SCROFULOUS AFFECTIONS
AND
THE ADVANTAGES OF THEIR TREATMENT ACCORDING
TO THE PRINCIPLES AND EXPERIENCES OF
HOMCEOPATHY.
DESCRIBED AND DEMONSTRATED BY NUMEROUS
EXAMPLES OF SUCCESSFUL CURES.
BY
DR. H.:GOULLON,
OF WEIMAR.
TRANSLATED FROM THE GERMAN
BY
EMIL TIETZE, M.D.
"A misunderstanding only can place the essence of Homceopathy in small doses."
B. HIRSCHEL.
BOERICKE & TAFEL.
NEW YORK:              PHILADELPHIA:
NO. 145 GRAND STREET.      NO. 635 ARCH STREET.



Entered according to Act of Congress, in the year 1872,
BY BOERICKE & TAFEL,
In the Office of the Librarian of Congress, at Washington, D. C.
SHERMAN & CO.. PRINTERS.



"ALLOPATHS content themselves but too often with a removal of the jeripheric phenomena, while the essence of the disease, the living centre, as it
were, from which the most various phenomena issue, remains unmoved in
all its force, or is transposed to a locality still more dangerous.
-"The Homceopath, on the other hand, after a careful search for the peripheric morbid phenomena, endeavors to pierce the centre of the disease
itself, and destroy it by a remedy homceopathically corresponding to it.,, J. BAMBERGER."






PREFACE.
ON superficial consideration it might appear superfluous to write
upon a subject sufficiently dwelt upon by the most different authors
in homceopathic literature; to speak at length of a disease, to recognize which, in many cases, is no difficult matter for laymen, even.
For here the question is not as to the establishment of a diagnosis
by means of laborious and minute microscopical experiments, or as
to researches for repugnant animal or vegetable parasites; on the
contrary, scrofulosis moves among the crowd of mortals unveiled,
clumsily and openly, impressing a seal upon its victims easily to
be recognized.
Though the fear of this momentous dyscrasia is not so strong
and intense, as that of its near relative, tuberculosis; yet the verdict
of the physician, " your child is scrofulous," does nevertheless, not
unfrequently occasion great anxiety. And it will afford much consolation to parents to know that their child may be freed from its
evil by gentle means.
This gentle liberation, however, can take place only by the application of the homzeopathic method of healing, and just here the
advantages and invaluable blessings of the new doctrine stand out
prominently.
In view of the enormous spread of scrofulosis, it is of the greatest
importance to state those advantages, as well as to uncover, without fear or favor, the shortcomings, not to say crimes, of the old
antiscrofulous method of treatment, and to acquaint the attending
physician with the new remedies in a comprehensible and practical
manner.  To write a monograph on scrofulosis in this sense,
from the standpoint of humanity, so to say, as well as of science,
is probably not without merit. It may be that Prof. Leo's notorious and ominous word of " the scrofulous plebs " will gradually die
out, and be forgotten, if only the mild, rational method of curing
gains ground over the erroneous one favoring both degenerations,
and increase of the evil. Then, the uninvited and obtrusive guest
will certainly have to shorten his visits, and the inmates of: huts



vi                        PREFACE.
and palaces alike fare much better. The panic fear of parents, as
well as of children, at mentioning the words "scrofula," and " antiscrofulous treatment," may be removed, and changed into hopeful
confidence.
Although there is no scarcity of reports of homneopathic cures
of scrofula and its many species, these reports, nevertheless, are
scattered, and mostly forgotten; they are, likewise, of unequal
value, and not all equally commendable for imitation. For the
purpose of obtaining homceopathic antiscrofulosa of real worth, we
will, hence, let pass in critical review those reports of cures from
the first date of their appearance to the present day, and recommend only what has proved itself of practical value.
There are self-evidently, as we have stated above, complications
of scrofulosis with other constitutional anomalies which, however,
cannot be regarded here; since the doctrine of genuine scrofulosis
itself presents to us a complete literature of its own. Moreover,
the prlincipal momentum of the whole treatise will have to be placed
in that portion of it pertaining to therapeutics. For, of what good
to the reader are hypotheses, however ingenious; what help does it
afford him, for instance, to be told that, according to Arlt, photophobia, blepharospasmnus, watering of the eyes in scrofulous ophthalmia (pustular ophthalmia) are said to be but the results of reflex-action which- the irritation of the sensitive branches of the n.
trigeminus exerts upon the ciliary, lachrymal and facial nerves;
would he not prefer to know, rather, that homeopathy possesses
remedies by which it masters these reflex-phenomelna together with
their original source, and what they are? Thus the possibility of
a quick and useful application of the material presented, must be
the leading tendency. Besides, no great importance is to be placed
upon the principle of classifying the various scrofula-forms, if only
none of them are forgotten that can be easily recognized, and thus
are well-fixed on account of their sufficiently characteristic phenomena.
It appears most convenient and practical, probably, to observe,
as I shall attempt to do in the following pages, a physiologicoanatomical order. Before, however, the general consideration regarding the origin and essence of scrofulosis, may find a place
here.



CONTENTS.
PA1qE,
PREFACE,.........                V
I. GENERAL PATHOLOGY OF SCROFULOSIS,..        17
DYSCRASIE RELATED TO SCROFULA,....  36
A. lTuberculosis,.......  36
B. Syphilis,........  38
C. Sycosis,........  41
D. Rhachitis,........  43
II. SPECIAL FORMS OF SCROFULA,....  46
A. Cutaneous System,.....  46
B. Muco-membranous System,..                 60
I. Organs of Sense,.....  60
II. Organs of Respiration,....  79
III. Organs of Digestion,....  84
C. Glandular System......  85
D. Scrofulous Affections of Bones and Joints,.  91
III. MOST APPROVED REMEDIES AGAINST SCROFULA,.. 104
RsvUME OF CURES REPORTED,..... 251



18              ON SCROFULOUS AFFECTIONS.
have to support life by potatoes, and other vegetable diet,
fall victims to this dyscrasia, as well as do the pets of fortune, and were they of royal blood, even.*
And sea-baths, an atmosphere loaded with the most precious perfumes; tender game, extracts of the most strengthening kind; mineral springs most carefully selected; amusements and entertainments the most exhilarating, are not
always able to arrest the progressing decline. And less so if
scrofulosis appears as a hereditary evil; or if unsuitable marriages are contracted among near relatives; for, from such
unions, forbidden as they were, by the most ancient legislation for reasons, undoubtedly, more philosophical than religious, arise the dispositions to mental disease, tuberculosis
and scrofulosis.
Bazin says: The scrofulous have "something in excess,"
" quelque chose d'excessif." They are either too tall or too
small; too bright or too dull; too fleshy or too lean; too
pink or too pale; have either too craving an appetite, or none
at all; are either too amorous or too cold. Unjustly, probably,
Jousset calls this characteristic picture: "Un tableau ou la
fantasie a sa bonne part."
But, as I have just mentioned, not only marriages among
near relatives favor the development of scrofula, but also the
descent from a scrofulous father or mother; in short, hereditability; or there is, as we are wont to express it, an organic
predisposition to the disease in question. Many families exhibit the taint through many generations, as Schoenlein has
proven of the Bourbons in France, and the Salis family in
Switzerland. In fact, not only scrofulosis as such is inherited,
but also its special form, e. g., a scrofulous affection of the
organ of hearing, in a similar manner as mental disease, in
general, and in a special form (e. g., as melancholy ending in
* In England scrofula is singularly called " king's evil;" because since the
time of Edward the Confessor, the gift of healing it has been attributed to the
kings of England. In Holland it is called Klieren, Kropzweeren; in France,
ecrouettes, skrophules. The Greek spoke of Xotp66ec, from Xoipoc, the hog;
on account of the similarity existing between scrofula and a disease peculiar
to hogs. Finally, the Romans, on account of the roundness of the swelling,
which is one of its most characteristic phenomena, used the term struma, and
designated by this word the whole dyscrasia. So Celsus in his time. The
term proper, scrofula, is derived from skropha (ypo/af&i), the sow.



GENERAL PATHOLOGY OF SCROFULOSIS.           19
suicide), not rarely transplants itself hereditarily from one individual to another. With regard to the question, whether
scrofulosis be communicated by the father or mother, Cullen
says that the children obtain the constitution of that parent
whom they resemble, hence, of the one who took the leading
part in the act of generation. Frequently we find the children of one marriage scrofulous; the father marries a second
time, and now begets entirely healthy children; the same
takes place sometimes when women marry other men. All
that makes generation abnormal favors scrofula; hence, weakness of the parents, in general, and of the sexual capacity,
particularly. Thus onanists or fathers who formerly had
healthy children, but had sexual intercourse while convalescent from a severe sickness, beget scrofulous children. It
seems self-evident, almost, that influences favoring the development of scrofula, generally, if they affect the mother during
pregnancy, or while nursing, indirectly carry -the disease to
the fcetus or infant.
Among these influences belongs also the return of the
menses while nursing, or continued nursing during a new
pregnancy.
Whether Lalouette is right when he says in his Traite des
Scrophules, that the offspring of a conception having taken
place during menstruation, comes to the world with scrofula,
is questionable without any reliable, comprehensive, and statistic proof.
Even as regards the predisposition of the female sex the
views differ.
According to Lepelletier, the scrofulous affections of the
female sex compared to those of the male appear in the proportion of 5 to 3; according to Doepp of 4 to 1. Although
there is a great distance, no doubt, between the lymphatic
temperament, represented by woman, as it were, and the
scrofulous state; phthisis, glandular swellings, scirrhous degenerations, in short, diseases in the texture of the tissues
mentioned, nevertheless occur oftener in females than in
males.
However, let us not be prevented by the above statements
from answering the question: wherein consists the essence of
scrofula; particularly as most will agree, on closer considera



20             ON SCROFULOUS AFFECTIONS.
tion, that only one answer call be given; for we must say:
scrofulosis is that dyscrasia which always aims at the formation of purulent exudations.  Pyonosos (Vereiterungssucht)
we could call it very fittingly, perhaps. There certainly exists,
from the very beginning, a wrong proportion in the physiological mixture of the sanguineous elements, similar to that
of the rheumatic, syphilitic, and other diatheses; forthwith
the power dwelling within every living organism tries to rid
it of the defective, pathological blood-elements, though this
may refer, pathologically, to the quantitative proportion only
between the parts constituting the blood. An excretion takes
place, or there appear several peripheric deposits. The contest becomes localized. We witness in this the same centrifugal force which, after an infection with dissecting-poison or
variola-poison, at once takes measures to reflect the disease
upon the surface. Indeed, the common eruptions of measles
and scarlatina, even, may be mentioned as analogies.*  The
scrofulous localizations, however, are not only characterized
by the tendency to puriformr decomposition of the exudations
produced by a preceding inflammation, but also by the seat
itself, i. e., by the preference to certain histological elements,
to certain anatomical districts.
Thus it appears to be a most peculiar fact that the local
affections of scrofula show themselves with the greatest constancy in the organs of sense; or, more correctly, in their
anatomical, auxiliary apparatuses. Scrofulous inflammations
of the eyes and ears are the most frequent. The affection of
the nose is likewise so well known that one can already diagnosticate the scrofulous habitus from its look. The auxiliary
apparatuses of the sense of taste (lips, mucous membrane of
the mouth, periosteun —Parulis and Epulis) are also often
enough the seat of the dyscrasia. Finally, the most extensive organ of sense, that of feeling, the skin, has undoubtedly
to suffer most; it has to intercept as an armor, so to say, the
blows which are struck for the radical expulsion of the scrofulapoison.' Here, then, the disease relieves itself, the scrofulous
cinders being cast out by that Vesuvius, called healthy life* Even the chronic ulcers of the foot are called by Schroen a reflex of a
constitutional disease, against which he recommends Arsenic in alternation
with Sulphur. (Hyg., iii, 365-369.)



GENERAL PATHOLOGY OF SCROFULOSIS.               21
force, working deeply in the interior, now in the form of
aphthae, now as intertrigo; more unmistakably, it is true, as
crusta lactea; ozsena; as blepharitis ciliaris; or, to hold on
to the simile, the stream of lava rolls into daylight as the product of an obstinate otorrhcea.
However, we have thus far marked too insufficiently the
importance of the lymphatic glandular system in its bearing
upon scrofula. Enlarged glands (the maxillary glands, especially) are frequently considered as being identical with
"scrofula."  These turgescent glands serve, no doubt, as receptacles of the scrofulous elements and products which are
directed against and inimical to the normal composition of
the blood, and the latter can remain deposited for a time
indefinitely long, as does the syphilitic poison in the indurated inguinal canals, until they are brought into course
again, as it were, into circulation by a cause more external.
From this now results forthwith a localized, new, scrofulous
inflammation, with all the terminations possible.
On account of the evident connection of scrofula with the
lymphatic (and, very probably, chylific) vessels,* we will
direct the attention of the reader to a few physiologico-anatomical facts.
The lymnphatic system is an appendix of the venous. The
main trunks of the lymphatics run into venous trunks, and
smaller lymphatics even are said to open out into veins. The
structure of the larger lymphatics agrees with that of the
veins in many points. The beginning of the lymphatics is,
as yet, not settled beyond dispute. The most popular view
is, that the lymphatics originate in certain membranes (e.g.,
the serous) from closed nets of a much larger diameter than
that of the capillary nets of the bloodvessels; while in the
connective tissue, on the contrary, they begin with free openings in the interstices of the tissue.
That the lymphatics resorb is sufficiently proven by the
reception of the intestinal contents by the chylus-vessels, as
well as by the observation that, after ligating the bloodvessels, substances easily resorbable, such as ferrocyanide of
* "Of the essence of scrofulosis, Baumgxertner says, we know nothing more
reliable than that the lymphatic system, and especially the lymphatic glands,
are the principal, and, as it seems, primary seat of the disease."



24            ON SCROFULOUS AFFECTIONS.
triously for our physical welfare as in scrofulosis, and the
existence of the numerous lymphatic glands, as mentioned
before, no doubt, assist them in their labor. As we have said
above, the possibility is afforded by the lymphatic glands for
the lymph to become embodied in the circulation after a considerable length of time, only. Indeed, it is certain even,
as we have likewise pointed out before, that in the glands
the (scrofula) poison (tubercle) may remain inactive for years,
encased, as it were, like a mature trichina. "Tuberculosis
of the lymphatic glands," Alfred Vogel says, and thus confirms the assertion made, " is not dangerous by itself; tuberculosis of the lungs, however, very usually develops after
the appearance of puberty, and this danger must, hence,
always be mentioned in our prognosis;" and it is, moreover,
not unlikely that the quality of the poison is changed in the
lymphatics, perhaps weakened, even, in its intensity of action.
This supposition is based upon the metabolic, change-begetting power of the glands in general. "We are inclined,"
says Budge, "to accept the cell-formations which appear at
the inside of the glandular membrane, and are called enchyma
(Purkinje) as the very apparatuses for secretion. We surmise
that these cells can assert an attraction, or a change-begetting
(metabolic) force upon the liquor sanguinis that courses around
them."
Are we to suppose that the inner texture of the lymphatic
glands is entirely indifferent as regards the contents coursing through the lymphatics? Scarcely.
The contents of the lymphatics, however, are, without any
doubt, of much greater importance than the lymphatics
themselves. " From a deficient lymph, arrested in its course,"
says Baumgertner, the pathologist already quoted above,
who, in this remark of his, squarely hits the nail on the head,
"may all the symptoms of scrofula be explained by the phenomena presented to us in the isolated plastic activity, and
cellular metamorphosis. If on account of weakness (mostly
inherited) of the lymphatic system, a deficient lymph is produced, and arrested in its flow in any part whatsoever, it terminates in isolated plastic activity. Cells are built up therein
which, in their turn, attract matter, and thus increase their
number, and form tumors. But these isolated cells have a



GENERAL PATHOLOGY OF SCROFULOSIS.           25
tendency to cellular metamorphosis; they decompose into
granula which unite into new cells, pus-cells. By these means
the greatest destructions are brought about in all kinds of
tissue."
This way of explaining the matter is, in my opinion, based
upon a more correct conception than are those other one-sided
ideas, according to which the essence of scrofulosis is said to
consist, at one time, in a peculiar scrofulous matter (miasma
scrofuilosum) (Schaefer); at another in an abnormal gastric
juice (Willis); now, in acidity of the primTe vike (Van HIelmont); now in an over-amount of albumen in the chylus
(Sunderlin); or according to which it is pronounced to be the
unfortunate offspring of the monster syphilis, even.
Hausmann, Hecker, Reichelt, Wharton, and Faure assert
that the sperma, if not evacuated through the natural channels, is resorbed, and thus produces scrofulous affections; a
view which is the crown, so to say, of all theoretical arbitrariness. Hippocrates and Galen attributed scrofula to mucus
clinging to the lymphatics, an idea which is based, probably,
upon the obtuse guessing that the termination of the dyscrasia in question, as we suppose to-day, has to be searched
for in an altered quality of the lymph; though the factor of
that change may not have been found out, as yet, beyond
dispute; because we cannot, as Baudelocque would have it,
declare that the factor to be blamed consists in spoiled air.
" If the air," said Baudelocque, " which we inhale, has suffered
a change in the relative quantities of the elements constituting it, by a diminution of oxygen or an increase of carbonic
acid, hoematosis necessarily becomes defective and incomplete;
and as the blood contains the materials of nutrition and secretion, it must necessarily occasion in the composition of this
fluid, alterations more or less harmful, and induce the development of scrofula."
Baudelocque is thus one of the main representatives of the
humoral pathology.
With good reason the objection has been made to this
theory that, its correctness presupposed, the scrofulous would
have to pass through a kind of asphyxia, and would show
symptoms accordingly, which, however, is not the case. Besides, in cases of slow asphyxia, the lymphatic glands are



26              ON SCROFULOUS AFFECTIONS.
never affected. And, then, why should scrofulosis not appear
upon the whole globe, provided the conditions for the deprivation of oxygen were present?
It is more correct, hence, to accuse as cetiological momentum
EVERYTHING that impoverishes the lymph. (Borden.)
Hain's view, by the way, is original, which declares scrofula
to be a metamorphosis of variola.
The idea indorsed by Ettmueller, Hauter, and others, which,
at first sight, lacks both logic and science, and yet does not
appear impossible, is that alkalescence OR an acid (which
Baumres believes to be phosphoric acid, others a specific one)
produces scrofulosis.
But let us abandon now theoretical grounds, and return to
the soil of a more correct pathology.
Thus it behooves us to listen to the views of several more
recent and famous authors upon scrofula.
I.
Wunderlich calls scrofula an anomaly of nutrition, whereby,
it is true, but little is said.
In advance of it he treats on pimelosis and stearosis, and
follows it up by marasmus.*
Wunderlich's statement, according to which scrofulosis is
said to have connection with hereditary syphilis, is more important.
Besides coarse, indigestible food, he mentions as other
authors do, among the external influences, deficient renewal
of air, want of sunlight, upon which causes the fact rests,
* He arranges the anomalies of nutrition mentioned (pimelosis, stearosis,
scrofula, marasmus), under the head of autogenetic constitutional diseases, and
counts among them:
A. Annemic forms.
B. Plethoric conditions.
C. Anomalies of nutrition.
D. Hemorrhagic diathesis.
E. Hydrops.
F. Constitutional disturbances manifesting themselves by peculiar urinary
secretions.
G. Rheumatism.
H. Gout.
I. Constitutional diseases with peculiar multiple localizations.



GENERAL PATHOLOGY OF SCROFULOSIS.           27
probably, that the symptoms of scrofula commence during
convalescence from  other diseases (after measles, hoopingcough, typhus, &c.) Surprising but very pleasing is the confession: "' Scrofula characterizes itself, neither by a demonstrable and peculiar change of the blood, nor by products of
a peculiar quality."
Almost all parts of the body may show changes, and the
anomalies originating are partly hypertrophies, partly serous,
plastic, purulent, tuberculous exudations, but very frequently
deposits that remain firm; or, thinly purulent, and caseous
or ichorous effusions.
The parts especially affected are the lymphatic, secretory
and vascular glands, the skin, the subcutaneous connective
tissue, the mucous membranes, the brain, lungs, serous membranes, muscles, bones, and joints.
The symptoms may show very different grades.
As regards the habitus scrofulosus, Wunderlich does not
differ in his description from the one generally known and
accepted.
" This habitus," Wunderlich says, " shows more or less distinctly the lymphatic character; at one time in a certain gross
nutrition, accompanied by a thick nose, thick lips, spongy,
bloated look, dirty-pale color, coarse and stiff hair, swollen
abdomen, thin, and, at the same time, clumsy limbs; at another
in a delicate bodily constitution with a thin transparent skin,
flushed cheeks, but great sensibility of the parts."
Wunderlich does not mention without purpose, first, the
processes upon the skin, then those of the mucous membrane,
then those of the lymphatic glands; fourthly, the affections
of the bones and joints; and, finally, those of the fatal termination of scrofula,-appearance of tubercles in the brain,
the lungs, and other internal parts-thus indorsing, to a certain extent, our theory of the originally centrifugal, and,
finally, centripetal direction of the scrofulous anomaly of
nutrition.
"The skin of the scrofulous becomes affected by the slightest causes; wounds heal with difficulty, and suppurate for a
long time; excoriations secrete and ulcerate; the skin covers
itself with obstinate eczematous and impetiginous eruptions,
and serpiginous forms frequently appear upon it; the meatus



28            ON SCROFULOUS AFFECTIONS.
auditorius externus often becomes the seat of an inflammation
with purulent discharge.
"In a similar manner the mucous membranes are affected;
especially, we observe, however, obstinate catarrhs and blennorrhceae of the eyes, nose, oral cavity, and pharynx; chronic
catarrhs of the stomach and intestines, with semi-paralysis
(paresis) of the intestinal musculature; catarrhs of the airpassages, often, indeed, with tubercular deposits; catarrhs of
the female sexual organs, often with ulcerations; not rarely
isolated, local pseudo-growths appear upon the mucosa, which
must be considered as a higher development of diseased portions of the mucous membrane.
"The affections most frequent, however, are the swellings
and diseases of the lymphatic glands, which show themselves
especially in the glands of the throat and neck, but also in
the axillary and inguinal, as well as in the bronchial and
mesenterial glands, and may appear on account of the most
insignificant peripheric affections, and originate spontaneously
even. The disturbance therein may consist in hyperaemia, or
tuberculous deposits, or hypertrophia.
"Not rarely do we witness among the scrofulous a hypertrophical thickening, and firm infiltrations of single vascular
or secretory glands (of the glandula thyreoidea, the ovaries,
mammae, even of the kidneys), mostly with a diminution of
their functional capacity.
"' As a frequent local manifestation of scrofula, malignant in
its nature, we observe affections of the joints, which, at the
beginning, show themselves as moderate pathological alterations in the parts surrounding the joints, and are accompanied
by swelling and pains. In consequence of frequent relapses
and neglect, the evil becomes more stubborn and chronic, the
synovial membrane becomes affected, and it may end in firm
deposits beneath the latter, or in puriform exudations in the
cavity of the joints. Other destructions of the joint may
develop therefrom, and the epiphyses may become involved
more or less. The affections run a different course in the different joints; at the cervical vertebrae and the knee they lead
to induration and swelling, rarely to extensive suppurations;
at the joint of the foot they tend toward isolated abscesses
and formation of fistulae; in the elbow-joint to abscesses and



30            ON SCROFULOUS AFFECTIONS.
II.
As supplements we will quote here now the remarks on
scrofulosis of a French writer of high standing, Jousset,
though only so far, of course, as he opens to us any new views.
(Elements de Medecine pratique, i, 60.)
Jousset names as a characteristic sign of scrofula the deposits of tubercular masses, especially in the lymphatic glands,
to which we have given due importance above.
According to Jousset the scrofula-dyscrasia may manifest
itself in four forms:
1. As common scrofulosis (forme commune).
2. As malignant (f. maligne).
3. As benignant (f. benigne).
4. As iwell-fixed, primitive form (f. fixe primitive).
Common scrofulosis comprises the complete development of
the disease, thus defining at the same time the fourth form,
which does not show either multiple localizations or free intervals, but contents itself with one single attack. It appears in the form of tumor albus, malum Pottii, tuberculosis
cerebri, alburninuria, morbus Addisonii, lupus or meningitis
basilaris; again as purulent pleuritis and pneumonia, as obstinate inflamnmation of the eye with destruction of it. Jousset is right in believing that some forms of croup (l'angine
couenneuse) must be considered as belonging here, and, above
all, phthisis pulmonum.
The designation "' fixe primitive " does not preclude the occasional appearance of scrofulous peritonitis, pleuritis, and
especially of tuberculous diarrhcea, towards the end of the
catastrophe. In the form of common scrofula Jpousset distinguishes four periods of development. lie confirms what we
have already said above, that it belongs to the physiological
course, so to speak, that scrofulosis attacks at first the skin,
then the mucous membranes (hence, at the commencement,
moves in a centrifugal, afterwards in a centripetal direction).
Bazin very adroitly calls the scrofulous cutaneous eruptions
scrofulides (who would not think here of syphilides?). These
belong either to the moist or dry kind. Among the former,
eczema, impetigo (in the. face), crusta lactea; among the latter, the erythemata, prurigo, lichen, psoriasis, acne. The



GENERAL PATHOLOGY OF SCROFULOSIS.            31
swelling of the lymphatic glands in the neighborhood is characteristic of all.
The scrofulous affections of the mucosa comprise that form
of coryza accompanied by impetigo of the nasal openings and
lips, which finally produce the "'i mufle scrofuleux;" the obstinate otorrhcea with sero-purulent discharge, " et encore sans
carie."
Blepharitis and hordeolum; ophthalmia of still benignant
character, granulous pharyngitis with hypertrophy of the
tonsils, catarrhal bronchitis, diarrhcea, balanitis, leucorrhcea,
and vulvitis among small girls. Scrofulous children are
sometimes very fleshy, at others very lean.
Singular as it may seem, Jousset considers rhachitis a disease, strictly to be distinguished in its nature from scrofulosis,
and does not agree with the idea (as does Bazin) that the
delay in teething, and in learning to walk, is a commencement
of scrofulosis, but of rhachitis.
Jousset having acknowledged the systematic progress of
scrofula from  outward inward (centripetal direction), the
second period begins, in his opinion, with the scrofulous affections of the lymphatic glands, and he accepts, in the third
only, an affection of the bones and viscera (des visceres),
among which we count brain, lungs, pleura, peritoneum,
ovaries, liver, pancreas, testicles; regarding panaritia, with
caries of the phalanges, a transition state from the second
to the third period. Generally a more intense aggravation of
the disease, self-evidently, takes place with its progress, and
thus the fourth period ends with the developed scrofulacachexia, of which Jousset gives the following description:
"Pale, ash-colored, bloated face, soft, flabby, dry skin; emaciation not too great; serous infiltrations; rarely hectic fever
with colliquative sweats, unless there exists, at the same
time, phthisis pulmonum. Appetite continues to be good for
some time. Colliquative diarrhcea; daily decrease of strength;
great indifference. Death from syncope."
One word more on.Jousset's malignant and benignant forms
of scrofiula. He bases the distinction between the two upon
the termination in tuberculosis, merely, the latter of which
he identifies, without hesitation, with (malignant) scrofulosis.
Ile deems himself justified in so doing upon the following



32            ON SCROFULOUS AFFECTIONS.
grounds: 1. The scrofulous can beget the tuberculous, and
vice versa. 2. The tuberculous are often affected in childhood by scrofulous affections (forme benigne). 3. In cases in
which the antecedents of the tuberculous show no symptoms
of scrofula, the malignant form (e. g., as meningitis tuberculosa), or the well-fixed, primitive form, mentioned above (in
the shape of the malum Pottii or tumor albus), may yet make
its appearance.
Finally, the chronic character by no means pertains to
scrofulosis.
Of the English physicians, Clarke, and of the German,
Cannstadt, side with Jousset; who also believe scrofula and
tubercles to be one and the same disease. Baumgsertner,
on the other hand, remarks: " The forms of the two diseases
are very different; therapeutics, frequently triumphant in
scrofula, is of no effect in tuberculosis; scrofulous individuals
are not much more frequently affected by phthisis than others,
and most of the consumptives have had no scrofula at any
period of their lives."
The benignant form is said to characterize itself by superficial, local affections, few relapses, and an entire or apparent
restitutio ad integrum, even. Females thus affected incline,
however, to abortus, dysmenorrhcea, leucorrhcea, and'get old
early; gmen cannot stand much, have no endurance, " ne supportent pas la fatigue."
The malignant form, on account of the sudden, simultaneous appearance of the various affections of the gravest
grade, is said to remind one of the poisoning by glanders (le
farcin). Multiplex abscesses, enormous glandular swellings,
sudden carious processes quickly following one another at the
most various places of the skeleton; pleuritis of a very acute
course, peritonitis, &c., mostly evince, moreover, the malignant character.
Yet in case of a benignant character of scrofulosis, even
(forme benigne), the children of those so affected not rarely
carry the germ of tubercular meningitis or phthisis within
them.
Jousset, aside from the usual momenta (see previous pages),
mentions also the following as predisposing: Excessus in
venere; pregnancies too often following one another; but espe



GENERAL PATHOLOGY OF SCROFULOSIS.           33
cially nursing for too long a time. A stronger predisposition
exists likewise after typhus, hooping-cough, and measles.
Bazin calls it a physiological prejudice, that blondes are
supposed to have more inclination to scrofula. In his opinion
the blonde race is the strongest race, and endowed with most
energy. Ile says that in France just the brunettes and lean,
not the plethoric, are affected preponderantly. The French
author, who only asserts the frequency of the affection to be
equal in Spain, England, and France, no doubt is in error as
regards Germany, a country which, in fact, he does not mention, even. He is right, however, in saying that scrofulosis
is a disease of the temperate zone. Iceland has no "scrofulous plebs." The torrid zone enjoys the same exemption.
The fact is that the disease is much more frequent in wet
than dry countries, and, for this reason, is found especially in
Holland, Poland, England, Vivarois, in the Sevennes, Alps,
Pyrenees, and in gorges and valleys which separate high
mountains; besides, it appears that the removal into a cold
and wet climate is especially one of the most potent causes of
scrofula. Some observers have adduced as illustration that
children, who were brought from India to England, became
scrofulous there (Buchan, Sam. Cooper). Others have made
the same observations with regard to persons who were
brought from  America and Brazil to France (Guersent).
Just as in cold, damp, low, marshy localities, which are deprived of the beneficial influence of air and sun, colorless
mushrooms and fungi sprout up, so the scrofulous habitus,
under the influence of the same local peculiarities, grows up
luxuriantly in numerous specimens without any possibility of
arresting it. This cause holds good in the etiology of scrofula
as one of the most important and frequent.
III.
Among the more comprehensive German honmeopathic textbooks, Kafka's treatise on scrofula is of prominent interest,
especially as he has bestowed the utmost care upon the therapeutic part. We shall return to his experience in this direction,
when we speak of the treatment ofscrofula. Kafka especially
points to the difficulty of reducing scrofulouts exudations. He con3



34            ON SCROFULOUS AFFECTIONS.
siders the process of digestion and assimilation, suffering from
a cause not fully discovered thus far (see Baumgsertner), to be
the essential terminating point of this dyscrasia. IIe thinks
that in acquired (in contradistinction to hereditary) scrofulosis, the first foundation is already laid in the first few
months by overfeeding. Other factors, of no less importance,
are want of fresh air and exercise. From these a slow exchange of matter results, and, above all, the necessary processes of oxidation are wanting; hence the prevailing venosity
in scrofulosis.
We are reminded, as already mentioned, by those unfortunate and fading creatures, of certain species of plants which
are deprived of light and air; pale and bloated, plethoric, not,
however, by really healthy juices, but by a watery, colorless
liquid, these "miserables" live but half a life. In the same
manner, in the animal kingdom, many species of amphibia,
with their cold blood and wabbling fleshiness, their construction of limb incapable of quick motion, their indolent, sleepy
character, secluded, moisty-cold domiciles, represent scrofulosis
with a predominating lymphatic system. This brings us to
the ingenious hypothesis of Ruetes on scrofula. He declares
the essence of the disease to be a retrogressive metamorphosis,
by which the organism attempts to go back to a former stage
of life.
Kafka directs our attention to the fact that a too scanty
supply of protein-substances favors the development of scrofula. The protein-substances contain, as is well known, Sulphur and Phosphorus. Now, it is remarkable that the two
latter frequently- are remedies which homceopathists cannot
dispense with in scrofulosis.
The authors mentioned above have paid no attention to
the closing up of the fontanel at a late date. Kafka especially
has marked it out. Even Lepelletier, finally, compares the
vital process of the scrofulous with the rapid sprouting (etiolement) of plants deprived of light. Deficiency in the vital
functions, poor assimilation, alteration of nutrition, are the
necessary consequences of the influences to which most scrofulous individuals have been exposed.
But we must remember, always, that the variety of those
influences is great, that for the begetting of what we term



GENERAL PATHOLOGY OF SCROFULOSIS.                35
scrofiula, neither the deprivation of light alone, nor solely the
insufficient supply of oxygen, nor a highly non-nitrogenous
food, nor one too rich in nitrogen, nor the descent from unhealthy parents suffice.*
On the contrary, a whole series of conditions is wont to
show itself as tending toward the development of this disease.
Hence it will suffice for us to hold on to the two main factors:
the organic predisposition, on one side, and certain disturbances of nutrition contaminating the blood, on the other.
NOTE.-The symptoms of scrofula, it is true, have been
divided into local and general. It is difficult, however, to
carry out this distinction, since, for instance, the movable
swellings in the neighborhood of the lymphatic glands and
vessels, which were mentioned among the local, are as well
the expression of a constitutional affection, as the degeneration of the bronchial and mesenterical glands (phthisis meselterica), which are named among the symptoms not purely
local. The best proof of the great significance of those swellings, considered to be a purely local symptom, lies in the fact
that they are frequently the forerunners of pulmonary tuberculosis, and that two and more children of the same family,
at the same time, i. e., when they have attained to a certain
age, become invested by such swellings, from which, as mentioned, the ominous tuberculosis results.
In the "Universal Lexicon der practischen Medizin u.
Chirurgie" (Leipzig, Voigt and Fernau, 1844), we find a good
description of this stadium prodromorum of scrofula; for those
swellings ought to be considered as nothing else.
"Most frequently," we read there, " we notice, notwithstanding all the external appearance of health, oviform swellings
or globules beneath the skin on places where the lymphatics
take their course, and glands are present which, more or less,
increase in number, and by and by gain in circumference; at
the beginning remain painless for months and years; are fol* Though Lugol, even, considers hereditabilitv as the sole cause, and Cullen as nearly the only cause of scrofula; and Lernmasson-Delalande says: " It.
is absolutely~impossible that a well-organized being should become scrofulous
spontaneously, no matter into what surroundings it might be brought, and
be it imprisoned for years, even."



36            ON SCROFULOUS AFFECTIONS.
lowed at a later date by heat, redness, local swelling and
febrile motions; afterwards fluctuation frequently appears;
the skin becomes thinner, ulcerates, and simultaneously or
successively allows a substance to penetrate it, resembling the
consistency of chestnuts or cheese, or a fluid filled up with
purulent or albuminous flakes. The suppuration arising from
the lymphatic glands or neighboring tissues, is more or less
considerable, and lasts for an indefinite time, amounting to
months and even years. At any rate, cicatrization proceeds
slowly; the bottom of the ulcers consists of flat or little developed granulation; the edges are bluish-purple, and if they
unite, show at the place of the cicatrix, indestructible signs
of the disease that has existed; a state of things that arises
from the loss of substance of the integuments of the connective tissue of the lymphatic glands, and the agglutinations
which the edges of the ulcers form with the muscles beneath
the skin. The symptoms usually manifest themselves around
the neck, more rarely in the axilla and groin, still more seldom
in the fossa poplitea. The skin is, in many cases, the seat of
tumors and ulcers, which multiply in various localities of the
body. From these ulcers oozes a watery pus, which may
leave behind a thick cheese-like (tubercular) mass. During
the whole time of this suppuration, likewise lasting for
months or years, the edges of the ulcers remain spongy and,
some time, muscular surfaces of considerable extent are denuded. In the ratio in which these ulcers increase in number, the general state of health declines; cachexia shows
itself; the disease has become general."
DYSCRASILE RELATED TO SCROFULA.
A.-TUBERCULOSIS.
WVe indorse Wunderlich's and Jousset's views, that the
tuberculous process appears where the conditions for scrofula
have reached their highest degree, and scrofula itself its
greatest intensity. When Baumgertner denies the identity
of the two processes on the ground that scrofula does not
necessarily terminate in death, while tuberculosis does, we



DYSCRASIE RELATED TO SCROFULA.              37
simply reply that the greatest intensity of a disease must needs
render the prognosis more unfavorable, and that, moreover,
many scrofulous persons die of caries, necrosis, inflammation
of the joints, abdominal diseases, exhausting abscesses, &c.
If we compare scrofula with a luxuriantly growing plant,
then tuberculosis is the blossom. Now, as there are many
plants (e. g., vinca minor; or the so-called porcelain flower,
asclepias odorata) which, in many cases, content themselves
with a mere luxuriant growth of leaves, so not every scrofulous existence develops its blossom. Or still more correctly,
perhaps, the scrofulous affections are the wild offshoots of
tuberculosis which, as is well known, seem likewise to be but
little adapted to the development of blossom or fruit.
According to BaumgTertner's second objection, most of the
tuberculous did not evince any sign of scrofula. This statement is exaggerated, not to mention that, in many cases, the
external cause for the development of the scrofulous predisposition existing, may have been wanting, thus far.
If hereditability is assumed as the most evident cause of
tuberculosis, we are compelled to concede the same cause to
scrofulosis.
And hereditability would much oftener be admitted, were
it not that existing tubercles were overlooked, for the reason
that they remain stationary, and are harmless in their latent
state for any length of time. Thus post-mortem  examinations after previous diseases of a non-tuberculous character,
have frequently brought to light such tuberculous deposits,
e. g., in the apices of the lungs, bronchial glands, &c. Vice
versa, persons exposed to most unfavorable outside influences
did remain free from tuberculosis, since they had no hereditary predisposition to it.
The reason why we cannot make up our mind to refer all
such (scrofulous and tuberculous) dyscrasie to hereditability,
is simply to be found in the fact that modifications of the
disease, incalculable in number, are possible which depend
upon relations more or less distant from the original individual seat of the infection. However, owing to the fact that
herpetic, syphilitic, carcinomatous, chlorotic, and other dyscratic influences are transferred simultaneously, or a surplus
of healthy blood from father or mother, asserts its influence



38            ON SCROFULOUS AFFECTIONS.
during the act of generation, it happens that innumerable
varieties and shades of the disease, monoform at the outset,
arise.
Thus some members of a family escape with a chronic blepharitis, or an ophthalmia (frequently recurring), or an inclination to bronchial catarrhs, &c., is the only expression of
the masked remnant of the dangerous tuberculous inheritance.
Not long ago I saw a child who had the blue eyes of the
mother, and the dark-colored iris of the father. If such a
differentiation of the parental physical peculiarities were a
rule and not an exception rather, we should more frequently
meet with pure forms of tuberculosis (and not with bastard
forms, i. e., scrofulous affections).  Here belongs also that,
only exceptionally, the child inherits the blue eyes of the
mother and the black hair of the father, and vice versa.
B.-SYPHILIS.
Scrofulosis has often been compared with syphilis, and the
former has been considered a masked form of the latter. They
resemble each other, it is true, among other things, in this
that, in both, the skin so often becomes the seat of the specific deposits; that, moreover, the cutaneous affections (syphilides and scrofulides) in both are apt to be of multiform, or
as we are wont to say, polymorph character. But in syphilis
the auxiliary apparatuses of the organ of taste (tongue, buccal
mucosa) are affected more than in scrofulosis; the ear and eye
much less. Except syphilitic iritis there is little mention
made of syphilitic affections of the eyes. For the direct infection with gonorrhieal pus (gonorrhceic inflammation of the
eyes) cannot be counted here.
The affection of the glandular system would be a tertiurn
comparationis as regards scrofulosis and constitutional syphilitic diseases. Supported by this criterion we could speak of
secondary scrofulosis as well as of secondary syphilis. Indeed,
the degenerations into necrosis and caries, and the appearance
of tuberculosis pulmonum, even, in persons previously scrofulous, might without any arbitrariness be understood as a
tertiary phenomenon of the scrofula-dyscrasia. Itufeland divided scrofulosis into Sc. occulta and manifesta. Syphilidolo



DYSCRASILE RELATED TO SCROFULA.              39
gists cling to this division with regard to syphilis. Even
Bazin speaks of masked scrofula.
Even the possibility of transferring the latter by inoculation does not constitute a characteristic distinction between
scrofula and syphilis, for although common scrofulosis is not
contagious as variola and scarlatina are, nor transferable as
is syphilis, vaccinating experiments with pus taken from tubercles have nevertheless given positive results. And how
small is the gap between the tuberculous and scrofillous dyscrasia?  Moreover, it is a fact, almost, that by transferring
the lymph of vaccina-pustules of vaccinated scrofulous children to others, scrofulosis can be communicated to them.
Although it is said that Kortum, Pinel, Alibert, Richerand,
Dupuytren, Lepelletier, and others have tried in vain to transfer the disease by laying healthy children into the same bed
with scrofulous, or by rubbing, inoculating, or injecting pus
of scrofulous children into the skin of healthy ones; yet
there exist too many and well-authenticated cases in which
children, previously healthy, have been infected by scrofuladyscrasia since vaccination. Notwithstanding, however, we
do not deny that in the surety and certainty with which
syphilitic pus causes syphilis, a difference, no doubt, between
syphilis and scrofulosis is well established de facto; as scrofuious pus does not, by any means, occasion scrofulosis with the
same certainty. Yet we must not forget, on the other hand,
that many do not believe secondary and tertiary syphilis capable of being inoculated.
HIere belong also the interesting experiments of Sebastian,
which have bearing, it is true, upon syphilis only. This
Lyonese physician maintains that if we take lynmph of a
(vaccinated) syphilitic child in such a manner as not to transfer any blood therewith, syphilis cannot be inoculated.* But
as soon as the blood of the diseased child gets into the vaccination-wound with the clear, watery lymph, syphilis is transferred (syphilis vaccinalis).  Ricord contradicts this view,
adducing that: 1. In the clear, watery lymph, even, blood
(blood-corpuscles) can be shown to exist microscopically.  2.
* Sebastian, strictly observing his own rules, vaccinated himself with matter
of a syphilitic child, and did not become syphilitic.



