonly experienced in cerebral congestions. In the incipient stages of meningitis, or hydrocephalus, dreams of being on the water are not unusual. Dr. Coe says it is a " soporific," but decrees that it is not a narcotic. Drs. Tully and Ives proved to their own satisfaction, that it was possessed of narcotic properties. The Veratrum viride belongs to the group of remedies of which Aconite, Veratrum album, Gelseminum semp. v., etc., are members. The primary action of all these remedies, 756 VERATRUM VIRIDE. when given in medicinal doses, is to depress the circulation through the agency of the nervous system. With this depression there is always present coldness or coolness of the skin, warm or cold perspiration, chilliness or coldness, and, in short, all the symptoms which generally characterize the cold stage of fevers. I have not been able to find, in any of the cases of poisoning by Veratrum viride, any general reaction following this cold stage. The same may be said of the other members of this group. It is only in careful and exhaustive provings, with small and repeated doses, that we get continuous febrile symptoms. But we may properly accept this statement, namely: That it is with medicinal, as with natural diseases, a fact that a febrile reaction always follows the cold stage, if the vital powers do not prevent. Any cause capable of depressing the nervous and vascular system (primarily) will cause excitation and irritation of the same system (secondarily). The secondary (reactive) symptoms will vary in nature, symptoms and intensity, with the cause. Thus, the secondary febrile symptoms following the primary febrile symptoms of Aconite are very different from those of Gelseminum or Veratrum. In fevers, in general, Veratrum viride enjoys the confidence of a great portion of the allopathic and eclectic schools of medicine; but, like all other powerful medicines, it has its enthusiastic adherents and its bitter opposers. Some very high authorities are extravagant in their laudations of its safety, efficiency and curative power over many diseases besides fevers; at the same time, other authorities equally high, denounce it as a dangerous drug. Prof. Lee says: " The same objections will apply to it, as has been brought against Aconite, namely: The difficulty of regulating its effect, and its dangerously depressing effects, even in small doses. From what we have seen and know of its use, we have little doubt that it has caused more deaths in one year than Chloroform has since its discovery." I am sorry, for the sake of humanity, that I can agree with Prof. Lee in his estimate of its danger, but only when used in 758 VERATRUM VIRIDE. Dr. Neidhard writes: "The Veratrum viride tincture cured the following symptoms in a boy aged twelve: Headache, with afternoon fever; dry skin; tongue coated thickly yellow; very thirsty; vomiting of bile; no appetite; constipation." Intermittent fever is not controlled by any remedy of the Aconite group. They do not seem to possess the antiperiodic power which is essential. I can not subscribe to the doctrine taught in our school, that'any medicine will cure ague if indicated by the symptoms.' I practiced in a malarious district over twelve years, and my experience in the treatment of miasmatic fevers led me to adopt this conclusion, namely, that there is a certain class of remedies which possess antidotal virtues, or are capable, when introduced into the system, of antidoting the malarious poison. I believe this poison to be a specific miasm, and not a mere'correlated force,' as some teach. Not all intermittents are due to the action of this poison, and some such fevers may be cured by others than members of the China group, namely, Quinine, Nux vomica, Arsenicum, Salicine, Cornus, Eucalyptus. Veratrum viride, although not indicated for the disease itself, is often of great use in the hot stage, when the action is intense and the vascular system is excited strongly. In such cases, in adults, we may have congestion of the brain, delirium, powerful action of the heart, and a hard, rapid pulse; and, in children, severe spasms and convulsions. In these cases this remedy is superior to Aconite or Belladonna. Under its use the intensity of the paroxysm will soon subside, and the threatened convulsions be arrested. I have sometimes given one or two drops of the mothertincture every half hour, to an adult, and half as much to a child, with the happiest results. Remittent or bilious fever, when not dependent on miasmatic influences, will often be amenable to the therapeutic influence of Veratrum viride; but will have to be alternated with other remedies, like Bryonia, Mercurius, Podophyllum, or Leptandra, as the symptoms and conditions demand. When the gastric symptoms are predominant, this remedy VERATRUM VIRIDE. 759 will have to be used in smaller doses (2d or 3d dilution) than when the stomach and bowels are irritated. When this form of fever assumes the character of a pernicious remittent, the Veratrum viride must be used with extreme caution. It is still indicated, but primarily, for the primary action of the drug is to cause conditions very similar to a pernicious fever, namely, a prostration of the vital forces, with typhus symptoms, etc. My experience in such fevers has taught me that the best and safest treatment is to use Baptisia, Veratrum viride, Aconite, or Veratrum album 3d, in alternation with a remedy secondarily indicated, namely, China, Quinine, Nitric acid, etc., in material doses. Indeed, it is often necessary in those low conditions which occur during pernicious fevers, to give Quinine in five or ten grain doses, repeated, in brandy, every hour. Those who have had to combat these terrible malarious diseases, will know and appreciate the necessity of resorting, in some cases, to such doses; and those who know the least, practically, of these diseases, are they who are loudest in denouncing what they term "gross medication." In yellow fever the Veratrum has been used by the allopathic school, with alleged success. Drs. White and Ford, of Charleston, S. C., treated many cases with Veratrum viride. In the Charleston Medical Journal and Review, they give the results of their treatment. They gave from eight to ten drops to adults, and from one to six drops to children, repeated every hour or two: By the administration of the Veratrum in this manner, the pulse was sooner or later subdued, and as it sank, became somewhat irregular. The first doses were often vomited, in severe cases, but the succeeding ones were commonly retained, and the patient did not vomit again until the pulse was reduced, when the effect of the remedy was occasionally marked by emesis. This vomiting was rarely severe, ceasing of itself upon a temporary discontinuance of the medicine, or yielding readily to common restoratives, The reduction of the pulse was accompanied by notable cooling of the body, by a well marked diminution of the headaches, pain in the back and limbs, of the restlessness and anxiety, of the frequency of the respiration, of the congestion of the skin, flushing of the face, tumefaction of the tongue, and injection of the conjunctiva. The patient felt much relieved, and slept tranquilly as soon as the vomiting had ceased; nor would the symptoms tend to recur for some hours, as they would always do, it was given in small doses; if black vomit supervened, and the pulse was slow, VERATRUM VIRIDE. 761 form of typhus. I immediately put five drops of the mother tincture in a tumbler half full of water, and ordered a teaspoonful to be taken every half hour, until perspiration was produced. I called in two hours, found the pulse down to 84; the patient was in a general perspiration; she recovered without any other remedy, in two days. Case II.- Mr. H., a young man, aged eighteen, sick two weeks. Found him with a very high fever; pulse I20; face very much flushed; fullness, with slight pain, and great buzzing in the head; gnats and bugs fly before the eyes; inclined to jump out of bed; talking at random; slight, bearing down pains in the bowels, attended with black diarrhcea; great weakness of the lower extremities, with general prostration. Six drops of the mother tincture of Veratrum viride were mixed with twelve teaspoonfuls of water, a teaspoonful to be taken every half hour. In three hours found the pulse down to 95; before the day was out he was in a fine perspiration; no fever for three days; has now a slight fever, which lasts two or three hours a day; every other symptom right. There is no question in my mind but that a continuance of the pathogenetic action of Veratrum viride would result in such lesions of the intestinal canal, as results in the typhus process. Rubbed on the skin or held in the mouth, it causes erosions and vesicular eruptions, and it will probably affect similarly the whole intestinal tract. I regard it as secondarily indicated in all fevers of the synochal or inflammatory type, and even in some typhoids. The above cases have many symptoms which resemble those caused by Veratrum viride; but Baptisia, Belladonna, Phosphoric acid and Muriatic acid, are more generally indicated. I do not consider my duty to my colleagues properly performed, did I not give allopathic testimony as regards the use of this medicine in typhoids. A little truth may be gleaned from the chaff, by careful winnowing. Dr. Staples (allopath), of Dubuque, Iowa, says: Veratrum viride has been condemned in some of our eastern hospitals, in asthenic cases attended with much prostration. For instance, typhoid fever; on the ground " that we have already a weak, feeble pulse, and the Veratrum would only make it weaker." Now, any observer who has carefully observed the action of Veratrum viride, has observed that the pulse, as it was reduced in frequency, became fuller and stronger, while the fact that it causes nervous sedation should not be lost sight of. It should also be borne in mind that the views of modern investigators in reference to the agency of the nervous system in pathology and therapeutics, essentially modify the treatment of disease. It is a fact well known to pathologists, that similar phenomena often attend totally opposite conditions of the brain, for which no satisfactory explanation can be 49 762 VERATRUM VIRIDE. given. There are functional derangements, watchfulness, etc., attendant upon super-excitation of the brain, while the debility and depression of the nervous system, which explode into delirium tremens, are followed by kindred phenomena. But in either case, the continuance of the disturbance enhances the primary affection, and by so much removes the system from convalescence. Take, now, typhoid fever. True, there is a rapid, feeble pulse, but the very excitation and irritation which grow out of cerebro-spinal debility and increased vascular action, perpetuate the disturbances, augment the very debility and wear out the system by excessive friction. In this condition the secretions are locked up; the brain is oppressed, the heart and lungs are laboring to free themselves from the tension to which they were subjected. Now here is a condition in which remedies can not act. But if we can subdue this nervous exaltation, the system becomes relaxed, the secretions are restored, the circulation and respiration becomes slower, fuller and stronger; the lungs oxygenate the blood more completely, and nutrition and depuration, which had before been impossible, is allowed to go on. I have seen typhoidal cases where the morbid action had continued for weeks, with the pulse from I 10 to I30, speedily convalesce, on reducing the cardiac pulsations by Veratrum viride to 70 or 80o per minute. Dr. S. submits the following hypothesis of the action of Veratrum viride, under which it may be serviceable in cases of debility, under certain restrictions, and at the same time valuable as an antiphlogistic: The administration of Veratrum viride, carried to a limited extent, allays, by its action upon the cerebro-spinal system, nervous and circulatory excitability, and places the system in a favorable condition for recuperation; another degree produces profounder impressions by attacking the sympathetic system, which presides over secretion and nutrition, inducing sedation and constitutional depression, evinced by the rapid waste, emesis, diuresis, and diaphoresis. The testimony of the eclectic and allopathic schools as to its usefulness in low forms of fever, is about equally divided. In small doses, in the dilutions, it will undoubtedly prove useful in typhoid and other low fevers, if homceopathic to the symptoms and conditions. Finally, besides the above general indications for the use of Veratrum viride in fevers, there are two characteristic symptoms which should always be present(1.) A very hard, full, quick, bounding pulse. (Aconite has small, very quick, hard, sharp pulse; Gelseminum, a quick, full, large, but soft pulse; Baptisia, a quick, full, bounding, but easily suppressed pulse.) (2.) A tongue yellow at the sides (edges) with a red streak, wide or narrow, in the middle. (Aconite, yellow, or white VERATRUM VIRIDE. 