40            ON SCROFULOUS AFFECTIONS.
That it is very difficult so to transfer the blood of one human
being to another that it will be resorbed and really become
embodied in its circulation. 3. That in view of the frequency
of syphilitic affections in large cities, and the difficulty of
collecting the poison without any admixture of blood, the
number of syphilitic cases transferred by inoculation would
be much larger. The second argument adduced by Ricord
proves, as every one will see at a glance, just the contrary to
that which was to be proven. The very fact that, for the
purpose of a lasting embodiment, the blood of one individual
as a general thing is difficult to transfer to another, explains
the proportionally rare occurrence of an infection by way of
vaccination. This holds good with syphilis as well as with
scrofulous children. The latter, as I have frequently observed, bleed more copiously on making an incision into the
vaccination pustule, and the blood shows a conspicuously dark
color (excess of carbon). It is too venous.
As early as 1578 the French Parliament inquired of the
medical faculty whether scrofula could be contagious, a question that was answered in the affirmative.
We know now to what extent this answer was erroneous.
Certainly no one will assume a real scrofula contagium, such as
surely exists with regard to syphilis. For this reason we
cannot but agree with Baudelocque, to whom we are indebted
for a comprehensive essay upon this subject, and who has
proven that scrofula existed several centuries before syphilis,
when he argues in the course of his work that the analogies
set up between the two diseases are only apparent.
Cullen, Boehmner, Kortum, Gourfand, and others side with
Baudelocque; i. e., they also deny such a connection. Kortum
in his district had many scrofulous, but almost no syphilitic
person, and Baudelocque states that there are a great many
syphilitic at Palermo, but almost no scrofulous.
This does not preclude, however, the possibility of syphilitic parents often having scrofulous descendants; yet it
happens often enough also, that such children come to the
world with syphilitic but not with scrofulous affections.
What may have contributed to that error, is the fact, probably, that both diseases, as already mentioned, are apt to have
their seat in the same organic parts (skin, lymphatic glands,



DYSCRASI2E RELATED TO SCROFULA.             41
bones, &c.). We are inclined, however, to find the most positive proof of a relation between the two affections in the fact
that the specific remedy against syphilis, mercury (and its
various preparations) is able to cure scrofulous diseases innumerable; in short, that the homceopathic antisyphilitica are
antiscrofulosa at the same time. Moreover, as mercury in
large doses produces the entire picture of the scrofula-cachexia,
we must not forget that persons affected by syphilis, who have
been fed upon that metallic poison, for this very reason, perhaps, beget children with apparently scrofulous affections.
From all this the difficulty is obvious, at least, of defending
in a one-sided manner one or the other theory.
C.-SYCOSIS.
There is another dyscrasia, finally, that has specific relations to the (lymphatic) glandular system, sycosis. An essential mark of the sycotic constitution is, according to Virchow,
the excess of white corpuscles in the blood. With good reason v. Grauvogl asks: Whence this excess? The same author quotes in his text-book of homceopathy (~ 297) the following remarks of Autenrieth, bearing on this point: "Sycotic
glandular formations appear even in places where otherwise
no glands can be found. Thus a degeneration of the glands
cannot make up the essence of this disease; the scrofulous
glandular swellings, however, always have their seat in the
glands originally present." Besides, he points to the difference between sycotic and scrofulous affections of the bones.
If the chronic form of sycosis attacks the bony system the
affection shows itself in the bones of the nose, buccal cavity,
hard palate, superior and inferior maxilla, sternum, os sacrum,
ribs, and the processus spinosi. In ozaena sycotica the fetid
smell is absent. IJpon the whole, the bones are not attacked
by sycosis immediately, but the affection starts at the soft
parts, or the periosteum; no carious form ever appears, as in
syphilis, but only necrosis with formation of sequestrum and
sclerosis; and while bony substance destroyed by syphilis,
scrofulosis, and tuberculosis is never repaired, a new, dense,
bony mass, endeavoring to fill up all the loss occasioned, forms
after the cessation of sycotic necrosis. We are of the opinion



42            ON SCROFULOUS AFFECTIONS.
that criteria, so well marked, fully justify a distinction between scrofulosis, syphilis, and sycosis. However, in view of
the confounding chaos which, nevertheless, may be possible,
regarding syphilitic, scrofulous, sycotic, psoric, and other dyscratic affections, we have, in my opinion, but one reliable
guide. For the Ariadne thread that leads us out of this
labyrinth consists in the specific remedy. From the fact that
Acid. nitr. cured one case, Iodium another, Sulphur a third,
the nature of the disease manifests itself. Here we had before us not only the foundation of a rational therapia, but
also of a rational pathology. Let us remember, however,
that Hahnemann has laid this foundation. Hence ex juvarntibus, as we say, we must infer the syphilitic, scrofulous, or
any other disease-genus. Thus we should at once have proven
the existence of a scrofulous diathesis where Iodiumn has
effected the cure of any morbid process whatsoever. For,
among other affections, lod. cures the indolent infiltrations of
the lymphatic glands pathognomonic of scrofula (v. Grauvogl, ii, 210). In this way the riddle is solved, why an obstinate gonorrhcea is suddenly cured by the aid of antipsoric
remedies; why, vice versa, Iodium and Fer. jodat. are frequently given in vain [for the diagnosis of scrofulosis was a
wrong one); why a violent neuralgia disappears without any
trace whatever upon the administration of antisycotic remedies; a, fact of which Gallavardin has recorded remarkable
examples. Then it requires no heroic treatment, no alterative method, no overfeeding with mercury, no Zittmann's
cure, either large or small; nay, submissive and gentle as the
refractory horse when it has found the right rider; the evil
combated so long in vain takes a turn under the influence of
the specific remedy.
As regards the course-to mention it by way of explanation-we observe it in scrofulosis to be less fixed than in
syphilis, the stability and successive outbreaks of which can
be stated more easily and almost predicted. A chancre of
the penis will never return the second time, if there has
been no new infection; a scrofulous ophthalmia may make
relapses, and does, indeed, as a rule return. A scrofulous
ozoena maligna may be cured, but the possibility of a return
is not excluded.



44            ON SCROFULOUS AFFECTIONS.
PATHOLOGICAL ANATOMY.
Although Wunderlich maintains that the blood of scrofulous persons, and the products of scrofulosis contain nothing
characteristic, we must, nevertheless, stop for a moment at
the pathological anatomy of this dyscrasia.
Hypertrophy, ulcerations, suppurations, and tubercles result
from the scrofulous process. The chronic course is a sufficient
characteristic of all. Besides the transition from one into
another, i. e., their alternate appearance, is peculiar to them.
In place of the eczema or impetigo an ophthalmia may set in,
as well as a meningitis in place of lymphatic swellings.
The lymphatic glands especially degenerate hypertrophically; their cellular elements multiply-hyperplasia-a complete resorption is not excluded.
The scrofulous ulcer easily becomes phagedenic, shows
itself, aside from  its appearance upon the skin, upon the
mucous membranes, and frequently produces hypertrophy of
the ulcerous tissue.
It exhibits the following character: hard, uneven edges,
which are undermined; it is painless, and its surroundings
show a pale or violet shiny redness; its bottom is covered with
some lymph or thin pus; when it heals, it leaves ugly, deep,
and hard cicatrices.
The suppurations generally produce a serous pus with an
admixture of caseous elements.
The scrofulous caries exhibits a combination of ulceration
and suppuration, which appears in a threefold form:
1. Simple caries.
The bony tissue is infiltrated with blood and atrophies, but
the membrana medullaris hypertrophies. The purulent infiltration immediately follows the bloody. From this results
a spongious condition of the bone, which softens, ulcerates,
and discharges a sanious blackish pus with fragments of bone.
2. Caries with sequestrum, s. pseudo-necrosis, is distinguished from the former by the dying off of a considerable
piece of bone, and thus exhibits a transition-form between
caries and necrosis.
3. If we find well-marked deposits of tubercle in the bony
tissue, we have a third form  before us, tuberculous caries.



DYSCRASIAE RELATED TO SCROFULA.             45
The tubercular mass is concentrated upon one point, and the
bony tissue infiltrated with it. In the latter case there exists simultaneously interstitial hypertrophy, which represents
a kind of ivory-ossification, and ends in necrosis.
Spina ventosa appears in the long bones only, and consists
in hypertrophy of the membrana medullaris, and a considerable thinning of the bony cylinder. In contradiction to the
negative results, which, according to Wunderlich, have issued
from the analysis of the blood and pus of scrofulous persons,
the pus of scrofulous individuals, according to Gendrin, is
said to distinguish itself from that of the non-scrofulous by a
larger percentage of soda, and chloride of sodium. Preuss
ascribes to it caseine such as belongs to the tubercle. Finally
it is asserted, that the urine shows oxalic and uro-benzoic
acids in considerable quantities.
In persons who have died of scrofulosis, we find the indurated glands changed into a whitish-gray, more or less fatty,
and often almost cartilaginous mass; in some cases they have
changed into the caseous mass which also appears in the pulmonary tubercle, the caseous substance being frequently
softened in the centre and transformed into pus.
However, let us turn as early as this, even, to the essential
part of our task, which consists in framing in the special pictures of scrofulosis, in which the remedies soon to be mentioned
find their place, as well as in giving special and precise indications for the several antiscrofulosa, and in proving their
efficacy by clinical examples.



46            ON SCROFULOUS AFFECTIONS.
II.
THE SPECIAL FORMS OF SCROFULA.
A.-THE CUTANEOUS SYSTEM.
THE skin, Wunderlich says very truly, is the most sensitive
organ for constitutional disturbances, and in none of them remains entirely intact. The anomalies of the skin, brought
about by the co-operation of scrofulous constitutional disturbances, appear polymorph with forms well marked but
little characteristic. It is always as difficult as important a
task to recognize, aside from the local changes, the constitutional disease lying at the bottom.
The scrofulous cutaneous affections do not belong either
among the cutaneous neuroses, or the independent cutaneous
hyperoemie;-(roseola, erythemnata, erysipelas-forms) or the
anomalies of cutaneous secretions-sudori-sebaceous secretions*-or among the hemorrhages or apoplexies of the skin,
but may be arranged most properly among the exudations.
These exudative processes upon the skin show very manifold
forms, which depend partly upon the nature of the product,
partly upon the character of the parts principally affected, but
are inexplainable for the most part. They appear in a fourfold form:
1. As noduli, papula —strophulus; lichen; prurigo.
2. As hives (pomphi; urticaria).
3. As serous exudations beneath the epidermis-vesiculke
and bulle-eczematous forms-miliaria-herpetic formsrhypia.
* The hordeolum (stye) so frequent among the scrofulous constitutes an exception.



THE SPECIAL FORMS OF SCROFULA.            47
4. As elevations of the epidermis filled with lymph or pus;
as pustules-impetigo, acne-pustules-ecthyma.
Only the two latter exudative forms are of interest to us,
here, they being truly characteristic of scrofulosis.
The process in the development of the eczematous form is
the following:
Upon a portion of the skin, more or less hypereemic, small
vesicles appear, which mostly stand closely together, have
watery clear or wheyish contents, and cover a surface indefinite in forin and extent. The eruption is generally accompanied by stinging and burning.
The vesicles terminateEither by bursting, and lamellose desquamation of the epidermis;
Or by the formation of crusts, more or less thick;
Or they become chronic by successive eruptions, and thus
occasion a change of the skin, which exhibits intensely chronic
injections, deposits a very thin epidermis, never attaining to
any degree of density, and shows great inclination to serous
secretions. The metamorphosis of the vesicles, last mentioned,
exactly corresponds to the scrofulous eczema. This eczema
has also been termed eczema rubrum (in contradistinction to
E. simplex and E. chronicum). However, it always exhibits
a form which, developing with intense hyperermia and corresponding violent burning, frequent and considerable swelling of the subcutaneous cellular tissue and fever, mostly befalls the face. The vesicles, having turbid contents, burst,
and the cutaneous surface appears abraded. This form frequently becomes chronic on account of fresh eruptions.
The eczema of the cheeks may also be designated as E.
rubrum, which, on account of its antagonistic relation to the
uropoetic apparatus, we have mentioned above.
However, since genuine eczema does not occur very frequently in scrofulosis, but, in most cases, shows itself in combination with serous and purulent exudations; the forms
accompanied by pustular developments are not of any less
interest to us, and among these again the impetiginous eruptions especially.
They consist in small pus-vesicles, which appear in irregular
clusters upon a surface more or less hyperemic; soon burst



48            ON SCROFULOUS AFFECTIONS.
and, by means of their contents, and in consequence of a continuous exudation, form flat, thick, firm or friable crusts.
Sometimes they run through their course rapidly, and heal
up in from three to four weeks; mostly, however, they drag
out for a greater length of time, and become very chronic by
successive eruptions or slow growth of the crusts.
As concomitants we observe sometimes fever during the
eruptive stage, and frequently swelling of the neighboring
lymphatic glands.
As we have already pointed out, the exudative form, consisting of impetigo and eczenia-eczema inlpetiginodes, impetigo eczernatodes-is, no doubt, the most frequent, though
we must also mention the genuine forms:
Impetigo erysipelatodes with prominent hyperaemia; located
in the face, especially.
Impetigofigurata; round or oval form of the eruption (generally appearing in several groups) and of the crusts afterwards formed, which occasionally become confluent. The
latter frequently have a honey-like appearance (melitagra).
They are found mostly in the face, also at the upper extremities of young persons, and run an acute or subacute course.
Impetigo larvalis, especially among children; a chronic form
with confluent crusts of a brown color, or a color changed by
the admixture of dirt. They cover the face like a mask
(crusta lactea; tinea mucosa; achores).
The MILK-CRUST-CRUSTA LACTEA —i probably always associated with scrofulosis. This eruption, as is well known, disfigures children considerably. They scratch it, knock against
it, and thus occasion is given for discharge of blood, and painful and too early detachment of the crusts. The surroundings
of the eyes often participate in the affection, so much so, as
to make the latter appear crusted over, almost; though two
blue, unharmed pupils may generally be seen through the
opening left. The tender skin is turgescent, and upon laying
the hand upon the inflamed spots of the head and face, a burning heat is often felt.
This form of impetigo is not hard to cure, but its sudden
disappearance is frequently followed by the most dangerous
consequences to the health and life of the child. Such a
sudden drying off of the eruption I have observed after



THE SPECIAL FORMS OF SCROFULA.               49
Silicea (if the eruption appeared on the head), followed by a
real withering of the children who, but a short time before,
were fleshy, and showed no signs of suffering from  disease.
For this reason the dose of the proper remedy ought not to
be repeated too often.* The worst consequences, however,
result from  the brusque besmearing and drying out of the
eruption by means of lead or zinc salves, and even from the
external application of cod-liver oil, which ought not to be
thought of here.
On account of such attempts at cure a sudden transposition of scrofulosis to inner organs may happen, no doubt; a
fatal pneumonia, meningitis, general marasmus, without any
visible local disease even, may result. However, those disinclined to believe Hahnemann in this respect, will probably
believe Hufeland, who says: " We must always try to direct
the disease toward the outer parts; cutaneous eruptions we
ought not to attempt to cure." IHufeland, of course, had
reference to old-fashioned allopathic attempts at cure.
Wunderlich mentions an impetigo scabiosa; an extensive,
very thick, bark-like formation of crusts, frequently spreading over a whole limb with sanious secretion, and often with
ulceration. I observed this form to run across the face: hard,
dry, now elongated, now round, elevated crusts, more disseminated, and well marked off from the healthy parts.
Very often the auricula is affected by such impetiginous
eezemata, especially in case of simultaneous otorrhcea.  But
they appear at the neck and arms, even. Calcar. carb. in
alternation with Lycopod. is specific. Now and then Ferrum
jodat. sachar. hastens the cure in a remarkable manner.
Impetigo decalvans, with sure loss of the hair. (Graphit.
30; Arsenic 9-24.)
Impetigo granulata: Scattered groups of crusts upon the
hairy parts of the head.  (Silic., Mercur. viv. 3d triturat.)
Impetigo sparsa: Scattered small groups of pustules which
may be found on different parts of the body (obstinate).
(Arsenic.)
* Next to Silic., Calcar. is to be considered, especially if the children are
pale, and suffer from habitual diarrhoea. Sulphur in case of a large abdomen
and constipation.
4



50             ON SCROFULOUS AFFECTIONS.
Imnpetigo rodens: Phagedenic, enlarging ulcers, covered with
crusts which, however, very rarely occasion any loss of tissue
in depth.  (Kal.jod.)
More frequent and, hence, more characteristic of scrofulosis
than most of the impetiginous eruptions last mentioned is
Blepharitis ciliaris,
which rightfully finds its place here.
The inference as to a relation existing between the two is
already justified for the two reasons that Silic. is just as efficacious against blepharitis as it is against those impetigoforms upon the hairy portion of the head, and that, moreover,
scrofulous persons are affected by both diseases so exceedingly
often; inflammation and deposits of a plastic exudation into
the connective tissue surrounding the glands of the hair-bulb
-are, likewise not absent, and the crumbling, friable, dirtycolored masses agglutinating the cilihe distinguish themselves
in nothing from the product of genuine impetiginous eruptions. However, homceopaths need not ask with anxious
care, whether this form more deserves the name of impetigo
fig rata, or that should be called larvalis, &c., rather.  Such
a pedantic classification would be of profit only if a fruitful
therapia could be based thereupon.  But the latter is very
rarely the case with professional dermatologists. As regards
the contradistinction between homceopathy and those gentlemen, we may say, perhaps, that it resembles that between
Jussieu's and Linnb's system. We do not care any for the
artificial nosological name which was obtained only by starting from this or that arbitrary principle of classification, but
we do care, above all, for the natural relation of the several
diseases among themselves; we search for the complexes of
disease-phenomena, and compare them with similar complexes
of' pathological pictures. Thus the local reflexes of scrofulosis
are to us but points of support, hints and guides for remedies,
more or less universal, eradicating the evil.*  The concomitants of the scrofulous exanthema are considered, at the same
* For: " Les lesions de texture sont la manifestation anatomique et sensible
-de la maladie; mais la maladie dans son essence et son point de depart est;toute dclynamique."



THE SPECIAL FORMS OF SCROFULA.              51
time, and have an influence upon the selection of the remedy,
often more decisive than the anatomical region of the eruption. The slaves of nomenclature never were great therapeutists.
We will yet mention that ophthalmologists speak of a
crusta lactea palpebrarum.  This eczema of the lids appears
by itself, or in company with facial eczema. The small vesicles filled with a yellowish liquid burst, the secretion excoriating the neighboring parts; crusts are forming, and frequently the entire lid appears to be one ulcerated surface.
From the complications of this palpebral eczema which may
possibly occur together with blepharitis ciliaris, inflammation
of the lid-glands, the close connection of these eruptive diseases with the scrofula diathesis is plainly evident.
For this very reason we will interpone at this place the description of this frequent scrofulous localization, i. e., of blepharitis ciliaris, and not where we speak of the affections of
the glandular system or eye.
The common inflammation of the glands of the hair-bulbs
of the lids, blepharitis, more corectly blepharadenitis ciliaris,
is said to affect the upper lid most frequently, is mostly
bilateral and characterized by redness, swelling, and inclination to punctiform  abscesses in the edge of the lid. The
edges of the lids, on account of the plastic exudation deposited
into the connective tissue surrounding the glands, assume a
tuberous, knotty shape and firmness. At the beginning, fine
scales, dependent upon an increased secretion of the glands,
show themselves around the basis of the several cilira which
may be observed as surrounding the latter in ring-form, and
when detached, as adhering to them in the form of circular
scales. After the detachment the bottom around the cilia is
slightly excoriated and even bloody, and encircled by very
minute vessels. If no resorption takes place, the edges agglutinate during the night and photophobia sets in, which grows
more and more intense; the eyes tire out by working at
things near. Now commences the formation of abscesses not
in the glands of the hair-bulbs, but in the connective tissue
enveloping them; the hair-bulbs remain intact until displaced
by oft-recurring inflammation, suppuration and cicatrization
of their glands and the adjacent tissue; they are deprived of



52            ON SCROFULOUS AFFECTIONS.
nutrition, degenerate, decay, and are cast off Thus originates
triehiasis madarosis and, by subsequent deposits of plastic or
indurating  exudations, tylosis; in the lower lid, ectropium.
Hypersemia of the conjunctiva palpebrarum  and blepharospasm accompany the more profuse secretion of the mucous
follicles and Meibomian glands; the tears, secreted more
copiously now, corrode the sore places freed from the crusts;
the tears being collected behind the ectropic and hypertrophic
lower lid, make the eye appear as if it were swimming in
water; the puncta lacrymalia close up, or located more outwardly, do not extend any longer into the lacus lacrymarum,
and the tears flow over the cheeks (epiphora). At a later
date tarsomalacia and deformities of the cartilages, ectropium
and epidermoid degeneration of the conjunctiva of the lids
appear as complications of the former.
Another complication consists in the so-called asthenopiadecrease of energy in the ciliary nerves of the eye —Romberganmesthesia with subsequent optic hypermesthesia, which requires the use of blue spectacles. According to Begin, intent
looking, when doing fine work, is said to be the aetiological
momentum of it.*
Aside from the glands of the hair-bulbs of the lids, the
sebaceous glands of the lids are extremely often affected in
scrofulosis, from which the well-known styes - (hordeola)
originate. The. hordeolum is neither a furuncle (since it does
not discharge a cord and leaves no cicatrix), nor an inflammation of the Meibomian glands (Desmarres, Juengken), nor
of the glands of the hair-bulb mentioned before (Leis).  The
hordeolum has nothing to do, moreover, with the chalazion
(a tumor seated in the cartilage of the lid), or the miliurn, a
nodulus originating in the sebaceous glands of the skin.  We
give these researches of more recent observers more for the
sake of completeness, than for the reason that the nice discussion upon the essence of the various processes in the lid will
be of any influence upon our therapeutics. For, aside from
the fact that several of the affections named may be present
* The author experienced on himself that even after protracted reading of
small type-a number of the Berliner Volkszeittng-at dusk, a complete
hordeolum developed within a few hours. To the subjective predisposition
an objective cause must apparently always correspond.



THE SPECIAL FORMS OF SCROFULA..53
simultaneously, and, according to experience, often are present; it must suffice for us to know whether a suppurative
process is to be expected or not, and to this our therapeutic
attention directs itself. Whether the sebaceous, Meibomian,
or hair-bulb glands, are the seat of the abscess, &c., is evidently of but little importance; for, upon the strength of this
one fact we should not be able to prefer iMercur. to Silic., or
any other remedy, hastening the suppurative process, to
iepar. Other indications determine the selection of these
several remedies.- As a rule, the common stye always heals
under the administration of SIL. (6-30) from one to two doses
daily, according to the acute character of the case.
Next, the cutaneous tubercle comes up for consideration.
It consists in infiltrations of the cutis which owe their origin
mainly to scrofulous constitutional anomalies-disturbances
in the return of the blood and lymph. Mechanical, local inj uries, are sometimes the cause of the formation of such cutaneous infiltrations. The spot is mostly elevated, of a red or
brown color, circumscribed and resistant.
Cutaneous tubercles heal with difficulty by resolution, frequently under exfoliations, and with subsequent cicatrix-like
contractions, or after previous softening and formation of
pustules; but they often persist for years, and may give rise
to superficial or deeper ulcerations. The several forms to be
distinguished are:
1. Acne-tubercle (acne rosacea, mentagra.
2. Lupus, located most frequently in the face, especially on
the nose and cheeks. Both do not belong among the characteristic, scrofulous eruptions.  Of the lupus-forms, probably the one described as lupus elevatus non exedens does.
The noduli appear here above the level of the skin in groups
as elevations of the size of a lentil, are flattened, and, at a
later period, become confluent, and show a yellow, red or reddish-brown color. They are of moderate consistency, gradually form plateaus or wall-like elevations from I'"' to 2"' in
height, which, however, are furrowed by incisions; the epidermis detaches itself upon their surface, yet becomes more
and more dense, scaly, even crusty, especially if some of the
spots are discharging. The affection spreads by new groups



54            ON SCROFULOUS AFFECTIONS.
of tubercles at the periphery, while the older remain as they
are, or sink in and dry up, forming cicatrices.
Among  the remedies against acne-tubercle  (especially
against mentagra) as well as against the lupus-forms, Arsenic.
and Caustic. deserve the greatest confidence, Clernatis against
simple acne, papuloe, and sycosis.
Next to the cutaneous tubercle come the deep suppurations
of the skin, standing midways, so to say, between the pustular
forms and the infiltrations of the cutis. As principal representation of the deep suppuration of the skin,
The Boil —Fa'runculus,
may be named. It plays a decidedly double role in scrofulosis. It appears sporadically, i. e., at shorter or longer intervals separate boils develop, which signify that something in
nutrition is at fault, be it called a humor or miasma scrofulosum, or by any other name whatsoever; in short, the furuncle
most surely carries away certain cinders of the blood, or something else not beneficial to the entire economy; or (in view of
the same aimn) a rising en masse of boils, so to say, takes place.
We could call them  a monster demonstration of scrofulosis.
The whole body is covered with boils more or less. The
critical nature of this eruption is to be doubted still less; for
it is preceded by a general decline, dependent, as it seems,
upon scrofulosis of the mesenterial glands. After emaciation,
increasing to a skeleton-like appearance with aged look, has
preceded for weeks, nutrition is entirely prostrated, and
atrophy has reached its highest degree; the organism still
succeeds sometimes in producing a restitution of the inner
organs by the development of those furunculous inflammations
en masse. Aside from genuine boils, knotty abscesses, especially beneath the scalp, with a sympathetic affection of the
swollen lymphatic glands, are not a very rare phenomenon,
and undoubtedly of a purely critical nature. We always succeed with Silie. in maturing the single boil, the breaking of
which may be preceded by violent pains and chills. If the
treatment of the multiple furuncle takes place after a grave
internal disease, Sul)h. 30 is preferable, or indicated, at least,
after Sit.



THE SPECIAL FORMS OF SCROFULA.              55
If the boil is located at the upper eyelid, the latter is frequently attacked by phlegmonous inflammation, and the
pains reach the highest degree. Discolored, livid look, firm
swelling, often as hard as a board, and fever. Here Mercur.
sol. and Acid. nitr. are well indicated after Bellad. In case
of threatening gangrenous decomposition, Arsenic (Apis, Carb.
veg., Laches.).
The course of boils, upon the whole, is too well known to
spend a single word on it. The exudation, consisting of a lump of
coagulated fibrin (cord), which is mixed with fragments of tissue, and pervaded and covered with blood- and pus-corpuscles,
is essential. The cord, at the beginning still intimately connected with the adjacent tissue-parts, becomes detached by
progressive suppuration; simultaneously the swelling increases
still more, the upper layers of the skin are consumed and
break, and, on moderate pressure, the cord-like mass together
with a bloody pus, is evacuated in toto, leaving a cavity which
closes up within a very short time with a small punctiform
cicatrix.
Very often, however, a general abscess develops from the
original furunculous inflammation, the breaking of which is
preceded by distinct fluctuation, a circumstance under which
the characteristic appearance of the cord cannot be reckoned
upon.
But few affections of the cutis and its appurtenances, preponderantly belonging to scrofulosis, remain for discussion
now.,Itertrigo.
The detachment of too young an epidermis, on places where
the skin forms folds and recesses, can scarcely be attributed
always to uncleanliness and fleshiness, especially as the secreted smeary-mucous, often incrusted, now and then seropurulent or offensive mass, as well as the obstinacy of the
affection in single cases, and its extension with general fiery
redness of the skin, sufficiently point to the specific significance of the trouble. Intertrigo will hardly ever owe its
origin to simply mechanical conditions; against this argues,
on the one hand, its appearance upon one side only (e. g., under
one arm), and its transition into other, for instance, herpetic
exanthemata.



56            ON SCROFULOUS AFFECTIONS.
This shows the irrationality of treating, or driving away intertrigo, with exsiccating salves or powders, such as Lycopodpowder, starch-powder, &c., which answer the same purpose.
On the other hand, Lycopod., in a honmceopathic preparation,
given internally, has proved its efficacy, we may say, perhaps,
in a very singular manner. Yet where it has already been
used externally, we must give Sulph., or another remedy corresponding to the complications of the trouble.
Next to intertrigo come the species of pityriasis, which, in
a strict anatomical view, likewise represent an anomaly in
the formation of the epidernmis which may be referred to a
disturbance of nutrition.
Since the connection between pityriasis and scrofula appears
to be less evident than that of intertrigo, we pass on, at
once, to
Psoriasis.
In districts (cities) where scrofula is endemic, as it were,
children are brought to us now and then, who are affected
over the whole body with a scaly eruption. The epidermical
larnelle, which can be detached very easily, lay upon a reddened bottom. Many spots, on account of their easy bleeding and watery discharge, remind one of eczema or impetigo,
though they must not be counted among them. The possi*
l)ility of a sudden spreading of the exanthema, its power
for luxuriant growth, and the want of preference for certain
localities, are characteristic of it. On the contrary, psoriasis,
leaps or creeps hither or thither, occupies the face as well as
the lower extremities, abdomen, calves, &c. It seems incomprehensible, how authors of name, on the one hand, admit of
a hereditary predisposition to psoriasis, on the other, attempt
to refer its existence to local causes (with bakers, storekeepers, &c.) to taking cold, the use of highly seasoned food, and
then again to depressing affections of the brain.
We need not stop at the origin of the several species of
psoriasis from small, round, disseminate, rose-red spots, &c.
We take the picture in its full development, and point out
that to psoriasis of the scrofulous-and this only interests us
here-Arsenic. most frequently corresponds homceopathically;
next Graphit. (hence the specifics against eczema rubrum), and
Cacusticurm.



THE SPECIAL FORMS OF SCROFULA.              57
We have no right to treat of scabies here, since it appears
wherever the acarus has access; we will, however, not omit
the remark, that dyscratic, hence scrofulous individuals, even,
are more exposed to the influence of the acarus, and are visited
by more obstinate consequences than healthy persons. Besides, we direct the attention to our remarks in our treatise
on Sulphur as a remedy against scrofulous diseases.
Favus- Tinea favosa.
Favus, considered though it is by many dermatologists as
solely depen ding upon vegetable parasites, just as plica polonica
is declared by the most short-sighted natural philosophers to
be but a local disease of the scalp, may certainly be looked
upon more correctly as the expression of a scrofulous constitution. Cazenave is very right in asking the question: " If
the disease were a formation of microscopical fungi, how,
then, can favus disappear so suddenly during the course of
pleuritis or typhus? Besides, how can a favus pustule around
a hair give rise to other pustules in places where no hairs are
to be found?" If the hair is not essentially necessary to this
evil, why does the contagious favus not always spread over
the skin more and more? (Prag. Viertelj. 5, Jahrg. iv, s. 59.)
Favus, in its fully developed form, presents a crust of grayish-yellow color, round shape, and mealy consistency, which is
depressed in the centre, confluent, almost pustular without
containing any pus, however, and has a smell resembling that
of the urine of cats. Eaclh crust is built up from a countless
number of fungous bodies and fibrils.
These formations are inhabited not unfrequently by lice,
occasion other eruptions, excoriations, and ulcerations, ruin
the hair, and produce infiltrations into the lymphatic glands
of the neck.
If we add that such patients grow dull gradually, and their
mental development stands still, we have reason to rejoice
over the fact that hornaeopathic literature, at least, can show
reliable and real cures, while the allopathic school confines
itself merely to mrechanico-surgical assistance.
Let us briefly recapitulate the therapia of scrofulous cutaneous diseases, in order to make some additions by way of



58            ON SCROFULOUS AFFECTIONS.
complement. "We ought to make no attempt at healing
eruptive diseases." In these words of the ingenious Hufeland,
already quoted above, the danger which an external treatment
of scrofulous cutaneous affections would have in its trail, is
hinted at. We homceopaths do not abandon, however, a
specific internal treatment. Our curative apparatus is exceedingly simple, notwithstanding; we pay principal attention to the locality of the eruption, and to its dry or serous
or purulent character. Thus Arsenic;. corresponds in most
cases to the scrofulous eczema (E. rubr.). Two drops of the
sixth or second dilution in twelve teaspoonfuls of water, a
teaspoonful morning and evening, suffice. In case of simultaneous obstruction, and when the hairy scalp is affected, at
the same time, Mercur., Silic., and Graphit. (the eruption behind the ear being characteristic of the latter remedy).
Ferrum jodat. is required generally at the close of the
cure. If the intensely itching spots bleed easily, Nitr. ac. is
preferable to Arsen.
Eczema impetiginodes (eczema with purulent discharge)
requires Rep. sulph. cale., the characteristic indications of
which Hirschel enumerates in the interesting case of LVII,
or Calc. carb., if the face is attacked (XXXIX), or Mercur.,
if the hairy scalp presents one purulent surface almost
(LXXXVI).  Besides Hep. sulph. calc.; Sulphur claims the
same importance (CXII and CXX-VII). Even if the cure requires weeks, the remedies mentioned nevertheless deserve
more confidence than the vegetable drugs, among which
Viola tricolor enjoys the reputation of a, specific against
Crusta lactea (CXXXIII).  The same remedies come up for
consideration in blepharitis ciliaris, characteristic on account
of its frequency among the scrofulous. Here, however, Silic.
most surely deserves preference to ARSENIC, SO important in the
mnost obstinate eczematous eruptions. On the other hand, besides Silic.; Riepar. sulph. cale., as well as Mere., are indispensable in many cases. In complications with styes (suppuration
of one or more sebaceous glands of the lid), Sil. is likewise in
place, to mature the small abscesses. Graphit., in case of intense photophobia, sensation of heaviness of the lids, and itching of the edges. Graphit., moreover, removes the predisposition to styes.



THE SPECIAL FORMS OF SCROFULA.              59
Mention has already been made of the therapia of the cutaneous tubercle (Arsen., Caust., besides Silic., sometimes entirely corresponding to facial eruptions in general, CI), and
thus we proceed to the deep suppurations of the cutaneous
integuments, so frequent in the life of scrofulous individuals.
These suppurations appear in an isolated form as furunculus
or carbunculus. The expulsion of the characteristic fibrinous
exudation (cord), or the hastening of the abscess (at the spot
of the original boil), again is brought about best by Silic.;
Stlflph. or Mercur. suits better for certain individualities. A
comparison between the pathogenesis of these minerals related
in their action, presents the more minute differences. SILIC.
seems to correspondc more to mature age (to scrofulosis and
arthritis), HEPAR to childhood alone (genuine scrofulosis),
MERCUR., probably, to scrofulosis upon an originally syphilitic
bottom. These criteria regarding the administration of these
suppurative remedies mentioned, would apply then not only
to blepharitis ciliaris, but also to all other cases. We will,
however, not anticipate.
One word more only as regards Rhus. _Rhus toxic. produces
a pure form of eczema, and has proved itself a remedy, especially for that form of it appearing at the nape of the neck.
A  complication of scrofula with rheuma would, moreover,
direct the selection to Rhus. The same holds good of Caustic.,
to which the purulent crusty forms of eruptions correspond.
In. tinea favosa which we mentioned lastly, Arsenic, with
its faculty of destroying parasitic life, deserves consideration.
Compare extracts taken from its pathogenesis. Finally, we
will mention cod-liver oil which, according to Kafka, is indicated in all scrofulous skin diseases, combined with exudations, hence, in eczema, impetigo, &c.
It cannot be too strongly impressed that one remedy does
not always correspond to the entire morbid state. If we believe, however, that our selection has been a correct one, it is
better to change the dose than the remedy. Moreover, in the
fact that the cure does not always succeed with one remedy,
the reason is to be found, why certain remedies marked out
as antiscrofulosa, are represented by but few cases, comparatively. For reports, clinical observations with one remedy
only, are suitable.



THE SPECIAL FORMS OF SCROFULA.              61
mia) do not fail to appear. Mostly we observe an unclean
complexion, thick nose, blonde hair, and other signs of a scrofulous habitus. Besides, the affection has a great tendency to
relapses. Under improper treatment it may drag out for
months. Some children, notwithstanding the existing spasm
of the lids and the intense photophobia, attain to a certain
dexterity in recognizing objects of their surroundings by
winking. Others squat for days in corners, and become almost brutalized, giving way, as they do, to the incontrollable
desire of searching for dark localities.
It is not practical, although ophthalmologists do so, to sep
arate scrofulous conjunctivitis from keratitis. They appear
too often simultaneously, too frequently run into each other,
and together form that scrofulous ophthalmia so common nowadavs.
If the conjunctiva is attacked, the affection locates mostly
in the conjunctiva scleroticae, not far from the edge of the
cornea, around which the exanthema often appears in the
shape of a rosary. There appears at first a circumscribed,
dense, vascular injection, in the centre of which almost always
a plastic exudation, resembling now a pustule, now a nodulus,
may be observed at an early hour, and toward which a ramification of vessels of triangular form, with the basis looking
toward the orbita, develops itself sooner or later (" scrofulo-vascular' ribbon"). If the exudation is deposited very
superficially, it is soon discharged in an outward direction,
leaving, however, superficial ulcers of small size and unclean
appearance; if the exudation is situated deeper, the ulcer becomes deeper and more obstinate. If the exudation is deposited evenly over the cornea, it does not break so easily, and
is more apt to occasion pannus scrofulosus.
It suffices to remark that the origin of the vesicles is nearly
the same in scrofulous keratitis. A reddened spot in the
cornea, the vessels of which communicate with those of the
conjunctiva, and in which a few days afterwards a vesicle of
a dirty-grayish color, as large as a millet-seed, develops itself,
above which the epitelium appears to be loosened, shows itself
now, and is accompanied by photophobia, more or less intense,
discharge of tears, and injection of the conjunctiva. If there
is but one vesicle present, it is apt, by depositing a greater



64            ON SCROFULOUS AFFECTIONS.
The development and course of this inflammation of the
cornea without vascular formations is exceedingly slow, lasting months and years, even.
Symptomrn.-The cornea shows a slight opacity, which soon
communicates itself to the whole cornea. The latter, therefdre, has an opaque coating, similar to glass that has been
breathed upon. Interlamellose thickening of a dirty-white
color, which seems to inclose one or more vessels, gradually
takes place. At other times we observe real bloody exudations of various extent which are resorbed gradually, i. e.,
the red-looking exudations become greenish and form a spot
often unremovable.
Sometimes the several exudations into the cornea may be
demonstrated, while the parts between them remain transparent. These spots are likewise hard to remove.
This form of keratitis is, now and then, entirely confined
to the cornea, though the sclerotica always exhibits a bluish
tint around the edge of the cornea, yet the remaining portion
of the memlbrane scarcely shows a rosy shine. The conjunctiva palpebrarum remains  intact, the mucosa bulbi exhibits
but a slight injection in the circumference of the cornea. At
a later date the outer membranes and iris become inflamed.
Exudations upon the capsula follow, which may be recognized
by a comparison with that portion of the cornea remaining
transparent. The cornea itself softens, and assumes a form
more or less conical. This kind of affection rarely ever ends
in ulceration.
It may also happen that the acute phenomena disappear,
the exudations become resorbed peripherically, and exhibit
in their centre a characteristic appearance.
The patients complain of fog before the eyes, but have no
pain; sometimes photophobia and watering of the eye during
aggravation.
In certain cases, finally, the retina, also, is irritated, and
the process may terminate in real amaurosis.
In most instances digestion is impaired simultaneously;
the patients are pale, and have lost flesh. The skin is dry and
colorless. At times hardness of hearing is connected with it;
oftener a somewhat hoarse voice and swelling of the submaxillary glands.



THE SPECIAL FORMS OF SCROFULA.                  65
Prognosis unfavorable on account of the residues mentioned.
Yet, we are able sometimes, at least, to resorb the exudations by homzeopathic remedies.
TERMINATIONS. —1. Resolution; rare, slow, and difficult.
2. Spots upon the cornea (usual termination).
3. Staphyloma, very seldom fully developed.
4. Amaurosis.
5. Adhesions of the iris to the capsula are frequent, since
the iris often partakes of the inflammation.
The third form of scrofulous ophthalmia, blepharitis ciliaris,
we have duly considered above.
The therapia of scrofulous ophthalmia is satisfactory, if we
consider that the most torpid cases have been cured by Calc.
carb.; now  and then, by Calc. jodat., Hep. sulph. c., Acid.
nitr., and  Arsenicum.   Mercur., KSulphur., Graphit. occupy
second rank, probably.  Calc. carb. is most efficacious in dilutions from the 12th to the 30th. Arsen. and Acid. nitr. cure
those cases in which an excessive irritation of the lachrymal
ducts exists.  Hepar is highly praised (applied externally
also), by colleague Teller, of Prague, as a specific against remaining spots and opacities of the cornea.* It has also been
observed, moreover, that upon the administration.of Apis,
Senega, Baryta, Aurum, and IBromrium, the cornea rendered
non-transparent by exudations (keratitis  parenchymatosa)
becomes transparent again. Rhus and Caustic. would correspond, probably, to the simultaneous rheumatic diathesis,
the presence of which proclaims itself by a more intense affection of the fibrous sclerotica.  Ulcerous processes come
within the sphere of Silic. and Acid. nitr.
As regards the time, Bellad. (6th dil.) would be the most
beneficial remedy in the- (first) inflammatory period. Later,
eight doses of Calc. carb.3~ (one dose daily).  If this does not
suffice, we shall, probably, be undecided between Acid. nit.
and Arsenic, to return, finally, however, to a preparation of
lime, either Hep. sulph. c. or Cale. jod. or again Calc. carb. in
a different dose, according to the individuality of the case.
* Internally the 3d trit. of Hep. sulph. caic. (morning and evening) has
done, in my hands, extraordinarily good services in subacute cases with
simultaneous agglutination of the lids, intense photophobia, and formation of
ulcers.



66             ON SCROFULOUS AFFECTIONS.
We shall be astonished at the superfluity of all adjuvants,
allopathically considered indispensable, such as leeches, purgatives, counter-irritants, eye-lotions, or even the gray mercurial salve, &c. It is precisely in scrofulous ophthalmia that
the natura mnedicatrix, if rationally aided, produces almost
miraculous results.
(b.) OPHTHALMIA NEONATORUM.
Since infants, preponderantly scrofulous, are exposed to this
disease, for which reason it reaches its highest degree of malignity, we will make the following remarks upon it.
The inflammation appears either as a sporadic, an epidemic,
or an endemic affection. Predisposition (to psora), bright
light, taking cold, infection of the eyes by impure substances,
especially by vaginal secretion-fluor albus-during the passage of the foetus through the genitals-as well as direct infection from one eye to another, contribute to the full development of the trouble.*
Small crusts around the ciliae, and a red longitudinal stripe
across the upper lid, which is but little swollen, mark out its
beginning. Afterwards the swelling becomes more intense.
The edge of the lid becomes red, the conjunctiva palpebrarum
loosened and velvety (on account of papillar infiltration), and
on opening the eyes but a single drop of a wheyish secretion,
intermixed with yellowish flakes, is discharged, at first.
Later, the upper lid becomes intensely red, often purple, tense,
and shiny. The swollen upper lid frequently overlaps the
lower entirely (oedema calidum).
At this time a secretion resembling bloody water signifies
danger.
Finally, the secretion becomes entirely purulent, yellow,
even greenish, and often shows traces of blood, produced by
the affection of the conjunctiva.
The cornea suffers from a subsequent parenchymatous inflammation, becomes opaque, passes into suppuration, formation of abscesses, perforation, &c., or softens (malacia). The
lens may drop out, and phthisis bulbi take place, even am* Piringers vaccinated with the pus of such children, and obtained positive
results.



THE SPECIAL FORMS OF SCROFULA.                 67
blyopia on account of the simultaneous irritation of the
retina.
THERAPIA.-IlHonieopathy, we may say without boasting,
does not know of any termination of so sad a character. We
possess in the RED PRECIPITATE especially, a remedy which
answers nearly all demands necessary to enable us to pronounce it a specific.*
Two grains (0, 1) of the 3d trit., morning and evening (or
three times daily) suffice even in neglected cases.
This preparation of Mercury corresponds to the most pernicious forms.  With Hep. sulph. calc., given in the same
manner, and which, probably, still better suits scrofulous individuals, I have obtained results not any less favorable.
Applications of tepid water (small linen compresses) which
may be covered with a warm cloth, and remain upon the eyes
during the night, advance the cure.
In place of the pure water we may also add to it a few
drops of the specific remedy.  Thus Acid. nitri and Lycopod.
in low dilutions (3d to 6th) have proved themselves beneficial.
A very efficacious remedy is ten drops of the first dilution of
Acid. nitri with two grammes of Spirit. vin. rectif.  Of this
solution fifteen drops in a saucerful of water to moisten compresses with.  Sulph., Cale. carb., and other remedies are likewise not to be despised. Yet, I have successfully treated the
most intense forms of that fearful ophthalmia by the remedies
first mentioned. Indeed, these cases were frequently such as
had been maltreated or neglected in the most inexcusable
manner, and in which perforation of and ulceration upon the
highly inflamed cornea gave occasion to fears of the worst
kind.
It is self-evident that we will treat a slight inflammation
of the eye by Aeon. or Bellad. (and a few doses of Calc. carb.
or Lycopod. at longer intervals), without taking refuge forthwith with the precipitate, &c. The further course of the inflammation alone indicates the subsequent selection of that
remedy.
* We mention here that, according to Adam Fischer, the white precipitate
of mercury (in the form of the Ung. hydr. pracc. albi) is said to be specific
also in common, scrofulous ophthalmia (with the," scrofulo-vascular ribbon'"
called after A. Fischer).



THE SPECIAL FORMS OF SCROFULA.              69
reappears. A slight disturbance of hearing is always present,
and roaring in the ears usually. The membrana tympani, in
the neighborhood of the handle of the malleus, is reddened.
The inflamed, serous, infiltrated lining of the meatus is
loosened in its tissue, covered here and there with small papule, vesicles or pustules, has a flaky, villous appearance, and
finally swells up to such a degree as to make the opposite
walls touch each other; a state of things which sometimes
renders the inspection of the membrana tympani utterly impossible.
Since the membrana tympani remains unaffected, the prognosis of this catarrhal, aural affection is favorable. I should
compare it to herpes conjunctivae or scrofulo-pustular ophthalmia. If this analogy is tenable, the remedies against both
affections will be the same. And, in fact, Calc. carb. (besides
Lycopod., Mercur., S'ltph., Hepar sulph. cale.) is in place
here as well as there.
Scrofulous otitis inclines toward a chronic course, and
changes, now and then, into genuine blennorrhoea, mostly with
an acrid, offensive secretion.  The membrana tympani is apt
to lose its lustre and to thicken. Upon longer duration papulous excrescences may form, now starting at the walls of the
meatus, now at the membrana tympani. The disease seldom
affects originally both ears simultaneously, yet, at a later date,
transplants itself almost always from one ear to the other, or,
perhaps, alternates between the two.
Hence, the scrofulous external catarrhs of the ear exhibit
the characteristic that they do not very easily terminate spontaneously, but drag out in the form of a so-called otorrhcea.
According to Rau, in catarrhal otitis, not only perforation of
the memlbr. tyrmp. never takes place, but also no secondary
inflammation of the periosteum of the meatus, of the mastoid
process, or of the brain, even such as are admitted by many
to occur. We may infer the scrofulous character of such cases
of otitis, especially when they set in after exanthemata (scarlatina; measles).
It is a pleasing sign that more recent therapeutics (Rau,
Politzer) warns against the intense cauterizations. It is true
it deems injections of metallic salts (Cupr. acet;, Zinc. acet.,
Plumb. acet. and sulph., Argent. nitric.) to be remedies, yet



70             ON SCROFULOUS AFFECTIONS.
Politzer himself admits that by means of too strong injections
one obtains a result exactly contrary to that he ainls at, a
more profuse discharge.* The injections ought not to occasion any burning.
Rau deems medicated injections and the dropping of Infus.
chamlom., millefolii, Liquamen  myrrhTe, into the ears, the
painting of the inner ear with Bals. peruv., the fumigations
of Mastix, Olibanum, &c., absolutely harmful.
It is most remarkable, however, that Rau (especially in case
of a simultaneous and offensive discharge) recommends limewater, the carbonate of lime being with us the remedy most
frequently applied.
(b.) THE INFLAMMATION OF THE INNER EAR.
Otitis Cctarrhalis Interna.
hIow much this inflammation interests us here is plain from
the words of the author mentioned above, who says: "On
more careful examination we shall usually observe that the
cause of the muco-membranous inflammation of the middle
ear is intimately connected with a scrofulous disposition.
There are families in which hardly one member remains free
from this disease of the middle ear.  Children of this predisposition are exposed to eruptions on the head and face, but
especially to frequent slight attacks of angina and coryza,
under the influence of which the disease develops now and
then entirely imperceptibly; or an acute exanthematic eruption, hooping-cough, catarrhal fever, causes a sudden appearance of otit. interna." Rau, as a rule, regards otit. int. to be
one of the most frequent disturbances of the ear existing.t
Besides the cavum tympani, the tuba Eustachii, and the processus mastoideus participate in the affection.  The catarrh,
in fact, is wont to start at the tuba Eustach.t  Hardness of
hearing, which may approach to complete deafness, more in* This was the case of a pale, feeble child, for whom a representative of the
school of 1' exact medicine " prescribed 3.0 (say three grammes) of Zinc. sulph.
(to 100 gramm. of water) as an injection.
t Of 1000 patients, afflicted with aural diseases, he saw 352 who suffered
from inflammation of the mucosa of the middle ear.
2 v. Tscharner, of 200 patients afflicted with aural diseases, found 62 who
suffered from inflammation of the tub. Eustach.



THE SPECIAL FORMS OF SCROFULA.            71
tense in the morning, and dependent upon changes of weather,
is never absent. Fresh catarrhal affections (a slight coryza,
the most insignificant beginning of an angina) forthwith
occasion an aggravation. The air-douche, which, in acute
forms, causes an unpleasant sensation, but improves the hearing almost immrnediately as soon as the air enters the cavum
tympani, alone gives positive information.
The acute form, almost always connected with other catarrhal affections, coryza, cough, hoarseness, &c., mostly begins
with hardness of hearing, roaring in the ears, sensation of
fulness, and heaviness in the ear, dulness in the head, and
especially with stitches running from the neck to the ear. In
case of a milder attack these symptoms imperceptibly disappear after a few days with an increased mucous discharge
from the nose and pharynx, the air entering sometimes suddenly into the reopened cavum tympani with a loud report.
If the mucus collected in the cavumrn tympani cannot be evacuated on account of the swelling of the tuba Eustachii, the hardness of hearing remains not only unimproved, but increases.
Perforation of the membrana tympani, destruction of the
ossicula auditus, caries of the proc. mastoid, do not belong to
this form, and their enumeration here is owing to a confounding of the trouble with periostitis cavi tympani.
(C.) PERIOSTITIS AURIS MEDIL.
This affection must also be mentioned here, since as otit.
int. it manifests a characteristic pathological picture, and
there cannot be any doubt as to its independence. Rau calls
it " the most important aural disease," endangering not only
the organ affected, but also life itself. Usually departing
from the menlbrana tympani, and simultaneously attacking
all parts of the middle ear, this inflammation affects, above
all, the periosteum. Without remaining confined to the middle ear, it passes almost invariably over to the tuba Eustach.,
and the cells of the mastoid process, is frequently communicated to the labyrinth, and may transplant itself to the meninges and even to the brain.
With the commencement of the purulent, exceedingly offensive discharge we always find the membrana tympani per



72            ON SCROFULOUS AFFECTIONS.
forated, sometimes destroyed to a great extent. In the acute
and chronic form the discharge, coloring the silver probe with
a blackish hue, is mixed with granules of bone, and at a later
date, the corpuscula auditus may be expelled. This, however, does not always occur. But if the caries makes any
progress, a soft, fluctuating swelling, with the color of the integurnments unchanged, appears upon the proc. mastoid, almost
without exception, which, settling in a downward direction,
frequently opens at a lower place, whereupon the destruction of the bony parts may be ascertained by the probe. At
the appearance of the purulent discharge from the meatus,
the cerebral symptoms (vertigo, one-sided pain in the head,
weakness of memory, sleepiness) often disappear temporarily,
and the hearing often improves to a considerable degree.
Notwithstanding, however, the patient is in constant danger,
since fresh inflammatory attacks frequently take place without any cause known, which at times occasion death by apoplexy very unexpectedly.
The disease mostly appearing before puberty, is usually connected with a scrofulous diathesis; so that the latter has to
be considered the predisposing momentum. In many cases
chronic exanthemata with reflex action upon the meat. audit.
ext. in form of otit. catarrh. ext., appear previously; after the
disappearance of which the disease often breaks out suddenly.
(d.)
Of less importance is the periostitis of the meat. aud. ext.,
for the diagnosis of which the silver probe suffices.
(e.)
The inflammation of the membrana tympani also occurs
preponderantly with the scrofulous, especially as a secondary
pathological process, resulting from the inflammation of the
external meatus and the middle portion of the ear. A purulent discharge, connected with hardness of hearing, frequently
is the first symptom arousing the attention of the patient.
Pain, if existing, is but transient in case of decrease or discontinuation of the discharge. The secretion of ear-wax is
regularly suppressed. The membrana tympani always thickens
in course of time. Partial destructions happen. Granulations
of polypous form; rarely genuine polypi.



THE SPECIAL FORMS OF,SCROFULA.            73
Now, as regards the therapeutics of all these conditions, the
homeopathic method of healing has the great advantage of
never contributing anything to the forcible suppression of the
otorrhcea, always to be considered as a beneficial crisis, though
of an incomplete character. If physicians, such as Hufeland,
warn against the suppression of cutaneous scrofulous eruptions, how much more ought this advice to apply with regard
to the internal, catarrhal, and periosteal otorrhcee, connected,
as they are, with the brain in a manner more or less demonstrable. Authorities in otiatrics admit at the same time that,
after the cessation of an otorrhoea, pain, hardness of hearing
and affections of the brain may appear, and when notwithstanding they cling to the Lapis infern. divinus, Cupr. sulph.,
Plumb. acet., &c., they occupy the position of those Athenians
of whom it was said that " they knew well enough what was
right, but did not do it."
As homceopath, moreover, one needs not be a specialist and
yet may make excellent cures of (scrofulous) diseases of the
ear. In order to apply the right remedy, it is fully sufficient
to know, whether a catarrh or a carious process is present,
and whether it bears the acute or chronic character. The
quality of the secretion is easily ascertained, as well as the
seat of the affection. From the above remarks it is plain that
the five usual fornls: catarrhal inflammation of the external
meatus, cavunl tympani, periosteal inflammation of the meat.
extern. and cavum tympani and, finally, meningitis must be
distinguished, and how.
Our suppuration-remedies, if I am permitted to use the expression, act just as surely upon that portion before as upon
that behind the nmembr. tympani.
It has already been mentioned that in the treatment of
mechanical conditions (narrowing of the tuba Eustach.), we
cannot do without certain mechanical aids, such as catheterization, air-douche, &c.
Besides, it has also been said that every disturbance of the
ear finds its analogon in a corresponding affection of the eye;
hence, the specific therapia, if fixed with regard to one organ,
would likewise apply to the analogous condition of the other.
In the treatment of scrofulous persons suffering from diseases of the ear, it is important to know that even the homce



74            ON SCROFULOUS AFFECTIONS.
opathic cure often requires a long time, weeks and months,
but that nevertheless the prognosis is not unfavorable. We
could mention more than one pernicious case in which under
allopathic treatment polypous growths, profuse, putrid discharge, general decline and a considerable degree of hardness
of hearing had made their appearance, where notwithstanding, Calcar., Silie., and Mlercur. (the first and third in their different preparations) were fully sufficient to master the pathological processes,.Ferrum jod. sach. has to be given, occasionally, as an intercurrent remedy, and as a drug improving the
constitution.
Iodine vapors have been lauded in chronic inflammation of
the membr. tymp. developing upon a scrofulous bottom.
(Tinct. Iodii, gtt. 2-6 to from 3 to 4 ounces of water) (Tscharner, Schw. Zeitschr., 1851.)
3. Scrofulous Affections of the Mucosa of the Nose.
The scrofulous affections of the nose, like those of the ear,
have also to be distinguished as acute and chronic.
(a.) CORYZA
Is too well known to be described here. I will mention,
however, that the cure of the chronic form is often of great
importance, scrofula in its totality not rarely being removed
with it. (Kafka.)
Besides the usual remedies (Sulph., Hep. sulph. calc.)
Graphit. and Arget. nitric. have effected results when profuse, puri-sanguineous nasal secretion existed, the sense of
smell was blunted, and the nasal mucosa appeared sore and
ulcerated. (Eczemata at the nasal openings and upper lip.)
In case of a bloated face, swollen nose and upper lip, offensive discharge, dried-up crusts in the interior of the nose,
ulcerated nasal openings, Cale. carb. 6. If this be without
result, Silic. or Mercur. prcecip. rub. 3. Aurum mur. natr. and
Kali. bichrom., and lastly, Arsenieum (Lacchesis). Arsenicum:
anaemia of a high grade, cedematous swellings of the lower
extremities, emaciation, increased thirst, eczemata, swelling
of the submaxillary and axillary glands.
Among the most important scrofulous affections of the nose
we count:



THE SPECIAL FORMS OF SCROFULA.                  75
(b.) OZANA.
Formation of ulcers and fetid smell accompany it. If but
the latter is present, the trouble is Oz. spuria, Oz. non-ulcerosa,
only.
Complete or but partial loss of smell, now a light-colored,
fluid, or reddish, now a yellow and thick quality of the secretion intermixed with streaks of blood, frequently drying up
to crusts, and the insufferable smell of the discharge characterize the ulcerous ozsena.
Sometimes we can observe the ulcers directly; any portion
of the nasal mucosa may become affected.
The obstinacy of the disease, frequently defying all therapeutics, is owing to the participating of cartilages and bones
in the pathological process.
Though CGale. carb., Hep. sulph., Phosph., Graph., Pulsat.,
Nux vorn., Silic., and Sulphur have been recommended, they
nevertheless not rarely fail.*
We may explain the recommendation of the various remnedies in this way that (by means of a remedy, or without it,
even) the subsequent amelioration was taken for a cure too
readily.  We have seen such improvements after Graph.,
Arsenic., &c., but no radical cures.  The same holds good of
Kal. hydroj., which, in doses of one grain daily, still deserves
most confidence.  Nlasal suctions of Chlorine-water even do
not dispel the penetrant " mouldy or caseo-putrid smell."
Kafka has recorded (Hom. Therap., ii, 743, case of ozaena
of eight years' standing) a cure by Hydr. prceeip. rubr. 3 internally (externally the crusts that could be reached were besmeared with Unguent. hydr. prcecip. rubr. (0.06: 2.0) ).  The
difficulty of a cure is owing, no doubt, to the peculiar con-e
struction of the nose, and (besides the partaking of cartilage
and bone in the pathological process) to the arrest of the
ulcerous secretion dependent thereupon.
Dr. Baer cured a girl, set. 13, with Aur. met., who had
already suffered for a long time to the greatest torment of her
* Thus Dr. Gentzke also describes (A. H. Z., 22, 9) an interesting case of Oz.
scrof. in a female servant, set. 22, and frankly confesses that Puls, Mler.,
Phosph., Aur., Thuj., Sulph., and Calc. carb., had not improved it any. He
closes with a modest quid hic faciendum?



76            ON SCROFULOUS AFFECTIONS.
friends from a horribly smelling, nasal discharge of a viscid,
purulent character, and very offensive breath. Her appearance was almost ruddy, yet somewhat " scrofulous " (A. H. Z.,
54, 1).
We repeat that ozmena is apt to show a very malignant
character, but that the want of therapeutic success is owing
to homccopaths, rather than homceopathy. It is an interesting
fact, however, that the remedy deserving of most confidence,
the red precipitate, is specific also against ophthalmia neonatorum, a disease which may be marked out as an expression
of a scrofulous constitution not any less obstinate. We may
be inclined to infer that both diseases belong, perhaps, to
scrofulous affections, modified by syphilitic antecedents.
(c.) POLYPI OF THE MUCOUS. MEMBRANE.
A peculiar termination of the chronic muco-membranous
inflammation is the polypous growth. They are distinguished
according to their consistency as fibrinous and mucous polypi.
Besides the aural mucosa, the nasal, especially, produces polypi,
which recur most obstinately in spite of surgical extirpation,
or their removal by torsion. The appearance of polypi is
mostly identical with intense scrofulosis, and especially with
that form of it modified by more advanced age. The soft
polypi start at the subcutaneous tissue or perichondrium.
In case of larger polypi we observe loss of smell, gaping of
the mouth, nasal voice, frequent but ineffective blowing of the
nose. Firm, fleshy polypi, may displace the lachrymal canal,
and thus occasion watering of the eyes, or since they affect
the tuba Eustach., hardness of hearing. Mucous, purulent
coryza, and ulceration even, may accompany the presence of
polypi.
If the polypus is seated high up, the diagnosis is facilitated
by closing up one nasal opening, and requesting the patient
to blow through the other. We recognize the presence of
polypi by the impossibility of air passing through it.
THERAPIA.-Whoever denies the efficacy of homeopathic
remedies, sees himself confined, as already said, to incomplete
surgical aid. Yet we possess drugs capable of counteracting



THE SPECIAL FORMS OF SCROFULA.             77
the polypous process, among which belong, especially, CALC.
CARB. and TEUCRIUM MARUM. Aside from these, according to
the individuality of the case, Conium, Phosph., Aurum, Bellad., Graphit., Mercur., Acid nitri, Silic., Sulph., Staphisagria.
(Journal de la Meidec. Hom., 1, 5). Polypi frequently appear
contemporaneously with those ominous chronic swellings of
the tonsils, which, likewise, have to be considered as an undeniable, partial phenomenon of general scrofulosis. Cale. jod.
has proved itself efficacious against these tonsilar swellings.
We request homceopaths to try it against polypi.
4. Mucosa of the Mlouth.
The connection between the affections to be mentioned here
and scrofulosis is more difficult to prove than that with regard to the eye, ear, and nose. Yet such affections do exist,
notwithstanding. Among them we count:
(a.) THE CATARRHAL INFLAMMATION OF THE MUCOSA.
Stomatitis Catarrhalis.
It is connected with redness and increased secretion. The
tongue looks as if it were covered with a thick layer of raspberry syrup. On longer duration a white coat appears upon
it. The children do not like to have any portion of the mouth
touched. Mucus always flows down the corners of the mouth,
excoriating them, reddening the chin, and soiling the clothes.
The mucus is wont to react acidly.
When redness and soreness have lasted a few days, small
vesicles, as real exudations, in appearance and course much
resembling herpes (labialis), rise up at the mucosa of the
tongue, gums, lips, and cheeks. They soon burst and leave
small, superficial ulcers with a yellowish-white bottom, increase in the first few days in all directions, become confluent,
and produce ulcerated surfaces of some extent, especially at
the edge of the tongue, and the mucosa of the lower lip.
These ulcers never have a peculiar smell.
THERAPIA.-Acid. nitr. when small ulcers are present.
Mercur. in case of great flow of saliva. But from the internal



78            ON SCROFULOUS AFFECTIONS.
and external application of Borax, also (1st or 2d trit.), beneficial results have been obtained.
A characteristic fetid smell we find in
(b.) STOMACACE,
which is not accompanied by increased secretion of the buccal
mucosa, as stomatitis catarrh. is, from which, according to
some authors, it may develop, and which occasions ulcerative processes of greater extent. It shows but little inclination to heal spontaneously; swelling, ulcers, and smell, without treatment, may last for months; the teeth become loose
and fall out, and the children become emaciated to a dangerous degree.
I should compare Stom. catarrh, to coryza with its termination into ozoena benigna (non-ulcerans), stomacace to ozaena
maligna.
The subsequent course (after the forerunners of simple
stomatitis) of stomacace is that the parts adjoining the gums,
are infected by contact, and suffer the same changes. The
mucosa of the cheeks swells considerably, so much so as to
show the impression of the several teeth upon it. The same
is true of the tongue (swelling of the cervical glands).
Alfred Vogel says: "'Calomel, in children, produces a disease of the mouth that cannot be distinguished in any way
from stomacace, unless the absence of contagiousness of
stomac. mercurialis, above mentioned, is to be set up as a
diagnostic sign."
By this remark, and the fact that Mercur. is homceopathically indispensable in stomacace, we again see the correctness
of the law of the simile confirmed.
Besides Acid. nitri., Sulph., and against stomac. catarrh.,
Borax is indicated. Since Borax is used allopathically, even,
against catarrhal inflammation of the buccal mucosa; there
could, as regards stomacace, also be no objection raised homceopathically against Kali chloric.; especially, as according to
the testimony of able allopathic therapeutists, it is said to be
the most specific remedy for it, existing.
(C.) APHTHe.
A form of stomatitis connected with the formation of fungi
(oidium albicans) which depends upon predominant acidity.



THE SPECIAL FORMS OF SCROFULA.           81
although the cough is rough and suppressed, the voice weak,
hoarse and interrupted by whistling sounds; the patient falls
asleep again, but breathes with whistling noises, and shows
restlessness during sleep with repeated starting. On the next
day there is a decided amelioration of the phenomena, but
still greater weakness remains. In the course of the same
day, or the night following, or on the next day, even, paroxysms of suffocation again set in which become more and more
violent.
In the intervals between the attacks we may observe mostly
pain in the region of the larynx, heaving and whistling respiration, now restlessness, now a semi-soporous condition together with a very accelerated pulse and increased temperature. At a later period the paroxysms come at shorter intervals, continue longer, and are interrupted only by soporous
exhaustion; the lung begins to distend itself emphysematically, and continuous dyspncea with a cyanotic appearance
shows itself during the intervals, even. Though the attacks
themselves gradually grow more moderate now, yet the respiratory impediment becomes more and more permanent, and
slight jerks and more violent convulsions appear in addition.
In some cases pseudo-membranes are coughed up, always with
relief, which, however, usually is but temporary. Now and
then, a mucous and viscid liquid is evacuated by vomiting
with some benefit.
In some cases, not so exceedingly rare, the symptoms decrease, it is true; the breathing becomes more free, and more
rest is obtained, yet the pulse remains extraordinarily frequent, and though the respiratory impediment is renloved,
the sopor increases, and death occurs from gradual collapse
with or without the addition, of cedema pulmonum.
THERAPIA.-There cannot be the slightest doubt but that
the prognosis of croup is not as hopeless under homceopathic
as under allopathic treatment. Indeed, we need but take up
allopathic textbooks of a recent date and more enlightened, to
perceive that the aids, formerly considered indispensable, such
as venesection, counter-irritants, cauterizations, and others,
are condemned; at the same time, however, so great a helplessness becomes apparent that things of the most contradictory nature are recommended. There a Wunderlich, even,
6



82            ON SCRO'FULOUS-AFFECTIONS.
does not scorn the idea of appealing " without hesitation,"
now to mercurial salve, now to inhalations of chloroform, now
to moschus, now to opium'" in large doses," now to asafcetid.,
now to tracheotomy. Indeed, in order to make the irony
complete, he mentions Hep. sulph., even, in doses from one to
six grains. In the latter recommendation we see the obtuse
presentiment of the possibility of a better therapia of croup
than the present one. Yet, there is no mention made of
remedies, such as Spong., Iod., Brom., Phosph., and Kali
bichrom., so important in the most severe cases of genuine
croup.
Nowhere is the recommendation of medicines connected
with so great a responsibility as in croup. For the most tortuous death would be the consequence of an erroneous treatment.  Our recommendation of the homceopathic therapia,
aside from its being based upon numerous and trustworthy
reports of others, rests, therefore, upon clinical observations
of our own. At this juncture we will not fail to remark, 1,
that we entirely agree with Dr. Weil's views, that when one
declares that he has treated croup in one and the same individual, five or more times, the disease was not membranous
croup, but pseudo-croup; 2, that the homoeopathic specifica,
though efficacious, are not able to arrest a case of croup at
once, but sometimes let us wait very long, indeed, for the final
removal of the ominous attacks.
Moreover, in case of a malignant course of the disease, we
would not like to do without the wet bandage around the
throat as an auxiliary means. It is remarkable how well it
is borne at the height of the disease. Upon the whole, we
have in the natural curative instinct a guide for the various
curative apparatuses. The cold bandage, if not appropriate
any longer, is refused. The same holds good of inhalations,
which, likewise, at a certain period and stage, prove themselves very beneficial (S. LXIII). Thus I let lodium (1 drop to
circa four grammes of water) or Bromiurm, or Hep. sutph. catc.,
even, vapor off; or be inhaled with benefit as long as no resistance is made.
The wet bandage is apt to produce sweat, which, starting
at the throat, spreads over the rest of the body. But it is the
sweat, especially, which is absent in membranous croup; the



THE SPECIAL FORMS OF SCROFULA.               83
skin remains hot and dry. When warm sweat is present, cold
water ought not to be applied.
Spurious croup, which, fortunately, is observed much oftener,
is cured by Aconit. (within the first twenty-four hours), and
Hep. sulph. calc. (Kafka), or Spongia.  If the crisis (loose
cough, sweat, discharge from the nose) has set in after Aconitum, Bellad. is well indicated for the second day. Hot, sweetened milk, drank in large quantities within the first hours of
a sudden attack of croup (usually at night) assists the crisis.
It is difficult to give TENABLE indications as regards the several croup-remedies.  If we look at the respective reports of
cures, we find that, in most desperate cases, the metalloids
named, Iod., Brom., Spong., have almost always been given
(and in this fact we notice, in contradistinction to the allopathic school, the observance of a uniform principle); but, at
other times, it required Kal. bichrom., Tr. Sambuci, Kaolin,
Tart. stib. (in horn. trit.), or Phosph. (applied locally, even),
before the disease was broken. It is a disadvantage that in
this disease we feel less inclined than almost in any other, to
allow the remedy to develop its full action, since otherwise
the danger might reach an incontrollable height.
Hoarseness, amounting to aphonia, pathognomonic of genuine croup, as we may say, sometimes requires an especial aftertreatment, lest it may continue for months even.' Lycopod.,
Caustic., Graph., Phosph., Silic. would be the remedies to be
tried. Also, hot milk and Seltzer water as auxiliary means.
2. The Bronchial Catarrh of the Serofulous
Characterizes itself by its chronic course-its appearance
during childhood, the partaking of the lungs in the affectionan occurrence that may easily happen-and the great quantity
of sputa of a sero-purnlent quality. On account of the relation of scrofulosis to tuberculosis such catarrhs ought to be
watched with the greatest care. The children have mostly
fever with it, lose flesh, and auscultation often shows surprising differences in the resonance between the right and left
pulmonary apex. A peculiar shortness of breathing, always
suspicious, and signs of disturbed digestion, mental depression, and changed disposition, are always present.



84               ON SCROFULOUS AFFECTIONS.
THERAPIA.-Sulphur, especially, is able to prevent the evil
terminations of this catarrh, and to resolve the infiltrations
in the pulmonary  tissue.  Afterwards  Phosph.,*  Mercur.,
Hep. sulph. calc., Calc. carb., Silic., Lycopod., but also Pulsat.,
Scill., and OChina, &c., effect much.
Ipecac. is likewise most valuable, especially in case of simultaneous chronic looseness of the bowels, and a spasmodic
character of the cough, but mostly is efficacious only in form
of a weak infusion.
Finally, we must not forget Kal. carb., which plays so important a part in incipient phthisis, and is indicated in case
of predominant stitching pains in the breast; hence, in case
of pleuritic symptoms, shortness of breathing, especially in
childhood, and with females. Hemorrhages would point to
Kal. carb. all the more.  I use the 3d trituration (morning
and evening 0.1 gramme) with very great benefit against the
respective chronic or subacute pulmonary catarrh of scrofulous persons, in whom I suspect a predisposition to tuberculosis. The characteristic swelling of the tonsils and crusty
soreness of the nasal mucosa (in the region of the nasal openings) mostly existed simultaneously with those catarrhs.
In such cases too much importance cannot be placed upon
a corresponding change of air, a residence in a country, sunny
and rich in pine forests, and upon the milk-cure, &c. (milk of
asses and goats, &c., warm as it is drawn from the bag).
III. ORGANS OF DIGESTION.
"Chronic catarrhs of the stomach and intestines, with
paresis of the intestinal musculature," according to Wunderlich, are troubles not rarely found with the scrofulous. These
conditions are either of a more transient nature (in which
now constipation, now diarrhcea, has to be met) or continuous,
* I found Phosph. repeatedly specific when breathing was so impeded that
one felt as if he should help the children in their res'piratory efforts; hence,
when a certain degree of dyspncea existed. Also Lycopod., in case of socalled consonant rdles, when a concomitant noise, like the sound from an
organ, or a whistling was heard while breathing. So in the cough accompanying influenza. Scilla (in a low dilution, a few drops at a time) in case of
excessive mucous rattling, when the children cannot get control over the
mucus. Here China (in a low dilution, or the mother-tincture even) is also
indicated.



THE SPECIAL FORMS OF SCROFULA.              85
and then of evil omen. An affection of the mesenterial
glands, and, in consequence, degeneration of those organs
takes place, and such children die miserably under the symptoms of a follicular enteritis or chronic atrophia, probably in
combination with ascites. The nosological picture of such an
abdominal localization of scrofula we find most instructively
given in the curative results of Baryta mur. and Arsenic (see
those). There we regularly find also scrofulous concomitants,
such as swollen glands of the neck, cutaneous eruptions of the
head, &c. The character and course of abdominal scrofula is
drawn nearly as precisely as is that of scrofulous ophthalmia
or ozena.
THERAPIA. —Aside from the remedies mentioned, Calc. carb.
and Phosph., and in those cases characterized by eruptions of
all kinds, especially furunculous abscesses on the head and
trunk, Sulph. and Silicea will suffice, perhaps. Carb. veg., also,
may come under consideration in atrophia infanturn, especially if decided symptoms of scrofulosis were present previously (see cures by CARBO VEG.).
NOTE.-Probably hydrocephalus acutus may, with more
propriety than any other disease, be compared to this manifestation of scrofulosis; and it seems that, at a certain period
of time, the nature of the child remains, so to say, undecided
before this alternation, until an external incidental cause (a
mistake in diet, chilling of the head, &c.) influences it to
decide itself for this or that cavity (abdominal or cranial).
C.-THE GLANDULAR SYSTEM.
1. The Lymphatic Glands.
That the lymphatic glands frequently are affected by scrofula, and become the seat of abscesses, is not to be wondered
at in view of the predominant significance of this anatomical
system with regard to scrofulosis in general; for swellings of
the neighboring glands never fail to appear in case of any
extensive peripheric localization of that diathesis.



86            ON SCROFULOUS AFFECTIONS.
We may distinguish between inflammatory, scrofulous, and
non-inflammatory infiltrations.
We observe the inflammations most frequently behind the
ears, at the lower jaw, neck, in the axilla, more rarely at the
inguinal region. According to the degree of the inflammation,
its extension over the subcutaneous connective tissue, and the
number of the glands affected, such inflammations are accompanied, more or less, by febrile symptoms, local pains, and
nightly exacerbation. They mostly terminate in suppuration,
sometimes after the previous appearance of severe chills. Not
unfrequently a complete cure follows upon the spontaneous or
artificial evacuation of pus; the inflammations often recur at
short intervals, or appear slowly with but slight inflammatory
symptoms; then the inflammatory infiltrations remain at an
incomplete staoe of development, and, by mostly spreading
from one portion of the gland to another, and thus forming
a connected chain of suppurative foci, pass over into the process of softening not before weeks or months, occasioning an
unhealthy look, loss of flesh and strength, and leaving behind
disfiguring and contracted cicatrices. In other cases a suppuration-focus develops only at a circumscribed spot of the
glands, infiltrated by inflammation; the pus, however, does
not perforate the glandular capsula, but thickens and passes
over into caseous metamorphosis. In consequence of these
hard knots the glands may assume an irregular, tuberous
appearance. If the cheesy content of the gland calcifies it
acts like a foreign body.
The non-inflammatory infiltration of the lymphatic glands
consists in chronic swelling of the separate glands, which occasion neither pain nor redness, mostly feel like round, oblong,
smooth or hard bodies, and often attain to a considerable
size. If several glands standing in a row, or forming clusters,
become scrofulously infiltrated simultaneously, or in succession, they frequently appear as knotty ropes, or as disfiguring
not smooth but tuberous packages. Resorption can take place
only, when the glandular contents (infiltration) are cellular
(increase of cells —Virchow), but hardly ever in case they be
lardaceous or chalky. Therefore, we cannot always expect,
as we have said above, cheesy or albumninous contents. Yet,



THE SPECIAL FORMS OF SCROFULA.              87
the idea of scrofula does not agree with that of cellular infiltration.
With many practitioners, however, the appearance of glandular infiltrations is taken to be a pathognomonic symptom
of scrofula.
THERAPIA.-The acute, scrofulous glandular inflammations
are treated with Bellad., Aconit., Mercur., or other remedies
corresponding to the individual case. If abscesses threaten to
form, Rep. sulph. calc., Mercur., Silie. If the opening does
not close up, but continually discharges a watery fluid, Caustic. (pledgets of lint saturated with it) is well suited. After
Sit., Phosph. will often be indicated, to which Kafka rightly
attributes a vitalizing effect upon the paralyzed curative activity. The same author recommends Kal. hydrojodl. 2d or
3d, externally and internally, or Conium, twice or three times
daily, in case of want of reaction in the purple, swollen, and
nearly painless glands, which do not pass on either into suppuration or resorption.
Silic. and Acid. nitri. modify too profuse suppuration.
They correspond also (besides Phosph.) to torpid (weak in reaction) scrofulous ulcers, such as may develop from abscesses
in the lymphatic glands.
In case of an ichorous, offensive discharge, Arsenic., Kreosot., Asafcet. However, the most sovereign remedy against
indolent non-inflammatory glands is Iodium and Kal. hydrojod. Sep., Con., Baryt. carb., without excluding Phosph. and
Silic., may be applied, if simultaneous coughing up of blood
exists, or if frail individuals pass, at the same time, through
the period of evolution.  Carb. an., finally, is a remedy not to
be despised in benignant as well as malignant glandular affections of the most various kind.
If the remedies mentioned are of no avail, we may infer a
lardaceous or colloid content of the glands. Then Brom. and
Aurum mur., in spite of the obstinacy of the trouble, are able
occasionally, to bring about resorption. The same holds good
of the mineral springs containing Jod. and Brom., such as
Hall, Kreuznach, Wittekind near Halle, Rehme, Kcesen,
Reichenhall, Ischl., &c. Besides, we refer to the clinical observations with Aur. and Baryt., but also with Con., Lycopod., &c.



88             ON SCROFULOUS AFFECTIONS.
NOTE.-It is not so unimportant, as it may seem, to strive
in a rational manner for the diminution of hypertrophical
glands. Let us be reminded of the consequences of such, frequently hard, glandular swellings. On account of the unavoidable pressure upon the adjacent parts, they may produce
results (asthma; atrophia of the respiratory muscles; convulsions; paralysis) endangering life which, without proper help,
have occasioned painful death. In a like manner we can,
vice versa, do a great deal of good with curative means so
well adapted as ours. Thus we may explain why Spong.
cured diseases of the heart of a grave (secondary) character,
or why Iod., Brom., Con., &c.. softening and resorbing, as they
did, occult glandular indurations at a critical locality, removed diseases which, in fact, were to be considered but the
sequelae of a primary glandular affection.
2. Struma.
The swelling of the thyroid gland is so intimately connected
with scrofulosis that formerly the term struma was used for
scrofulosis. Goitre is mostly a stationary phenomenon, similar to hypertrophy of the lymphatic glands of the neck, axilla,
&c. But its growth, as well as its first unexpected appearance,
may make it seem desirable to interfere with it, especially, if
dyspncea or considerable disfigurement results from it. The
symptoms of compression depend upon the direction in which
the thyroid gland, or single portions thereof, increase in size.
A growth anteriorly is most disfiguring, but, at the same
time, most favorable as regards general health, especially respiration. On the other hand, disturbances of circulation and
respiration appear in consequence of a displacement of the
musculi sterno-cleid.- mastoidei, in case of lateral or posterior
hypertrophy. Distuli,ances of deglutition and impediments
of respiration, if the struma surrounds the cesophagus or
trachea in ring form. Enlargements, inferiorly, as far as
below the manubrium sterni, are most dangerous.
We distinguish between struma lymphatica, a simple enlargement of the glandular knots, and str. cystica, an enlargement
of the several knots into cysts. Thus, with children cysts
may develop of one inch in diameter. A  colloid mass (a



THE SPECIAL FORMS OF SCROFULA.                 89
thickly-fluid, gluey, yellow or brownish liquid) constitutes the
contents of the cysts. From globular, tuberous enlargements
we may infer struma cystica.
THERAPIA.-TO extirpate strumata for aesthetical reasons
is generally condemned.  There exists, however, the shortsightedness of recommending painting with Iodine (from six
to twelve times, at intervals from three to six days) for the
purpose of effecting a cure. The relation of the thyroid
gland to the lungs is too important (though not sufficiently
understood) to permit without obnoxious consequences, the
remnoval of such hypertrophies (which certainly do not exist
without purpose) by external means.
The removal of the pathological products by-internal remedies specifically homoeopathic is a different matter, however.
Among these strictly belong only the Carbonate of Lime,
which produces strumata, and lodium, of which the same is
maintained, and both of which are advantageously combined
in the preparation of Calc. jodata; besides these, Iron, which
favors the growth of goitre, may be mentioned here, probably.
Aside from Calc. carb., and Iodium, Apis has the name
of removing goitre; against struma cystica we should prefer
Calc. carb., because, according to experience, other cysts also
have given way under its systematic (i. e., temporary discontinuation and administration of the remedy in different dilutions) application.
Spong. and Brom., moreover, in suitable dilutions bring no
danger.  The term of" Kropf-Schwamnm" (goitre-sponge) for
Spongia is very properly applied.*
Finally, there is nothing to contraindicate the prudent application of Kali hydrojod.  (IX.)
3. Chronic Hypertrophy of the Tonsils.
It may be doubtful whether it is always inherited, as Alfred
Vogel thinks, but it is certain that children two years old
may be already affected by it.  If we inspect the oral cavity
* I can hardly sufficiently recommend the following treatment: Spong. 1,
ten drops in two granmm. of Spirit. vin. rectific. Of this morning and evening from two to three drops for several weeks. In chronic cases Spong., in
alternation with Brom., lod., Phosph., especially if dyspnea, shortness of
breathing while walking and ascending stairs result from struma.