763 all over; Gelseminum, pale red or yellowish white; Baptisia, dark red or brown.) On the muscular and fibrous tissues the Veratrum viride has an undoubted, and perhaps direct effect, similar perhaps to Bryonia, Belladonna, Colchicum, Cimicifuga, etc. In some clinical remarks upon the Veratrum viride, the late Dr. J. C. Peterson reported the cases below, illustrating its action in rheumatism: Case I.- Mr. S., aged 37, sanguine, nervous temperament, was attacked with violent rheumatic pains in the left pectoral region, and elbow of the same side. The pain was so severe that he was delirious. I gave him Veratrum viride Ist, one drop every fifteen minutes; perfect relief followed the exhibition of this drug within an hour. He fell asleep and perspired profusely. Although of a decided rheumatic diathesis, he has had no return of a similar attack. Case II.- Master F., II years of age, was attacked with violent inflammatory rheumatism of the left knee. The part was much swollen, but not discolored; impossible to move the limb on account of the agony it produced. Gave Veratrum viride tincture, one drop every half hour, until relief from the pain resulted, then a dose every three hours. In 24 hours he fully recovered, and has since remained well. Case III.- Miss P., aged 26. Was attacked with severe pain in the left knee, which prevented the use of the limb. I found her excessively nervous and with some general fever. Gave Veratrum viride tincture, one drop every hour. In a few hours complete relief followed the use of this drug. Case IV.- Mrs. H., aged 42, of a decided scrofulous diathesis, was attacked with rheumatism of the left hip and leg. The pain was severe and the limbs restless. Gave Veratrum viride tincture, a dose every two hours, one drop, which relieved her of her suffering in 48 hours. Case V.- Mrs. H., aged 40, nervous temperament and subject to dyspepsia, had severe, agonizing pains in the right shoulder, extending along the scapula and into the back of the neck. The arm was paralyzed and immovable, pulse accelerated and tense, tongue coated white. She had been in this condition for several days, with aggravation at night, so as to preclude sleep. Gave Veratrum viride tincture, one drop every hour. The effect of a few doses was to produce profuse perspirations, and to bring about relief from her sufferings. Rhus tox. was given in alternation with Veratrum viride to relieve the paralyzed condition of the arm. This case fully recovered in a few days. It will be observed that all these cases occurred upon the left side. I have been led to look upon Veratrum viride as a specific for all this form of trouble. In neuralgia I do not think it equal to Belladonna, Aconite, Spigelia, or Kalmia. Dr. J. C. Peterson expressed his opinion that, "In all 768 VERATRUM VIRIDE. Case II.-Mr. N, aged 62, employed in a glass works, called upon me on the I2th of June, I865. He had been spending a few days in the country, and had been exposed to excessive sun heat. His face was greatly swollen, and the eyelids so much puffed that he could only find his way with difficulty, and he complained of the burning and stinging pain of the face. He had applied, during the two previous days, cream and buttermilk, and had taken some aperient medicine, but without the slightest relief. As there was little constitutional disturbance I simply ordered him to use the Veratrum viride as a lotion to the face, by means of lint moistened with it. This gave relief, and I heard no more about him except directly through his son. Case III.-Miss T. D., aged nineteen, after an exposure to damp during the catamenial period, was attacked with erysipelas. I did not see her at the onset of the disease, but she had been advised to take Belladonna and Rhus alterternately, and to apply a saturnine lotion to the face. She disliked this lotion, and at last refused to use it, and gin and water was substituted by her friends. The next day I visited her; the nose, eyes and forehead were much swollen, and the scalp was very sensitive to pressure to the vertex, although it did not appear puffed. The only change suggested in the treatment was the substitution of the Veratrum viride for the other lotions. Amendment at once set in, and she was convalescent within a week, and she spoke most favorably of the effects of the Veratrum. Case IV.-Mrs. G., aged forty-six, a stout, plethoric lady, with a strongly marked gouty diathesis, was taken ill on the 2Ist of May, I865. She had been sitting on the lawn watching some friends play croquet until late in the evening; after returning to the house she had a severe rigor, followed by pungent fever and distressing, throbbing headache. I saw her next day, pulse Too, tongue coated and dry, thirst, headache, severe pain in the right leg, and complete inability to move it. Upon examining the leg, found it intensely red from the ankle to above the knee, swollen and cedematous; the skin looking as though it must burst. Low diet, Aconite A. and Belladonna A., alternately, and dressed the leg with strips of lint, moistened with Veratrum lotion, which were covered with oiled silk. In the evening the fever less severe, the headache still most intense, ordered Rhus and Belladonna, and the lotion to be continued. May 23d.-The headache most distressing, the leg looks paler, but the erysipelatous blush has extended up the back of the thigh. Lotion to be applied to these parts, to take Mercurius vivus A, gr. ij immediately, and then continue the Belladonna and Rhus. Evening, the headache is so intense she declares she must go mad if she does not get relief, and is annoyed at my expressing a wish to examine the leg, which she says is comfort ble; the erysipelas less; ordered Glonoine I, and Apis mel. B, and the lotion to be continued. May 24th.-After the first dose of Glonoine, fell asleep and slept tranquilly for two hours. Head much relieved, leg better. From this date she gradually improved, and it is not necessary to detail the daily symptoms. Several weeks elapsed before she regained sufficient strength to move about, the leg remaining so much swollen. that she could not put a stocking on. She, however, gradually improved, from day to day, and went to Weisbaden in July, for the benefit of her gouty symptoms, from which place I have received most favorable accounts of her progress. VERATRUM VIRIDE. 769 The Veratrum viride acts upon the brain similarly to Aconite and Gelseminum; yet their effects are far from identical. The therapeutic range of Veratrum over affections of the brain, is far greater than that of the latter. I know of no drug, not even Belladonna, so useful in affections of the head, when they are of a congestive character. In cerebral congestions it is immensely superior to any known drug. This assertion is made understandingly, and based upon an experience of twenty years with it. It is most useful when the congestion arises from plethora, vascular irritation, coup de soliel, alcoholic stimulants, teething in children, and especially when it occurs from suppressed discharges. When the congestion occurs from rheumatic irritation, Cimicifuga or Aconite are better indicated. The symptoms calling for Veratrum viride are: a sense of fullness; weight or distension of the head; giddiness; intense headache, with fullness and throbbing of the arteries, sometimes with stupefaction; increased sensitiveness to sound, with buzzing, roaring, etc.; double, partial, luminous, painful, dim, or otherwise disordered vision; nausea and vomiting; tingling, numbness, etc., in the limbs; mental confusion; thick speech; loss of memory; convulsions or paralysis of motion. For the congestions of the head, in young children, from teething, I have for several years given this medicine the preference over Belladonna or Aconite; also in cerebral oppression, occurring during the progress of a pneumonia. I consider it as perfectly homeopathic to these before-mentioned congestive conditions, as any other drug in our Materia Medica, for it has caused all the symptoms of such morbid states. It does not cure by depressing the vital powers, as bleeding does. Those who denounce the use of Veratrum viride in vascular irritation, fever, etc., might as well denounce Aconite and Gelseminum, for they all act in a similar manner. The increased action of the vascular system is a secondary effect of these medicines. In meningitis, the Veratrum vir. should be used' promptly, in the lowest dilutions, alternated with Belladonna, when the latter remedy seems indicated. I believe it to be more use 770 VERATRUM VIRIDE. ful in this disease, as well as cerebritis, than Aconite. In tubercular meningitis, or hydrocephalus, it can do no good, except in the stage of active inflammation, if that stage exists; but it may be palliative in preventing or arresting spasms in the later stages. Three cases occurring in my own practice will illustrate its usefulness in congestive headaches. Case I. -Five drops of Veratrum viride, one-tenth, three times a day, cured a case of habitual congestive headache, which had troubled a young and plethoric lady for over six months. She took the medicine four weeks. From having attacks every day or two, they came only once a week, and finally subsided entirely. Case II.-A young, stout and very plethoric servant girl, had intense congestive headache at each menstrual period (the menstrua were very scanty and painful.) The attacks were almost apoplectic, rendering her delirious or insensible, with dark purple redness of the face, throbbing of the carotids, epistaxis, and partial paralysis of motion, and sometimes cramps. No hysterical complication was present. After takingfive drops of Veratrum viride, one-tenth, as follows: three times a day during the inter-menstrual period, and every hour during the attack. She was much benefited, the menstrua were more abundant, and the headache slight. The second period was much more natural, with very little headache. Case III.-Intense congestive cephalalgia from suppression of the menses. Bleeding had been decided upon by another physician (an allopathist), but at my suggestion to the family, the Veratrum viride was tried. Ten drops of the one-tenth every 30 minutes, relieved her in two hours, and the menses reappeared. A plethoric gentleman of this city has attacks of intensely congestive headaches; he becomes stupid, has ringing in the ears, bloodshot eyes, thickness of speech, hot head, and a slow pulse (70) full, and hard as iron. Bromide of potassa never relieves him, but a few doses of Veratrum (2 drops 0 every half hour), always gives him relief. Most of the effects of Veratrum upon the ears and eyes arise from a depressed state of the circulation. The same condition is present as after excessive bleedings, or loss of any of the vital fluids. In high potencies it may prove useful in similar affections. But Veratrum viride causes, secondarily, congestion of the brain, with ringing of the ears. In low dilutions it is one of the best remedies for the latter condition. It is well known that anaemia and plethora will produce nearly the same array of brain symptoms, although opposite pathological states are really present. Thus, acute VERATRUM VIRIDE. 