90             ON SCROFULOUTS AFFECTIONS.
of such patients, we see two fleshy plethoric swellings at the
side of the uvula; smaller and larger vessels cover them, and
single spots are frequently denuded of their common encasing
membrane in a manner that makes it appear as if a real almond could be seen behind the defective shell.  From the enlargement toward the nose, a nasal voice, snoring and difficult
breathing during sleep result, and there is in such children a
noticeable disposition to angina, diphtheritis, and membranous
croup. Other symptoms of a scrofulous diathesis hardly ever
are absent. The enlarged tonsils take position in front of the
tuba Eustachii, and occasion hardness of hearing of a higher
or less grade and abnormal sounds.
There can be no doubt as to the scrofulous nature of this
trouble, for the reason that Iodium and its preparations, especially Calcar. jodata (Vehsemeyer) affords help. It characterizes itself, moreover, by this, that, though admitting of a
certain spontaneous diminution of the glands, in the course
of years (in the same manner as inherited strumata heal spontaneously), it yet continues to the age of manhood, and to a
later date even. Allopathic physicians praise the efficacy of
Cod-liver oil in this affection-a praise that is identical with
that of Iodine.
Dupuytren thinks that these glandular swellings, in consequence of the pressure upon the muscles of respiration,
atrophy the latter, and thus produce the "'chicken-breast"
(pectus carinatrum) afterwards. But it is our opinion that,
where such tonsilar hypertrophies exist, there is predisposition
to tuberculosis ab initio. Hoarseness, shortness of breathing,
and easy tiring while speaking, appear in company. If we
deprive scrofulosis of the locality chosen by it, e.g., by extirpation or cauterization of the tonsils, or a forced Iodine-treatmnent, it is likely to be followed by the same sad consequences
as are wont to set in in case of treating strumata in the same
manner; hence, here even the essence of the disease ought
not to be lost sight of over the anatomical lesion.
However, a reasonable administration of the remedies
named, as well as of Cailc. phosph. (jodata?), almost specific in
this trouble, and of Baryt. mur., is not excluded.*
* In the Journal des Connaissances M6dicales (May 20, 1866), Lambron
recommends the mineral sulphur-waters (" en boisson et en douches locales "),



THE SPECIAL FORMS OF SCROFULA.               91
On theoretical grounds, and because this affection, together
with ozoena scrofulosa and ophthalmia neonatorum, represents, so to say, the prototype of scrofulosis, two diseases, for
which Mercur. prxcipitat. ruber has proved its efficacy in a
brilliant manner, we are inclined to consider this remedy
worthy of trial here.
Kali bichromicum, a remedy that shows its curative power
peculiarly in the most intense and inveterate symptoms of
scrofulosis, has likewise produced good results.
Finally, a concentrated extract of the.Foliajuglandis, with
which the tonsils were painted, has been used. This means
is almost as little deserving of imitation as the gargarisms
with Alum and the applications of Nitrate of Silver.
Hardness of hearing, occasioned by hypertrophy of the tonsils, gives way, sometimes, in an amazing manner, upon the
administration of lod. and Brom. (S. XXX), a fact not explainable without a simultaneous partial resorption of the
hypertrophied tissue.
(S. under BARYT., Dr. Zwingenberg's method against hypertrophy of the tonsils.)
D.-SCROFULOUs AFFECTIONS OF THE JOINTS AND BONES.
At another place we have called them —rightly or wrongly
— the tertiary phenomena of scrofulosis. Other (primary and
secondary) scrofulous conditions are wont to precede them,
and, no doubt, always do precede them, until the osseous systeml and skeleton are affected in their turn, as occurrences of
muchi greater significance.  As regards our treatise this section is of especial interest to us, in so far as it again offers
us a chance for indicting the old school for the inexcusable
thoughtlessness which permits it to make use, without the
slightest ado whatever, of amputations and operations, where
homneopathy treats in the most considerate and conservative
manner.
Far from denying the necessity of surgical interference for
Luxeuil-Bar6ges. Dr. Caffe recommends the partial removal of the tonsils
(in which case they continue to secrete when food is swallowed).



THE SPECIAL FORMS OF SCROFULA.            93
may form a large cavity. Usually the periosteum is detached
to a considerable extent, the bone itself necrotizes and ulcerates (caries).
Tuberculous masses appear as products of inflammation.
The pain, dull at the beginning, and worse upon touch, is
aggravated by changes of weather and at night. The skin
becomes stretched and hard at the diseased spot, until fluctuation and breaking of the abscess take place. Spongy granulations that bleed easily.
The prognosis is unfavorable on account of the frequent
transition into necrosis or caries. Its course, to the horror
of the patient and his friends, is sometimes exceedingly chronic.
A hectic condition may occasion death before complete ulceration and necrotic detachment have taken place.
2. Osteomyelitis, Endostitis.
(INFLAMMATION OF THE MARROW.)
The inflammation of the marrow within the cavum medullare of the cylindrical bones happens with scrofulous subjects,
and that very frequently.  There exists simultaneously infiarmmation of the periosteum, and likewise not rarely inflammation of the marrow in the bony network of the short cylindrical bones. All the spaces within the osseous network and
the cavum medullare are filled up at the commencement with
dark-red marrow, which is rich in blood and cells, sometimes
even of a decomposed, puriform character. In its later stages
the process is called osteoporosis, osteospongiosis, spina ventosa.
Purulent softening and resorption of osseous substance takes
place and make the bone appear inflated. In a certain sense
we could speak of eccentric hypertrophy, especially, as the
simultaneous periostitis deposits lamellose neoplasmata. The
joints are apt to remain free from the affection; on this account, and in view of the tuberous swellings in places where
enchondroma makes its appearance (metacarpal and metatarsal bones), the affection reminds us of the latter. If those
swellings break, numerous but small fistulous openings are
formed.



94            ON SCROFULOUS AFFECTIONS.
3. Oslitis Scrofulosa.
(INFLAMMATION OF THE BONE ITSELF.)
A frequent manifestation of scrofula. The spongious bones
(short bones of the hand and foot, epiphyses of the long
bones-vertebrae) are attacked, especially.
At first, one or more inflammatory foci show themselves.
The osseous spaces, which are soon taken possession of by
granulations, and show a great richness in cellular structures,
are filled up to excess with a fatty-gelatinous liquid; the
meshes of the long bones enlarge, bony substance being resorbed by the growth of the granulation (osteoporosis).
The bone appears more voluminous at the spot inflamed,
though the whole amount of its mass has grown less. Frequently we notice, even if the inflammation reaches the depth
of the bone, that the adjacent soft tissues already show forming abscesses.
The tuberculous form of ostitis is frequent among the scrofulous. Several foci form, or a uniform infiltration of the
bony substance with a semi-transparent, grayish-yellow, and
gelatinous exudation. If separate foci exist, they are surrounded with a kind of capsula which encases, so to say, that
exudation, but disappears in consequence of the subsequent
changes in the latter. Softening soon takes place; the foci
assume a yellowish color; crummy, cheesy elements may be
found in a thick-flowing, pappy mass, and in case of a quick
enlargement (of the foci), not rarely small bony fragments.
In consequence of this process in the bones, caverns are formed
which, if several of them run together, make the bones brittle.
A cure may be accomplished by resorption of the liquid contents, with simultaneous calcification of the remainder, while
in the surroundings thickening of the bony tissue takes place,
by which, now and then, encasement is effected. However,
perforation and discharge of tuberculous pus with continuation of the process as tuberculous caries are more frequent.
The tuberculous infiltration affects either an entire bone
(e.g., a vertebra) or a portion thereof. In the bones, which are
permeated by grayish-yellow products of inflammation, yellowish streaks and spots appear which rapidly enlarge, become



THE SPECIAL FORMS OF SCROFULA.               95
confluent, and consist of a purulent liquid, intermixed with a
crummy mass, which soon assumes the pyonichorous and
sanious character. By its influence the bony tissue is destroyed in larger or smaller portions, and may be found sometimes in the ichorous discharge. If the process progresses, it
may affect the periosteum, and occasion its ichorous decomposition and destruction.
The terminations of scrofulous ostitis are:
1. Resorption (exceedingly rare).
2. Suppuration with subsequent healing without transition
into caries. This termination also is rare, if perforation and
discharge have taken place. Under the influence of the dyscratic diathesis,
3. Caries, or
4. Necrosis,
follow much oftener.
Caries.
The characteristics of caries consist in this, that it affects
spongious bones, usually develops from primary ostitis; progresses from the interior of the bone to its surface (caries
centralis), and much more rarely migrates from the periosteum
inwardly (caries peripherica). The osseous ulcer " par excellence" is produced, if the carious inflammation attacks a
circumscribed spot; for several spots may be affected.  The
bone mray ulcerate at one time in separate portions (C. partialis), at another in, toto (C. totalis).
Caries develops in this way: the granulations secrete a
reddish-brown liquid which,-in combination with the decomposing fat-cells and. the few pus-corpuscles, produces the ichor
with which Jhe spaces of the osseous network are filled.
Then atrophia of the osseous partition-walls takes place, in
consequence of which the bone thus diseased becomes soft and
compressible until it entirely disappears on account of the
destruction progressing from layer to layer.
Caries necrotica takes place, if portions of the bone, themselves normal, which are adjacent to the carious spots, are
deprived of nutrition, die off, and form smaller or larger pieces
of sequestrum.
The soft tissues participate the more as the carious process



96             ON SCROFULOUS AFFECTIONS.
progresses; the connective tissue is attacked by ulceration,
especially, where the periosteum is destroyed. Larger or
smaller purulent foci and fistulae form; perforation outwardly,
discharge of the carious ichor.
The secretion is mostly thin, of a nauseating disgusting
smell (similar to decomposing meat), intermixed with bony
particles, or in case of tuberculous caries, with caseous crumbs
and flakes (and bony particles).  Spongious granulations
sprout up around the fistulous opening which frequently cover
the entrance and easily bleed upon touch. The ichor often
gets to the surface by a circuitous route. The silver probe,
wvhich becomes blackened on account of the sulphur-compound
of the ichor, feels the diseased bony part rough, uneven,
worm-eaten, as it were, and compressible.
If smaller bones, distant from the trunk, are affected by
caries, the general health suffers but little.
In case of a cure the atrophy of the bones ceases, the discharge stops, the granulations become more firm and richer in
fibres; then ossification and repair of the substance lost start
at those granulations, as well as at the adjacent tissue, and
especially at the thickened periosteum.
Necrosis.
All the causes and conditions of caries may also produce
necrosis. In consequence of undermining the periosteum or
membrana medullaris, and of pressure upon the vessels after
copious exudations have been deposited, a piece of bone
becomes isolated, and dies off. According to the seat and
extent, we distinguish likewise between superficial, internal
(central), partial, or total necrosis. In contradistinction to
the carious process, necrosis affects more the long, cylindrical
bones. It is plain, moreover, that the anatomico-physiological peculiarities of the part affected modify scrofulosis, which,
in its essence, remains the same always. Hence necrosis appears here, and caries there. In the same manner sclerotitis
develops in one case, and a stye in another under the same,
e. g., rheumatic influence. But necrosis itself, even, appears
to be different according to its seat.
a. In central necrosis the isolated piece of bone, deprived



THE SPECIAL FORMS OF SCROFULA.             97
of nutrition —the sequestrum-is found to be inclosed in a capsula lined with granulations-death-shrine. From the capsula incasing the sequestrum, openings, varying in number,
take their departure, which are also lined with granulations,
and lead in an outward direction (cloacx).
The holes in the bones are round or oval, variable in size,
and externally surrounded by a wall of granulation; pus issues
therefrom as long as the sequestrum is within the capsula,
and though they may temporarily heal up, usually break open
again soon.
If the sequestrum is removed the cavity is filled with granulations, and forthwith by a granular mass, provided that the
general health has not run down too much; and the fistulous
sinuses heal up, mostly by leaving cicatricial contractions.
b. In superficial necrosis, after periostitis, the sequestrum
usually is not incased in a complete capsula; on this account
it can be expelled more easily. The canal in which it was
imbedded fills up with granulations, and a cicatrix is formed
immediately adhering to the bone.
c. In necrosis totalis a complete " death-shrine" is likewise
but rarely formed; this is pierced, on the contrary, by openings; the soft tissues are traversed by wide and long fistulous
sinuses.
d. Lastly, the dying off of whole bones takes place occasionally, e. g., in case of scrofulosis at the hand and foot, as
sequela of.intense ostitis and periostitis. IIence, the sequestrum, consisting of the entire bone, shows traces of inflammation, sometimes is carious, even, in a high degree, osteo-porous,
and imbedded in a wide cavern filled with pus and ichor.
If the swelling has broken, or been opened, we reach the
dead bone through the opening; in most cases it gives a hard
sound upon touch, and feels smooth and firm.
Spondylarthr ocace.
SCROFULOUS INFLAMMATION OF THE VERTEBR~E —MALUM POTII,
KYPHOSIS PARALYTICA.
In scrofulous children, either spontaneously, or upon some
injury,, such as a fall, &c., one or more vertebrse become inflamed often, with inclination to ulcerous destruction of the
7



98            ON SCROFULOUS AFFECTIONS.
bone (as central caries); the affection usually sets in in form
of infiltrated tuberculosis. If caverns have formed by softening of the tuberculous masses, and the vertebra cannot resist
any longer the weight of the parts above it, curving in of the
vertebrne takes place. The curvature mostly takes place posteriorly (Kyphosis, Malum Pottii),but is combined with lateral
curvature also (Skoliosis, Kyphosis skoliotica). The symptoms of an affection of the spinal marrow, dependent thereupon, are not always of a grave character.
Another sequela we observe in the so-called metastatic
abscesses (which extend mostly along the anterior side of the
spinal column, and appear at the groin or small pelvis). Perforation with discharge into the spinal canal is rare. The
quality of the pus corresponds to its origin; it is thin, ichorous, intermixed with decomposed tuberculous masses and,osseous fragments and remnants of ligaments; has an offenAsiye smell, and discolors the probe, &c.
Pains, either fixed or migratory, are the first symptom.
Afterwards loss of appetite, febrile attacks, sleeplessness,
decrease of mental capacity.  The curvature appears at a
later date, and' mostly gradually.
According to the seat of the affection we speak of spondylarthrocace thoracica, cervicalis (angina Hippocratis), lumbalis,
and sacralis.
THERAPIA.-The acute stages of periostitis may be met with
Aconit. and Bellad., yet Mercur., above all, seems to be able
to effect resorption and amelioration of the intense nocturnal
pains (LXXXV).  Mercur. and Phosph. produce necrosis,
and both have done excellent service in its homceopathic
treatment. The excessive formation of pus, and the consumption of strength therewith connected, may be prevented by
injections of Iodine. Though Aurum is said to correspond
more to syphilitic necrosis, yet we know  that scrofulous
ozaena, depending upon bony ulceration of the nose, is also
cured by Aurum; more frequently, however, by Hydr. praec.
rubr. From the curative influence of the remedies mentioned
upon the carious and necrotic process, the cures of some cases
of hardness of hearing, and many results in dental practice,
may be explained. However, SILICEA has been and remains the
most irnportant remedy in the treatment of (scrofulous) diseases of



100           ON SCROFULOUS AFFECTIONS.
The Scrofulous Inflammation of the Hip-Joint.
COXITIS SCROFULOSA; COXARTHROCACE; COXALGIA MORBUS
COXARUM; LUXATIO SPONTANEA.
This affection belongs to those scrofulous troubles which are
apt to show themselves during the second period of dentition.
1. Acute Course. - Starting at the caput femoris, it is, in
acute cases, accompanied by the most intense pain at the
inside of the thigh down to the knee, increasing upon touch
or use of the joint. Sleep is disturbed. Exhausting, febrile
motions. The thigh is somewhat adduced inwardly. The
buttock swollen.  Its fold stands lower.  The affected extremity appears longer or shorter. The termination in suppuration is accompanied by the formation of abscesses in the
neighborhood of the joint which communicate with the latter.
In consequence of the consumption of a portion of the femoral
head a disturbance in space takes place, and escape of the
head out of the acetabulum. Hectic fever and pyaemia lead
to fatal termination.  In rare cases only the suppuration
diminishes, portions of the bone are detached, and the openings of the abscesses close up.
2. Chronic Course. -Insignificant dragging of the extremity
in walking; easy tiring and complaints of weakness and stiffness of the leg as well as unsteady gait indicate the beginning
disease. The vague, insignificant pain running down the leg
resembles the rheumatic. It is present mostly in the morning, and sometimes in the evening accompanied by febrile
symptoms. There is hardly anything abnormal in the hipjoint; yet, the diseased extremity when lifted up, is apt to
assume the position mentioned above (drawing up of the leg
with foot inverted). These conditions, with intermissions
may exist for months and years even.
If the disease exacerbates, the characteristic pain in the
knee appears which, however, does not aggravate upon touch
or motion, and which some have attempted to explain by
irritation of the nervous obturatorius or saphenus int. In
stooping the patients use the healthy knee and keep the diseased leg 4i-T. L.-'rjpnng is occasioned. In sitting also, the



THE SPECIAL FORMS OF SCROFULA.               101
body rests upon the healthy hip. In walking the point of
the foot of the diseased extremity touches the floor. As regards the question, agitated for a good while, whether shortening or elongation of the diseased extremity takes place,
this much is settled now, that neither the one nor the other
exists, but such an elongation or shortening takes place apparently* only, on account of a sinking down, or rising of one
side of the pelvis (displacement upwardly with subsequent
spinal curvature). Hence, those theories, according to which
the (apparent) shortening is said to arise from muscular strain
and contraction which were to press the femoral head against
the acetabulum; or, according to which, on the other hand,
the head was to be pressed downwardly in consequence of
effisions, exudations, &c., to produce the (apparent) elongation, must be abandoned forever.
In this, so to say, second stage even, resorption, i.e., a cure,
is possible. If not, the suppuration increases after previous
swelling, redness, fluctuation, metastatic abscesses into the
knee-joint and still lower down; finally, on account of carions
destruction of the femoral head and decrease of its size; disproportion with regard to the acetabulum, and real, not apparent elongation or shortening and spontaneous luxation
occur.  The femoral head escapes mostly posteriorly, and
upon the upper external surface of the os ilei, rarely into the
foramen obturatorium, or upon the horizontal portion of the
os pubis.  Exceptionally the decayed femoral head has been
discharged through a fistulous opening. If the ligamentumn
capsulare is perforated by pus, the perforation takes place
mostly at its posterior or inferior portion. Not unfrequently
we observe that the pus escapes from the cavity of the joint
at the point of communication with the bursa mucosa subcutanea beneath the musculus ilio-psoas into the latter, and
thence into the pelvic cavity, though the pus may also get
into the pelvic cavity by perforating the os ilei at the point
* In proof thereof the following modus operandi has been proposed: Both
spinae anteriores superiores of the patient, who is in a lying position, are
brought into a line as straight as possible; upon this a second straight line is
drawn, starting at the processus xiphoideus sterni. Then we try to bring
both extremities in precisely the same position, and measure with a rule of
solid material from the spina to the condyl. int. tibiae and malleolus int.



102           ON SCROFULOUS AFFECTIONS.
of the gluteal muscles. The fistulous openings formed by the
perforation of the skin are mostly surrounded by spongious
and easily-bleeding granulations which rise above the level of
the skin.
Extensive cutaneous and subcutaneous ulcers in the neighborhood of the point of perforation are not of rare occurrence.
THERAPIA.-In Rhus and Silicea we possess two remedies
which, according to experience, have cured cases of coxarthrocace not too far developed (S. XCV, CII, CCV, CXIII).
But ASilic. would be preferable to other remedies in the most
desperate cases of coxarthrocace, even; for the malignity of
the trouble could be owing only to a deeper affection of the
bones, the very domain of Silicea. _odium and its preparations require caution, though we shall report at another place
an interesting cure with 01. jec. aselli. (LXVII).  After
Silicea; Cale. and also Sulph. have to be given frequently,
after which fresh doses of Silicea evince a more penetrating
effect. A change in the dose (between 30th and 3d), and a
steady, slow action of the remedy (one dose daily, at the
highest) secure a good result.
The Scrofulous Inflammation of the Knee-Joint.
TU3IOR ALBUS GENU; GONARTHROCACE; GONALGIA, WHITE
SWELLING AT THE KNEE.
The affection has been counted among the white swellings
for the reason that the synovial membrane is the terminating
point of the inflammation more frequently than the condyli
and ligaments. Its course, as in similar cases, may be exceedingly acute, even suddenly lethal, as well as slow and
dragging.
Its pathological picture is self-constructing, so to say, since
the usual symptoms of inflamnmation, redness, heat, swelling,
stiffness, functional disturbance of the part and pain manifest
themselves. At the beginning the knee is bent. If it comes
to suppuration, the pus discharges now above the klnee, now
burrows toward the malleoli of the leg, and may appear at
any place (though not anteriorly). In consequence of caries
of the bones, dislocation of the lower leg may take place.'ermzinations: cure in every, stage of the disease; con



THE SPECIAL FORMS OF SCROFULA.            103
tinuous stiffness of the knee, produced by spurious or genuine
anchylosis; hence, tendinous adhesions of the connective
tissue, or osseous adhesions. In case of fatal termination it
is preceded by edematous swelling and very copious, ichorous
discharge.
THERAPIA.-The chronic white swelling of the knee is very
obstinate, though very good results may be obtained by Calcar. and Silic.  According to Kallenbach's experience, the
pressing, stitching pain, intermitting at rest and during the
night, is bearable, if the case corresponds to Calc. carb. In
the reverse case, Baryt. carb. is said to be preferable.
Mineral springs (Teplitz) ought also not to be undervalued.
Sulphur springs, as well as sand-baths, the value of which is
more and more appreciated nowadays, deserve our full confidence. The more the organism is attacked in its inmost
parts by the scrofulous process, as is the case in all affections
of the bones and joints, the more we must endeavor to produce
a more energetic exchange of matter and a more efficient expulsion of organic cinders by an increased activity of the
peripheric organs, i. e., of the skin in our case; and this is
accomplished by the full bath, aside from the possibility of
thus permitting the specific remedy to act upon the body upon
an extent of surface as great as possible. Among the cures
by Silic., a case is also mentioned in which decoctions of grassseed, applied externally, were of essential benefit. We gladly
notice such observations, because they all evince the purpose
to allow the really active agent (here Silic.), to exhibit its
effect by breaking up the cohesion of its particles to a considerable extent.
Besides Silicea, Calcar., Baryt., and the preparations of Sulphur; Bhus, Caustic., _Ferrum, Kali, Mere., and Phos., as well
as Iodium, in low dilutions, may be recommended, most of
which have already proved their efficacy by clinical tests.
tIeyne prefers Calcar. phos. to Calec. carb. in tumor albus.
The cure of a scrofulous inflammation of the knee-joint we
shall report at another place. See Case LI.



104            ON SCROFULOUS AFFECTIONS.
III.
THE MOST APPROVED REMEDIES AGAINST
SCROFULA.
THE rationality of the antiscrofulous treatment is certainly
decisive as regards the prognosis and eventuality of relapses.
Orthodox allopathic treatment offers the worst guarantees.
By its mania forthwith to bleed in every case of hypereremia
and trifling pain, it contributes to the derangement of the
bodily constitution. The blood, already predisposed to dropsy,
is made still more watery.*
Moreover, by its anointing and exsiccating method (using
zinc, lead, and mercurial salves, astringent injections, &c.), it
induces the vis medicatrix naturce, aiming at the expulsion of
the inimical matter, again to transfer those causes, imponderable though they be, yet morbific in their action, to internal
organs. For this very reason we can indorse only that portion of the therapeutics of allopathic authorities which dwells
upon general hygienic rules, and is, for the greatest part, of a
purely prophylactic nature.
Self-evidently, the homreopathic physician will not oppose
the recommendation of pure air, proper strengthening and
concentrated food, the culture of the skin as far as it can possibly go, nor a cautious hardening of the body, if the disease
has not, as yet, progressed too far. An exclusively vegetable
diet is to be forbidden from the very fact that the scrofulous
represent the vegetable type of man in an abnormal manner,
* It is certain that in the scrofulous an anomaly exists in the proportion
between the solid and liquid organic parts; and this anomaly, as Portal has
shown, exists, in all probability, at the expense of the red parts of the blood,
or in favor.of its serous portion.



106            ON SCROFULOUS AFFECTIONS.
valuable article of food which is to be estimated more highly,
since, as is well known, all the constituents of the blood may
also be found in the milk.
Scrofulous children frequently suffer from diarrhcea. In
such cases milk-diet ought to be abandoned for a time. Salep
and arrowroot hardly answer as substitutes; even Liebig's
celebrated soup does not always agree with children. Grits
and barley-water, when they are borne well, are not nutritious
enough. On the contrary chicken broth prepared from an old
chicken with soft-boiled farina, is to be greatly recommended,
and may be taken as a substitute for milk for a week and
longer. Goat's milk is tried too little, as yet, where cow's
milk is not well borne. We hear the objection also, that
goat's milk is too fat; yet, the capricious stomach, in such
cases, just requires fat, in a similar manner, as there is often
an unexpected tolerance of Cod-liver oil. Besides I have
ordered the goat's milk to be given warm as it is drawn from
the bag, and imagine that I have saved more than one child
by this means.
Finally, we mention acorn coffee as a dietetic aid of importallce. I heard from trustworthy mothers that their weakly
children had begun to walk only since they had been given
acorn coffee. This is easily explained, if we remind ourselves
of the roborant and tonic property of this drink which contains tannin.
Dr. Weil, no doubt, was supported by similar experiences,
since he orders the following regimen for weakly, scrofulous,
and rhachitic children.
For breakfast: two cupfuls of acorn coffee, or of homceop.
coffee (prepared of half an ounce thereof) with the addition of
some sugar and a little milk.
For luncheon, he recommends finely scraped (raw) veal or
beef spread over a piece of twist.
For dinner: beef tea, lean, roasted meat, a few vegetables,
stewed fruit, wheat bread, light desserts (prepared of eggs).
For supper: soup prepared of farina or grits.
The use of good and pure malt-beer is very beneficial to
such children.*
* Anleitung zur diaetetischen Krankenpflege von Dr. med. Weil, S. 161.
Gotha, 1869.



MOST APPROVED REMEDIES AGAINST SCROFULA. 107
Bathing in water containing Iod. and Brom., still approaches to hon-ceopathic ideas; though we have accustomed
ourselves to set up strict indications for such aids. The same
holds good of Cod-liver oil, of which we shall speak anon.
However, we will here mention that authors of name deem it
indispensable in rhachitis.
The following recommendations in allopathic textbooks we
consider to evince but little rationality:
"Several vegetable substances, such as Dulcam., Sarsapar.,
Cicuta, Folia jugl., &c," as if one and the same antiscrofulous
principle were contained in all of them. How differently the
physician thinks and judges who treats according to the
strictest symptomatic similarity, and is guided by the Mat.
Med. PURA. He knows that among the "several vegetable
substances " the one corresponds only to this, the other to that
pathological complex, diseased individual and disease-stage.
In place of arbitrariness a necessary law exists for him.
It is remarkable, notwithstanding, that as regards the most
sovereign antiscrofulosa, both schools join hands unconsciously. Who would wish to deny that Cicuta, in fact, is one
of our foremost (antiscrofulous) remedies (I refer only to
bllepharitis cil., scroful.). Hufeland concedes to Baryt. mur.
one of the first places among the exceedingly few antiscrofulosa which he accepts, and our homeopathic literature contains the most remarkable cures of intense scrofulosis by
IBaryt. tour. What important parts do Iod., Ferrum, and the
compounds of both; the mercurialia and ammonia preparations, play here as well as there. Aside from these, however,
we possess a sufficient number of peculiar remedies. For, of
what value are Arsen., the Carbonate of Lime, Sulph,., and
Nitri acid., to traditional medicine?
Let us now proceed to the valuation of the several antiscrofulosa. We intended at first to arrange them in a manner differing from a mere alphabetical enumeration; yet, no
essential gain would result therefrom for practice. If we
divide, for example, the antiscrofulosa into such as are of
organic or inorganic nature, we should have to separate
Graphit. from Carb. veg., and the latter again from Carb.
anim., though all three of them have many phenomena in
common, e.g., their relations to the glands; moreover, for the



108           ON SCROFULOUS AFFECTIONS.
sake of consistency, we should have to separate Lycopod. from
Calc. carlb., and to place the former in the category in which
Calendula, Viola tricol., Euphrasia, &c., belong. And where
should we speak of Apis which we cannot pass over in silence,
entirely; though its curative power in scrofulous ophthalmia
and its result (opacity of the cornea) has been doubted, or is
not proved, at least, as is that of Acid. nitri., Calcar. carb., &c.
For this' reason let us not sacrifice to the mania for classification, the only principle which can engage our consideration
regarding the comparison of the various medicinal substances,
i. e., the principle of the physiological proving. And here we
find that remedies of the organic world may bear similar relations to the same organs as do remedies of the inorganic;
hence, that in therapeutics they call for a similar application.
We have given the several reports of cures mostly verbatim, because a short resumre, no matter how good a survey
it may offer, always lacks the agreeable impression of immediate, personal experience. It is more profitable, if we participate in the subjective impressions of the author in the
course of a clinical report; if we feel with him his troubles,
and finally enjoy with him the favorable termination.
Finally, we have interfused, here -and there, in a somewhat
independent manner, practical remarks and hints of the most
various observers, and hope that every one —notwithstanding
he may miss therein, perhaps, organic connection-will judge
for himself and, by the aid of experiences already gained for
himself, gain in surety and ease, successfully to grapple with
the host of scrofulous diseases.
ACIDUM NITRI.
GENERALITIES.
Acid. nitri is homoeopathically specific in all aphthous
ulcers of the mouth, in phlyctsense of the cornea developing
into superficial ulcers; inflammations of the connective tissue
of the inner canthus (cgilops), terminating in suppuration and
subsequent ulceration; in superficial and offensive ulcers accompanying balanorrhoea.
Moreover, in many cases of common scrofulous ophthalmia



MOST APPROVED REMEDIES AGAINST SCROFULA. 109
(ophthal. pustul., herpes conjunctive, Ruete), especially in the
later stages, at the height of the inflammation, and after Calcar. carb. has been given in vain.
Most of my colleagues will admit that those cases of scrofulous ophthalmia sometimes belong among the most tedious,
because most obstinate objects of cure existing. Merc., Arsen.,
Hepar., Lycopod., Conium, and Heaven knows what else, are
tried, with and without the patience of the physician and
patient, and-fail.  Iowever, in many such cases, we will yet
be rewarded upon the administration of Acid. nitri.*
Aside from scrofulous ophthalmia, which is not dangerous,
but often very obstinate, Acid. nitri is indispensable in ophth.
neonat., a fact from which we may, probably, infer very correctly the scrofulous nature of this disease; or we may say
that, in both cases, one and the same morbid diathesis exists,
which finds its curative simile in Acid. nitri.t
It remains but to point to the following symptoms of Acid.
nitri, as recorded in the M. M. P., the complex of which presents a characteristic picture of scrofulous ophthalmia:
"Pressing in the eyes as from  sand, in the outer canthi;
winking; great sensitiveness to light; stitches and itching in
the eyes; smarting and burning; redness of'the white; inflammation of the conjunctiva; swelling of the lids; spots upon
the cornea; watering of the eyes; acrid humor; agglutination; difficult opening of the lids in the morning; photophobia; obscurity of sight; the right eye becomes obscure; objects
appear dark; mist before the eyes; myopia."
The symptoms of Nitr. ac., enumerated under the head of
" Ears and Nose," likewise indicate that we possess in this
remedy a true antiscrofulosum, and practice has long ago confirmed this supposition in a brilliant manner. It has proved
efficacious in hardness of hearing (afterwards Petroleum).
* Six drops of the 3d dil. in 60 grammes of water, morning and evening a
teaspoonful.
t Ten drops of Acid. nitri 1 or 2, in a saucerful of water; compresses moistened therewith, and applied to the eyes; over the compresses a cloth for protection; the dry compresses to be removed.



110           ON SCROFULOUS AFFECTIONS.
CLINIQUE.
1. (I.) Ophthalmia Scrofulosa.
L. W., set. 4, for a year has suffered from scrofulous ophthalmia. The lids of the right eye are red and swollen; vessels of the eye injected, the cornea opaque, especially below
the pupil; photophobia; the eye waters, especially when looking into the light; lids are agglutinated in the morning, and
itch; from the right nasal opening a watery discharge; a
nodulous eruption at the buttocks; crusts and soreness behind
the ears. The trouble began with a purulent, offensive tinea
capitis et faciei.
Sulph., Bellad., Calcar., Euphras. effected nothing. Puls.
12, alternated every fourth day with Ac. nitr. 12, occasioned
a considerable aggravation, upon which improvement followed
so rapidly, however, that this chronic trouble was completely
removed within twenty days. (Erfahrungen aus der Praxis-v.
Haustein, A. H. Z., 39, 10.)
2. (II.) JBlepharitis Phlegmonosa.
(Observation of my own, A. H. Z., 69, 13.)
The daughter of the- stonemason G., aet. 5, has been treated
allopathically for six days, until the increasing aggravation
has induced the parents to abandon this treatment. There
existed a phlegmonous inflammation of the upper, and afterwards of the lower lid; the skin of the lid discolored, swelling of the connective tissue considerable, so that the bulbus
could not be seen; the ciliary glands secrete a gluey humor,
which mixes with the tears discharged in profusion; the child
had fever, was very restless, and the whole affection made an
unfavorable impression.
Mercur. viv. 3. (Cotton to the swollen lid.)
December 7th (i. e., tile day following). The swelling has
gone down remarkably.  Less pain.  Skin less discolored.
Better in general.
One dose of Mercur.
Dec. 9th, without any cause (known) the lower lid is inflamed again and swollen. Bellad. 12, every two hours.



MOST APPROVED REMEDIES AGAINST SCROFULA. 111
Dec. 10th. More satisfactory state of things. Yet the condition remained oscillating, notwithstanding Bellad. given in
alternation with Sulph.
In the surrounding of the eye, purulent-crusty exanthemata
formed which bled easily. This symptom led us to give Acid.
nitri 9th dil., every two hours. The effect wtas surprising.
From this time on improvement was steady and rapid.
APIS.
GENERALITIES.
Dr. Genzke, of Buetzow, aside from an increased frequency
of the pulse, which he rightly ascribes in part to the action
of the alcohol, observed obscuration of sight from the continued
use, and large doses of Apis-tincture. At the conjunctiva and
membrana nictitans (of the dog experimented upon) distinct
vascular injections showed themselves, on account of which
the cornea assumed a smoky appearance, and the eyelids were
agglutinated in the morning by the mucus secreted. These
symptoms continued during the remainder of the proving, and
soon disappeared after its termination (N. Z. f. h. Il., 5, 23).
These are facts. On the other hand, there is scarcely any
remedy in the application of which one may deceive himself
more than in that of Apis (see, also, Bolle's popul. Zeitschrift,
Jahrg., 1866, 1 and 2).
Dr. Genzke noticed, further, that Apis (2d dil.) produced
satisfactory results in rheumatic, catarrhal, and scrofulous
ophthalmia. It acted splendidly in young persons, and especially in acute cases. In older persons and in inveterate cases
the effect was but palliative or naught. (In both of the latter
conditions we would direct the attention to Eitphrasia internally and externally.)
Dr. Battmann, of Grossenhain, has observed of Apis 2other remedies had been given in vain previously - several
times a very surprising effect in inflammation of the conjunctiva palpebrarum, seleroticee and cornese, with vesicles or
small ulcers, and infiltrated vascular nets around them, accompanied by photophobia, often of a very high grade, watering of the eyes, pressing and smarting pain. B13., for his dilu



112           ON SCROFULOUS AFFECTIONS.
tion, used a mother-tincture prepared of three bees, which
were mashed in one drachm of diluted alcohol. (N. Z. f. h.
Xl., iv, 4).
Dr. Paulson obtained good results with Apis in struma
(Apis 15th and 30th) (A. H. Z., 72, 22). A remedy that accomplishes results in this direction surely deserves to be
counted rightfully among the antiscrofulosa. The cures, moreover, %ere obtained in individuals who had passed childhood
long ago, and of whom no other symptoms of scrofulosis are
mentioned.
CLINIQUE.
1. (III.) Ophthalmia Scrofulosa.
A girl, aged thirteen years, who for nearly a year had
been suffering from an inflammatory affection of the right
eye — a condition which, in spite of former medical treatment, and especially within three months, became so aggravated gradually that the power of sight was totally annulled, and the patient was tortured by severe pains appearing in paroxysms, exhibited the following pathological picture: Conjunctiva inflamed in its entire extent; redness more
saturated at the outer canthus. From this point a so-called
" scrofulo-vascular ribbon" departs, which threatens to develop
into a pterygium, and sufficiently explains the complete disturbance of the power of sight. On examination of the eye
a stream of tears gushes out. Great photophobia; pain on
opening the eye; increased secretion of mucus. Agglutination of the lids in the morning. The nose of the child considerably swollen without being inflamed.
Every evening one dose of the 2d dil. of the bee-tincture.
Within fourteen days a considerable improvement had set in;
the conjunctivitis had nearly disappeared, the pseudo-membranes had become thinner, and had redrawn from the cornea;
all opacity still remained upon the latter which did not permit
of complete sight. Pain, flow of tears, agglutination of the
lids had entirely disappeared. Four weeks afterwards the
same prescription, after which the trouble could be considered
as entirely removed, with the exception of a nebulous spot
upon the cornea at the pupillary edge.