771 hydrocephalus is often simulated by the hydrocephaloid disease, which arises from sheer debility. It is primarily homceopathic to amaurosis from ancemia, or from loss of fluids, or from debility during convalescence (should be alternated with China, Phosphoric acid 1st,) and given in the 6th dilution. It is also indicated in amaurosis from irritation or congestion of the optic nerves, when the symptoms correspond with its pathogenesis. The Veratrum viride produces undoubted inflammation of the mucous membrane of the cesophagus, with superficial erosion, spasm, etc. We have here a truly homeopathic remedy for oesophagitis. It is also homceopathic to spasmodic stricture of that tube. Its action on the stomach is quite similar to that of Veratrum album, Tartar emetic, or Arsenicum. It is evidently homoeopathic to cardialgia, gastralgia, and neuralgic or spasmodic affections of the stomach, when accompanied by vomiting, retching and excessive irritation. Dr. Burt considers it the best remedy in such cases-better than the Veratrum album. He uses it at the 3rd or 6th. It should not be given lower. It should prove curative in gastritis, erosion of the stomach, and ought to palliate the pain and vomiting in cancer of the stomach. It causes all the symptoms of pyrosis, water-brash, and many of the symptoms of "dyspepsia." There is no reason why Veratrum should not be an excellent remedy in vomiting. The act of vomiting, however, should be attended by some peculiar symptoms; either (a) loss of power over the cesephagus, in which the vomiting is painless; or (b) intensely painful mucous irritation of the cesophagus, with burning, rising of bloody mucus, and very severe cramps in the stomach and spasms of the oesophagus, empty retching, etc. Like the vomiting of V. album, the slightest quantity of food or fluid is ejected, but it has not the intense thirst of that remedy. There is nothing very peculiar about the substances vomited. I consider the empty, painful retching, with ejection of a little bloody, frothy mucus, as the chief indication. 772 VERATRUM VIRIDE. The liver and portal system must be affected by this drug, as it affects other organs. By its primary effect it causes venous stasis in the portal circulation, but I have not discovered its special usefulness in this condition; nor should I consider it indicated unless the pulse were very weak and very slow. A microscopical examination of the liver of dogs killed by Veratrum showed intense capillary engorgement. In hepatitis, during the first stages, it should be a capital remedy. It will be indicated more by the absence of acute pain than its presence. It is well known, particularly since Inman called attention to the fact, that inflammation of the liver, lungs, pleura and peritoneum may occur without any of the sharp, stitching pains which are generally considered as belonging to such conditions. Veratrum, unlike Aconite and Bryonia, is not indicated by the pain, soreness, etc. The intense fever, the hard pulse, and the usual physical signs, are its best indication. Of its action on the spleen we we know very little. In the urzemia which attends the last weeks of pregnancy, and precedes convulsions, the kidneys are very torpid (acutely congested),. and the pulse becomes intensely hard. Here we shall find the Veratrum a most powerful remedy for arousing the kidneys to action, causing the elimination of urea, and lessening the dangerous arterial pressure. It is agreed by all allopathic medical writers who speak of this plant, that it irritates the bowels much less than Veratrum album. Some, however, claim that it should not be used indiseases where any intestinal irritation exists. Wood, however, does not mention it as a purgative. Dr. Coe remarks: " The employment of Veratrum viride in the treatment of diarrhoea and dysentery affords occasion for some remarks in regard to the action of this remedy upon the bowels. We have seen it stated by some writers, that Veratrum is objectionable on account of its irritating influence upon the intestines. Such has not been our experience. We have employed it much in the treatment of bowel complaints, and with the most happy results." Yet he admits that it VERATRlUM VIRIDE. 773 has an "emetocathartic " action, and says it is contra-indicated in "intestinal ulcerations." He says it is useful in all cases of "torpor and debility of the abdominal organs," and is of utility in mania, epilepsy, hysteria, convulsions, melancholy, etc., when arising from "functional obstructions of the abdominal viscera, and disturbed and discordant action the abdominal nervous plexus." All this, however, is quite conjectural, although it is apparently indicated in abdominal congestions. Dr. Norwood says, " it is not cathartic," but he speaks of " avoiding its drastic effect," and mentions that " the only cases in which we have seen it purge, were when given in combination with tartar emetic. In most of these cases it excited a violent cholera morbus." Concerning its therapeutic effects, he states: " We have found it of great value in the treatment of typhoid dysentery, and would feel unable to combat that disease without it, or some other remedy of equal power." It seems homceopathic to about the same condition of the bowels as Veratrum album; also to hemorrhoids. Its action on the kidneys has been pretty well investigated by allopathic observers. Prof. Lee says: "Its diuretic action has been established by numerous experiments. It is worthy of particular note that it does not act as a mere renal hydragogue, but like Colchicum, it increases the solid constituents of the urine. While it increases the amount of organic and inorganic solids, it is not positively established that it augments the quantity of the uric acid. Like Colchicum, it increases the amount of the urine, as well as the total amount of the solids eliminated, but it is pretty generally certain that this is mainly dependent on an increase of organic matter. Its curative influence in gout and rheumatism may thus be explained. It is said to eliminate lithic acid through the kidneys." Dr. Abbott made some experiments which proved that it causes a considerable increase in the amount, and a corresponding decrease in the specific gravity of the urine. It would seem to be homceopathic, primarily, to certain forms of diuresis, enuresis, and perhaps diabetes. It is curative in acute inflammation of the kidneys and bladder. We have yet no symptomatic proving of Veratrum viride upon the female organism. It is said to have caused abortion 774 VERATRUM VIRIDE. in numerous instances, yet Drs. Ford and White, who used it so freely in yellow fever, thought it prevented that accident. It may not cause abortion directly, as Sabina or Cimicifuga, but indirectly, by the great prostration of the general symptoms, the severe efforts to vomit, etc. In the same way it would cause haemorrhage from the uterus. It is probably homzeopathic, primarily, to passive congestions of that organ. My experience with the Veratrum viride, in this class of diseases, is confined principally to acute inflammation of the uterus, or puerperal metritis, in which I place a high estimate upon its value.' I think I have arrested the inflammation, or materially modified it, by the use of the lower dilutions. There are certain conditions attending uterine disorders, in which the Verat. v. has proved very successful in my hands. I allude to those congestions of the head or lungs which occur during uterine disorders, such as menstrual congestions of the head (menstrual headache), also congestion of the head and lungs from suppressed menses, suppressed lochia, etc. In these accidents, a few drops of the lowest dilutions has never failed to prove promptly curative in my practice. It is highly recommended by Dr. Miller (eclectic), in dysmenorrhoea, occurring in plethoric subjects (i. e., congestive dysmenorrhcea). In anmemic subjects, he pronounces it decidedly injurious. It is probably indicated in this affection, for similar symptoms to Aconite and Belladonna. Acute congestion of the uterus causes scanty menses. When this disorder is present in plethoric women, and is attended or not by congestion to the head or chest, give the medicine in drop doses of the tincture. Congestive dysmenorrhoea comes under its curative sphere. Dr. Eggert, of Indianapolis, made a brilliant cure of this condition with Veratrum v. Although a staunch partisan of the high dilutions, he used the lowest in his case with very excellent results. In acute metritis and ovaritis, attended with a high grade fever, no remedy is more efficient. It equals Apis in pelvic cellulitis; in fact, to treat a case of this grave disease suc VERATRUM VIRIDE. 775 cessfully without the two remedies, is next to impossible. They will often prevent suppuration if given in time. Puerperal peritonitis is most successfully treated (if high fever is present) with Veratrum viride and Opium (both in appreciable doses). In idiopathic orchitis, its internal administration, aided by its local application, often acts magically. If the inflammation be traumatic, alternate it with Arnica or Hamamelis; if gonorrhoeal, with Pulsatilla, Clematis or Erigeron, and Hamamelis topically. The treatment of orchitis by means of strapping is a great aid to internal remedies. The treatment of mastitis, when the breasts are very hot, hard and engorged, is most successful when Veratrum viride and Phytolacca are given alternately, and cloths wet in a lotion of Phytolacca are applied. Dr. A. C. Barton, of Toledo, writes: "For violent menstrual colic previous to the occurrence of the discharge, I use Veratrum viride tincture in drop doses, repeated every half hour or hour. It is invariably followed by a marked mitigation of suffering and the establishment of the periods. I could cite from my note book hundreds of these cases. It has been found useful in palliating violent attacks of hysterical convulsions. Many allopathic writers, among them Dr. Simpson, of Edinburgh, extol it highly in puerperal fever. It may prove useful in the vomiting, pyrosis, and other symptoms occurring during pregnancy. Many of the symptoms occurring during the change of life, are simulated by this medicine. In acute mastitis with high febrile action, and great tumefaction of the breasts I have used it alternately with Belladonna, with very satisfactory results. It has been used boldly-recklessly-by the allopathic school, in purpureal convulsions (eclampsia) as a substitute for blood-letting, but in such doses as to be nearly or quite as pernicious as the abstraction of blood. I have never used it in that affection, but I have administered it in cases where I thought convulsions would ensue if not warded off, and with the apparent result of preventing that terrible array of symptoms. In puerperal mania it has proved curative. (See a 776 VERATRUM VIRIDE. case reported by Dr. Woodward.) Dr. Atlee reports a case as follows: The labor had been preternatural, child delivered dead, by podalic version. She did well until ten days after confinement, when she became silent, suspicious, and distrustful of those about her, without any obvious cause. In the hope that the change was temporary, opium and perfect rest, with careful watching, was enjoined. Two days after, symptoms of puerperal mania were still more developed; it was impossible for the doctor to come near her, his presence seemed to terrify her, and her husband told him that since the last visit she expressed strong apprehensions that the doctor had poisoned her and meditated her destruction. She had slept little or none, and it wa* difficult to keep her confined to her bed and room. In the hope that some benefit might result by controlling the general circulation and diminishing the nervous excitement, five drops of the tincture were given every three hours, as long as it did not produce nausea, vomiting, or prostration. On the following morning, on entering the room, he found his patient lying quietly and calmly on the bed, with a total absence of the sinister expression of the day before. She answered him slowly, but in a whisper, put out her tongue, and let him feel her pulse without resistance. Upon inquiry he found that soon after the administration of the third dose of Veratrum on the previous evening, she had become calm, had rested quietly, and had remained so. Pulse fifty-six. She was cheerful and obedient, conversed rationally and freely,.and without allusion to her previously unhappy condition. She recovered perfectly in a few days. Dr. Coe states that a majority of the cases of mental aberration arise from, and are dependent upon a morbidly increased activity of the nervous structure of the abdomen. "This," he says, "would seem to explain why Veratrin is of utility in the treatment of mania, melancholy, and mental weakness." (Very doubtful.) " In cases of mental aberration, accompanied with torpor and debility of the abdominal organs, Veratrum will be found serviceable." (Mere theory.) The symptoms of Veratrum relating to the chest, consist only of "great oppression," and "heavy weight." But the physical symptoms are very important. It decreases the number of respirations to twelve or fourteen, in health. In dogs poisoned with Veratrum there was found " violent congestion of the lungs, especially the lower lobes." In cats both lungs were engorged. In the second edition of New Remedies I wrote as follows:In Dr. Burt's proving, made on himself, he makes no mention of any pains VERATRUM VIRIDE. 777 which may be termed pneumonic, or pleuritic; the pain in the heart, only, was noticed. It is a notable fact, however, that in the provings of Tartar emetic, we have the same absence of acute thoracic pain; yet the latter drug has a high reputation, even in the homoeopathic school, in the treatment of pneumonia. It is well known by all practical physicians that severe cases of pneumonia may run their course with little or no pain at any time being present. The Veratrum viride has not been extensively used by homceopathists in the'treatment of thoracic diseases. Satisfied with that time honored remedy, Aconite, they prefer to adhere to that drug. But many of my colleagues, both East and West, agree with me in considering the Veratrum viride as superior to Aconite, in pneumonia in particular. My own experience with it has so far been satisfactory. In the incipient stage of that affection, when simple engorgement only exists, I believe it has the power of arresting the disease, and in the later stages it proves a valuable auxiliary to such remedies as Bryonia, Phosphorus, Tartar emetic and Sanguinaria. I usually give the lowest dilution (ten or fifteen drops of the Ist dec.), every thirty or sixty minutes to adults, and half the quantity to children. In a few cases only have I been obliged to resort to the mother tincture. In one case, that of a strong, robust man, five drops were given every two hours; after ten hours, profuse vomiting with sweating set in; the previously intense fever subsided, and did not return, and a rapid convalescence followed. It was given on the third day of the fever, when there was bloody sputa, severe oppression and pain in the chest (left side), and all the physical signs of the first stage of pneumonia. Seven years have now elapsed since that was written, and I have had no occasion for changing my opinion. I have been criticised for asserting that Veratrum viride has the power of arresting pneumonia in the first stage. From the language of some of my critics, I do not think they are aware of what consists the first stage. One of the best authorities thus defines it as "a stage of congestion, in which the affected portion of the lung is a deep red color, crepitates under pressure, though less than in health, and when cut, exudes copiously a bloody, turbid, and somewhat frothy serum. * * If the disease be arrested in this stage the lung re-assumes the healthy appearance." Another great authority (Stokes) maintains that the congestive stage is preceded by another, " marked by intense arterial injection with dryness —in other words, a condition of irritationwhich always precedes inflammation." Now it is evident that these two conditions rarely exist separately. They must blend together in a majority of cases, and it is in these conditions - the first stage of pneumonia- that Veratrum is useful. 50 778 VERATRUM VIR1DE. What are the symptoms which attend this first stage? They are (a) more or less chilliness (although that may be wanting), (b) great heat, and oppression of the chest, with sensation of a heavy load on it; rapid, laborious breathing, with or without pain; short, dry cough, etc. I still assert that if Verat. vir. is indicated in this stage, it will arrest the disease, and rapid resolution will take place. What indicates Verat. vir.? The character of the pulse. If you find a full, hard, bounding pulse, that can not be obliterated by the pressure of the finger, give Veratrum. The pulse need not be quick. It is the hardness of the pulse, and its fullness, that calls for this remedy. If the pulse is hard, quick and small, Aconite is indicated. My experience confirms me in the opinion that the dose in such conditions should be about one-tenth of a drop every half hour, and in severe cases one or two drops, until the pulse becomes compressible. So soon as this occurs decrease the size of the dose, or suspend it altogether after a few hours — for it is only in the stage of irritative congestion that Veratrum is indicated in the low dilutions. In the second and third stages it should be used above the 3x, if at all, and in alternation with Tartar emetic, Sanguinaria, or Phosphorus. Dr. Ringer, of England, in his Therapeutics, says it is used and recommended in both sthenic and asthenic pneumonia. He specially quotes the experience of Dr. Drosch, who used it in seventy-three cases with good results -with the effect of "lessening the pulse, lowering the temperature 10 to 3~ C., quieting the breathing, changing the character of the expectoration to a light yellow color, rendering it scanty, and calming the patients." "It did not appear," he says, "to shorten the acute stage, but seemed even to lengthen it, retarding the resolution of the lung, and caused vomiting and diarrhcea." It is evident that Drosch committed the great error of all allopathists, of giving it in too large doses, and continuing its use too long. By following my directions, and substituting the proper homceopathic remedy after the first stage, rapid resolution will ensue, and the violence of the disease will be greatly modified. VERATRUM VIRIDE. 779 Drs. Patton and Lee (allopathic), of this country, give the following excellent testimony, and it is a notable fact that they decry against the large doses in use by that school. They say: Pneumonia is the disease in which Veratrum viride is particularly indicated. It seems to have more controlling power in this than any other disease, reducing the inflammation, and favoring the expectoration in a very few hours; in some instances vomiting is induced, which is generally of tough, viscid mucus; the pulse now rapidly declines, if not affected before; the breathing becomes very easy, and the patient falls into an easy sleep, with, perhaps, a gentle perspiration -the dose, now, is to be managed so as to sustain the depressed circulation. I find that in pneumonia it is better to reduce the pulse as soon as possible. The inflammation being in a degree arrested, the lung is saved from the more severe consequences of the second stage, or that of red heipatization, from the concrete fibrinous exudation being caused by a peculiar inflammatory action- thus, the cause being in part removed — this exudation is in a great degree arrested, and the patient, in a majority of cases, enters into a favorable convalescence. As to the use in asthenic cases of pneumonia, I am of the opinion that it is primarily indicated by the prostration, the feeble, oppressed pulse, the passive stasis in the lungs, and the low grade of inflammation. Verat. vir. differs from Gelseminum and Aconite in its power of causing primarily a kind of typhoid condition, in which it somewhat resembles Baptisia. It should therefore be given above the 3x, and in alternation with Phosphorus. In pleuritis it is not indicated, unless in the stage of irritative congestion. The same might be said of its value in pleuro-pneumonia. The indications which I have given for its use in pneumonia must be your guide. I have never used it in diaphragmitis, but I predict it will prove a useful remedy in that rare disease, in which it wil probably rival Cactus. Acute inflammatory diseases of the heart, at their onset, certainly call for the free use of Veratrum. Experiments have proved that it causes death by paralyzing the muscular structures of the heart, by poisoning the nerves leading to the heart, or by acting on the cardiac ganglia, in the substances of that organ. It is primarily indicated in cardiac oppression, with pas 780 VERATRUM VIRIDE. sive congestion; cardiac debility, with fainting and collapse therefrom. In those heart affections occurring during prostrating diseases, after haemorrhages, etc., it may be used, but always in the minutest doses. No remedy exercises a more depressing action on the heart than the Veratrum viride in large doses. It is secondarily indicated in increased activity of the heart, after previous depression. In carditis and pericarditis it has been used with alleged success by allopathic practitioners. In rheumatic affections of the heart it is especially lauded, but may do as much injury as bleeding, if used in large doses. Having an action similar to Aconite, it will, perhaps, be found as useful as that medicine in heart affections. It does not, however, cause that intense cardiac anxiety, with fear of death, which Aconite does. It will be found palliative in many organic diseases of the heart, but should be used with great caution. It is not a " cardiac tonic," in material doses, as Digitalis is said to be. It will alleviate, according to my experience, those palpitations attended with faintness, or dyspncea, which occur in many diseased conditions of the heart, or attend the "change of life" in women. Some of the symptoms felt by Dr. Burt resemble those found in the pathogenesis of Spigelia. It may be a matter of doubt whether the "burning sensation," experienced by Dr. Burt, was really in the heart; the aesophagus may have been the seat of the sensation. Dr. Scudder (eclectic) says that he has ascertained by actual clinical experiment, that the Veratrum viride, in small doses, is as much a " cardiac tonic " as Digitalis is in large. This effect is due to its primary homceopathicity to a weak condition of the heart, which it causes in pathogenetic doses. In all asthenic cases, when the heart's action is slow and feeble, small doses (the 3x or 6x) will rally the failing vitality in a manner similar to the Veratrum album, to which it is very closely related. The question arises-Is Verat. viride indicated in any VALERIANATE OF AMMONIA. 781 chronic structural diseases of the heart? I believe it is, and in my practice it has done me good service in hypertrophy with dilatation, used as a continuous remedy, not as a palliative. In your studies of the action of Verat. album, you will remember the statement that it has been used by soldiers and others to cause "pseudo-cardiac diseases," which so closely simulated the organic as to deceive the medical examiners. Dr. Muller gives many such cases; the disorders thus caused resembled hypertrophy with dilatation, or even valvular lesions! The ultimate primary effects of Verat. viride will cause very similar conditions, and when given in small doses (3x) alone, or alternated with Nux, Ignatia, Collinsonia or Digitalis, will do good service. It may be of service in the treatment of cardiac disorders marked by irritability from weakness. It ought to be homceopathic to those cases of cardiac failuzre, or cardiac syncope, which come on suddenly, while in apparent health. It might be tried in the 30th dil. But as such cases generally occur in hysterical subjects, Sumbul or Ignatia are probably more useful. When cardiac hypertrophy with enlargement, causes intense pressure of blood ill the head, no better remedy can be found than Verat. vir. (one or two drops of the tincture until the fever is lessened.) VALERIANATE OF AMMONIA. This medicine has not been used to any extent in our school, but allopathists value it very highly in those severe neuralgic headaches which are attended by great nervous agitation, conjoined to physical prostration. It is equally useful in prosopalgia when the pain is insupportable, the face is cold and "pale, the extremities cold, and great nervous erethism exists. Some of the Ammonia salts seem to have specific power over neuralgia. The bromide is efficacious when congestion of the head is present; the muriate when the liver is the seat of the original disorder; and the valerianate when the cranial nerves are especially involved. 