MOST APPROVED  REMEDIES AGAINST SCROFULA.  113
The power of sight is completely restored. The opacity gave
way rapidly upon the use of Aurum  3 (one dose every other
evening).
Dr. Genzke, to whom we are indebted for this report, adds
with good reason: This removal, rapid and mild as it is, of a
firmly-rooted disease of the eye, allows of no comparison with
the treatment of allopathic oculists who, in such a case, undertake at first to combat it by local applications of caustic, or
so-called astringent remedies; and since they almost always
fail in this, proceed with an operation which, in the most
favorable case even, too often only leaves behind a permnanent
opacity of the cornea (N. Z. f. h. Kl., 5, 34).
2. (IV.) Ophthalmia Scrofulosa.
Dr. Bolle recommends Apis against scrofulous diseases of
the eye. He reports (A. H. Z., 52, 6) two interesting cures.
Apis 1,* was given, and in the one case an obstinate photophobia removed, in the other total blindness, i. e., complete
opacity of the cornea in front of the pupil.  Even a scabious
eruption at the neck appeared upon the girl, one year old,
after six powders (morning and evening one powder).  She
had been afflicted previously with genuine itch.
Regarding these results, Dr. Gerster remarks that we ought
to be cautious in judging of the influence of such remedies.
His words deserve to be quoted here.t
3. (V.) Struma.
A young lady had an enlargement of the thyroid gland.
* Six grains of Apis to one and a half drachm of Alcohol. Globules
wetted with this tincture.
t Without doubting in the slightest the highly praised curative action of
Apis against scrofulous ophthalmia, and especially against photophobia of
scrofulous children, I beg to be permitted the remark that such troubles frequently make remissions, intermissions, exacerbations, and metastases with or
without the use of remedies. The aural discharge, facial and cranial eruptions, for instance, disappear, and in their place inflammations of the ocular
membranes, phlyctenne, photophobia, &c., appear; or the aural disease ceases,
and otorrhoea, tinea faciei, crusta lactea, swelling of the cervical glands, flowing
coryza, &c., set in. Since scrofulous affections of the eye are not a local disease but the expression of a constitutional anomaly, relapses are avoided most
surely, if we succeed in removing as much as possible the fundamental trouble
by the aid of nature or art.
8



MOST APPROVED REMEDIES AGAINST SCROFULA. 117
Atrophia in consequence of Chronic Intestinal Catarrh.
A boy, aet. 2, had already been affected by diarrhcea for six
months. All professional and non-professional means used
against it, remained without any result. Iwas consulted December 9th, 1853, and found the boy emaciated to the highest
degree, pale, like a corpse, of withered and senile features.
The eyes rolled about wildly in their deep sockets, animatedly
following every word and motion of mine and those surrounding. His thirst was not to be quenched; every five or six
seconds he asked for a drink. Appetite tolerably keen, yet
as soon as food is taken, rumbling in the abdomen sets in, and
from four to six fluid, painless stools of an excessively nauseating and cadaverous smell follow each other in quick succession. Their number within twenty-four hours, I was told,
approached to from 16 to 20. The abdomen is distended meteoristically, and gives a clear, tympanitic sound at all points
with the exception of the region of the liver and spleen, where
percussion proves a considerable organic enlargement. Nasal
openings, mouth and anus red and sore; dentition has nearly
terminated; worms were never passed.
Upon the use of Arsen. 6 (10 drops in half pint of water),
two teaspoonfuls every two hours, the child was completely
convalescent within four weeks.
NoTE.-Although Kafka does not say that the child was
scrofulous; leaning upon considerable experience, I yet may
maintain that scrofulous children, affected by such chronic
diarrhceae, endangering life, are exceedingly well served by
Arsen. The 6th dilution has proved itself to me also, the
most effective. It is very important not to confound the indications for Arsen. with those of Carb. veg.
In the N. Z. f. h. Kl., 4, 20, we read of very interesting cures
by Arsen., obtained by Dr. Eidherr, of Vienna, in atrophia
infantum.
In those cases in which intermitting fever, hot head and
hands and a disturbance of the process of nutrition plainly
manifested themselves, he gave Arsen. 15, and followed it up
by Calc. carb., if the intermitting fever had disappeared, the
children became more lively, and looked better, but the



118           ON SCROFULOUS AFFECTIONS.
diarrhceic green stools, hardness and tenderness of the abdomen remained.
6. (XII.) Abdominal Scrofula, Atrophia Infantum.
Harriet B., aet. 11, a miserable child, emaciated to a skeleton, with a large, distended abdomen, and thin legs, upon
which the muscles hung down like old rags, the skin of the
whole body shrivelled, dry and of a dirty-grayish color, has
suffered for nearly six months from a watery, cadaverously
smelling diarrhcea which passes involuntarily from 20 to 25
times a day. Besides, she has an enormous navel-hernia,
nearly as large as a hen's egg, eats little, sleeps still less, but
drinks all the time, especially cold water, greedily; the voice
resembles that of a kitten. Arsen. 30, three drops in two
ounces of water, a teaspoonful twice a day; fourteen days afterwards the child looked better, and no longer drank so
much. Diarrhcea, though still passing from 10 to 15 times a
day, no longer offensive. Arsen. as before. October 25th, 1866,
her mother came to me with another child of hers afflicted
with otorrhcea, and told me that Harriet had been running
about lively and healthy for eighteen months (A. H. Z., 80,
15, Dr. Bojanus, in Moskau).
NoTE.-Arsen. and Graph. in alternation (continued for six
months with intervals), are praised against malignant impetigo of the head upon a scrofulous bottom (also, when plica
polonica exists at the same time*) (Bericht'ueber die am 20.
Juli, 1868, in Dortmund abgehaltene Versammlung der Hornoeopathen Rheinlands u. Westphalens).
AURUM.
GENERALITIES.
Aurum  has many characteristic drug effects in common
with A rsen. Thus great dzfficulty of breathing during the night,
and violent palpitation of the heart. But as Aurum acts more
* Others praise here Staphisagria 1, one drop morning and evening for
weeks.



MOST APPROVED REMEDIES AGAINST SCROFULA. 119
decidedly upon the glandular system, it is a more useful
remedy in scrofula. In the torpid form of scrofula it has been
given with more success. Thus especially, Aur. mur. natronat. 3 trit. (according to Schweikert, of Breslau), against
scrofulous glandular ulcers with torn, indented edges, and
caseo-lardaceous secretion; scrofulous ulcers of the conjunctiva and cornea, but also against knotty, scirrhous glands.
Nightly pains in the bones, especially of the nasal bones,
fetid smell from the nose. Aurumn, it is true, cures ulceration
of the bone, also, but more when the anamnesis allows us to
infer the influence of syphilis or Mercury. Swelling and suppuration of the inguinal glands. Induration or swelling of
the testes.
Next to Arsenicum;, Aurum much resembles Silic. It may
also be mentioned that mental depression, hence melancholic
temperament, decrease of memory, rabid appetite, simultaneous affections of the gums would speak for the selection of
Aurum (S. Dr. Bser's Beobacht. fiber Primrvrwirkg. von Gold.,
A. H. Z., 54, 1).
CLINIQUE.
1. (XIII.) Ozcena.
C., a young girl, set. 18, suffered for several years from
ozena with caries of the nasal bones. The affected organs
made so fearful a smell that doors and windows had always
to be opened where the patient remained. Aurum 3, one dose
every third day, restored her health completely.
2. (XIV.) Ozcena.
Dr. BDer within three weeks cured a girl, Pet. 13, by Aur.
met., who to the torment of her friends suffered for a long
while from a horribly smelling nasal discharge of a purulent,
viscid character, and very offensive breath. She looked almost
ruddy, but somewhat " serofulous " (A. H. Z., 54, 1).
3. (XV.) Chronic Inflanmation of the Cornea.
Dr. Genzke cured with Aurum 3, one dose every evening, a
chronic keratitis in a scrofulous girl, aet. 10. The cornea of
the left eye was completely opaque. All the external reme



MOST APPROVED REMEDIES AGAINST SCROFULA. 121
Now, of Aurum. 3, which taken in doses of a whole powder
daily, increased the irritability (photophobia), one grain was
given every other day, which brought forth the following report: " There is, Heaven be praised, so essential an improvement that my wife is already able to read well." The complete cure (July 1st) resulted from the sole and continuous
administration of Aurum. At the same time with it the diplopia disappeared, which was occasioned by a perpendicular
cicatrix upon the cornea.
NoTE.-The experiments of Dr. v. Pratobevera do not seem
to be void of interest with regard to the indications of gold.
Aside from the boring and burning pains, accompanied by
redness and swelling, even, which he felt in various parts of
the body, especially in the bones of the foot, he observed that
an eczematous eruption which, thus far, had not molested him
any, began to discharge after itching previously, and spread
considerably. The axillary glands in the neighborhood were
swollen.
A dose of Aurum 12, taken at a later date, compelled him
to give up his experiments.
BARYTA MURIATICA.
GENERALITIES.
Baryt. mur. was used for a time as an excellent antiscrofulosumn, especially on Hufeland's recommendation, who advised
its application in inflammatory conditions of the glands. At
present its use is more limited, though Baryt. is equally indispensable as Iodine, and in its place equally efficacious. It
is true the indications regarding its application cannot be
given so definitely. Its physiological effects upon the glandular system were principally observed in the tonsils and axillary
glands. As a therapeutic effect it was observed that. during
its administration, scrofulous and other glandular swellings
decreased, and inflamed glands became more painful.
Of the several preparations, Baryt. mur. seems to act more
energetically than ]Baryt. acet., and the latter less than Baryt.
carb. (Dr. Reil in N. Z. f. h. KI1., 1, 10).



122            ON SCROFULOUS AFFECTIONS.
WVhile gold corresponds to the torpid forms of scrofula,
Bar yt. is indicated in all forms of scrofulosis florida (glandular
indurations and swellings) (Altschul). Also in hypertrophy
of the thyroid gland (struma), induration of the mamma; in
tumor albus (Lisfranc), a specific in existing predisposition to
angina.* Among the characteristic drug effects, Baryt. has
even swelling of the testes in common with Aurum.
According to the valuable experiences of Dr. Altmueller, of
Cassel, the sphere of action of Baryt. mur. is principally the
lymphatic and glandular system, and the tissues standing
upon the same step of organization with the former. Its curative effects are confirmed only in scrofulous diseases, scrofulous
ophthalmia, scrofulous cutaneous eruptions and diarrhoea resulting therefrom, as well as in pulmonary blennorrhoa.
Dr. Altmlueller, in our opinion, is the first who has pointed
here to the connection of scrofula with certain affections of
the mucosa of the respiratory organs. Most surely, however,
there exists such a connection.  The proof of it must be of
the greatest importance to therapeutics. It is, no doubt, more
generally known that, among the diseases of the upper portion of the organs of respiration, i. e., of the larynx; croup
frequently enough coincides with the most developed habitus
scrofulosus. For this reason the specific beneficial influence
of the genuine antiscrofulosa, Hepar., Cale., Spong., lod., and
Brom.  This connection, marked out by Altmueller, becomes
still more evident, if one reminds himself of the cases so frequent in practice, from which, after spontaneous or non-spontaneous disappearance of a scrofulous cutaneous eruption, an
obstinate cough (bronchitis), and even pneumonia, with copious
expectoration, result. But we have, also, frequently enough
opportunity of observing that scrofulous diarrhcea appears as
a substitute. That the diarrhcea is a scrofulous one, is plain
from the fact that the antiscrofulosum, Cale. carb., corresponds
to it in the most effective manner.
"The application of Baryta mur.," Altmueller further says,
"I have found most powerful in the following fluid form: One
* Dr. Zwingenberg (Brandenburg) recommends against scrofulous hypertrophy of the tonsils: Liquor. baryt. mur. one drop in one-half a cupful of
lukewarm water, as a gargarisma, from two to three times a day, with intermissions, used for weeks.



MOST APPROVED REMEDIES AGAINST SCROFULA. 123
scruple (1, 2) of the third trit. in four tablespoonfuls of distilled water. Of this a child one year of age was given a
tablespoonful every three hours; and in this way the quantity
of doses was increased or decreased, according to age and
individuality.*
CLINIQUE.
1. (XVIII.) Alrophia.  Abdominal Serofula.
The son of Mr. A., a child two years of age, suffered from
atrophia. The whole neck, covered with indurated glands of
egg-size; the abdomen much distended and hard; the seventh
and eighth dorsal vertebrae grown out into a hump; from both
ears discharge of offensive pus; tongue coated; stool produced
by enemata only; the fieces, small in quantity, as hard as a
stone, and white of color; the urine yellowish, very offensive;
the feet swollen. Such was the pathological picture when I
was called, after an unsuccessful allopathic treatment of
many (years?t) months. I gave twenty grains of the third
trit. of Baryt. mur. in four tablespoonfuls of distilled water, a
teaspoonful three times a day. The vegetable diet, consisting
of mucilaginous food, the animal diet of milk only. To counteract the progress in the dislocation of the vertebrae, the
child was laid upon a sand-pillow one hand in width and one
foot long, corresponding to the dislocated part. An injection
of oil and water was given every day. In the course of fourteen days the child improved from day to day and became
more lively; appetite returned, especially for milk; the urine
changed for the better. Three. months afterwards all troubles
had subsided; no trace is left of the dislocation of the vertebrse, and the boy is now well and healthy. He received no
other remedy but Baryt. mur., and took twelve doses, such as
mentioned, during the whole treatment.
* Dr. A. triturated four grains of baryt. mur. with ninety-six grains of
sach. lact., and prepared from this the second, and from this again the third
trit.
t Dr. A. seems to have forgotten that the child was only two years old.



124           ON SCROFULOUS AFFECTIONS.
2. (XIX.) Atrophia.
E. KW., et. 1I, was covered with ulcers over the whole body;
the whole head with thick, offensive crusts; abscesses behind
the ears, which discharged an offensive pus; fetid discharge
from the ears like rotten cheese; both eyelids swollen; the
bulbs of the eye very much inflamed; photophobia, so that
the child always lay upon its face; abdomen considerably
swollen; thin, watery, very offensive stools; both feet very
much swollen.
Sixteen grains of Barit. mur., third trit., in three tablespoonfuls of distilled water, a teaspoonful three times a day,
improved before the exhaustion of the solution to such a
degree as to completely restore health within six months; and
now, a year from the time, a healthy and fleshy girl has developed from this complete picture of misery, for whom the
parents had frequently wished liberation from her sufferings
by death. During the treatment, the dose was increased two
grains from time to time.
3. (XX.) Ophthalmia Serofulosa.
The daughter of shoemaker G., set. 6, was afflicted with
scrofulous ophthalmia, and was treated for a whole year by
the allopathic physician Dr. Stilling. After Dr. S. had dismissed her as incurable, I undertook the treatment of the
child, her condition being then as follows: Total opacity of
the cornea; the sclerotica inflamed and loosened in its tissue;
entire blindness; both nasal openings sore and inflamed. She
received 20 grains of Baryt. mur., in four tablespoonfuls of
distilled water, half a tablespoonful three times a day. After
a treatment of three weeks the ophthalmia disappeared, and
four months afterwards the child's eyes were entirely clear,
and her power of sight complete.
BROMIUM.
GENE RALITIES.
]By its continued use enlargement of glandular organs and
swellings of the lymphatics were observed to disappear; but



MOST APPROVED REMEDIES AGAINST SCROFULA.  120
from its similarity to lodium, its similar physiological action
and therapeutic usefulness were inferred. Especially Glower
frequently applied Kal. brom., successfully in scrofula and
chronic diseases of the glands (Dr. Reil in N. Z. f. h. Kl., 2, 9).
The celebrated springs of JKreuznach (Elizabeth-spring) owe
their antiserofulous action, aside from IoD., to their contents of
BROMIUM.
Brom. has been warmly recommended by Gauwerky against
obstinate scrofulous affections, and by Hofrichter, against suppuration of the glands.
Among its characteristic, pathogenetic effects are: Flow of
tears; burning in the mouth and esophagus; cough and paroxysms of suffocation; impeded respiration and gasping for
air; stitches in the lungs while breathing; glandular affections. Its action upon the organs of respiration, and among
the glandular organs, upon the thyroid gland and testicles, is
remarkable.
Succor has been obtained in membranous croup from the
vapors of Brom., when Iod. had failed.* Upon the whole, the
cures of scrofulous affections effected by Bromine may be
principally divided into such as pertain either to glandular
diseases or croup.
As regards the dose, Dr. Kaesemann remarks that IBrom.
would prove itself most efficacious, probably, in the lower
dilutions. He bases his opinion upon a passage of the H.
M. M. of Noack and Trinks which reads as follows: " If the
volatility of a remedy constitutes a reason for its application
in the lower grades of dilution and more frequent repetition;
this rule will be worth observing with regard to the administration of Bromine."
CLINIQUE.
1. (XXI.) Cure of Croup.
K. W., set. 11, feeble, descending from  rhachitic parents,
and living upon unhealthy food, pot-bellied and of scrofulo* Pathological anatomy teaches us that swelling and induration of the
mesenterial glands, inflammation of the larynx and air-passages with exudations of a plastic lymph (inflammation and hypertrophy of the heart), result
from toxical doses of Bromine.



126           ON SCROFULOUS AFFECTIONS.
rhachitic habitus. About eight days ago she had an intense
coryza which suddenly disappeared previous to her sickness.
For a few days past the child has suffered from hoarseness
which has so increased since evening that at 9 P.M. entire
aphonia has set in; besides, very laborious, long-drawn inspirations, at times resembling snoring;-according to report previously mucous rattling to such a degree, as to make one fear
suffocation. Cough is absent; temperature of the skin but
little raised; no thirst; she does not wish to eat anything;
during the day she has still eaten and played.
Brom. 0, 3, six drops in twelve teaspoonfuls of water, a teaspoonful from one-quarter to one-half hour. Better; she has
already left her bed for several hours. After ]Bromium relief
had set in at once; cough and expectoration had appeared,
something that recurred several times through the night.
One dose of the above prescription every hour, 9 P.M., I was
told that her condition had grown worse again, considerably;
return of aphonia with mucous rattling on respiration, so
much so, that suffocation was feared; the skin covered with
cold sweat.
Brom. 0, 3, nine drops from one-quarter to one-half hour.
Had left her bed next day, though she had perspired much
during the night.  Cough, the evening previous barking and
laborious, to-day more sonorous, easy, moist and more frequent, seldom during the night, though accompanied by much
rattling and difficulty of breathing. The same prescription.
The child, although poorly cared for, recovered under the
continued use of Brom. within a few days.
It was discontinued, however, when slight coughing up of
blood and nose-bleed set in. Dr. Kesesmann considers the
latter symptoms to be the effects of ]Bromium; from this it is
self-evident, no doubt, that the dose might be a smaller one,
and, indeed, very brilliant results have been obtained since
with higher dilutions given at long intervals (S. the next cure,
but also No. 8*). Moreover, in another cure of genuine croup
(by Kali bichr.), blood and bloody mucus were coughed up at
the termination of the disease.
* Heilungen von Croup, Croupine, Asthma, &e., mit Brom. von Dr. Kwescmann in Lich. (A H. Z., 48, 24).



128            ON SCROFULOUS AFFECTIONS.
ing cures by Brom., especially in croup and affections related
to it.  Loc. cit., Dr. Kseeemann designates Brom. as, probably,
the grandest remedy in croup. Dr. KIirsch, of Wiesbaden, has
had similar experiences, which he has published in A. H. Z.,
46, and 47, 141, &c.
4. (XXIV.) Cure of Croup.
In a desperate case of croup in a feeble, scrofulous girl, aet.
5, Spong., H-ep., and Brom. 30, were unable to arrest the increase of the disease. But upon the use of Brom. 1X, six drops
to two ounces (60, 0) of water, a teaspoonful from one-half to
two hours, improvement set in slowly.
A highly interesting case was cured only after Phos. 1 and
Brom. 2 had been given (A. H. Z., 53, 14, Theuerkauf.).
5. (XXV.) Cure of Croup.
In the A. H. Z., 54, 2, a cure of a case of intense torpid
croup is communicated by Dr. Elb, in which Bromn. 3 (two
drops every hour) likewise averted the danger to life* (after
Aeon. 2 and lod. 3 had been given in vain). But upon returning aggravation he was compelled to give Brom. in alternation with Rep. s. 2 (gr. ij). " With the disappearance of the
croup, coryza had appeared." When refuge was taken with
_Brom. the first time, Dr. Elb found the boy, met. 21, icy cold,
the breathing short, superficial, and violently sawing; the
head bent back, the face pale and bloated, the lips blue, the
pulse very weak and rapid; total aphonia; the eyes set; cough
had been absent almost totallyfor two hours.  The remark interponed here by Dr. Elb is of interest: " During a practice of
nineteen years it was the first time that lod. failed to do its
service in such a case, apparently so suitable for it."
6. (XXVI.) Cure of Croup.
In L'Art. Med., Jan., 1858, cure of a violent case of croup
by Brom.; Dr. Milcent.
* Dr. Elb calls croup " torpid" on account of the slow development and
long duration of the cough, comparatively rare; the degree of dyspncea, slight,
upon the whole, and absence of synochal fever; though a considerable quantity of exudation was present.



MOST APPROVED REMEDIES AGAINST SCROFULA. 129
The child was,seven years old, had a rough cough, violent
fever, and pain in the throat. Two days afterwards the voice
became hoarse, the cough more dry, respiration more difficult;
a rough, dry whistling, seated in the larynx, accompanied
every breath of air; the fever increased; delirium; paroxysms
of suffocation; the child lay on its back with a pale and somewhat livid face; totally aphonous; breathing frequent and
short; pulse 160; now restless, now comatose; the short, dry
cough threatened to suffocate it; skin burning hot; the
pseudo-membranous exudations confined to the larynx; while
coughing the child vomited up, now and then, a serous liquid,
in which shreds of the pseudo-menmbranes were observed.
Brom. 4, gtt. 4, in 125, 0 of water, every two hours, effected
at least an arrest of the progress of the trouble for two days;
indeed, the paroxysms of suffocation had become less frequent,
and the fever less. Upon renewed hourly doses of the remedy
(Brom. 4, gtt. 10, in 240, 0 of water), the improvement was
surprising, and ended with complete recovery; the hoarseness
lasted longest.
BROMINE. IN SCROFULOUS GLANDULAR AFFECTIONS.
7. (XXVII.) Affection of the Mesenterial Glands.
Dr. IHIilberger, of Trieste, communicates, in his " Klinischen
Beobachtungen" (Z. f. h. K1., 2, 15), a very interesting case of
"scrofulous infiltrations of the mesenterial glands and chronic
pneumonia," in which Brom. 6 effected the resorption of the
mesenterial glands after Arsen. 6, in alternation with Carb.
veg. 6, had removed the existing edematous swelling and intense dyspncea, in short, the pneumonic portion of the disease,
which did not point by any means to a spontaneous improvement, not to say recovery. It is probable that Cacrb. veyet. also
had influence upon the resorption within the glands.
"Of late Hofrichter says, I have sufficiently convinced myself of the extraordinary and sure effect of Brom. in scrofulous
affections, i. e., in inveterate indurated and already partly suppurating glandular swellings. I began my experiments with
the 15th dilution, descended, however, to the 6th, and believe
that the latter is to be preferred to the former, since by its
9



130           ON SCROFULOUS AFFECTIONS.
aid glandular swellings and indurations soften more rapidly
without in any way affecting the rest of the organism."
8. (XXVIII.) Scrofulous Affections of the Cervical Glands.
H. H., pupil of the Polytechnic Institute, Pet. 20, has suffered four years from swollen suppurating cervical glands on
the right side. There is, likewise, a hard painful gland of
the size of a fist, studded with several cicatrices, still suppurating, in the right axilla, which hinders him especially in
drawing, and threatens to compel him from continuing his
studies. The neighboring glands feel like large peas, and
some still larger; he has to carry the arm in a sling, to keep
the upper arm at a distance from the chest; cold lodging;
poor food.
Jan. 15th, 1852. Sulphur 60, four doses; every second day
one powder. A month afterwards pain less; swelling somewhat smaller.
Feb. 17th. Silic. 30 in the same manner. First the glandular swelling seemed to increase in size, discharged a good
deal of pus, but finally the openings seemed to have closed up.
March 26th. Cale. carb. 30. Upon its use for two months
the glandular swelling decreased, broke open again a few
times, and healed again, but finally a standstill took place,
and Calcar. did not seem to exert any subsequent effect.
Aug. 1st. Brom. 15. Fourteen days afterwards the axillary
glands became painful, blisters formed upon its surface, which
broke and developed into suppurating ulcers; yet, in proportion to the suppuration the swelling decreased. His general
health improved remarkably, and his face assumed a healthy
complexion.
Brom. was continued for a whole year, whereupon the enlargement of the cervical and axillary glands had been resorbed, and the best health followed.
9. (XXIX.) Scrofulous Glandular Affection.
A youth, met. 17, suffered from his childhood from swollen
cervical glands. When he came to Dr. N. he could wear no
neckcloth; the left submaxillary gland was twice as large as
a walnut, and hung down on the neck like a bag; onl the



MOST APPROVED REMEDIES AGAINST SCROFULA. 131
right side the glands were swollen to the size of hazelnuts.
They were, however, not painful, and not sensitive upon touch,
though several parts thereof during the treatment became
red and painful, and made us suspect suppuration, but the
the process always ended with resorption.
IHe was treated for nine months with Brom. 6, one powder
every forty-eight hours, and the swellings disappeared completely.
What important relations exist between the curative effects
of PBrom. and the scrofula-dyscrasia, that just the presence of
the latter, if we are undecided among several remedies, decides for Brom., evidently seems to follow from the following
clinical observations of the same author.
10. (XXX.) Chronic Swelling of the Tonsils.
A boy, Tet. 8, after preceding chronic inflammation of both
eyes, suffered from such extensive opacities of the cornea as
to compel him to roll the eyes in a horrible manner, in order
to distinguish the road before him; the lids swollen and knotty
to the touch; purulent discharge of the swollen conjunctiva
palpebrarum; besides, the child was deaf in consequence of
the disease. Inspection of the throat showed very large tonsils; otorrhea had been present previously. The whole face
bloated; the nose thick; continuous and offensive coryza;
lips swollen; most of the teeth carious, and the submaxillary
glands as large as walnuts, but painless. Yet notwithstanding
all this Brom. 6, one powder every forty-eight hours, made
such an improvement as to enable his parents to send him to
the country. The glandular swellings, as well as the deafness, had disappeared with the decrease of the tonsilar enlargement. Even the opacities of the cornea were removed so far
that the darkest portion only looked opaque; the lids returned to their normal form; the chronic inflammation of the
conjunctiva, and thus its swollen condition, even, disappeared,
as well as the discharge from the nose, in consequence of which
the swelling of nose and lips went down naturally.
5NOTE.-Dr. Kallenbach has often prescribed Brom. or Kal.
brom. 6 in scrofulous affections, but cannot maintain that it
has done any more than the well-known remedies, Sulph.,



134            ON SCROFULOUS AFFECTIONS.
pervous system of the entire lymphatic and glandular system
(especially upon the mesenterial glands).
In view of the characteristic pathogenetic effects of Cale.
carb., such as glandular swellings, ophthalmia scrofulosa (opacity of the cornea), otorrhoea; discharge of an offensive fluid
from the nose; distension of the abdomen; constipation (but
also diarrhcea), the remedy has been tried and found efficacious in the various manifestations of scrofulosis:
1. In crusta lactea, acne, facial eczema, impetigo, pemphigus, and onychia, especially when acidity of the stonlach is
present.
2. In scrofulous degeneration of the mesenterial, thyroid
(struma), and cervical glands.
3. In chronic headaches of scrofulous persons.
4. In ophthalinia scrofulosa.
5. In otorrhoea purulenta scrofulosa.
6. In ozoena scrofulosa with loss of smell, as well as against
the formation of polypi.
7. In dyspepsia, accompanied by water-brash and eructations with the taste of the food taken.
8. In habitual diarrhoea, sour-smelling diarrhcea of children;
ascarides.
9. In incipient rhachitis (walking of children at a late date),
difficult dentition of infants, slowly-closing fontanels.
Caustic. and Lycopod. much resemble Calear. carb.
Caustic. is indicated also in strumatous swellings, in pustular eruptions, moist eczema, scrofulous otorrhoea; (nervous)
dyspepsia; panaritium; ophth. scrof. of a chronic character,
with spots upon the cornea; but it is hardly possible to confound them, if we consider that Caustic.'like Rhus) corresponds more to the rheumatic than scrofulous diathesis.
At the head of the Caustic. symptoms stand arthritic and
rheumatic tearing in the limbs; contractions of the limbs,
with paralysis; paralysis after apoplexy; pain as from luxation in the hip-joint, &c.
It is more difficult to draw a line between Calcar. and Lycopod., since both complement and not oppose each other in
their action.  Lycop. resembles Sulplhur, but the fact that
Calcar. carb. does excellent service in suppressed hermorrhoids
and their evil consequences-(Richter recommends here injec



136            ON SCROFULOUS AFFECTIONS.
2. (XXXIV.) Otorrhma.
Dr. Rentsch, of Potsdam, reports instructive cases of catarrh of the meat. audit. ext. in originally scrofulous individuals by Calc. carb.  They are instructive for the reason
that they testify to the possibility of a lull in scrofulosis, lasting for years, as well as show that the sudden disappearance
of habitual otorrhcea has bad consequences; that, moreover, if
such a morbid drying up takes place, the lymphatics swell,
and that the scrofulous materia peccans moves thither, as it
were.*
In one case, Ferr. metedal. 1, ten grains morning and evening
had to be given besides Cale. carb., the patient being a chlorotic girl, eleven years of age.
3. (XXXV.),Serofulous Inflammation of the Knee.
Dr. Kallenbach, of Cleve, describes the Calcarea-affections
of the knee-joint,t and says that they attack mostly scrofulous individuals. Slight digestive disturbances, loss of appetite, irregularity in the stools are present. The pains are
bearable (in contradistinction to the ]Baryta-affections of the
knee-joint), pressing and stinging, intermitting  at night and
when at rest, worse in going up and down stairs (flexion).
Very often the trouble aggravates at the time of the full
moon. Swelling, if present at all, at the inner and lower side.
The painful spot at the inner side of the patella.
In his "Klinischen Beobachtungen,"  Dr. ltilberger, of
Trieste, compares Calc. carb. with Conium, and says: "' While
the curative power of Con. confines itself to the softening of
the iiduration, the effect of Calc. is more marked. It corresponds upon the whole to the scrofula-dyscrasia. That this,
without having manifested itself in childhood, may become
the cause of many diseases, frequently in an advanced age,
every practitioner will have convinced himself."
Its special relation to glandular affections is equally evident, and fully justifies its application (Z. f. h. Kl., 3, 14).
* Beitraege zur Erkenntniss und Behandlung einiger Ohren Krankheiten
v. Dr. Rentsch XXXVI, 1, 6.
t 52, S. 51.



140           ON SCROFULOUS AFFECTIONS.
of breathing sets in also, compelling her repeatedly to jump
up at night.
Clec. cacrb. 3, trit. 0, 12 centigrammnes for twelve days; a dose
every evening.
Three weeks afterwards, menstruation, more copious, appears at the 26th day. The struma has not increased any
during the menses. No difficulty of respiration.
The same prescription.
Dec. 20th. Considerable improvement of the struma, which
appears softer, less tense, and prominent. Menses after four
weeks.
Cale. carb. 6, six drops in 200, 0 of water, two tablespoonfuls
every day. At the end of January the swellingo was unmistakably decreasing in size.
Cale. caw'b. 30.
During the course of March there is but a single spot at
the neck which transgresses the normal level; nothing is
seen, however, if one is not looking at it intently.
Dr. Bourgeois's method, in a long-continuing treatment to
run over the entire scala of the ltahnemannian posology, is
not at all unessential.
11. (XLIII.) Cure of Struma.
Miss K.  aet. 19, affected with a considerable swelling of the
thyroid gland, the increase of which she notices since a few
days, and the origin of which she is not able to account for,
wished to be freed from it. Difficult respiration, on lying on
the back during sleep, is the only complaint made.
Brom. 0, 3, one drop in a tablespoonful of water, three times
a day. No change within ten days.
Cale. carb. 0, 3, morning and evening, as much as will lay
upon the point of a pocket-knife.
Eight days afterwards noticeable decrease of the swelling.
Complete cure after three weeks more.
Dr. A. Starke, of Nagy Karolyi, remarks, upon this case,
that Miss K. previously had been treated allopathically for
one year, yet, without noticing the smallest change in her
condition (i. e., the smallest change for the better); for the
famous Iodine-coryza appeared frequently, since she had been



MOST APPROVED REMEDIES AGAINST SCROFULA. 143
serous membranes and upon the venous (but also upon the
lymphatic) system."
From this it is evident, therefore, that it becomes one of the
most important remedies in diseases of reproduction.
Thus Cale. carb., 3 trit, one grain morning and evening, was
given.
Every other day ablution of the whole body in the room,
with water of a temperature of from fifteen to eighteen degrees (R.), and walking about of the patient with the assistance of her friends.
As early asfourteen days afterwards the improvement was remarkable. Not only the dry cough, but also the fever decreased from day to day. After the course of a month the
head did not require to be supported any longer. Pain in the
back upon pressure only. Can walk around in the room without assistance. Mind more lively and active. Upon the
upper part of the body and both arms, as well as at the nape
of the neck, a slight eruption, somewhat itching, has shown
itself within a short time.
Now Silie. 30, every second day, five globules, till the end of
May, when patient could take walks out of doors again.
Of the disease nothing remained except that the head was
carried bent down somewhat, but in case of an energetic will
of the patient, it may be presumed that in this respcct, even,
improvement is still possible.
Mention must also be made of Calc. phosph. The role it
plays in scrofulous products is evident. We know that, besides carbonate of lime and chloride of sodium, Cale. phosph.
preponderates in the lymph or the serous portion of the blood
of scrofulous persons; we know, further, that the milk of
scrofulous (tuberculous) cows contains seven times more phosphate of lime than other milk.*  This surplus of saline salts
is not accidental, and may, probably, be made use of by homceopathic therapeutics, as well as the fact that the abuse of
Mercury reflects the entire picture of scrofulosis. CGalc. phosph.
so far as we know, has been justly recommended by French
authors only, against chronic swelling of the tonsils, no doubt
mostly upon a scrofulous bottom.
* Clark refers scrofulosis to an overloading of the general constructive material with phosphate of lime.



144           ON SCROFULOUS AFFECTIONS.
Heyne, of Beckurnm, praises Cale. phosph. 12 (to be given
from three to four days every fourteen days) in tumor albus.
One word more of Cale. acetica. Dr. Ilofrichter (Prague)
calls it, as Spirit. caie. acet., or as trituration of 1: 100, or 1:
10, repeated several times a day, the principal remedy in infantile diarrhcea. The principal symptoms, which, in his
opinion, urgently demand its application are: inclination to
looseness of the bowels and diarrhoea; diarrhoea with prolapsus ani; diarrhcea of scrofulous infants during dentition; in
short, those cases of infantile diarrhcea described under the
head of "softening of the stomach and intestinal tract"
(gastromalacia). The diarrhcea sets in without any noticeable
cause; the copious discharges rapidly following one another,
according to the violence of the disease, consist of watery
mucous, now greenish, flocculent stools, the cadaverous or
characteristically sour smell of which, characteristic of the
flatus also, soon communicates itself to the garments and bedlinen, and thus continually contaminates the atmosphere; at
the same time slight fever, burning of the hands and soles of
the feet, continual and intense thirst, loss of appetite, rapid
emaciation of the whole body, and especially of the face, which
assumes an aged look; continuous restlessness, tossing about;
wailing and crying; pale, dry skin; sensitive elastically distended abdomen; occasional vomiting; scanty, pale urine, or
easily disturbed sleep with eyes half closed (A. H. Z., 43, 11).
CALENDULA OFFICINALIS.
GENERALITIES.
"It promises to become a useful remedy in glandular diseases; the physioiogical proving, though aphoristic, already
gives a few hints. Especially, it was recommended and used
against scrofula by Tournecort, against bubo by Franc. Valleriola; against induration and carcinoma (scirrhus) of the
mammary glands by Rudolph" (Dr. Reil, N. Z. f. h. K(1., 2, 9).
In developed scirrhus, carcinoma of the mamma and uterus,
as well as in cutaneous cancer.



MOST APPROVED REMEDIES AGAINST SCROFULA. 145
CARBO VEGETABILIS.
GENERALITIES.
"When in acute as well as chronic diseases the vital forces
are nearly exhausted, the circulation begins to flag, a condition that reflects itself externally in cyanosis of evil omen;
when the vital temperature sinks to a minimum, and the distress of the patient, whose mental capacities are mostly undisturbed, reaches its maximum; when all motions are expressive of the last smouldering vital spark; when we despair of
all reaction, the effect of this truly magic remedy still surprises us, now and then."
CLINIQUE.
1. (XLVIII.) Atrophia.
With the above words Dr. lHilberger, of Trieste, introduces
a few interesting clinical observations on Carb. veg., from
which it is plainly visible when this remedy is indicated.
1. A feeble boy, 9 months old, whose mother while nursing
him, became a victim to cholera, from this moment on suffered from  diarrhcea that had lasted several months and
seemed incontrollable. Though it had, finally, begun to abate
somewhat, yet the little fellow did not pick up in the least,
and the picture of atrophia infant. more and more developed
itself. The child, emaciated to a skeleton, got into such a
state of weakness that all capability of motion ceased, complete aphonia set in, and it could not take nourishment any
more. Pulse small, scarcely perceptible, the body cold. Only
the power of sight did not seem to be lost, just as a feeble
breathing seemed to be the only sign of life left. For eight
days it remained in this condition. For the sake of experiment, and more on account of the friends, I gave remedies
which, however, were all fruitless; (Sulph., Arsen., China,
&c.), finally, I administered two doses of Carb. veg. (6), and to
the greatest surprise of all, as early as the next day, the
child's voice returned, the temperature rose, and it was convalescent after receiving the remedy for fourteen days, and
now is a lively and strong boy.
10



146           ON SCROFULOUS AFFECTIONS.
2. (XLIX.) General S:rofulosis. Broncho-pneumonia.
A child, Fet. 2, who in the first year of life, had fortunately
recovered from hydrocephalus, was attacked by whoopingcough, epidemic here the winter previous. For three weeks
the disease took a tolerably favorable course, when on taking
cold, pneumonia of the right side and an intense bronchial
catarrh developed themselves additionally. The upper portion of the lung had already become somewhat emphysematous, the characteristics of the whooping-cough disappeared
forthwith, but on the other hand, an extraordinary and continuous dyspncea, mucous rattling, audible at a distance, even,
and intense fever set in. In spite of all remedies (Acon.,
Bryon., Sulph., Phosph., Tart.) no improvement had taken
place, and eight days afterwards the patient was in almost a
dying condition. The skin cold, face bloated and cyanotic,
extremities swollen, expression of the face corpse-like. Breathing so rapid that one could not distinguish the number of
respirations. Excessive distress. The ominous wringing of
the hands and the dull glances, looking out for help, of the
child, who had its full consciousness, enlisted the strongest
sympathy. Pulse could not be felt. Nothing but death by
suffocation could be looked for now every hour. However, I
gave the child one dose of Carb. veg. 6, and left two doses for
the night. When I called the next morning, I scarcely
credited my ears to hear that already after the first dose, half
an hour afterwards, after so terrible an aggravation that the
child was believed to be dead, more comfort set in. Upon the
second dose the remedial aggravation had likewise appeared,
but much weaker, and afterwards the dyspncea decreased considerably, the pulse rose, the expression of the features became
brighter. Improvement continued now for five days, when
in consequence of stormy weather the child had a relapse, and
the same sad phenomena reappeared. Upon Carb. veg., an
entirely similar reaction followed again, from which time on
the child recovered slowly upon the administration of Baryt.
carb., which I always have seen act beneficially in similar
cases, when such affections appeared in scrofulous individuals.
The child now enjoys complete health.



MOST APPROVED REMEDIES AGAINST SCROFULA. 153
1. Antiscrofulosum;
2. Constipation; 
3. Burning and itching pains;
4. Eruption behind the ear;
5. Psoriasis palmaris;
6. Hemiplegia facialis;
7. Chronic laryngitis; rough voice;
8. Dryness of skin; fissures;
9. Ophthalmia.
CLEMATIS ERECTA.
GENERALITIES.
" Regarding it the same holds good that has been said of
Calendula; homceopaths saw  satisfactory cures from  it in
swellings of various glands and in torpid scrofula " (Dr. Reil,
N. Z. f. h. Kl., 1, 9).
"As regards the exanthemata, in which we are guilty of
generalizing too much, Clematis seems to have been much
neglected. It has proved itself efficacious especially in the
pustular forms (papuloe, acne, sycosis). Here I have found it
to be specific and exceedingly prompt in its action; much more
efficacious than in eczema (impetigo, bullae, ecthyma); in
short, in the vesicular forms, in which it has also been recommended from different quarters" (Hirschel, N. Z. f. h. 1Kl., 2,
23).
Dr. Steus nanmes Clematis among the cancer remedies (besides Con., Lycopod., Sep., and Sulph. ace.) (N. Z. f. h. Kl., 4,
19).
Dr. Kallenbach praises the curative power of Clemnat. erecta
in tumors of the mammoe, with simultaneous affection of the
whole mammary gland (otherwise not), especially if the pains
are aggravated by west wind, cold weather in general, and
during the night.
Dr. Weber corroborates the efficacy of Clemat. in such cases,
saying that he had found it confirmed in a girl to whom he
had given this remedy for soreness of both nasal openings.
v. Boenninghausen remarks upon this that the principal
indication for Clemat., in such glandular affections, is a burn



154           ON SCROFULOUS AFFECTIONS.
ing, tensive, and itching pain, which is considerably aggravated, especially after cold washing, or cold, wet applications
(Neunte Jahresvers. d. hornm. Aerzte Rheinlands und Westphalens, 31 Juli, 1856. A. H. Z., 53, 12).
NOTE.-The testicle corresponds to the mamma.*  We see
now that Clemat. shows its action upon that also. From all
this it may be seen that Clemat. suits better for grownl-up
persons; hence for the scrofula-forms more modified by increasing years, among which affections, finally, we may rightly
count the scirrhous degeneration of the glands. At any rate,
the remedy ought to be tried in affections of the skin and
glands, with due observation of the indications above mentioned:
1. Torpidity of the trouble.
2. Aggravation from cold and wet.
3. Glandular organs affected, or the skin amid efflorescence
of a papulous exanthema.
4. Burning, tensive, and itching pain in the part affected.
CONIUM  MACULATUM.
GENERALITIES.
Conium has a more decided action upon the glandular system than Cicuta, belonging to the same natural fanmily, which
manifests its effects more in the nervous system. Not only
the ancients, Dioscorides, Plinius, Avicenna, observed after
the use of Con. the glands of healthy persons to grow smaller
in size, but also more recent experiences have confirmed these
facts. Especially do all agree in its pain-allaying action.
Dr. Kurz (N. Z. f. h. Ki., 2, 9) recommends Con. against periodical, nightly cough, if predisposition to scrofula sustains
the cough. My own clinical observations corroborate these
recommendations.  Con. 3, a few drops in two grammes of
alcohol. Of this from 2 to 3 drops from three to twelve hours
(N. Z. f. h. Ki., 2, 14).
* For this reason abuse of lodium occasions atrophia of the testicles, as
well as of the mammae.