782 VALERIANATE OF ZINC-VERBENA HASTATA. This salt will be found useful in certain kinds of sleeplessness, especially when it arises from emotional excitements, hysterical conditions, or excessive indulgence in the drinking of green tea or coffee. The first decimal dilution, in doses of ten drops, or a teaspoonful, is usually sufficient. The allopathists use the Elixir; each teaspoonful containing ten grains, which they give at each dose-repeating it every two or three hours. VALERIANATE OF ZINC. This salt was introduced into our school by Dr. Banks, of New York. He used it very successfully in neuralgic headaches. Its sphere is analagous to the Ammonia salt in the kind of pain it cures, but differs from it in the concomitant conditions. Zinc acts more upon the brain, inter-cranial nerves, and the membranes of the brain. It has of itself cured many terrible cases of headache, with or without delirium, and sometimes periodical. The addition of the Valerianic acid gives it greater control over the nervous agitation which often attends neuralgia. In Vol. I you will find a brief report of several typical cases of neuralgia, prosopalgia, spinal neuralgia, sciatica, angina pectoris, ovarialgia, etc. It has also been used successfully in sleeplessness; for the consequences (pains, etc.) of cerebro-spinal meningitis, and in some stages of tubercular meningitis in children (as a palliative). It is best administered in very small pills, - to i gr. of the crude, or 1 gr. of the lx or 2x coated with sugar or gelatine. VERBENA HASTATA. This plant, commonly known as Ironweed, grows profusely on the prairies and low bottom lands all over the United States. It is a popular domestic remedy for ague, especially when chronic. The root is intensely and disagreeably bitter. VERONICA BECABUNGA —VISCUM ALBUM. 780 Dr. Griffin, of New York, introduced it into our practice, in a paper read before the N.Y. State Hornm. Soc., as a remedy for the poisoning of Rhus tox. and other species of Rhus. He relied upon its' external application. If it has any specific powers over Rhus poisoning, I do not see why it should not prove curative in vesicular and erysipelatous eruptions in general. I trust you will test its value in such cases. A weak infusion is, after being strained, applied constantly to the affected skin. It should be given internally at the same time in small doses. If a distilled extract, prepared as Hamamelis is, was made officinal, I think it would be the most eligible application. I hope the whole plant will be proven soon. VERONICA BECABUNGA. We know nothing of this plant beyond a remark by the late Dr. Prentice, that he had used it successfully in stomatitis materna and the aphthous sore mouth in children. It has been considered by old authorities as anti-scorbutic. That medical archeologist, Dr. S. A. Jones, has been delving in musty and forgotten tomes, and has found therein many rare and curious bits of medical lore. His latest researches relate to the Veronica. He finds that as early as 1578 one Dodoens wrote of it as follows: " Brooklime leves dranken in wine do help strangullion and the inward scabbes of the bladder." All those old authorities recommend it against the "gravel, stone, and scurvy." It would seem that something ought to be made out of this plant, if properly proven and studied. VISCUM ALBUM. This mistletoe grows in England and on the Continent, and the parasite indigenous to the Southern United States, is supposed to be identical. In the British Journal of Homceopathy, vol. xxii, and some later journals, I find this remedy highly recommended for 784 VIBURNUM OPULUS. epilepsy, chorea, cephalalgia, vertigo, periodical neuralgia, hydrothorax, cardiac disorders (choreic?), menorrhagia, uterine spasms, sciatica (many severe cases cured), and many other nervous disorders. The author of the paper claims to have cured all the above disorders with the mother tincture and attenuations. From earliest times it had a popular reputation in epilepsy. In a recent journal I find a report of its successful use in several cases of chorea from fright. The chorea is probably spinal, for it is said that the movements continued during sleep. It seems specially indicated in violent neuralgic pains in the lower extremities, simulating sciatica, rheumatic-neuralgia and even peritonitis. It seems to be a medicine having an important range of action, but I am not aware that it has been used in this country. I have never prescribed it. In my Symptomatology you will find all the characteristic symptoms now known of this powerful medicine., VIBURNUM OPULUS. The physician who finds a remedy for any painful disorder is a public benefactor. The physician who shall find a remedy for painful menstruation, will have the blessings of thousands of suffering women. The use of Viburnum opulus, in the treatment of dysmenorrhcea, did not originate in the practice of any physician. It is a tradition in this country that the aborigines so used it among themselves, and that the secret of its use was handed down to the white people. Any way, it has been in successful use here for more than a century as a domestic remedy in many painful affections of women. It was from observation of its domestic uses that the writer gained his first knowledge of its value. I first prescribed it in the form of a weak infusion, then in drop doses of the mother tincture, and finally in the dilutions up to the VIBURNUM OPULUS. 785 3x. Its specific action often seems to manifest itself in the dilutions as well as in more material doses. I find by reference to works on botany that the V. opulus is a native of America, England and Scotland. It grows wild here, and is also cultivated in gardens. The cultivated variety is so changed in its character, that all the flowers are destitute of stamens, making it sterile. In this form it is called the Gueldres Rose, or Snowball, from the large globular or white inflorescence. In this country the wild species is called Cramp bark, one of those, felicitous names which indicates its specific action. It is also called High Cranberry, from the resemblance its berries have to those of another species of the same genus, namely, the V. oxycoccus, or common edible cranberry. Its berries are red and sour, and remain on the shrub all winter. They are eaten in this country, and ih England and Norway, and are quite palatable when stewed with sugar. For medical purposes we procure the bark of the root, shrub, and its limbs (the fresh bark is preferable), and make a tincture with alcohol of 75 or 80 per cent. This tincture should have a dark red color and a peculiar acid odor, very similar to the odor of Valerian; so closely does it resemble it, that I am quite certain a chemical analysis of the bark would detect the presence of Valerianic acid. (An eminent chemist, D. W. Chapman, of Hudson, Mich., assures me that such is the case.) In my treatment of spasmodic dysmenorrhcea, for which variety this remedy is specifically indicated, I prescribe the 0 tincture, or lx to 3x dil., a few drops three times a day for a week previous to the expected period. When the pains set in, give it every hour, or every fifteen minutes if the pains are severe. It is equally useful for the severe false pains preceding normal labor, and which often render the woman's life a torture for weeks. It is of great value for after-pains, and a dose should be given after every pain. Cramps in the abdomen and legs of pregnant women are controlled very quickly by it. It will prevent miscarriage, if given before the membranes are injured, and when the pains 786 VIBURNUM OPULUS. are spasmodic or threatening. I have not tested it sufficiently in spasmodic affections of other organs, but predict that it will prove useful in spasmodic conditions of all hollow muscular organs and their muscular connections. Nor have I decided whether it acts on the muscular tissues directly or indirectly through the motor nerves. It may prove to be a spinal remedy after all. I have used the Viburnum in many cases of neuralgic and spasmodic dysmenorrhoea, and have yet to meet with a single case where it has failed to cure. So confident have I been in its almost marvelous powers, that I have-taken pains to look up some old cases that I had dismissed years ago as incurable, in order to test this new remedy on them. In every instance, so far, it has cured. these old, obstinate cases. Its sphere of action seems to cover nearly the same grounds as galvanism. In the N. A. Journal of Homceopathy, 1874, Dr. Neftel has a valuable paper illustrating the curative power of galvanism in dysmenorrhcea. He gives many illustrative cases, and, singularly enough, they all resemble the cases I have cured with the Viburnum. I use the 1st dec. dil., or 0 tincture. Since I published my first account of the value of Viburnum opulus, I have received letters from many physicians corroborative of my experience. In some cases the testimony extends the sphere of action to more serious maladies. One physician reports a case of membranous dysmenorrhoea cured by giving this medicine through two months. If this shall be verified, we have now four remedies for that painful condition, namely: Borax, Guiacum, Ustilago and Viburnum. It remains to be seen whether the V. prunifolium will be equally valuable. Dr. Foote, of Galesburg, Ill., has had favorable results from its use. Dr. Ruddock, of England, writes me that since the appearance of my paper on the use of Viburnum, which appeared in the Homoeopathic World, he has learned of its successful use in dysmenorrhoea, in the practice of many English physicians. His own experience with it leads him to recom VIBURNUM PRUNIFOLIUM. 787 mend it in irritable ovaries, spasmodic contraction of the cervix uteri, and several other painful menstrual troubles. I shall not be surprised if it is found useful in heart cramp, which is the real condition, in angina pectoris, also, perhaps, in spasmodic laryngitis. VIBURNUM PRUNIFOLIUM. This species appears to possess some of the properties of the V. opulus, but is probably not identical in its powers. It is said that it does not contain the Valerianic acid found in the latter species. I am not sure of this, for I prepared a tincture from the Black Haw bark, or what was sold as the V. prunifolium, and it has the Valerianic acid odor. In vol. vi, p. 129, of the North American Journal of Homoeopathy, were reported, by Dr. E. P. Fowler, two cases of Cancer of the Tongue. These were undoubtedly cases of malignant disease of the tongue. They were cured by the use of a decoction of the bark, used topically. I have used the tincture in threatened premature labor or miscarriage, dysmenorrhoea, and various spasmodic uterine pains, with good results. Dr. Phares, of Alabama (allopathist), who has used the Viburnum prunifolium very extensively, writes of his experience as follows: It is nervine, antispasmodic, tonic, astringent, diuretic, and may be used to very good purpose in urinary affections, ophthalmia, aphthous sore mouth chronic diarrhcea, dysentery, indolent ulcers, etc. It is an excellent remedy in colic, cramp, spasms, palpitation, and other affections incident to pregnancy, or arising from uterine disorder, and for after-pains. But it is particularly valuaable in preventing abortion and miscarriage, whether habitual or otherwise; whether threatened from accidental cause or criminal drugging. It tones up the system, preventing or removing those harassing nervous symptoms that so often torment, wear down and disqualify the pregnant woman for the parturient effort. It enables the system to resist the deleterious influences of drugs so often used for the purpose of procuring abortion. It is well known that the inner bark of the cotton root is used by many to induce miscarriage, one pint of the strong decoction being sufficient for this purpose. The regular exhibition of the Viburnum completely neutralizes the effect of the Gossip'um, compelling the delinquent mother, however unwilling, to carry the foetus VIBURNUM PRUNIFOLIUM. 789 August following, before day, she was alarmed by the escape of liquor amnii, and I saw her early in the morning. As there was no pain, contractions or other indications of labor, I left her. This was a small leak, and she informed me that labor had been brought on in a previous pregnancy by a similar leak. About dark of the next day, forty hours after the flow commenced, I again saw her, and at ii P.M. delivered her of a healthy eight-months child, which still survives. Case IV.- January 25, I866, Mrs. L, eighteen months married, had miscarried last year, in consequence of which she had suffered long and much, now pregnant and threatened with abortion. I ordered tincture Viburnum f 3j thrice a day; oftener if necessary. She went on well till the Ioth of April, when she was severely injured by a fall from her carriage. Strong uterine contractions ensued, but were arrested by the medicine, which had to be used freely for several days, gradually diminishing the quantity per diem. For nearly a week abortion was threatened whenever the use of the Viburnum was too long omitted. From this time she went on to full term without further accident, and was delivered of a large boy. Case V.