MOST APPROVED REMEDIES AGAINST SCROFULA. 155
The relations of Coniurn, says Dr. Hilberger, of Trieste, to
glandular affections, and especially to the mammary gland,
were already surmised by old school physicians. Physiological provings have confirmed these properties de facto. The
considerable hardness of an infiltrated gland, and the flying
stitches resulting from its pressure upon the nerves, form a principal indication for its administration. It develops its effect
most likely by causing a reaction in the compressed, and hence
relaxed nervous and vascular ramifications, and in this manner brings about the resorption of the softening tissue, without, however, being capable of altering the dyscratic character
itself.
The N. Z. f. h. K1. 2, 21, recommends Con. 6 against photophobia and presbyopia, already manifesting itself in early
years.
In the same journal, Bd. vi (x), 24, a cure by Conium is mentioned; a few noduli, resembling hard beans, in the left mamma, with a slight short cough (in a young lady aet. 25), were
resorbed upon the use ofR. Conii macul. fort. gtt. iij.
Sach. lact., gr. vij (0, 5).
M. f. p. d. dos. t., No. xii.-Two powders daily.
Dr. L. Battmann (of Grossenhain) deems Con. (2) the most
specific remedy in suppuration of the mesenterial glands, and
in support of his opinion quotes the report of an interesting
case (A. HI. Z., 54, 21).
CLINIQUE.
1. (L.) Affection of the Nervus laryngeus inferior,
Consisting in a clapping sound in the larynx, in a scrofulous
boy aet. 13, with previous spasmodic pressure in the region of
the ligamenta glottidis. Dr. Schwenke supposed pressure upon
the n. vagus, in consequence of glandular swelling, and cured
the trouble by Con. mac. 6 rapidly and permanently. Allopaths
had given the same remedy before without result (A. H. Z.,
49, 19).



156           ON SCROFULOUS AFFECTIONS.
DULCAMARA.
GENERALITIES.
Characteristic remedial action (according to Altschul): suppurating, wetting, herpetic eruptions; vesicular eruptions, with
a yellowish, watery liquid; glandular swellings, and induration of the glands; bad effects of taking cold, especially from
wet, cold weather; sudden hydropical swelling of the body
(hydropical dyscrasia).
CLINIQUE:
1. (LI.) Scrofallosis.
In the long account of suffering of a boy, set. 14, in whom,
as usually, accompanied by obstinate, sour diarrhcea, vomiting, knotty distension of the abdomen, subsequent cough, and
furunculous eruptions, &c., an exceedingly high grade of general scrofulosis and atrophia developed itself, Dr. Buerkner
(N. Z. f. h. K1., 3, 9) marks out two periods. After the malady, in spite of the most careful dietetic as well as therapeutic
treatment of the child, had already become very severe; when
the child, emaciated to a skeleton, with a shrivelled, wrinkled
skin, covered on the back, buttocks, and legs, with furunculous, hard, red knots, lay in bed, which it soiled several times
daily by excessively fetid, thin discharges, not crying any
more, but hoarsely moaning the whole time; a pemphigus,
the bullae of which partly had the size of a pigeon's egg,
broke out over the whole body, amid the most distressing
restlessness. Against this, though with no hope of success,
Dulcamara 1 was prescribed every two hours; a remedy which
the writer remembered to have seen recommendeded against
this disease-form. Almost from the very moment of its application, improvement set in in the general condition of the
child; it became more quiet; the diarrhcea grew less; sleep
came on; and when, five or six days afterwards, upon the
continued use of the remedy in a higher dilution, even the
pemphigus blisters, to which, at the beginning, a few fresh
ones had been added, began to heal up, the whole condition
was so changed, that one could again entertain hope for the
child, given up long ago. And, in fact, from this date on, re



158           ON SCROFULOUS AFFECTIONS.
mia which left spots of considerable size on the cornea, this
remedy alone was efficacious (Brit. Journ. of Hom., 1850, Jan.).
2. (LIII.) Opacity of the Cornea.
In April, 1851, I observed the rapid curative effect of
Euphras. 1, daily one drop in three tablespoonfuls of water,
four days in succession, in a young female badger dog, against
a severe blennorrhcea of the conjunctiva of the right eyeball,
and pterygium, which, departing from the inner canthus,
spread over nearly the whole transparent cornea. The pathological formative process ceased forthwith, and the pterygium
disappeared in the shortest time without any further local
application. The most prominent symptoms were: intense
redness of the eye, swelling of the lower lid, increased mucopurulent secretion, nightly agglutination of the lids, and
photophobia (A. II. Z., 44, 16).
NOTE.-Dr. Lobethal, on the contrary, says that in scrofulous ophthalmia the effect of Euphras. is uncertain, and appropriately assisted by the internal use of Cannabis and Nitri
acid., and in case of severe photophobia by Rhus 1.
He thinks that in catarrhal ophthalmia Euphr. is of acknowledged efficacy, a reason for which it is kept officinally
in all drug stores.*
We also believe that Euphras. in the most pernicious form
of scrofulous ophthalmia, can never render superfluous such
remedies as Cale. carb., Acid. nitri., Mercur., Arsenic., &c. It
can claim here, consequently, but the name of a so-called intercurrent remedy.
FERRUM.
GENERALITIES.
If Iron were of benefit in anemia alone, we could not use
it much in scrofulosis; however, it cures those diseases coincident with dropsical conditions, and, from this view, it is an
antiscrofulosum.
* Aus den Verhandlungen des Vereins schlesischer hornm. Aerzte, in Breslau, A. HR. Z., 76, 10.



MOST APPROVED REMEDIES AGAINST SCROFULA. 159
We name (according to Rueckert's industrious compilations) the following confirmed indications:
1. Relaxation and weakness of the entire musculature and
emaciation, weakness of digestion, coldness of the extremities.
2. Ansemia under the mask of plethora and congestion, accompanied by a whitish color of the mucous membranes.
3. Pulmonary tuberculosis, especially in young, florid subjects with a remarkable erethism of the vascular system, inclination to congestion toward the-chest. But we will remind
here of the property of Iron, in larger doses, to occasion hemorrhages, a reason for which allopathic physicians do not give
it in tuberculosis with inclination to hemorrhages.
4. Aphonia, very distressing.
5. Chronic, watery diarrhcea in children, usually soon after
eating and drinking, wvithout pain and effort, mostly containing
undigested substances.*
Iron is the remedy, also, indicated after previous abuse of
Iodine (likewise after Arsen. and China), and what scrofulous
patients have not already been overfed by Iodine (or a compound thereof) when they are transferred to us from allopaths?
The Monatsblatt to the 82d vol. of the A. H. Z., presents a
very interesting contribution to the action of Iron. There we
find an essay by Dr. E. Seitz (of Buer, near Osnabrueck), which
shows that a great number of strumata decidedly grow in size
and are produced by the use of Iron preparations (confirmed
in Virchow's Jahresbericht of 1868, Bd. 1, Abth. 2, S. 287).
" Very similar relations," continues Seitz, "exist moreover,
with regard to scrofulous glandular swellings, and every objectively observing physician may convince himself that with
some scrofulous children the submaxillary glands grow larger
and more painful after the administration of Iron preparations"t (Allgern. med. Central-Ztg., 1870, 103).
There exists scarcely a more direct appeal to give Iron in a
homceopathic preparation against such glandular hypertrophies. Allopaths can, probably, best quiet their conscience
by giving Iodide of Iron, in place of Iron. For Iodine as surely
* Calc. carb. or acet., Phosphor., Arsen., are more frequently administered
against this affection as the expression of a scrofulous trouble.
- Calc. carb. or acet., Phosph. and Arsen, are more frequently indicated
in this affection as an expression of scrofula.



160           ON SCROFULOUS AFFECTIONS.
reduces the size of the glands (especially of the gl. thyreoidea)
as Iron, according to Seitz, increases it.
HEPAR SULPHURIS CALCAREUM.
GENERALITIES.
Coinciding, as a general thing, with the action of Sulphur;
Hep. sulph. calc., on account of its combination with lime, still
more acts upon the lymphatic and glandular system, and especially moderates plasticity. Hence its curative action in
pathological processes with pseudo-membranous deposits
(croup). Secretions of the skin and mucous membranes are
excited by it, as well as exudations of serous membranes more
rapidly resorbed by it. Like Sulphur itself, Hep. sulph. calc.,
affects disturbances dependent upon prevailing venosity. All
this insures to it a prominent position among the antiscrofulosa.
IHepar has shown itself useful in the following forms of
scrofula-dyscrasia:
1. In abscesses, the maturing and suppuration of which are
hastened under its influence.
2. In moist and wet tinea.
3. In panaritia, in which ]Hepar in alternation with Silic.
renders surgical interference superfluous.
4. In inveterate glandular indurations, which are brought
to suppuration or resorption by it.
5. Its curative action is indubitable in scrofulous ophthalmia, in which it acts all the surer the more pure the habitus
scrofulosus presents itself in its totality.
6. In scrofulous, purulent otorrhcea.
7. In angina membranacea, in croup and pseudo-croup.
They, as is well known, cannot always be distinguished from
each other during life, as long as real membranes are not
coughed up. Ilep. sulph. soon changes the dry, harsh, and
crowing cough into a loose one. We do not always succeed in
this with Spong., which is still more used in the treatment of
croup. The torture of emetics is spared to children, treated
homceopathically, on account of the certainty with which our
remedies, among which Hep. sulph. belongs par excellence,
bring about a crisis.



MOST APPROVED REMEDIES AGAINST SCROFULA. 161
8. Again Hepar recommends itself in relapses of amygdalitis. We find chronic enlargement of the tonsils as an unmistakable expression of existing scrofulosis.  Every cold
settles there.  After Bellad., the reduction of the tonsils
which have grown still larger, hesitates sometimes; then
iep. ought to be given.
9. Against ulcerated corners of the mouth.
10. In ophthal. neonator. (simultaneously with the external
application of Acid nitri. See that).
11. In febrile flowing coryza, when the flow becomes very
easily arrested, especially in scrofulous and rhachitic children;
if hoarseness or a hollow rough cough appears in addition
(Kafka).
12. In ozoena scrofulosa (Kafka).
Mercurius is the remedy with which Hepar sulph. could be
confounded most easily. Mercur. within the domain of scrofulosis has almost all the therapeutic virtues of Hepar sulph.
Hence we shall have to fall back upon the total characteristics of both, in order not to commit any mnistake. Yet this
is not to be understood as if both, now and then, were not in
place, one soon after the other (in a similar manner as Lycopod.
may immediately be given after Calt. carb.), e. g., if the improvement obtained by Hepar comes to a standstill (see note
to LIV and LVI).
Both remedies have in common:
1. Pain as from being bruised.
2. Excessive sweats.
3. Inflammatory swellings of the glands.
4. Acne rosacea.
5. Scrofulous ophthalmia and otitis.
6. Inflammation and suppuration of the tonsils.
7. Great flow of saliva.
8. Dry cough.
9. Symptoms of rheumatismus acutus; inflammatory erysipelatous redness and pains.
10. Leucorrhcea.
11. Panaritium.
12. Coryza, with copious discharge of an acrid fluid.
11



162            ON SCROFULOUS AFFECTIONS.
DIFFERENCES.
Hepar sulph.
la. i)ifficult stool as from inactivity of the Intestines.*
Mercurius.
lb. Bloody mucous stools, excoriating the anus.  Greenish,
slimy (bilious) stools.  Tenesmus.  Dysentery.
Hepar sulph.
2a. Has many more specific relations to the exudative process of the larynx.
Mercurius.
2b. Mercur. is never used in croup so often; in hoarseness
and pseudo-croup we find Hepar indicated.
On the contrary, MIere. more than lep. in cases of angina
which are occasioned by swelling (formation of abscesses) of
the tonsils, inflammation of the uvula (accompanied by copious
flow of saliva).
Iep. sulph.
3a. Efficacious in mercurial dyscrasia.
Long-continuing or retarded suppuration.
Festering, easily ulcerating skin; putrid, fetid, carcinomatous ulcers.  Hair falls out very much.
JMercurius.
3b. Various manifestations of syphilis fall within its therapeutic sphere.
Nightly inflammatory pains of the bones.  Inflamed
swollen suppurating glands.
Highest degree of emaciation.
Ulcerated, whitish-dentated, detached gums, looseness
and falling out of the teeth. Fetid salivation.
* In certain cases Hepar even is to be considered as a remedy in dysentery;
yet we read in the proving of Hepar more of whitish and muco-sanguinous
diarrhmea, or sour-smelling and whitish discharges.



MOST APPROVED REMEDIES AGAINST SCROFULA. 163
Inflammatory swelling and suppuration of the inguinal
glands (bubo venereus).
Hepar sulph.
4a. Hep. sdiph. corresponds more to the torpid form  of
scrofula.
Mercurius.
4b. In scrofulosis erethica et florida.
Mere., moreover, cures also the following affections,
which cannot be reached by tHepar.
a. Epilepsia (Trinks).
b. Zona with violent burning-itching at night (Schroen).
c. Icterus and cutaneous cedema after scarlatina.
d. Nervous fever with pain in the region of the liver,
diarrhcea, and easily-bleeding gums.
e. Typhus abdominalis, in its first stage, swith tenderness of the liver (status biliosus et pituitosus).
f. Gastric and scorbutic stomacace.
g. Glossitis.
A. Atrophia mesaraica, with a large abdomen of the infants, soft stools, and hectic fever'see Arsen).
i. Gonorrhcea, dysuria, stranguria, hmmaturia,
k. Balanitis from suppressed gonorrhcea (Trinks).
We briefly repeat that the affections cured by Mere. presupposes a greater participation of the organs connected with
the production of bile than is the case with Hepar. The latter
better corresponds and is more suitable to the infantile organism, and for this reason, even, better fitted to be a more
mrany-sided remedy in scrofula than Mercur., inseparable from
the idea of syphilis.
CLINIQUE.
1. (LIV.) Scrofulous Ophthalmia.
A. N., set. 7, of a very well-marked scrofulous habitus.
The left eye intensely inflamed; the sclerotica of a violetreddish color; the cornea turbid and dusty-looking; the eye
watering profusely; the lower lid swollen; great photophobia.



164           ON SCROFULOUS AFFECTIONS.
High potencies of Bellad., Cale., and Rep. had no effect.
Feb. 21st. Hep. sulph. calc. 3, trit. four doses.
" 23d. Pain decreased.
" 24th-28th. One dose daily. As early as on the 25th,
the ulcer is evidently smaller and flatter; and, on March 2d,
a complete cure has been accomplished.*
NOTE. —" Scrofulous ophthalmia, in which the lids are reddened, swollen, and agglutinated, accompanied by ulcers on
the cornea, require Hepar sulph. as their principal remedy"
(sometimes beneficial in alternation with Mercur., —Hyd. prcecip. rubr.) (A. H. Z., 77, 10.)
2. (LV.) Croup.
Anton Scholz communicates a cure of croup (probably of
pseudo-croup only) with Rep. sulph, of which he gave one
grain (4th trit.) every hour: " All danger was removed as by
magic, and I had good reason for praising Hep. sulph. as an
excellent remedy" (A. II. Z., 24, 13).
3. (LVI.) Ophthalmia Neonatorum.
Rueckert does not doubt that Hep. sulph. cale., this efficacious remedy in catarrhal and scrofulous ophthalmia, especially in intense affection of the Meibomian glands (K1. Erfahr.
1i, 235 and 271), now and then, will act favorably also in ophth.
neonat. (N. Z. f. h. K1., 5,';12); and we read on page 79, Bd.
77, of the A. II. Z., of a very bad case, in which the cornea
was pouched out, all the soft tissues of the eye were thickly
swollen and of a spongy appearance, accompanied by a terrible purulent discharge and photophobia, which was treated
with the best result by Rep. sulph. (in the morning) and
Mere. 3 (in the evening,.
4. (LVII.) Eczema of the Head.
Mr. NT., a government officer of high rank, asked advice
with regard to his children, who exhibited a well-marked
* Ein Beitrag zur Frage ueber die Hochpotenzen von Dr. Kallenbach in
Goerlitz. A. H. Z., 30, 7.



MOST APPROVED REMEDIES AGAINST SCROFULA. 165
scrofulous habitus, and suffered at times from  glandular
swellings and acne, as well as from numerous small boils.
The whole family went to Kreuznach, since the father, likewise scrofulous, suffered from a chronic conjunctivitis of both
eyes; he also took the baths, and afterwards drank the water
of the Elizabeth spring.
During the drinking-cure small vesicles had already appeared upon the head; first at the occiput, which soon spread
over the vertex and synciput as far as to that portion of the
forehead free from hair. The vesicles had become larger and
larger, formed thick crusts, which discharged a moisture, and,
upon drying up, thickly covered the portion affected, so that
but one yellowish-white crust was visible, which detached
itself in form of light scales and lamellie, covered the clothing
and floor, and caused violent itching, especially at the parts
covered with hair. The hair itself seemed sickly, died off,
and fell out more and more.
A Parisian physician, who declared the trouble to be Eczema
rubrum, and a consequence of the use of the Kreuznach
springs, since it had been present once before, prescribed, without result, Rhus tox. and Merc. sol., after which the discharge
became more copious. Graphit., which counteracted the latter
effect, and produced more dryness; Sulph., Phosph., Clemratis,
which comforted much; Iaches., which subdued the redness,
did most without curing definitely, however; Sulphur-Amidine baths, which acted favorably upon the thickness of the
crusts; Dulcamara.
When Hirschel saw the eruption it was confined to the
scalp, and presented the form well known as eczema impetiginosum. Hepar sulph. was selected, 1, in view of the antidotal relation to the effects of Iodium and Bromium contained
in the waters of Kreuzlach, which, at all events, had awakened the dormant scrofulo-dyscratic conditions, and brought
them to the surface; 2, in view of the existing scrofulons
foundation of the cutaneous affection itself; and 3, in consideration of the peculiar form of the eruption, the " moistening soreness," "inflamed cutaneous surface," "puriform discharge," "crusty character," of which, as well as its "secretion of a whitish-bubbly liquid," "its itching and itching



166           ON SCROFULOUS AFFECTIONS.
gnawing," together with the "falling out of the hair," are
distinctly recorded in our M. M.
He gave the remedy in the 3d trit., one grain of it morning
and evening, combined with the use of baths, each containing
two ounces of Hep. sulph., of which, however, on account of
the advanced season, but three could be taken; forbade the
use of all others, even the most innocent washes or softening
oils, in order to keep the head perfectly dry, and ordered the
strictest diet. After eight days already a complete arrest of
the trouble manifested itself; since the eruption did not
spread any further, the moisture decreased, and the itching
grew less. Six weeks later the cure, in its main feature, was
completed. The eruption dried off more and more; the crusts
separated easier, grew thinner and thinner, the cutaneous redness, at the place of the detached crusts, more and more disappeared. The subsequent crop, in place of the crusts, showed
but scales which easily detached themselves; small, dry
noduli, in place of the filled vesicles. The hair fell out more
and more. Only at the occiput it remained; and here, also,
the most intense itching was experienced, against which glycerine was allowed to allay it. At first the vertex healed up,
next the synciput, then the occiput, and, latest of all, the
right parietal surface, upon which the most intense redness
of the skin had been observed. When the friseur -two
months too late-brought the wig ordered, he was surprised
that it had become unnecessary, since all parts of the scalp
were healed, and the hair in a healthy growth. Only one
spot made a stubborn resistance; for, after the affection of
the scalp had healed, the eruption spread from  the right
parietal bone over the right ear, and crept from the right
auricula into the meatus audit. This affection was removed
by Hep. sulph. 2 within four weeks, so that the whole cure
required the time of ten weeks.
Besides Hepar sulph., Mercur. sol. Hahn. 2 was interponed
but two or three times when the reaction following upon
He par came to a halt. Then discharge and aggravation*
always set in, but forthwith upon the reapplication of Hep.
sulph. the improvement progressed in a most decided manner.
* This aggravation, no doubt, could have been prevented in the most simple
manner by selecting a higher dilution in place of the 2d trit.



168           ON SCROFULOUS AFFECTIONS.
IODIUM AND ITS PREPARATIONS.
A.-IODIUM PURUM.
"' Iodium est avec Silicea le meilleur mwdicament de la scrofule."-JovssET.
GENERALITIES.
NOTWITHSTANDING many contradictory statements, it is a
fact that Iodium, in its physiological action, has a specific influence upon the glandular system. At the beginning and
after small doses the secretions of the glands are mostly somewhat increased, but even if intense salivation has sometimes
been observed after Todium, it is, as a general thing, much
less the case than with Mercury, and more dependent upon
individual irritability. On the other hand, two other important phenomena have been noticed to appear after the use of
Iodine, namely, atrophia of the mammae and testes. It was
found, however, in autopsies that other glandular structures
even, such as the mesenterial and suprarenal glands, had
grown smaller after the continued use of Iodine, as well as
that the fat and connective tissue had been consumed.
However, experience ex usu in morbis much more decidedly
argues for the specific action of Iodium upon the glands.
Hypertrophies of the most various glandular structures, as
well as of other formations differently constructed, tuberculosis and scrofulosis have always been, and will ever continue
to be, the curative domain of this potent remedy. (Dr. Reil,
N. Z. f. h. K1., 1, 9.)
The remark of Dr. Knod v. Helmstreit, that Iodium has
proved itself efficacious against mercurial ulcers, salivation
and stomacace of scorbutic nature, may also be mentioned
here, because the scrofula-process is frequently complicated
with the affections named.
Dr. Schweikert is of the opinion that among the inhabitants
of regions, the springs of which contain Iodine, struma is occasioned by the physiological action of the frequent use of
Iodium; hence, in a similar manner as we see it with regard



170           ON SCROFULOUS AFFECTIONS.
Respiration entirely good; can remain in every bodily position* (A. H. Z., 60, 11).
Swelling and induration of the glands, emaciation with ravenous appetite, inclination to tubercular meningitis, all point
to Iodium. It corresponds to caries, to pleuritic exudation,
phthisis, and tubercles; suppuration, with and without caries.
According to Jousset, injections of Iodine (the pure or diluted
tincture) prevent the appearance of hectic fever; it moderates
suppuration, and unexpectedly often effects a cure. On the
other hand, we read in the "Universal-Lexicon der pract.
Medicin und Chirurgie," in the article on scrofulosis, written
with much industry and professional knowledge: " In case of
tubercular degeneration and suppurating abscess, the results
of Iod. have been naught. Frequently the effects were harmful and fatal in cases of scrofulous cachexia, which were accompanied by febrile symptoms and emaciation."
In the A. H. Z., 46, 8, we find the following warning example against traditional doses of Iodine:
"A girl, aet. 18, ruddy, and well developed, consulted a
physician on account of a swelling of the throat, a so-called'saddle-throat' (Sattelhals). He prescribed an Iodine salve
and Tr. iodii in increasing doses up to fifteen drops three
times a day. When I was called to see the girl, six months
afterwards, she had changed so that I scarcely could recognize her. Her form was withered, the bosom had disappeared,
her face was of an ashy pallor, and around the eyes blue rings
had formed. She complained of a large number of troubles,
especially of oppression, dry cough, palpitation of the heart,
loss of appetite, pressure in the stomach. The menses, previously regular, and at first failing to reappear after taking
the medicine, had afterwards appeared all the rmore copiously,
and since that time she had almost from every three to four
days, a discharge of a thin watery blood from the vagina.
The situation of the patient was a dangerous one. At any
rate, by the clumsy experiments with Iodine, the blossom of
a youthful life is destroyed forever."
Where, then, is to be found the true, curative sphere of
* Dr. Lobethal cannot do without a salve of Kali jodat. (05: 90, 00) in the
treatment of large lymphatic strumata.



MOST APPROVED REMEDIES AGAINST SCROFULA. 171
Iodium? The following case may present the answer to this
question.
2. (LXI.) Asthma Laryngeum.
A child, nine months old, suffering from atrophia mesenterica, underwent treatment for this trouble. Emaciation has
not yet reached the highest degree; abdomen large, legs thin,
stools irregular, now constipation, now diarrhcea. In addition
there were troubles from teething. Upon the administration
of Cale. carb. and Sulphur, alternately every other day, the
child improved rapidly. But fourteen days afterwards convulsions set in, which presented the following symptoms:
Sudden rigidity of the body, bending back of the head, tight
closing of the hands, lips growing purple and, in connection
therewith, the appearance as if the child were strangling;
respiration momentarily suspended; dry heat of the skin, and
frequent jerks and starts. The attack appeared usually when
crying or coughing, and at waking up.
In consideration of the periodical heat of the skin, Aconit.,
and afterwards Bellad. was given, but although the heat disappeared, the spasms nevertheless remained as before. Ipecac.,
as well as Hep. (the latter on account of the peculiar sound of
the cough, reminding one of croup) effected nothing; after
Zinc. met., it is true, no general and fully developed spasIn reappeared, but still momentary constriction of the larynx.
The sound of the cough, the glandular affection and the general emaciation, as well as the irregular stools, led me to give
Iod. Upon its use the attacks soon became weaker, and
finally ceased entirely. Under' the continued application of
this remedy, the child is now strong, fleshy, and healthy.
In a second case of asthma laryng., lodiurn did the same
good service; in a third it only helped in alternation with
Sambucus (Dr. Seybel, Aschersleben, A. H. Z., 50, 15).
In croup of scrofulous children, which likewise has its
asthma laryng., lodium deserves the greatest consideration,
and it seems almost as if many cures with Spongia, which is
related to the former, in most cases had appertained to spurious
croup (without formation of membranes) only. Otherwise,
how could such facts as the following find an explanation?



MOST APPROVED REMEDIES AGAINST SCROFULA. 173
intense any more, increased on the next day, more and more.
lod. 2, up to five drops, every hour. At the eighth day decrease of the croup-synlptorrs, only the cough remains dry,
and has a metallic sound up to the eleventh day, when it becomes more loose and solvent. Hepar sulph. 3, one grain
every four hours, removed all the remaining symptoms (IHom.
Vierteljahrschrift, 3, 2, Trinks).
4. (LXIII.) Iodine Vapors successfully applied in a Severe
Case of Croup.
BY DR. W. ARNOLD, OF HEIDELBERG (A. H. Z., 2, 19).
Membranous croup, by the specific remedies that homceopathy has given into our hands, is usually treated with such
success as soon to remove all its danger. Though the cases
which resist our method of treatment for a longer time, are
rare, they yet occur sometimes; especially if the patient comes
under our treatment after the disease has already lasted some
time and has progressed considerably. In several cases of
this kind, which partly had been given up by other physicians, I have successfully used fodium internally. In a few
other cases which resisted this remedy, even, and which would
have prompted some physician to perform the operation of
tracheotomy, I found myself induced to let lodium act directly upon the mucosa of the respiratory organs; and I have
always seen the best result from this procedure. Not only
were the lives of the three children in whose cases I saw myself
compelled to apply Iodine vapors, saved, but they recovered completely, i. e., no subsequent diseases of the respiratory organs
occurred.
In one of the three cases the croupous inflammation had
confined itself to the larynx; in the two others bronchial
croup was plainly marked. The effects of the Iodine-vapors
could soon be recognized by the fact that after the cough had
become somewhat moist, some mucus intermixed with membranous fragments was expectorated shortly afterwards, which
brought some relief, though very slight at the beginning.
However, upon the repeated application of the vapors, the
cough became more and more loose, and, aside from a mostly
very viscid mucus, and amid the strong efforts of coughing or



178            ON SCROFULOUS AFFECTIONS.
"An extended sphere of action," Dr. Madden says, in a
paper on 01. jec. asel]., read before the Brit. Horn. Society, in
1848, " is conceded to it, especially in scrofulous diseases and
all their kin, and above all where the osseous tissue suffers,
as in rhachitis, caries, spina ventosa, &c. In diseases of the
mesenterial glands and atrophia dependent thereupon, it is
not any less efficacious. Scrofula, as is well known, appears
in individuals of two different bodily states; individuals of
the one look fresh, fleshy, and fat; those of the other pale,
lean, emaciated, and cachectic.  The remedyis especially efficient in the latter, but only exceptionally in the former."
According to Dr. Madden, Iodine even is effective only in
lean scrofula, and not in the fat.
In osteomalacia, atrophia mesenterica, and phthisis pulmonum, especially in tuberculosis, when the tubercles have not
yet softened entirely, cod-liver oil proves its efficacy. Accord-'ing to Bennett's* observations, it surely cures chronic cutaneous diseases. scrofulous ulcers, and ophthalmia.
The administration of cod-liver oil, limited though it be,
can be justified from  the standpoint of homieopathy all the
more, as the symptoms which the oil occasions in the healthy
correspond with those of Iodine as recorded by Hahnemann.
Kopp was the first to point to the fact tMat 01. jec. aselli is
efficacious in those cases in which physicians prescribe small doses
of Iodine.  And Falkner found that the oil contained 4-6-0
portion of Iodium, a quantity which is equal to that in our
4th or 5th dilution.  The mineral springs of Kissingen,
Kreuznich, Nlauheim, Salins, likewise act as antiscrofulosa
by virtue of their homceopathic contents of Chlorine, iodine,
and Bromine.
But since Iodine does not show itself as efficient as the oil,
the oily menstruum must share essentially in its curative
power.  Observations have taught us that those continually
handling fatty substances are fleshy and free from scrofula.
It has been endeavored to demonstrate by experiments in
what manner the fat exerts a beneficial influence upon the
body, and it has been found that it forms a kind of emulsion
* Dr. Hughes Bennett has exhausted in his work (1841) everything that can
be said on C. L. Oil.



180               ON SCROFULOUS AFFECTIONS.
It is, probably, not superfluous to quote here a remark from
the A. II. Z., 46, 6:
"Test of cod liver oil.-If we dip a strip of copper or brass
into pure cod-liver oil, the metal is not changed by it.  If,
however, the cod-liver oil is adulterated with vegetablle oil,
the metal assumes a green color, if after dipping it into the
oil, we expose it to the air."
In the Dublin Medical Press, Oleum  cocos is recommended
by Thompson as one of the best antiscrofulous remedies, which
is equal in effect to cod-liver oil.*
We add the data of a chemical analysis of cod-liver oil,
according to Dr. Jongh:
COD-LIVER OIL.
Black.  Brown.  White.
Oleic acid, gaduine, and two other substances       (59,106?)
as yet not definitely determined,...  69,951   50,106  74,033
Margaric acid,..                            16,145   10,121   11,758
Glycerine,.......   9,711    9,075   10,127
Butyric acid,..                         0,159    9,075   0,074
Acetic acid,..                         0,125    9,075   0,046
Choleic acid (Acides felliniques et choliniques),   0,299    0,062   0,043
Bilifuolin and bilifellinic acid,...   0,376    0,445    0,263
Substance soluble in alcohol,...   0,038   0,015   0,006
Substance insoluble in water, alcohol, and ether,   0,005    0,002    0,001
Iodine,........  0,0295    0,041    0,037
Chlorine, with some bromine,..    0,084   0,159    0,149
Acid. phosph.,..             0,054   0,079    0,091
Acid. sulph.,.               0,010   0,086    0,071
Phosphorus,.....  0,0075   0,0114   0,021
Magnesia,.......   0,004   0,012   0,0()9
Soda,..... 0,018  0,068  0,055
Lime,..                 0,082    0,012    0,009
Waste,....2,569  2,603  3,209
100,000 100,000  100,000
91,000? 100,002
(E. T.)
* But we remind the reader of the fact that the black, as well as the white
C. L. O., contains acetic acid, by virtue of which such a reaction may take
place.



MOST APPROVED REMEDIES AGAINST SCROFULA.  181
HIence, cod-liver oil, according to the opinion of all authors,
acts by virtue of its contents of Iodine, Bromine, Phosphorus,
and Chlorine. But, as we see from the above table, all those
substances exist in truly infinitesimal proportion, if compared
to the quantity of fat, indifferent in its nature.
Dr. WVeil, without hesitation, calls cod-liver oil " a natural
honmeopathic dilution of oil in fat."* However, the recommendation of cod-liver oil in cases of scrofulosis, with emaciation, speaks eloquently and decidedly in favor of the idea that
we have to do with a homceopathic preparation, not only as
regards the quantitative proportion of Iodine, but also, and
above all, as regards its therapeutic action; for the effect of
large doses of Iodium upon the healthy consists in atrophia of
all the glandular tissues, as well as other structures; in short,
in emaciation.
We meet with an entirely similar view in the excellent
pathologico-therapeutic study of Kafka, " Anaemia, or Bloodpallor" (A. 11. Z., 59, 24).
He considers cod-liver oil to be "'a homeopathic dilution of
an Iodide of Phosphorus," and for this reason deems it to be
appropriate only to definite disease forms, corresponding to
its physiological sphere of action.
Since, however, the glands, the skin, the mucous membrane
of the respiratory organs, and the osseous system, are the
principal parts upon which Iodine, as well as Phosph., have a
decided effect, its therapeutic application, in his opinion, extends only:
1. To all forms of scrofulosis and tuberculosis of the glands,
especially if the hypersemic and inflammatory processes have
run their course, and a chronic swelling has remained.
2. To all forms of scrofulous cutaneous diseases which produce exudations, such as eczema, impetigo, pityriasis rubra,
tinea, favus, prurigo, &c., as well as in that degeneration of
the cutaneous follicles which is known by the name of cutaneous tubercle.
3. To all chronic catarrhal processes of the organs of respiration, e.g., of the nose, larynx, pharynx, trachea, bronchi,
&c., which accompany scroffilosis and tuberculosis.
* Anleitung zur Krankenpflege, von Dr. Weil, S. 102.



182            ON SCROFULOUS AFFECTIONS.
4. To all scrofulous diseases of the bones, joints, periosteum,
as well as to tuberculosis of the bones.
5. Also rheumatic affections, so far as they lay within the
sphere of action of Iodine, especially if they are connected
with chronic exudations in the joints, between the muscles,
or in the subcutaneous cellular tissue, are suitable for the application of cod-liver oil.
Moreover, the opinion of those therapeutists deserves notice
who attribute an essential share of its action to " the admixture of decomposing liver-elements," which can be found in all
kinds of cod-liver oil.
"There has been a good deal of debating, A. Vogel says, as
regards the active substance proper of cod-liver oil. Some believe that by its large amount of fat it simply act as a means
for respiration; others search for its efficacy in the traces of
Iodine and Bromine; still others, finally, in its fatty acids, and
the admixture of decomposing liver-elements."
Since experiments with pure fat as well as with small doses
of Iodine and Bromine, did not produce the results desired,
the latter view seems probably the most tenable.
It yet remains for us to utter a word of warning as regards
the external use of cod-liver oil. By the application of compresses saturated with it, we very easily succeed in the rapid
removal of tinea-eruptions on the head; but these very exanthemata by no means are local processes, but the expression
of scrofulosis coming to the surface. A sudden suppression
occasions an obstruction and exsiccation of the innumerable
springs, the contents of which now make a retrogressive movement; or, more scientifically, the liquid pathological products
are resorbed and deposited in the interior; meningitic and
pneumonic processes are developing, or in the most favorable
instance, hardness of hearing, otorrhcea, diseases of the eye, &c.
To our treatise on the physiological and chemical peculiarities of cod-liver oil we finally attach the appeal to try it in
the form of inhalations in croup. In almost all grave cases of
genuine croup it has thus far been necessary to employ several
of the most approved remedies. Since, however, Bromine,
Iodine, and Phosphorus, above all, belong to the latter, and
all of these are contained in the cod-liver oil, it is possible that



184           ON SCROFULOUS AFFECTIONS.
scrofulous blennorrhwa, chronic skin diseases upon scrofulous
bottom. Scrofulous ulcers. Scrofulous ophthalmia (.Magendie);
against pannus and leukornatous obscuration of the cornea.
(Chelius); induration of the rammae and hypertrophy of the
lacteal glands.
2. Against goitre - struma lymphatica — allopathic textbooks recommend from 2 to 5 grains three or four times daily.
It seems absolutely necessary, however, to illustrate by an
example what value is to be placed upon recommendations
from this side, especially as it is to be the principal aim of
this small essay to expose the dangers contained in the orthodox allopathic therapia; to show how, in fact, the efficacy of
the remedy, correctly selected, is only too often annulled by
the senseless adherence to large doses.
"A rman, et. 62 (Goullon, Sr., writes, A. II. Z., 45, 5), very
bilious, and suffering from gout since his youth, received of
an allopathic physician Kali jod. ()ij in 5iv of water) against
ischias, with the advice to take a tablespoonful morning and
evening for weeks. About eight days afterwards a very suddenly increasing swelling of the whole thyroid gland appeared,
with tenderness on touch and dyspncea; he nevertheless was
told to continue the remedy, and in the second week mnanifested all the symptoms of endocarditis: dyspncea; fainting,
with great exhaustion; violent, jerking, intermitting, and irregular beat of the heart and pulse; tensive pain across the
chest; especially the right ventricle was affected, which at the
same time gradually enlarged somewhat. Besides, loss of appetite and vomiting. Mercur. 2, in several doses, and Arsen.,
on returning aggravation a few days later, removed the trouble
almost entirely. Sepia removed the remaining symptoms."
If the obnoxiousness of massive doses is demonstrated by
the report of this case, the highly specific relation of Kal.
hydrojod. to strumata, very correctly pointed out by the old
school, is evident from the following communication of the
same author, just as the very fact mentioned that upon the
use of large doses of Kali hydrojod. intumescence of the glandula thyreoidea was observed, clearly enough proves such a
specific bearing.



MOST APPROVED REMEDIES AGAINST SCROFULA.  185
CLINIQUE.
1. (LXVIII.) Struma.
A young blooming girl feebly menstruated on account of a
dry, oppressive, and painful cough, which had lasted for years,
and was connected with heaving and whistling respiration,
both troubles being dependent upon a large swelling of the
thyroid gland, which pressed inwardly and downwardly; after
a resultless administration of Phosph. and Cale., received but
four grains of Kal. jod., in four ounces of water, half a tablespoonful morning and evening. As early as ten days after..
wards the cough, and the symptoms connected therewith, had
entirely disappeared, and the thyroid gland become smaller
and soft, so that it did not occasion any further trouble.
Is not the truth of the homceopathic curative principle brilliantly set forth in these two reports? In the pathogenesis of
Kali jodat., swelling of the thyroid gland after large doses;
according to clinical experience, decrease of the struniatous
swelling after small doses.*
Finally, another example of the injuriousness of large doses.
A girl, get. 13, took Kali jod., a few grains morning and
evening for several weeks against scrofulous ulcers, caries of
the lower jaw, and a very malignant scrofulous ophthalnia
with ulcers on the cornea. Under this treatment the ophthalmia was cured rapidly and permanently, and the ulcers
improved so much as to form  cicatrices, when she was attacked by pneumonia which rapidly passed into suppuration,
and of which she died.
According to the above, Kali hydrojod. has a cumulative
effect, similar to chloroform, which makes the person to be
operated upon fall into a beneficial sleep, but which, above
the effect desired, has already put many to eternal sleep.
The syphilitic bear Kali hydrojod. better than the scrofuIous.
* We cannot omit the remark, however, that in the case mentioned the
small doses were still not small enough; for we read at the close of the report
of the second case: the patient, who felt entirely well, had lost flesh in a remarkable manner (during the administration of Kal. hydrojod.).



186            ON SCROFULOUS AFFECTIONS.
The sleeplessness of which patients complain, even after
proportionally small doses of Iodide of Potassium, is. worthy
of notice.
D.-FERRUM  JODATUM.
GENERALITIES.
Ferrum jodat. is indispensable also to us homceopaths in
complicated scrofula. It accomplishes more here than the
pure antiscrofulosa, such as Silicea, Phosph., Iod., Calcar., &c.
One does well not to give it in infinitesimal doses.  Ferrum
jod. is indicated where chlorosis, rhachitis, and syphilis combine with scrofulous processes. It removes especially impetigo
of the cheek, and eczematous exanthemata of the face and
whole body.
CLINIQUE.
1. (LXIX.) Hydrocephalus.
A child who suffered from Hydroc. acutus in a high degree,
and previously had been treated with Calomel and Jalappa,
and fly-blisters to the head, was saved yet by _Ferr. jodat. in
the paralytic stage.*
Dr. Langheinz states having observed this specific curative
power of }Ferr. jodat. in from six to eight cases, when children,
who are anemic and poor in flesh, were attacked, or when
such a condition had been produced artificially by previous:antiscrofulosa (leeches, calornel, jalappa).
Rueckert in his attempt at utilizing the curative material
*obtained ab usu in morbis, gives as indication for Ferrumn:
Hydrocephal. acutus, with large, open jbntanels, from which folllows that the iron in the Ferr. jod. was probably more essen-:Atial in the cases quoted above than Iodine.
* The diagnosis had been made out by Prof. Winter and another experienced
physician of the University of Giessen (A. H. Z., 60, 19).