-January 25, i866, Mrs. H, married in I862, has had no children, but an abortion or two, now pregnant, and threatened with abortion at the usual stage with her. I gave her tincture Viburnum, with directions to use pro re nata. March 4, summoned again to see her. I find she has had considerable pains, contractions, and discharges for two days. She had taken the medicine as ordered, and was now up, easy, and the discharge a slight oozing merely. Ordered the medicine discontinued for the present. She had to use it again a month later, and from that time continued well, and at full term gave birth to a healthy child. Case VI.-July II, i866, Mrs. J-, six or seven months pregnant, has had labor pains increasing in frequency and force for over thirty hours. I ordered tincture Viburnum every hour, or as often as needed, till pains cease. Labor was soon arrested, and no further trouble has occurred. Case VII.- Mrs. P-, April I6, 1866, has had severe colic, after noon, several days. Tincture viburnum f 3 iss was ordered, and the single dose was all required. Many cases might be cited, but the above handful will suffice as well as a thousand. There will be cases and conditions, of course, in which no intelligent practitioner would attempt to prevent abortion by the use of Viburnum, or any other means: as where the placenta is extensively detached, the membranes ruptured, the foetus partly expelled from the uterine cavity, etc. I have heretofore, for some years past, made known the use of this valuable agent, in conversations with members of the profession, as well as by letter. Its value as a medicine is so well ascertained as to justify a lengthy article in print, and its general use by the medical profession. The bark may be gathered at any time, but is best, perhaps, gathered in October and November. When practicable, I have preferred obtaining it from trees in open, exposed situations. Situation materially affects the qualities of plants. A plant, for instance, which gathered on the level of New Orleans is inert, gathered here is probably the best remedy in the world for tetanus; of which, more a.lother time. 796 XANTHOXYLLUM. Within a few years, and since the above was written, several physicians, especially Dr. Williams, of Joliet, claim to have used it with almost marvellous effect in dysmenorrhcea; others, physicians of close observation, have carefully followed the dose and repetition, recommended by Williams, and failed to cure. This failure in the hands of some, and success in others, can not be accounted for, except on the theory that it was not affiliated properly. It appears to me that Xanthoxyllum is only indicated in dysmenorrhcea where the neuralgic element predominates. It is well known that what one physician considers a congestive, another would consider neuralgic. Again, it is well known that a remedy which will relieve a neuralgia at one time, will fail at another. Unless a medicine corresponds to the primary cause of a neuralgia, it is only a palliative. I have often relieved a neuralgic dysmenorrhcea completely with Xanthoxyllum, Viburnum, or Iodoform, and there would be perfect immunity from pain, for three periods, under the use of the remedy. But, very strangely, at the fourth period the old sufferings would come back! I would have to select some other remedy and would meet with the same results. I have also known similar alleviations to occur from change of climate. Some women always have dysmenorrhcea while they remain in Chicago, but are free from suffering when in New York or Boston. Others I have known whose experience is just the reverse. In Volume I, will be found a brief narration of several cases of amenorrhcea, of long standing, cured by the use of the 1x. They were all chlorotic, and suffered with ovarian pains. I have cured several presenting similar symptoms. Other physicians report adversely of its curative power in such cases. (I prefer the tincture of the berries.) Dr. Massey, of England, has perhaps hit upon a key-note for its use. He says it is indicated in dysmenorrhcea, when severe pains follow the course of the crural nerve. I would advise it in sciatica and crural neuralgia, and also rheumatalgia, when occurring in patients having a sluggish circulation. INDEX OF REMEDIES. PAGE. PAGE. ABIES Canadensis, - - 9 Ceanothus Virginiana, 120 Acalypha Indica, - - 9 Cerasus Virginiana, - 121 YEsculus Hippocastanum, 10 Cedron, - 123,Esculus glabra, - - - 14 Chelidonium majus, - - 132 Ailantus glandulosa, - - 14 Chelone glabra, - 145 Aletris farinosa, - - - - 17 Chloral hydrate, - - - - 146 Alnus rubra, - - - - 18 Croton chloral, - - - - 158 Ampelopsis quinquefolia, - - 18 Chimaphila umbellata, - - 159 Amyl, Nitrite of - - - 19 Chionanthus Virginica, - - 160 Apocynum androsemifolium, - - 31 Cimicifuga racemosa, - - 161 Apocynum Cannabinum, - 32 Cistus Canadensis, - 181 Apomorphia, - - - 35 Coca, - 183 Arctium Lappa, - - 39 Coccus cacti (vol. i), - 221 Aralia racemosa, - - - 39 Codeine, - - - - 185 Aranea diadema, - - 41 Collinsonia Canadensis, - - 185 Arsenite of copper, - - 44 Cucurbita pepo semen, 189 Arseniate of iron, - - 45 Cyanuret of mercury, - - 192 Arseniate of quinia, - - 45 Cyanuret of potassium, 193 Arum triphyllum, - - 47 Cypripedium pubescens, - - 196 Asarum Canadense, - - 48 Cotyledon umbilicus, - 199 Asclepias incarnata, - - 49 Cundurangu, - - - 199 Asclepias Syriaca, - - 49 Cosmoline, - - 202 Asclepias tuberosa, - - 51 Clematis Virginica, - - 204 Atropine, 53 Comocladia dentata, - - 204 Cornus Florida, - 206 BADIAGA, - - - - 56 Cornus circinata, - 206 Balsamum Peruvianum, - - - 57 Corydalis Formosa, - - 207 Baptisia tinctoria, - - - 59 Barosma crenata, - 66 DI-ITAINE, - 66- 208 Bellis perennis, - - - 67 Dioscorea villosa, - 213 Benzoate of ammonia, - - - 67 Doryphora decem-liniata, - 219 Bismuth, - - - - 68 Bisulphide of carbon, - - - 70 E thites heiracifolius, - 220 Erecthites heiracifolius, - - - 220 Bromides, The ~ 72 Bromide of ammonium, - - - 74 Erigeron Canadense, - 221 Bromide of ammonium, - - -74 Equisetum hyemale, - - 223 Bromide of calcium, - - - 77 Bromide of camphor, - - - 79 Ergotin,224 Bromide of iron, - - - 81 Eryngium aquaticum, - - - 228 Bromide of lithiunm, - - - 81 Eucalyptus globulus (vol. i), - 284 Bromide of mercury,- - - 82 Euonymus atropurpureus, - - 230 Bromide of potassium, - - -82 Eupatoriu aromaticum, - 231 Bromide of quinia, - - - 92 Eupatorium perfoliatum, - - 231 Bromide of sodium, - - - 92 Eupatorium purpureum, - - 235 Bufo, - - - - - 92 Euphorbia corollata, - - - 237 Euphorbia hypericifolia, - - 237 CACTUS grandiflorus,. - 93 Calabar bean, - 97 FAGOPYRUMr esculentum, - - - 239 Caffiene, - -100 Ferrocyanuret of potassium, - 240 Canchalagua, - 102 Formica, - - 243 Cannabis Indica, - 102 Carbolic acid, - 107 GALLIC acid, - 243 Carduus Marice, - 114 Galium aparine, - - 246 Castanea vesca, 117 Gelseminum sempervirens, - - 250 Caulophyllum thalictroides, - 118 Geranium maculatum. - - - 262 798 INDEX OF REMEDIES. PAGE. PAGE. Gnaphalium polycephalum, - 271 PAULLINIA sorbilis, - 483 Gossipium herbaceum, - - 272 Passiflora incarnata, 488 Gymnocladus Canadensis, - - 273 Pepsin, -490 Guaco, - 275 Pancreatine, - - 493 Guaroea trichloides, - - 276 Phosphide of zinc, - 493 Phytolacca decandra, 495 HAMAXELIS Virginica, - - - 276 Hala Sviriia, 2760 Podophyllum peltatum, 516 Hecla lava, - 90 Plantago major, - - - 559 Hedeoma pulegioides, - - - 291 lantago major - 559 Hedoma plgioid,2913 Polygonum punctatum, 561 Helonias dioica, - -293 Hepnica dioia, 29305 Protosulphide of mercury, 563 Hepatica triloba,.... 805 Heprastic tlan i, -3058 Pulsatilla Nuttalliana, - 566 Hydrastis Canadensis, 308 Ptelea trifoliata, - — 581 Hydrophyllum virginianum, 332 P rii, 58 Picric acid, - -— 583 Hypophosphites, The - 333 Populus tremuloides, 591 Hypophosphite of lime, 334 Polyporus o~ficinalis, - — 596 Hypophosphite of potassa, - 336 Polyporus ini, 59 Polyporus pinicola, 599 IBERIS amara, - - - - 338 QUNA,599 QUINIA, -..599 Iodide of arsenic, - - - 341 Iodide of baryta, - - - 343 RHUS glabrum, - - - 615 Iodide of lead, - - - 345 Rhus venenata, - - - - 619 Iodide of sulphur, - - - 346 Ricinus communis, - - - 622 Iodide of ammonium, - - 346 Robinia pseudo-acacia, - - 634 Iodide of cadmium, - - - 347 Rumex crispus, - - - 635 Ilex opaca, - - - - 347 Iris versicolor, - - - - 348 Sa~cGUINARIA Canadensis, 648 Ilex opaca, 347 ~~SAWGUINARIA Canadensis, - -648 Santonine. - - - - 669 JUGLANS cinerea, - - - 361 Scutellaria lateriflora, - - - 672 Juniperus communis, - - - 366 Senecio aureus, - - - 677 Sarracenia purpurea, - - - 684 HINO, ~~~~~~368 Kaolin,-369 Stillingia sylvatica, - - 693 Strychnia, - 696 LAPIS alba, - - - - 369 Sticta pulmonaria, - - 709 Lachnanthes tinctoria, - - 370 Sempervivum tectorum, 711 Leptandra virginica, - - 371 Silphium laciniatum, - - 712 Lilium Tigrinum, - - - 389 Solanum nigrum, - 714 Lycopus Virginicus, - - 398 Sulphate of nickel, - 715 Lithium carbonicum, - - - 413 Sumbul, -715 Lobelia cerulea, - - - 415 Lobelia laflata, - - - -416 TANACETUM vulgare, - - 717 Tarantula. - - - - 719 MITCHELLA repens, - - 430 Theridion curassavicum, - - 719 Mygale lasiodora, - - - 431 Thasplum aureum, - - - 720 Myrica cerifera, - - - 432 Thlaspi bursa pastoris, - - 720 Myosotis symphitifolia, - - 437 Trillium pendulum, - - - 721 Myrtus communis, - - - 440 Trifolium pratense, - - - 725 NABULUS serpentarla, - - - 441 Trifolium repens, - 726 Trlfolium repens, - — 726 Naja~n tripudiran, - - - Naa tripudians, - 441 Triosteum perfoliatum, - - 727 Naja tripudians, ~441 Nitrate of uranium, - - - 442 URTICA urens, - - - - 727 Nuphar lutea, - - - 444 Ustilago maydis, 728 Nymphcea odorata, - - - 447 VERATRUM viride, - - - 785 (EqOTaHERA biennis, - -448 Ete biennis, - - -4489 Valerianate of ammonia, - - 780 (Enanthe crocata, - — 449 enmanthcatau, - - 453 Valerianate of zinc, - - - 782 Oleum santalum, - - - 453 Oleum santm, - - - 40 Verbena hastata, - - - 782 Oleum cajuputi, - - - - 460 Oleum cajup,- - - 460 Veronica Becabunga, - - - 783 Oleum ricinus, - - - 463 Viscumu album, -— 783 Oleum jecoris aselli, - - - 464 Vium lu, 78 Viburnum opulus, - — 784 Opuntia vulgaris, - - - 481 Viburnum 78 Oxalate of cerium, - - - 481 Viburnum prunifollu, 787 Origanum vulgare, - - 483 XANTHOXYLLUM fraxineum, - 790 INDEX TO THERAPEUTICS. ABSCEss, axillary. Arctlum lappa, 89 Amenorrhoea. Eupatorium purp., 236 Cistus, 182 Gossipium, 273 inguinal. Badlaga, 56 Hedeoma, 291 Cistus, 182 Helonias, 294 Oleum jecoris, 470 Oleum jecoris, 465 Phytolacca, 495 Oleum cajuputi, 460 Mercurius protosul., 538 Podophyllum, 543 pulmonary. Balsam Peru, 58 Polygonum, 563 Hypophos. lime, 334 Pulsatilla Nutt., 578 Oleum jecoris, 470 Ricinus, 633 Myrtus com., 543 Sanguinaria, 661 mammary. Phytolacca, 497 Senecio, 680 scrofulous. Cistus, 182 Tanacetum, 718 Iodide of arsenic, 872 Ustilago, 730 Lapis alb., 390 Veratrum viride, 780 Oleum jecoris, 470 Angina (sore throat). Arum try., 48 Abortion. Vide Miscarriage. Asculus hip., 10 Acne. Arctium lappa, 39 Baptisia, 61 Bromide of potash, 91 Doryphora, 219 Iodide of sulphur, 346 Gymnocladus, 274 Pulsatilla Nutt., 539 Hamamelis, 281 Adiposis. Bromide of ammon., 109 Hydrastis, 320 Phytolacca, 503 Lachnanthes, 370 Albuminuria. Cyanuret of merc., 193 Lithium, 414 Eupatorium purp., 298 Phytolacca, 516 Equisetum, 223 Podophyllum, 524 Gallic acid, 244 Pulsatilla Nutt., 577 Helonlas, 297 Sanguinaria, 656 Nitrate of uranium, 442 maligna. Ailantus, 16 Phytolacca, 510 Baptisia, 61 Ricinus, 629 Carbolic acid, 147 Alopecia. Ustilago, 730 Cyanuret of merc., 192 Amblyopia. Bromide of potassa, 85 Solanum, 714 Chelidonium, 136 Angina pectoris. AEsculus hip., 10 Cimicifuga, 169 Amyl nitrite, 22 Calabar, 134 Arsenite of copper, 44 Gelseminum, 257 Bromide of potassa, 80 Lachnanthes, 370 Cactus, 94 Lilium tig., 396 Chloral, 146 Quinia, 612 Cimicifuga, 161 Santonine, 671 Dioscorea, 217 Strychnia, 705 Lobelia inf., 430 Solanum, 714 Naja, 441 Theridion, 620 Scutellaria, 675 Veratrum viride, 771 Zinc. val., 782 Amenorrllcea. Aletris, 17 Viburnum op. (?), 787 Apocynum cann., 35 Aneurisms. Eucalyptus, vol. i, 284 Asclepias inc., 49 Lycopus, 398 Asclepias syr., 64 Anus, fissure of. AEsculus hip., 11 Asarum can., 58 Hydrastis, 324 Caulophyllum, 163 Phytolacca, 505 Cimicifuga, 170 fistula of. Hypophos. lime, 334 800 INDEX TO THERAPEUTICS. Anus, fistula of. Phytolacca, 505 Bladder, catarrh of. Galium, 247 Anmemia. Aletris, 17 Hydrastis, 308 Arsenite of iron, 45 Mitchella, 431 Bromide of iron, 81 Oleum santalum, 460 Ferro cy. of pot., 241 Populus, 593 Helonias, 294 Santonine, 672 Hydrastis, 324 Senecio, 677 Kali hypophos., 337 Silphium, 712 Oleuml jecoris, 464 inflammation of. Vide Cystitis. Pulsatilla Nutt., 566 paralysis of. Gelseminum, 259 Solanum, 714 Strychnia, 726 Aphasia. Bromide of potash, 83 Brain. Vide Cerebral. Aphthae. Vide also Stomatitis. Boils. Vide Furunculi. Carbolic acid, 109 Bronchitis. Ailantus, 16 Eucalyptus, vol. i, 284 Aralia, 39 Eupatorium arom., 231 Asclepias tub., 51 Oleum ricinus, 463 Balsam of Peru, 57 Populus, 594 Cactus. 