MOST APPROVED REMEDIES AGAINST SCROFULA. 187
2. (LXX.) Eczema of the Whole Body (E. rubrum).
(My own observation.)
C. S., a small, fleshy, and very scrofulons boy, was brought
to me with a general, moist, eczematous eruption which
formed thick, dirty crusts on several places (temples, forehead). Extensive, circumscribed eczematous spots on various
parts of the body; at the outer surface of the right lower leg
a fiery-red, hot, and moist spot resembling raw-meat. Violent
itching and ill-humor accompanied this characteristic eruption.
Graph. and Arsen. caused the beginning of the improvement;
but the crusts fell off in the course of fourteen days upon the
use of Ferr. jodat. sach. (0, 03 triturated with 2, 0 Sach. lact.,
as much as will lay on the point of a knife). The presence of
crusts resembling bark seems of some importance for the selection of Ferr. jod.
E.-CALCAREA JODATA.
GENERALITIES.
Recommended by Vehsemeyer against struma and chronic
hypertrophy of the tonsils. It corresponds to scrofulosis of
an intense form. For those chronic scrofulous intumescences
of the tonsils remain up to virile age, and frequently occasion
intercurrent catarrhs of the larynx. Upon the use of Cale.
jod. the swellings, the fissured appearance with the cup-shaped
excavations of which is characteristic, decrease in size.
I have learned highly to appreciate the remedy in ophthalmia perniciosa of scrofulous persons, when CGale. carb. remained without effect.* Cale. jodat. undoubtedly has a great
future.
FOLIA JUGLANDIS.
GENERALITIES.
Negrier (Arch. gen. Fevr., Avr., 1850), praises walnut leaves
in scrofulous affections. According to him, they produce
* The report of the respective case is to be found in the A. H.. Z., 22 Mai,
1871.



MOST APPROVED REMEDIES AGAINST SCROFULA. 189
regulating the activity of the heart. Otherwise the two
preparations of Kali differ so much from another, as to induce
us to speak of them separately.
A. KALI CARBONICUM.
GENERALITIES.
We have already mentioned the importance of Kal. carb.,
as regards the lungs; before, however, tuberculosis has fully
developed, catarrhs of the nose and larynx precede it; our
preparation corresponds, therefore, to these troubles of a definite and specific character. The chronic character and inclination to relapses, as in all scrofulous affections, stand out
prominently even here.
Ihence Kal. carb. cures dry coryza, which renders breathing
through the nose impossible, but becomes fluent upon walking
in the open air, and returns in the room, and is accompanied
by a great deal of itching in the nose and secretion of a yellowish-green or bloody mucus; in other cases, a puriform.
mucous discharge, mostly from one side of the nose, and of
an offensive smell; burning pain in the nose; sore, crusty
nasal openings, even entire obstruction of the nasal openings;
bluntness of smell; in the evening often intense, fluent coryza
with frequent sneezing and headache, rough voice, a titillating
sensation in the throat, which creates a desire for hawking and
coughing, and the feeling of firmly lodged mucus (A. H. Z.,
1 Febr., 1869).
",Kali, says also Kafka, is an excellent remedy in dry
coryza with complete hoarseness and aphonia, in catarrh of the
pharynx with the sensation of a plug in the throat; in nocturnal spasmodic cough and tussis titilans; in strangling and
gagging which terminate in vomiting, especially in the morning."  Graphit. also has the symptom of the "plug" when
swallowing; Caustic. the symptom of hoarseness and aphonia.*
* STINGING pains, in many cases, indicate Kal. carb.



190           ON SCROFULOUS AFFECTIONS.
B.-KALI CHROMICUM.
The Chromate as well as the Bichromate of Potash deeply
affect inveterate scrofulous troubles, and it is just their obstinate character that furnishes a palpable indication for the
administration of these remedies. For this reason they cure
genuine membranous croup, ozaena, and such forms of coryza
as by their long duration have almost become physiological
processes, so to say. The hvpertrophy of the tonsils, of no
less chronic a nature, as well as the malignant forms of cutaneous eruptions, fall likewise within the curative sphere of
these drugs. Suspicion of a combination with hereditary
syphilitic causes render more sure the propriety of selecting
them.
CLINIQUE.
1. (LXXI.) Membranous Croup.
A boy, set. 8, with all the symptoms of membranous croup
received Tinct. Aconit. and Tinct. lodii, of each four drops in
half a wineglassful of water, a teaspoonful every two hours
alternately; besides a wet, cold towel across the chest and
throat, renewed as often as it became warm.
The disease was not removed by these means; on the contrary some symptoms had grown worse, and, upon local examination, one could plainly see the upper part of the larynx
covered with white and thick membranes.'In place of Iodine, Kali chromic. 1, two drops in four
ounces of water, was given every three hours, alternately with
Aconit. Since the skin was burning hot, the cold applications
were continued with more energy. Four hours afterwards a
piece of membrane as large as a finger-nail was coughed up.
The fever decreased, and within four days several pieces of
membrane, one more than three inches long and half an inch
wide, were thrown up by the cough, and blood and bloody
mucus were coughed up from four to five days, until the
cough changed into a simply catarrhal one. After this remedy
had been given for a week the boy could be considered cured.
Wherever this remedy proved efficacious the mucosa of the



192             ON SCROFULOUS AFFECTIONS.
3. (LXXIII.) Kali chromicum  against Enlarged Tonsils.*
A man, aet. 50, for a long time suffered from  swelling of
the tonsils and submaxillary glands. At the same time the
Eustachian tube was obstructed, and in consequence thereof
there existed hardness of hearing. Various remedies had
been applied for a good while without result.  Kal. bichromic.
1, within fourteen days restored the hearing, and within other
fourteen days almost completely removed the swelling. The
same author employed Kal. chromic. with excellent results
against torpid swelling of the tonsils, not accompanied by
inflammatory symptoms, especially in children of lax, leucophlegmatic constitution, and if loosening of the nasal mucosa
and crusts in the nose existed simultaneously (Dr. Drysdale,
Brit. Jour. of IHom., 1857).
4. (LXXIV.) Kali chronzicum and bichromicum against Chronic
Inflammation of the Nasal Mucosa.
A woman, set. 50, who had suffered much from congestion
and a sensation of coldness in the head, after an attack of
coryza which appeared with the cessation of menstruation,
since two years presented the following symptoms: Continual,
thick, yellowish discharge from the left nasal opening, which
became offensive upon the influence of the open air, and was
most copious in the morning.  Violent pain in the muscles of
the left side of the neck, extending to the head, and called
forth and aggravated by blowing the nose.  In the nose feeling of soreness extending to the cheeks. Sneezes but rarely;
smell undisturbed; general health good, with the exception
of some constipation, with a white coating of the tongue.
KTi, - i. 2hrorm., now the 6th, now the 3d, or 2d dilution every
* The following notice regarding the physiological action of the Bichromate of Potash is probably of some interest:
" A lean, anaemic man, Wet. 30, engaged in a factory with the preparation of
Bichromate of Potash, for a few months had had several ulcers on the tonsils
and cesophagus, which are covered by an ashy gray crust, and surrounded by
a dark-colored, livid, and swollen mucosa. Pulse.small, 120; great thirst;
tongue dry and red; difficult swallowing and sleeplessness. He stated that
all his comrades in the factory were suffering more or less from the same
trouble (Lancet, February, 1854; Schmidt's Jahrb., 1851, 82).



MOST APPROVED REMEDIES AGAINST SCROFULA.  193
other day, and a solution of Kal. chrom. (t grain to,j of
water) externally, removed the trouble within a fortnight
(Dr. Drysdale, Brit. Jour. of Hom., 1857).
5. (LXXV.) Kali chromicurn and bichromicum against Chronic
Eczema of the Head and Face.
A healthy servant, aet. 36, for three years suffered from an
intensely irritating and burning eruption, which extended
over the whole head, almost deprived of all hair, to the eyebrows. The whole surface was red, raw, and discharged a
thin matter, here and there drying up into yellow crusts.
Rhus, Graph., Mercur., &c., had sufficed temporarily only.
Kal. bichrom. 2, morning and evening, together with one daily
application of a solution of Kal. bichr. neutr. (1 grain to 1
ounce of water), soon removed the trouble.
A relapse of it was permanently removed by Kal. chrom. 0,
jth of a grain daily, and the external application mentioned
above (Ibidem).
6. (LXXVI.) Coryza Chronica.
A strong youth, Pet. 17; coryza of three years' standing,
without interruption, accompanied by heaviness and dulness
in the head, nasal voice, and a thin, mucous discharge. Pulsat. 2, for fourteen days, did not improve any. Kal. bichrom.
4, sixteen doses. Radical cure within eight days (Bolle).
7. (LXXVII.) Catarrh with Hoarseness.
Kali bichrom., 2d trit., removed a laryngeal catarrh with
hoarseness in a singer. Dr. Teller recommends Kal. bichrom.,
one grain of the 2d trit. in four ounces of water, a teaspoonful from one to two hours, against catarrh, even with feverish
conditions of a lighter grade (A. H. Z., 59, 10).
It is not unimportant to know, as we have already mentioned, that Kal. bichrom. has also been given advantageously
against secondary and tertiary forms of syphilis. Drysdale
cured with it syphilitic periostitis and exanthemata;probably
of a syphilitic nature (A. H. Z., 55, 14). It seems to be suit13



194           ON SCROFULOUS AFFECTIONS.
able, precisely as is the red precipitate of Mercury, against
scrofulo-syphilitic affections.
NOTE.-The CHLORIDE OF POTASSIUM has h characteristic
curative action so definite that we will also mention it here.
It is the specific remedy against stomacace (always accompanied by a peculiar fetid smell). It is remarkable that both
allopaths and homceopaths give it in this disease.
According to the " Homceopathic Times," 1853, No. 188, p.
449, Laurie cured a case of stomacace by Kal. chior., 1st trit.,
one grain three times a day, which had developed to such a
degree as to cause perforation of the cheek.
And Alfred Vogel says, in his excellent text-book on diseases of children:
4"We are so fortunate as to possess one remedy against
stomacace. By this remark enough is said for its recommendation. It is CHLORIDE OF POTASSIUM." TO children less
than one year old Vogel gives 20 grains daily; to those less
than two years of age, 30 grains; to those less than three
years old, 40 grains; and continues, somewhat naively:
" Children who have reached the fourth year already bear a
drachm of it very well." We know, however, that one needs
not give so much of the specific remedy as may be borne.,Odorffwtidus from the stomach: Chloride of Potassium, 6, 0
in sugar-water 120, 0, a teaspoonful three hours after eating.
(Stanislaus Martin.)
LYCOPODIUM.
GENERALITIES.'S Lycopodium is closely related to Sulphur, which is also
contained in the plant from which we obtain the Lycopodium
seeds." For this reason alone the second designation of Lycopodium, " Sulphur vegetabilis " is justified.
By this fact only a series of curative results can be explained, so especially its efficacy in malignant ophthalmia of



MOST APPROVED REMEDIES AGAINST SCROFULA. 197
In contradistinction from Calc. carb., which corresponds more
to the pastous form, combined with mental indolence, Lycopodium would correspond more to the erethic form.
From Rueckert's "Attempt at utilizing the curative material obtained ab usu in morbis," we quote yet the following
indications for Lycopodium:
" 1. Sensation in the cesophagus as from a hard body, with
stitching pains, a feeling of swelling, and morning expectoration of a yellowish, thick mucus, which is firm, almost hard
in the centre, and of a greenish-yellow color.
" I have several times had the pleasure of completely curing
with Lycopod. 30 that disease of the esophagus, otherwise
known to be incurable, which ends with caries of the cervical
vertebrae, and which, as the expression of an affection of a very
grave nature, we see accompanied by a swollen and irritated
mnucosa of the throat, varicose vessels, and a herpes-like eruption thereupon, together with small, fleshy excrescences luxuriantly growing and passing into suppuration."
2. Chronic scrofulous eruptions, which always cover themselves freshly with dirty-yellowish, brownish, or greenish
crusts, have a nauseating, flat, mouldy, or decaying smell, are
partly dry, partly discharging, mostly show a fungus-like
formation under the magnifying glass, and predominantly
appear upon the hairy parts of the body.
3. The boils preceding panaritium diffusum exhibit the
characteristic that they terminate incompletely only, suppurate but little, but become bluish, cease to suppurate, and
leave incomplete cicatrices and purple spots.
The boils in and around the axilla, with discharging, crusty,
and itching herpetic eruptions upon it, and swelling of the
axillary glands. The boils suppurate for a long time, and
fresh ones appear continually.
Lycopodium, is also a coryza remedy.
Present are: Dryness of the nose, and acrid secretion, especially, however, an annoying frontal headache (for which Mereurius also comes under consideration), with aggravation in
the evening, and final blowing out of a lemon-colored mucus
(Goullon).
Crusts in the nose; nocturnal agglutination of the nasal
openings, with dry coryza (Hahnemann).



198             ON SCROFULOUS AFFECTIONS.
Dryness of the choanTe, with offensive nasal secretion, hoarseness, rawness and soreness in the chest; in nocturnal tussis
titilans, with a sensation as from sulphur vapors (Kafka).
CLINIQUE.
1. (LXXVIII.) Lycopodium against Warts.
In a scrofulous girl, Pet. 6, who was affected with several
facial ulcers, corresponding to her constitutional trouble, a
considerable number of small, soft, pedicellate-warts formed
upon the chin over night.  When I was shown the child, I
remembered having read that Leon Simon successfully employed Lycopod. in a similar trouble.  I prescribed Lycopod. 6,
two drops morning and evening, and recommended to moisten
the epidermoid formations twice daily with Lycopod. tincture,
diluted with alcohol. After a few days all the warts disappeared, and the scrofulous ulcers assumed a better appearance.
It is questionable in this case whether the external or internal treatment effected most.  Skeptics may attribute a
portion of the effect to the influence of the alcohol, yet the
action of Lycopod. upon scrofulosis and abnormal vegetation
has been confirmed in too many cases to admit of any doubt*
(Z. f. h. KL., 4, 21, Verrucce, Dr. Teller, of Prague).
2. (LXXIX.).ntertrigo.
An infant, one year old, suffered from intertrigo.  Violent
crying when urinating. Tr. Lycopod., in water, internally
and externally. Cure within a few days.
3. (LXXX.) Glandular Swelling.
Miss S., about 30 years of age, a true type of the scrofulons
habitus, for more than a year has suffered from glandular
* A. H. Z, 31, 3. Segin took from 20 to 50 drops of the 30th dil. for 5
days. On the third day, papulae on the legs, stinging like needles. After 8
days, sweat and feeling of soreness between the toes.-Enuresis nocturna.The latter, as well as the pain in the toes, returned after 14 days. (Never
experienced previously.)



MOST APPROVED REMEDIES AGAINST SCROFULA. 199
swellings. Along the right side of the throat and neck a
number of glands, about as large as nutmegs, were observed,
which were painless and movable, but very hard. However,
a hypertrophical swelling of the submaxillary gland, as big
as a man's fist and as hard as cartilage, surpassed all the
others. It was firmly fixed, painless, reached far above the
level of the jaw, and gave to the scrofulous face a very deforming appearance. Patient had been scrofulous since childhood, but could not remember having had ally other diseases,
and even presently did not complain of any other trouble
except constipation.
Treated without result,from January 20th to July 18th
with Staphisagria, Sulph., and Calc. carb. (highpotencies).
July 18th, August 7th and 22d, and September 9th, three
doses of Lycopodiuem (high potency), one to be taken every
third day.
Four weeks after the first doses, the effect upon the glandular tumor was perceptible. It began to get movable, could
be displaced, and the examining finger could feel a beginning
division of the conglomerate. These divisions became more
plain from week to week; the swelling separated more and
more into single and smaller glandular portions, which severed from another, and thus the hard tumor dissolved, no
more medicine being given after the middle of September.
At the end of the year the ungainly swelling was entirely
removed. The cervical glands were reduced simultaneously.
"I would like to know," Dr. Fielitz concludes, "whether
the Mat. Med. of the physiological school possesses remedial
powers which cure such an evil more surely and without
poisoning by Mercury and Iodine. A cure of this kind by
the vis medicatrix naturce alone I have never witnessed in my
practice of thirty-six years' standing" (A. H. Z., 52, 14).



200               ON SCROFULOUS AFFECTIONS.
MERCURIU S.*
GENERALITIES.
Experience teaches that the various preparations of this
remedy can impress upon and communicate to the whole lymphatic system a peculiar modification, and to the whole economy of the body a tendency similar to the scrofula-dyscrasia.
Indeed, John Hunter, Vigaroux, Samuel Cooper, Richerand,
Alibert, and others demonstrated that persons who, in consequence of their calling, were exposed to the evil influences of
quicksilver, frequently beget scrofulous children.  Homaeop* According to A. Lutze, it does not make any difference which preparation of quicksilver is employed. since the symptoms produced by all the various preparations agree. He generally uses, however, Hydrargyrum oxydatuim
rubrum as the purest, and, therefore, most suitable preparation for triturations
and potencies. According to Dr. G. Gerson the red precipitate is vastly superior in its specific curative action against single forms, especially the scrofuIous, to Mere. solubilis. He bases his remark upon the relation between scrofulosis and syphilis, and believes that the contagiousness is a characteristic of
both. Of the several forms of the scrofula-dyscrasia in which the red precipitate deserves preference, he names:
1. Scrofulous ophthalmia (believing that even its external application is to
be considered as a specific and not as a caustic), if the swelling of the conjunctiva is not very considerable, its redness of a bright color, its discharge purulent, and photophobia has not reached its highest degree. Also where troubles
from teething were present at the same time.
2. Scrofulous eczematous eruptions which have their principal seat at the
flexor-planes of the extremities, especially near the joints and at the musculi
glutmei, and are characterized by the severity of the pains. The discharged
pus is contagious. The healing up starts at the centre of the plaques.
3. Scrofulous bubo with acute inflammatory irritation and tendency to suppuration. The pains quickly ameliorate, and where resorption does not take
place, suppuration appears soon, and is of benign nature, without any turbid
ulcers developing at the opened spot.
4. A peculiar form of scrofulous ulcers among girls and boys from 4 to 10
years of age, which entirely simulates the character of syphilis. Among boys
the ulcers appeared at the anterior portion of the penis, on the praputium and
scrotum; among girls at the labia and urethral orifice, and even at the perineum. They lacked the hardness of the subcutaneous cellular tissue. Characteristic, is their painfulness and the sympathetic irritation and swelling of
the inguinal glands.
5. Scrofulous superficial ulcers developing from large, doughy tumors at
the neck and thorax.



MOST APPROVED REMEDIES AGAINST SCROFULA. 201
athy has good reason to hold on to this experience without,
however, overrating this source of scrofulosis. Because we
are indebted to it for a series of genuine curative results,
which furnish at the same time a brilliant testimony of the
truth of our therapeutic principle, "Similia similibus curantur."
The physiological effect of Mercury upon the salivary glands
is most remarkable and known. Dieterich (Mercurial Krankheiten, Leipzig, 1837), above all, counts the "hypertrophy of
the glands," i. e., the enlargement of the inguinal, axillary, mesenterical glands, of the parotis, the pancreas, and even the testes
and liver, among his forms of mercurial dyscrasia. Increase
of the glandular secretion is almost always connected therewith.  Mercury, hence, has been the first refuge in all glandular diseases, and, as a general thing, is still considered as one
of the principal remedies in scrofulosis (glandular diseases).
But as there can be no exclusive panacea against diseases of
single systems or organs, the use of Mercury also has been
carried too far, and its administration in diseases of the glands
ought to be restricted without any doubt (Dr. Reil, N. Z. f.
h. K1., 1, 9).
As regards its influence upon the osseous system, Mercurius
is closely related to Silicea, and in fact is utterly indispensable
in most of the scrofulous processes by virtue of its property
as a suppuration remedy.  We mention, moreover, of the
mercurial effects pertaining here: "inflammatory, especially
nocturnal pains in the bones; crookedness and great fragility
of the bones. Eruptions resembling scabies florida, or dry,
rash-like, easily bleeding, itch. Inflammatory swelling of the
glands; suppurations of every kind; swelling of the head, or
eruptions upon it; ophthalmia, especially if the lids are red and
swollen; tearing and itching pains in the ears; purulent or
bloody discharge; hardness of hearing with bellowing and
roaring in the ears; also in otitis interna acuta with violent
nocturnal pains and suppuration (Trinks); inflammation and
swelling of the nose, especially of its tip; stomacace; angina
with swelling of the tonsils and copious flow of saliva;" (Angina tonsillarum ulcerosa-Goullon).
For scrofulosis erethica et florida, inflammation of the glands



202           ON SCROFULOUS AFFECTIONS.
with phlegmonous redness, swelling and pains aggravating in
the evening, Mercur. is especially suitable. Further in blepharoadenitis of scrofulous persons (here surpassed or complemented only by Silic.). Ulceration of the cornea and photophobia.
Though not always connected with scrofulosis, angina
uvularis (elongated and swollen uvula) presents a perspicuous
proof of the therapeutic action of Mercury. Dr. Bolle (Aachen)
has been first in pointing out that such an inflammation, even
if it has already become chronic, gives way anazingly quickly
to the influence of sublimate.*
Trinks, moreover recommends Mercurius against atrophia
meseraica, pot-bellies of children who mostly have been brought
up by hand, with diarrhcea and fever from teething. IHartmann's recommendation in mastitis, in which Mercury is said
to hasten suppuration, confirms the analogy between this
remedy and Silic. mentioned by us. Both remedies resemble
each other also in their curative power against coxalgia (claudicatio spontanea).
Again, the greatly experienced Trinks calls Mere. (sol.) one
of the most efficacious remedies against coryza with copious
discharge of a corroding (mucous-Baer) liquid, and finally
against the inflammatory stage of panaritium. Here it ameliorates the pain, hastens the formation of pus, and again, unquestionably, shows its therapeutic relation to Silicea. But
why do we administer Silic. in one case, and Mercurius in the
other? What is the essential difference between remedies apparently agreeing so much?
SILICEA.
Bone-remedy.
Aggravation at the time of the new moon and full moon;
pains on changes of weather.
Indurations (scirrhous).
Herpetic eruptions.
Beginning suppuration, or defective suppressed suppuration.
Suppressed sweat of the feet.
* A few grains of a lower trituration mixed with four ounces of distilled
water, and used as a gargarism, suffice.



MOST APPROVED REMEDIES AGAINST SCROFULA. 203
Yellow, crippled, and brittle finger-nails.
CONSTIPATION.
MERCURIUS.
Gland-remledy.
Appearance of the symptoms at night (in the warm bed).
Established suppuration.
Easily bleeding ulcers.
Bloody discharge from the ear.
Bloody, blood-streaked, and bloody-mucous diarrhcea.
LOOSENESS OF THE BOWELS.
Mercurius more resembles Cale. carb., Caustic., Phosph., and
Acid nitr. Silicea, on the contrary, finds its best analogue in
Arsenic (besides in Graphit. and Lycopod.), and in common with
it has " vomiting every time after drinking."  The antagonism
existing between Silic. and Mercur., notwithstanding all similarity, already follows from the fact that Silicea cures ulcers
which owe their origin to abuse of Mercury.
CLINIQUE.
MERCURIUS SOLUBILIS.
1. (LXXXI.) Ophthalmia Scrofulosa.
Mercur. sol. Hahn. 2, one grain morning and evening, within
five weeks cured a genuine scrofulous ophthalmia of three
months' standing. Flow of acrid tears corroding the cheeks.
Lids swollen; a pustular eruption upon them and the cheeks;
dried-up pus on the ciliae. Whitish-gray spots have formed
upon the cornea of both eyes. Photophobia. The child lies
upon its face continually. Nose and lips swollen; a copious,
green, thick, and acrid mucus, which makes the nasal openings and upper lip sore, flows out of the former. The profuse
nasal discharge requires constant wiping. The outer surface
of the hand and the outer side of the lower part of the forearm, with which the child wipes off the acrid nasal discharge,
are corroded by it. The parotid glands are swollen; the child
is very ill-humored and impatient, and cries almost constantly.



204           ON SCROFULOUS AFFECTIONS.
Several remedies, also Arsenic (high and low), had remained
without any effect.
2. (LXXXII.) Offensive Otorrhoea with Polypous Formations,
Chronic _lnflammation of the Membrana Tympani, and
Hardness of Hearing.*
After the measles (in the sixth year), otorrheoa. The smell
of the discharge so offensive that nobody could remain near
the patient, and its quantity so great that clothing and pillows were really wet with it.
The right meatus closed by a soft polypus. Mucosa of the
meatus red, loosened, sore, and tender. Hearing distance on
the right side = 0.
To be taken, two grains of Merc. sol. H. 3 in the evening.
(Externally, frequent injections of tepid water, and powdering
of the meatus with one grain of Mere. sol. H.)
The offensive smell of the discharge, as well as the discharge
itself, decreased rapidly, and the polypus became detached
after using the remedy for six days. At the inmost and posterior portion of the meatus (at this spot polypi of the meatus
almost always originate) only a trace was to be seen of the
spot where the polypus was inserted, but the membrana tympani presented a dark-red, granular (frog's-spawn-like), convex surface, which proved itself very tender on touch with
the probe.
Distance of hearing, two inches.
Upon the continued internal use of Mere. sol. 1I., two grains
every other evening, and daily injections. of tepid water, the
otorrhcea entirely ceased within four weeks, the granulations
upon the membrana tympani and meatus likewise disappeared,
the hearing distance increased to 8", the roaring in the ear
passed away, but the sound of the tuning-fork was still heard
stronger on the right (?) side.
3. (LXXXIII.) Stomacace.
One dose of Mercur. sol. H. 2, gr. j, removed aphthae, bad
* Beitraege zur Erkenntniss u. Behandlung einiger Ohrenkrankheiten.
Von Dr. Rentsch, in Potsdam, XXXVIII, 5.



208            ON SCROFULOUS AFFECTIONS.
by Natr. mur., and this already shows its especial adaptation
to chronic diseases.
The intermitting character of the trouble still more points
to Natr. mur., which, otherwise, can easily be confounded with
Lycopodium.  The latter circumstance argues in favor of its
antiscrofulous action. Under certain conditions Natr. mour.
seems to be especially suitable in ophthalmia scrofulosa. One
of these conditions is the secretion of acrid tears, corroding
nose and upper lip.  Obstruction of the canalis lacrymalis.
Again: turbid look of the eyes; suppuration of the cornea.
Watering of the eyes, aggravated in the open air. Photophobia with stitching pains in the eyes. Eruptions at the
mouth, lips, corners of the mouth; pustules; crusts; ulcers
(similar to Graphit. and Ca usticum).
Scrofulous persons are frequently afflicted with constipation, and in this condition Natr. mur. is a remedy that has
removed such obstructions of the most stubborn kind.  Such
momenta must strictly be taken in consideration, if we wish
to give to Natr. mur. the preference over the many antiscrofulous remedies with more numerous indications, and do not
want to regret our choice.*
B. —NATRIJM CARBONICUM.
CLINIQUE.
1. (LXXXVII.) Coryza Chronica.
A young girl, set. 16, of lymphatic constitution, pale face,
rings around the eyes, delaying and feeble menstruation, for
years suffers from coryza, accompanied by discharge of a thick
and copious mucus during the day, and obstruction of the
nose at night. Her voice has assumed a very disagreeable,
nasal sound.  Since the middle lobe of the thyroid gland was
swollen, a dosis of Spongia 3, was given morning and evening.
But her condition remained the same three weeks afterwards.
Now, after Natr. carbon, - had been given in the same man* If we wish to use Natr. mur., in the form of baths, it is done by mixing
brine with river-water (equal parts), or by adding one pound of common salt
and one pound of sea salt to common warm water.



MOST APPROVED REMEDIES AGAINST SCROFULA. 209
ner for four weeks, the secretion of mucus has nearly become
normal; the gland, still somewhat swollen, had become softer,
less resistant, and four weeks afterwards both troubles were
completely removed.
2. (LXXXVIII.) (Coryza Chronica.
A lady, set. 40, who supported herself by singing, took cold
in the concert room, and her skin did not perspire since, on
the contrary remained entirely dry. What annoyed her most
was a chronic coryza with abundant discharge and an unpleasant effect upon her voice.
Sulphur aggravated. Sach. lact. to wait for the action of
the remedy. No result. Natrum carbon. cured the coryza and
restored the normal activity of the skin (Hirsch of Prague, A.
H. Z.).
PHOSPHORUS.
GENERALITIES.
For the very reason that Phosph. frequently complements
and completes the curative action of Silicea, e. g., in cases of
mastitis and its terminations, we may infer its antiscrofulous
character. Like Silicea it is a bone-remedy, but still more a
lung-remedy.  However, its antiscrofulous character shows
itself more distinctly in croup, and just in the most dangerous
forms of genuine croup, which rightfully is counted among
the characteristic expressions of the scrofula-dyscrasia. Acting, as it does (even according to the views of the old school),
as an irritant upon depressed nerve-force, it has done wonders
even in the last stage of croup, and at this point mention may
be madle of the physiological action of Phosphorus: "Pulse
scarcely perceptible; cold, clammy sweat; chronic hoarseness;
burning in the larynx."  Moreover, its curative action in
chronic diarrhcea, by which scrofulous children are afflicted
in the period of dentition and afterwards, in which only Calc.
carb., Calc. acetica, and Arsen. contend with it for supremacy,
is well known.
14



210           ON SCROFULOUS AFFECTIONS.
Otherwise, as regards the curative action of Phosph. in the
special forms of scrofula, its use must be called limited. Aside
from its effect upon croup in the last stage with rattling respiration in the upper portion of the chest and trachea (GoulIon, Sr.), and in diseases of the bones, such as caries, scrofulosa with hectic fever, and exostoses (Trinks, Knorre), it plays
an important part in ozena narium scrofulosa (Strecker).
We could ask the question, moreover, whether the wellknown action of Phosph. to produce necrosis of the maxillae
has not been taken advantage of in homceopathy. We believe that we can answer in the affirmative, since we possess
in Phosph. a valuable remedy against toothache of carious
teeth (which form, so to say, a part of the jaw). Phosph. corresponds to caries sicca (Mercur. to caries humida).  Both
kinds of toothache undoubtedly count among the annoying
privileges of scrofulous individuals.
CLINIQUE.
1. (LIXXXIX.) Croup.
The daughter of teacher P., five years of age, was attacked
by croup in the night from the 20th to the 21st of March.
The family physician, who had been called immediately, pre-;scribed an emetic of Tart. stibiat. and Radix ipecac., which
-produced repeated vomiting, but no change in the course of
-the disease. On! the next day, after a second physician had
been called in, leeches were applied to the throat, and calomel
Bwas given internally, but the disease rose to its highest degree in spite of this treatment continued up to the third day.
In the evening of that day, after the physicians in attendance.had pronounced the prognosis to be most unfavorable, the dis-;tressed father requested Dr. Vehsemeyer to take charge of the
child.
The latter found the little patient lying in bed, purple in the
face, covered with cold sweat, looking about in agony, and,periodically boring her head backward into the pillow; respiring with a highly raised chest and stretched neck; then
again hastily rising in the greatest distress, grasping herself.at the throat and pulling her hair. Respiration wheezy and



MOST APPROVED REMEDIES AGAINST SCROFULA. 211
whistling; voice whispering; speaks by hastily thrusting out
single words; cough soundless. Larynx and trachea painful
upon touch; pulse small, irregular, and not countable on account of its frequency.
During the night five grains of the 2d trit. of Hepar sulph.
and Spongia,* every hour in alternation, were given to the
child, and sponges, dipped in hot water, laid upon its throat.
There was not the slightest improvement on the next morning, the fourth day of the sickness.  Now two drops of the
undiluted Spiritus Phosphori, in sugar-water, were given every
hour, but already after a few hours the child was not able
any more to swallow. I found her apathetic, with her lower
jaw hanging down, her eyes deeply sunken and half closed,
only now and then making efforts of breathing; face and
hands bloated, purple, cool, the whole body covered with cold
sweat.  Cough set in, but very seldom, in single, soundless
thrusts; (abdominal) respiration irregular, voice entirely gone.
The unfortunate parents stood, loudly crying, at the bedside
of their darling, and I had to confess to myself that there
was no hope in this case. At that instant the thought
flashed through Dr. Vehsemeyer's mind to try externally
what could not be administered any longer internally.
Phosph., gr. 2, with 01. amygdal. dulc. Wi, was prescribed.
This was to be rubbed'in every ten minutes upon throat and
chest, and the latter to be covered with flannel. After this
treatment had been continued for 1- hours, the child showed
signs of returning life by reaching at her throat, and making
the motion of rubbing in a distressed and imploring manner.
Now the inunctions were repeated at longer intervals (from
14 to 11 hours). The cough, still soundless though, returned.t
During the night the child began to swallow again, and forthwith Spirit. Phosph. was resumed in the dose mentioned above.
On the morning of the fifth day, the little patient had improved so far that the most dangerous symptoms were removed, and her condition resembled that in which Dr. Vehse* Vehsemeyer calls these " his usual croup remedies," and at the beginning
of the disease they seem to be sufficient, indeed, and render leeches, Spanish
flies, and especially emetics superfluous.
t Also C. A. Tietze calls the entire disappearance of cough in croup "an
ominous symptom."



212            ON SCROFULOUS AFFECTIONS.
meyer had found her on his first visit. In the course of the
day, the cough became more frequent, and though remaining
dry, reassumed the usual croup-sound; respiration became
more even, yet remained accelerated and whistling (rhonchus
sibilans), and was still predominantly abdominal, the chest
raising but little, and the intercostal spaces not expanding
any. Yet the paroxysms of distress, less frequent though, returned, during which the child begged for the inunctions.
Thus intermissions of shorter or longer duration set in. The
pulse remained still small and exceedingly frequent (135); the
urine showed a white sediment; the expression of the face
was less distressed, except during the real paroxysms. Plhosph.
was continued, externally and internally, in smaller doses, and
given less frequently (2d dil., 3 drops). In the course of the
sixth day, the cough finally assumed the catarrhal sound, and
brought up several coherent, firm pieces of mucus, with evident relief to the patient, respiration began to rattle (mucous
rattling!, the pulse became stronger and less frequent, the
skin warm and moist with perspiration; the voice, however,
was still without any sound.
For the following six days HIep. sulph. c. 2 was given, at
first frequently, afterwards in rare doses. During this time
the, cough became more and more loose, large pieces of coherent mucus (no real membranes) were thrown up, respiration
became more and more free and deeper, the appetite returned,
only the voice of the child remained without sound; and not
before six weeks afterwards, when the child had already recovered and left her bed for some time, did the voice, still
hoarse though, assume a louder sound, which, two yeai's later
even, was muffled, and deprived of its metallic tone.'
2. (XC.) Croup.
A. K., son of Prof. K., a weakly, scrofulous boy, ten years
old, one morning, when just at the eve of taking his breakfast, was suddenly seized by a violent and distressing sen* Let it be mentioned here that Dr. Vehsiemeyer published this certainly
highly instructive cure on account of Dr. Elb's remark, " that Phos. was not
exe,'i,,i   any curative action in genuine croup " (S.; A. H. Z., 51, 8).