93 Rhus glabra, 617 Eupatorium purp., 230 Veronica, 783 Iberis, 340 Aphonia. Arum try, 47 Lobelia inf., 416 Eryngium, 228 Rumex, 635 Iod. of arsen., 342 Sanguinaria, 663 Rumex, 645 Senecio, 683 Rhus glabra, 114 Sticta, 709 Stillingia, 696 Stillingia, 696 Apoplexy. The Bromides, 75 to 90 Bright's disease. Apocynum can., 33 Cactus, 93, Chelidonium (?), 140 Cyanide of potash, 194 Cyanuret of merc., 193 Gelseminum, 256 Iod. of arsen., 343 Guaco, 276 Nitrate of Uranium, 442 Phosphide of zinc, 493 Phytolacca, 570 Sanguinaria, 654 Bruises. Bellis, 67 Solanum, 714 Collinsonia, 189 Veratrum viride, 770 Erigeron, 223 Asthenopia. Gelseminum, 257 Bubo. Vide Abscesses. Strychnia, 696 Burns. Nitrate of Uranium, 442 Asthma. Amyl nitrite, 23 Plantago, 559 Aralia, 40 Rhus ven., 619 Atropia, 53 Urtica, 727 Bromide of potassa, 90 CALCULI, cystic. Epigeea, 219 Caffeine, 101 Cannasffeine, 101 6renal. Epigsea, 219 Cannabis ind., 106 Equisetu, 223 Equisetun, 223 Eupatorium purp., 236 Coca, 184 ~~~~Coca, ~184 ~Galium, 246 Lobelia inf., 425 Cancer. Carbolic acid (?), 107 Naja, 441 Chimaphila (?), 199 t~hus glabrum, 617 ~Cusdurangu (?), 199 Strychnia, 707 Galium (?), 246 Sticta, 709 Guaco (?), 275 Silphium, 712 Hecla lava (?), 290 Sumbul, 716 Veratrum viride, 780 Hydrastis (?), 318 of Millar. Bromide of potassa, 90 mp en. (?), 43 Lapis (?), 369 Nymphcea (?), 447 Lobelia inf., 427 Phytolacca (?), 501 cardiac. Cactus, 94 Trifolium (?), 726 Trifolium (?), 726 CDigitalnine, 208 6Viburnum prun. (?), 787 Ieisgitaln, 3408 Carbuncle. Phytolacca, 498 Sumbuls, 71540~ ~Theridion, 719 Cardialgia. Vide Gastralgia. BLADDER, catarrh of. Balsam of Peru, 57 Carditis. Asclepias tub., 51 Barosma, 66 Cactus, 93 Chimaphilla, 160 Cimicifuga, 261 Collinsonia, 186 Naja, 441 Erigeron, 222 Veratrum viride, 764 INDEX TO THERAPEUTICS. 805 Dysmenorrhoea, spasmodic. Dysuria. Mitchella, 431 Tanacetum, 718 Populus, 593 Viburnum opulus, 785 Santonine, 671 congestive. Esculus hip., 13 Tanacetum, 718 Bromide of ammol:, 76 Urtica, 728 Collinsonia, 186 Dysentery. Ailantus, 16 Cimicifuga. 171 Asclepias tub., 52 Eupatorium purp., 236 Cistus, 182 Hedeoma, 291 Cornus circin., 207 Helonias, 301 Dioscorea, 216 Juniperus, 367 Doryphora, 219 Lilium, 392 Erecthites, 221 Pulsatilla Nutt., 578 Ergotin, 228 Sanguinaria, 662 Euphorbia cor., 237 Senecio, 681 Euphorbia hyper., 239 Tanacetum, 718 Gelseminum, 259 Ustilago, 730 Geranium, 263 Veratrum viride, 774 Guaraea, 276 pseudo-membranous. Ustilago, 731 Hamamelis, 283 Viburnum op., 786 Iris, 359 Dyspepsia. Abies canadensis, 9 Kino, 368 Aletris, 17 Leptandra, 382 Baptisia, 62 Nabulus, 441 Bismuth, 68 Oleum ricinus, 463 Calabar, 99 Phytolacca, 510 Cannabis Ind., 105 Podophyllum, 537 Carbolic acid, 110 Plantago, 561 Cerasus, 122 Polyporus off., 598 Cedron, 125 Rhus glabrum, 616 Chelidonium, 141 Ricinus, 625 Chelone, 145 Sanguinaria, 660 Coca, 184 Senecio, 677 Helonias, 294 Trilium, 722 Hydrastis, 321 Triosteum, 727 Iris, 355 Urtica, 728 Lithium, 413 Veratrum viride, 772 Lobelia inf., 425 Xanthoxyllum, 794 Myrica, 436 malignant. Ailantus, 16 Oleum cajuputi, 461 Baptisia, 61 Pepsin, 491 Cyanuret of mere., 193 Pancreatin, 493 Podophyllum, 546 ECLAMPSIA. Amyl nitrite, 27 Pulsatilla Nutt., 577 Bromide of potassa, 90 Ptelea, 581 Chloral, 146 Popul.us, 592 Gelseminum, 260 Robinia, 634 Enteritis. Ailantus, 16 Rumex, 639 Iris, 359 Sanguinaria, 658 Phytolacca, 509 Strychnia, 726 Ricinus, 627 Triosteum, 727 Senicio, 677 Dysuria. Apocynum cann., 33 Mere. proto sul., 563 Arctium lappa, 39 Enteralgia. Atropine, 55 Barosma, 66 Bromide of potassa, 87 Cannabis Ind., 105 Dioscorea, 213 Cedron, 121 Iris, 359 Coccus cacti, vol. i, 221 Polygonum 556 Chimaphila, 160 Endocarditis. Cimicifuga, 180 Doryphora, 219 Naja, 441 Epigsea, 219 Epistaxis. Erecthites, 220 Erigeron, 222 Erigeron, 222 Equisetum, 223 Hamamelis, 280 Eupatorium purp., 236 Sanguinaria, 654 Galium, 247 Senecio, 720 Gelseminum, 259 Thlaspi, 654 Hamamelis, 285 Trilium, 722 Lithium, 414 Epilepsy. Amyl nitrite, 24 INDEX TO TMHRAPEUT1CS. 807 Fever, malarial. Gelseminum, 255 Glands, scrofulous enlargement. Quinia, 604 Chimaphila, 159 puerperal. Baptisia, 59 Cistus, 181 Cimicifuga, 161 Iod. baryta, 345 Eucalyptus, (?) Iod. cadmium, 347 Gelseminum, 255 Iod. lead, 345 Erigeron, 221 Juglans, 366 Oleum Cajuputi, 460 Oleum jecoris, 464 Solanum, 714 Phytolacca, 503 Veratrum viride, 758 Stillingia, 693 remittent. Cornus flor., 206 Gastralgia. Atropine, 55 Eupatorium perf., 232 Amyl nitrite, 19 Gelseminum, 254 Bismuth, 68 Podophyllum, 522 Codeine, 185 Santonine. 672 Dioscorea, 216 Veratruin viride, 758 Iris, 356 scarlet. Vide Scarlatina. Lobelia inf., 416 typhoid. Ailantus, 15 Ptelea, 581 Atropine, 55 ~ Rumex, 640 Baptisia, 59 Strychnia, 726 Iris, 349 Veratrum viride, 771 Lachnanthes, 370 Gastritis. Arsen iod., 341 Leptandra, 389 Carbolic acid, 107 Oleum Cajuputi, 461 Iris, 356 Podophyllum, 523 Phytolacca, 509 Protosulphide mere., 563 Sanguinaria, 656 Rhus ven., 619 Veratrum viride, 771 Scutellaria, 673 Gravel. Vide Calculi. Solanum, 714 Gall stones. Amyl nitrite, 15 Sumbul, 717 Carduus, 115 Triosteum, 727 Chelidonium, 137 Veratrum viride, 760 Chloral, 151 Xanthoxyllum, 791 Dioscorea, 216 eruptive. Ailantus, 15 Lobelia inf., 424 Aruin try., 47 Podophyllum, 533 Gelseminum, 255 Gleet. Doryphora, 219 Juglans, 361 Erecthites, 221 Lachnanthes, 370 Erigeron, 222 Gymnocladus, 283 Eryngium aq., 230 Comocladia, 204 Equisetum, 220 Solanum, 714 Hedeoma, 292 Sarracenia, 684 Hydrastis, 326 Rhus ven., 619 Oleum santalum, 459 Urtica, 727 Populus, 594 Veratrum viride, 755 Silphium, 712 Xanthoxyllum, 791 Senecio, 680 yellow. Chelidoniuln, 132 Stillingia, 696 Gelseminum, 255 Glossitis. Arum try., 48 Picric acid (?), 587 Cyanuret of potash, 193 Veratrum viride, 759 Doryphora, 219 Furuncull. Aretium lappa, 39 Glottis, cedema of. Arum try., 48 Bellis, 67 spasms of. Arsen. of Copper, 44'Bromide of potassa, 91 Bromide of potassium, 90 Carbolic acid, 107 Gelseminum, 258 Cistus, 182 Gonorrhcea. Asclepias inc., 49 Hamamelis, 276 Asclepias Syr., 50 Phytolacca, 505 Barosma, 66 Rhus ven., 619 Cannabis Ind.. 102 Sempervivum, 711 Carbolic acid, 107 Fistula lachrymalis. Phytolacca, 505 Doryphora, 219 Pulsatilla Nutt. (?), 568 Erecthites, 221 Erigeron, 222 Eryngium, 230 GLANDS, scrofulous enlargem't, Ailantus, 15 Equisetum, 223 Alnus, 18 Gelseminum, 260 Badiaga, 56 Hedeoma, 292 Calcis hypophos., 335 Hydrastis, 326 808 INDEX TO THERAPEUTICS. Gonorrhoea. OIleum Santalum, 458 Hay fever. Aralia, 40 Senecio, 680 Carbolic acid, 107 Stillingia, 696 Chloral, 149 Silphium, 712 Gelseminum, 253 Sumbul, 716 lod. arsen., 341 Gout. Apocynum andro., 321 Sticta, 729 Benzoate of ammon., 67 Headache. (Escuilus hip., 12 Bromide of lithium, 81 Chelidonium, 135 Eupatorium perf., 231 Cornus cir., 207 Iberis, 340 Eupatorium perf., 234 Lithium, carb., 414 Helonias, 296 Podophyllum, 552 Iris, 349 Veratrum viride, 735 Leptandra, 387 Goitre. Iod. baryta, 345 Podophyllum, 528 Urtica, 728 Ptelea, 581 Phytolacca (?) 495 Triosteum, 727 Podophyllum (?) 523 congestive. Asclepias Syr., 49 Atropia, 55 H12EMATURIA. Chimaphila, 160 The Bromides,'75 to 90 Coccus cacti, vol. i, 221 Cactus, 93 Erigeron, 222 Cannabis Ind., 103 Erecthites, 221 Cedron, 125 Equisetum, 225 Chelidonium, 132 Eryngium, 229 Ergotin, 226 Gallic acid, 244 Gelseminum, 256 Hamamelis, 285 Hamamelis, 276 Senecio, 684 Iod. of ammon., 346 Thlaspi, 720 Lachnanthes, 370 Trillium, 722 Lilium, 394 Urtica, 728 Nickel sulph., 715 Haematemesis. Erigeron, (?) 221 (Enanthe, 449 Eryngium, 229 Phosphide of zinc, 493 Hamamelis, 282 Quinia, 599 Nitrate of uranium, 443 Santonine, 671 Sanguinaria, 652 Solanum, 714 Trillium, 720 Uranium nitrate, 442 Hoemorrhage, from bowels. Erigeron, 221 Veratrum viride, 7,70 Hamamelis, 282 Viscum, 784 Trillium, 722 catarrhal. Cimicifuga, 161 HMemoptysis. Acalypha, 10 Gelseminum, 256 Apocynum cann., 35 Hydrastis, 308 Cactus, 93 Iod. arsen., 341 Carduus, 115 Pulsatilla Nutt., 566 Collinsonia, 187 Senecio, 677 Ergotine, 223 Sanguinaria, 648 Erigeron, 222 Sticta, 709 Erecthites, 221 h.emorrhoidal. (Esculus, 12 Hamamelis, 288 Collinsonia, 185 Juniperus, 367 Hamamelis, 276 Lycopus, 399 Podophyllum, 528 Sanguinaria, 664 menstrual. Asclepias Syr., 49 Senecio, 683 The Bromides, 75 to 90 Trillium, 722 Cactus, 93 Veratrum viride, 745 Cimicifuga, 161 Hsemorrhage. Vide Uterine. Gelseminum, 256 Hoemorrhoids. _Esculus hip., 10 Pulsatilla Nutt., 566 AEsculus Glabra, 14 Senecio, 677 Badiaga, 57 Sanguinaria, 682 Collinsonia, 186 Veratrumrn viride, 770 Cyanuret of merc., 192 myalgic. Aletris, 17 Dioscorea, 217 Cimicifuga, 161 Eryngium aq., 230 Hydrastis, 308 Hamamelis, 282 Strychnia, 696 Hydrastis, 308 neuralgic. Asclepias Syr., 50 Phytolacca, 510 Atropia, 55 Podophyllum, 539 Caffeine, 101 INDEX TO THERAPEUTICS. 809 Headache, neuralgic. Cannabis Ind., 103 Heart, functional disorders of. Chelidonium, 135 Cannabis Ind., 107 Cimicifuga, 161 Cerasus, 122 Cypripedium, 197 Cedron, 128 Dioscorea, 216 Chelidonium, 141 Ferro-cy. pot., 241 Chloral, 154 Gelseminum, 256 Cimicifuga, 180 Gnaphalium, 271 Coca, 184 Iris, 349 Collinsonia, 185 Naja, 441 Cyanuret of potassa, 196 Nitrate of Uranium, 443 Digitaline, 212 Nickel sulph., 715 Ferro-cy. of potassa, 241 Oleum Cajuputi, 460 Gelseminum, 256 Paullinia, 484 Iberis, 338 Pulsatilla Nutt., 576 Lilium, 395 Quinia, 599 Lycopus, 403 Scutellaria, 670 Mlygale, 431 Sticta, 709 Naja, 441 Strychnia, 705 Paullinia, 484 Solanum, 714 Podophyllum, 544 Thaspium, 720 Rumex, 648 Zinc val., 781 Scutellaria, 675 Val. Ammon., 782 Stillingia, 696 Vlscum, 784 Strychnia, 707 rheumatic. Asclepias Syr., Sumbul. 716 Apocynum andro., 31 Tanacetum, 718 Cimicifuga, 161 Tarantula, 719 Cactus, 103 Theridion, 720 Formica, 243 Veratrum viride, 780 Lithium, 43 Viscum, 784 Phytolacca, 495 debility of. Amyl nitrite, 25 Pulsatilla Nutt., 576 Cerasus, 107 Rhus ven., 619 Collinsonia, 180 Triosteum, 727 Digitaline, 196 periodic. Atropia, 53 Ferro-cy. potassa, 212 Cedron, 125 Gelseminum, 241 Chelidonium, 135 Lycopus, 411 Cyanuret of potassa, 195 Veratrum viride, 780 Gelseminum, 256 paralysis of. Amyl nitrite (p), 25 Polyporus off., 598 Cactus (s), 93 Quinia, 613 Calabar (p), 97 Nickel sulph., 715 Carbolic acid (p), 113 Sanguinaria, 682 Chloral (p), 154 Strychnia, 706 Cyanuret of mere. (p), 193 Viscum, 784 Cyanuret of potash (p), 194 Zinc val., 781 Digitaline (s), 213 "sick-headaclle.,' Amyl nitrite, 25 Gelseminum (p), 261 Caffeine, 101 Iberis (p), 338 Chelidonium, f35 Lobelia inf. (p), 430 Eupatorium perf., 234 Naja (p), 441 Iris, 349 Veratrum viride (p), 780 Lilium, 394 chorea of. Arsenite of copper, 44 Paullinia, 484 Calabar, 97 Podophyllum, 528 Cimicifuga, 180 Pulsatilla Nutt., 576 Lilium, 395 Robinia, 634 Mygale, 431 Sticta, 702 Tarantula, 719 Thaspium, 720 Veratrum viride, 780 Heart, functional disorders of. Viscum, 784 Amy] nitrite, 25 spasms of. Amyl nitrite, 31 AEsculus hip., 12 Cactus, 93 Arsenite of copper, 44 Calabar (s), 97 Badiaga, 57 Chloral, 154 Bromide of potassa, 89 Lilium, 395 Cactus, 93 Veratrum viride, 780 Caffeine, 101 irritable. The Bromides, 75 to 90 INDEX TO THERAPEUTICS. 811 Influenza. Senecio, 677 Labor, rigid os-uteri. Caulophyllum, 120 Sticta, 729 Cimicifuga, 173 Silphium, 713 Gelseminum (s), 260 Thaspium, 720 Lobelia inf., (s) 429 Veratrum viride, 775 pains, false. Aletris, 17 Indigestion. Vide Dyspepsia. Aralia, 17 Insomnia. Vide Sleeplessness. Cimicifuga, 173 Impotence. The Bromides, 75 to 90 Ergotine (p), 272 Cannabis Ind., 135 Gelseminum, 257 Chloral, 146 Gossipium, 272 Digitaline, 213 Mitchella, 431 Dioscorea, 318 Ustilago (p), 728 Eryngiumn mar., 230 Viburnum op., 785 Eupatorium purp., 236 Viburnum prun., 787 Gelseminum, 250 deficient. Aralia, 39 Helonias, 260 Cannabis Ind. (s), 106 The Hypophosphites, 304 Caulophyllum, 118 Nuphar, 444 Cimicifuga, 173 Phosphide of zinc, 494 Ergotine, 225 Picric acid, 583 Eupatorium purp., 236 Strychnia, 726 Gelseminum, 260 Sumbul, 715 Gossipium, 273 Insanity. Vide also Delirium. Guaraea, 276 The Bromides, 75 to 60.Quinia, 615 Cannabis Ind., 103 spasmodic. Cannabis Ind. (p), 106 Chloral, 148 Caulophyllum, (p) 118 Cimicifuga, 162 Chloral, (s) 152 Coca, 183 Cimicifuga, 173 Doryphora, 219 Ergotine (p), 006 Lilium, 394 Gelseminum (s), 260 Lachnanthes, 370 Ustilago, (p) 728 Oleum jecoris, 476 Viburnum prun., 787 Solanum, 714 hsemorrhage, after. Caulophyllum, 120 Sumbul, 715 Digitaline, 208 Thaspium, 720 Erigeron, 222 Tarantula, 719 Ergotine, 225 Zinc phos., 493 Ustilago, 728 Zinc val., 782 Laryngitis, acute. Atropia, 53 Iritis. Bromide of merc., 82 Cedron, 128 Iod. arsen., 341 Iod. of arsen., 341'Ischuria. Vide Urine. Lachnanthes, 370 Naja, 441 JAUNDICE. Benzoate of ammonia, 68 Phytolacca, 495 Carduus, 114 Rumex, 635 Chelidonium, 114 Sanguinaria, 665 Chelone, 133 Silphium, 712 Chionantlius, 145 Sticta, 709 Cornus cer., 161 Stillingia, 696 Hydrastis, 207 chronic..Esculus hip., 10 Iberis, 338 Carbolic acid, 112 Leptandra, 374 Cedron, 128 Myrica, 435 Iod. of arsen., 341 Podophyllum, 532 Oleum jecoris, 864 Ptelea, 582 Phytolacca, 506 Populus, 592 Sanguinaria, 648 Polyporus, 596 Silphium, 712 Ricinus, 629 Sticta, 709 Stillingia, 696 LABOR, premature. Caulophyllum, 119 Laryngismus. Vide Asthma of Millar. Cimicifuga, 173 Leucorrhcea. AEsculus hip., 13 Tanacetum, 718 Aralia, 46 Ustilago, 731 Baptisia, 61 Viburnum op., 785 Carbolic acid, 111 Viburnum prun., 787 Cedron, 127 rigid os-uteri. Amyl Nitrite (?), 19 Cimicifuga, 171 Atropine, 53 Hamamelis, 286 INDEX TO THERAPEUTICS. 813 Menses, profuse. Senecio, 680 Miscarriage, results of. Cimicifuga, 176 Thlaspi, 720 Hedeoma, 291 Trillium, 721 Helonias, 301 Ustilago (s), 734 Senecio, 681 too soon (frequent). Erigeron, 222 Tanacetum, 718 Ergotine, 224 Trillium, 723 Iod. arsen., 342 Ustilago, 731 Senecio, 680 Milk, effects of loss of. Kali hypo., 337 Thlaspi, 720 suppression of. Aumpelopsis, 19 Trillium, 721 Ricinus, 631 Ustilago, 734 Urtica, 728 too late (delaying). Cimicifuga, 170 Morbus coxarius. Vide Hip-joint disease. Calcis hypo., 334 Myalgia. Aletris, 17 Mitchella, 431 Caulophyllum, 118 Pulsatilla Nutt., 578 Cimicifuga, 161 Senecio, 680 Hydrastis, 308 Thlaspi, 720 Kali hypophos., 336 vicarious. Hamamelis, 285 Ptelea, 581 Senecio, 680 Quinia, 599 Trillium, 721 Strychnia, 696 irregular. Pulsatilla Nutt., 580 Myelitis. Calabar (?), 97 Quinia, 599 Cannabis Ind. (?), 102 Senecio, 680 Ergotin (?), 224 suppressed. Vide Amenorrhcea. Strychnia, 703 Melancholy. Bromide of potassa, 83 Veratrum viride, 735 Cactus, 93 Cannabis Ind., 103 NEURALGIA. Amyl nitrite, 29 Carduus, 115 Arsenite of quinia, 46 Cimicifuga, 162 Atropine, 53 Cypripedium, 198 Bi-sulph. carb., 72 Helonias, 296 Cedron, 125 Lobelia cer., 415 Codeine, 1851 Phosphide of zinc, 493 Cyanide of pot., 195 Pulsatilla Nutt., 680 Ergotin, 228 Strychnia, 727 Ferro-cy. of pot., 241 Veratrum viride, 776 Gelsemionum, 250 Marasmus. Calcis hypo., 336 Iris, 350 Kali hypo., 336 Oleum jecoris, 476 Iod. of arsen., 343 Paullinia, 485 Miscarriage, prevention of. Asarum, 49 Passiflora (?), 488 Aletris, 17 Phytolacca, 515 Asclepias syr., 50 Sulphate of nickel, 715 Baptisia, 63 Theridion, 719 Caulophyllum, 119 Thaspium, 720 Cimicifuga, 175 Zinc. val., 781 Eupatorium purp., 246 Ammon. val., 782 Ergotin, 224 Viscum, 784 Gossipium, 272 Xanthoxyllum, 796 Hedeomna, 291 ovarian. Vide Uterine. Helonias, 301 intermittent. Arsen. of quinia, 46 Sanguinaria, 662 Chelidonium, 152 Tanacetum, 718 Gelseminuui, 250 Trillium, 723 Polyporus off., 598 Ustilago, 731 Quinia, 613 Viburnum op.. 784 of the eyes. Atropine, 53 Viburnum prun., 787 Cedron, 123 habitual. Aletris, 17 Arsen. of quinia, 45 Caulophyllum, 119 Cimicifuga, 161 Gossipium, 272 Gelseminum, 250 Helonias, 301 Solanum, 714 Tanacetum, 718 Thaspium, 720 Ustilago, 731 Theridion, 719 Viburnum prun., 787 Nephralgia. Atropine, 55 results of. Asarum, 49 The Bromides, 75 to 90 Aletris, 17 Caffeine, 101 Baptisia, 63 Cannabis Ind., 103 INDEX TO THERAPEUTICS. 815 Paralysis. Cannabis Ind., 105 Prosopalgia. Paullinia, 483 Gelseminum, 253 Strychnia, 705 Guaco, 276 Sulphate of nickel, 715 Guarvea, 276 Zinc val., 781 Strychnia. 703 Val. Ammon., 782 agitans. Bromide of potassa, 92 periodic. Chelidonium, 135 Calabar, 97 Cyanide of potassa, 195 Cannabis Ind., 105 Gelseminum, 250 Oleum jecoris, 476 Polyporus off., 598 haemiplegia. Oleum cajuputi, 460 Quinia, 613 Rhus ven. (?). 619 Strychnia, 705 Sanguinaria, 648 Prostate gland; diseases of. Barosma, 66 Xanthoxyllum, 791 Chlimaphila, 160 paraplegia..Esculus hip., 10 Iod. of baryta, 345 AEsculus glabrum, 14 Populus, 591 Cannabis ind., 107 Senecio, 680 Caulophyllum, 120 Pruritus. Carbolic acid, 111 Ergotin, 226 Chloral, 155 Hedeoma, 292 Collinsonia, 180 Picric acid (s), 585 Hamamelis, 286 Strychnia, 703 Psoriasis. Vide Eruptions. Pericarditis. Asclepias tub., 51 Ptyalsm. Carbolic acid, 107 Cactus, 93 Helonias, 293 Cimicifuga, 170 Cyanuret of merc., 192 Veratrum viride, 780 Cyanuret of potassa, 195 Periostitis. Corydalis (?), 290 Hydrastis, 320 Hecla lava (?), 290 Iris, 354 Ilex, 348 Podophyllum, 524 Phytolacca, 499 Trifolium repens. 726 Stillingia, 693 Xanthoxyllum, 790 Peritonitis. Ricinus (?), 627 Puerperal mania. The Bromides, 75 to 90 Asclepias tub. (?), 51 Chloral, 148 Cimicfuga, 161 Cimicifuga, 177, 163 Erigeron (?), 221 Solanum, 714 Oleum cajuputi (?), 460 Veratrum viride, 776 Solanum (?), 714 Pulse, in fever, of. Aconite, Gelseminum, Veratrum viride, 745 Baptisia and Veratrumn viride, 254 Phlebitis. Hamamelis, 276 Purpura hTemorrhagica. Erigeron (?), 221 Phthisis, Hypophosphites, 334 Chloral, 146 Myosotis, 440 Hamamelis (?), 276 M- rtus, 440 Ptelea, 581 Oleum jecoris, 467 Pyrosis. Cerasus, 122 Sanguinaria, 662 Cornus flor., 206 Pleuritis. Asclepias tub,, 51 Gallic acid, 243. Carduus, 116 Podoph., 516 Veratrum viride, 777 Strychnia, 696 Pleurodynia. Asclepias tub., 51 Cimicifuga, 179 RACHITIS. Oleum jecoris, 470 Dioscorea, 218 Calcis hypophos., 334 Kali hypo. 337 Rectum, stricture of. AEsculus hip., 11 Pneumonia. Cheidonium, 140 Bromide of potassa, 88 Myosotis (?), 439 Phytolacca, 495 Sanguinaria, 662 prolapsus. AEsculus hip., 11 Veratrum viride, 777 Erygium aq., 230 Polypi, nasal. Sanguinaria, 655 Podophyllum, 537 rectal. Bromide of potassa, 88 Strychnia, 705 Sanguinaria, 652 ulceration of. Hydrastis, 324 uterine. Sanguinaria, 652 Iod. of arsen., 342 Prosopalgia. Cedron, 125 Phytolacca, 505 Croton chloral, 158 Podophyllum, 537 Cimicifuga, 170 Rheumatism. Apocynum andro., 32 Cyanuret of potassa, 195 Asclepias syr., 50 Ergotin, 224 Asclepias tub., 51 Ferro-cy. of potassa, 241 Benzoate of amm., 67 Gnaphalium, 271 Bi-sulph. carb., Iris, 348 Bromide of lithium, 81 816 INDEX TO THERAPEUTICS. Rheumatism. Cactus, 95 Sleeplessness. Chloral, 147 Caulophyllum, 120 Cimicifuga, 162 Ciniicifuga, 166 Coca, 185 Comocladia, 205 Cypripedium, 197 Eryngium (?), 222 Eupatorium arom., 231 Formica, 243 Ferro-cy. of pot., 240 Gelseminum, 262 Phosphide of zinc, 494 Hamamelis, 290 Pulsatilla Nutt., 580 Iberis, 340 Scutellaria, 675 Iris, 351 Sumbul, 716 Lithium, 414 Zinc val., 781 Oleum jecoris, 468 Val. Ammon., 782 Paullinia, 485 Spasms. 2Esculus glabra, 14 Phytolacca, 499 Ailantus, 15 Podophyllum, 552 Amyl nitrite, 24 Pulsatilla Nutt., 578 Atropine, 56 Ptelea, 581 Calabar, 99 Quinia, 614 Cimicifuga, 164 Sanguinaria, 651 Gelseminum, 250 Sticta, 710 CEnanthe, 454 Triosteum, 727 Solanum, 714 Urtica, 728 Tanacetum, 718 Veratrum viride, 763 Tarantula, 719 Rubeola. Arum try., 47 Veratrum viride, 743 Aralia, 39 Viscum, 784 Ailantus, 14 infantile. Bromide of camph., 79 Gelseminum, 250 Caffeine, 101 Pulsatilla Nutt., 566 Chloral, 153 Sticta, 79 Gelseminum, 253 Veratrum viride, 745 Guareea, 276 Passiflora, 489 SCARLATINA. Ailantus, 15 Solanum, 714 Arum try., 48 Veratrum viride, 748 Chloral (?), 146 Viscum, 784 Solanum, 714 puerperal. Chloral, 153 Verat. viride, 766 The Bromides, 75 to 90 malignant. Ailantus, 15 Gelseminum, 253 Arum try., 48 Lobelia inf.. 429 Carbolic acid, 112 Solanum, 714 Cyanuret of merc., 193 Veratrum virde, 750 Cytod. of arsen., 342 1Somnambulism. Bromide of pot., 84 Iod. of arsen., 342 Chloral (?), 158 Veratrum viride 766 Veratrum viride 766 Sore throat. Vide Angina. Sciatica. _Esculus hip., 13 Bromide of camph., 80 Bi-sulph. of carbon, 72 Bromide of iron, 81 Bromide of iron, 81 Dioscoreal, 2716 Digitaline, 213 ~Gnaplslalium, 271 ~Dioscorea, 218 Lobelia cer., 415 Eryngium, 230 Paullinia, 485 Formica, 243 Phytolacca, 501 Gelseminum, 260 Zinc val., 781 Hydrastis, 327 Viscum, 784 Hydrastis, 327 Xanthoxyllum, 796 Origaum, 483 Scrofulosis. Badiaga, 57 Picric aid, 83 Picric acid, 583 Cistus can., 181 Strychnia, 726 Calcis hypo., 335 Sumbul, 716 Oleum jecoris, 466 stilago, 730 Phytolacca, 504 Scurvy. Agave (?) Spine, curvature of. Esculus hip., 12 Carbolic acid (?) 107 Calcis hypo., 334 Rhus glabrum, 616 Hecla lava (?), 290 Rhus gl~Rumex, 636 Spinal Irritation. Atropine, 53 Rumex, 636 Sleeplessness. Bromide of ammon., 77 Cedron, 128 Bromide of calcium, 77 Cimicifga, 161 Caffeine, 101 Dioscor 218 Cannabis Ind., 107 Guaco, 275 INDEX TO THERAPEUTICS. 817 Spinial irritation. Kali hypo., 337 Tremors, mercurial. Oleum jecoris, 476 Oleum jecoris, 476 Phosphide of zinc, 493 exhaustion. Hypophosphites, 333 Tinea capitis. Arctium lappa, 39 Oleum jecoris, 476 Iris ver., 348 Phosphide of zinc, 493 Phytolacca, 498 Picric acid, 590 Tinnitis aurium. Cedron, 125 Strychnia, 726 Chelidonium, 136 Spleen, enlargement. Aranea, 42 Quinine, 612 Ceanothus, 121 Tonsils, hypertrophy. Iod. baryta, 345 Quinia, 599 Oleum jecoris, 476 Sterility. Aletris, 17 Tonsillitis. Ailantus, 16 Cimicifuga, 175 Arum try., 48 Eupatorium purp., 236 Phytolacca, 505 Gossipium, 273 Toothache. Vide Odontalgia. Helonias, 304 Tumors. Iod. baryta, 345 Ustilago, 731 Phytolacca, 514 Stomatitis (sore mouth). Baptisia, 61 Ustilago, 730 Carbolic acid. 107 malignant. Iod. of arsen., 343 Cornus circin., 207 Lapis, 369 Eupatorium arom., 231 Phytolacca, 514 Hydrastis, 319 of bones. Vide Nodes. Iris, 254 ovarian. Bromide of potassa, 89 Myrica, 436 Lilium. 389 Phytolacca, 505 Phytolacca, 514 Podophyllum, 525 Ustilago, 730 Sanguinaria, 656 uterine. Bromide of Potassa, 89 Veronica, 783 Ergotin, 228 Stomach, ulceration of. Iod. of arsen. (?) Phytolacca, 514 Arsenite of copper (?). Ustilago, 730 Nitrate of uranium, 443 mammary. Chimaphila, 160 Sun stroke. Amyl nitrite (?). Hydrastis, 320 Gelseminum (?) 250 Iod. baryta, 345 Scutellaria (?) 672 Phytolacca, 514 Veratrum viride, 674 epigastric. Hydrastis, 322 Syncope. Amyl nitrite, 23 tongue. Galium, 249 Digitaline, 213 Viburnum prun., 787 Syphilis. Corydalis, 208 Tuberculosis. Bi-sulph. carb., 72 Guaco, 276 Hypophosphites, 334 Hecla lava, 290 Lycopus, 349 Hydrastis, 320 Myrtus, 440 Merc. protosul., 563 Oleum jecoris, 467 Phytolacca, 488 Sarracenia, 685 Stillingia, 693 mesenterica. Kali hypo., 336 Oleum jecoris, 470 T.ENIA (tape worm). Ctucurbita, 190 Tympanites. Erigeron, 222 Felix masc, 191 Hedeoma, 292 Kousso, 191 Oleum cajuputi, 461 Kaineela, 191 Podophyllum, 549 Tabes mesenterica. Vide Tuberculosis. Xanthoxyllum, 792 Testicles. Vide Orchitis, and Orchialgia. ULCERS. Ailantus, 16 Tetanus. Amyl nitrite, 23 Aranea, 42 Atropine, 56 Balsam of Peru, 59 Bromide of potassa, 92 Baptisia, 61 Calabar, 99 Carbolic acid, 109 Caffeine, 100 Cundurango, 200 Chloral, 156 Comocladia, 205 Gelseminum (s), 253 Guaco, 276 Guar-ea, 276 Hydrastis, 315 Passiflora, 488 Hecla lava (?) 290 Phytolacca, 501 Iod. of arsen., 343 Strychnia, 700 Lapis, 369 Veratrum viride, 751 Oleum jecoris, 470 Tremors. Cannabis Ind., 102 Phytolacca, 498 Cimicifuga, 164 Sanguinaria, 652 Oleum jecoris, 476 Sempervivum, 711 Scutellaria, 673 Stillingia, 693 53 INDEX TO THERAPEUTICS. 819 Vomiting of pregnancy. Pepsin, 491 Worm affections. Apocynum cann., 32 Strychnia, 726 Plantago, 560 Theridion, 719 Santonine. 670 WHOOPING-CouGH. Amyl nitrite, 23 Sumbul, 716 Atropine, 55 Tanacetum, 718 Bromide.of Potassa, 89 Whitlow. Bellis (?), 67 Bromide of Ammon., 75 Dioscorea, (?), 213 Carbolic acid, 112 Plantago, (?), 559 Castanea, 117 Lapis, (?) 359 Coccus cacti, vol. 1, 221 Ustilago (?), 728 Sticta, 710 Trifolium, 729 YELLOW FEVER. Vide Fevers.