214           ON SCROFULOUS AFFECTIONS.
without result. On the second day fever, accelerated respiration and pulse. Child lies in bed with a distressed expression
on the face; mucous rattling over both lungs.
Tart. emet. 1 in solution, a teaspoonful every hour.
In the following night the child is in a very critical condition. Pulse small, quick, and intermitting; face purple; heat
over the whole body; abdominal respiration; crackling, with
mucous rattling. In this case of bronchitis capillaris, connected with the greatest danger of life, Dr. Schleicher now
administered Phosph. I in water, a teaspoonful every half
hour.
As early as after one hour the child respired more freely,
and expectorated; expression on face more quiet and content.
6 A.M., quiet sleep.
Pulse energetic again; temperature of the skin moderate;
respiration free. Phosph. every three hours.  Three days,
afterwards the affection was completely cured; but at the
same time the eczema began to develop again, and a week later
was at its height.
One dose of Sulph. 3, every morning, cured the eruption
within three weeks, without any subsequent affection of the
lungs, or relapse (A. H. Z., 55, 2).
4. (XCII.) Scarlatina Scrofulosa.
In the meeting of the homceopathic physicians of Saxony,
at Dresden, August 30th, 1857, Hirschel reported a case of
scarlatina scrofulosa, with convulsions, in which, after the
administration of Zinc. met. 1, sopor and collapse of the vital
forces, stertorous respiration, involuntary discharge of urine
and fseces appeared, and in which considerable improvement
set in on the same day after Phos. 2. The exanthema did not
break out until the day following, so that the good result
cannot be attributed to it, but to Phosphorus (A. H. Z., 55, 4).
5. (XCIII.) Phthisis Incipiens.
There have been many discussions on the question, whether
tuberculosis and scrofulosis are one and the same dyscrasia.
Since there are remedies which are able to arrest the tubercu



MOST APPROVED REMEDIES AGAINST SCROFULA. 215
lous process, as well as the scrofulous, we are undoubtedly
compelled, to a certain extent, to consider both identical.
Among these remedies, especially, Phosphor. belongs, and the
following case will probably suffice as illustrative of this view:
A landed proprietor of Krajoda, thirty some years of age,
slenderly built, brunette, was declared to be consumpted by
Drs. Sigmund and Oppolzer. Patient has had many chancres,
and frequently gonorrhcea.
Great weakness of all functions; dry, short cough; pain in
the chest; flabbiness of the muscles; great nervous irritability;
want of appetite. Discharge of a mucous liquid front the
urethra. Severe pain in the lower part of the back, and
irregularity of the bowels.
Six doses of Phosph. 30, a dose of six pellets every eighth
day, completely cured the patient, who now feels entirely
strong and healthy again.
6. (XCIV.) Bronchitis.
(My own observation.)
O. S., ten weeks old, could' be nursed only the first week.
Since that time he lives on cows' milk diluted with water
(2: 1), and some salep nmixed with it, without gaining in flesh,
however.  On the contrary, the little face frequently looks miserably and full of wrinkles, like the face of a little old man. From
the beginning of his life he suffered much from Jfatulency, cried
much, and drew up his legs similar to one who has severe
pain in the bowels. He but very rarely slept quietly, and
several hours at a time, and when he drinks-, does it so greedily,
that he frequently chokes; and then he cries again, until he
falls into a sleep, which, however, is but short, and often
interrupted.
In the third week he was attacked by a cough, which
disappeared and reappeared in alternation. At present it is
loose, but the poor little fellow has such a rattling on the
chest, as makes one feel always as if he should help him clear
the throat.
His stool is not watery, and looks yellow. IIe has an
evacuation, probably, four times within twenty-four hours.
Phosph. 30, five pellets every morning. Eight days after



216           ON SCROFULOUS AFFECTIONS.
wards: "Your powders have had a very good effect, especially
on the stool. He usually has a stool now of firm consistency
twice within twenty-four hours. Since about eight days we
all see that he improves very satisfactorily, he is much fleshier,
and feels a good deal better."
This child, whose mother is exceedingly scrofulous, grew
up to be a stout boy, but had a permanent disposition to
cough. He is affected by that chronic swelling of the tonsils,
which apparently characterizes a dyscrasia, standing midway
between scrofulosis and tuberculosis (A. I. Z., 74, 8).
Moleschott (Kreislauf des Lebens, S. 44), as well as G. Rose
and Bromeis, are of the opinion that Phosph. acid (and Fluor),
is introduced into our blood and bones by the consumption of
barley. For this reason Kafka orders barley, either roasted
as coffee, or broken up and put into soup, or boiled with milk,
to pap for children, in whom the formation of bone goes on
slowly. On using this article of diet he observed the repair
of matter in general, and, above all, the formation of the bony
substance to go on mlore rapidly (see Die Ansemie oder Blutblaesse, Eine pathol. and therapeut. Studie, A. H. Z., 59, 21).
L. C., " a chronic, dry, and short cough, with vague stitches
deeply in the breast, which, though not continuous, hinder
respiration, and increase on deep respiration," is mentioned
among the symptoms of an impending or freshly developing
tuberculous localization.
Since Cod-liver oil (especially the brown), aside from Iodine,
contains Phosph. (0,0114 in 100,000), a fact of essential importance, we are probably justified in supposing that this old
remedy has frequently owed its results to this circumstance.
It was applied then, we may say, in cases which were appropriate for small homceopathic doses of Phosphorus.
PETROLE U M.
GENERALITIES.
Petroleum is an important remedy in scrofulous diseases of
the ear. When the Eustachian tube participates in the coryza



MOST APPROVED REMEDIES AGAINST SCROFULA. 217
which occasions the most various noises, such as bellowing,
roaring, crackling in the ears, we likewise think of Petr.
Kafka gives Petrol. in coryza with hoarseness and obstruction
of the choanm, accumulation in the cesophagus, with pressing,
tickling, and roaring; in tussis titilans nocturna, with dryness of the trachea.
Besides, Petrol. has cured facial hemiplegia (of scrofulous
children). I will not omit the remark, however, that my observations in two cases gave negative results.
RHUS TOXICODENDRON.
GENERALITIES.
Dr. Gentzke says of Rhus: Its beneficial action in the first
stage of coxarthrocace, which colleague Ressig of Berlin has
tested in several cases, seems to confirm itself. (This remark
is preceded by the report of a cure of coxarthrocace by Rhus:
6.) Meyer praises Rhus against eczema (besides Sulphur).
CLINIQUE.
1. (XCV.) Luxatio Spontanea.
Mary H., met. 6, who formerly has suffered from glandular
swellings at the neck, which suppurated, assumed a dragging
gait in walking, and had pain in the hip-joint, which was increased by pressure upon the large trochanter. Violent pains
set in, however, if upon fixing the pelvis, some one with a jerk
pressed the femoral head into the acetabulumn, one of the surest
diagnostic signs of this disease. There could be observed as
yet no elongation of the leg and flattening of the glutpei
muscles.
The trouble had already existed for from three to four weeks
with amelioration alternating with aggravation, the latter
being wont to set in amid the appearance of febrile symptoms
and with drawing pains in the leg. Forbidding all motions
I gave Rhus 6 every evening, afterwards less often. The result was favorable.  Six weeks later the child could stand



MOST APPROVED REMEDIES AGAINST SCROFULA. 221
2. (XCVIII.) Spondylarthroeaee.
Dr. Kihmpfer (A. H. Z., 24, 9) cured a case of spondylarthrocace with Silic. 3. Afterwards Cale. carb. 3.
"I several times observed scrofulous caries of long duration
in children to heal within a short time after a few doses of
Silic. 30, a few pellets at the time (though larger doses were
required in other cases'."
3. (XCIX.) Abscess of the Upper Leg.
In a boy, about two years old, a large inflammatory swelling
developed at the right upper leg. A surgeon had ordered the
application of some herbs, without result. The whole upper
leg shiny-red and hot; not the slightest touch could be endured; the child groans, and is in a continual fever, with profuse sweats, very nmuch emaciated, and without any sleep and
appetite.
I had the external application removed, and gave Silic. 30
in several doses. The child became more quiet and went to
sleep. Some time afterwards a small opening formed spontaneously in the smelling, into which the thinnest probe could
scarcely be introduced; there was a thin discharge from it,
after which the opening closed up again. From this time on
the boy improved rapidly (A. H. Z., 39, 2.  -I. Weber, of
Brilon).
4. (C.) Caries-Dyscrasia.
A girl, et. 8, could not straighten the left knee. Several
fistulous ulcers upon it as well as on the lower leg. The tibia
could be seen entirely denuded in several places, and smaller
or larger pieces of it became detached. The whole tibia and
knee was one single crusty ulcer almost, which bled on the
slightest cause, and pained much, especially at night. Besides
a few other remedies, the girl received Calcar. and Silicea for
from three to four weeks. After the course of a year the
crutches were laid aside, and gradually the whole leg healed.
The crooked knee became straight and movable again, and at
present the girl walks about as well as other people. No one



222           ON SCROFULOUS AFFECTIONS.
would see that she ever had been sick (A. II. Z., 39, 19. Dr.
Weber, of Brilon).
5. (CI.) Eruption on the Face.
Dr. KIimpfer (A. H. Z., 24, 10) reports a remarkable example of the great medicinal power of Silicea.
A woman, et. 32, a blonde, who since childhood had suffered
fromn a psoric-scrofulous ophthalmia, and against which she
had formerly tried various cures, including honmceopathic
remedies, without result, was affected by an eruption of large,
hard, brown crusts all over her lips, especially at the corners
of the mouth, which very much disfigured the face. The eyes
were almost entirely healthy. The remedies administered
against it, among which was also Silicea 30, remained without
any result.
I now prescribed Silicea 4, one drop to be taken every morning, and later every fourth morning before breakfast. She
felt unwell every time after taking the medicine. After the
first doses she was attacked by intense vertigo, violent headache with fulness and dulness in the head, heat and redness
of the face, intense pain in the abdomen, nausea, heaviness in
the limbs, feverish pulse, &c., so that she had to lie in bed for
a few hours; affections she had never had before, and to which
no cause could be assigned except the remedy, and which
troubles always disappeared spontaneously. After the third
dose these symptoms became lighter, and after the fourth she
felt only fulness in the head and weakness. At the same
time the eruption improved rapidly and without interruption,
so that it healed up after five doses. The eyes and her general health continued to remain good. But soon afterwards
a large and deep ulcer formed at the inside of the left lower
leg, which continued for years.
It cannot be mistaken that the acute morbid phenomena,
repeatedly appearing in this case after the remedy, were
primary effects of the drug, and neither can it be doubted that
the formation of the ulcer on the leg was owing to the action
of the medicine (which has proved itself to me one of the most
efficacious remedies against inveterate ulcers of this kind).
Hence, in this case also, intense remedial aggravations took



MOST APPROVED REMEDIES AGAINST SCROFULA. 223
place, while high dilutions remained without any effect whatever. I have frequently made this observation, and could
mention several similar cases.
NoTE.-With Silicea 3, I have repeatedly cured complaints
that owed their origin to suppressed sweat of the feet.
Nausea, fainting, weakness, especially were complained of;
hence, just the very symptoms called forth by Silicea 4, in
Kimpfer's case. The sweat of the feet returned after the removal of the morbid phenomena mentioned.
6. (CII.) Luxatio Spontanea.
Dr. Weber, of Brilon (A. H. Z., 39, 2), reports: "A boy,
ret. 8, from lying upon the damp ground in spring, was attacked by a fixed pain in the right hip-joint; the leg shortened,
and patient began to limp. Soon afterwards the whole buttock
swelled, the swelling, which is burning hot, extending down to
the knees; patient has to lie down, and can lie only on the
healthy side. Finally, the swelling threatened to break in
several places, and to discharge the fluctuating contents.
" For this affection I treated patient for more than eight
weeks. I'He received within this time Aeon., Arnic., Arsen.,
Calcar., Chin., tIep. s., Lycopod., Phosph., Phosph. ac., Rhus,
Sulphur, and Silicea. The latter remedy was given repeatedly.
The swelling did not break but scattered entirely, and the
boy was completely cured, and did not limp any longer. Every
one who saw the swollen leg deemed resorption impossible;
and yet it was possible, after all."
7. (CIII.) Collection of Pus in the Cervical Glands and
Lymphatic &Selling at the Elbow-Joint.
TUMOR ALBUS.
A girl, met. 15, a blonde, weakly formed, of phthisic habitus,
and not menstruating yet, from her third year on frequently
suffered from oft-recurring scrofulous glandular swellings. At
her 9th year, without any cause known, a painful swelling of
the left elbow-joint formed, which continued to grow for fully
three years, and finally terminated in a painful hard swelling



224            ON SCROFULOUS AFFECTIONS.
and anchylosis of the joint. After a pause of two years the
pains returned, and the swelling began to enlarge again.
Various cures tried against this trouble remained without any
result. Lastly, on account of a fresh aggravation, warm applications and inunction of Iodine-salve were used; internally
Kali hydrojod. in large doses. During this treatment, continued for two months, a considerable swelling of the right
cervical glands formed again, swelling and pain increased, and
the general health assumed a threatening aspect, which induced the parents to place patient under homeopathic treatmrent.
St!rlus prcsens: Patient is very much emaciated, has a pale
face with circumscribed redness on the cheeks. Increased respiratory murmur; percussion normal. Transient stitches below both clavicule. Dry, short cough, slight dyspncea. Pulse
very variable. At times febrile symptoms. The cervical
glands of the right side had united into a swelling of the size
of a hen's egg which was reddened and evenly fluctuating in
its entire circumference. At the elbow-joint of the left arm a
fluctuating swelling as large as a man's fist, which covered the
olecranon partially, but the condylus humeri entirely. The
forearm was bent at an angle of sixty degrees. On account of
the great pain, the nights were passed sleepless; the stool was
diarrhceic, especially at night.
The threatening development of acute pulmonary tuberculosis renders her condition very precarious.
Patient received now of Arsen. 15 (, ) two doses daily, five
pellets pro dosi.
Ten days later her general health improved somewhat.
Arsen. was continued for other eight days, when the swelling
at the joint broke in several places, and discharged a large
quantity of thin, fluid pus and caseous masses. Since the
chest symptoms had considerably improved.  I gave Silic. 4
trit. (:0o) two grains of it daily, and ordered the arm to be
bathed twice daily in a decoction of hay. This popular remedy
is probably efficacious in scrofulous diseases, as I repeatedly had
the opportunity of observing, only on account of its contents of
TERRA SILICEA. This treatment was continued a whole year,
during which time the complete cure of the arm, and the resorption of the swelling of the cervical glands were accom



226           ON SCROFULOUS AFFECTIONS.
was removed by Sil. 30 (together with Sulph., Asafcetid., Bellad, Merc. sol., Acid. nitri, as intercurrent remedies), and afterwards by Silic. in alternation with Calc. 30 within two years,
while his general constitution was improved by sea-baths.
The shortening of the leg, of course, remained.
10. (CVI.) Luxatio spontanea femoris
In consequence of preceding coxitis.  Cured by Surgeon
Schnappauf, of Dresden (Z. f. h. K1. II, 9).
In an infant, seven months old, the femoral head had completely escaped out of the acetabulum and taken position posterio-superiorly; the leg was nearly one-twelfth of an inch
shorter than the healthy one, yet not atrophic. Several physicians had declared the evil to be incurable on account of the
acetabulum being filled up by exudations. When I reduced
the femoral head and moved the extremity in various directions I distinctly heard a crackling and rubbing noise of the
femoral head, entirely similar to that observed in fractures.
As soon as the leg was released, and the child made a few
motions with it, the femoral head again slipped out posteriorly with a crackling noise, without, however, causing the
slightest painful sensation. The infant was a delicate but
fleshy girl, and was nursed by her mother. In the first eight
days after her birth, which had been natural and easy, a certain stiffness and immobility of the left leg had been observed;
the babe always held it in a drawn-up position, and did not
stretch it out even while being in the bath. Dr. EK. declared
the disease to be inflammation of the hip-joint. The entire
region of the hip-joint was inflamed and swollen, a condition
which had communicated itself also to the upper portion of
the femur. An inunction had removed the inflammation, it
is true, but now the femoral head was noticed to be outside
of the acetabulum. Two experienced allopathic colleagues,
in agreement with the first physician, declared that nothing
could be done any more.
The attempts at reduction which Dr. K. daily made for
some time, remained without permanent result. The advice
of another physician, who ordered a pair of lace-boots, which
sole side by side of sole were fastened to a tin plate, in hope



MOST APPROVED REMEDIES AGAINST SCROFULA. 227
that thus the healthy leg might draw down the diseased and
keep it in the same position, proved also of no benefit to the
affected extremity.  This machine had almost occasioned
another deformity, since the child, on account of the discomfort or pain originating therefrom, assumed a position inclining with the pelvis and vertebral column to the left side, for
which reason the father Qf the child soon removed this contrivance.
Under such unfavorable circumstances the child was passed
over to homoeopathic treatment.
Prescript.on: Silicea 5 dil. from 2 to 3 drops to be taken in
a teaspoonful of water every other evening. The child was
not interfered with in its voluntary motions. After the course
of five weeks no perceptible change in the condition had taken
place, and the femoral head, after attempts at reduction, again
slipped backward as on previous occasions. Notwithstanding,
I continued Silicea, except that in place of the solution I gave
the trituration in the same potency, because I presumed that
in the trituration all the efficient constituents of the remedy
were contained. This change was rewarded by the best result. After Silicea had been given in this manner for about
three weeks, the crackling noise on moving the leg became
slighter, the femoral head, after attempts at reposition, remained longer in the acetabulum, a fact which allowed the
inference that the resorption of the hardened exudation had
already begun. In order to support the soft tissue also, I
ordered, at the intervals when no Silic. was taken, a teaspoonful of a mixture of one part of Arnica fort. to two parts of alcohol, to be rubbed into the region of the hip;joint and leg.
By the aid of these prescriptions, which I continued without alteration, I had the great pleasure of observing that the
exudation was entirely resorbed at the latter part of January,
and the femoral head, without any inclination to escape out
of the joint upon motion and stepping on the foot, remained
in the acetabulum, as well as that every noise had disappeared,
of course, and could declare the child entirely cured at its first
birthday, February 19th.
The author concludes his reports of this certainly highly
instructive clinical observation with the following remark:
"This cure has to be considered as the result of medical art



228           ON SCROFULOUS AFFECTIONS.
all the more as the child meanwhile was carried about, and
rest, which no doubt has effected a cure occasionally in single
cases, was not observed in this one. An influence upon the
main trouble could be attributed to the simultaneous use of
Arnica all the less as the most evident signs of a beginning
cure already appeared previously to it, and as such an influence upon cartilage and bone-tissue seems foreign to the action
of Arnica, but is very characteristic of Silicea.
2. (CVII.) Abscess.
Dr. Billig, of Hohenstein (Z. f. h. Kl., 3, 8), reports a very
remarkable result of the action of Silicea in a case of scrofulous suppuration. It was that of a boy, Det. 10, in whom, after
recovery from typhus, an abscess developed. It opened at the
right side of the thorax. From a fistulous opening at the
place named, pus was discharged for three and a half years.
Whenever the discharge stopped for a day or two, pain and
dyspncea set in. The fistulous character of the sinus, and the
well-known power of Silic. in suppurations of various kinds,
induced Dr. B. to give nine doses of Silic. 3, one grain pro
dosi. These were consumed within the period of time from
January 20 to February 6. Afterwards, six powders, with
the direction to take one of the first three every third, of the
remaining, one every fourth day. February 24th, the pus
has become thinner and less. Six more powders, one from
three to six days. They were the last given. Because suppuration soon ceased, the wound closed up without any coniplaints of the patient, similar to those previously experienced
upon the arrest of the suppuration.
Against panaritia with which the scrofulous are so often
afflicted, there is, aside from  Causticum (Goullon), no better
remedy than Silicea.
12. (CVIII.) Thickening of the Last Phalanx qof the Finger.
A remarkable example of the amazing action of Silicea
Kafka communicates (N. Z. f. h. KI., 3, 4):
The last phalanx of the ring-finger of the right hand was



MOST APPROVED REMEDIES AGAINST SCROFULA. 229
observed to be enlarged to double size; the skin around the
edges of the nail is swollen, purple, and shiny; at both sides
of the nail we see club-shaped, purple, and fleshy excrescences,
as long as the nail, which nearly cover half of it with their
broad, free surface, while, with their pedicle, they grow out
of the side-walls of the matrix; the nails bleed very easily,
and cause the most violent pain. Moreover, the nail over its
whole length is undermined by pus, almost excavated underneath, and movable. Upon every motion or touch, indeed,
even while at rest, throbbing and burning pains torture the
patient during the day, which become unbearable at night,
occasion sleeplessness, in consequence of which she looks very
pale, and her appetite has become very poor.
The beneficial effect of Silicea 6 (morning and evening a
powder, and externally white cerate), manifested itself as
early as in the first night, since patient quietly slept several
hours, and at waking up found the pains to be ameliorated in
a high degree. Improvement progressed very rapidly; about
six days later the excrescences looked shrunken and withered,
were almost painless, and did not bleed any more. After
other eight days the nail began to grow already, and after a
treatment of three weeks the cure was accomplished, and a
new, smooth, and pretty nail decorated the formerly diseased
finger.
The woman had been under allopathic treatment for three
months, and the nail was to be removed at the time she placed
herself under homlceopathic treatment.
13. (CIX.) Panaritium.
Dr. Eidherr, of Vienna, may be mentioned here as another
authority. He says (N. Z. f. h. KI., 5, 15):
No doubt every homoeopathic physician has sufficiently
experienced in his practice what value is to be ascribed to
Silicea in diseases of the bones. I, at least, have learned its
efficacy in felons, which were accompanied by the most
violently stitching pains; in caries, and especially tumor
albus, three cases of which I had the opportunity of observing
within a very short time. I believe that Silicea in the diseaseforms mentioned cannot be surpassed by any other remedy.



MOST APPROVED REMEDIES AGAINST SCROFULA. 233
pause of from three to four days being made after every six
days' use of the remedy, as well as during menstruation.
April 25th. The forearm can be flexed without any pain so
far as to form a right angle. The ulcer at the olecranon is
cicatrizing. At the bottom of the ulcer healthy granulation.
Continuatur.
At the end of May even the fistulous opening at the condylus internus had healed by cicatrization, and Miss
was able to flex her arm so far as to form an acute angle;
in short, to execute any kind of motion with it (Z. f. h. KlI.,
10, 20).
16. (CXII.) Caries of the _F mur and Tibia.
Dr. Godee treated a scrofulous person, ret. 14, suffering from
caries of the femur and the upper portion of the tibia. He
received Silicea -o- from six to eight days, according to the
profuseness of the suppuration and detachment of the osseous
fragments. He was told here that he could be cured only by
an amputation of the leg. Indignant at this advice he returned to the former treatment, and was cured in ten months.
Now twenty years of age, he enjoys the best of health
(L'Hahnemannisme, 1868, No. 9; Silicea terra, Dr. Desterne>.
Jousset calls Silicea le grand medicament de la scrofule.
Should it, therefore, have no beneficial effect in scrofulous
ophthalmia, which is the frequent expression of this dyscrasia?
Dr. Schlosser, of Munich, mlay answer this question in place
of us (A. H. Z., 56, 4).
17. (CXIII.) Photophobia. —Perforating Ulcer on the Cornea.
Linna H., aet. 7, of decidedly scrofulous constitution, a blueeyed blonde, with delicate skin, since her vaccination has frequently been afflicted with cutaneous eruptions and ophthalmia. For six weeks she has suffered from photophobia, with
pains in the eyes. On the right cornea an ulcer, with deeply
imbedded bottom, and nearly perforating; considerable hyperaemia of the conjunctiva bulbi and eyelids; moist, vesicular
eruption on the occiput.



234           ON SCROFULOUS AFFECTIONS.
Clematis 3, five pellets, twice a day, as well as Graphit. 12,
remained without any effect.
One dose Silicea 200.
As early as in the evening patient complains less of pain.
On the next morning she opened her eyes for the first time
within seven weeks; simultaneously an exanthema, resembling
measles, had broken out over her whole body during the night.
The ophthalmic trouble remained cured; slight desquamation
of the epidermis followed at the same time. The ulcer of the
cornea so rapidly healed from the bottom and edges, and amid
constant decrease of the conjunctivitis, that the effect of Silic.
cannot be doulted.
18. (CXIV.) Coxitis.
The A. H. Z., 56, 9, among "Klinische Beobachtungen aus
dem hnom. Spitale in der Leopoldstadt zu Wien," contains a
case of coxitis.
Silicea, it is said at the close, had a permanent effect.
Though slowly, the pain nevertheless steadily decreased upon
the continuation of the remedy until remarkable improvemnent had set in.
19. (CX.) Caries of the Big Toe.
G. B., of K., aet. 19, for more than a year suffered from caries
of the right big toe. The physicians proposed the amputation of the toe as the only means to free him fromn his affliction. The toe was very thick, red, and swollen around the
carious ulcer, so that he could not step on the foot. April
2d, Silie. 30. In June the toe was cured. Increased irritability in it again required Silicea, and August 14th patient
wrote as follows: "I always think of you, and do not know
what I ought to do to you out of gratitude for the delivery
from my dangerous disease. I would never have believed
that your powders, apparently a mere nothing, could produce
such miracles."*
* Homoopath. Heilungen v. Dr. Kirsch, in Wiesbaden. A. H. Z., Bd. 79,
No. 4.



236            ON SCROFULOUS AFFECTIONS.
Its indications, corroborated as they have been in diseases
of the eye, are valuable: Swelling of the right saccus lacrymalis; the discharged tears are hot.
In the gravest affections of the most various kind, especially in ophthalmia, when perforation of the cornea threatens,
in ulcerations of the cornea with swelling of the lids, if it has
become chronic and painful.
Formation of abscesses of the size of a lentil in the upper
part of the iris appearing as yellowish-red swellings, covering
the entire pupil. The pus, a portion of which has escaped
into the anterior eye-chamber, was entirely removed.*
Sensation as from smoke or mist before the eyes.  Eyes in.
flamed, red, and watering.  An unmistakable, intense, and
grayish turbidity of the crystalline lens of the right eye was
removed so far as to leave but a very minute small speck.
Complete cure of a gray cataract of more than one year's
standing by Silicea, one dose every month.
In dysekoia and arnblyopia of sensitive persons.
A woman got rid of the sweat of the feet, but was afflicted
in consequence by a decrease of the power of vision so that
she could see but capitals. The sweat of the feet having returned upon taking Silicea, she sees better now than before.t
Scrofulous otorrhcea of several years' standing, offensive,
with soreness of the inner nose and a crusty eruption on the
upper lip.
For scrofllous and rhachitic persons whose teeth are mostly
carious and necrotic, and when the toothache aggravates, especially at night and on inhaling cold air.
The throbbing toothache cured by Silicea is connected with
swelling of the periosteum or the lower jaw itself; the pain
is seated more in the latter than in the tooth, and sleep is disturbed on account of general heat.
Spitting of a viscid and mucous saliva is frequently connected therewith; profuse secretion of saliva indicating Silicea
all the more. Iere we observe a relation to Mercur., with
which remedy, moreover, Silicea has in common the name of
* Senega is also recommended for the resorption of hypopia.
t I recollect a similar cure with Silicea, in which, according to report, the
hearing of the ear previously diseased became better than that of the healthy
ear.



MOST APPROVED REMEDIES AGAINST SCROFULA. 237
a toothache remedy. This may also be said of Arsen. All
three frequently relieve the sleeplessness of persons afflicted
with toothache, which tortures them to desperation almost.
If resorption cannot be expected any more in tonsillitis, the
tongue is thickly coated, and the face distorted spasmodically
while swallowing, Silicea rapidly matures and cures the abscess.
It is also suitable if the throat, without being inflamed,
pains on swallowing.
Further, in scrofulous swelling and induration of the cervical glands, in parotitis, gradually developing, slowly increasing, very chronic, frequently attaining to an enormous
size, nearly without pain, redness and heat of the skin. (See
also Cure III, Lycopod.)
Again, in malignant scrofulous ulcers and fistulous sinuses
of the lymphatic cervical glands, and caries of the clavicula.
Finally, panaritia (p. cutaneum, p. tendinosum, and p. periosticum), so frequent among the scrofulous, as well as the
carbuncle at the neck, offer excellent opportunities to convince us of the specific curative action of Silicea.
NOTE 1.-Dr. A. R., of S., reports: " I have not known that
Silicea is also a popular remedy. In this section of the country the inhabitants use the fine dust of a pebble, the so-called'Tetfelsfinger' (devil's-Jinger), against ulcers and suppurating
wounds. It is a very hard, blackish, and smooth stone, of
elongated form, somewhat resembling a finger. It is scraped,
the powder being strewed upon the suppurating spot. I have
been told that frequent cures of old, malignant sores have
been accomplished by it " (A. H. Z., Mdirz, 1869).
NOTE 2.-Kaoline, potentized porcelain-earth, recently often
mentioned in the A. H. Z., is related to Silic.*  October 4th,
1869, Dr. Landesmann, of Geneva, published a few interesting
cures of croup by'Kaoline 6. - It helped in the very worst
cases in which Acon., Hep. sulph., Spong., Brom., Phosph.,
and Iodium had failed.
Shortly afterwards the homeopathic veteran Aegidi claimed
* Kaoline is a Silicate of Alumina = A 13 S' + 6H.



MOST APPROVED REMEDIES AGAINST SCROFULA.  239
system may also be explained. Aside from its action upon
the thyroid gland, its influence upon the testes (in orchitis),
is unmistakable.
CLINIQUE.
1. (CXVII.) Croup.
Bolle, of Paderborn (A. H. Z., 48, 8), reports two interesting
cures of croup, from which he infers that Sponvqia, by itself;,
cures not only fresh, but also neglected cases. " I could," he
continues, " mention still many more fresh and neglected cases
which were cured by me with Spong. 3. It would be of no
interest, however, to do so, since one case of angina membran.
too much resembles the other, in order to find it worth while
to report them separately."*
2. (CXVIII.)
Dr. Billig cured his own blooming boy, five years old, who
was attacked by croup, with Tinct. Spongice alone (gtt. vj to
a cupful of water, two teaspoonfuls from i to 1 hour) (A. H.
Z., 44, 22).
SULPHUR.
GENERALITIES.
"After Serapion, of Alexandria, 270 A.C., had discovered Sulphur as the
specific against chronic cutaneous eruptions, it was used and praised in all its
preparations for centuries, to the most recent times."
The great range of the curative action of Sulphur can be
explained only by the aid of'Hahnemann's psora-hypothesis,
which, taken cum grano salis, allows a deep insight into the
inner nature of many chronic diseases. For seven-eighths of
the latter, according to Ilahnemann's researches, owe their
origin,.and especially their obstinacy to this cause. By psora
* Bolle gives 1 gr. of Spong. 3, and then waits for another spell of cough
before administering a second dose.



240           ON SCROFULOUS AFFECTIONS.
we do not understand, however, the eruption produced by the
acarus, but the sum of certain biological obstacles which resist, deface, and complicate the natural course of diseases.
These hindrances do not refer to the phenomena comprised
by the term " syphilitic," but, on the contrary, occupy a posi-'tion opposite thereto.
The constitutional conditions of our ancestors play, probably, the principal part in the appearance of psora. For, in
the same manner as mental deficiencies and anomalies are
transferred to us from our parents, grandparents, and ancestors far more remote, so their physical deficiencies, though
modified, are also transferred to us; hence, mental and physical tendencies.*
It is of practical importance to abandon the division of
chronic diseases into two large classes (psora and syphilis, to
which, as the third, we must properly add sycosis) and, according to the name of the specific remedy eradicating the
disease, to speak of Sulphur-psora, Arsenic-psora, PhosphorSilicea-psora, &c.
So many " antipsorica," so many'" psora species."
Without these remedies no chronic psora-disease is ever
cured. On the contrary, however, innumerable other nonpsoric (non-syphilitic and non-sycotic) diseases heal spontaneously by proper diet and manner of living (a fact that was
known to Hahnemann as well as to the more recent physiological school).
The great merit of the introduction of psora, in our opinion,
consists in this, that, by means of it, the connection of certain
(not of all) processes on the skin (the mucous membranes included) with the entire organism has been fixed for all time to
come, and the doctrine of the local nature of cutaneous eruptions has been completely overthrown.
Virchow's remark, "The parasitic acari may pass through
their whole development on a human being, they may copulate, lay eggs, and the offspring may be developed without
any perceptible trace whatever of scabies in some persons"
(Handbuch der Pathologie und Therapie, 1, 471), presents a
* Among the primary groups of psora-symptoms, the so-called "Grindkopf " has received the name of " Erbgrind," not accidentally, perhaps.



MOST APPROVED REMEDIES AGAINST SCROFULA. 241
brilliant proof of the acarus becoming only the occasional
cause of awakening the slumbering disease (the slumbering
psora-poison) which, otherwise, might probably not have manifested itself before months or years, or even not at all.
And now we will pass on to' Sulphur-psora," and thus to
the relations of Sulphur to scrofulosis.
Since Sulphur in its principal physiological action affects
the venous system, it becomes the most excellent scrofularemedy. It is specific in all scabious forms of cutaneous
eruptions, of which scrofulosis can exhibit so many without
any dependence of the eruption upon the presence of parasites.*  The therapeutic bearing of Sulphur to the glandular
system becomes plain from the fixed fact that it affects the
whole lymphatic system as well as all secreting surfaces and, hence,
also the glands, and has been employed with the best results
in diseases that have taken root there (Reil).
Sulphur removes troubles of the respiratory organs (hoarseness, blennorrhcea pulmonum, difficult respiration, asthmatic
affections, symptoms of incipient phthisis paulmonum-condensation of the pulmonary tissue in the apices; irritation in the
larynx, dry cough), the more easily, the more plainly the scrofulous habitus is associated with the symptoms mentioned.
The same holds good of aphthoe, panaritia, inflammation of
the eyelids, photophobia, &c., finally of the swellings of the
lips, nose, submaxillary glands and tonsils so suitable for
Sulphur.
What an immense difference between the vague recommendation of laxants consisting of calomel and jalap, or of
teas said to purify the blood, or cures with Cod-liver oil, &c.,
and the recommendation of Sulphur, incomparably more clear
and sure, where it is indicated homceopathically. Within the
firmly fixed sphere of its positive, curative power belong,
moreover: Crusta lactea; tinea capitis humida, ophth.
scroful. (ulcera cornese), ophth. neonat. (here especially Hepar
sulph. c.), otorrhmea scrof., rhachitic affections, and such comnplaints especially as owe their origin to an irrational removal
of exanthematous affections, i. e., of peripheric curative at* Scabies of a pointed form, according to Heichelheim, was not cured by
Sulphur.
16



244           ON SCROFULOUS AFFECTIONS.
child within a short time* (Bd. xxi, No. 19, Beobachtungen
und Erfahrungen aus der Praxis v. Dr. Frank).
4. (CXXII.) Scrofulous Eruption.
A boy, three years of age, pot-bellied, with pustules and
herpetic crusts in the face, around the ear, and on the hairy
scalp; a swelling as large as a pigeon's-egg, dark-red, elastic,
and painful, on which a punctum suppurativum could be seen,
and disturbed general health, was cured within ten days by
Sulphur, a dose every other day.
(I wonder whether the favored laxantia and the Pulv. alterans Plummeri, which is said to have helped frequently, would
have effected a cure of the eruption as rapidly and pleasantly
as Sulphur indicated here? Counting eczema among the most
benignant forms of cutaneous eruptions, we are notwithstanding told bvy Schdnlein that in the majority of cases the disease
lasts from six to seven weeks. Rep.) (Hygea 15, 3 Heft.)
5. (CXXIII.) Otorrhewa.
In another case Sulphur 3, a dose every other day, within
six days cured a purulent, offensive otorrhcea, with discharging crusts behind the ears (Ibidem).
6. (CXXIV.)
Three panaritia and a digital ulcer, treated partly by poultices, partly with salves and knife, were rapidly cured by
Silicea and Sulphur, in which cures the speedy removal of the
pains proved itself an especial blessing (Ibidem).
7. (CXXV.)
Rilekert cured with Sulph. 30 and 2, two cases of ophthalmia neonatorum (N. f. h. M1., 5, 22).
* In this case we deem the simultaneous application of Cale. carb. unessential.



246             ON SCROFULOUS AFFECTIONS.
months after birth, had developed itself within a year or so
to its present height, and existed to this extent nine months.
Besides large quantities of Cod-liver oil, all allopathic remedies
had been used, without, however, effecting an amelioration of
the evil, even.
Four powders of Sulph. 30, one every third day.
Fourteen days later, says Dr. C., the woman returned with
another boy who likewise suffered from  tinea faciei, though
of a very slight nature. It consisted in dry, red, herpetic
spots on cheeks and forehead, and a small discharging spot on
the chin. Above all I inquired how the other patient was.
"Well," said the woman, "he is better, as you see." As I see!
The woman had to assure me repeatedly that the boy before
me looking like a human being was the frightful sight I had
seen fourteen days ago.  The remedy is repeated, and in
another fortnight the face was completely clean and healthy.
The crusty herpes upon the body considerably diminished.
After four more doses of Sulph. the whole eruption had disappeared, with the exception of a few crusts.  The propter hoe,
Cohnfeld concludes this interesting report, in which every
word is conviction, cannot be subjected to any doubt in this
case* (A. I-I. Z., 60, 25).
We will yet mention that C., in his recommendation of
Sulphur and Arsen., has in view the higher potencies. Dr.
Freitag (Leipzig) also says (where he speaks of the nature
and treatment of scabies, A. H. Z., 60, 9): " Sulphur, in the
higher potencies, always seemed to me to act more favorably than
in the lower."
From this very able article ee will quote yet the following
passage, deserving our consideration:
"Every homceopathic physician, industrious in his researches, and impartial in his observations, will be able to
adduce examples which show that upon the internal use of
* Dr. I. O. Miiller is of the opinion "that the external application of Sulphur, in fresh, genuine itch, can be made without any harm, and that only
those forms have to be excluded, probably, the duration of which for years
proves a relation (which cannot be defined more precisely though) between
the affection and the entire organism, in which case, then, the internal treatment offers results all the more satisfactory." Cohnfeld's case belongs here.



MOST APPROVED REMEDIES AGAINST SCROFULA. 247
the antipsorica, so called, especially of Sulphur, eruptions of
the most various kind develop, eruptions by the appearance
of which a gradual cure of the diseased inner organ is initiated. I have seen such very extraordinary results obtained
by the hornceopathic method of healing in inveterate and
neglected cases of eczema, lichen, prurigo, &c., dependent
upon scabies driven away previously. Cases which, for years,
resisted all the artificially compounded washes and salves of
allopathic physicians, gave way within months to the (socalled) antipsorica employed without any external medicines
whatever having been administered as aids. And here Sulphur, again, is an inestimable remedy.
NOTE I. —Scrofulons troubles (especially among children)
in which the eye seems to be affected little proportionally
(the eyes are somewhat red, hardly agglutinate, and show but
a slight degree of photophobia), but a formation of small pustules takes place at the temporal region, and around the eye,
are cured, even after a duration of years, in a short tinle, by
Sulph. 3, a dose every evening (A. II. Z., 77, 10).
NOTE 2. —Sulphur deserves consideration in fluent coryza
with spasmodic sneezing, intense catarrh of the choanae, in
which the nasal discharge is frequently intermixed with blood;
in hoarseness, with a rough bass voice, dryness in the throat,
and burning on swallowing (Kafka).
Sulphutr affords help yet in neglected cases of chronic
coryza (Biir).
TEUICRIUM MARUMI VERUM.
GENERALITIES.
Against nasal polypi, and the catarrhal discharge dependent thereupon (Dr. Black, Brit. Journ. of IIom., Apr., 1857).
Especially against mucous polypi (Kopp). We must not overlook this remedy on account of its action upon the nasal mucosa, though we may not be justified, on the other hand, to
count it among the most approved antiscrofulous remedies.



248           ON SCROFULOUS AFFECTIONS.
Besides, Teucrium is used against ascarides, the presence of
which so frequently coincides with the scrofulous habitus:
Of the remedial effects pertaining here we name: Headache; dulness of the head; pressing in the forehead above
the eyes; eyes red and inflamed, accompanied by coryza; violent sneezing; great obstruction in the nose; dry cough, with
tickling in the trachea.
CLINIQUE.
1. (CXXVIII.) Polypi.
Dr. Tuwar, of Prague, reports a case, in which nasal polypi
were removed by painting with Tinct. Teucrii mar. ver. In
similar cases Teucrium was also used in the form of snuff (as
errhinum).
2. (CXXI.) Polypi.
Dr. Rhees (Amer. IHorn. Review) reports:
A woman, Pet. 25, had a polypus in the right cavity of the
nose, which had been removed by an operation twice within
the last three years, but in consequence of coryza had re-formed
again for the third time. Patient felt tickling and painful
pricking at the root of the nose, and in the left frontal protuberance. The eye watered, and much mucus is discharged
from the left nasal cavity. Blowing the nose occasions pain,
and occasionally hemorrhage. She can inhale only through
the right nasal cavity.  Teucrium 6, twice a day, for fourteen
days remained without result. PNow the 1st dilution was
given for one week, in the second week the 3d dilution, and
in. the third week again the 1st dilution. Hereupon decrease
of the polypus in size, and decrease of the mucous discharge.
Air can pass through the left nasal cavity. During the next
week the same prescription. After that the polypus had
disappeared, and patient experienced only an unpleasant feeling in the left nasal cavity, which soon disappeared, however.
Four years later, in consequence of coryza, patient was affected
by obstruction of the left nasal cavity and occasional pricking
at the root of the nose, yet an examination did not disclose



MOST APPROVED REMEDIES AGAINST SCROFULA.  249
anything. This trouble disappeared after the first dose of
Teucrium 6.
3. (CXXX.) Polypi.
In the Hygea, Veith reports the cure of a nasal polypus by
Teucrium.  And, in the same manner, Dr. Hermel cured one
by Teucr. 3 (2 drops in 200, 0 of water, morning and evening
a spoonful). L'Art. Med., Nov., 1858. We repeat that other
remedies have relations much more specific to the scrofulaprocess itself, and hence come into consideration in cases of
polypus upon purely scrofulous bottom. Among these Cale.
carb. especially belongs.
As regards external applications in the treatment of polypi,
we deem it in place to say that polypi of the meatus audit.
ext. were also cured in the same manner; but in these cases
it was not done by Tinct. Teucr., but by Tr. Opii, in its remedial relation very different, no doubt, from the former*
(Rainer).
4 and 5. (CXXXI and CXXXII.)
Dr. Gabaldo also cured a nasal polypus with Teucriurn 12,
and afterwards T. 24, and Dr. Roth a pear-shaped, soft, and
flat polypus, five inches in length, protruding from the vaginal
opening in a girl 25 years of age (L'Art. Med., Nov., 1858, in
A. H. Z., 58, 4).
VIOLA TRICOLOR, IACEA.
GENERALITIES.
Stark regards it a specific against crusta lact. Although,
aside from its action upon the urinary organs, intestinal tract
and skin, the secretion of which it increases, it affects the
* As early as in 1809, Primus cured an aural polypus by applying to it lint
saturated with Tr. Opii several times a day. As early as after a few days the
polypus very perceptibly decreased in size, and eight days later fell off spontaneously as a dried up, skinny concreinent. In the cases observed by Rau
the polypus withered much more slowly, and did not become detached before
several weeks.



250           ON SCROFULOUS AFFECTIONS.
lymphatic system also; the indication for it, nevertheless,
appears to have been based upon too general grounds. How
often, on receiving scrofulous patients, must we hear the
answer to the question,' Have you given the child something
already?" " Yes, we did let it drink pancey tea." It is a fact,
however, that the provings of 1lahnemann, Franz, WVislicenus
a. o., mention as special remedial effect, "Eruption with
nightly itching, and dense, thick crusts in the face, from
which a yellow pus discharges."
CLINIQUE.
1. (CXXXIII.) Crusta Iactea.
A girl, six years old, for weeks suffered from scrofulous
ophthalmia of both eyes. The face was covered formerly with
a dry, and now, in consequence of poultices, discharging
crusta lactea. Viol. tr. caused the eruption to become dry
again, and cured it within three weeks. The eyes improved
with the disappearance of the eruption (Z. f. h. 1(1., 2, 21).



RESUME OF CURES REPORTED.                    253
F.-GLANDS.
XXVII. Mesenterial glands,... Bromium.
XXVIII. Cervical         "...         
XXIX. ~  
XXX. Amygdalitis chronica,...
XXXI. Submaxillary glands,...
XXXII.     
L. Hypertrophical gland,..    Conium.
LIX. Axillary gland,.... Hep. sulph. calc.
LXXVIII. Hypertrophia of the tonsil,.. Kali chrom.
LXXX. Cervical glands,.... Lycopodium.
LXXXIV. Angina tonsillaris,... Mercurius.
CURES OF STRUMATA.
V. Struma,..... Apis.
VI....... 
VII.    "...... 
XLI.  C"..... Cale. carb.
XII.    ".....  
XLIII.    "....   "    "
IX.   "...... Iodium.
LXVIII.   "...... Kali hydrojod.
G.-BONES AND JOINTS.
XXV. Gonarthrocace,.... Cale. carb.
XLVII. Spondylarthrocace,...   "    "
LXVII. Coxarthrocace,.... O1. jec. as.
LXXXV. Periostitis,.                        Mercurius.
XCV. Luxatio spontanea,... Rhus.
XCVII. Caries of the right metatarsal
bones,..... Silicea.
XCVIII. Spondylarthrocace,... 
C. Dyscrasia cariosa,...
CII. Luxatio spontanea,..
CIII. Tumor albus,...
CIV. Caries of the tarsal joint,..'
CV. Gonarthrocace,...



254             RESUME OF CURES REPORTED.
CVI. Luxatio spontanea,... Silicea.
CVIII. Thickening of phalanx,..
CIX. Panaritium,.
CX. Caries of the metatarsal bones,.    "
CXI. Caries of the elbow-joint,..
CXII.   "   femoris,..."
CXIII. Coxitis,....
CXV. Caries of the big toe,...
H.L A R Y N X.
CURES OF CROUP.
XXI. Croup,..... Bromium.
XXII.   "....
XXIII.   "......      "
XXV.   "......
XXVI.   "....
LV.   "...... Hep. sulph. calc.
LXI. Asthma laryngeum,... Iodium.
LXII. Croup,....
LXIII..
LXIV......
LXV.   ".....
LXVI.   ".....
LXXI.   "...... Kali chromicum.
LXXXIX.   "...... Phosphorus.
XC.   "...."
CXVII.   "...... Spongia.
CXYIII.   ".......- CRANIAL CAVITY.
LXIX. iydrocephalus acutus,.. Ferrum jod.
K.-PECTORAL CAVITY.
XLIX. Broncho-Pneumonia,... Carb. veg.
LXXVI. Catarrh with hoarseness,.. Kal. chrom.
XCI. Bronchitis capillaris,... Phosphor.
XCIII. Phthisis incipiens,..
XCII. Bronchitis,....